Paul Loubet1, Charlotte Charpentier2, Benoit Visseaux3, Abraham Borbor4, Cecilia Nuta4, Eric Adu4, Jean-Marc Chapplain5, Maima Baysah6, Pierre Tattevin5, Yazdan Yazdanpanah7, Diane Descamps3. 1. Ensemble pour une Solidarité Thérapeutique en Réseau (GIP-ESTHER), Paris, France INSERM, IAME, UMR 1137, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France. 2. INSERM, IAME, UMR 1137, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France charlotte.charpentier@bch.aphp.fr. 3. INSERM, IAME, UMR 1137, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, F-75018 Paris, France. 4. John F. Kennedy Medical Center, Infectious Diseases Clinic, Monrovia, Liberia. 5. Centre Hospitalo-Universitaire de Rennes, Service de Maladies Infectieuses et Tropicales, Rennes, France. 6. Redemption Hospital, Infectious Diseases Clinic, Monrovia, Liberia. 7. INSERM, IAME, UMR 1137, F-75018 Paris, France AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France Université Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France.
Abstract
OBJECTIVES: To assess the prevalence of acquired drug resistance in HIV-1-infected patients living in Monrovia, Liberia, who had clinical and/or immunological failure of first-line ART according to WHO criteria. PATIENTS AND METHODS: Patients receiving ART for >1 year with clinical and/or immunological failure were included. Sequencing of protease and reverse transcriptase regions was performed using Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS) procedures and sequences were interpreted using the ANRS resistance algorithm. RESULTS: Ninety patients were enrolled. They had been receiving ART for a median time of 42 months and half were receiving zidovudine/lamivudine/nevirapine. Seventy-five per cent of patients were infected with CRF02_AG. Twenty-seven per cent of patients displayed a plasma viral load <50 copies/mL. Among the 66 patients with detectable viraemia, the median viral load was 4.7 log10 copies/mL (IQR = 3.0-5.6). The prevalence of NRTI and NNRTI resistance-associated mutations (RAMs) was 63% and 71%, respectively; and the median number of NRTI and NNRTI RAMs was 2 and 3, respectively. Two patients (4%) displayed viruses with PI RAMs. Regarding NRTI drug resistance, 29%, 38%, 63%, 29% and 25% of patients had viruses resistant to zidovudine, stavudine, lamivudine/emtricitabine, abacavir and tenofovir, respectively. Regarding the NNRTI drug class, 56%, 65%, 33% and 42% of patients had viruses resistant to efavirenz, nevirapine, etravirine and rilpivirine, respectively. CONCLUSIONS: The high prevalence of acquired drug resistance in patients followed in two centres of the Liberian capital city, documented after a median of 3 years on a first-line ART regimen, jeopardizes the activity of second-line regimens and highlights the need for virological monitoring in these settings.
OBJECTIVES: To assess the prevalence of acquired drug resistance in HIV-1-infectedpatients living in Monrovia, Liberia, who had clinical and/or immunological failure of first-line ART according to WHO criteria. PATIENTS AND METHODS: Patients receiving ART for >1 year with clinical and/or immunological failure were included. Sequencing of protease and reverse transcriptase regions was performed using Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS) procedures and sequences were interpreted using the ANRS resistance algorithm. RESULTS: Ninety patients were enrolled. They had been receiving ART for a median time of 42 months and half were receiving zidovudine/lamivudine/nevirapine. Seventy-five per cent of patients were infected with CRF02_AG. Twenty-seven per cent of patients displayed a plasma viral load <50 copies/mL. Among the 66 patients with detectable viraemia, the median viral load was 4.7 log10 copies/mL (IQR = 3.0-5.6). The prevalence of NRTI and NNRTI resistance-associated mutations (RAMs) was 63% and 71%, respectively; and the median number of NRTI and NNRTI RAMs was 2 and 3, respectively. Two patients (4%) displayed viruses with PI RAMs. Regarding NRTI drug resistance, 29%, 38%, 63%, 29% and 25% of patients had viruses resistant to zidovudine, stavudine, lamivudine/emtricitabine, abacavir and tenofovir, respectively. Regarding the NNRTI drug class, 56%, 65%, 33% and 42% of patients had viruses resistant to efavirenz, nevirapine, etravirine and rilpivirine, respectively. CONCLUSIONS: The high prevalence of acquired drug resistance in patients followed in two centres of the Liberian capital city, documented after a median of 3 years on a first-line ART regimen, jeopardizes the activity of second-line regimens and highlights the need for virological monitoring in these settings.
Authors: George A Yendewa; Foday Sahr; Sulaiman Lakoh; Marta Ruiz; Lucia Patiño; Andrés Tabernilla; Gibrilla F Deen; Momodu Sesay; Robert A Salata; Eva Poveda Journal: J Antimicrob Chemother Date: 2019-07-01 Impact factor: 5.790
Authors: Kevin Melody; Chandra N Roy; Christopher Kline; Mackenzie L Cottrell; Dwayne Evans; Kathleen Shutt; Pleuni S Pennings; Brandon F Keele; Moses Bility; Angela D M Kashuba; Zandrea Ambrose Journal: J Virol Date: 2020-03-31 Impact factor: 6.549