Out of the Conference on Retroviruses and Opportunistic Infections (CROI) held in Boston last week came news of a 43-year-old gay man who seroconverted despite being compliant with the drug taken for pre-exposure prophylaxis, or PrEP.
But scientists were quick to point out the case was “rare” and an exception to the high efficacy of the drug. They noted that the patient in the case contracted a virus that had resistance to several drugs used to treat HIV, including both drugs in Truvada, the brand name of the drug that is used as PrEP. Studies on the virus the man contracted showed resistance to drugs in nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and integrase inhibitors classes of drugs.
Drug resistance is linked to people living with HIV failing to continue to take their prescribed medicine properly — cited reasons for this include missing doses or not taking them on time. In Michigan, a study of newly diagnosed people living with HIV found 15.3 percent of cases of the virus contained resistance to at least one drug used to treat HIV. About 11 percent of the 422 cases studied had resistance to the two drug classes found in Truvada.
Angela Minicuci, a spokesperson for the Michigan Department of Health and Human Services, said the state data could not be parsed to determine how many of those viruses studied had resistance to both drugs in Truvada.
“We don’t have a way to link up genotypes with the data collected on the case report form either because those algorithms and software are only housed at CDC,” Minicuci said in an email Friday. “We can watch if NRTI resistance is increasing in general, and perhaps correlate that to PrEP prescriptions. We will have a new MHS report coming out soon but because it is CDC data, there is a significant lag in the timing and the data would likely be a year behind.”