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
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Frange, Pierre | Assoumou, Pierre | Descamps, Diane | Chéret, Antoine | Goujard, Cécile | Tran, Laurent | Gousset, Marine | Avettand-Fenoël, Véronique | Bocket, Laurence | Tran, Samira | Guinard, Jérôme | Morand-Joubert, Pierre | Nicot, Florence | Plantier, Jean-Christophe | Rogez, Sylvie | Wirden, Pierre | Rouzioux, Christine | Meyer, Laurence | Chaix, Marie-Laure | Abel, S. | Abraham, B. | Antoniotti, A. | Armero, R. | Audhuy, B. | Aumaitre, H. | Beaucaire, G. | Beck-Wirth, G. | Berger, J.L. | Bernard, L. | Beuscart, C. | Bodard, L. | Bouchaud, O. | Boue, F. | Cabane, J.-P. | Cabié, A. | Champagne, H. | Cheneau, C. | Chennebault, J.-M. | Cheret, A. | Christian, B. | Compagnucci, A. | Daneluzzi, V. | Debab, Y. | Dellamonica, P. | Delfraissy, F. | Devidas, A. | Diab, G. | Doll, J. | Drobacheff-Thebaut, C. | Durel, A. | Esnault, L. | Faba, L. | Froguel, E. | Garipuy, D. | Garrait, V. | Geffray, L. | Genet, C. | Genet, P. | Gérard, L. | Ghosn, J. | Girard, J. | Girard, Pascal | Godin-Collet, C. | Hochedez, P. | Hoen, B. | Houlbert, D. | Jacomet, C. | Jeantils, V. | Jidar, K. | Klement, E. | Lafeuillade, A. | Launay, V. | Leprêtre, A. | Levy, Y. | Makhloufi, D. | Malbec, D. | Martha, B. | May, T. | Merrien, D. | Miailhes, P. | Miodovski, C. | Morlat, P. | Mortier, E. | Neau, D. | Obadia, M. | Patey, O. | Pellegrin, L. | Perronne, V. | Philibert, P. | Pialoux, G. | Pichancourt, G. | Piroth, L. | Poinsignon, Y. | Poizot-Martin, I. | Prazuck, T. | Prendki, V. | Du Clary, F. | Quinsat, D. | Regnier, A. | Reynes, J. | Rosenthal, E. | Rouveix, E. | Salmon, D. | Salanville, F. | Schmitt, L. | Simon-Coutellier, A. | Sotto, A. | Souala, F. | Stein, A. | Timsit, F. | de Truchis, P. | Uludag, A. | Vaillant, O. | Verdon, R. | Verlesch-Langlin, A. | Viard, J.-P. | Vittecoq, D. | Weiss, L. | Yéni, P. | Zucman, D. | Allavena, C. | Allegre, T. | Amri, I. | Autran, B. | Bacchus, C. | Blanc, C. | Bonne, S. | Bonne, B. | Bouchez, S. | Charlier, C. | Consigny, H. | Duvivier, C. | Fourn, E. | Guiroy, F. | Huleux, T. | Katlama, C. | Lascoux, C. | Leplatois, A. | Lyavanc, T. | Molina, J.-M. | Naqvi, A. | Nembot, G. | Quertainmont, Y. | Raffi, F. | Samri, A. | Schneider, L. | Seang, S. | Seksik, B. | Shoai-Tehrani, M. | Slama, L. | Valentin, A. | Yazdanpanah, Y. | Alloui, C. | Amiel, C. | André, P. | André, E. | Anies, G. | Barin, F. | Bellecave, P. | Bettinger, D. | Bouvier-Alias, M. | Brun-Vézinet, F. | Calmy, A. | Calvez, V. | Caveng, W. | Chaillon, A. | Chapalay, S. | Charpentier, C. | Costagliola, D. | Cottalorda, J. | Delamare, C. | Delaugerre, C. | Dina, J. | Santos, G. | Ferre, V. | Flandre, P. | Fleury, H. | Fourati, S. | Gaille, C. | Giraudeau, G. | Guigon, A. | Haim-Boukobza, S. | Lagier, E. | Le Guillou-Guillemette, H. | Henquell, C. | Izopet, Jacques | Lambert-Niclot, Lambert | Leroux, M. | Maillard, A. | Malet, I. | Marcelin, Marc | Marque-Juillet, S. | Masquelier, B. | Mirand, A. | Morand, P. | Montes, B | Mouna, L. | Noel, C. | Pallier, C. | Peytavin, G. | Pinson-Recordon, P. | Poveda, J. | Raymond, S. | Reigadas, S. | Roques, A. | de Rougemont, A. | Roussel, C. | Schmitt, P. | Schneider, V. | Schvoerer, E. | Signori-Schmuck, A. | Soulié, C. | Tamalet, C. | Tardy, C. | Trabaud, A. | Vabret, A. | Vallet, S. | Yerly, S.
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CCSD ; Oxford University Press (OUP) -
International audience.
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.
