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

Lambert Assoumou (1, 2) , Laurence Bocket (3, 4) , Coralie Pallier (5) , Maxime Grude (1, 2) , Rachid Ait-Namane (2, 1) , Jacques Izopet (6) , Stéphanie Raymond (6) , Charlotte Charpentier (7, 8) , Benoit Visseaux (7, 8) , Marc Wirden (1, 9) , Mary-Anne Trabaud (10) , Hélène Le Guillou-Guillemette (11) , Chakib Allaoui (12) , Cécile Henquell (13) , Anne Krivine (14) , Georges dos Santos (15) , Catherine Delamare (16) , Magali Bouvier-Alias (17) , Brigitte Montes (18) , Virginie Ferré (19) , Anne de Monte (20) , Anne Signori-Schmuck (21) , Anne Maillard (22) , Laurence Morand-Joubert (23, 1, 24) , Camille Tumiotto (25) , Samira Fafi-Kremer (26) , Corinne Amiel (27) , Francis Barin (28) , Stéphanie Marque-Juillet (29) , Laurence Courdavault (30, 31) , Sophie Vallet , Agnès Beby-Defaux (32) , Alexis de Rougemont (33) , Honorine Fenaux (34) , Véronique Avettand-Fenoël (35, 36) , Annick Allardet-Servent (37) , Jean-Christophe Plantier (38) , Gilles Peytavin (39) , Vincent Calvez (1, 9, 24) , Marie-Laure Chaix (40) , Diane Descamps (7, 8)

1 Epidémiologie, Systèmes d'Information, Modélisation
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 Service de Virologie [Lille]
4 Laboratoire de Virologie - Laboratoire de Virologie - ULR 3610
5 Hôpital Paul Brousse
6 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
7 Service de Virologie [CHU Bichat]
8 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
9 CHU Pitié-Salpêtrière [AP-HP]
10 Hôpital de la Croix-Rousse [CHU - HCL]
11 CHU Angers - Centre Hospitalier Universitaire d'Angers
12 Hôpital Avicenne [AP-HP]
13 Service de Virologie Médicale et Moléculaire [CHU Clermont-Ferrand]
14 Service de Virologie [CHU Cochin]
15 EA 4537 - Laboratoire de Virologie-Immunologie [Fort de France, Martinique]
16 CHR Metz-Thionville - Centre hospitalier régional Metz-Thionville
17 CHU Henri Mondor [Créteil]
18 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
19 CHU Nantes - Centre Hospitalier Universitaire de Nantes
20 CHU Nice [Cimiez]
21 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
22 Laboratoire de Virologie [Rennes] = Virology [Rennes]
23 CHU Saint-Antoine [AP-HP]
24 SU - Sorbonne Université
25 Service de virologie et unité de surveillance biologique [Bordeaux]
26 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
27 CHU Tenon [AP-HP]
28 CHU Trousseau [Tours]
29 CHV - Centre Hospitalier de Versailles André Mignot
30 Centre Hospitalier Victor Dupouy
31 CH Argenteuil - Centre hospitalier Argenteuil
32 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
33 CHU Dijon
34 Service de Virologie [CHRU Nancy]
35 Hôpital Necker - Enfants Malades [AP-HP]
36 Université Paris Descartes, Sorbonne Paris Cité
37 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
38 GRAM 1.0 - Groupe de Recherche sur les Antimicrobiens et les Micro-Organismes
39 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
40 Pathologie cellulaire : aspects moléculaires et viraux / Pathologie et Virologie Moléculaire

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.

Mots clés: hiv; mutation; drug resistance; cd4 count determination procedure; endopeptidases; hiv-1; integrase inhibitors; plasma; rna-directed dna polymerase; safe sex; viruses; rna; hiv infections; peptide hydrolases; anti-retroviral agents

Domaines: Virologie; Sciences du Vivant [q-bio]; Microbiologie et Parasitologie; Bactériologie

Lambert Assoumou, Laurence Bocket, Coralie Pallier, Maxime Grude, Rachid Ait-Namane, et al.. 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. Journal of Antimicrobial Chemotherapy, 2019, 74 (5), pp.1417-1424. ⟨10.1093/jac/dkz011⟩. ⟨hal-02154058⟩