French national sentinel survey of antiretroviral drug resistance in patients with HIV-1 primary infection and in antiretroviral-naive chronically infected patients in 2001-2002.
OBJECTIVE
To survey the frequency of genotypic antiretroviral resistance and the spread of non-B subtypes in patients with primary HIV-1 infection (2001-2002) and in treatment-naive chronically HIV-1-infected patients (2001).


METHODS
Plasma samples from 303 patients with acute HIV-1 infection (Primo study) and 363 treatment-naive patients with chronic HIV-1 infection (Odyssee study) were tested for genotypic resistance. Resistance mutations were identified from the International AIDS Society Resistance Testing-USA panel and resistant viruses were defined according to the French Agence Nationale de Recherches sur le SIDA (ANRS) resistance algorithm.


RESULTS
In the Primo study, 14% of the patients had viruses with resistance mutations and 12% of patients had viruses with mutations conferring resistance to least 1 antiretroviral drug. Thirty patients had viruses with mutations to at least 1 antiretroviral drug in a single pharmacologic class. Six patients were infected by viruses resistant to 2 or 3 classes of drugs. In the Odyssee study, the prevalence of reverse transcript (RT) associated and major protease inhibitor-associated mutations was 6.1% (95% CI: 3.6-8.6). Six patients had viruses resistant to at least 1 antiretroviral drug and 3 patients had viruses resistant to 2 classes of antiretroviral drugs. Twenty-four percent of acutely infected patients harbored non-B subtype strains (19% in 1999-2000) and 33.2% of chronically infected patients (10% in 1998; P < 0.0001).


CONCLUSIONS
In France, the frequency of HIV-1 resistance in untreated patients was not significantly higher in 2001-2002 than in previous surveys while the prevalence of non-B subtypes is increasing.
Descamps
Diane
D
Laboratoire de Virologie, CHU Bichat-Claude Bernard, Paris, France. diane.descamps@bch.ap-hop-paris.fr
Chaix
Marie-Laure
ML
André
Patrice
P
Brodard
Véronique
V
Cottalorda
Jacqueline
J
Deveau
Christiane
C
Harzic
Martine
M
Ingrand
Didier
D
Izopet
Jacques
J
Kohli
Evelyne
E
Masquelier
Bernard
B
Mouajjah
Said
S
Palmer
Pierre
P
Pellegrin
Isabelle
I
Plantier
Jean-Christophe
JC
Poggi
Cécile
C
Rogez
Sylvie
S
Ruffault
Annick
A
Schneider
Véronique
V
Signori-Schmück
Anne
A
Tamalet
Catherine
C
Wirden
Marc
M
Rouzioux
Christine
C
Brun-Vezinet
Françoise
F
Meyer
Laurence
L
Costagliola
Dominique
D
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000208:Acute Disease; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002908:Chronic Disease; D015331:Cohort Studies; D004351:Drug Resistance; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009313:National Health Programs; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral