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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 1, 2 Lambert Assoumou 3 Diane Descamps 4, 5 Antoine Chéret 6, 2 Cécile Goujard 7, 8 Laurent Tran 7, 9 Marine Gousset 1 Véronique Avettand-Fènoël 2 Laurence Bocket 10 Samira Fafi-Kremer 11, 12 Jérôme Guinard 13 Laurence Morand-Joubert 14 Florence Nicot 15 Jean-Christophe Plantier 16, 17 Sylvie Ranger-Rogez 18 Marc Wirden 19 Christine Rouzioux 1, 2 Laurence Meyer 2, 7 Marie-Laure Chaix 20
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 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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https://hal.univ-lorraine.fr/hal-01486966
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Submitted on : Friday, March 10, 2017 - 4:22:44 PM
Last modification on : Thursday, December 10, 2020 - 3:42:19 AM

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Pierre Frange, Lambert Assoumou, Diane Descamps, Antoine Chéret, Cécile Goujard, et al.. 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. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2015, 70 (7), pp.2084-2089. ⟨10.1093/jac/dkv049⟩. ⟨hal-01486966⟩

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