{"id":43744,"date":"2022-09-01T06:18:53","date_gmt":"2022-09-01T06:18:53","guid":{"rendered":"https:\/\/127.0.0.1\/htb\/?p=43744"},"modified":"2022-09-10T21:54:35","modified_gmt":"2022-09-10T21:54:35","slug":"hiv-seroconversions-on-prep-in-australian-study-are-linked-to-low-adherence","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/43744","title":{"rendered":"HIV seroconversions on PrEP in Australian study are linked to low adherence"},"content":{"rendered":"<p><strong>Kirk Taylor, HIV i-Base<\/strong><\/p>\n<p><b>A large Australian PrEP implementation study involving 9,596 participants over two years only reported 30 people becoming HIV positive (0.31%) and these cases were linked to low adherence. Only one seroconversion was attributed to ART resistance (FTC: M184V mutation).<span class=\"Apple-converted-space\">\u00a0 \u00a0<\/span><\/b><\/p>\n<p>Seroconversions were all men that identified as gay\/bisexual (97%) and reported condomless sex in the previous three months (90%). Median age was 31 years (IQR: 25 to 38). Median time from starting PrEP to diagnosis was 409 days (IQR: 347 to 656) and median viral load was 61,000 copies\/mL. Two-thirds of participants were diagnosed with an additional STI, similar to rates for the overall group.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>Adherence was tracked through dispensing logs, with perfect adherence defined as taking five or more doses\/week with &lt;4 doses\/week considered insufficient.<\/p>\n<p>Reasons for low adherence included recent change in sexual activity\/entering monogamous relationships (n=5), renal impairment (n=1), affordability of PrEP (n=1) and not packing PrEP for vacation (n=1).<\/p>\n<p><b>comment <span class=\"Apple-converted-space\">\u00a0<\/span><\/b><\/p>\n<p><b>These results show that oral PrEP continues to be highly effective when taken as prescribed but that the difficulties of adherence still leads to HIV seroconversions.<\/b><\/p>\n<p><b>It is notable that this large cohort only identified low adherence as a factor involved in the new cases.<\/b><\/p>\n<p><b>Recent experience at the London clinic at 56 Dean Street, where more than 25,000 people have been prescribed oral PrEP, included 7 out of 52 seroconversions (13%) which occurred despite good adherence. Only one of these was linked to drug resistance. [2]<\/b><\/p>\n<p>References<\/p>\n<ol>\n<li>Dharan NJ et al. Characteristics of HIV seroconversions in a large prospective implementation cohort study of oral HIV pre-exposure prophylaxis in men who have sex with men (EPIC-NSW). Clinical Infectious Diseases, ciac660. (19 August 2022).<br \/>\n<a href=\"https:\/\/doi.org\/10.1093\/cid\/ciac660\">https:\/\/doi.org\/10.1093\/cid\/ciac660<\/a><\/li>\n<li>56 Dean Street reports M184V common with recent low adherence to PrEP and seven transmissions with good adherence. HTB (20 December<br \/>\n2021).<br \/>\n<a href=\"https:\/\/i-base.info\/htb\/41912\">https:\/\/i-base.info\/htb\/41912<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Kirk Taylor, HIV i-Base A large Australian PrEP implementation study involving 9,596 participants over two years only reported 30 people becoming HIV positive (0.31%) and these cases were linked to low adherence. Only one seroconversion was attributed to ART resistance &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[],"class_list":["post-43744","post","type-post","status-publish","format-standard","hentry","category-transmission-and-prevention"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43744","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=43744"}],"version-history":[{"count":2,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43744\/revisions"}],"predecessor-version":[{"id":43962,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/43744\/revisions\/43962"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=43744"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=43744"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=43744"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}