1. 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
- 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, and Prazuck, T
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,HIV/AIDS ,Antimicrobial Resistance ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Infection ,Anti-HIV Agents ,Disease Transmission ,Infectious ,Drug Resistance ,Viral ,Female ,France ,Genotype ,Genotyping Techniques ,HIV Infections ,HIV-1 ,Homosexuality ,Male ,Humans ,Male ,Mutation ,Missense ,Prevalence ,resistance-associated mutations ,primary HIV infection ,French ANRS CO 6 PRIMO Cohort ,the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups ,French ANRS CO 6 PRIMO Cohort the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups ,Microbiology ,Pharmacology and Pharmaceutical Sciences ,Clinical sciences ,Pharmacology and pharmaceutical sciences - 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.
- Published
- 2015