Response to HAART in French patients with resistant HIV-1 treated at primary infection: ANRS Resistance Network.
OBJECTIVE
The aim of the study was to analyse the response to highly active antiretroviral therapy (HAART) initiated at the time of primary HIV infection (PHI) in patients infected with a virus resistant to > or = 1 drug of their treatment compared with patients infected with a wild-type virus.


METHODS
We analysed data from 350 patients who were enrolled from 1996-2004 in the French ANRS PRIMO Cohort or in the ANRS Resistance Group and treated with HAART during PHI. During the study period, HAART was initiated before the result of the genotypic resistance test was available. We compared patients infected with a virus resistant to > or = 1 drug of their regimen (GR group, n = 46) with patients harbouring a wild-type virus (WT group, n = 304). Virological and immunological response to treatment according to drug-resistance profile was analysed 3 months and 6 months after HAART initiation.


RESULTS
In GR and WT groups, HIV RNA level was < 400 copies/ml in 68% and 83% (P = 0.02) and < 50 copies/ml in 23% and 40% (P = 0.08) 3 months after HAART initiation. In multivariable logistic regression taking into account gender, age, boosted PI regimen, plasma HIV RNA and CD4+ T-cell count at HAART initiation, patients with virus resistant to > or = 1 drug of their regimen were significantly less likely to achieve undetectable viral load at month 3 (odds ratio 0.32, 95% confidence interval 0.15-0.72) than the others. This difference was sustained up to month 6.


CONCLUSIONS
In this large cohort of HAART-treated PHI-patients, the presence of drug resistance mutations led to suboptimal response to early therapy.
Chaix
Marie-Laure
ML
EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France. marie-laure.chaix@nck.aphp.fr
Desquilbet
Loic
L
Descamps
Diane
D
Costagliola
Dominique
D
Deveau
Christiane
C
Galimand
Julie
J
Goujard
Cécile
C
Signori-Schmuck
Anne
A
Schneider
Veronique
V
Tamalet
Catherine
C
Pellegrin
Isabelle
I
Wirden
Marc
M
Masquelier
Bernard
B
Brun-Vezinet
Francoise
F
Rouzioux
Christine
C
Meyer
Laurence
L
D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents