Characterization of Human Immunodeficiency Virus (HIV) Infections in Women Who Received Injectable Cabotegravir or Tenofovir Disoproxil Fumarate/Emtricitabine for HIV Prevention: HPTN 084

作者：Susan H. Eshleman, Jessica M. Fogel, Estelle Piwowar‐Manning, Gordon Chau, Vanessa Cummings, Yaw Agyei, Paul Richardson, Philip A. Sullivan, Casey D Haines, Lane R. Bushman, Christos J. Petropoulos, Deborah Persaud, Ryan Kofron, Craig W. Hendrix, Peter L. Anderson, Jennifer Farrior, John W. Mellors, Adeola Adeyeye, Alex R. Rinehart, Marty St. Clair, Susan L. Ford, James F. Rooney, Carrie‐Anne Mathew, Portia Hunidzarira, Elizabeth Spooner, Juliet Mpendo, Gonasagrie Nair, Myron S. Cohen, James P. Hughes, Mina C. Hosseinipour, Brett Hanscom, Sinéad Delany‐Moretlwe, Mark A. Marzinke · 发表于：The Journal of Infectious Diseases · 年份：2021 · DOI：10.1093/infdis/jiab576 · 被引用次数：69 · 研究领域：HIV/AIDS drug development and treatment、HIV-related health complications and treatments、HIV/AIDS Research and Interventions

BACKGROUND: HIV Prevention Trials Network 084 demonstrated that long-acting injectable cabotegravir (CAB) was superior to daily oral tenofovir (TFV) disoproxil fumarate (TDF)/emtricitabine (FTC) for preventing human immunodeficiency virus (HIV) infection in sub-Saharan African women. This report describes HIV infections that occurred in the trial before unblinding. METHODS: Testing was performed using HIV diagnostic assays, viral load testing, a single-copy RNA assay, and HIV genotyping. Plasma CAB, plasma TFV, and intraerythrocytic TFV-diphosphate concentrations were determined by liquid chromatography-tandem mass spectrometry. RESULTS: Forty HIV infections were identified (CAB arm, 1 baseline infection, 3 incident infections; TDF/FTC arm, 36 incident infections). The incident infections in the CAB arm included 2 with no recent drug exposure and no CAB injections and 1 with delayed injections; in 35 of 36 cases in the TDF/FTC arm, drug concentrations indicated low or no adherence. None of the cases had CAB resistance. Nine women in the TDF/FTC arm had nonnucleoside reverse-transcriptase inhibitor resistance; 1 had the nucleoside reverse-transcriptase inhibitor resistance mutation, M184V. CONCLUSIONS: Almost all incident HIV infections occurred in the setting of unquantifiable or low drug concentrations. CAB resistance was not detected. Transmitted nonnucleoside reverse-transcriptase inhibitor resistance was common; 1 woman may have acquired nucleoside reverse-transcriptase i...