Genotypic resistance profiles of HIV-2-treated patients in West Africa

• Published in: AIDS (London) Vol. 28; no. 8; pp. 1161 - 1169
• Main Authors: CHARPENTIER, Charlotte, EHOLIE, Serge, DABIS, François, PEYTAVIN, Gilles, BRUN-VEZINET, Françoise, EKOUEVI, Didier K, ANGLARET, Xavier, BERTINE, Mélanie, ROUZIOUX, Christine, AVETTAND-FENOËL, Véronique, MESSOU, Eugène, MINGA, Albert, DAMOND, Florence, PLANTIER, Jean-Christophe
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 15.05.2014
• Subjects: Adult; AIDS/HIV; Anti-Retroviral Agents - blood; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Chromatography, Liquid - methods; Cote d'Ivoire; Cross-Sectional Studies; Drug Resistance, Viral - genetics; Female; Genotype; HIV Infections - drug therapy; HIV Infections - genetics; HIV-2 - genetics; Human immunodeficiency virus; Human immunodeficiency virus 2; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Lentivirus; Male; Medical sciences; Middle Aged; Mutation - genetics; Patient Compliance; Pharmacology. Drug treatments; Retroviridae; Sequence Analysis, RNA - methods; Tandem Mass Spectrometry - methods; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Côte d'Ivoire; West Africa; Africa; Cote d'Ivoire; ASE, Cote d'Ivoire; Immunopathology; Antiretroviral agent; HIV-2; Retroviridae; Genotype; AIDS; Côte d'Ivoire; Concentration; Immune deficiency; Lentivirus; Blood plasma; HIV-2 virus; Infection; Virus; Resistance; Treatment; antiretroviral resistance; Viral disease; plasma drug concentrations; Antiviral; Human immunodeficiency virus
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0000000000000244

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.