L Assoumou1, C Charpentier2, P Recordon-Pinson3, M Grudé1, C Pallier4, L Morand-Joubert5, S Fafi-Kremer6, A Krivine7, B Montes8, V Ferré9, M Bouvier-Alias10, J-C Plantier11, J Izopet12, M-A Trabaud13, S Yerly14, J Dufayard15, C Alloui16, L Courdavault17, H Le Guillou-Guillemette18, A Maillard19, C Amiel20, A Vabret21, C Roussel22, S Vallet23, J Guinard24, A Mirand25, A Beby-Defaux26, F Barin27, A Allardet-Servent28, R Ait-Namane1, M Wirden29, C Delaugerre30, V Calvez29, M-L Chaix30, D Descamps2, S Reigadas3,31. 1. Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France. 2. INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Laboratoire Associé au Centre National de Référence du VIH-Résistance aux Antirétroviraux, Paris, France. 3. PTBM, Laboratoire de Virologie, Hôpital Pellegrin, CHU de Bordeaux; UMR 5234 MFP CNRS, Université de Bordeaux, 33076 Bordeaux cedex, France. 4. HU Paris sud, Hôpital Paul Brousse, Laboratoire de Virologie, Villejuif, France. 5. Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Saint-Antoine, F75012 Paris, France. 6. Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. 7. AP-HP, Hôpital Cochin, Laboratoire de Virologie, Paris, France. 8. Laboratoire de Virologie, Hôpital Saint-Eloi, CHU Montpellier, Montpellier, France. 9. EA 4271, Nantes Université UFR Pharmacie, Laboratoire de Virologie, CHU Nantes, Nantes, France. 10. INSERM U955, National Reference Center for Viral Hepatitis B, C et Delta, Department of Virology, Henri Mondor Hospital, University of Paris-Est, Créteil, France. 11. Laboratoire de Virologie et COREVIH Haute-Normandie, CHU de Rouen, Rouen, France. 12. Laboratoire de Virologie, Hôpital Purpan de Toulouse, Toulouse, France. 13. Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 14. Laboratoire de Virologie, Hôpitaux Universitaires de Genève, Genève, Switzerland. 15. Laboratoire de Virologie, Hôpital l'Archet de Nice, Nice, France. 16. Laboratoire de Virologie, Hôpital Avicenne, APHP, HU Paris Seine Saint Denis, Bobigny, France. 17. Laboratoire de Virologie, Centre Hospitalier Victor Dupouy d'Argenteuil, Argenteuil, France. 18. Laboratoire de Virologie, CHU Angers et HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France. 19. Laboratoire de Virologie, CHU de Rennes, Rennes, France. 20. AP-HP, Hôpital Tenon, Laboratoire de Virologie, Paris, France. 21. Laboratoire de Virologie, CHU Caen, Caen, France. 22. Laboratoire de Virologie, CHU Amiens, Amiens, France. 23. Laboratoire de Virologie, CHU Brest, Brest, France. 24. Laboratoire de Virologie, CHR Orléans, Orléans, France. 25. Laboratoire de Virologie, CHU Clermont-Ferrand, Clermont-Ferrand, France. 26. Laboratoire de Virologie, CHU Poitiers, Poitiers, France. 27. Laboratoire de Virologie, CHU Bretonneau, & INSERM U966, Tours, France. 28. Laboratoire de Virologie, CHU de Nimes, Nimes, France. 29. Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Pitié-Salpêtrière, F75013 Paris, France. 30. Laboratoire de Virologie, AP-HP, Hôpital Saint Louis, INSERM U941, Université Paris Diderot, Paris, France. 31. CRB plurithématique, Bordeaux Biothèques Santé, Groupe hospitalier Pellegrin-CHU de Bordeaux, Bordeaux, France.
Abstract
Background: Surveillance of HIV-1 resistance in treated patients with a detectable viral load (VL) is important to monitor, in order to assess the risk of spread of resistant viruses and to determine the proportion of patients who need new antiretroviral drugs with minimal cross-resistance. Methods: The HIV-1 protease and reverse transcriptase (RT) and integrase genes were sequenced in plasma samples from 782 consecutive patients on failing antiretroviral regimens, seen in 37 specialized centres in 2014. The genotyping results were interpreted using the ANRS v24 algorithm. Prevalence rates were compared with those obtained during a similar survey conducted in 2009. Results: The protease and RT sequences were obtained in 566 patients, and the integrase sequence in 382 patients. Sequencing was successful in 60%, 78%, 78% and 87% of patients with VLs of 51-200, 201-500, 501-1000 and >1000 copies/mL, respectively. Resistance to at least one antiretroviral drug was detected in 56.3% of samples. Respectively, 3.9%, 8.7%, 1.5% and 3.4% of patients harboured viruses that were resistant to any NRTI, NNRTI, PI and integrase inhibitor (INI). Resistance rates were lower in 2014 than in 2009. Resistance was detected in 48.5% of samples from patients with a VL between 51 and 200 copies/mL. Conclusion: In France in 2014, 90.0% of patients in AIDS care centres were receiving antiretroviral drugs and 12.0% of them had VLs >50 copies/mL. Therefore, this study suggests that 6.7% of treated patients in France might transmit resistant strains. Resistance testing may be warranted in all treated patients with VL > 50 copies/mL.
Background: Surveillance of HIV-1 resistance in treated patients with a detectable viral load (VL) is important to monitor, in order to assess the risk of spread of resistant viruses and to determine the proportion of patients who need new antiretroviral drugs with minimal cross-resistance. Methods: The HIV-1 protease and reverse transcriptase (RT) and integrase genes were sequenced in plasma samples from 782 consecutive patients on failing antiretroviral regimens, seen in 37 specialized centres in 2014. The genotyping results were interpreted using the ANRS v24 algorithm. Prevalence rates were compared with those obtained during a similar survey conducted in 2009. Results: The protease and RT sequences were obtained in 566 patients, and the integrase sequence in 382 patients. Sequencing was successful in 60%, 78%, 78% and 87% of patients with VLs of 51-200, 201-500, 501-1000 and >1000 copies/mL, respectively. Resistance to at least one antiretroviral drug was detected in 56.3% of samples. Respectively, 3.9%, 8.7%, 1.5% and 3.4% of patients harboured viruses that were resistant to any NRTI, NNRTI, PI and integrase inhibitor (INI). Resistance rates were lower in 2014 than in 2009. Resistance was detected in 48.5% of samples from patients with a VL between 51 and 200 copies/mL. Conclusion: In France in 2014, 90.0% of patients in AIDS care centres were receiving antiretroviral drugs and 12.0% of them had VLs >50 copies/mL. Therefore, this study suggests that 6.7% of treated patients in France might transmit resistant strains. Resistance testing may be warranted in all treated patients with VL > 50 copies/mL.
Authors: Oscar Blanch-Lombarte; José R Santos; Ruth Peña; Esther Jiménez-Moyano; Bonaventura Clotet; Roger Paredes; Julia G Prado Journal: J Antimicrob Chemother Date: 2020-09-01 Impact factor: 5.790