title: Tenofovir Disoproxil Fumarate Fails to Prevent HIV Acquisition or the Establishment of a Viral Reservoir: Two Case Reports.
abstract: The use of antiretrovirals as pre-exposure prophylaxis (PrEP) is highly efficacious in HIV prevention. The World Health Organization recently recommended Truvada(®) (Gilead Sciences, Inc.) or tenofovir disoproxil fumarate (TDF) for high-risk individuals, with limited data for single-agent TDF PrEP in men who have sex with men (MSM). We report two cases of TDF PrEP failure in MSM who had received long-term TDF for hepatitis B infection and had therapeutic levels of drug immediately after HIV acquisition. Rapid antiretroviral intensification at diagnosis of acute HIV infection failed to limit immune dysfunction or prevent the establishment of a viral reservoir.
authors.affiliation: Department of Genitourinary Medicine and Infectious Disease, Guys and St Thomas' NHS Trust, London, UK. julie.fox@kcl.ac.uk.
authors.forename: Julie
authors.identifier: http://orcid.org/0000-0002-0583-8019
authors.initials: J
authors.lastname: Fox
authors.affiliation: Department of Sexual Health and HIV, Kings College Hospital, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Brady
authors.affiliation: Department of Sexual Health and HIV, Kings College Hospital, London, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Alexander
authors.affiliation: Department of Genitourinary Medicine and Infectious Disease, Guys and St Thomas' NHS Trust, London, UK.
authors.forename: Olubanke
authors.initials: O
authors.lastname: Davies
authors.affiliation: Nuffield Department of Medicine, University of Oxford, Oxford, UK.|Oxford NIHR Biomedical Research Centre, Oxford, UK.|Oxford Martin School, Oxford, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Robinson
authors.affiliation: Nuffield Department of Medicine, University of Oxford, Oxford, UK.|Oxford NIHR Biomedical Research Centre, Oxford, UK.|Oxford Martin School, Oxford, UK.
authors.forename: Mathew
authors.initials: M
authors.lastname: Pace
authors.affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Else
authors.affiliation: Department of Infectious Diseases, Kings College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Cason
authors.affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: Saye
authors.initials: S
authors.lastname: Khoo
authors.affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: David
authors.initials: D
authors.lastname: Back
authors.affiliation: Department of Infectious Diseases, Imperial College, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fidler
authors.affiliation: Nuffield Department of Medicine, University of Oxford, Oxford, UK.|Oxford NIHR Biomedical Research Centre, Oxford, UK.|Oxford Martin School, Oxford, UK.
authors.forename: John
authors.initials: J
authors.lastname: Frater
keywords: HIV; Pre-exposure prophylaxis; Tenofovir; Viral reservoir