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Bérot V, Eremin A, Fauchois A, Dechamp J, Schneider L, Chermak A, Faycal A, Sellem B, Orriere T, Favier M, Tubiana R, Valantin MA, Pourcher V, Todesco E, Monsel G, Agher R, Palich R, Katlama C. Hepatitis A, hepatitis B and HPV vaccine needs and coverage in MSM initiating HIV PrEP in a sexual health clinic in Paris. Sex Transm Infect 2023:sextrans-2023-055802. [PMID: 37173130 DOI: 10.1136/sextrans-2023-055802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Affiliation(s)
- Vincent Bérot
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Anton Eremin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Antoine Fauchois
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Jeanne Dechamp
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Luminita Schneider
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Aziza Chermak
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Antoine Faycal
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Baptiste Sellem
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Thibault Orriere
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Marion Favier
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Roland Tubiana
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Marc-Antoine Valantin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Valerie Pourcher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Eve Todesco
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Gentiane Monsel
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Rachid Agher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Romain Palich
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Christine Katlama
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
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Wirden M, Palich R, Abdi B, Valantin MA, Tubiana R, Schneider L, Seang S, Faycal A, Sellem B, Katlama C, Calvez V, Marcelin AG. More HIV-1 RNA detected and quantified with the Cobas 6800 system in patients on antiretroviral therapy. J Antimicrob Chemother 2022; 77:2251-2256. [PMID: 35640662 DOI: 10.1093/jac/dkac174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Target-detected (TD) results or low-level viraemia (LLV) can be observed in HIV-1 patients on ART, which regularly raises questions. OBJECTIVES We describe here the impact on HIV-1 RNA quantification of switching from the COBAS AmpliPrep/COBAS TaqMan (CAP/CTM) to the Cobas 6800 system (C6800), based on analyses of viraemia close to the lower limit of quantification (LLoQ). PATIENTS AND METHODS We retrospectively selected two groups of patients: 200 individuals whose viral loads (VLs) were consistently <50 copies/mL with CAP/CTM for at least 3 years before switching to C6800 (group 1), and 35 other patients with confirmed LLV when C6800 was in use (group 2). In both groups, we compared several consecutive VL results performed before and after the change of quantification assay. Analyses were performed with McNemar's paired tests or Fisher's exact tests. RESULTS In group 1, the frequency of TD results (below or above the LLoQ) increased significantly after the switch to C6800 for patients with <25% of results being TD for VLs performed with CAP/CTM (P < 0.0001). Significantly more patients had at least one VL ≥20 or ≥50 copies/mL with C6800, in both group 1 (37.0% versus 18.5%; P < 0.0001 and 6.5% versus 0%; P = 0.0009, respectively) and group 2 (100% versus 66%; P = 0.0015 and 97% versus 40%; P < 0.0001, respectively). CONCLUSIONS C6800 revealed residual or low-level HIV-1 RNA that was not detected with CAP/CTM, resulting in twice as many patients being found to have a VL ≥20 copies/mL. Physicians and patients should be aware of possible differences in results between assays, and it is crucial to specify the quantitative assay used in studies.
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Affiliation(s)
- Marc Wirden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Romain Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Basma Abdi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Marc Antoine Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Roland Tubiana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Luminita Schneider
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Sophie Seang
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Antoine Faycal
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Baptiste Sellem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Christine Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
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3
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Katlama C, Dudoit Y, Huyard J, Blanc C, Soulié C, Schneider L, Faycal A, Lenclume L, Hamani N, Qatib N, Tubiana R, Seang S, Sellem B, Costagliola D, Palich R, Valantin MA, Assoumou L. Household transmission of SARS-CoV-2 infection in the Paris/Ile-de-France area. Eur J Clin Microbiol Infect Dis 2022; 41:445-454. [PMID: 34997388 PMCID: PMC8741543 DOI: 10.1007/s10096-021-04345-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023]
Abstract
This st udy aims to evaluate the prevalence of SARS-CoV-2 antibodies in locked-down family households to determine viral dynamics and immunity acquisition. COVID-19 individuals and their households in lockdown under the same roof during early spring 2020 were interviewed and tested using rapid immunochromatographic lateral flow antibodies assays (LFA) between July and September 2020. Outcomes were secondary infection rate (SIR) among contacts, household infection rate, and predictors of transmission. We enrolled 87 households including 87 COVID-19 index cases (female 78.2%; median age: 47.0 years, IQR: 42.0-51.5) and 255 contacts (males: 52.9%; median age: 19.0 years, IQR: 11.0-43.5) consisting of their children (42%) or spouses/partners (28.2%). A total of 95/255 contacts were SARS-CoV-2 antibody positive leading to a SIR of 37.3% (95% confidence interval (CI): 31.3-43.5%). Viral transmission was observed in 54 households (62%). SARS-CoV-2 infection was asymptomatic in 33/95 (34.7%) of SARS-CoV-2-positive contacts. Independent predictors of virus transmission from index to contacts were housing surface area < 60 m2 (OR: 5.6 [1.1; 28.2] and a four-member family compared to five (OR: 3.6 [1.2; 10.3]). Households represent a high-risk setting for SARS-CoV-2 transmission through close contact within the family amplified by the number of family members and the housing surface area.
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Affiliation(s)
- Christine Katlama
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France.
- Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, AP-HP 47-83 Boulevard de l'hôpital, 75013, Paris, France.
| | - Yasmine Dudoit
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Julien Huyard
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
| | - Christine Blanc
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Cathia Soulié
- Department of Virology, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 75013, Paris, France
| | - Luminita Schneider
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Antoine Faycal
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Ludovic Lenclume
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Naima Hamani
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Naoual Qatib
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Roland Tubiana
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Sophie Seang
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Baptiste Sellem
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Dominique Costagliola
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
| | - Romain Palich
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Lambert Assoumou
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
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Jary A, Marot S, Faycal A, Leon S, Sayon S, Zafilaza K, Ghidaoui E, Quoc SN, Nemlaghi S, Choquet S, Dres M, Pourcher V, Calvez V, Junot H, Marcelin AG, Soulié C. Spike Gene Evolution and Immune Escape Mutations in Patients with Mild or Moderate Forms of COVID-19 and Treated with Monoclonal Antibodies Therapies. Viruses 2022; 14:v14020226. [PMID: 35215820 PMCID: PMC8877338 DOI: 10.3390/v14020226] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 12/16/2022] Open
Abstract
We explored the molecular evolution of the spike gene after the administration of anti-spike monoclonal antibodies in patients with mild or moderate forms of COVID-19. Four out of the 13 patients acquired a mutation during follow-up; two mutations (G1204E and E406G) appeared as a mixture without clinical impact, while the Q493R mutation emerged in two patients (one receiving bamlanivimab and one receiving bamlanivimab/etesevimab) with fatal outcomes. Careful virological monitoring of patients treated with mAbs should be performed, especially in immunosuppressed patients.
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Affiliation(s)
- Aude Jary
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
- Correspondence: ; Tel.: +33-1-4217-7401
| | - Stéphane Marot
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Antoine Faycal
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Maladie Infectieuses et Tropicales, 75013 Paris, France;
| | - Sacha Leon
- Service de Pharmacie, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.L.); (H.J.)
| | - Sophie Sayon
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Karen Zafilaza
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Emna Ghidaoui
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Stéphanie Nguyen Quoc
- Service d’Hématologie Clinique, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.N.Q.); (S.C.)
| | - Safaa Nemlaghi
- Service de Médecine Intensive–Réanimation (Département “R3S”), AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.N.); (M.D.)
| | - Sylvain Choquet
- Service d’Hématologie Clinique, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.N.Q.); (S.C.)
| | - Martin Dres
- Service de Médecine Intensive–Réanimation (Département “R3S”), AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.N.); (M.D.)
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM, Sorbonne Université, 75013 Paris, France
| | - Valérie Pourcher
- Service de Maladie Infectieuses et Tropicales, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France;
| | - Vincent Calvez
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Helga Junot
- Service de Pharmacie, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (S.L.); (H.J.)
| | - Anne-Geneviève Marcelin
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Cathia Soulié
- Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), INSERM, Sorbonne Université, 75013 Paris, France; (S.M.); (S.S.); (K.Z.); (E.G.); (V.C.); (A.-G.M.); (C.S.)
- AP-HP, Pitié-Salpêtrière, Service de Virologie, Bâtiment CERVI, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
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5
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Palich R, Abdi B, Wirden M, Lourida G, Tubiana R, Faycal A, Valantin MA, Schneider L, Seang S, Agher R, Simon A, Soulie C, Le MP, Peytavin G, Calvez V, Marcelin AG, Katlama C. Intermittent two-drug antiretroviral therapies maintain long-term viral suppression in real life in highly experienced HIV-infected patients. J Antimicrob Chemother 2021; 76:1893-1897. [PMID: 33855355 DOI: 10.1093/jac/dkab108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess in real life whether two-drug regimens (2-DRs) given 4-5 days a week in virally suppressed patients can maintain viral suppression over 48 and 96 weeks. METHODS This observational single-centre study enrolled all patients who initiated an intermittent 2-DR between 01/01/2016 and 30/06/2019. The primary outcome was the rate of virological failure (VF), defined as confirmed plasma viral load (pVL) ≥50 copies/mL or single pVL ≥50 copies/mL followed by ART change at week 48 (W48) and W96. Secondary outcomes were the 2-DR intermittent strategy success rate (pVL <50 copies/mL with no ART change), change in CD4 count, CD4/CD8 ratio and rate of residual viraemia. RESULTS Eighty-five patients were included; 67/85 (79%) were men, median age = 57 years (IQR = 50-63), CD4 nadir = 233 cells/mm3 (110-327), ART duration = 21 years (13-24), duration of virological suppression = 6.5 years (3.7-10.8) and CD4 count = 658 cells/mm3 (519-867). Intermittent 2-DRs consisted of integrase strand transfer inhibitor (INSTI)/NNRTI (58%), INSTI/NRTI (13%), two NRTIs (11%), PI/NRTI (7%) and other combinations (11%). The median follow-up was 90 weeks (IQR = 64-111). Overall, four VFs occurred, leading to a virological success rate of 98.8% (95% CI = 93.6-100) at W48 and 95.3% (95% CI = 88.4-98.7) at W96. Resuming the same 2-DR 7 days a week led to viral resuppression in three patients, whereas the M184V mutation emerged in one patient, leading to ART modification. There was no significant change in the CD4 count or residual viraemia rate, but a small increase in the CD4/CD8 ratio (P = 0.009) occurred over the study period. CONCLUSIONS This observational study shows the potential for intermittent 2-DRs to maintain a high virological success rate, which should be assessed in larger prospective randomized studies.
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Affiliation(s)
- Romain Palich
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Basma Abdi
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Marc Wirden
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Giota Lourida
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Roland Tubiana
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Antoine Faycal
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Marc-Antoine Valantin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Luminita Schneider
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Sophie Seang
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Rachid Agher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Anne Simon
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Cathia Soulie
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Minh-Patrick Le
- Bichat Claude Bernard Hospital, Pharmacology-Toxicology Department, AP-HP, INSERM, UMRS 1144, Université de Paris, Paris, France
| | - Gilles Peytavin
- Bichat Claude Bernard Hospital, Pharmacology-Toxicology Department, AP-HP, IAME, INSERM, UMRS 1137, Université de Paris, Paris, France
| | - Vincent Calvez
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Christine Katlama
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
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