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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

2015; Oxford University Press; Volume: 70; Issue: 7 Linguagem: Inglês

10.1093/jac/dkv049

1460-2091

Pierre Frange, Lambert Assoumou, Diane Descamps, Antoine Chéret, Cécile Goujard, Laurent Tran, Marine Gousset, Véronique Avettand-Fènoël, Laurence Bocket, Samira Fafi‐Kremer, Jérôme Guinard, Laurence Morand-Joubert, Florence Nicot, Jean‐Christophe Plantier, Sylvie Ranger‐Rogez, Marc Wirden, Christine Rouzioux, Laurence Meyer, Marie‐Laure Chaix, Sylvie Abel, Bruno Abraham, T. Allegre, A. Antoniotti, R. Armero, B. Audhuy, Hugues Aumaître, G. Beaucaire, Geneviève Beck-Wirth, J.L. Berger, Louis Bernard, C. Beuscart, Loïc Bodard, O. Bouchaud, François Boué, J.-P. Cabane, André Cabié, H. Champagne, Geneviève Chêne, Jean-Marie Chennebault, Antoine Chéret, Brander Christian, A. Compagnucci, V. Daneluzzi, Yasmine Debab, P. Dellamonica, Jean‐François Delfraissy, A. Devidas, Georges Diab, J. Doll, M.C. Drobacheff-Thebaut, A. Durel, C. Duvivier, J.-L. Esnault, L. Faba, Eric Froguel, D. Garipuy, Valérie Garrait, L. Geffray, Claire Genet, P. Genet, Laurence Gérard, Jade Ghosn, Jean-Jacques Girard, Pierre Marie Girard, C. Godin-Collet, P. Hochedez, Bruno Hoën, D. Houlbert, Christine Jacomet, V. Jeantils, K. Jidar, Christine Katlama, E. Klement, Alain Lafeuillade, C. Lascoux, V. Launay, A. Leprêtre, Yves Lévy, Djamila Makhloufi, D Malbec, B. Martha, T. May, Dominique Merrien, P. Miailhes, C. Miodovski, Jean‐Michel Molina, Philippe Morlat, E. Mortier, D. Neau, M. Obadia, O. Patey, J.L. Pellegrin, V. Perronne, P. Philibert, Gilles Pialoux, G. Pichancourt, L. Piroth, Yves Poinsignon, Sylvie Abel, T. Prazuck, Virginie Prendki, F. Preveteau du Clary, D. Quinsat, F. Raffi, Angelique Regnier‐Golanov, J. Reynes, É. Rosenthal, É. Rouveix, D. Salmon, F. Salanville, J.‐L. Schmitt, A. Simon-Coutellier, Albert Sotto, Faouzi Souala, A. Stein, F.-J. Timsit, P. de Truchis, A. Uludag, O. Vaillant, Renaud Verdon, A. Verlesch-Langlin, Jean Paul Viard, Daniel Vittecoq, Laurence Weiss, P. Yéni, David Zucman, C. Allavena, T. Allegre, I. Amri, Brigitte Autran, C. Bacchus, Catherine Blanc, S. Bonne, B. Bonnet, S. Bouchez, C. Charlier, Paul‐Henri Consigny, C. Duvivier, Erwan Fourn, F. Guiroy, T. Huleux, Christine Katlama, Caroline Lascoux‐Combe, A. Leplatois, Thomas L’Yavanc, Jean‐Michel Molina, A. Naqvi, Georges Nembot, Yann Quertainmont, F. Raffi, A. Samri, L Schneider, Sophie Seang, Bao Chau Phung Seksik, M. Shoai-Tehrani, Laurence Slama, M. A. Valentin, Y. Yazdanpanah, C. Alloui, Corinne Amiel, Patrice André, Elisabeth André‐Garnier, Guerric Anies, F. Barin, P. Bellecave, D. Bettinger, Magali Bouvier‐Alias, F. Brun-Vézinet, A. Calmy, Vincent Cálvez, W. Caveng, Antoine Chaillon, S. Chapalay, C. Charpentier, Dominique Costagliola, J Cottalorda, Catherine Delamare, Constance Delaugerre, Julia Dina, G. Dos Santos, Virginie Ferré, Philippe Flandre, Heloísa Junqueira Fleury, S. Fourati, C. Gaille, G. Giraudeau, A. Guigon, S. Haïm-Boukobza, E. Lagier, Hélène Le Guillou‐Guillemette, C. Henquell, J. Izopet, S. Lambert-Niclot, M. Leroux, Anne Maillard, I. Malet, Anne‐Geneviève Marcelin, Stéphanie Marque‐Juillet, B. Masquelier, A. Mirand, P. Morand, Brigitte Montès, L. Mouna, C. Noël, C. Pallier, G. Peytavin, P. Pinson-Recordon, J.D. Poveda, Stéphanie Raymond, Sandrine Reigadas, A. M. Roques, Alexis de Rougemont, C. Roussel, Marie‐Paule Schmitt, V. Schneider, E. Schvoerer, A. Signori-Schmuck, Cathia Soulié, Catherine Tamalet, J.C. Tardy, Mary‐Anne Trabaud, Astrid Vabret, Sophie Vallet, Sabine Yerly,

Pneumocystis jirovecii pneumonia detection and treatment

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 2010–12 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.