학술논문
HIV-1-infected patients from the French National Observatory experiencing virological failure while receiving enfuvirtide.
Document Type
Article
Author
Diane Descamps; Lambert Assoumou; Bernard Masquelier; Anne-Geneviève Marcelin; Souhila Saidi; Catherine Tamalet; Jacqueline Cottalorda; Jean-Christophe Plantier; Brigitte Montes; Jacques Izopet; Gilles Peytavin; Sabine Yerly; Véronique Schneider; Constance Delaugerre; Virginie Ferré; Annick Ruffault; Coralie Pallier; Laurence Morand-Joubert; Marie-Laure Chaix; Vincent Calvez
Source
Subject
*HIV-positive persons
*PATIENTS
*HIV infections
*AIDS patients
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Language
ISSN
0305-7453
Abstract
: Objectives We studied gp41 mutations associated with failing enfuvirtide salvage therapy. : Methods This multicentre study involved patients with HIV-1 plasma viral load (pVL) > 5000 copies/mL after at least 3 months of uninterrupted enfuvirtide therapy and with plasma samples available at inclusion (T0), at initial enfuvirtide failure (T1) and at last follow-up visit during continued failing enfuvirtide therapy (T2). The HR-1 and HR-2 domains of the gp41 gene were sequenced at T0, T1 and T2. : Results Ninety-nine patients were enrolled. At baseline, the median pVL and CD4 cell count were 5.1 log copies/mL and 72 cells/mm3, respectively. Based on the ANRS Resistance Group algorithm, the proportion of patients harbouring viruses with enfuvirtide resistance mutations increased significantly between T0 and T1. In the HR-1 domain, the V38A/M, Q40H, N42T, N43D and L45M mutations wereselected (P < 0.02). In the HR-2 domain, no mutations were significantly selected during the follow-up. None of the mutations was associated with a CD4 cell count increment. : Conclusions Mutations selected during failing enfuvirtide salvage therapy are mainly located in the HR-1 domain of the gp41 gene, between codons 38 and 45. No mutations were associated with an increase in the CD4 cell count. [ABSTRACT FROM AUTHOR]