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Pre-exposure Prophylaxis Use History in People With Antiretroviral Resistance at HIV Diagnosis: Findings From New York City HIV Surveillance and Partner Services, 2015–2022.
- Source :
-
Clinical Infectious Diseases . 5/15/2024, Vol. 78 Issue 5, p1240-1245. 6p. - Publication Year :
- 2024
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Abstract
- Background Drug resistance may be acquired in people starting human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) during undiagnosed infection. Population-based estimates of PrEP-related resistance are lacking. Methods We used New York City surveillance and partner services data to measure the effect of PrEP use (tenofovir disoproxil fumarate/tenofivir alafenamide fumarate with emtricitabine) history on the baseline prevalence of M184I/V mutations in people with HIV diagnosed in 2015–2022. PrEP use was categorized as "recent" (defined as PrEP stopped ≤90 days before diagnosis), "past" (PrEP stopped >90 days before diagnosis), or "no known use." Resistance-associated mutations were determined using the Stanford algorithm. We used log binomial regression to generate the adjusted relative risk (aRR) of M184I/V by PrEP use history in people with or without acute HIV infection (AHI). Results Of 4246 people with newly diagnosed HIV and a genotype obtained within ≤30 days of diagnosis, 560 (13%) had AHI; 136 (3%) reported recent and 124 (35%) past PrEP use; and 98 (2%) harbored M184I/V. In people with AHI, recent PrEP use was associated with a 6 times greater risk of M184I/V than no known use (aRR, 5.86 [95% confidence interval, 2.49–13.77]). Among people without AHI, the risk of M184I/V in recent users was 7 times that in people with no known use (aRR, 7.26 [95% confidence interval, 3.98–13.24]), and in past users, it was 4 times that in those with no known use (4.46 [2.15–9.24]). Conclusions PrEP use was strongly associated with baseline M184I/V in New York City, regardless of AHI status. Ordering a nucleic acid test when indicated after assessment of exposure, antiretroviral history, and AHI symptoms can decrease PrEP initiation in people with undetected infection. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DIAGNOSIS of HIV infections
*HIV infection epidemiology
*HIV prevention
*ANTIRETROVIRAL agents
*DISEASE prevalence
*DESCRIPTIVE statistics
*PRE-exposure prophylaxis
*EMTRICITABINE-tenofovir
*EFAVIRENZ-emtricitabine-tenofovir (Drug)
*CONFIDENCE intervals
*DRUG resistance
*ALGORITHMS
*GENOTYPES
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 78
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 177249794
- Full Text :
- https://doi.org/10.1093/cid/ciad699