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.

Abstract

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 2010-12 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.

• Authors: Pierre Frange, Lambert Assoumou, Diane Descamps, Antoine Chéret, Cécile Goujard, Laurent Tran, Marine Gousset, Veronique Avettand-Fenoël, Laurence Bocket, Samira Fafi-Kremer, Jerome Guinard, Laurence Morand-Joubert, Florence Nicot, Jean-Christophe Plantier, Sylvie Rogez, Marc Wirden, Christine Rouzioux, Laurence Meyer, Marie-Laure Chaix, French ANRS CO 6 PRIMO Cohort, the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups, French ANRS CO 6 PRIMO Cohort the ANRS 147 OPTIPRIM Clinical Trial and the AC11 Resistance Study Groups
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 70 Issue 7 Pg. 2084-9 (Jul 2015) ISSN: 1460-2091 [Electronic] England
• PMID: 25885327 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• Anti-HIV Agents

Topics

• Anti-HIV Agents (pharmacology)
• Disease Transmission, Infectious
• Drug Resistance, Viral
• Female
• France (epidemiology)
• Genotype
• Genotyping Techniques
• HIV Infections (epidemiology, transmission)
• HIV-1 (classification, drug effects, genetics, isolation & purification)
• Homosexuality, Male
• Humans
• Male
• Mutation, Missense
• Prevalence