Protection against rectal transmission of an emtricitabine-resistant simian/human immunodeficiency virus SHIV162p3M184V mutant by intermittent prophylaxis with Truvada

J Virol. 2011 Aug;85(15):7933-6. doi: 10.1128/JVI.00843-11. Epub 2011 Jun 1.

Abstract

Daily preexposure prophylaxis (PrEP) with Truvada (emtricitabine [FTC] and tenofovir disoproxil fumarate [TDF]) is a novel HIV prevention strategy recently found to reduce HIV incidence among men who have sex with men. We used a macaque model of HIV transmission to investigate if Truvada maintains prophylactic efficacy against an FTC-resistant isolate containing the M184V mutation. Five macaques received a dose of Truvada 3 days before exposing them rectally to the simian/human immunodeficiency virus mutant SHIV162p3(M184V), followed by a second dose 2 h after exposure. Five untreated animals were used as controls. Virus exposures were done weekly for up to 14 weeks. Despite the high (>100-fold) level of FTC resistance conferred by M184V, all five treated animals were protected from infection, while the five untreated macaques were infected (P = 0.0008). Our results show that Truvada maintains high prophylactic efficacy against an FTC-resistant isolate. Increased susceptibility to tenofovir due to M184V and other factors, including residual antiviral activity by FTC and/or reduced virus fitness due to M184V, may all have contributed to the observed protection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology*
  • Cell Line
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / pharmacology
  • Drug Combinations
  • Drug Resistance, Viral
  • Emtricitabine
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • HIV / drug effects*
  • HIV / genetics
  • Humans
  • Macaca mulatta
  • Mutation*
  • Organophosphorus Compounds / pharmacology*
  • Simian Acquired Immunodeficiency Syndrome / prevention & control
  • Simian Acquired Immunodeficiency Syndrome / transmission*
  • Simian Immunodeficiency Virus / drug effects*
  • Simian Immunodeficiency Virus / genetics

Substances

  • Antiviral Agents
  • Drug Combinations
  • Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Organophosphorus Compounds
  • Deoxycytidine
  • Emtricitabine