title: Response to HAART in French patients with resistant HIV-1 treated at primary infection: ANRS Resistance Network.
abstract: 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.
authors.affiliation: EA 3620, Université Paris Descartes, Service de Virologie, CHU Necker-Enfants Malades, Paris, France. marie-laure.chaix@nck.aphp.fr
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Chaix
authors.forename: Loic
authors.initials: L
authors.lastname: Desquilbet
authors.forename: Diane
authors.initials: D
authors.lastname: Descamps
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Christiane
authors.initials: C
authors.lastname: Deveau
authors.forename: Julie
authors.initials: J
authors.lastname: Galimand
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.forename: Anne
authors.initials: A
authors.lastname: Signori-Schmuck
authors.forename: Veronique
authors.initials: V
authors.lastname: Schneider
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pellegrin
authors.forename: Marc
authors.initials: M
authors.lastname: Wirden
authors.forename: Bernard
authors.initials: B
authors.lastname: Masquelier
authors.forename: Francoise
authors.initials: F
authors.lastname: Brun-Vezinet
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.forename: Laurence
authors.initials: L
authors.lastname: Meyer
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents