학술논문
HIV-1 subtype B-infected MSM may have driven the spread of transmitted resistant strains in France in 2007–12: impact on susceptibility to first-line strategies
Document Type
article
Author
Frange, Pierre; Assoumou, Lambert; Descamps, Diane; Chéret, Antoine; Goujard, Cécile; Tran, Laurent; Gousset, Marine; Avettand-Fenoël, Veronique; Bocket, Laurence; Fafi-Kremer, Samira; Guinard, Jerome; Morand-Joubert, Laurence; Nicot, Florence; Plantier, Jean-Christophe; Rogez, Sylvie; Wirden, Marc; Rouzioux, Christine; Meyer, Laurence; Chaix, Marie-Laure; Abel, S; Abraham, B; Allegre, T; Antoniotti, A; Armero, R; Audhuy, B; Aumaitre, H; Beaucaire, G; Beck-Wirth, G; Berger, JL; Bernard, L; Beuscart, C; Bodard, L; Bouchaud, O; Boué, F; Cabane, J-P; Cabie, A; Champagne, H; Cheneau, C; Chennebault, J-M; Cheret, A; Christian, B; Compagnucci, A; Daneluzzi, V; Debab, Y; Dellamonica, P; Delfraissy, J-F; Devidas, A; Diab, G; Doll, J; Drobacheff-Thebaut, MC; Durel, A; Duvivier, C; Esnault, J-L; Faba, L; Froguel, E; Garipuy, D; Garrait, V; Geffray, L; Genet, C; Genet, P; Gerard, L; Ghosn, J; Girard, J-J; Girard, P-M; Godin-Collet, C; Hochedez, P; Hoen, B; Houlbert, D; Jacomet, C; Jeantils, V; Jidar, K; Katlama, C; Klement, E; Lafeuillade, A; Lascoux, C; Launay, V; Lepretre, A; Levy, Y; Makhloufi, D; Malbec, D; Martha, B; May, T; Merrien, D; Miailhes, P; Miodovski, C; Molina, J-M; Morlat, P; Mortier, E; Neau, D; Obadia, M; Patey, O; Pellegrin, J-L; Perronne, V; Philibert, P; Pialoux, G; Pichancourt, G; Piroth, L; Poinsignon, Y; Poizot-Martin, I; Prazuck, T
Source
Journal of Antimicrobial Chemotherapy. 70(7)
Subject
Language
Abstract
BackgroundOur study describes the prevalence of transmitted drug resistance (TDR) among 1318 French patients diagnosed at the time of primary HIV-1 infection (PHI) in 2007-12.MethodsHIV-1 resistance-associated mutations (RAMs) were characterized using both the 2009 WHO list of mutations and the French ANRS algorithm. A genotypic susceptibility score was estimated for each first-line recommended ART combination.ResultsPatients were mainly MSM (72.6%). Non-B variants were identified in 33.7% of patients. The proportion of TDR was estimated as 11.7% (95% CI 10.0-13.5). The prevalences of PI-, NRTI-, first-generation NNRTI and etravirine/rilpivirine-associated RAMs were 2.5%, 5.2%, 3.9% and 3.2%, respectively. Single, dual and triple class resistance was found in 9.6%, 1.0% and 1.1% of cases, respectively. Additionally, 5/331 strains isolated in 2010-12 had integrase inhibitor (II)-related RAMs (isolated E157Q mutation in all cases). TDR was more common among MSM than in other groups (12.9% versus 8.6%, P = 0.034), and in case of B versus non-B subtype infections (13.6% versus 7.9%, P = 0.002). The proportions of fully active combinations were ≥99.2%, ≥97.3% and ≥95.3% in cases of PI-, II- and NNRTI-based regimens, respectively. In 2010-12, the proportion of fully active efavirenz-based ART was lower in cases of subtype B versus non-B infection (P = 0.021).ConclusionsCompared with our previous studies, the proportion of NRTI- and first-generation NNRTI-related TDR has continued to decline in French seroconverters. However, subtype B-infected MSM could drive the spread of resistant HIV strains. Finally, we suggest preferring PI- or II- to NNRTI-based combinations to treat PHI patients.