And the third case is here

[6811283]

The guy sought out PrEP because he knew he was at risk and didn't feel he could change his behavior. He was being responsible under the circumstances.

The "shame, shame, shouldn't have done all that sex and all those drugs" attitude from some posters here -- members of a group that is devoted to highly stigmatized sexual behavior -- is really hard to fathom.

[DBCB]

On 3/31/2017 at 3:26 PM, JizzDumpWI said:

My thoughts on the case where they stopped PrEP on the compliant guy due to a poz result was probably a bad idea.  He had HIV in his system, but there was evidence it was not taking hold.  I wonder what would have happened had he stayed on PrEP for another month? 

This is one of those cases where it's really hard to tell what could have happened, but I think the risk outweighed the benefits of doing so.  Clinicians have to make decisions every step of the way, and the details of the case are so contradictory and hard to wrap one's head around (literally, nobody had ever seen a clinical picture of symptoms like this guy developed) that I think they decided it was better to be conservative and treat infection as a foregone conclusion and cull the Truvada rather than risk the strain becoming fully resistant and imbricated in the community.  It seems like it wasn't fully able to thrive and reproduce in a system flush with Truvada, but it was able to at least hold its ground long enough that periodic bouts of immune modulation/drug level fluctuation allowed it to continue progressing.  I think of it like musical chairs.

[rawfuckr]

On 3/31/2017 at 10:26 PM, JizzDumpWI said:

My thoughts on the case where they stopped PrEP on the compliant guy due to a poz result was probably a bad idea.  He had HIV in his system, but there was evidence it was not taking hold.  I wonder what would have happened had he stayed on PrEP for another month? 

Must have been a tough call for the caregivers, but the fact that he was AB positive was an omnious sign that HIV had taken hold somewhere even if he was PCR negative everywhere. What to do? They ended living him off Truvada and HIV came out of hiding.

This case is extremely bizarre. 100% of PrEP seroconversion cases before this one had had resistance to Truvada.