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

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

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.

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • Emtricitabine / therapeutic use
  • HIV Infections* / diagnosis
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • HIV-1* / genetics
  • Homosexuality, Male
  • Humans
  • Male
  • Medication Adherence
  • Netherlands / epidemiology
  • Pre-Exposure Prophylaxis*
  • Self Report
  • Sexual and Gender Minorities*
  • Tenofovir / therapeutic use

Substances

  • Anti-HIV Agents
  • Tenofovir
  • Emtricitabine