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Palich R, Wirden M, Peytavin G, Lê MP, Seang S, Abdi B, Schneider L, Tubiana R, Valantin MA, Paccoud O, Soulié C, Calvez V, Katlama C, Marcelin AG. Persistent low-level viraemia in antiretroviral treatment-experienced patients is not linked to viral resistance or inadequate drug concentrations. J Antimicrob Chemother 2021; 75:2981-2985. [PMID: 32642769 DOI: 10.1093/jac/dkaa273] [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: 01/13/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess genotypic sensitivity scores (GSSs), plasma antiretroviral concentrations (PACs) and immunovirological outcomes at Week 96 (W96) in patients with persistent low-level viraemia (LLV). METHODS On 1 January 2017, we analysed data from patients on three-drug regimens with persistent LLV defined as at least two consecutive plasma viral loads (pVLs) between 21 and 200 copies/mL (including one pVL of ≥50 copies/mL), at the Pitié-Salpêtrière Hospital. Outcomes were: GSS, PACs and HIV-DNA load at study entry; and virological status and proportion of patients with resistance-associated mutations (RAMs) at W96. RESULTS Fifty-seven patients were included, with median age of 52.6 years (IQR 45.2-57.9), last CD4 count of 658 cells/mm3 (IQR 462-909) and total ART duration of 10.2 years (IQR 5.7-15.2). LLV duration was 14.0 months (IQR 5.5-22.3). GSS was 3 in 46/57 (81%) patients and PACs were adequate in 53/57 (93%) patients. Median total HIV-DNA was 2.65 log10 copies/106 cells (IQR 2.44-2.86). During follow-up, 26/57 (46%) had experienced ART modifications. At W96, 38/57 (67%) patients remained with LLV, 15/60 (26%) had achieved confirmed pVL of <20 copies/mL and 4/57 (7%) had virological failure. The four virological failures were due to three ART interruptions and one incomplete adherence (selection of Y181C RAM). No factors (patient characteristics at study entry, GSS, PACs, total HIV-DNA load and ART modification) were associated with W96 viral outcome, except for time from HIV diagnosis and the LLV duration at study entry. CONCLUSIONS A substantial number of patients harbouring LLV had no resistance to ART and adequate PACs. Two-thirds of these patients remained with this LLV status.
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Affiliation(s)
- R Palich
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M Wirden
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - G Peytavin
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - M-P Lê
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - S Seang
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - B Abdi
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - L Schneider
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Tubiana
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M-A Valantin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - O Paccoud
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Soulié
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - V Calvez
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - A-G Marcelin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
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2
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Nguyen T, Fofana DB, Lê MP, Charpentier C, Peytavin G, Wirden M, Lambert-Niclot S, Desire N, Grude M, Morand-Joubert L, Flandre P, Katlama C, Descamps D, Calvez V, Todesco E, Marcelin AG. Prevalence and clinical impact of minority resistant variants in patients failing an integrase inhibitor-based regimen by ultra-deep sequencing. J Antimicrob Chemother 2019; 73:2485-2492. [PMID: 29873733 DOI: 10.1093/jac/dky198] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/27/2018] [Indexed: 12/20/2022] Open
Abstract
Background Integrase strand transfer inhibitors (INSTIs) are recommended by international guidelines as first-line therapy in antiretroviral-naive and -experienced HIV-1-infected patients. Objectives This study aimed at evaluating the prevalence at failure of INSTI-resistant variants and the impact of baseline minority resistant variants (MiRVs) on the virological response to an INSTI-based regimen. Methods Samples at failure of 134 patients failing a raltegravir-containing (n = 65), an elvitegravir-containing (n = 20) or a dolutegravir-containing (n = 49) regimen were sequenced by Sanger sequencing and ultra-deep sequencing (UDS). Baseline samples of patients with virological failure (VF) (n = 34) and of those with virological success (VS) (n = 31) under INSTI treatment were sequenced by UDS. Data were analysed using the SmartGene platform, and resistance was interpreted according to the ANRS algorithm version 27. Results At failure, the prevalence of at least one INSTI-resistant variant was 39.6% by Sanger sequencing and 57.5% by UDS, changing the interpretation of resistance in 17/134 (13%) patients. Among 53 patients harbouring at least one resistance mutation detected by both techniques, the most dominant INSTI resistance mutations were N155H (45%), Q148H/K/R (23%), T97A (19%) and Y143C (11%). There was no difference in prevalence of baseline MiRVs between patients with VF and those with VS. MiRVs found at baseline in patients with VF were not detected at failure either in majority or minority mutations. Conclusions UDS is more sensitive than Sanger sequencing at detecting INSTI MiRVs at treatment failure. The presence of MiRVs at failure could be important to the decision to switch to other INSTIs. However, there was no association between the presence of baseline MiRVs and the response to INSTI-based therapies in our study.
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Affiliation(s)
- T Nguyen
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - D B Fofana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Saint-Antoine, Laboratoire de virologie, F-75012 Paris, France
| | - M P Lê
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Département de Pharmaco-Toxicologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - C Charpentier
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - G Peytavin
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Département de Pharmaco-Toxicologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - M Wirden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - S Lambert-Niclot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Saint-Antoine, Laboratoire de virologie, F-75012 Paris, France
| | - N Desire
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - M Grude
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), F-75013 Paris, France
| | - L Morand-Joubert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Saint-Antoine, Laboratoire de virologie, F-75012 Paris, France
| | - P Flandre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de maladies infectieuses, F-75013 Paris, France
| | - D Descamps
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - V Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - E Todesco
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - A G Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
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3
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Assoumou L, Charpentier C, Recordon-Pinson P, Grudé M, Pallier C, Morand-Joubert L, Fafi-Kremer S, Krivine A, Montes B, Ferré V, Bouvier-Alias M, Plantier JC, Izopet J, Trabaud MA, Yerly S, Dufayard J, Alloui C, Courdavault L, Le Guillou-Guillemette H, Maillard A, Amiel C, Vabret A, Roussel C, Vallet S, Guinard J, Mirand A, Beby-Defaux A, Barin F, Allardet-Servent A, Ait-Namane R, Wirden M, Delaugerre C, Calvez V, Chaix ML, Descamps D, Reigadas S. Prevalence of HIV-1 drug resistance in treated patients with viral load >50 copies/mL: a 2014 French nationwide study. J Antimicrob Chemother 2017; 72:1769-1773. [PMID: 28333232 DOI: 10.1093/jac/dkx042] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/19/2017] [Indexed: 11/14/2022] Open
Abstract
Background Surveillance of HIV-1 resistance in treated patients with a detectable viral load (VL) is important to monitor, in order to assess the risk of spread of resistant viruses and to determine the proportion of patients who need new antiretroviral drugs with minimal cross-resistance. Methods The HIV-1 protease and reverse transcriptase (RT) and integrase genes were sequenced in plasma samples from 782 consecutive patients on failing antiretroviral regimens, seen in 37 specialized centres in 2014. The genotyping results were interpreted using the ANRS v24 algorithm. Prevalence rates were compared with those obtained during a similar survey conducted in 2009. Results The protease and RT sequences were obtained in 566 patients, and the integrase sequence in 382 patients. Sequencing was successful in 60%, 78%, 78% and 87% of patients with VLs of 51-200, 201-500, 501-1000 and >1000 copies/mL, respectively. Resistance to at least one antiretroviral drug was detected in 56.3% of samples. Respectively, 3.9%, 8.7%, 1.5% and 3.4% of patients harboured viruses that were resistant to any NRTI, NNRTI, PI and integrase inhibitor (INI). Resistance rates were lower in 2014 than in 2009. Resistance was detected in 48.5% of samples from patients with a VL between 51 and 200 copies/mL. Conclusion In France in 2014, 90.0% of patients in AIDS care centres were receiving antiretroviral drugs and 12.0% of them had VLs >50 copies/mL. Therefore, this study suggests that 6.7% of treated patients in France might transmit resistant strains. Resistance testing may be warranted in all treated patients with VL > 50 copies/mL.
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Affiliation(s)
- L Assoumou
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France
| | - C Charpentier
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Laboratoire Associé au Centre National de Référence du VIH-Résistance aux Antirétroviraux, Paris, France
| | - P Recordon-Pinson
- PTBM, Laboratoire de Virologie, Hôpital Pellegrin, CHU de Bordeaux; UMR 5234 MFP CNRS, Université de Bordeaux, 33076 Bordeaux cedex, France
| | - M Grudé
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France
| | - C Pallier
- HU Paris sud, Hôpital Paul Brousse, Laboratoire de Virologie, Villejuif, France
| | - L Morand-Joubert
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Saint-Antoine, F75012 Paris, France
| | - S Fafi-Kremer
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Krivine
- AP-HP, Hôpital Cochin, Laboratoire de Virologie, Paris, France
| | - B Montes
- Laboratoire de Virologie, Hôpital Saint-Eloi, CHU Montpellier, Montpellier, France
| | - V Ferré
- EA 4271, Nantes Université UFR Pharmacie, Laboratoire de Virologie, CHU Nantes, Nantes, France
| | - M Bouvier-Alias
- INSERM U955, National Reference Center for Viral Hepatitis B, C et Delta, Department of Virology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - J-C Plantier
- Laboratoire de Virologie et COREVIH Haute-Normandie, CHU de Rouen, Rouen, France
| | - J Izopet
- Laboratoire de Virologie, Hôpital Purpan de Toulouse, Toulouse, France
| | - M-A Trabaud
- Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Yerly
- Laboratoire de Virologie, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - J Dufayard
- Laboratoire de Virologie, Hôpital l'Archet de Nice, Nice, France
| | - C Alloui
- Laboratoire de Virologie, Hôpital Avicenne, APHP, HU Paris Seine Saint Denis, Bobigny, France
| | - L Courdavault
- Laboratoire de Virologie, Centre Hospitalier Victor Dupouy d'Argenteuil, Argenteuil, France
| | - H Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers et HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - A Maillard
- Laboratoire de Virologie, CHU de Rennes, Rennes, France
| | - C Amiel
- AP-HP, Hôpital Tenon, Laboratoire de Virologie, Paris, France
| | - A Vabret
- Laboratoire de Virologie, CHU Caen, Caen, France
| | - C Roussel
- Laboratoire de Virologie, CHU Amiens, Amiens, France
| | - S Vallet
- Laboratoire de Virologie, CHU Brest, Brest, France
| | - J Guinard
- Laboratoire de Virologie, CHR Orléans, Orléans, France
| | - A Mirand
- Laboratoire de Virologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - A Beby-Defaux
- Laboratoire de Virologie, CHU Poitiers, Poitiers, France
| | - F Barin
- Laboratoire de Virologie, CHU Bretonneau, & INSERM U966, Tours, France
| | | | - R Ait-Namane
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France
| | - M Wirden
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Pitié-Salpêtrière, F75013 Paris, France
| | - C Delaugerre
- Laboratoire de Virologie, AP-HP, Hôpital Saint Louis, INSERM U941, Université Paris Diderot, Paris, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Pitié-Salpêtrière, F75013 Paris, France
| | - M-L Chaix
- Laboratoire de Virologie, AP-HP, Hôpital Saint Louis, INSERM U941, Université Paris Diderot, Paris, France
| | - D Descamps
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Laboratoire Associé au Centre National de Référence du VIH-Résistance aux Antirétroviraux, Paris, France
| | - S Reigadas
- PTBM, Laboratoire de Virologie, Hôpital Pellegrin, CHU de Bordeaux; UMR 5234 MFP CNRS, Université de Bordeaux, 33076 Bordeaux cedex, France.,CRB plurithématique, Bordeaux Biothèques Santé, Groupe hospitalier Pellegrin-CHU de Bordeaux, Bordeaux, France
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4
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Todesco E, Charpentier C, Bertine M, Wirden M, Storto A, Desire N, Grude M, Nguyen T, Sayon S, Yazdanpanah Y, Katlama C, Descamps D, Calvez V, Marcelin AG. Disparities in HIV-1 transmitted drug resistance detected by ultradeep sequencing between men who have sex with men and heterosexual populations. HIV Med 2017; 18:696-700. [PMID: 28444829 DOI: 10.1111/hiv.12508] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Transmitted drug resistance (TDR) can impair the response to first-line antiretroviral therapy. In treatment-naïve patients chronically infected with HIV type 1 (HIV-1), it was previously shown through Sanger sequencing that TDR was more common in men who have sex with men (MSM) than in other transmission risk groups. We aimed to compare two HIV-1 transmission groups in terms of the presence of TDR mutations. METHODS We investigated, through Sanger sequencing and ultradeep sequencing (UDS), the presence of resistance mutations, both in majority (> 20%) and in minority (1-20%) proportions, in 70 treatment-naïve MSM and 70 treatment-naïve heterosexual patients who recently screened positive for HIV-1. RESULTS The global prevalence of TDR was not significantly different between the two groups, either by Sanger or by UDS. Nevertheless, a higher frequency of nucleoside reverse transcriptase inhibitor TDR was observed among heterosexual patients (P = 0.04). There was also a trend for a higher frequency of TDR among MSM infected with HIV-1 subtype B compared with MSM infected with HIV-1 non-B subtypes (P = 0.06). CONCLUSIONS Ultradeep sequencing UDS allowed sensitive monitoring of TDR, and highlighted some disparities between transmission groups.
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Affiliation(s)
- E Todesco
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - C Charpentier
- INSERM, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.,Univ Paris Diderot, IAME, UMR 1137, Paris, France.,Department of Virology, AP-HP, Bichat-Claude Bernard Hospital, Paris, France
| | - M Bertine
- INSERM, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.,Univ Paris Diderot, IAME, UMR 1137, Paris, France.,Department of Virology, AP-HP, Bichat-Claude Bernard Hospital, Paris, France
| | - M Wirden
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - A Storto
- Department of Virology, AP-HP, Bichat-Claude Bernard Hospital, Paris, France
| | - N Desire
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - M Grude
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - T Nguyen
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - S Sayon
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Y Yazdanpanah
- INSERM, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.,Univ Paris Diderot, IAME, UMR 1137, Paris, France.,Department of Infectious Diseases, AP-HP, Bichat-Claude Bernard Hospital, Paris, France
| | - C Katlama
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - D Descamps
- INSERM, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France.,Univ Paris Diderot, IAME, UMR 1137, Paris, France.,Department of Virology, AP-HP, Bichat-Claude Bernard Hospital, Paris, France
| | - V Calvez
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - A G Marcelin
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.,Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
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5
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Lambert-Niclot S, Allavena C, Grude M, Flandre P, Sayon S, Andre E, Wirden M, Rodallec A, Jovelin T, Katlama C, Calvez V, Raffi F, Marcelin AG. Usefulness of an HIV DNA resistance genotypic test in patients who are candidates for a switch to the rilpivirine/emtricitabine/tenofovir disoproxil fumarate combination. J Antimicrob Chemother 2016; 71:2248-51. [PMID: 27231280 DOI: 10.1093/jac/dkw146] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 04/01/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In the context of a rilpivirine/emtricitabine/tenofovir disoproxil fumarate switch in HIV-1-infected patients with at least 1 year of virological success, we determined whether proviral DNA is an alternative to plasma HIV RNA for resistance genotyping. METHODS Resistance-associated mutations (RAMs) in DNA after at least 1 year of virological success [viral load (VL) <50 copies/mL] were compared with those identified in the last plasma RNA genotype available. Rilpivirine/emtricitabine/tenofovir disoproxil fumarate RAMs studied were K65R, L100I, K101E/P, E138A/G/K/R/Q, V179L, Y181C/I/V, M184V/I, Y188L, H221Y, F227C and M230I/L in the RT. We studied patients without virological failure (VF) and with at least 1 VF (two consecutive VLs >50 copies/mL). Kappa's coefficient was used to measure agreement between the DNA and RNA genotypes. RESULTS In patients without VF (n = 130) and with VF (n = 114), RNA and DNA showed resistance to at least one drug of the rilpivirine/emtricitabine/tenofovir disoproxil fumarate combination in 8% and 9% and in 60% and 45%, respectively. For rilpivirine RAMs, correlation between RNA and DNA was higher in patients without VF than in patients with VF (kappa = 0.60 versus 0.19, P = 0.026). Overall, the prevalence of RAMs was lower in DNA than in RNA. CONCLUSIONS Incomplete information provided by the DNA genotypic test is more notable in patients with VF, suggesting that all resistance mutations associated with prior VF have not been archived in the proviral DNA or decreased to a level below the threshold of detection. In the case where no historical plasma genotypic test is available, DNA testing might be useful to rule out switching to rilpivirine/emtricitabine/tenofovir disoproxil fumarate.
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Affiliation(s)
- S Lambert-Niclot
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - C Allavena
- Infectious Diseases Department, University Hospital of Nantes, Nantes, France
| | - M Grude
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - P Flandre
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - S Sayon
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - E Andre
- Virology, University Hospital of Nantes, Nantes, France
| | - M Wirden
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - A Rodallec
- Virology, University Hospital of Nantes, Nantes, France
| | - T Jovelin
- Infectious Diseases Department, University Hospital of Nantes, Nantes, France
| | - C Katlama
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de maladies Infectieuses, Paris F-75013, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, France
| | - F Raffi
- Infectious Diseases Department, University Hospital of Nantes, Nantes, France
| | - A-G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris F-75013, 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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Calin R, Fourati S, Schneider L, Gautheret-Dejean A, Lambert-Niclot S, Wirden M, Carcelain G, Katlama C, Marcelin AG, Tubiana R. Very early ART resulting in the absence of HIV-1 antibodies and in a sustained undetectable plasma HIV-1-RNA and proviral-DNA in an HLA-B*5701 and 32 heterozygote HIV-1-infected patient was not associated with functional cure. J Antimicrob Chemother 2014; 70:317-9. [DOI: 10.1093/jac/dku370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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, Visseaux B, Wirden M, Morand-Joubert L, Soulie C, Charpentier C, Masquelier B, Descamps D, Calvez V. NRTI-sparing regimens yield higher rates of drug resistance than NRTI-based regimens for HIV-1 treatment. J Glob Antimicrob Resist 2013; 2:103-106. [PMID: 27873586 DOI: 10.1016/j.jgar.2013.12.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 09/13/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022] Open
Abstract
To treat human immunodeficiency virus (HIV)-infected patients, international guidelines recommend the combination of two nucleos(t)ide reverse transcriptase inhibitors [N(t)RTIs] and a third agent [non-NRTI (NNRTI), boosted protease inhibitor (r/PI) or integrase inhibitor (INI)] for initial treatment. The objective of this study was to compare the selection of resistance to antiretrovirals (ARVs) for regimens containing or lacking N(t)RTIs in patients experiencing their first virological failure. Eligible patients had a first virological failure, defined as the occurrence of two consecutive HIV plasma viral loads ≥50copies/mL. Genotypic resistance testing was performed at the time of virological failure (on the second sample with detectable viral load ≥50copies/mL) in patients failing regimens of N(t)RTIs+r/PI or NNRTI or INI, r/PI+NNRTI or INI, and INI+NNRTI. Among 434 virological failures analysed, resistance testing results were available in 416 cases (95.9%). Higher rates of drug resistance were observed in patients receiving N(t)RTI-sparing regimens. When the combination of N(t)RTIs+r/PI was used, PIs protect themselves and the associated N(t)RTIs from the selection of resistance; however, this was not observed with the NNRTI+r/PI combination. The same phenomenon was observed for raltegravir: when used in combination with N(t)RTIs, INI resistance mutations were less frequently selected compared with its use in combination with PIs or NNRTIs. In conclusion, regimens of the ARV classes combined impact the frequency of resistance development. Lower resistance is observed for N(t)RTI-based regimens, with more therapeutic options for subsequent regimens after failure.
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Affiliation(s)
- A G Marcelin
- Université Pierre et Marie Curie - Paris 6, UMR S-943, 75013 Paris, France; INSERM, U943, 75013 Paris, France; AP-HP Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Virologie, 75013 Paris, France.
| | - B Visseaux
- Université Paris Diderot, Sorbonne Paris Cité, EA4409, 75018 Paris, France; AP-HP Groupe Hospitalier Bichat-Claude Bernard, HUPNVS, Laboratoire de Virologie, 75018 Paris, France
| | - M Wirden
- Université Pierre et Marie Curie - Paris 6, UMR S-943, 75013 Paris, France; INSERM, U943, 75013 Paris, France; AP-HP Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Virologie, 75013 Paris, France
| | - L Morand-Joubert
- Université Pierre et Marie Curie - Paris 6, UMR S-943, 75013 Paris, France; INSERM, U943, 75013 Paris, France; AP-HP Groupe Hospitalier Saint-Antoine, Laboratoire de Virologie, 75011 Paris, France
| | - C Soulie
- Université Pierre et Marie Curie - Paris 6, UMR S-943, 75013 Paris, France; INSERM, U943, 75013 Paris, France; AP-HP Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Virologie, 75013 Paris, France
| | - C Charpentier
- Université Paris Diderot, Sorbonne Paris Cité, EA4409, 75018 Paris, France; AP-HP Groupe Hospitalier Bichat-Claude Bernard, HUPNVS, Laboratoire de Virologie, 75018 Paris, France
| | - B Masquelier
- Université de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France; Laboratoire de Virologie, CHU de Bordeaux, 33000 Bordeaux, France
| | - D Descamps
- Université Paris Diderot, Sorbonne Paris Cité, EA4409, 75018 Paris, France; AP-HP Groupe Hospitalier Bichat-Claude Bernard, HUPNVS, Laboratoire de Virologie, 75018 Paris, France
| | - V Calvez
- Université Pierre et Marie Curie - Paris 6, UMR S-943, 75013 Paris, France; INSERM, U943, 75013 Paris, France; AP-HP Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Virologie, 75013 Paris, France
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Lambert-Niclot S, Charpentier C, Storto A, Fofana D, Soulie C, Fourati S, Wirden M, Morand-Joubert L, Masquelier B, Flandre P, Calvez V, Descamps D, Marcelin AG. Rilpivirine, emtricitabine and tenofovir resistance in HIV-1-infected rilpivirine-naive patients failing antiretroviral therapy. J Antimicrob Chemother 2013; 69:1086-9. [DOI: 10.1093/jac/dkt463] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caby F, Schneider L, Blanc C, Soulié C, Tindel M, Peytavin G, Agher R, Valantin MA, Tubiana R, Wirden M, Calvez V, Marcelin AG, Katlama C. Efficacy of raltegravir switching strategies in HIV-infected patients with suppressed viraemia according to the genotypic sensitivity score. Infection 2013; 42:295-301. [PMID: 24155032 DOI: 10.1007/s15010-013-0542-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND PURPOSE The lack of antiretroviral (ARV) backbone activity associated with raltegravir has been proposed as the main explanation for virological relapse observed in patients with undetectable viraemia who are switched from a ritonavir-boosted protease inhibitor (PI) to raltegravir. However ARV activity remains difficult to assess in this context. The aim of our study was to precisely assess the ARV backbone activity in patients with undetectable viraemia who underwent raltegravir switching strategies and to evaluate the efficacy of such switching strategies based on the genotypic sensitivity score (GSS). METHODS Patients with a plasma human immunodeficiency virus type 1 (HIV-1) RNA level of <50 copies/mL on a stable two ARV-class regimen were enrolled if they switched one of their ARV drugs to raltegravir 400 mg twice daily. The GSS was calculated using a genotyping test performed on the HIV-1 RNA of the last plasma measurement with a HIV-1 RNA level of >50 copies/mL before the switch and on the results of all previous genotyping tests. The primary endpoint was the proportion of patients with a plasma HIV-1 RNA level of <50 copies/mL at week 24. RESULTS Fifty-six patients were enrolled in this study. The proportion of patients with a plasma HIV-1 RNA level of <50 copies/mL at week 24 was 92.9 % (range 83.0-97.2 %) in the intent-to-treat analysis and 98.1 % (90.0-99.7 %) in per-protocol analysis. When the backbone was fully active, the proportion was 100.0 % (86.7-100.0 %) at week 24 and week 48 in the per-protocol analysis. We observed a decrease in plasma total cholesterol and triglycerides of -12.7 % (p = 0.005) and -26.5 % (p = 0.001), respectively. CONCLUSIONS Raltegravir switching strategies are effective when the associated backbone is fully active according to the GSS. In the context of undetectable viraemia, where ARV activity remains difficult to assess, the determination of the GSS requires the entire ARV history of the patient and all previous HIV-RNA genotyping test results.
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Affiliation(s)
- F Caby
- Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, 47/83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France,
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Todesco E, Sayon S, Fourati S, Tubiana R, Simon A, Ktorza N, Schneider L, Peytavin G, Malet I, Van den Eede P, Katlama C, Calvez V, Marcelin AG, Wirden M. Highly multidrug-resistant HIV: clonal analysis and therapeutic strategies. J Antimicrob Chemother 2013; 68:2882-9. [DOI: 10.1093/jac/dkt272] [Citation(s) in RCA: 3] [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: 12/25/2022] Open
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Fofana DB, Soulie C, Maiga AI, Fourati S, Malet I, Wirden M, Tounkara A, Traore HA, Calvez V, Marcelin AG, Lambert-Niclot S. Genetic barrier to the development of resistance to rilpivirine and etravirine between HIV-1 subtypes CRF02_AG and B. J Antimicrob Chemother 2013; 68:2515-20. [PMID: 23833185 DOI: 10.1093/jac/dkt251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/13/2022] Open
Abstract
OBJECTIVES It has been demonstrated for some drugs that the genetic barrier, defined as the number of genetic transitions and/or transversions needed to produce a resistance mutation, can differ between HIV-1 subtypes. We aimed to assess differences in the genetic barrier for the evolution of resistance to the second-generation non-nucleoside reverse transcriptase inhibitors etravirine and rilpivirine in subtypes B and CRF02_AG in antiretroviral-naive patients. METHODS An analysis was undertaken of 25 substitutions associated with etravirine and rilpivirine resistance at 12 amino acid positions in 267 nucleotide sequences (136 HIV-1 B and 131 HIV-1 CRF02_AG subtypes) of the reverse transcriptase gene. RESULTS The majority (7/12) of amino acid positions studied were conserved between the two HIV-1 subtypes, leading to a similar genetic barrier. Different predominant codons between the subtypes were observed in 5/12 positions (90, 98, 179, 181 and 227), with an effect on the calculated genetic barrier only at the V179D and V179F codons (2.5 versus 3.5 for V179D, and 2.5 versus 5 for V179F, respectively, for subtype B versus subtype CRF02_AG). CONCLUSIONS The majority of amino acids involved in etravirine and rilpivirine resistance showed a high degree of conservation of the predominant codon between the B and CRF02_AG subtypes. For rilpivirine, the genetic barrier was the same between the two subtypes. Nevertheless, subtype CRF02_AG showed a higher genetic barrier to acquiring mutations V179D and V179F (mutations associated with resistance to etravirine) compared with subtype B, suggesting that it would be more difficult to produce resistance to etravirine in the CRF02_AG subtype than the B subtype.
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Affiliation(s)
- D B Fofana
- APHP, Hôpital Pitié-Salpêtrière, Laboratoire de Virologie, UPMC Univ Paris 06, INSERM U 943, F75013 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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Lambert-Niclot S, Charpentier C, Storto A, Fofana DB, Soulie C, Fourati S, Visseaux B, Wirden M, Morand-Joubert L, Masquelier B, Flandre P, Calvez V, Descamps D, Marcelin AG. Prevalence of pre-existing resistance-associated mutations to rilpivirine, emtricitabine and tenofovir in antiretroviral-naive patients infected with B and non-B subtype HIV-1 viruses. J Antimicrob Chemother 2013; 68:1237-42. [DOI: 10.1093/jac/dkt003] [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: 01/17/2023] Open
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Marcelin AG, Charpentier C, Wirden M, Landman R, Valantin MA, Simon A, Katlama C, Yeni P, Descamps D, Aubron-Olivier C, Calvez V. Resistance profiles of emtricitabine and lamivudine in tenofovir-containing regimens. J Antimicrob Chemother 2012; 67:1475-8. [DOI: 10.1093/jac/dks047] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lambert-Niclot S, Machouf N, Peytavin G, Soulie C, Wirden M, Simon A, Murphy RL, Katlama C, Thomas R, Calvez V, Marcelin AG. Pharmacokinetics, protein-binding-adjusted inhibitory quotients for atazanavir/ritonavir 300/100 mg in treatment-naïve HIV-infected patients. HIV Med 2011; 11:666-9. [PMID: 20497253 DOI: 10.1111/j.1468-1293.2010.00839.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Studies have shown the importance of having a high protein-binding-adjusted inhibitory quotient (IQ) for protease inhibitors (PIs) boosted with ritonavir. The objective of this study was to explore the virological response when combination atazanavir/ritonavir was administered to treatment-naı¨ve patients. METHODS Protein-binding-adjusted IQs were calculated in 100 treatment-naı¨ve patients initiating therapy with atazanavir 300 mg/ritonavir 100 mg plus two nucleoside reverse transcriptase inhibitors. RESULTS The median atazanavir trough level was 635 ng/mL [interquartile range (IQR) 342-1000] and the median atazanavir protein-binding-adjusted IQ was 45 (IQR 24-71). Eighty-four per cent of patients had a successful virological response, and those who failed did not develop resistance. The IQ for boosted atazanavir is high, resulting in rare treatment failure without resistance mutations. CONCLUSIONS This study showed that the protein-binding-adjusted IQ of atazanavir is close to those measured for lopinavir and darunavir used once daily in first-line treatment. Finally the selection of resistance in the case of virological failure (plasma viral load 4400 HIV-1 RNA copies/mL) to atazanavir/ritonavir used in first-line therapy seems uncommon, as it is for all boosted PIs.
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Affiliation(s)
- S Lambert-Niclot
- INSERM U943, AP-HP, Hôpital Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France.
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Marcelin AG, Charpentier C, Wirden M, Descamps D, Calvez V. Darunavir resistance spectrum in darunavir-naᵢve patients harboring virological failure to antiretroviral therapy. J Int AIDS Soc 2010. [PMCID: PMC3112909 DOI: 10.1186/1758-2652-13-s4-p133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Marcelin AG, Charpentier C, Ferreira C, Wirden M, Lemarchand C, Descamps D, Calvez V. Prevalence of resistance and HIV-1 protease mutation patterns after failures with fosamprenavir-containing regimens. J Int AIDS Soc 2010. [PMCID: PMC3112912 DOI: 10.1186/1758-2652-13-s4-p136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Soulie C, Fourati S, Lambert-Niclot S, Malet I, Wirden M, Tubiana R, Valantin MA, Katlama C, Calvez V, Marcelin AG. Factors associated with proviral DNA HIV-1 tropism in antiretroviral therapy-treated patients with fully suppressed plasma HIV viral load: implications for the clinical use of CCR5 antagonists. J Antimicrob Chemother 2010; 65:749-51. [DOI: 10.1093/jac/dkq029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [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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Audard V, Avouac J, Wirden M, Pardon A, Matignon M, Remy P, Desvaux D, Lang P, Grimbert P. HIV-related nephropathies associated with changes in blood and kidney tissue virus load. Kidney Int 2008; 73:651-5. [PMID: 18185508 DOI: 10.1038/sj.ki.5002765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- V Audard
- Department of Nephrology and Renal Transplantation, Hôpital Henri Mondor, AP-HP, Université Paris XII and IFRNT (Institut Francilien de Recherche en Néphrologie-Transplantation), Créteil, France
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Reynes J, Pellegrin I, Peytavin G, Wirden M, Giffo B, Aquilina C, Pinta A, Pierre N, Kraemer S, Calvez V. INDEED study: final results of an induction treatment strategy with enfuvirtide in treatment failure patients. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Canestri A, Blanc C, Wirden M, Peytavin G, Ktorza N, Katlama C. Efficacy and safety of an antiretroviral regimen containing etravirine plus raltegravir in HIV-1 treatment-experienced patients failing darunavir. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Marcelin AG, Milliancourt C, Dupin N, Wirden M, Huraux JM, Agut H, Calvez V. Effects of cyclosporine and hydrocortisone on Kaposi's sarcoma-associated herpesvirus genome replication and cell apoptosis induction. Transplantation 2001; 72:1700-3. [PMID: 11726836 DOI: 10.1097/00007890-200111270-00023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Iatrogenic immunosuppressed patients are at increased risk for development of various cancers that comprise Kaposi's sarcoma (KS). METHODS To investigate the direct impact of immunosuppressive agents on Kaposi's sarcoma-associated herpesvirus (KSHV) and KS development, we quantified the effects of cyclosporine (CsA) and hydrocortisone (HC) on KSHV genome replication and the consequences on the cell survival. RESULTS In the presence of phorbol ester 12-O-tetradecanoyl phorbol-13-acetate, we observed an increase of intracellular and extracellular KSHV DNA concomitantly with an increase of gp (glycoprotein) K8.1 expression, indicating KSHV genome replication. This replication was accompanied by cell apoptosis. In comparison, in the presence of CsA, HC, or both, we did not observe any effect on KSHV replication or gp K8.1 expression. CONCLUSION Our results suggest that immunosuppressive agents such as HC and CsA do not activate the lytic cycle of KSHV and do not modify the cell survival thus promoting cancer progression by a direct cellular effect.
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Affiliation(s)
- A G Marcelin
- Department of Virology, CERVI, Pitié-Salpêtrière Hospital, AP-HP, 83 Bd de l'Hôpital, 75013 Paris, France
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Wirden M, Botterel F, Romand S, Ithier G, Bourée P. [Significance of post-partum diagnosis of congenital toxoplasmosis primary maternal infection at the end of the pregnancy]. J Gynecol Obstet Biol Reprod (Paris) 1999; 28:566-7. [PMID: 10598352] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We report two cases of congenital toxoplasmosis following maternal primary infection occurring late during pregnancy. These congenital infections are often asymptomatic at birth and can be recognized only by an appropriate serological screening program performed in mothers after delivery.
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Affiliation(s)
- M Wirden
- Unité de Parasitologie, Centre Hospitalo-Universitaire de Bicêtre, Kremlin-Bicêtre
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