Acquisition of wild-type HIV-1 infection in a patient on pre-exposure prophylaxis with high intracellular concentrations of tenofovir diphosphate: a case report.
Abstract | BACKGROUND: METHODS: The patient participated in the Amsterdam PrEP project, a demonstration project of daily and event-driven PrEP. We did extensive testing for HIV, including plasma HIV RNA and nested PCR on bulk peripheral blood mononuclear cells (PBMCs) and sigmoid biopsies after seroconversion. FINDINGS: INTERPRETATION: To our knowledge, this is the first detailed case report suggesting wild-type HIV-1 infection despite good adherence, evidenced by repeatedly high concentrations of tenofovir diphosphate in dried blood spots. PrEP providers need to be aware that infection can occur despite good adherence. Regular HIV testing and awareness of atypical patterns of seroconversion is highly recommended. FUNDING: ZonMw, National Institute for Public Health and the Environment, Internal GGD research funds, Aidsfonds, Stichting AmsterdamDiner Foundation, Gilead Sciences, Janssen Pharmaceutica, M A C AIDS Fund, and ViiV Healthcare.
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Authors | Elske Hoornenborg, Maria Prins, Roel C A Achterbergh, Lycke R Woittiez, Marion Cornelissen, Suzanne Jurriaans, Neeltje A Kootstra, Peter L Anderson, Peter Reiss, Henry J C de Vries, Jan M Prins, Godelieve J de Bree, Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Consortium (H-TEAM) |
Journal | The lancet. HIV
(Lancet HIV)
Vol. 4
Issue 11
Pg. e522-e528
(11 2017)
ISSN: 2352-3018 [Electronic] Netherlands |
PMID | 28919303
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2017 Elsevier Ltd. All rights reserved. |
Chemical References |
- Anti-HIV Agents
- Organophosphates
- RNA, Viral
- tenofovir diphosphate
- Tenofovir
- Emtricitabine
- Adenine
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Topics |
- Adenine
(administration & dosage, adverse effects, analogs & derivatives, blood, therapeutic use)
- Anti-HIV Agents
(administration & dosage, adverse effects, blood, therapeutic use)
- Emtricitabine
(administration & dosage, therapeutic use)
- HIV Infections
(complications, drug therapy, microbiology, prevention & control)
- HIV Seropositivity
(diagnosis)
- HIV-1
(drug effects, genetics)
- Homosexuality, Male
- Humans
- Lymphogranuloma Venereum
(diagnosis)
- Male
- Medication Adherence
(statistics & numerical data)
- Middle Aged
- Organophosphates
(administration & dosage, adverse effects, blood, therapeutic use)
- Pre-Exposure Prophylaxis
- RNA, Viral
(blood)
- Tenofovir
(administration & dosage, adverse effects, therapeutic use)
- Transgender Persons
- Urinary Tract Infections
(diagnosis, microbiology)
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