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First Case of HIV Despite PrEP

by Redaktie in Health & Body , 24 April 2016

Dit artikel is ook in het Nederlands beschikbaar

For the first time ever, a case has been made public in which PrEP did not work. A Canadian man was infected with HIV in spite of dedicated use of PrEP. However, according to experts, it is nothing to be alarmed about. The high effectiveness of PrEP is still undisputed, in spite of this one exceptional case.

The case was presented at CROI 2016, a leading congress on HIV and related matters. It concerns a 43-year-old gay man who had been using PrEP with high compliance. Blood test revealed that he had been taking his medication following his daily prescription. It is striking that he contracted HIV. People were infected by the virus in various trials, but test always revealed that they had not taken their Truvada pills regularly or not at all.

This man's HIV infection was very recent, as PrEP users are regularly tested. In addition to this, the combination of various tests could determine the period in which the HIV infection had taken place quite accurately.

The virus this man contracted showed a high immunity to both medicines (Tenofovir and Emtricitabine) in Truvada, which in his case can explain why PrEP did not prevent contacting the HIV virus. Immunity to both substances in Truvada is very rare. Research shows that approximately 1% of people get infected with an HIV virus that is immune to Tenofovir. Immunity to Emtricitabine is even less common, and a virus that is immune to all medication is even rarer.

This case can therefore be called exceptional. It is a first, although it is not very pleasant. The fact that after many trials world-wide and an estimated use by tens of thousands in the US, there has only been one documented case of PrEP failure, which shows that PrEP is still effective. It does show, however, that 100% certainty simply does not exist. Not in medical science, and not in our daily lives.

Or, as Dr. Robert Grant, one of the most important PrEP researches in the world, puts it in a response to the news: “After 32 years of experience with HIV research, I have learned never to say ‘never’. Yet I also think that gay men benefit from feeling safer during sex, and I am grateful that PrEP affords that feeling.”



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