Breakthrough HIV infection on PrEP with injectable cabotegravir

[Jim Allen]

To me, it reads like a possible blunted HIV infection that can happen with PrEP and was missed whilst messing about with antigen testing as standalone 

https://i-base.info/htb/46003

A case report of breakthrough HIV on injectable PrEP was published as an early access concise communication in the journal AIDS. [1]

A 28-year-old gender diverse person switched from daily oral PrEP (TAF/FTC) to CAB-LA PrEP due to regularly missing doses. Their primary partner is living with HIV and carries resistance mutations for NRTIs (65R and 118I) and INSTIs (92G). HIV antigen tests were negative before CAB-LA doses on D0, D27 and D91. However, a positive HIV RNA test was reported on D91 with a. viral load of 1.48 log copies/mL. Subsequent antigen testing at D100 was positive.

https://pubmed.ncbi.nlm.nih.gov/37418423/

Breakthrough HIV-1 infection in setting of cabotegravir for HIV pre-exposure prophylaxis. Aniruddha Hazra 1 2, Raphael J Landovitz 3, Mark A Marzinke 4, Connor Quinby 1, Catherine Creticos 1
PMID: 37418423 DOI: 10.1097/QAD.0000000000003644

Note: In a few weeks, I will recheck and see if I can find full access for free and update the thread accordingly. 

[leatherman]

A 28-year-old gender diverse person switched from daily oral PrEP (TAF/FTC) to CAB-LA PrEP due to regularly missing doses. Their primary partner is living with HIV and carries resistance mutations

so many obstacles/red flags/risks/disparities for this PLWH