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Brief Report: New HIV Diagnoses in PrEP-Experienced and PrEP-Naive Persons in the ICONA Cohort

Taramasso, L; Rossotti, R; Tavelli, A; Santoro, MM; Mazzotta, V; Bandera, A; D'Ettorre, G; ... ICONA Foundation Study Group; + view all (2025) Brief Report: New HIV Diagnoses in PrEP-Experienced and PrEP-Naive Persons in the ICONA Cohort. JAIDS: Journal of Acquired Immune Deficiency Syndromes , 98 (4) pp. 352-356. 10.1097/QAI.0000000000003576.

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Abstract

Background: The best therapeutic management for people with HIV (PWH) who have a history of preexposure prophylaxis (PrEP) is still debated. // Objectives: The aim of this study was to describe recent HIV infections in PrEP users compared with people never exposed to PrEP. // Methods: Multicentre retrospective analysis evaluating all recent HIV infections from 2018 to 2021 within the Italian Cohort Naive Antiretrovirals. PWH, PrEP experienced or not, were compared using χ2 test and Wilcoxon rank-sum test for categorical and continuous variables, respectively. A mixed linear model was used to estimate the change of the estimated mean HIV-RNA in the first year after ART initiation, according to PrEP exposure. // Results: Fifty-one recent HIV diagnoses were identified, 9 in PrEP-experienced people, with an increasing temporal trend over the study period. Clinicians often initiated four-drug ART or NRTI-avoiding regimens in PrEP-experienced individuals, but this approach did not result in better viral decay or faster virologic suppression compared with traditional three-drug regimens. All achieved viral suppression during follow-up, within a median of 5.1 (IQR, 3.2–8.7) months in PWH never exposed to PrEP and 5.2 (IQR 3.2–9.4) months in PrEP-experienced PWH (P = 0.937). M184I/V was the most common mutation in PrEP-experienced individuals (37.5%). // Conclusions: An increasing number of people newly diagnosed with HIV report previous use of PrEP. All PrEP-experienced PWH in ICONA cohort have achieved rapid virologic suppression, even in cases with the presence of transmitted viral mutations.

Type: Article
Title: Brief Report: New HIV Diagnoses in PrEP-Experienced and PrEP-Naive Persons in the ICONA Cohort
Location: United States
DOI: 10.1097/QAI.0000000000003576
Publisher version: https://doi.org/10.1097/qai.0000000000003576
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: PrEP; acute/early HIV infection; resistance mutations; rapid ART; first-line antiretroviral treatment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10207220
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