1. HIV-1-infected patients from the French National Observatory experiencing virological failure while receiving enfuvirtide.
- Author
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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, and Vincent Calvez
- Subjects
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HIV-positive persons , *PATIENTS , *HIV infections , *AIDS patients - 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]
- Published
- 2008