We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Surveillance of HIV-1 primary infections in France from 2014 to 2016: toward stable resistance, but higher diversity, clustering and virulence?
- Authors
Visseaux, Benoit; Assoumou, Lambert; Mahjoub, Nadia; Grude, Maxime; Trabaud, Mary-Anne; Raymond, Stéphanie; Wirden, Marc; Morand-Joubert, Laurence; Roussel, Catherine; Montes, Brigitte; Bocket, Laurence; Fafi-Kremer, Samira; Amiel, Corinne; Monte, Anne De; Stefic, Karl; Pallier, Coralie; Tumiotto, Camille; Maillard, Anne; Vallet, Sophie; Ferre, Virginie
- Abstract
<bold>Objectives: </bold>Patients with primary HIV-1 infection (PHI) are a particular population, giving important insight about ongoing evolution of transmitted drug resistance-associated mutation (TDRAM) prevalence, HIV diversity and clustering patterns. We describe these evolutions of PHI patients diagnosed in France from 2014 to 2016.<bold>Methods: </bold>A total of 1121 PHI patients were included. TDRAMs were characterized using the 2009 Stanford list and the French ANRS algorithm. Viral subtypes and recent transmission clusters (RTCs) were also determined.<bold>Results: </bold>Patients were mainly MSM (70%) living in the Paris area (42%). TDRAMs were identified among 10.8% of patients and rose to 18.6% when including etravirine and rilpivirine TDRAMs. Prevalences of PI-, NRTI-, first-generation NNRTI-, second-generation NNRTI- and integrase inhibitor-associated TDRAMs were 2.9%, 5.0%, 4.0%, 9.4% and 5.4%, respectively. In a multivariable analysis, age >40 years and non-R5 tropic viruses were associated with a >2-fold increased risk of TDRAMs. Regarding HIV diversity, subtype B and CRF02_AG (where CRF stands for circulating recombinant form) were the two main lineages (56% and 20%, respectively). CRF02_AG was associated with higher viral load than subtype B (5.83 versus 5.40 log10 copies/mL, P=0.004). We identified 138 RTCs ranging from 2 to 14 patients and including overall 41% from the global population. Patients in RTCs were younger, more frequently born in France and more frequently MSM.<bold>Conclusions: </bold>Since 2007, the proportion of TDRAMs has been stable among French PHI patients. Non-B lineages are increasing and may be associated with more virulent CRF02_AG strains. The presence of large RTCs highlights the need for real-time cluster identification to trigger specific prevention action to achieve better control of the epidemic.
- Subjects
FRANCE; PARIS (France); INFECTION; HIV; NON-nucleoside reverse transcriptase inhibitors; VIRAL load; NUCLEOSIDE reverse transcriptase inhibitors; HIV infection epidemiology; ANTI-HIV agents; HIV infections; RESEARCH; GENETICS; BIOLOGICAL evolution; SEQUENCE analysis; GENETIC mutation; RESEARCH methodology; EPIDEMIOLOGY; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; GENOTYPES; DRUG resistance in microorganisms; MICROBIAL virulence; PHARMACODYNAMICS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2020, Vol 75, Issue 1, p183
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkz404