HIV-1 subtype B-infected MSM may have driven the spread of transmitted resistant strains in France in 2007–12: impact on susceptibility to first-line strategies

Medientyp: E-Artikel
Titel: HIV-1 subtype B-infected MSM may have driven the spread of transmitted resistant strains in France in 2007–12: impact on susceptibility to first-line strategies
Beteiligte: Frange, Pierre; Assoumou, Lambert; Descamps, Diane; Chéret, Antoine; Goujard, Cécile; Tran, Laurent; Gousset, Marine; Avettand-Fenoël, Veronique; Bocket, Laurence; Fafi-Kremer, Samira; Guinard, Jerome; Morand-Joubert, Laurence; Nicot, Florence; Plantier, Jean-Christophe; Rogez, Sylvie; Wirden, Marc; Rouzioux, Christine; Meyer, Laurence; Chaix, Marie-Laure; Abel, S.; Abraham, B.; Allegre, T.; Antoniotti, A.; Armero, R.; [...]
Erschienen: Oxford University Press (OUP), 2015
Erschienen in: Journal of Antimicrobial Chemotherapy
Sprache: Englisch
DOI: 10.1093/jac/dkv049
ISSN: 1460-2091; 0305-7453
Schlagwörter: Infectious Diseases ; Pharmacology (medical) ; Pharmacology ; Microbiology (medical)
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Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Our study describes the prevalence of transmitted drug resistance (TDR) among 1318 French patients diagnosed at the time of primary HIV-1 infection (PHI) in 2007–12.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>HIV-1 resistance-associated mutations (RAMs) were characterized using both the 2009 WHO list of mutations and the French ANRS algorithm. A genotypic susceptibility score was estimated for each first-line recommended ART combination.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Patients were mainly MSM (72.6%). Non-B variants were identified in 33.7% of patients. The proportion of TDR was estimated as 11.7% (95% CI 10.0–13.5). The prevalences of PI-, NRTI-, first-generation NNRTI and etravirine/rilpivirine-associated RAMs were 2.5%, 5.2%, 3.9% and 3.2%, respectively. Single, dual and triple class resistance was found in 9.6%, 1.0% and 1.1% of cases, respectively. Additionally, 5/331 strains isolated in 2010–12 had integrase inhibitor (II)-related RAMs (isolated E157Q mutation in all cases). TDR was more common among MSM than in other groups (12.9% versus 8.6%, P = 0.034), and in case of B versus non-B subtype infections (13.6% versus 7.9%, P = 0.002). The proportions of fully active combinations were ≥99.2%, ≥97.3% and ≥95.3% in cases of PI-, II- and NNRTI-based regimens, respectively. In 2010–12, the proportion of fully active efavirenz-based ART was lower in cases of subtype B versus non-B infection (P = 0.021).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Compared with our previous studies, the proportion of NRTI- and first-generation NNRTI-related TDR has continued to decline in French seroconverters. However, subtype B-infected MSM could drive the spread of resistant HIV strains. Finally, we suggest preferring PI- or II- to NNRTI-based combinations to treat PHI patients.</jats:p> </jats:sec>
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