Pre-exposure prophylaxis (PrEP) with TDF/FTC significantly reduces the risk for HIV-1 transmission, but, to date, nobody knows if PrEP can still be useful in case of viruses harboring resistances to TDF/FTC or if alternative antiretroviral drugs might be rather proposed in selected cases. We promote the debate by describing a case of an acute infection with multiresistant HIV that occurred in a young girl who started a relationship with an HIV-infected partner who had a known multiresistant HIV.
Get full access to this article
View all access options for this article.
References
1.
U. S. Food and Drug Administration. FDA approves first drug for reducing the risk of sexually acquired HIV infection. U. S. Department of Health and Human Services, Silver Spring, United States. FDA news release July16, 2012. Available at https://aidsinfo.nih.gov/news/1254/fda-approves-first-drug-for-reducing-the-risk-of-sexually-acquired-hiv-infection, accessed on May20, 2016.
2.
Agency : First medicine for HIV pre-exposure prophylaxis recommended for approval in the EU. London, United Kingdom. Press Release July, 222016. Available at www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2016/07/news_detail_002578.jsp&mid=WC0b01ac058004d5c1, accessed on May20, 2016.
3.
World Health Organization: Policy brief: Pre-exposure prophylaxis (PrEP): WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP). World Health Organization, Geneva, Switzerland. Institutional Repository for Information Sharing 2015. Available at http://apps.who.int/iris/bitstream/10665/197906/1/WHO_HIV_2015.48_eng.pdf, accessed on May20, 2017.
4.
AntinoriA, Di BiagioA, MarcotullioS, et al.: Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. New Microbiol, 2017; 40:86–98.
5.
European Medicine Agency: First medicine for HIV pre-exposure prophylaxis recommended for approval in the EU. Truvada to enhance existing HIV prevention strategies. Press release of 22July2016. Available at www.ema.europa.eu/docs/en_GB/document_library/Press_release/2016/07/WC500210885.pdf, accessed on September9, 2017.
6.
McCormackS, DunnDT, DesaiM, et al.: Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): Effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet, 2016; 387:53–60.
7.
MurnanePM, CelumC, MugoN, et al.: Efficacy of preexposure prophylaxis for HIV-1 prevention among high-risk heterosexuals: Subgroup analyses from a randomized trial. AIDS, 2013; 27:2155–2160.
8.
DimitrovDT, BoilyMC, HallettTB, et al.: How much do we know about drug resistance due to PrEP use? Analysis of experts' opinion and its influence on the projected public health impact. PLoS One, 2016; 11:e0158620.
9.
KojimaN, DaveyDJ, KlausnerJD: Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS, 2016; 30:2251–2252.
10.
GiromettiN, JonesR, LevyJ, et al.: Risks and benefits HIV preexposure prophylaxis with tenofovir/emtricitabine in an older male with comorbidities. AIDS, 2016; 30:2131–2133.
11.
TenoRes Study Group: Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: A multicenter retrospective cohort study. Lancet Infect Dis, 2016; 16:565–575.
12.
KnoxDC, AndersonPL, HarriganPR, et al.: Multidrug-resistant HIV-1 infection despite preexposure prophylaxis. N Engl J Med, 2017; 376:501–502.
13.
De MulderM, YebraG, NavasA, et al.: High drug resistance prevalence among vertically HIV-infected patients transferred from pediatric care to adult units in Spain. PLoS One, 2012; 7:e52155.
14.
Stanford University: HIV drug resistance database. Available at https://hivdb.stanford.edu. Accessed on September7, 2017.
