This report describes a case of multidrug-resistant HIV-1 infection despite preexposure prophylaxis.
We now know that HIV preexposure prophylaxis (PrEP) with tenofovir/FTC is efficacious and effective when there is high adherence. Little is known about potential failures despite seemingly excellent adherence. This case report from Toronto describes a 43-year-old man who had been on PrEP for 2 years with excellent adherence and who had multiple episodes of unprotected receptive anal intercourse and became infected with HIV-1.
The virus that infected the patient was resistant to 3TC/FTC (with an M184V mutation), resistant to nevirapine and intermediately sensitive to efavirenz, etravirine, and rilpivirine (with a 181C mutation), high-level resistance to elvitegravir and intermediate to raltegravir (with 51Y and 92Q mutations). The virus was s…
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)