HIV seroconversions and genotypic viral resistance profiles in the PrEP impact trial

Abstract

Objectives: Here we describe HIV seroconversion events in participants of the PrEP Impact trial. Methods: Of 24 268 participants, we reviewed data for the 54 who were diagnosed with HIV during the trial; 11 at baseline. Results: Incidence was low for those diagnosed pre-pandemic at 0.13 per 100 person-years, and mainly linked to low self-reported adherence. The emergence of drug resistance in participants reporting recent oral PrEP (tenofovir disoproxil maleate with emtricitabine (TDF/FTC)) exposure was low (where analysis results are available, 21% of participants who seroconverted during trial participation showed drug resistance). Conclusions: Oral PrEP TDF/FTC is an effective HIV prevention intervention. Further data are needed to assess the prevalence and impact of increasing oral PrEP TDF/FTC use on HIV resistance.