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Truvada Resistance
Mar 23, 2014

Hey Dr.Young!

I'm currently on PreP and adhere perfectly. I just have a hypothetical question of resistance that is probably relevant to other PrePs out there: if I became infected while on PreP, unlikely as it is, what would the resistance look like? What kind of treatment options are available for those who become resistant to Truvada? Are those treatment options less ideal than a cocktail that contains Truvada?

Sorry if this question is a repeat. I looked through the archive and didn't find anything. Thank you in advance!


Response from Dr. Young

Hello and thank you for posting.

It turns out that the answer to your question is quite simple. Preexposure prophylaxis is very effective in preventing HIV infection. So much so that if taken appropriately(there are drug levels detectable in the blood) then HIV transmission does not occur.

It is reasonable to ask the question about the selection of drug-resistant variants of HIV, among those people who are unfortunate enough to acquire viral infection it appears that there was not enough drug present to either prevent the infection or to select for drug resistance.

So while transmitted HIV drug resistance still occurs in roughly 10% of new infected persons this does not seem to be an issue with pre-exposure prophylaxis treatment.

Hope that's helpful, BY.

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