Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma.
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Date publication
février 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Dr JEULIN Hélène
Tous les auteurs :
Soulie C, Descamps D, Grude M, Schneider V, Trabaud MA, Morand-Joubert L, Delaugerre C, Montes B, Barin F, Ferre V, Raymond S, Jeulin H, Alloui C, Yerly S, Pallier C, Reigadas S, Signori-Schmuck A, Guigon A, Fafi-Kremer S, Haim-Boukobza S, Mirand A, Maillard A, Vallet S, Roussel C, Assoumou L, Calvez V, Flandre P, Marcelin AG
Lien Pubmed
Résumé
OBJECTIVES: The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. METHODS: Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. RESULTS: On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P=0.0455) and T215Y (P=0.0455). CONCLUSIONS: In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performed.
Référence
J Antimicrob Chemother. 2015 Feb;70(2):566-72