Elsevier

Antiviral Research

Volume 179, July 2020, 104717
Antiviral Research

Failure to bictegravir and development of resistance mutations in an antiretroviral-experienced patient

https://doi.org/10.1016/j.antiviral.2020.104717Get rights and content

Highlights

  • Unintended misuse of BIC/FTC/TAF led to failure and development of resistance mutations.

  • R263K in the integrase and M184V in the Reverse transcriptase of HIV developed.

  • BIC/FTC/TAF use in integrase experienced patients must be avoided.

  • BIC/FTC/TAF administration through a nasogastric tube also contributed to failure.

Abstract

We present here one of the first cases of virological failure during treatment with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). 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 BIC/FTC/TAF 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 and treatment. After several weeks, virological failure was confirmed with 4.01 HIV RNA Log copies/mL and R263K and M184V resistance mutations were detected.

Section snippets

Funding

This work was supported in part by Plan Nacional de I + D + I and Fondo Europeo de Desarrollo Regional-FEDER [RD16/0025/0040] and Fundación Progreso y Salud, Junta de Andalucia [PI-0550-2017].

Declaration of competing interest

The authors declare no conflict of interest.

Acknowledgment

We acknowledge Nutraceutical Translations for English language editing of this manuscript.

References (19)

There are more references available in the full text version of this article.

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