Stable prevalence of transmitted drug resistance mutations and increased circulation of non-B subtypes in antiretroviral-naive chronically HIV-infected patients in 2015/2016 in France.
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Assoumou Lambert, Bocket Laurence, Pallier Coralie, Grude Maxime, Ait-Namane Rachid, Izopet Jacques, Raymond Stéphanie, Charpentier Charlotte, Visseaux Benoit, Wirden Marc, Trabaud Mary-Anne, Le Guillou-Guillemette Hélène, Allaoui Chakib, Henquell Cécile, Krivine Anne, Dos Santos Georges, Delamare Catherine, Bouvier-Alias Magali, Montes Brigitte, Ferre Virginie, De Monte Anne, Signori-Schmuck Anne, Maillard Anne, Morand-Joubert Laurence, Tumiotto Camille, Fafi-Kremer Samira, Amiel Corinne, Barin Francis, Marque-Juillet Stéphanie, Courdavault Laurence, Vallet Sophie, Beby-Defaux Agnès, de Rougemont Alexis, Fenaux Honorine, Avettand-Fenoel Véronique, Allardet-Servent Annick, Plantier Jean-Christophe, Peytavin Gilles, Calvez Vincent, Chaix Marie-Laure, Descamps Diane, ANRS AC-43 Resistance Study Group
Аннотация
PATIENTS AND METHODS: TDRAMs were sought in samples from 660 diagnosed HIV-1-infected individuals in 2015/2016 in 33 HIV clinical centres. Weighted analyses, considering the number of patients followed in each centre, were used to derive representative estimates of the percentage of individuals with TDRAMs. Results were compared with those of the 2010/2011 survey (n = 661) using the same methodology.
RESULTS: At inclusion, median CD4 cell counts and plasma HIV-1 RNA were 394 and 350/mm3 (P = 0.056) and 4.6 and 4.6 log10 copies/mL (P = 0.360) in the 2010/2011 survey and the 2015/2016 survey, respectively. The frequency of non-B subtypes increased from 42.9% in 2010/2011 to 54.8% in 2015/2016 (P < 0.001), including 23.4% and 30.6% of CRF02_AG (P = 0.004). The prevalence of virus with protease or reverse-transcriptase TDRAMs was 9.0% (95% CI = 6.8-11.2) in 2010/2011 and 10.8% (95% CI = 8.4-13.2) in 2015/2016 (P = 0.269). No significant increase was observed in integrase inhibitor TDRAMs (6.7% versus 9.2%, P = 0.146). Multivariable analysis showed that men infected with the B subtype were the group with the highest risk of being infected with a resistant virus compared with others (adjusted OR = 2.2, 95% CI = 1.3-3.9).
CONCLUSIONS: In France in 2015/2016, the overall prevalence of TDRAMs was 10.8% and stable compared with 9.0% in the 2010/2011 survey. Non-B subtypes dramatically increased after 2010. Men infected with B subtype were the group with the highest risk of being infected with a resistant virus, highlighting the need to re-emphasize safe sex messages.