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. 2022 Apr;27(14):2200275.
doi: 10.2807/1560-7917.ES.2022.27.14.2200275.

HIV-1-infection in a man who has sex with men despite self-reported excellent adherence to pre-exposure prophylaxis, the Netherlands, August 2021: be alert to emtricitabine/tenofovir-resistant strain transmission

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HIV-1-infection in a man who has sex with men despite self-reported excellent adherence to pre-exposure prophylaxis, the Netherlands, August 2021: be alert to emtricitabine/tenofovir-resistant strain transmission

Jeffrey Cd Koole et al. Euro Surveill. 2022 Apr.

Abstract

In August 2021, a man who has sex with men was diagnosed with HIV-1 infection despite using event-driven pre-exposure prophylaxis for over 2 years with self-reported excellent adherence. Sequencing identified resistance-associated mutations (RAM) M184V and K65R, conferring resistance to emtricitabine and tenofovir, and RAM V108I and E138A. Background RAM prevalence was two of 164 (1.2%) new HIV diagnoses in Amsterdam (2017-19). We reiterate the need for frequent HIV testing among PrEP users and additional testing in case of symptoms.

Keywords: HIV; HIV pre-exposure prophylaxis; antiretroviral drug resistance; case report; diagnostics; genomic surveillance; prevention.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Timeline of reported sex acts, healthcare events from last negative HIV-test until antiretroviral therapy initiation, and PrEP failure in a man who has sex with men with self-reported excellent PrEP adherence, the Netherlands, August 2021

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