Prep May Not Protect You Due To Your Genetic Makup

[rawfuckr]

This article has mostly gone unnoticed but it seems to provide a plausible way in which PrEP may just not work for some people.

http://www.aidsmap.com/Study-sheds-light-on-how-tenofovir-is-processed-in-different-body-tissues/page/2985533/

Some people genetic makeup make it difficult to metabolize Tenofovir properly in certain areas of the body. Article talks in particular about women and vaginal tissue, and how 8% of women tested had gene makeup that suggests inneficient Tenofovir processing leading to improper levels for protection. It's murky from the article what happens in rectal tissue and if there's a segment of subjects who also struggle to process Tenofovir properly in those areas.
 

A bright point of this is that if if true, we could actually get tested before starting PrEP to know if it would be protective for a particular individual or not.

[BiAggieGuy]

Not really a surprise.  There are always people that certain medications just will not work for, or will make them very sick.

[bearbandit]

I'm with BiAggieGuy on this one. As an example, I'm one of the 8% of people of north European origin with the gene HLA5701, which is strongly associated with the often fatal abacavir sensitivity syndrome. The paper reads as a "mopping up" job, seeking to explain the extremely rare incidents where truvada as PrEP has failed. I would imagine that by the time an answer has been found here and, if necessary genetic testing is introduced for PrEP, truvada will be yesterday's drug as far as PrEP is concerned, and something else (most likely, in my opinion, cabotegravir) will have long succeeded it.