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Known failures of Pep with Tenofovir, 3TC, AZT
Mar 5, 2011

Hello.

I know that so much has changed over the course of PEP cycles but the above mentioned combination has been becoming more popular. I wanted to know if you have any information about any reported failures with this regimen?

I know that the SF study where 7 seroconverted (6 if you don't consider the one person who actually was + a the onset) didn't use a triple drug. I also know that the data with the seroconverted lab workers were all exposed to people with AIDS and didn't have a triple drug regimen. I also only know of the monkey tests that showed that tenofovir is very effective if given within 36 hours. I also know of the french test that had zero seroconversions. SAme thing with the Boston date. I haven't been able to find a single seroconversion with this combination- has it happened?

Response from Dr. Frascino

Hello,

I don't have a scientific answer for you. I'm not personally aware of any tenofovir, 3TC, AZT PEP failures; however, such failures are indeed possible. PEP is not 100% effective. The reason I can't provide a completely definitive answer for you is that there are many confounding variables associated with HIV transmission and PEP therapy. These, among many others, would include:

1. Viral strain

2. Viral load

3. Route of exposure

4. Local trauma

5. Concurrent STDs

6. Timing of first dose (the earlier PEP is taken, the more effective it is)

7. Adherence to PEP regimen

Certainly our PEP regimens have become less toxic, more convenient, better tolerated and more effective as newer and better antiretrovirals have been developed and become available. However, even in spite of these improvements, PEP failures are certainly still possible.

Dr. Bob



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