A case report from Amsterdam documents HIV infection with wild-type virus despite good adherence and high concentrations of tenofovir in dried blood spots.
Daily tenofovir + FTC is highly effective in the prevention of HIV acquisition. Most cases of pre-exposure prophylaxis (PrEP) failure are due to poor adherence or infection with multidrug-resistant virus. Investigators from Amsterdam present the case of a 50-year-old man who has sex with men on daily PrEP who had unprotected receptive anal intercourse with multiple partners and who seroconverted 8 months after starting PrEP despite reporting excellent adherence.
Tenofovir concentrations in dried blood spots were high at the time of seroconversion, and no mutations were detected in the virus isolated from the patient. The seroconversion pattern was atypical: The initial test was negative for p24 antigen but positive only for gp160 antibodies.…
Reviewing Author
DisclosuresGrant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse
Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines
Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)
DisclosuresGrant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse
Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines
Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)