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Loubet P, Charpentier C, Visseaux B, Borbor A, Nuta C, Adu E, Chapplain JM, Baysah M, Tattevin P, Yazdanpanah Y, Descamps D. Prevalence of HIV-1 drug resistance among patients failing first-line ART in Monrovia, Liberia: a cross-sectional study. J Antimicrob Chemother 2015; 70:1881-4. [PMID: 25698771 DOI: 10.1093/jac/dkv030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/25/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the prevalence of acquired drug resistance in HIV-1-infected patients living in Monrovia, Liberia, who had clinical and/or immunological failure of first-line ART according to WHO criteria. PATIENTS AND METHODS Patients receiving ART for >1 year with clinical and/or immunological failure were included. Sequencing of protease and reverse transcriptase regions was performed using Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS) procedures and sequences were interpreted using the ANRS resistance algorithm. RESULTS Ninety patients were enrolled. They had been receiving ART for a median time of 42 months and half were receiving zidovudine/lamivudine/nevirapine. Seventy-five per cent of patients were infected with CRF02_AG. Twenty-seven per cent of patients displayed a plasma viral load <50 copies/mL. Among the 66 patients with detectable viraemia, the median viral load was 4.7 log10 copies/mL (IQR = 3.0-5.6). The prevalence of NRTI and NNRTI resistance-associated mutations (RAMs) was 63% and 71%, respectively; and the median number of NRTI and NNRTI RAMs was 2 and 3, respectively. Two patients (4%) displayed viruses with PI RAMs. Regarding NRTI drug resistance, 29%, 38%, 63%, 29% and 25% of patients had viruses resistant to zidovudine, stavudine, lamivudine/emtricitabine, abacavir and tenofovir, respectively. Regarding the NNRTI drug class, 56%, 65%, 33% and 42% of patients had viruses resistant to efavirenz, nevirapine, etravirine and rilpivirine, respectively. CONCLUSIONS The high prevalence of acquired drug resistance in patients followed in two centres of the Liberian capital city, documented after a median of 3 years on a first-line ART regimen, jeopardizes the activity of second-line regimens and highlights the need for virological monitoring in these settings.
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Affiliation(s)
- Paul Loubet
- Ensemble pour une Solidarité Thérapeutique en Réseau (GIP-ESTHER), Paris, France INSERM, IAME, UMR 1137, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Charlotte Charpentier
- INSERM, IAME, UMR 1137, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
| | - Benoit Visseaux
- INSERM, IAME, UMR 1137, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
| | - Abraham Borbor
- John F. Kennedy Medical Center, Infectious Diseases Clinic, Monrovia, Liberia
| | - Cecilia Nuta
- John F. Kennedy Medical Center, Infectious Diseases Clinic, Monrovia, Liberia
| | - Eric Adu
- John F. Kennedy Medical Center, Infectious Diseases Clinic, Monrovia, Liberia
| | - Jean-Marc Chapplain
- Centre Hospitalo-Universitaire de Rennes, Service de Maladies Infectieuses et Tropicales, Rennes, France
| | - Maima Baysah
- Redemption Hospital, Infectious Diseases Clinic, Monrovia, Liberia
| | - Pierre Tattevin
- Centre Hospitalo-Universitaire de Rennes, Service de Maladies Infectieuses et Tropicales, Rennes, France
| | - Yazdan Yazdanpanah
- INSERM, IAME, UMR 1137, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France
| | - Diane Descamps
- INSERM, IAME, UMR 1137, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France
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