Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma.
- Author(s): Soulie, Cathia;
- Descamps, Diane;
- Grudé, Maxime;
- Schneider, Véronique;
- Trabaud, Mary-Anne;
- Morand-Joubert, Laurence;
- Delaugerre, Constance;
- Montes, Brigitte;
- Barin, Francis;
- Ferre, Virginie;
- Raymond, Stéphanie;
- Jeulin, Hélène;
- Alloui, Chakib;
- Yerly, Sabine;
- Pallier, Coralie;
- Reigadas, Sandrine;
- Signori-Schmuck, Anne;
- Guigon, Aurélie;
- Fafi-Kremer, Samira;
- Haïm-Boukobza, Stéphanie;
- Mirand, Audrey;
- Maillard, Anne;
- Vallet, Sophie;
- Roussel, Catherine;
- Assoumou, Lambert;
- Calvez, Vincent;
- Flandre, Philippe;
- Marcelin, Anne-Geneviève;
- ANRS Resistance AC11 Group
- et al.
Published Web Location
https://academic.oup.com/jac/article/70/2/566/2911334Abstract
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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