Comparison of the immunological and virological responses to cART between HIV-1/O and HIV-1/M patients followed up in France
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Duthe, J | Perfezou, P | L Berger, J | Brodard, V | Kmiec, I | Rouger, C | Strady, C | M Chappelin, J | Maillard, A | Ratajczak, M | Debab, Y | de Oliveira, F | Depatureaux, A | Gueit, I | Lemee, V | Theron, D | Pasdeloup, I | Camps, P | Bigaillon, C | Ficko, C | Imbert, C | Rapp, C | Grand, C | Michau, C | Bornarel, D | Devillier, P | Farfour, E | Majerholc, C | Vignon, D | Zucman, D | El Addouli, M | F Danjoux, M | Journe, J | Leveneur, Y | Marchou, B | Nicot, F | Prevoteau Du Clary, F | Bonne, S
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CCSD ; Oxford University Press (OUP) -
International audience.
Abstract Background Therapeutic outcomes for patients infected by genetically divergent HIV-1/O are not well-known due to scarce data and the lack of an appropriate comparison with patients infected by pandemic HIV-1/M. We aimed to compare the immunological and virological response to cART between HIV-1/O and HIV-1/M patients followed in France. Methods All naïve HIV-1/O subjects initiating cART in France in ANRS-ORIVAO study were compared to naïve HIV-1/M subjects initiating cART in ANRS-COPANA cohort. Piecewise linear mixed-effect models and Kaplan–Meier survival curves were used to analyse immunological and virological response to cART overall (65 HIV-1/O versus 279 HIV-1/M), then only in patients initiating 2INTI + 1PI/r. Results Plasma viral load (pVL) at treatment initiation was 0.6 log10 copies/mL lower in HIV-1/O than in HIV-1/M patients (P = 0.004) in the overall population, but there was no difference in the time to pVL < 200 cp/mL after cART initiation (log rank test, P = 0.57). Meanwhile, baseline CD4 counts were lower in HIV-1/O (median 180/mm3) than HIV-1/M (248/mm3) patients (P = 0.001). At 4 months, the increase in CD4 counts did not differ (P = 0.96) between groups but remained lower in HIV-1/O patients beyond 4 months of treatment (P = 0.04). In PI/r population, baseline pVL was 1 log10 copies/mL lower for HIV-1/O than HIV-1/M patients, leading to significantly faster attainment of pVL < 200 cp/mL (log rank test: P < 0.001); immunological response to cART was similar. Conclusions HIV-1/O and HIV-1/M immunological and virological responses to cART did not differ when epidemiological characteristics of the patients were taken into account. In France, treating HIV-1/O following HIV-1/M guidelines leads to similar therapeutic outcomes.
