We present here one of the first cases of virological failure in real world during treatment with bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy®). On March 2019, an antiretroviral-experienced HIV-infected patient was admitted to hospital because of cerebral toxoplasmosis. After undergoing treatment with sulfadiazine-pyrimethamine for two weeks, the patient initiated a Biktarvy® treatment, with 6.01 HIV RNA Log copies/mL, and 37 CD4 cells/μL. After two months under antiretroviral therapy (ART), acute neurologic deterioration with epilepsy, right hemiparesis and dysphagia occurred, leading to nasogastric nutrition. Virological failure was confirmed with 4.01 HIV RNA Log copies/mL and R263K and M184V resistance mutations were detected.

中文翻译：

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bictegravir 失败和抗逆转录病毒经验患者发生耐药突变。

我们在此介绍了在使用比克替拉韦/恩曲他滨/替诺福韦艾拉酚胺 (Biktarvy®) 治疗期间出现的第一批真实世界中病毒学失败的病例之一。2019 年 3 月，一名接受过抗逆转录病毒治疗的 HIV 感染患者因脑弓形体病入院。在接受磺胺嘧啶-乙胺嘧啶治疗两周后，患者开始了 Biktarvy®治疗，6.01 HIV RNA Log 拷贝/mL 和 37 CD4 细胞/μL。在接受抗逆转录病毒治疗 (ART) 两个月后，出现癫痫、右侧偏瘫和吞咽困难的急性神经功能恶化，导致鼻胃营养。病毒学失败证实为 4.01 HIV RNA Log 拷贝/mL，并检测到 R263K 和 M184V 抗性突变。