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Tenofovir Disoproxil Fumarate Fails to Prevent HIV Acquisition or the Establishment of a Viral Reservoir: Two Case Reports

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Julie Fox, Michael Brady, Hannah Alexander, Olubanke Davies, Nicola Robinson, Mathew Pace, Laura Else, John Cason, Saye Khoo, David Back, Sarah Fidler, John Frater

Original languageEnglish
Pages (from-to)65-71
Number of pages7
JournalInfectious diseases and therapy
Issue number1
Early online date9 Jan 2016
E-pub ahead of print9 Jan 2016
PublishedMar 2016


King's Authors


The use of antiretrovirals as pre-exposure prophylaxis (PrEP) is highly efficacious in HIV prevention. The World Health Organization recently recommended Truvada(®) (Gilead Sciences, Inc.) or tenofovir disoproxil fumarate (TDF) for high-risk individuals, with limited data for single-agent TDF PrEP in men who have sex with men (MSM). We report two cases of TDF PrEP failure in MSM who had received long-term TDF for hepatitis B infection and had therapeutic levels of drug immediately after HIV acquisition. Rapid antiretroviral intensification at diagnosis of acute HIV infection failed to limit immune dysfunction or prevent the establishment of a viral reservoir.

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