Prevalence of HIV-1 drug resistance in treated patients with viral load >50 copies/mL: a 2014 French nationwide study.
Surveillance of HIV-1 resistance in treated patients with a detectable viral load (VL) is important to monitor, in order to assess the risk of spread of resistant viruses and to determine the proportion of patients who need new antiretroviral drugs with minimal cross-resistance.



The HIV-1 protease and reverse transcriptase (RT) and integrase genes were sequenced in plasma samples from 782 consecutive patients on failing antiretroviral regimens, seen in 37 specialized centres in 2014. The genotyping results were interpreted using the ANRS v24 algorithm. Prevalence rates were compared with those obtained during a similar survey conducted in 2009.



The protease and RT sequences were obtained in 566 patients, and the integrase sequence in 382 patients. Sequencing was successful in 60%, 78%, 78% and 87% of patients with VLs of 51-200, 201-500, 501-1000 and >1000 copies/mL, respectively. Resistance to at least one antiretroviral drug was detected in 56.3% of samples. Respectively, 3.9%, 8.7%, 1.5% and 3.4% of patients harboured viruses that were resistant to any NRTI, NNRTI, PI and integrase inhibitor (INI). Resistance rates were lower in 2014 than in 2009. Resistance was detected in 48.5% of samples from patients with a VL between 51 and 200 copies/mL.



In France in 2014, 90.0% of patients in AIDS care centres were receiving antiretroviral drugs and 12.0% of them had VLs >50 copies/mL. Therefore, this study suggests that 6.7% of treated patients in France might transmit resistant strains. Resistance testing may be warranted in all treated patients with VL > 50 copies/mL.
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France.
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Assoumou
INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Laboratoire Associé au Centre National de Référence du VIH-Résistance aux Antirétroviraux, Paris, France.
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Charpentier
PTBM, Laboratoire de Virologie, Hôpital Pellegrin, CHU de Bordeaux; UMR 5234 MFP CNRS, Université de Bordeaux, 33076 Bordeaux cedex, France.
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Recordon-Pinson
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France.
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Grudé
HU Paris sud, Hôpital Paul Brousse, Laboratoire de Virologie, Villejuif, France.
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Pallier
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Saint-Antoine, F75012 Paris, France.
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Morand-Joubert
Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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Fafi-Kremer
AP-HP, Hôpital Cochin, Laboratoire de Virologie, Paris, France.
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Krivine
Laboratoire de Virologie, Hôpital Saint-Eloi, CHU Montpellier, Montpellier, France.
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Montes
EA 4271, Nantes Université UFR Pharmacie, Laboratoire de Virologie, CHU Nantes, Nantes, France.
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Ferré
INSERM U955, National Reference Center for Viral Hepatitis B, C et Delta, Department of Virology, Henri Mondor Hospital, University of Paris-Est, Créteil, France.
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Bouvier-Alias
Laboratoire de Virologie et COREVIH Haute-Normandie, CHU de Rouen, Rouen, France.
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Plantier
Laboratoire de Virologie, Hôpital Purpan de Toulouse, Toulouse, France.
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Izopet
Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
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Trabaud
Laboratoire de Virologie, Hôpitaux Universitaires de Genève, Genève, Switzerland.
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Yerly
Laboratoire de Virologie, Hôpital l'Archet de Nice, Nice, France.
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Dufayard
Laboratoire de Virologie, Hôpital Avicenne, APHP, HU Paris Seine Saint Denis, Bobigny, France.
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Alloui
Laboratoire de Virologie, Centre Hospitalier Victor Dupouy d'Argenteuil, Argenteuil, France.
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Courdavault
Laboratoire de Virologie, CHU Angers et HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
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Le Guillou-Guillemette
Laboratoire de Virologie, CHU de Rennes, Rennes, France.
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Maillard
AP-HP, Hôpital Tenon, Laboratoire de Virologie, Paris, France.
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Amiel
Laboratoire de Virologie, CHU Caen, Caen, France.
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Vabret
Laboratoire de Virologie, CHU Amiens, Amiens, France.
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Roussel
Laboratoire de Virologie, CHU Brest, Brest, France.
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Vallet
Laboratoire de Virologie, CHR Orléans, Orléans, France.
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Guinard
Laboratoire de Virologie, CHU Clermont-Ferrand, Clermont-Ferrand, France.
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Mirand
Laboratoire de Virologie, CHU Poitiers, Poitiers, France.
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Beby-Defaux
Laboratoire de Virologie, CHU Bretonneau, & INSERM U966, Tours, France.
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Barin
Laboratoire de Virologie, CHU de Nimes, Nimes, France.
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Allardet-Servent
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France.
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Ait-Namane
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Pitié-Salpêtrière, F75013 Paris, France.
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Wirden
Laboratoire de Virologie, AP-HP, Hôpital Saint Louis, INSERM U941, Université Paris Diderot, Paris, France.
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Delaugerre
Sorbonne Universités, UPMC Univ. Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Laboratoire de Virologie, Hôpital Pitié-Salpêtrière, F75013 Paris, France.
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Calvez
Laboratoire de Virologie, AP-HP, Hôpital Saint Louis, INSERM U941, Université Paris Diderot, Paris, France.
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Chaix
INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Laboratoire Associé au Centre National de Référence du VIH-Résistance aux Antirétroviraux, Paris, France.
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Descamps
PTBM, Laboratoire de Virologie, Hôpital Pellegrin, CHU de Bordeaux; UMR 5234 MFP CNRS, Université de Bordeaux, 33076 Bordeaux cedex, France.|CRB plurithématique, Bordeaux Biothèques Santé, Groupe hospitalier Pellegrin-CHU de Bordeaux, Bordeaux, France.
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Reigadas
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D024921:Drug Resistance, Multiple, Viral; D005260:Female; D005602:France; D005814:Genes, Viral; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology*; D019427:HIV Integrase / Q000097:blood / Q000235:genetics; D016333:HIV Protease / Q000097:blood / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000097:blood / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D017211:Treatment Failure; D019562:Viral Load
D019380:Anti-HIV Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019427:HIV Integrase; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease