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Amsterdam PrEP failure patient had unusual course of HIV infection

By David Rowlands, Oct 3 2017 06:59AM

At last February’s Conference on Retroviruses and Opportunistic Infections (CROI), Dutch clinicians presented a so-far unique case of a man who had apparently become infected with non-drug-resistant HIV while taking pre-exposure prophylaxis (PrEP) consistently. Two previous cases of PrEP failure had been reported, but in both cases, the men concerned had been infected with multidrug-resistant HIV. This case, therefore, raised concerns that PrEP may not be 100% effective.


The case has now been published as a paper in The Lancet HIV journal. The report confirms the details presented at CROI but adds interesting data on an unusual course of seroconversion. Although there is no direct evidence for this, the researchers hypothesise that the PrEP might have stopped a localised HIV infection in rectal tissue spreading through the body, and the infection only became a typical, systemic infection when PrEP was stopped.


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