Doctors in France have discovered two men with drug-resistant strains of HIV. One is a 23-year-old man who was diagnosed with HIV in September of 2019, the second is a 54-year-old man who has had HIV since 1995. Both men have sex with other men and they are from the same region in southern France.
The men don’t know each other, but both have the same HIV-1 mutation that is resistant to all three main classes of antiretroviral medications. The 23-year-old man wasn’t taking pre-exposure prophylactics (PrEP), a medication protocol that prevents most transmissions of HIV.
Usually resistant strains mutate within individuals who haven’t regularly taken their medication and are only resistant to one class of HIV drugs, which leaves treatment options open. Moreover, they are more difficult to transmit to others because the mutations make the virus heavier.
French doctors, though, believe this current case is the first instance of a strain that was transmitted from one individual to another. And since the two men they found with the strain don’t know each other, they believe there could be others who passed the virus along.
Such strains are rare for now, in France at least. French doctors say this and similar strains likely account for only 0.1% of all HIV cases in the country, and doctors would like to keep it that way.
They have alerted clinics throughout the country and in Spain. Both men have said they would wear condoms for the rest of their lives. The men will be given aggressive drug regimens to try and keep the virus from replicating in their bodies.
According to Gay Nation, the first case of a completely drug-resistant strain of HIV was found in New York in 2004.
In the past, doctors have found PrEP-resistant strains of HIV, though these strains weren’t resistant to all three main classes of HIV antiretroviral medications.
In the first two cases — detected in February and October 2016 — both men contracted a strain of HIV that was resistant to tenofovir and emtricitabine, the two active medications used in Truvada, the most common medication used for PrEP.
Scientists in those cases determined that people who regularly stick to their PrEP regiment can contract HIV when they’re exposed to a virus that’s resistant to both drugs used in Truvada.
Such cases are very rare, doctors say.
Correction: A previous version of this story incorrectly stated one man’s PrEP use and both men’s treatment regimen.