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Reigadas S, Marcelin AG, Houssaini A, Yerly S, Descamps D, Plantier JC, Ruffault A, Amiel C, Trabaud MA, Flandre P, Fleury H, Masquelier B, Roussel C, Alloui C, Leguillou-Guillemette H, Bettinger D, Pallier C, Descamps D, Brun-Vezinet F, Peytavin G, Masquelier B, Pinson P, Reigadas S, Vallet S, Poveda JD, Mirand A, Krivine A, Auvray C, de Rougemont A, Yerly S, Signori-Schmuck A, Bocket L, Rogez S, Tamalet C, Schneider V, Amiel C, Bouvier-Alias M, Montes B, Schvoerer E, Ferre V, Chaix ML, Guinard J, Haim-Boukobza S, Soulie C, Marcelin AG, Flandre P, Assoumou L, Calvez V, Maillard A, Morand-Joubert L, Chaplain C, Delaugerre C, Bourlet T, Bertsch S, Plantier JC, Raymond S, Marque-Juillet S. HIV-1 integrase variability and relationship with drug resistance in antiretroviral-naive and -experienced patients with different HIV-1 subtypes. J Antimicrob Chemother 2012. [DOI: 10.1093/jac/dks474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nguyen HL, Charpentier C, Nguyen N, de Truchis P, Molina JM, Ruxrungtham K, Delaugerre C. Longitudinal analysis of integrase N155H variants in heavily treated patients failing raltegravir-based regimens. HIV Med 2012; 14:85-91. [PMID: 22994529 DOI: 10.1111/j.1468-1293.2012.01039.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The mechanism of raltegravir (RAL)-resistant evolutions has not already been elucidated. Because the emergence of RAL resistance is usually initiated by the N155H mutant, we assessed the role of minor N155H-mutated variants in circulating RNA and archived DNA in five heavily treated patients experiencing long-term RAL therapy failure and harbouring three different resistance profiles determined by standard genotyping. METHODS Allele-specific polymerase chain reaction (AS-PCR) was used to detect N155H mutants in longitudinal stored plasma and whole-blood samples before, during and after RAL-based regimens in five patients infected with the HIV-1 B subtype. RESULTS No minor N155H-mutated variant was found by AS-PCR in either plasma or whole-blood samples collected at baseline and after RAL withdrawal in any of the five patients. During RAL failure, the mutation N155H was detected at different levels in three patients displaying the N155H pathway and gradually declined when the double mutant Q148H+G140S was selected in one patient. In two patients with the Q148H resistance pathway, no N155H variant was identified by AS-PCR in either viral RNA or DNA. CONCLUSIONS The N155H mutation present at various levels from minority to majority showed no relationship with the three RAL-associated resistance profiles, suggesting that this mutant may not play a role in determining different resistance profiles. Moreover, pre-existing N155H is very infrequent and, if selected during RAL failure, the N155H mutant disappears quickly after RAL withdrawal.
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Lambert-Niclot S, Masquelier B, Cohen Codar I, Soulie C, Delaugerre C, Morand-Joubert L, Charpentier C, Ferre V, Plantier JC, Montes B, Carret S, Perrot V, Peytavin G, Costagliola D, Calvez V, Marcelin AG. Impact of lopinavir/ritonavir use on antiretroviral resistance in recent clinical practice. J Antimicrob Chemother 2012; 67:2487-93. [DOI: 10.1093/jac/dks226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Delaugerre C, Braun J, Charreau I, Delarue S, Nere ML, de Castro N, May T, Marchou B, Simon F, Molina JM, Aboulker JP. Comparison of resistance mutation patterns in historical plasma HIV RNA genotypes with those in current proviral HIV DNA genotypes among extensively treated patients with suppressed replication. HIV Med 2012; 13:517-25. [PMID: 22416781 DOI: 10.1111/j.1468-1293.2012.01002.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Heavily treatment-experienced patients with good virological control could be at risk of virological failure on switching to a new regimen if pre-existing drug resistance is not taken into account. We examined whether genotyping based on cellular HIV-1 DNA during controlled viraemia identifies resistance mutations detected in plasma HIV-1 RNA during treatment with previous antiretroviral regimens. PATIENTS AND METHODS All 169 patients enrolled in the Agence Nationale de Recherche sur le SIDA (ANRS) 138-intEgrase inhibitor MK_0518 to Avoid Subcutaneous Injections of EnfuviRtide (EASIER) trial had already received three antiretroviral drug classes [nucleoside reverse transcriptase inhibitor (NRTI), nonnucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI)] and had plasma HIV-1 RNA<400 copies/ml at baseline. The results of previous resistance genotyping of plasma HIV-1 RNA in individual patients were compared with those of resistance genotyping of whole-blood HIV-1 DNA at randomization. RESULTS A median of 4 plasma RNA genotypes were available for the 169 patients. The median numbers of resistance mutations in HIV-1 RNA and DNA were, respectively, 5 and 4 for NRTIs, 2 and 1 for NNRTIs, and 10 and 8 for PIs. The difference was significant for all three drug classes (P=0.001). Resistance to at least one antiretroviral drug was detected exclusively in HIV-1 RNA or in DNA in 63% and 13% of patients for NRTI, 47% and 1% of patients for NNRTI, and 50% and 7% of patients for PI, respectively. CONCLUSION This study shows that, among highly treatment-experienced patients on effective highly active antiretroviral therapy, resistance genotyping of HIV-1 DNA detects fewer resistance mutations than previous analyses of HIV-1 RNA. These results have implications for patient management and for the design of switch studies.
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Pavie J, Porcher R, Torti C, Medrano J, Castagna A, Valin N, Rusconi S, Ammassari A, Ghosn J, Delaugerre C, Molina JM, Franzetti M, Lascoux-Combes C, Lorenzini P, Carosi G, Albini L, Nasta P, Quiros-Roldan E, Castelnuovo F, Rachline A. Efficacy and safety of a switch to unboosted atazanavir in combination with nucleoside analogues in HIV-1-infected patients with virological suppression under antiretroviral therapy. J Antimicrob Chemother 2011; 66:2372-8. [DOI: 10.1093/jac/dkr316] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Delaugerre C. [HIV viral dynamic after antiretroviral treatment initiation: is a rapid decay a good pronostic?]. PATHOLOGIE-BIOLOGIE 2010; 58:403-405. [PMID: 19481371 DOI: 10.1016/j.patbio.2009.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Accepted: 03/06/2009] [Indexed: 05/27/2023]
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Avettand-Fenoel V, Flandre P, Chaix ML, Ghosn J, Delaugerre C, Raffi F, NgoVan P, Cohen-Codar I, Delfraissy JF, Rouzioux C. Impact of 48 week lopinavir/ritonavir monotherapy on blood cell-associated HIV-1-DNA in the MONARK trial. J Antimicrob Chemother 2010; 65:1005-7. [DOI: 10.1093/jac/dkq084] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghosn J, Delaugerre C, Pinta A, Pierre N, Etienne D, Raffi F, Morand-Joubert L. Short-course intensification with enfuvirtide in virologic failure: impact on intracellular HIV reservoir and on viral tropism (INNOVE study). J Int AIDS Soc 2010. [PMCID: PMC3113043 DOI: 10.1186/1758-2652-13-s4-p40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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De Castro N, Braun J, Charreau I, Pialoux G, Katlama C, Delaugerre C, Aboulker JP. H-34 Switch de l’enfuvirtide (ENF) pour le raltegravir (RAL) chez des patients infectés par un VIH multi-résistant et bien contrôlés sous traitement : Résultats de l’essai Easier-ANRS 138. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pavie J, Rachline A, Porcher R, Colin de Verdière N, de Castro N, Delaugerre C, Molina JM. H-29 Étude rétrospective de l’efficacité et de la tolérance d’une stratégie de switch vers atazanavir (ATV) non boosté chez des patients VIH, bien contrôlés sous traitement antirétroviral. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Belarbi L, Delaugerre C, Krivine A, Rouanet S, Morini JP, Salmon S, Viard JP, Launay O. H-30 Associations d’inhibiteurs de protéase : tolérance et efficacité immunovirologique. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74403-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ghosn J, Flandre P, Delaugerre C, Chaix ML, Girard PM, Raffi F, Cohen-Codar I, Van PN, Chauvin JP, Rouzioux C, Delfraissy JF. Analyse finale à 96semaines des résultats des patients infectés par le VIH-1 et randomisés dans le bras monothérapie lopinavir/ritonavir en première ligne de traitement dans le cadre de l’essai Monark. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Descamps D, Assoumou L, Masquelier B, Marcelin AG, Saidi S, Tamalet C, Cottalorda J, Plantier JC, Montes B, Izopet J, Peytavin G, Yerly S, Schneider V, Delaugerre C, Ferre V, Ruffault A, Pallier C, Morand-Joubert L, Chaix ML, Calvez V, Brun-Vezinet F, Costagliola D. HIV-1-infected patients from the French National Observatory experiencing virological failure while receiving enfuvirtide. J Antimicrob Chemother 2008; 62:451-5. [DOI: 10.1093/jac/dkn225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Delaugerre C, Flandre P, Marcelin A, Descamps D, Tamalet C, Cottalorda J, Schneider V, Yerly S, LeGoff J, Morand-Joubert L, Chaix M, Costagliola D, Calvez V. National survey of the prevalence and conditions of selection of HIV-1 reverse transcriptase K70E mutation. J Med Virol 2008; 80:762-5. [DOI: 10.1002/jmv.21158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Delaugerre C, Chaix ML, Warszawski J, Rouzioux C, Blanche S. La résistance du VIH-1 aux antirétroviraux chez les enfants infectés : du nouveau-né à l'adolescent. Arch Pediatr 2007; 14:298-302. [PMID: 17287114 DOI: 10.1016/j.arcped.2006.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Revised: 11/29/2006] [Accepted: 12/07/2006] [Indexed: 11/16/2022]
Abstract
Limit of antiretroviral treatment success is the emergence of drug-resistant virus. As reported in adult population, prevalence of resistance was high in treated HIV-infected children with detectable HIV viral load. Resistance increased with number of prior antiretroviral treatments, particularly with protease inhibitors. Adolescent boys seem at greater risk to harbor multi-classes resistant virus. In HIV-infected newborns, prevalence of resistance was 20%. Most of resistance mutations detected were in accord to perinatal antiretroviral exposition. Principal mechanism of resistance acquisition in newborns was transmission of resistant viruses from mother to child with early archive in cellular reservoir and long term persistence with or without treatment. Consequences of long term therapeutic strategies in children are major.
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Jullien V, Raïs A, Urien S, Dimet J, Delaugerre C, Bouillon-Pichault M, Rey E, Pons G, Blanche S, Tréluyer JM. Age-related differences in the pharmacokinetics of stavudine in 272 children from birth to 16 years: a population analysis. Br J Clin Pharmacol 2007; 64:105-9. [PMID: 17324223 PMCID: PMC2000613 DOI: 10.1111/j.1365-2125.2007.02854.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To develop a population pharmacokinetic model for stavudine in children and to investigate the consistency of the currently recommended dose based on adult target concentrations. METHODS The pharmacokinetics of stavudine were investigated using a population approach. Individual estimates of CL/F were used to calculate the stavudine dose required to achieve the area under the concentration-time curve reported in adults given recommended doses. RESULTS Stavudine pharmacokinetics were well described by a one-compartment model with zero-order absorption. Typical population estimates (% interindividual variability) of the apparent distribution volume (V/F) and plasma clearance (CL/F) were 40.9 l (32%) and 16.5 l h(-1) (38%), respectively. Stavudine V/F and CL/F were similarly related to age. Mean calculated doses (0.61 mg kg(-1) for children less than 2 weeks, 1.23 mg kg(-1) for children more than 2 weeks with bodyweight less than 30 kg, and 31.5 mg for children with a bodyweight between 30 and 60 kg) were in agreement with the current paediatric doses (0.5 mg kg(-1), 1 mg kg(-1), and 30 mg, respectively). CONCLUSIONS Our findings support the current recommended paediatric dosage regimens for stavudine, as they result in the same exposure to the drug as in adults.
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Delaugerre C, Chaix ML. [HIV resistance to non-nucleoside reverse transcriptase inhibitors]. Virologie (Montrouge) 2006; 10:255-266. [PMID: 34731991 DOI: 10.1684/vir.2011.7155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) has been found to develop rapidly after initiation of NNRTI therapy with high level of phenotypic resistance and large cross-resistance to all licensed NNRTI. NNRTI-selected mutations confer little damage to viral fitness and persist in absence of drug. In HIV-1 non-B subtype, resistance profile could differ and survey is needed. Single dose of nevirapine in the prevention of HIV mother-tochild transmission was associated with selection of resistance and loss of virologic response to NNRTI including-regimen. Furthermore, with continued therapy, viral evolution persists, creating species with greater numbers of mutations and higher level of phenotypic resistance that limits future treatment options.Absence of immunologic and virologic effect when NNRTI interruption was proposed in patients with resistant virus suggest that these compounds have lost all their in vivo antiviral activity. Taken together, strong consideration should be given to discontinuing NNRTI after virologic failure is confirmed.
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Leruez-Ville M, Galimand J, Ghosn J, Briat A, Delaugerre C, Chaix ML. [Male genital tract infection: the point of view of the virologist]. ACTA ACUST UNITED AC 2005; 33:684-90. [PMID: 16126433 DOI: 10.1016/j.gyobfe.2005.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Accepted: 07/08/2005] [Indexed: 11/18/2022]
Abstract
Attention to viral infection of the male genital tract has been renewed over the last 15 years as a result of the prolific ongoing research on AIDS. Epidemiological studies of the virus in sperm and male genital tract contributes to the understanding of STD physiopathology and helps assessing their impact on male fertility. Recent advances in this field have allowed to offer Assisted reproductive techniques to couples with chronic viral infection, under strict and specific protocols. This paper presents an overview of these recent developments.
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Delaugerre C, Teglas JP, Chaix ML, Tréluyer JM, Blanche S. [Therapeutic strategies for HIV infection: boost antiproteases in pediatrics]. Med Mal Infect 2005; 34 Suppl 3:S205-8. [PMID: 15906443 DOI: 10.1016/s0399-077x(04)80006-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bossi P, Peytavin G, Ait-Mohand H, Delaugerre C, Ktorza N, Paris L, Bonmarchand M, Cacace R, David DJ, Simon A, Lamotte C, Marcelin AG, Calvez V, Bricaire F, Costagliola D, Katlama C. GENOPHAR: a randomized study of plasma drug measurements in association with genotypic resistance testing and expert advice to optimize therapy in patients failing antiretroviral therapy. HIV Med 2004; 5:352-9. [PMID: 15369510 DOI: 10.1111/j.1468-1293.2004.00234.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the benefits of therapeutic drug monitoring (TDM) in association with genotypic resistance testing and expert advice to optimize therapy in multiexperienced patients infected with HIV-1. METHODS Patients with a viral load>1000 HIV-1 RNA copies/mL and an unchanged antiretroviral therapy regimen over the last 3 months were randomized into two groups: a genotypic group (G) and a geno-pharmacological group (GP). Treatment was selected by an expert committee according to genotypic resistance testing (the G and GP groups) and TDM (the GP group) at week 4. Treatment could be modified at each visit according to toxicity, poor virological response and TDM. Results of TDM were withheld from the G group until week 12. The primary endpoint of the study was the percentage of patients with viral load<200 copies/mL at week 12. RESULTS A total of 134 patients were randomized in the study, with 67 in each group, and included in the intent-to-treat (ITT) analysis. At baseline, median values were as follows: viral load (log(10) copies/mL): G=4.1, GP=4.0; CD4 cell count (cells/microL): G=292, GP=294; and number of prior drugs: G=7, GP=8. The median number of resistance mutations was five in the G group [nucleoside reverse transcriptase inhibitors (NRTIs)=three; non-nucleoside reverse transcriptase inhibitors (NNRTIs)=one; protease inhibitors (PI)=one] and seven in the GP group (NRTI=four; NNRTI=two; PI=one). At week 8, treatment was adjusted according to the TDM in 13 of the 67 patients in the GP group (19%). By ITT missing equal failure analysis at week 12, and after only one intervention according to plasma concentration results, a viral load<200 copies/mL was achieved in 30 of the 67 patients (45%) in the G group and in 29 of the 67 patients (43%) in the GP group (not significant). In the multivariate analysis, only prior exposure to at least two PIs at baseline gave a poor response to subsequent antiretroviral therapy. At week 24, a viral load<200 copies/mL was achieved in 35 of the 67 patients (52%) in the G group and in 40 of the 67 patients (60%) in the GP group. CONCLUSIONS A statistically significant benefit of using TDM was not found in this short-term study where patients appeared to be adherent. However, combining genotypic resistance testing with the use of an expert committee to monitor subsequent therapy individually in patients with multiple resistance mutations was associated with high antiviral efficacy.
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Delaugerre C, Valantin MA, Mouroux M, Bonmarchand M, Carcelain G, Duvivier C, Tubiana R, Simon A, Bricaire F, Agut H, Autran B, Katlama C, Calvez V. Re-occurrence of HIV-1 drug mutations after treatment re-initiation following interruption in patients with multiple treatment failure. AIDS 2001; 15:2189-91. [PMID: 11684940 DOI: 10.1097/00002030-200111090-00016] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Antiretroviral treatment interruption in 20 extensively pre-treated HIV-1 patients with treatment failure led to genotype viral reversion of at least one class of drug-mutation resistance in half of the patients. The only predictive factor of reversion was found to be the duration of interruption. The outgrowth of residual wild-type virus seems not to be a true genetic reversion because drug mutations are detected rapidly at salvage therapy re-initiation.
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Delaugerre C, Rohban R, Simon A, Mouroux M, Tricot C, Agher R, Huraux JM, Katlama C, Calvez V. Resistance profile and cross-resistance of HIV-1 among patients failing a non-nucleoside reverse transcriptase inhibitor-containing regimen. J Med Virol 2001; 65:445-8. [PMID: 11596076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The objectives were to determine the resistance profile and the rate of cross-resistance in HIV-1 infected patients failing an efavirenz or a nevirapine or a nevirapine then efavirenz containing regimens, and to investigate if zidovudine and more generally thymidine analog nucleosides lead to a particular genotypic pattern in nevirapine failing patients. A study was conducted in 104 patients with virological rebound to a non-nucleoside reverse transcriptase inhibitors (NNRTI) regimen (efavirenz n = 39, nevirapine n = 46 and nevirapine then efavirenz n = 19). Genotypic resistance testing was carried out of detectable plasma HIV-1 RNA (> 200 copies/ml). Among the 104 patients studied, only two patients failed to respond to the nevirapine regimen without selection of a NNRTI resistance mutation. All patients failing an efavirenz regimen harboured mutations conferring cross-resistance to nevirapine (K103N, Y188L, G190S). Among patients failing the nevirapine regimen and presenting with NNRTI mutations, 35 (80%) harboured mutations conferring cross-resistance to efavirenz (K101E, K103N, Y188L) and 9 (20%) harboured mutations conferring resistance to nevirapine alone (V106A and Y181C). In patients failing nevirapine then efavirenz therapy, all NNRTI resistance profile led to cross-resistance to all available NNRTIs. Among patients receiving nevirapine, the selection of mutations associated with a cross-resistance to efavirenz was more frequent statistically when a thymidine nucleoside analog (zidovudine or stavudine) was used in the regimen (P = 0.02). In conclusion, 100% of patients developed cross-resistance to nevirapine and efavirenz after treatment by efavirenz and 80% after treatment by nevirapine. The use of a thymidine analog concomitantly with nevirapine leads to the preferential selection of cross-resistance NNRTI mutations.
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Mouroux M, Descamps D, Izopet J, Yvon A, Delaugerre C, Matheron S, Coutellier A, Valantin MA, Bonmarchand M, Agut H, Massip P, Costagliola D, Katlama C, Brun-Vezinet F, Calvez V. Low-rate emergence of thymidine analogue mutations and multi-drug resistance mutations in the HIV-1 reverse transcriptase gene in therapy-naive patients receiving stavudine plus lamivudine combination therapy. Antivir Ther 2001; 6:179-83. [PMID: 11808752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVES Mutations usually associated with zidovudine exposure have been observed in zidovudine-naive patients treated by stavudine in combination. These mutations were named thymidine analogue mutations (TAMs). This fact, combined with phenotypical and biochemical findings provided additional evidence for cross-resistance between zidovudine and stavudine. A recent genotypic study in naive patients receiving stavudine/didanosine combination showed emergence of TAMs and a multidrug-resistance mutation (MDR), Q151M, in 36 and 10% of cases, respectively. Stavudine plus lamivudine is one of the most used binucleoside associations in the antiretroviral combinations. The objective of this study was to assess the genotypic changes in the HIV-1 reverse transcriptase (RT) gene in antiretroviral-naive patients treated by stavudine plus lamivudine. METHODS We analysed the RT gene of 44 HIV-1 patients, naive of antiretroviral therapy, who were treated for 24 or 48 weeks with stavudine/lamivudine. RESULTS At the end of the follow-up, all patients acquired the lamivudine-associated mutation M184V. Only two subjects (4.5%) developed a TAM (T215Y; M41L), one subject developed a V75T/A mutation and one subject developed the particular MDR pattern F116Y, Q151M. CONCLUSIONS Our study clearly demonstrated that naive subjects treated with stavudine/lamivudine for 24-48 weeks selected a low rate of TAMs and MDR Q151M. One hypothesis explaining these results could be the development of the M184V mutation.
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Delaugerre C, Mouroux M, Yvon-Groussin A, Simon A, Angleraud F, Huraux JM, Agut H, Katlama C, Calvez V. Prevalence and conditions of selection of E44D/A and V118I human immunodeficiency virus type 1 reverse transcriptase mutations in clinical practice. Antimicrob Agents Chemother 2001; 45:946-8. [PMID: 11181387 PMCID: PMC90400 DOI: 10.1128/aac.45.3.946-948.2001] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Recently, it has been shown that a new mutational pattern (the E44D/A and/or V118I mutation) confers moderate phenotypic lamivudine resistance in the absence of the M184V mutation. The E44D/A and/or the V118I mutation does not exist in drug-naive patients, and the prevalence increases with the number of treatment regimens and lamivudine experience. The mutations can preexist in nucleoside-experienced but lamivudine-naive patients. They are always associated with zidovudine resistance-associated mutations, even in the absence of M184V. These mutations are more stable than the M184V substitution during antiretroviral treatment interruptions.
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