Preexposure Prophylaxis and Newly Diagnosed HIV

A recent study looked to examine the proportion of individuals who reported recent exposure to preexposure prophylaxis (PrEP) at HIV diagnosis over time, and data was looked at for probable reasons for failure of PrEP, baseline genotypic resistance, and clinical management using Mann-Whitney U test and Fisher’s exact test. Of 1,030 individuals, 52 reported recent PrEP exposure at HIV diagnosis, with 98% being men who have sex with men, 65% white, 65% non-UK-born, and a median age of 34 years. Thirty-five percent of individuals reported intaking PrEP the day prior to testing positive for HIV, and 46% reported sub-optimal PrEP adherence since the previous HIV-negative test result.

Lower HIV viral load and higher CD4+ cell count was associated with recent PrEP use at baseline compared with counterparts who were not recently exposed to PrEP (P <.01). Despite considerable rates of M184V mutation harboured in individuals who were newly diagnosed with HIV reporting recent PrEP exposure, rapid PrEP intensification to antiretroviral treatment brought upon high rates of HIV viral suppression.

Reference:

Girometti N, McCormack S, Tittle V, McOwan A, Whitlock G; 56 Dean Street Collaborative Group. Rising rates of recent preexposure prophylaxis exposure among men having sex with men newly diagnosed with HIV: antiviral resistance patterns and treatment outcomes. AIDS. 2022;36(4):561-566. doi:10.1097/QAD.0000000000003143

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