Sixth case of HIV transmission to person taking PrEP

In the United States, the sixth case of HIV transmission to a person with a high degree of adherence to pre-exposure prophylaxis (PrEP) has been reported. According to a report published this week in Lancet magazine, a 21-year-old Latin American from San Francisco test tested positive for an emtricitabine-resistant virus, one of the key components of PrEP.

The patient himself reported a good adherence to PrEP and for 13 months of treatment showed negative results on HIV. Nevertheless, during this time he had several other STIs, including urethral chlamydia, recurrent genital herpes type 2 (HSV) and gonococcal urethritis.

However, this did not affect the fact that the patient was taking PrEP drugs on a daily basis, which was confirmed by pharmacological indications.

The person himself was infected by an HIV-positive partner, who had never reached an undetectable viral load for 7 years from the time of diagnosis.

Laboratory tests showed that a patient with PrEP and his sexual partner had the same HIV genotype, resistant to emtricitabine, but sensitive to tenofovir deoproxil fumarate.

Currently, a person who has previously taken PrEP, has already begun treatment for HIV infection. It is reported that he is still very committed to the simplified scheme of ART, regularly pscheschay doctor and has an undetectable viral load.

Researchers led by Dr. Stephanie Cohen from the San Francisco Department of Health stated that the likelihood of transmitting a PrEP-resistant HIV strain is “extremely rare”, which, however, does not preclude the need for regular screening among people who take prophylaxis.

Experts believe that PrEP is effective in 99% of cases among MSM when it comes to full adherence (daily intake), and in 96% of cases when it is taken at least four times a week.

According to Dr. Ben Bavinton, a researcher at the Kirby Institute in Sydney, "PrEP is still the most effective strategy for preventing HIV infection."