Benoit Visseaux1,2, Lambert Assoumou3, Nadia Mahjoub4, Maxime Grude5, Mary-Anne Trabaud6, Stéphanie Raymond7, Marc Wirden8, Laurence Morand-Joubert9, Catherine Roussel10, Brigitte Montes11, Laurence Bocket12, Samira Fafi-Kremer13, Corinne Amiel14, Anne De Monte15, Karl Stefic16, Coralie Pallier17, Camille Tumiotto18, Anne Maillard19, Sophie Vallet20, Virginie Ferre21, Magali Bouvier-Alias22, Julia Dina23, Anne Signori-Schmuck24, Marie-Josée Carles25, Jean-Christophe Plantier26, Laurence Meyer27, Diane Descamps1,2, Marie-Laure Chaix2,4,28. 1. IAME, Université de Paris, AP-HP, UMR 1137, INSERM, Virology, Hôpital Bichat, AP-HP, Paris, France. 2. Centre National de Référence VIH, Paris, France. 3. INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France. 4. Hopital Saint-Louis, Virology, Paris, France. 5. AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France. 6. Hôpital de la Croix Rousse, Virology, Lyon, France. 7. CHU Purpan, Virology, Toulouse, France. 8. CHU Pitié-Salpêtrière, Virology, Paris, France. 9. AP-HP, Hôpital Saint-Antoine, Laboratoire de virologie, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (iPLESP), Paris, France. 10. CHU Amiens, Virology, Amiens, France. 11. CHU Montpellier, Virology, Montpellier, France. 12. CHU Lille, Virology, Lille, France. 13. CHU Strasbourg, Virology, Strasbourg, France. 14. Hopital Tenon, Virology, Paris, France. 15. CHU Nice, Virology, Nice, France. 16. INSERM U1259, Université de Tours, CHU Tours, Virology, Tours, France. 17. Hopital Paul Brousse HUPS, Villejuif, France. 18. CHU Bordeaux, Virology, Bordeaux, France. 19. CHU Rennes, Virology, Rennes, France. 20. CHU Brest, Virology, Brest, France. 21. CHU Nantes, Virology, Nantes, France. 22. CHU Henri Mondor, Virology, Créteil, France. 23. CHU Caen, Caen, France. 24. CHU Grenoble Alpes, Virology, Grenoble, France. 25. CHU-Nimes, Virology, Nimes, France. 26. Normandie University, UNIROUEN Rouen, EA2656, Rouen University Hospital, Virology, Rouen, France. 27. INSERM SC10 US19, Villejuif, INSERM CESP U1018, Université Paris Sud, Université Paris Saclay, France. 28. Université de Paris, INSERM U944, Paris, France.
Abstract
OBJECTIVES: Patients with primary HIV-1 infection (PHI) are a particular population, giving important insight about ongoing evolution of transmitted drug resistance-associated mutation (TDRAM) prevalence, HIV diversity and clustering patterns. We describe these evolutions of PHI patients diagnosed in France from 2014 to 2016. METHODS: A total of 1121 PHI patients were included. TDRAMs were characterized using the 2009 Stanford list and the French ANRS algorithm. Viral subtypes and recent transmission clusters (RTCs) were also determined. RESULTS: Patients were mainly MSM (70%) living in the Paris area (42%). TDRAMs were identified among 10.8% of patients and rose to 18.6% when including etravirine and rilpivirine TDRAMs. Prevalences of PI-, NRTI-, first-generation NNRTI-, second-generation NNRTI- and integrase inhibitor-associated TDRAMs were 2.9%, 5.0%, 4.0%, 9.4% and 5.4%, respectively. In a multivariable analysis, age >40 years and non-R5 tropic viruses were associated with a >2-fold increased risk of TDRAMs. Regarding HIV diversity, subtype B and CRF02_AG (where CRF stands for circulating recombinant form) were the two main lineages (56% and 20%, respectively). CRF02_AG was associated with higher viral load than subtype B (5.83 versus 5.40 log10 copies/mL, P=0.004). We identified 138 RTCs ranging from 2 to 14 patients and including overall 41% from the global population. Patients in RTCs were younger, more frequently born in France and more frequently MSM. CONCLUSIONS: Since 2007, the proportion of TDRAMs has been stable among French PHI patients. Non-B lineages are increasing and may be associated with more virulent CRF02_AG strains. The presence of large RTCs highlights the need for real-time cluster identification to trigger specific prevention action to achieve better control of the epidemic.
OBJECTIVES:Patients with primary HIV-1 infection (PHI) are a particular population, giving important insight about ongoing evolution of transmitted drug resistance-associated mutation (TDRAM) prevalence, HIV diversity and clustering patterns. We describe these evolutions of PHI patients diagnosed in France from 2014 to 2016. METHODS: A total of 1121 PHI patients were included. TDRAMs were characterized using the 2009 Stanford list and the French ANRS algorithm. Viral subtypes and recent transmission clusters (RTCs) were also determined. RESULTS:Patients were mainly MSM (70%) living in the Paris area (42%). TDRAMs were identified among 10.8% of patients and rose to 18.6% when including etravirine and rilpivirine TDRAMs. Prevalences of PI-, NRTI-, first-generation NNRTI-, second-generation NNRTI- and integrase inhibitor-associated TDRAMs were 2.9%, 5.0%, 4.0%, 9.4% and 5.4%, respectively. In a multivariable analysis, age >40 years and non-R5 tropic viruses were associated with a >2-fold increased risk of TDRAMs. Regarding HIV diversity, subtype B and CRF02_AG (where CRF stands for circulating recombinant form) were the two main lineages (56% and 20%, respectively). CRF02_AG was associated with higher viral load than subtype B (5.83 versus 5.40 log10 copies/mL, P=0.004). We identified 138 RTCs ranging from 2 to 14 patients and including overall 41% from the global population. Patients in RTCs were younger, more frequently born in France and more frequently MSM. CONCLUSIONS: Since 2007, the proportion of TDRAMs has been stable among French PHI patients. Non-B lineages are increasing and may be associated with more virulent CRF02_AG strains. The presence of large RTCs highlights the need for real-time cluster identification to trigger specific prevention action to achieve better control of the epidemic.
Authors: Karl Stefic; Nadia Mahjoub; Céline Desouche; Marie Laure Néré; Damien Thierry; Constance Delaugerre; Francis Barin; Marie Laure Chaix Journal: Open Forum Infect Dis Date: 2020-04-21 Impact factor: 3.835
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