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Marcelin AG, Charpentier C, Bellecave P, Abdi B, Chaix ML, Ferre V, Raymond S, Fofana D, Bocket L, Mirand A, Le Guillou-Guillemette H, Montes B, Amiel C, Pallier C, Fafi-Kremer S, De Monte A, Alessandri-Gradt E, Scholtes C, Maillard A, Jeulin H, Bouvier-Alias M, Roussel C, Dos Santos G, Signori-Schmuck A, Dina J, Vallet S, Stefic K, Soulié C, Calvez V, Descamps D, Flandre P. Factors associated with the emergence of integrase resistance mutations in patients failing dual or triple integrase inhibitor-based regimens in a French national survey. J Antimicrob Chemother 2021; 76:2400-2406. [PMID: 34100068 DOI: 10.1093/jac/dkab193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/11/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Successful 2-drug regimens (2DRs) for HIV were made possible by the availability of drugs combining potency and tolerability with a high genetic barrier to resistance. How these deal with resistance development/re-emergence, compared with 3DRs, is thus of paramount importance. MATERIALS AND METHODS A national survey including patients who were either naive or experienced with any 2DR or 3DR but failing integrase strand transfer inhibitor (INSTI)-containing regimens [two consecutive plasma viral load (VL) values >50 copies/mL] was conducted between 2014 and 2019. Genotypic resistance tests were interpreted with the v28 ANRS algorithm. RESULTS Overall, 1104 patients failing any INSTI-containing regimen (2DRs, n = 207; 3DRs, n = 897) were analysed. Five hundred and seventy-seven (52.3%) patients were infected with a B subtype and 527 (47.3%) with non-B subtypes. Overall, 644 (58%) patients showed no known integrase resistance mutations at failure. In multivariate analysis, factors associated with the emergence of at least one integrase mutation were: high VL at failure (OR = 1.24 per 1 log10 copies/mL increase); non-B versus B subtype (OR = 1.75); low genotypic sensitivity score (GSS) (OR = 0.10 for GSS = 2 versus GSS = 0-0.5); and dolutegravir versus raltegravir (OR = 0.46). Although 3DRs versus 2DRs reached statistical significance in univariate analysis (OR = 0.59, P = 0.007), the variable is not retained in the final model. CONCLUSIONS This study is one of the largest studies characterizing integrase resistance in patients failing any INSTI-containing 2DR or 3DR in routine clinical care and reveals factors associated with emergence of integrase resistance that should be taken into consideration in clinical management. No difference was evidenced between patients receiving a 2DR or a 3DR.
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Affiliation(s)
- Anne-Genevieve Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, laboratoire de virologie, F-75013 Paris, France
| | - Charlotte Charpentier
- Service de Virologie, Université de Paris INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude-Bernard, F-75018 Paris, France
| | - Pantxika Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, Univ. Bordeaux, CNRS UMR 5234, F-33076 Bordeaux, France
| | - Basma Abdi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, laboratoire de virologie, F-75013 Paris, France
| | - Marie-Laure Chaix
- INSERM U941, Université de Paris, Laboratoire de Virologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Virginie Ferre
- CHU Nantes, Laboratoire de Virologie, CIC INSERM 143, F-44093 Nantes, France
| | - Stephanie Raymond
- INSERM UMR 1291 Toulouse, F-31300 France and Laboratoire de Virologie, CHU Toulouse Purpan, F-31300 Toulouse, France
| | - Djeneba Fofana
- AP-HP, CHU Saint Antoine, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France
| | - Laurence Bocket
- Univ. Lille, CHU Lille, Laboratoire de Virologie, Lille, France
| | | | | | - Brigitte Montes
- Laboratoire de Virologie, CHU Montpellier, Univ Montpellier, France
| | | | | | | | | | | | - Caroline Scholtes
- INSERM U1052, CRCL, Université de Lyon, Laboratoire de Virologie, Lyon, France
| | - Anne Maillard
- Laboratoire de Virologie, CHU de Rennes, Rennes, France
| | - Helene Jeulin
- Laboratoire de Virologie, CHRU de Nancy Brabois, Vandoeuvre-lès-Nancy, France
| | | | | | | | | | - Julia Dina
- Normandie Univ, UNICAEN, UNIROUEN, GRAM 2.0, Caen University Hospital Department of Virology, F-14000, Caen, France
| | - Sophie Vallet
- Laboratoire de Virologie, CHRU de Brest, Brest, France
| | - Karl Stefic
- INSERM U1259, Université de Tours et Laboratoire de Virologie, CHRU de Tours, Tours, France
| | - Cathia Soulié
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, laboratoire de virologie, F-75013 Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, laboratoire de virologie, F-75013 Paris, France
| | - Diane Descamps
- CHU de Bordeaux, Laboratoire de Virologie, Univ. Bordeaux, CNRS UMR 5234, F-33076 Bordeaux, France
| | - Philippe Flandre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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Visseaux B, Assoumou L, Mahjoub N, Grude M, Trabaud MA, Raymond S, Wirden M, Morand-Joubert L, Roussel C, Montes B, Bocket L, Fafi-Kremer S, Amiel C, De Monte A, Stefic K, Pallier C, Tumiotto C, Maillard A, Vallet S, Ferre V, Bouvier-Alias M, Dina J, Signori-Schmuck A, Carles MJ, Plantier JC, Meyer L, Descamps D, Chaix ML. Surveillance of HIV-1 primary infections in France from 2014 to 2016: toward stable resistance, but higher diversity, clustering and virulence? J Antimicrob Chemother 2021; 75:183-193. [PMID: 31641777 DOI: 10.1093/jac/dkz404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/19/2019] [Accepted: 08/23/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Patients with primary HIV-1 infection (PHI) are a particular population, giving important insight about ongoing evolution of transmitted drug resistance-associated mutation (TDRAM) prevalence, HIV diversity and clustering patterns. We describe these evolutions of PHI patients diagnosed in France from 2014 to 2016. METHODS A total of 1121 PHI patients were included. TDRAMs were characterized using the 2009 Stanford list and the French ANRS algorithm. Viral subtypes and recent transmission clusters (RTCs) were also determined. RESULTS Patients were mainly MSM (70%) living in the Paris area (42%). TDRAMs were identified among 10.8% of patients and rose to 18.6% when including etravirine and rilpivirine TDRAMs. Prevalences of PI-, NRTI-, first-generation NNRTI-, second-generation NNRTI- and integrase inhibitor-associated TDRAMs were 2.9%, 5.0%, 4.0%, 9.4% and 5.4%, respectively. In a multivariable analysis, age >40 years and non-R5 tropic viruses were associated with a >2-fold increased risk of TDRAMs. Regarding HIV diversity, subtype B and CRF02_AG (where CRF stands for circulating recombinant form) were the two main lineages (56% and 20%, respectively). CRF02_AG was associated with higher viral load than subtype B (5.83 versus 5.40 log10 copies/mL, P=0.004). We identified 138 RTCs ranging from 2 to 14 patients and including overall 41% from the global population. Patients in RTCs were younger, more frequently born in France and more frequently MSM. CONCLUSIONS Since 2007, the proportion of TDRAMs has been stable among French PHI patients. Non-B lineages are increasing and may be associated with more virulent CRF02_AG strains. The presence of large RTCs highlights the need for real-time cluster identification to trigger specific prevention action to achieve better control of the epidemic.
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Affiliation(s)
- Benoit Visseaux
- IAME, Université de Paris, AP-HP, UMR 1137, INSERM, Virology, Hôpital Bichat, AP-HP, Paris, France.,Centre National de Référence VIH, Paris, France
| | - Lambert Assoumou
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | - Maxime Grude
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Marc Wirden
- CHU Pitié-Salpêtrière, Virology, Paris, France
| | - Laurence Morand-Joubert
- AP-HP, Hôpital Saint-Antoine, Laboratoire de virologie, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (iPLESP), Paris, France
| | | | | | | | | | | | | | - Karl Stefic
- INSERM U1259, Université de Tours, CHU Tours, Virology, Tours, France
| | | | | | | | | | | | | | | | | | | | - Jean-Christophe Plantier
- Normandie University, UNIROUEN Rouen, EA2656, Rouen University Hospital, Virology, Rouen, France
| | - Laurence Meyer
- INSERM SC10 US19, Villejuif, INSERM CESP U1018, Université Paris Sud, Université Paris Saclay, France
| | - Diane Descamps
- IAME, Université de Paris, AP-HP, UMR 1137, INSERM, Virology, Hôpital Bichat, AP-HP, Paris, France.,Centre National de Référence VIH, Paris, France
| | - Marie-Laure Chaix
- Centre National de Référence VIH, Paris, France.,Hopital Saint-Louis, Virology, Paris, France.,Université de Paris, INSERM U944, Paris, France
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3
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Assoumou L, Bocket L, Pallier C, Grude M, Ait-Namane R, Izopet J, Raymond S, Charpentier C, Visseaux B, Wirden M, Trabaud MA, Le Guillou-Guillemette H, Allaoui C, Henquell C, Krivine A, Dos Santos G, Delamare C, Bouvier-Alias M, Montes B, Ferre V, De Monte A, Signori-Schmuck A, Maillard A, Morand-Joubert L, Tumiotto C, Fafi-Kremer S, Amiel C, Barin F, Marque-Juillet S, Courdavault L, Vallet S, Beby-Defaux A, de Rougemont A, Fenaux H, Avettand-Fenoel V, Allardet-Servent A, Plantier JC, Peytavin G, Calvez V, Chaix ML, Descamps D. Stable prevalence of transmitted drug resistance mutations and increased circulation of non-B subtypes in antiretroviral-naive chronically HIV-infected patients in 2015/2016 in France. J Antimicrob Chemother 2020; 74:1417-1424. [PMID: 30753724 DOI: 10.1093/jac/dkz011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/27/2018] [Accepted: 12/31/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We estimated the prevalence of transmitted-drug-resistance-associated mutations (TDRAMs) in antiretroviral-naive chronically HIV-1-infected patients. PATIENTS AND METHODS TDRAMs were sought in samples from 660 diagnosed HIV-1-infected individuals in 2015/2016 in 33 HIV clinical centres. Weighted analyses, considering the number of patients followed in each centre, were used to derive representative estimates of the percentage of individuals with TDRAMs. Results were compared with those of the 2010/2011 survey (n = 661) using the same methodology. RESULTS At inclusion, median CD4 cell counts and plasma HIV-1 RNA were 394 and 350/mm3 (P = 0.056) and 4.6 and 4.6 log10 copies/mL (P = 0.360) in the 2010/2011 survey and the 2015/2016 survey, respectively. The frequency of non-B subtypes increased from 42.9% in 2010/2011 to 54.8% in 2015/2016 (P < 0.001), including 23.4% and 30.6% of CRF02_AG (P = 0.004). The prevalence of virus with protease or reverse-transcriptase TDRAMs was 9.0% (95% CI = 6.8-11.2) in 2010/2011 and 10.8% (95% CI = 8.4-13.2) in 2015/2016 (P = 0.269). No significant increase was observed in integrase inhibitor TDRAMs (6.7% versus 9.2%, P = 0.146). Multivariable analysis showed that men infected with the B subtype were the group with the highest risk of being infected with a resistant virus compared with others (adjusted OR = 2.2, 95% CI = 1.3-3.9). CONCLUSIONS In France in 2015/2016, the overall prevalence of TDRAMs was 10.8% and stable compared with 9.0% in the 2010/2011 survey. Non-B subtypes dramatically increased after 2010. Men infected with B subtype were the group with the highest risk of being infected with a resistant virus, highlighting the need to re-emphasize safe sex messages.
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Affiliation(s)
- Lambert Assoumou
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Maxime Grude
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Rachid Ait-Namane
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Charlotte Charpentier
- Hopital Bichat Claude Bernard, Virology, Paris, France.,Univ Paris-Diderot, INSERM UMR 1137, CNR VIH, Paris, France
| | - Benoit Visseaux
- Hopital Bichat Claude Bernard, Virology, Paris, France.,Univ Paris-Diderot, INSERM UMR 1137, CNR VIH, Paris, France
| | - Marc Wirden
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,CHU Pitié-Salpêtrière, Virology, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laurence Morand-Joubert
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Hopital Saint-Antoine, Virology, Paris, France.,Sorbonne Université, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Véronique Avettand-Fenoel
- CHU Necker-Enfants Malades, Virology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | | | - Gilles Peytavin
- Univ Paris-Diderot, INSERM UMR 1137, CNR VIH, Paris, France.,Hopital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, Paris, France
| | - Vincent Calvez
- INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,CHU Pitié-Salpêtrière, Virology, Paris, France.,Sorbonne Université, Paris, France
| | | | - Diane Descamps
- Hopital Bichat Claude Bernard, Virology, Paris, France.,Univ Paris-Diderot, INSERM UMR 1137, CNR VIH, Paris, France
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4
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Marcelin AG, Grude M, Charpentier C, Bellecave P, Le Guen L, Pallier C, Raymond S, Mirand A, Bocket L, Fofana DB, Delaugerre C, Nguyen T, Montès B, Jeulin H, Mourez T, Fafi-Kremer S, Amiel C, Roussel C, Dina J, Trabaud MA, Le Guillou-Guillemette H, Vallet S, Signori-Schmuck A, Maillard A, Ferre V, Descamps D, Calvez V, Flandre P. Resistance to integrase inhibitors: a national study in HIV-1-infected treatment-naive and -experienced patients. J Antimicrob Chemother 2020; 74:1368-1375. [PMID: 30789205 DOI: 10.1093/jac/dkz021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To describe integrase strand transfer inhibitor (INSTI) resistance profiles and factors associated with resistance in antiretroviral-naive and -experienced patients failing an INSTI-based regimen in clinical practice. METHODS Data were collected from patients failing an INSTI-containing regimen in a multicentre French study between 2014 and 2017. Failure was defined as two consecutive plasma viral loads (VL) >50 copies/mL. Reverse transcriptase, protease and integrase coding regions were sequenced at baseline and failure. INSTI resistance-associated mutations (RAMs) included in the Agence Nationale de Recherches sur le SIDA genotypic algorithm were investigated. RESULTS Among the 674 patients, 359 were failing on raltegravir, 154 on elvitegravir and 161 on dolutegravir therapy. Overall, 90% were experienced patients and 389 (58%) patients showed no INSTI RAMs at failure. The strongest factors associated with emergence of at least one INSTI mutation were high VL at failure (OR = 1.2 per 1 log10 copies/mL increase) and low genotypic sensitivity score (GSS) (OR = 0.08 for GSS ≥3 versus GSS = 0-0.5). Patients failing dolutegravir also had significantly fewer INSTI RAMs at failure than patients failing raltegravir (OR = 0.57, P = 0.02) or elvitegravir (OR = 0.45, P = 0.005). Among the 68 patients failing a first-line regimen, 11/41 (27%) patients on raltegravir, 7/18 (39%) on elvitegravir and 0/9 on dolutegravir had viruses with emergent INSTI RAMs at failure. CONCLUSIONS These results confirmed the robustness of dolutegravir regarding resistance selection in integrase in the case of virological failure in routine clinical care.
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Affiliation(s)
- Anne-Genevieve Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Maxime Grude
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Charlotte Charpentier
- INSERM, IAME, UMR 1137, F-75018 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France; AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Pantxika Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, Université Bordeaux, CNRS UMR 5234, Bordeaux, France
| | - Laura Le Guen
- CHU de Nantes, Laboratoire de Virologie, Nantes, France
| | | | - Stéphanie Raymond
- INSERM U1043 Toulouse, F-31300 France and Laboratoire de Virologie, CHU Toulouse Purpan, Toulouse, France
| | | | | | - Djeneba Bocar Fofana
- Sorbonne Université, INSERM, Institut Pierre Louis, d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Saint Antoine, Service de Virologie, Paris, France
| | | | - Thuy Nguyen
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | | | - Hélène Jeulin
- Laboratoire de Virologie, CHRU de Nancy Brabois, Vandoeuvre-lès-Nancy, France
| | | | | | | | | | | | | | | | | | | | | | - Virginie Ferre
- CHU Nantes, Laboratoire de Virologie, CIC INSERM 143, Nantes, France
| | - Diane Descamps
- INSERM, IAME, UMR 1137, F-75018 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France; AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Philippe Flandre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
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5
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Raymond S, Nicot F, Pallier C, Bellecave P, Maillard A, Trabaud MA, Morand-Joubert L, Rodallec A, Amiel C, Mourez T, Bocket L, Beby-Defaux A, Bouvier-Alias M, Lambert-Niclot S, Charpentier C, Malve B, Mirand A, Dina J, Le Guillou-Guillemette H, Marque-Juillet S, Signori-Schmuck A, Barin F, Si-Mohamed A, Avettand Fenoel V, Roussel C, Calvez V, Saune K, Marcelin AG, Rodriguez C, Descamps D, Izopet J. Impact of Human Immunodeficiency Virus Type 1 Minority Variants on the Virus Response to a Rilpivirine-Based First-line Regimen. Clin Infect Dis 2019; 66:1588-1594. [PMID: 29244143 DOI: 10.1093/cid/cix1070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/12/2017] [Indexed: 12/11/2022] Open
Abstract
Background Minority resistant variants of human immunodeficiency virus type 1 (HIV-1) could influence the virological response to treatment based on nonnucleoside reverse transcriptase inhibitors (NNRTIs). Data on minority rilpivirine-resistant variants are scarce. This study used next-generation sequencing (NGS) to identify patients harboring minority resistant variants to nucleos(t)ide reverse transcriptase inhibitors and NNRTIs and to assess their influence on the virological response (VR). Methods All the subjects, 541 HIV-1-infected patients started a first-line regimen containing rilpivirine. VR was defined as a HIV-1 RNA load <50 copies/mL at month 6 with continued suppression at month 12. NGS was performed at baseline (retrospectively) on the 454 GS-FLX platform (Roche). Results NGS revealed resistance-associated mutations accounting for 1% to <5% of variants in 17.2% of samples, for 5%-20% in 5.7% of samples, and for >20% in 29% of samples. We identified 43 (8.8%) and 36 (7.4%) patients who harbored rilpivirine-resistant variants with a 1% sensitivity threshold according to the French National Agency for Research on AIDS and Viral Hepatitis and Stanford algorithms, respectively. The VR was 96.9% at month 12. Detection of minority rilpivirine resistant variants was not associated with virological failure (VF). Multivariate analysis indicated that VF at month 12 was associated with a CD4 count <250 cells/µL at baseline, a slower decrease in viral load at month 3, and rilpivirine resistance at baseline using the Stanford algorithm with a 20% threshold. Conclusions Minority resistant variants had no impact on the VR of treatment-naive patients to a rilpivirine-based regimen.
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Affiliation(s)
- Stéphanie Raymond
- Institut national de la santé et de la recherche médicale (INSERM).,Université de Toulouse, Université Paul Sabatier, Physiopathology Center of Toulouse-Purpan
| | - Florence Nicot
- Laboratoire de Virologie, Centre Hospitalier Universitaire (CHU) de Toulouse
| | | | | | | | - Mary Anne Trabaud
- Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
| | | | | | | | | | | | | | | | | | - Charlotte Charpentier
- Infection, Antimicrobials, Modelling, Evolution, Unité Mixte de Recherche 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris.,Laboratoire de Virologie, Hôpital Bichat-Claude Bernard
| | | | | | | | | | | | | | | | | | | | | | - Vincent Calvez
- Laboratoire de Virologie, Hôpital de la Pitié-Salpêtrière
| | - Karine Saune
- Institut national de la santé et de la recherche médicale (INSERM).,Université de Toulouse, Université Paul Sabatier, Physiopathology Center of Toulouse-Purpan
| | | | | | - Diane Descamps
- Infection, Antimicrobials, Modelling, Evolution, Unité Mixte de Recherche 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris.,Laboratoire de Virologie, Hôpital Bichat-Claude Bernard
| | - Jacques Izopet
- Institut national de la santé et de la recherche médicale (INSERM).,Université de Toulouse, Université Paul Sabatier, Physiopathology Center of Toulouse-Purpan
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6
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Wirden M, De Oliveira F, Bouvier-Alias M, Lambert-Niclot S, Chaix ML, Raymond S, Si-Mohammed A, Alloui C, André-Garnier E, Bellecave P, Malve B, Mirand A, Pallier C, Poveda JD, Rabenja T, Schneider V, Signori-Schmuck A, Stefic K, Calvez V, Descamps D, Plantier JC, Marcelin AG, Visseaux B. New HIV-1 circulating recombinant form 94: from phylogenetic detection of a large transmission cluster to prevention in the age of geosocial-networking apps in France, 2013 to 2017. Euro Surveill 2019; 24:1800658. [PMID: 31576801 PMCID: PMC6774227 DOI: 10.2807/1560-7917.es.2019.24.39.1800658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundEnding the HIV pandemic must involve new tools to rapidly identify and control local outbreaks and prevent the emergence of recombinant strains with epidemiological advantages.AimThis observational study aimed to investigate in France a cluster of HIV-1 cases related to a new circulating recombinant form (CRF). The confirmation this CRF's novelty as well as measures to control its spread are presented.MethodsPhylogenetic analyses of HIV sequences routinely generated for drug resistance genotyping before 2018 in French laboratories were employed to detect the transmission chain. The CRF involved was characterised by almost full-length viral sequencing for six cases. Cases' clinical data were reviewed. Where possible, epidemiological information was collected with a questionnaire.ResultsThe transmission cluster comprised 49 cases, mostly diagnosed in 2016-2017 (n = 37). All were infected with a new CRF, CRF94_cpx. The molecular proximity of this CRF to X4 strains and the high median viraemia, exceeding 5.0 log10 copies/mL, at diagnosis, even in chronic infection, raise concerns of enhanced virulence. Overall, 41 cases were diagnosed in the Ile-de-France region and 45 were men who have sex with men. Among 24 cases with available information, 20 reported finding partners through a geosocial networking app. Prevention activities in the area and population affected were undertaken.ConclusionWe advocate the systematic use of routinely generated HIV molecular data by a dedicated reactive network, to improve and accelerate targeted prevention interventions. Geosocial networking apps can play a role in the spread of outbreaks, but could also deliver local targeted preventive alerts.
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Affiliation(s)
- Marc Wirden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - Fabienne De Oliveira
- Normandie Université, UNIROUEN, EA2656 GRAM, CHU de Rouen, Laboratoire de virologie associé au CNR VIH, Rouen, France
| | | | | | - Marie-Laure Chaix
- AP-HP, Hôpital Saint-Louis, Laboratoire de virologie, INSERM U944, Paris, France
| | | | | | - Chakib Alloui
- Laboratoire de virologie, Hôpital Avicenne, Bobigny, France
| | | | | | - Brice Malve
- Laboratoire de virologie CHU de Nancy, Nancy, France
| | - Audrey Mirand
- Laboratoire de virologie CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Coralie Pallier
- Laboratoire de virologie, Hôpital P. Brousse, Villejuif, France
| | | | - Theresa Rabenja
- Laboratoire du Grand Hôpital de l’Est Francilien, Jossigny, France
| | | | | | - Karl Stefic
- Laboratoire de virologie CHU de Tours, Tours, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - Diane Descamps
- Laboratoire de virologie, AP-HP, Hopital Bichat Claude Bernard, Univ Paris-Diderot, INSERM, IAME, CNR VIH, Paris, France
| | - Jean-Christophe Plantier
- Normandie Université, UNIROUEN, EA2656 GRAM, CHU de Rouen, Laboratoire de virologie associé au CNR VIH, Rouen, France
| | - Anne-Genevieve Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - Benoit Visseaux
- Laboratoire de virologie, AP-HP, Hopital Bichat Claude Bernard, Univ Paris-Diderot, INSERM, IAME, CNR VIH, Paris, France
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7
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Charpentier C, Malet I, Andre-Garnier E, Storto A, Bocket L, Amiel C, Morand-Joubert L, Tumiotto C, Nguyen T, Maillard A, Rodallec A, Leoz M, Montes B, Schneider V, Plantier JC, Dina J, Pallier C, Mirand A, Roussel C, Signori-Schmuck A, Raymond S, Calvez V, Delaugerre C, Marcelin AG, Descamps D. Phenotypic analysis of HIV-1 E157Q integrase polymorphism and impact on virological outcome in patients initiating an integrase inhibitor-based regimen. J Antimicrob Chemother 2019; 73:1039-1044. [PMID: 29342281 DOI: 10.1093/jac/dkx511] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/07/2017] [Indexed: 01/09/2023] Open
Abstract
Objectives To assess the phenotypic susceptibility of the E157Q polymorphism in HIV-1 integrase (IN) and the virological outcome of patients infected with E157Q-mutated virus initiating an IN inhibitor (INI)-based regimen. Methods This was a multicentre study assessing IN sequences from INI-naive patients among 17 French HIV clinical centres. E157Q site-directed mutants in pNL4.3 and pCRF02_AG contexts were assessed in a recombinant phenotypic assay. Results Prevalence of the E157Q polymorphism was 2.7% among 8528 IN sequences from INI-naive patients and its distribution was 1.7%, 5.6% and 2.2% in B, CRF02_AG and various non-B subtypes, respectively. Thirty-nine INI-naive patients with E157Q-mutated virus initiated an INI-based regimen. Among them, 15 had a viral load (VL) <50 copies/mL at initiation and virological suppression was maintained during the first year of follow-up in all but two exhibiting a viral blip. Twenty-four patients had a VL > 50 copies/mL at the time of INI-based regimen initiation. Among them eight were receiving a first-line regimen and the only two patients who did not reach VL < 50 copies/mL at week 24 were receiving elvitegravir. The 16 remaining patients were ART experienced in virological failure with drug-resistant viruses displaying several virological outcomes independently of the genotypic susceptibility score. Phenotypic analyses showed a fold change in EC50 of 0.6, 0.9 and 1.9 for raltegravir, dolutegravir and elvitegravir, respectively, in a subtype B context, and 1.1, 1.9 and 2.4 for raltegravir, dolutegravir and elvitegravir, respectively, in a CRF02_AG context. Conclusions Assessment of virological response in 39 patients initiating an INI-based regimen with E157Q-mutated virus, in combination with phenotypic analysis, suggests that particular attention should be paid to antiretroviral-naive patients and dolutegravir should be preferentially used in these patients.
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Affiliation(s)
- Charlotte Charpentier
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Isabelle Malet
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,AP-HP, Laboratoire de Virologie, Hôpital La Pitié Salpêtrière, Paris, France
| | | | - Alexandre Storto
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | | | - Corinne Amiel
- Hôpital Tenon, Laboratoire de Virologie, Paris, France
| | - Laurence Morand-Joubert
- Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France; AP-HP, Centre Hospitalo-Universitaire Saint-Antoine, Laboratoire de Virologie, F-75012, Paris, France
| | | | - Thuy Nguyen
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,AP-HP, Laboratoire de Virologie, Hôpital La Pitié Salpêtrière, Paris, France
| | - Anne Maillard
- CHU Rennes, Laboratoire de Virologie, Rennes, France
| | | | - Marie Leoz
- CHU Rouen, Laboratoire de Virologie, Rouen, France
| | - Brigitte Montes
- CHU Montpellier, Laboratoire de Virologie, Montpellier, France
| | | | | | - Julia Dina
- CHU Caen, Laboratoire de Virologie, Caen, France
| | - Coralie Pallier
- Hôpital Paul Brousse, Laboratoire de Virologie, Villejuif, France
| | - Audrey Mirand
- CHU Clermont-Ferrand, Laboratoire de Virologie, Clermont-Ferrand, France
| | | | | | | | - Vincent Calvez
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,AP-HP, Laboratoire de Virologie, Hôpital La Pitié Salpêtrière, Paris, France
| | | | - Anne-Geneviève Marcelin
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,AP-HP, Laboratoire de Virologie, Hôpital La Pitié Salpêtrière, Paris, France
| | - Diane Descamps
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
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8
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Soulie C, Grudé M, Descamps D, Amiel C, Morand-Joubert L, Raymond S, Pallier C, Bellecave P, Reigadas S, Trabaud MA, Delaugerre C, Montes B, Barin F, Ferré V, Jeulin H, Alloui C, Yerly S, Signori-Schmuck A, Guigon A, Fafi-Kremer S, Haïm-Boukobza S, Mirand A, Maillard A, Vallet S, Roussel C, Assoumou L, Calvez V, Flandre P, Marcelin AG. Antiretroviral-treated HIV-1 patients can harbour resistant viruses in CSF despite an undetectable viral load in plasma. J Antimicrob Chemother 2018; 72:2351-2354. [PMID: 28472307 DOI: 10.1093/jac/dkx128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/03/2017] [Indexed: 11/14/2022] Open
Abstract
Background HIV therapy reduces the CSF HIV RNA viral load (VL) and prevents disorders related to HIV encephalitis. However, these brain disorders may persist in some cases. A large population of antiretroviral-treated patients who had a VL > 1.7 log 10 copies/mL in CSF with detectable or undetectable VL in plasma associated with cognitive impairment was studied, in order to characterize discriminatory factors of these two patient populations. Methods Blood and CSF samples were collected at the time of neurological disorders for 227 patients in 22 centres in France and 1 centre in Switzerland. Genotypic HIV resistance tests were performed on CSF. The genotypic susceptibility score was calculated according to the last Agence Nationale de Recherche sur le Sida et les hépatites virales Action Coordonnée 11 (ANRS AC11) genotype interpretation algorithm. Results Among the 227 studied patients with VL > 1.7 log 10 copies/mL in CSF, 195 had VL detectable in plasma [median (IQR) HIV RNA was 3.7 (2.7-4.7) log 10 copies/mL] and 32 had discordant VL in plasma (VL < 1.7 log 10 copies/mL). The CSF VL was lower (median 2.8 versus 4.0 log 10 copies/mL; P < 0.001) and the CD4 cell count was higher (median 476 versus 214 cells/mm 3 ; P < 0.001) in the group of patients with VL < 1.7 log 10 copies/mL in plasma compared with patients with plasma VL > 1.7 log 10 copies/mL. Resistance to antiretrovirals was observed in CSF for the two groups of patients. Conclusions Fourteen percent of this population of patients with cognitive impairment and detectable VL in CSF had well controlled VL in plasma. Thus, it is important to explore CSF HIV (VL and genotype) even if the HIV VL is controlled in plasma because HIV resistance may be observed.
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Affiliation(s)
- Cathia Soulie
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France.,AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
| | - Maxime Grudé
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | - Diane Descamps
- IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Corinne Amiel
- Laboratoire de Virologie, AP-HP, Hôpital Tenon, Paris, France
| | - Laurence Morand-Joubert
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France.,Laboratoire de Virologie, AP-HP, CHU Saint Antoine, Paris, France
| | | | - Coralie Pallier
- CHU Paul Brousse, Laboratoire de Virologie, Villejuif, France
| | - Pantxika Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, F-33000 Bordeaux, France.,Univ. Bordeaux, CNRS UMR 5234, F-33000 Bordeaux, France
| | - Sandrine Reigadas
- CHU de Bordeaux, Laboratoire de Virologie, F-33000 Bordeaux, France.,Univ. Bordeaux, CNRS UMR 5234, F-33000 Bordeaux, France
| | | | - Constance Delaugerre
- INSERM U941-Université Paris Diderot, Sorbonne Paris Cité, INSERM, F-75010 Paris, France.,AP-HP, Hôpital Saint-Louis, Laboratoire de Virologie, F-75010 Paris, France
| | | | | | | | - Hélène Jeulin
- Laboratoire de Virologie, CHU de Nancy Brabois, Vandoeuvre les Nancy, France.,EA 7300, Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy, France
| | | | - Sabine Yerly
- Laboratory of Virology, Geneva University Hospitals, Switzerland
| | | | | | | | | | | | | | | | | | - Lambert Assoumou
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | - Vincent Calvez
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France.,AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
| | - Philippe Flandre
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Universités, UPMC Univ. Paris 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France.,INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France.,AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
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9
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Soulie C, Morand-Joubert L, Cottalorda J, Charpentier C, Bellecave P, Le Guen L, Yerly S, Montes B, Fafi-Kremer S, Dina J, Avettand-Fenoel V, Amiel C, Roussel C, Pallier C, Zafilaza K, Sayon S, Signori-Schmuck A, Mirand A, Trabaud MA, Berger S, Calvez V, Marcelin AG. Performance of genotypic algorithms for predicting tropism for HIV-1 CRF01_AE recombinant. J Clin Virol 2018; 99-100:57-60. [PMID: 29331843 DOI: 10.1016/j.jcv.2017.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/04/2017] [Accepted: 12/28/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES There is no consensus about the performances of genotypic rules for predicting HIV-1 non-B subtype tropism. Three genotypic methods were compared for CRF01_AE HIV-1 tropism determination. METHODS The V3 env region of 207 HIV-1 CRF01_AE and 178 B subtypes from 17 centers in France and 1 center in Switzerland was sequenced. Tropism was determined by Geno2Pheno algorithm with false positive rate (FPR) 5% or 10%, the 11/25 rule or the combined criteria of the 11/25, net charge rule and NXT/S mutations. RESULTS Overall, 72.5%, 59.4%, 86.0%, 90.8% of the 207 HIV-1 CRF01_AE were R5-tropic viruses determined by Geno2pheno FPR5%, Geno2pheno FPR10%, the combined criteria and the 11/25 rule, respectively. A concordance of 82.6% was observed between Geno2pheno FPR5% and the combined criteria for CRF01_AE. The results were nearly similar for the comparison between Geno2pheno FPR5% and the 11/25 rule. More mismatches were observed when Geno2pheno was used with the FPR10%. Neither HIV viral load, nor current or nadir CD4 was associated with the discordance rate between the different algorithms. CONCLUSION Geno2pheno predicted more X4-tropic viruses for this set of CRF01_AE sequences than the combined criteria or the 11/25 rule alone. For a conservative approach, Geno2pheno FPR5% seems to be a good compromise to predict CRF01_AE tropism.
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Affiliation(s)
- C Soulie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France.
| | - L Morand-Joubert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Saint Antoine, Service de Virologie, Paris, France
| | | | - C Charpentier
- IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, INSERM, AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - P Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, Univ. Bordeaux, CNRS UMR 5234, Bordeaux, France
| | - L Le Guen
- Laboratoire de virologie, CHU, Nantes, France
| | - S Yerly
- Laboratory of Virology, Geneva University Hospitals, Switzerland
| | - B Montes
- Laboratoire de Virologie, CHU, Montpellier, France
| | | | - J Dina
- Laboratoire de virologie, CHU, Caen, France
| | - V Avettand-Fenoel
- AP-HP, Laboratoire de Virologie, Hôpital Necker, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA7327, France
| | - C Amiel
- AP-HP, Laboratoire de Virologie, Hôpital Tenon, Paris, France
| | | | | | - K Zafilaza
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - S Sayon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | | | | | - M A Trabaud
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Berger
- Laboratoire de Virologie, CHU de Nancy Brabois, EA 7300, Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - A G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
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10
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Epaulard O, Signori-Schmuck A, Larrat S, Kulkarni O, Blum MG, Fusillier K, Blanc M, Leclercq P, François O, Morand P. Ultradeep sequencing of B and non-B HIV-1 subtypes: Viral diversity and drug resistance mutations before and after one month of antiretroviral therapy in naive patients. J Clin Virol 2017; 95:13-19. [PMID: 28830014 DOI: 10.1016/j.jcv.2017.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 05/14/2016] [Revised: 04/06/2017] [Accepted: 07/21/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ultradeep pyrosequencing technologies permit an assessment of the genetic diversity and the presence and frequency of minority variants in a viral population. The effect of these parameters on the outcome of highly active antiretroviral therapy (HAART) in HIV-infected patients is poorly understood. OBJECTIVES The present study used the pyrosequencing Roche 454 prototype assay to determine whether antiretroviral efficacy is correlated with viral diversity and minority drug resistance mutations in HIV-infected treatment-naive patients and to compare assay performance in B and non-B subtypes. STUDY DESIGN The study included 30 HIV-1 infected naive patients (20 with subtype non-B and 10 with subtype B). Ultradeep pyrosequencing of protease and reverse transcriptase genes was performed at baseline and 1 month after HAART initiation. Plasma HIV VL was measured at 0 and after 1, 3, and 6 months of HAART. RESULTS Pre-HAART minority drug resistance mutations were observed to NRTI in 4 patients, to NNRTI in 6 patients, and to PI in 1 patient; there was no difference in HAART-induced VL decay between patients. Pre-HAART diversity was significantly correlated with the time elapsed since HIV-1 infection diagnosis, but not with the subtype, VL, or CD4 count. Patients with an undetectable VL after 3 months of HAART had a higher pre-HAART diversity. Pre- and post-HAART diversities were not statistically different. There was no difference in assay performance between subtype B and non-B. CONCLUSIONS A high pre-HAART viral diversity might have a positive effect on the outcome of HAART. Pre-therapeutic minority drug resistance mutations are uncommon in naive patients.
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Affiliation(s)
- Olivier Epaulard
- Infectious Disease Unit, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France; Team "HIV and human persistent viruses", Institut de Biologie Structurale, UMR5075 CNRS-CEA-UGA, Grenoble, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France.
| | - Anne Signori-Schmuck
- Team "HIV and human persistent viruses", Institut de Biologie Structurale, UMR5075 CNRS-CEA-UGA, Grenoble, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France; Virology Laboratory, Infectious Agents Department, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France
| | - Sylvie Larrat
- Team "HIV and human persistent viruses", Institut de Biologie Structurale, UMR5075 CNRS-CEA-UGA, Grenoble, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France; Virology Laboratory, Infectious Agents Department, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France
| | - Om Kulkarni
- Computational and Mathematical Biology, TIMC-IMAG UMR 5525 UJF-INPG-CNRS, Domaine de la Merci, 38706 La Tronche Cedex, France
| | - Michael G Blum
- Computational and Mathematical Biology, TIMC-IMAG UMR 5525 UJF-INPG-CNRS, Domaine de la Merci, 38706 La Tronche Cedex, France
| | - Katia Fusillier
- Virology Laboratory, Infectious Agents Department, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France
| | - Myriam Blanc
- Infectious Disease Unit, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France
| | - Pascale Leclercq
- Infectious Disease Unit, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France
| | - Olivier François
- Computational and Mathematical Biology, TIMC-IMAG UMR 5525 UJF-INPG-CNRS, Domaine de la Merci, 38706 La Tronche Cedex, France
| | - Patrice Morand
- Team "HIV and human persistent viruses", Institut de Biologie Structurale, UMR5075 CNRS-CEA-UGA, Grenoble, France; Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, France; Virology Laboratory, Infectious Agents Department, Centre Hospitalier Universitaire Grenoble Alpes, CS10217, 38043 Grenoble Cedex 9, France
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11
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Le Guillou-Guillemette H, Pivert A, Bouthry E, Henquell C, Petsaris O, Ducancelle A, Veillon P, Vallet S, Alain S, Thibault V, Abravanel F, Rosenberg AA, André-Garnier E, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F, Lemaire C. Natural non-homologous recombination led to the emergence of a duplicated V3-NS5A region in HCV-1b strains associated with hepatocellular carcinoma. PLoS One 2017; 12:e0174651. [PMID: 28394908 PMCID: PMC5386276 DOI: 10.1371/journal.pone.0174651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/13/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The emergence of new strains in RNA viruses is mainly due to mutations or intra and inter-genotype homologous recombination. Non-homologous recombinations may be deleterious and are rarely detected. In previous studies, we identified HCV-1b strains bearing two tandemly repeated V3 regions in the NS5A gene without ORF disruption. This polymorphism may be associated with an unfavorable course of liver disease and possibly involved in liver carcinogenesis. Here we aimed at characterizing the origin of these mutant strains and identifying the evolutionary mechanism on which the V3 duplication relies. METHODS Direct sequencing of the entire NS5A and E1 genes was performed on 27 mutant strains. Quasispecies analyses in consecutive samples were also performed by cloning and sequencing the NS5A gene for all mutant and wild strains. We analyzed the mutant and wild-type sequence polymorphisms using Bayesian methods to infer the evolutionary history of and the molecular mechanism leading to the duplication-like event. RESULTS Quasispecies were entirely composed of exclusively mutant or wild-type strains respectively. Mutant quasispecies were found to have been present since contamination and had persisted for at least 10 years. This V3 duplication-like event appears to have resulted from non-homologous recombination between HCV-1b wild-type strains around 100 years ago. The association between increased liver disease severity and these HCV-1b mutants may explain their persistence in chronically infected patients. CONCLUSIONS These results emphasize the possible consequences of non-homologous recombination in the emergence and severity of new viral diseases.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Adeline Pivert
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Elise Bouthry
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | | | - Odile Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Pascal Veillon
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Sophie Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | | | | | - Florence Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Arielle A. Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, Paris, France
| | | | | | - Yazid Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France
| | - Pascale Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France
| | - Patrice André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France
| | | | | | - Sylvie Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Anne Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Hénia Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | | | | | | | | | - Jacques Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Christopher Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Françoise Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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Le Guillou-Guillemette H, Ducancelle A, Bertrais S, Lemaire C, Pivert A, Veillon P, Bouthry E, Alain S, Thibault V, Abravanel F, Rosenberg AR, Henquell C, André-Garnier E, Petsaris O, Vallet S, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F. Identification of a duplicated V3 domain in NS5A associated with cirrhosis and hepatocellular carcinoma in HCV-1b patients. J Clin Virol 2015. [PMID: 26209408 DOI: 10.1016/j.jcv.2015.06.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The NS5A protein of the hepatitis C virus has been shown to be involved in the development of hepatocellular carcinoma. OBJECTIVES In a French multicenter study, we investigated the clinical and epidemiological features of a new HCV genotype 1b strain bearing a wide insertion into the V3 domain. STUDY DESIGN We studied NS5A gene sequences in 821 French patients infected with genotype 1b HCV. RESULTS We identified an uncharacterized V3 insertion without ORF disruption in 3.05% of the HCV sequences. The insertion comprised 31 amino-acids for the majority of patients; 3 patients had 27 amino-acids insertions and 1 had a 12 amino-acids insertion. Sequence identity between the 31 amino-acids insertions and the V3 domain ranged from 48 to 96% with E-values above 4e(-5), thus illustrating sequence homology and a partial gene duplication event that to our knowledge has never been reported in HCV. Moreover we showed the presence of the duplication at the time of infection and its persistence at least during 12 years in the entire quasispecies. No association was found with extrahepatic diseases. Conversely, patients with cirrhosis were two times more likely to have HCV with this genetic characteristic (p=0.04). Moreover, its prevalence increased with liver disease severity (from 3.0% in patients without cirrhosis to 9.4% in patients with both cirrhosis and HCC, p for trend=0.045). CONCLUSIONS We identified a duplicated V3 domain in the HCV-1b NS5A protein for the first time. The duplication may be associated with unfavorable evolution of liver disease including a possible involvement in liver carcinogenesis.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - A Ducancelle
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - C Lemaire
- IRHS, PRES LUNAM, SFR QUASAV, Angers, France.
| | - A Pivert
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - P Veillon
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - E Bouthry
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Alain
- Laboratoire de Virologie, CHU Limoges, France.
| | - V Thibault
- Laboratoire de Virologie, CHU Pitié-Salpêtrière, Paris, France.
| | - F Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - A R Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, EA 4474 "Hepatitis C Virology", Paris, France.
| | - C Henquell
- Laboratoire de Virologie, CHU Clermont-Ferrand, France.
| | | | - O Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - S Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - J B Bour
- Laboratoire de Virologie, CHU, Dijon, France.
| | - Y Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France.
| | - P Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France.
| | - P André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France.
| | - C Gaudy-Graffin
- Université François Rabelais, Inserm U966, CHU Tours, France.
| | - D Bettinger
- Laboratoire de Virologie, CHU Besançon, France.
| | - S Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - A Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - H Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - B Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - G Lagathu
- Laboratoire de Virologie, CHU Rennes, France.
| | | | - F Stoll-Keller
- Institut de Virologie, CHU Strasbourg, Inserm U748, Strasbourg, France.
| | - J M Pawlotsky
- Laboratoire de Virologie-Bactériologie, CHU Henri-Mondor, Créteil, France.
| | - J Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - C Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - F Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
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Raymond S, Maillard A, Amiel C, Peytavin G, Trabaud MA, Desbois D, Bellecave P, Delaugerre C, Soulie C, Marcelin AG, Descamps D, Izopet J, the ANRS ACll Resistance Study Group, Reigadas S, Bellecave P, Pinson-Recordon P, Fleury H, Masquelier B, Signori-Schmuck A, Morand P, Bocket L, Mouna L, Andre P, Tardy JC, Trabaud MA, Descamps D, Charpentier C, Peytavin G, Brun-Vezinet F, Haim-Boukobza S, Roques AM, Soulie C, Lambert-Niclot S, Malet I, Wirden M, Fourati S, Marcelin AG, Calvez V, Flandre P, Assoumou L, Costagliola D, Morand-Joubert L, Delaugerre C, Schneider V, Amiel C, Giraudeau G, Maillard A, Nicot F, Izopet J. Virological failure of patients on maraviroc-based antiretroviral therapy. J Antimicrob Chemother 2015; 70:1858-64. [DOI: 10.1093/jac/dkv026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 01/25/2015] [Indexed: 11/14/2022] Open
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14
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Fourati S, Charpentier C, Amiel C, Morand-Joubert L, Reigadas S, Trabaud MA, Delaugerre C, Nicot F, Rodallec A, Maillard A, Mirand A, Jeulin H, Montès B, Barin F, Bettinger D, Le Guillou-Guillemette H, Vallet S, Signori-Schmuck A, Descamps D, Calvez V, Flandre P, Marcelin AG. Cross-resistance to elvitegravir and dolutegravir in 502 patients failing on raltegravir: a French national study of raltegravir-experienced HIV-1-infected patients. J Antimicrob Chemother 2015; 70:1507-12. [PMID: 25558077 DOI: 10.1093/jac/dku535] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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: 09/02/2014] [Accepted: 12/01/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objectives of this study were to determine the prevalence and patterns of resistance to integrase strand transfer inhibitors (INSTIs) in patients experiencing virological failure on raltegravir-based ART and the impact on susceptibility to INSTIs (raltegravir, elvitegravir and dolutegravir). PATIENTS AND METHODS Data were collected from 502 treatment-experienced patients failing a raltegravir-containing regimen in a multicentre study. Reverse transcriptase, protease and integrase were sequenced at failure for each patient. INSTI resistance-associated mutations investigated were those included in the last ANRS genotypic algorithm (v23). RESULTS Among the 502 patients, at failure, median baseline HIV-1 RNA (viral load) was 2.9 log10 copies/mL. Patients had been previously exposed to a median of five NRTIs, one NNRTI and three PIs. Seventy-one percent harboured HIV-1 subtype B and the most frequent non-B subtype was CRF02_AG (13.3%). The most frequent mutations observed were N155H/S (19.1%), Q148G/H/K/R (15.4%) and Y143C/G/H/R/S (6.7%). At failure, viruses were considered as fully susceptible to all INSTIs in 61.0% of cases, whilst 38.6% were considered as resistant to raltegravir, 34.9% to elvitegravir and 13.9% to dolutegravir. In the case of resistance to raltegravir, viruses were considered as susceptible to elvitegravir in 11% and to dolutegravir in 64% of cases. High HIV-1 viral load at failure (P < 0.001) and low genotypic sensitivity score of the associated treatment with raltegravir (P < 0.001) were associated with the presence of raltegravir-associated mutations at failure. Q148 mutations were selected more frequently in B subtypes versus non-B subtypes (P = 0.004). CONCLUSIONS This study shows that a high proportion of viruses remain susceptible to dolutegravir in the case of failure on a raltegravir-containing regimen.
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Affiliation(s)
- Slim Fourati
- AP-HP, Hôpital Pitié-Salpêtrière, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France
| | - Charlotte Charpentier
- INSERM, IAME, UMR 1137, F-75018 Paris, France Université de Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | | | - Laurence Morand-Joubert
- AP-HP, CHU Saint Antoine, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France
| | - Sandrine Reigadas
- CHU de Bordeaux, Laboratoire de Virologie, Université de Bordeaux, CNRS UMR 5234, F-33076 Bordeaux, France
| | | | | | - Florence Nicot
- CHU de Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300 Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | - Diane Descamps
- INSERM, IAME, UMR 1137, F-75018 Paris, France Université de Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Vincent Calvez
- AP-HP, Hôpital Pitié-Salpêtrière, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France
| | - Philippe Flandre
- AP-HP, Hôpital Pitié-Salpêtrière, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France
| | - Anne-Genevieve Marcelin
- AP-HP, Hôpital Pitié-Salpêtrière, INSERM-Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris, France
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15
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Soulie C, Descamps D, Grudé M, Schneider V, Trabaud MA, Morand-Joubert L, Delaugerre C, Montes B, Barin F, Ferre V, Raymond S, Jeulin H, Alloui C, Yerly S, Pallier C, Reigadas S, Signori-Schmuck A, Guigon A, Fafi-Kremer S, Haïm-Boukobza S, Mirand A, Maillard A, Vallet S, Roussel C, Assoumou L, Calvez V, Flandre P, Marcelin AG. Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma. J Antimicrob Chemother 2014; 70:566-72. [PMID: 25344810 DOI: 10.1093/jac/dku419] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. METHODS Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. RESULTS On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P=0.0455) and T215Y (P=0.0455). CONCLUSIONS In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performed.
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Affiliation(s)
- Cathia Soulie
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
| | - Diane Descamps
- IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, INSERM, F-75018 Paris, France AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Maxime Grudé
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | | | | | - Laurence Morand-Joubert
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France Laboratoire de Virologie, AP-HP, CHU Saint Antoine, Paris, France
| | - Constance Delaugerre
- INSERM U941-Université Paris Diderot, Sorbonne Paris Cité, INSERM F-75010 Paris, France AP-HP, Hôpital Saint-Louis, Laboratoire de Virologie, F-75010 Paris, France
| | | | | | | | | | - Hélène Jeulin
- Laboratoire de Virologie, CHU de Nancy Brabois, Vandoeuvre les Nancy, France EA 7300, Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy, France
| | | | - Sabine Yerly
- Laboratory of Virology, Geneva University Hospitals, Switzerland
| | | | - Sandrine Reigadas
- CHU de Bordeaux, Laboratoire de Virologie, F-33000 Bordeaux, France Université de Bordeaux, CNRS UMR 5234, F-33000 Bordeaux, France
| | | | | | | | - Stéphanie Haïm-Boukobza
- CHU Paul Brousse, Laboratoire de Virologie, Villejuif, France INSERM U795, Univ Paris Sud, Hepatinov, Villejuif, France
| | | | | | | | | | - Lambert Assoumou
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | - Vincent Calvez
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
| | - Philippe Flandre
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Universités, UPMC Université de Paris, 06-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75005 Paris, France INSERM-UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health, F-75013 Paris, France AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, F-75013 Paris, France
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Descamps D, Assoumou L, Chaix ML, Chaillon A, Pakianather S, de Rougemont A, Storto A, Dos Santos G, Krivine A, Delaugerre C, Montes B, Izopet J, Charpentier C, Wirden M, Maillard A, Morand-Joubert L, Pallier C, Plantier JC, Guinard J, Tamalet C, Cottalorda J, Marcelin AG, Desbois D, Henquell C, Calvez V, Brun-Vezinet F, Masquelier B, Costagliola D, Lagier E, Roussel C, Le Guillou-Guillemette H, Alloui C, Bettinger D, Anies G, Reigadas S, Bellecave P, Pinson-Recordon P, Fleury H, Masquelier B, Vallet S, Leroux M, Dina J, Vabret A, Poveda JD, Mirand A, Henquell C, Bouvier-Alias M, Noel C, De Rougemont A, Dos Santos G, Yerly S, Gaille C, Caveng W, Chapalay S, Calmy A, Signori-Schmuck A, Morand P, Pallier C, Bocket L, Mouna L, Ranger-Rogez S, Andre P, Tardy JC, Trabaud MA, Tamalet C, Delamare C, Montes B, Schvoerer E, Andre-Garnier E, Ferre V, Cottalorda J, Guigon A, Guinard J, Descamps D, Charpentier C, Peytavin G, Brun-Vezinet F, Haim-Boukobza S, Roques AM, Soulie C, Lambert-Niclot S, Malet I, Wirden M, Fourati S, Marcelin AG, Calvez V, Flandre P, Assoumou L, Costagliola D, Morand-Joubert L, Delaugerre C, Schneider V, Amiel C, Giraudeau G, Maillard A, Plantier JC, Fafi-Kremer S, Schmitt MP, Raymond S, Izopet J, Chaillon A, Barin F, Marque Juillet S. National sentinel surveillance of transmitted drug resistance in antiretroviral-naive chronically HIV-infected patients in France over a decade: 2001-2011. J Antimicrob Chemother 2013; 68:2626-31. [DOI: 10.1093/jac/dkt238] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marcelin AG, Delaugerre C, Beaudoux C, Descamps D, Morand-Joubert L, Amiel C, Schneider V, Ferre V, Izopet J, Si-Mohamed A, Maillard A, Henquell C, Desbois D, Lazrek M, Signori-Schmuck A, Rogez S, Yerly S, Trabaud MA, Plantier JC, Fourati S, Houssaini A, Masquelier B, Calvez V, Flandre P. A cohort study of treatment-experienced HIV-1-infected patients treated with raltegravir: factors associated with virological response and mutations selected at failure. Int J Antimicrob Agents 2013; 42:42-7. [PMID: 23562640 DOI: 10.1016/j.ijantimicag.2013.02.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 02/14/2013] [Accepted: 02/18/2013] [Indexed: 10/27/2022]
Abstract
This study aimed to identify factors associated with virological response (VR) to raltegravir (RAL)-containing regimens in 468 treatment-experienced but integrase inhibitor-naive HIV-1 patients receiving a RAL-containing regimen. VR was defined at Month 6 (M6) as HIV-1 RNA viral load (VL) <50 copies/mL. The impacts on VR of baseline integrase mutations, VL, CD4 count, genotypic sensitivity score for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors, and the number of new antiretrovirals used for the first time associated with RAL were investigated. For patients with VL >50 copies/mL at M6, integrase mutations selected were characterised. Median baseline VL was 4.2 log(10)copies/mL (IQR 3.3-4.9 log(10) copies/mL) and CD4 count was 219 cells/mm(3) (IQR 96-368 cells/mm(3)). At M6, 71% of patients were responders. In multivariate analysis, baseline VL and CD4 count and ≥ 2 new antiretrovirals among darunavir, etravirine, maraviroc and enfuvirtide were associated with VR to RAL. Neither HIV-1 subtype nor baseline integrase polymorphisms were associated with VR to RAL. Among 63 failing patients at M6, selection of ≥ 1 change in the integrase gene was observed in 49 (77.8%), and 27/63 (42.9%) were considered as RAL-associated resistance mutations. Factors independently associated with the occurrence of ≥ 1 RAL-associated resistance mutation were VL at failure >3 log(10) and having no new drugs associated with RAL. RAL showed great potency in treatment-experienced patients. The number of new drugs associated with RAL was an important factor associated with VR. HIV-1 subtype and baseline integrase polymorphisms do not influence the RAL VR.
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Affiliation(s)
- Anne-Geneviève Marcelin
- Laboratoire de Virologie, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, UPMC Univ. Paris 06, INSERM U943, Paris, France.
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Larrat S, Bourdon C, Baccard M, Garnaud C, Mathieu S, Quesada JL, Signori-Schmuck A, Germi R, Blanc M, Leclercq P, Hilleret MN, Leroy V, Zarski JP, Morand P. Performance of an antigen-antibody combined assay for hepatitis C virus testing without venipuncture. J Clin Virol 2012; 55:220-5. [PMID: 22901327 DOI: 10.1016/j.jcv.2012.07.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 07/24/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is underdiagnosed and therefore increasing the opportunities for HCV testing without venipuncture may be useful. OBJECTIVES We evaluated the analytical performance of a modified, commercially available, combined HCV antigen-antibody assay (cEIA) (Monolisa(®) HCV-Ag-Ab-ULTRA) and a commercially available point-of-care (POC) device (OraQuick(®) HCV) on fingerstick blood (FSB) and oral mucosal transudate (OMT). STUDY DESIGN FSB, OMT and serum samples were collected from 113 cases of HCV-antibody-positive patients and 88 HCV-antibody-negative controls. The HCV-antibody-positive group included 63 patients with quantifiable HCV-RNA (56%) and 17 HIV/HCV co-infected patients (15%). FSB and OMT specimens were collected as dried blood spots (DBSs) or with the OraSure collection system, before testing with cEIA. RESULTS With FSB specimens, the cEIA and the POC device exhibited 100% specificity and 98.2% and 97.4% sensitivity, respectively. The specificity of the cEIA in FSB sharply decreased if stored 3days at room temperature. With OMT specimens, the cEIA sensitivity (71.7%) and specificity (94.3%) were significantly lower than the performance of OraQuick(®) HCV (sensitivity, 94.6%; specificity, 100%). The optical densities obtained with the cEIA in FSB and OMT were lower in HIV/HCV co-infected patients compared with HCV monoinfected patients. CONCLUSION The cEIA using FSB specimens collected on DBSs preserved in appropriate storage conditions was a reliable alternative, equivalent to the POC assay, for HCV testing without venipuncture. The cEIA was not adapted for HCV testing on OMT.
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Affiliation(s)
- Sylvie Larrat
- Laboratoire de Virologie, Département des Agents Infectieux, Pôle Biologie, Centre Hospitalier Universitaire Grenoble, BP 217, 38043 Grenoble Cedex 9, France.
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Marcelin AG, Descamps D, Tamalet C, Cottalorda J, Izopet J, Delaugerre C, Morand-Joubert L, Trabaud MA, Bettinger D, Rogez S, Ruffault A, Henquell C, Signori-Schmuck A, Bouvier-Alias M, Vallet S, Masquelier B, Flandre P, Calvez V. Emerging mutations and associated factors in patients displaying treatment failure on an etravirine-containing regimen. Antivir Ther 2011; 17:119-23. [DOI: 10.3851/imp1886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chaix ML, Desquilbet L, Descamps D, Costagliola D, Deveau C, Galimand J, Goujard C, Signori-Schmuck A, Schneider V, Tamalet C, Pellegrin I, Wirden M, Masquelier B, Brun-Vezinet F, Rouzioux C, Meyer L. Response to HAART in French patients with resistant HIV-1 treated at primary infection: ANRS Resistance Network. Antivir Ther 2007. [DOI: 10.1177/135965350701200814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective The aim of the study was to analyse the response to highly active antiretroviral therapy (HAART) initiated at the time of primary HIV infection (PHI) in patients infected with a virus resistant to ≥1 drug of their treatment compared with patients infected with a wild-type virus. Methods We analysed data from 350 patients who were enrolled from 1996–2004 in the French ANRS PRIMO Cohort or in the ANRS Resistance Group and treated with HAART during PHI. During the study period, HAART was initiated before the result of the genotypic resistance test was available. We compared patients infected with a virus resistant to ≥1 drug of their regimen (GR group, n=46) with patients harbouring a wild-type virus (WT group, n=304). Virological and immunological response to treatment according to drug-resistance profile was analysed 3 months and 6 months after HAART initiation. Results In GR and WT groups, HIV RNA level was <400 copies/ml in 68% and 83% ( P=0.02) and <50 copies/ml in 23% and 40% ( P=0.08) 3 months after HAART initiation. In multivariable logistic regression taking into account gender, age, boosted PI regimen, plasma HIV RNA and CD4+ T-cell count at HAART initiation, patients with virus resistant to ≥1 drug of their regimen were significantly less likely to achieve undetectable viral load at month 3 (odds ratio 0.32, 95% confidence interval 0.15–0.72) than the others. This difference was sustained up to month 6. Conclusion In this large cohort of HAART-treated PHI-patients, the presence of drug resistance mutations led to suboptimal response to early therapy.
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Affiliation(s)
- Marie-Laure Chaix
- EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France
| | - Loic Desquilbet
- Inserm, U822, IFR69, Le Kremlin-Bicêtre; Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre; AP-HP, Hopital Bicêtre, Service de Santé Publique, Le Kremlin Bicêtre, France
| | - Diane Descamps
- Service de Virologie, CHU Bichat-Claude Bernard, Paris, France
| | | | - Christiane Deveau
- Inserm, U822, IFR69, Le Kremlin-Bicêtre; Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre; AP-HP, Hopital Bicêtre, Service de Santé Publique, Le Kremlin Bicêtre, France
| | - Julie Galimand
- EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France
| | | | | | | | | | | | - Marc Wirden
- Service de Virologie, CHU Pitié-Salpétrière, Paris, France
| | | | | | - Christine Rouzioux
- EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France
| | - Laurence Meyer
- Inserm, U822, IFR69, Le Kremlin-Bicêtre; Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre; AP-HP, Hopital Bicêtre, Service de Santé Publique, Le Kremlin Bicêtre, France
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Chaix ML, Desquilbet L, Descamps D, Costagliola D, Deveau C, Galimand J, Goujard C, Signori-Schmuck A, Schneider V, Tamalet C, Pellegrin I, Wirden M, Masquelier B, Brun-Vezinet F, Rouzioux C, Meyer L. Response to HAART in French patients with resistant HIV-1 treated at primary infection: ANRS Resistance Network. Antivir Ther 2007; 12:1305-1310. [PMID: 18240870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The aim of the study was to analyse the response to highly active antiretroviral therapy (HAART) initiated at the time of primary HIV infection (PHI) in patients infected with a virus resistant to > or = 1 drug of their treatment compared with patients infected with a wild-type virus. METHODS We analysed data from 350 patients who were enrolled from 1996-2004 in the French ANRS PRIMO Cohort or in the ANRS Resistance Group and treated with HAART during PHI. During the study period, HAART was initiated before the result of the genotypic resistance test was available. We compared patients infected with a virus resistant to > or = 1 drug of their regimen (GR group, n = 46) with patients harbouring a wild-type virus (WT group, n = 304). Virological and immunological response to treatment according to drug-resistance profile was analysed 3 months and 6 months after HAART initiation. RESULTS In GR and WT groups, HIV RNA level was < 400 copies/ml in 68% and 83% (P = 0.02) and < 50 copies/ml in 23% and 40% (P = 0.08) 3 months after HAART initiation. In multivariable logistic regression taking into account gender, age, boosted PI regimen, plasma HIV RNA and CD4+ T-cell count at HAART initiation, patients with virus resistant to > or = 1 drug of their regimen were significantly less likely to achieve undetectable viral load at month 3 (odds ratio 0.32, 95% confidence interval 0.15-0.72) than the others. This difference was sustained up to month 6. CONCLUSION In this large cohort of HAART-treated PHI-patients, the presence of drug resistance mutations led to suboptimal response to early therapy.
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Affiliation(s)
- Marie-Laure Chaix
- EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France.
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