A second person taking daily PrEP has become HIV-positive

A SECOND man this year has acquired a drug-resistant strain of HIV despite taking the prevention pill Truvada daily.

The patient’s case was revealed at a HIV Research for Prevention conference in Chicago earlier this week, by HIV specialist Howard Grossman.

In an interview with The Body, Grossman said the man had been using Truvada since December last year and when he came in for his routine follow-up he had a positive fourth generation HIV test.

“Two cases out of perhaps 100,000 people is a very low failure rate,” he said.

“PrEP is still the most effective tool for HIV prevention we have ever had – every scientific paper has shown it to be less than 100 per cent effective.

“There is absolutely no reason why PrEP will protect against a virus already resistant to these drugs, so having sex with people who could potentially be infected with a resistant virus and not know it, carries a risk.”

The first documented case of a person adhering to the once-a-day pill and acquiring HIV was revealed earlier this year, where a gay man from Toronto became positive after taking Truvada for over 24 months with no prior issues.

Chief Executive of ACON, Nicolas Parkhill, said he remains very confident that PrEP provides high levels of prevention for individuals despite the recent news out of the U.S.

“This is the second recorded case of HIV transmission occurring when someone is adherent to their medication,” he said.

“There have been clinical trials with almost 10,000 people and tens of thousands more now taking it through their doctors in the U.S., thousands within Australia and in other places around the world.

“No HIV prevention tool is perfect, including both condoms and PrEP, and so each individual must weigh up the relative risks of different approaches.”

Parkhill added that the research places PrEP around the top of the pile of HIV prevention approaches.

“This second case announced in Chicago mirrors the circumstances of the first in February, where the patient was infected with a multi-drug resistant form of the virus,” he said.

“Resistance to both TDF and FTC (the two drugs in PrEP) remain exceedingly rare, and testing of resistance to particular drugs will continue to occur in Australia as PrEP becomes more available.

“If there are any significant increases in resistance, we will let our community know straight away.”

If you have more questions about PrEP you can visit Ending HIV.