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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.

  • Author(s): 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
  • French ANRS CO 6 PRIMO Cohort, the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups
  • French ANRS CO 6 PRIMO Cohort the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups
  • et al.

Published Web Location

https://academic.oup.com/jac/article/70/7/2084/774670
No data is associated with this publication.
Abstract

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.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.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).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.

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