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.

Pierre Frange,Lambert Assoumou,Diane Descamps,Cecile Goujard,Laurent Tran,Marine Gousset,Veronique Avettandfenoel,Laurence Bocket,Samira Fafikremer,Jerome Guinard,Laurence Morandjoubert,Florence Nicot,Jeanchristophe Plantier,S Rogez,Marc Wirden,Christine Rouzioux,Laurence Meyer,Marielaure Chaix,Sylvie Abel, B Abraham,T Allegre, A Antoniotti, R Armero, B Audhuy,Hugues Aumaitre,Gilles Beaucaire, G Beckwirth, J Berger,Louis Bernard, C Beuscart, L Bodard,O Bouchaud,F Boue, J Cabane,A Cabie, H Champagne,C Cheneau,J M Chennebault,Antoine Cheret, B Christian,A Compagnucci, V Daneluzzi, Y Debab, P Dellamonica,J F Delfraissy,Alain Devidas, G Diab, J Doll,M C Drobacheffthebaut, A Durel,C Duvivier, Jeanluc Esnault, L Faba, E Froguel, D Garipuy, Valerie Garrait, L Geffray, C Genet,Philippe Genet,Laurence Gerard,Jade Ghosn, J J Girard, P M Girard, C Godincollet,Patrick Hochedez,B Hoen, D Houlbert,C Jacomet, Vincent Jeantils, K Jidar,Christine Katlama, E Klement,Alain Lafeuillade,C Lascoux, V Launay, Annie Lepretre,Yves Levy, Djamila Makhloufi, D Malbec,Benoit Martha,Thomas May, D Merrien,Patrick Miailhes, C Miodovski,J M Molina,P Morlat,E Mortier,D Neau,Martine Obadia,O Patey, J L Pellegrin,V Perronne, P Philibert,G Pialoux, G Pichancourt,Lionel Piroth, Yves Poinsignon,Isabelle Poizotmartin,T Prazuck,Virginie Prendki,F Preveteau Du Clary, D Quinsat,F Raffi, Arnaud Regnier, J Reynes,E Rosenthal,E Rouveix, D P Salmon, F Salanville, J L Schmitt, A Simoncoutellier,A Sotto, F Souala, Anthony S Stein, F J Timsit,P De Truchis, Agnes Villemant Uludag, Odile Luycx Vaillant,R Verdon, A Verleschlanglin,Jeanpaul Viard,D Vittecoq, L Weiss,P Yeni,D Zucman,Clotilde Allavena, I Amri,Brigitte Autran,Charline Bacchus,Catherine Le Blanc, S Bonne, Brice Bonnet,S Bouchez, Caroline Charlier,P H Consigny,E Fourn, Frederique Guiroy, T Huleux,Caroline Lascouxcombe,A Leplatois, T Lyavanc,A Naqvi,Georges Nembot, Y Quertainmont,Assia Samri,Lon S Schneider, S Seang,Bao Chau Phung Seksik, M Shoaitehrani,L Slama, M A Valentin,Yazdan Yazdanpanah,C Alloui,Corinne Amiel,Patrice Andre,Elisabeth Andregarnier,Guerric Anies,Francis Barin,Pantxika Bellecave,D Bettinger,Magali Bouvieralias, F Brunvezinet,Alexandra Calmy,Vincent Calvez, W Caveng,Antoine Chaillon, S Chapalay,Charlotte Charpentier,Dominique Costagliola, J Cottalorda,C Delamare,Constance Delaugerre,Julia Dina,G Dos Santos,Virginie Ferre,Philippe Flandre,Herve J Fleury,Slim Fourati, C Gaille, G Giraudeau,A Guigon,Stephanie Haimboukobza, Evelyne Lagier,H Le Guillouguillemette,Cecile Henquell,Jacques Izopet,Sidonie Lambertniclot, Michel R Leroux,A Maillard,Isabelle Malet,A G Marcelin, S Marquejuillet,Bernard Masquelier,Audrey Mirand, P Morand,Brigitte Montes, L Mouna,C Noel,C Pallier,Gilles Peytavin, P Pinsonrecordon,Jeandominique Poveda,Stephanie Raymond,Sandrine Reigadas, A M Roques,A De Rougemont,C Roussel, M P Schmitt,Veronique Schneider,Evelyne Schvoerer,Anne Signorischmuck,Cathia Soulie,C Tamalet,J C Tardy,M A Trabaud,Astrid Vabret,Sophie Vallet,Sabine Yerly

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY（2015）

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摘要

Background: 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. Methods: 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. Results: 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 201012 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). Conclusions: 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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HIV-1,resistance-associated mutations,primary HIV infection

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