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A Very Low Geno2pheno False Positive Rate Is Associated with Poor Viro-Immunological Response in Drug-Naïve Patients Starting a First-Line HAART

2014; Public Library of Science; Volume: 9; Issue: 8 Linguagem: Inglês

10.1371/journal.pone.0105853

1932-6203

Daniele Armenia, Cathia Soulié, Domenico Di Carlo, Lavinia Fabeni, Caterina Gori, Federica Forbici, Valentina Svicher, Ada Bertoli, Loredana Sarmati, Massimo Giuliani, Alessandra Latini, Evangelo Boumis, Mauro Zaccarelli, Rita Bellagamba, Massimo Andreoni, Anne‐Geneviève Marcelin, Vincent Cálvez, Andrea Antinori, Francesca Ceccherini‐Silberstein, Carlo Federico Perno, Maria Mercedes Santoro,

HIV/AIDS Research and Interventions

We previously found that a very low geno2pheno false positive rate (FPR ≤ 2%) defines a viral population associated with low CD4 cell count and the highest amount of X4-quasispecies. In this study, we aimed at evaluating whether FPR ≤ 2% might impact on the viro-immunological response in HIV-1 infected patients starting a first-line HAART.The analysis was performed on 305 HIV-1 B subtype infected drug-naïve patients who started their first-line HAART. Baseline FPR (%) values were stratified according to the following ranges: ≤ 2; 2-5; 5-10; 10-20; 20-60; >60. The impact of genotypically-inferred tropism on the time to achieve immunological reconstitution (a CD4 cell count gain from HAART initiation ≥ 150 cells/mm(3)) and on the time to achieve virological success (the first HIV-RNA measurement 60; p = 0.008). The overall proportion of patients achieving virological success was 95.5% by 12 months of therapy. Multivariable Cox analyses showed that patients having pre-HAART FPR ≤ 2% had a significant lower relative adjusted hazard [95% C.I.] both to achieve immunological reconstitution (0.37 [0.20-0.71], p = 0.003) and to achieve virological success (0.50 [0.26-0.94], p = 0.031) than those with pre-HAART FPR >60%.Beyond the genotypically-inferred tropism determination, FPR ≤ 2% predicts both a poor immunological reconstitution and a lower virological response in drug-naïve patients who started their first-line therapy. This parameter could be useful to identify patients potentially with less chance of achieving adequate immunological reconstitution and virological undetectability.