Genotypic resistance profiles of HIV-2-treated patients in West Africa.
Genotypic resistance profiles of HIV-2-treated patients in West Africa.
复制标题
DOI：
10.1097/qad.0000000000000244
复制
发表时间：
2014-05-15
期刊：
影响因子：
--
通讯作者：
IeDEA West Africa Collaboration
中科院分区：
文献类型：
--
作者：
Charpentier C;Eholié S;Anglaret X;Bertine M;Rouzioux C;Avettand-Fenoël V;Messou E;Minga A;Damond F;Plantier JC;Dabis F;Peytavin G;Brun-Vézinet F;Ekouevi DK;IeDEA West Africa Collaboration
评估科特迪瓦HIV-2抗逆转录病毒治疗（抗逆转录病毒疗法）患者的病毒学应答、基因型耐药特征和抗逆转录病毒血浆浓度。在接受抗逆转录病毒治疗的HIV-2患者中进行横断面调查。使用国家艾滋病和病毒性肝炎研究机构（ANRS）检测试剂盒进行血浆HIV-2病毒载量检测。使用内部方法进行蛋白酶和逆转录酶测序，并使用超高效液相色谱-串联质谱法评估抗逆转录病毒血浆浓度。入组了145例接受HIV-2治疗的患者，中位CD 4+细胞计数为360个细胞/μl（四分位距，IQR = 215-528）。ART的中位持续时间为4年（IQR = 2-7），74%的患者显示病毒载量低于50拷贝/ml。病毒载量超过50拷贝/ml的患者中位血浆HIV-2 RNA为3016拷贝/ml（IQR = 436-5156）。大多数患者（84%）接受了基于洛匹那韦/利托那韦的方案。在25份样本中分别有21份（84%）和29份样本中分别有20份（69%）检测到HIV-2对核苷类逆转录酶抑制剂和蛋白酶抑制剂的耐药突变。最常见的核苷逆转录酶抑制剂耐药突变是M184 I/V（90%）、Q151 M（24%）和S215 F/Y（24%）。最常见的蛋白酶抑制剂耐药突变是V47 A（60%）和I54 M（30%）。病毒载量低于50拷贝/ml的患者和病毒学失败的患者中位CD 4+细胞计数分别为434个细胞/μl（292-573）和204个细胞/μl（122-281）（P < 0.0001）。在病毒学失败和病毒载量低于50拷贝/ml的患者中，具有足够抗逆转录病毒血浆浓度的患者比例分别为81%和93%（P = 0.046），表明治疗依从性良好。我们在高比例的HIV-2感染患者中观察到足够的药物血浆浓度和病毒学抑制。然而，在病毒学失败的情况下，有限的HIV-2治疗武器和交叉耐药性大大减少了治疗选择。
To assess the virological response, genotypic resistance profiles, and antiretroviral plasma concentrations in HIV-2 antiretroviral-treated (antiretroviral therapy, ART) patients in Côte d‘Ivoire. A cross-sectional survey was conducted among HIV-2 patients receiving ART. Plasma HIV-2 viral load was performed using the Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS) assay. Protease and reverse transcriptase sequencing was performed using in-house methods and antiretroviral plasma concentrations were assessed using ultra performance liquid chromatography combined with tandem mass spectrometry. One hundred and forty-five HIV-2-treated patients were enrolled with a median CD4+ cell count of 360 cells/µl (interquartile range, IQR = 215–528). Median duration of ART was 4 years (IQR = 2–7) and 74% of patients displayed viral load less than 50 copies/ml. Median plasma HIV-2 RNA among patients with viral load more than 50 copies/ml was 3016 copies/ml (IQR = 436–5156). Most patients (84%) received a lopinavir/ritonavir-based regimen. HIV-2 resistance mutations to nucleoside reverse transcriptase inhibitors and protease inhibitors were detected in 21 of 25 (84%) and 20 of 29 (69%) samples, respectively. The most prevalent nucleoside reverse transcriptase inhibitor resistance mutations were M184I/V (90%), Q151M (24%), and S215F/Y (24%). The most prevalent protease inhibitor resistance mutations were V47A (60%) and I54M (30%). Median CD4+ cell counts were 434 cells/µl (292–573) and 204 cells/µl (122–281) in patients with viral load less than 50 copies/ml and those exhibiting virological failure (P < 0.0001), respectively. The proportions of patients with adequate antiretroviral plasma concentrations were 81 and 93% in patients displaying virological failure and in those with viral load less than 50 copies/ml, respectively (P = 0.046), suggesting good treatment adherence. We observed adequate drug plasma concentrations and virological suppression in a high proportion of HIV-2-infected patients. However, in cases of virological failure, the limited HIV-2 therapeutic arsenal and cross-resistance dramatically reduced treatment options.