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J Antimicrob Chemother. 2019 May 1;74(5):1417-1424. doi: 10.1093/jac/dkz011.

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.

Author information

1
INSERM, UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
2
CHU Lille, Virology, Lille, France.
3
Hopital Paul Brousse HUPS, Villejuif, France.
4
CHU Purpan, Toulouse, France.
5
Hopital Bichat Claude Bernard, Virology, Paris, France.
6
Univ Paris-Diderot, INSERM UMR 1137, CNR VIH, Paris, France.
7
CHU Pitié-Salpêtrière, Virology, Paris, France.
8
Hôpital de la Croix Rousse, Virology, Lyon, France.
9
CHU Angers, Angers, France.
10
Hopital Avicenne, Virology, Bobigny, France.
11
CHU Clermont-Ferrand, Virology, Clermont-Ferrand, France.
12
Hopital Cochin, Virology, Paris, France.
13
CHU de Martinique, Virology, EA 3547, Fort de France, France.
14
CHU Metz-Thionville, Virology, Metz, France.
15
CHU Henri Mondor, Virology, Créteil, France.
16
CHU Montpellier, Virology, Montpellier, France.
17
CHU Nantes, Virology, Nantes, France.
18
CHU Nice, Virology, Nice, France.
19
CHU Grenoble Alpes, Virology, Grenoble, France.
20
CHU Rennes, Virology, Rennes, France.
21
Hopital Saint-Antoine, Virology, Paris, France.
22
Sorbonne Université, Paris, France.
23
CHU Bordeaux, Virology, Bordeaux, France.
24
CHU Strasbourg, Virology, Strasbourg, France.
25
Hopital Tenon, Virology, Paris, France.
26
CHU Tours, Virology, Tours, France.
27
CHU Versailles, Virology, Versailles, France.
28
CH Argenteuil, Virology, Argenteuil, France.
29
CHU Brest, Virology, Brest, France.
30
CHU Poitiers, Virology, Poitiers, France.
31
CHU Dijon, Virology, Dijon, France.
32
CHU Nancy, Virology, Nancy, France.
33
CHU Necker-Enfants Malades, Virology, Paris, France.
34
Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
35
CHU-Nimes, Virology, Nimes, France.
36
Normandie Univ, UNIROUENRouen, EA2656, Rouen University Hospital, Virology, Rouen, France.
37
Hopital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, Paris, France.
38
Hopital Saint-Louis, Virology, INSERM U944, CNR VIH, Paris, France.

Abstract

OBJECTIVES:

We estimated the prevalence of transmitted-drug-resistance-associated mutations (TDRAMs) in antiretroviral-naive chronically HIV-1-infected patients.

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.

PMID:
30753724
DOI:
10.1093/jac/dkz011

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