Low-level viral loads and virological failure in the integrase strand transfer era
Author:
Cuzin Lise12ORCID, Flandre Philippe3ORCID, Allavena Clotilde4, Palich Romain5ORCID, Duvivier Claudine678, Becker Agathe9, Laroche Hélène10, Pugliese Pascal11, Cabie André112, Chirouze C, Babre O, Bouiller K, Bozon F, Brunel A S, Chevalier E, Hustache-Mathieu L, Lagoutte J, Lepiller Q, Marty-Quinternet S, Muret P, Rosolen B, Tissot N, Jaffuel S, Jacomet C, Aumeran C, Baud O, Brebion A, Corbin V, Goncalvez E, Henquell C, Laurichesse H, Lesens O, Mazzocolin D, Mirand A, Mrozek N, Theis C, Vidal M, Lamaury I, Bissuel F, Boulard F, Curlier E, Fabre I, Halley E, Herrmann-Storck C, Le Guillou C, Markowicz S, Marquet M, Ouissa R, Receveur M C, Reltien J, Roger P M, Tressieres B, Merrien D, Bollangier O, Boucher D, Guimard T, Laine L, Leautez S, Morrier M, Perré P, Point P, Faucher J F, Cypierre A, Ducroix-Roubertou S, Durox H, Genet-Villeger C, Pascual J, Pinet P, Rogez S, Woillard J B, Cotte L, Ader F, Alfaiate D, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Conrad A, Degroodt S, Ferry T, Godinot M, Icard V, Livrozet J M, Makhloufi D, Perpoint T, Perry M, Pouderoux C, Roux S, Trabaud M A, Triffault-Fillit C, Valour F, Ravaux I, Ménard A, Aherfi S, Amrane S, Belkhir A Y, Colson P, Dhiver C, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Tissot-Dupont H, Toméi C, Poizot-Martin I, Brégigeon S, Ducassou M J, Galie S, Ivanova A, Jaquet I, Laroche H, Obry-Roguet V, Orticoni M, Ressiot E, Ritleng A S, Rojas-Rojas T, Zaegel-Faucher O, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Lehoux M, Montagnac C, Pierre-François S, Rome K, Turmel J M, Reynes J, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Lejeune J, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Lefèvre B, André M, Baronnet G, Bevilacqua S, Boyer L, Bouillon M P, Charmillon A, Delestan M, Frentiu E, Goehringer F, Hénard S, Jeanmaire E, Rabaud C, Radjabaly-Mandjee A, Raffi F, Allavena C, André-Garnier E, Asquier-Khati A, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Cavellec M, Deschanvres C, Ferré V, Gaborit B J, Grégoire A, Grégoire M, Jovelin T, Lefebvre M, Lecomte R, Mahot R, Morineau P, Paredes E, Reliquet V, André-Garnier E, Sécher S, Soria A, Pugliese P, Bréaud S, Buscot M, Carles M, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Ferrando S, Garraffo R, Michelangeli C, Naqvi A, Perbost I, Pradier C, Prouvost-Keller B, Risso K, Touitou I, Viot A, Wehrlen-Pugliese S, Hocqueloux L, Gubavu C, Legros V, Peira F, Prazuck T, Rzepecki V, Sève A, Cheret A, Barrail-Tran A, Castro A, Colarino R, Goujard C, Jaureguiberry S, Quertainmont Y, Teicher E, Joly V, Charpentier C, Descamps D, Digumber M, Gervais A, Ghosn J, Julia Z, Landman R, Lariven S, Le Gac S, Louni F, Peytavin G, Rioux C, Yazdanpanah Y, Duvivier C, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny P H, Gomes-Pires E, Jidar K, Lafont E, Lanternier F, Lortholary O, Louisin C, Lourenco J, Melenotte C, Parize P, Pouvaret A, Rouzaud C, Serris A, Touam F, Katlama C, Agher R, Blanc C, Dudoit Y, Hamani N, Qatib N, Qzaibri I, Lenclume L, Palich R, Schneider L, Seang S, Tubiana R, Valantin M A, Bani-Sadr F, Bermejo M, Berger J L, Demotier S, Hentzien M, Julien G, Kmiec I, Lambert D, Marty H, N’Guyen Y, Romaru J, Arvieux C, Baldeyrou M, Benezit F, Chapplain J M, Dupont M, Duthé J C, Jovelin T, Lebot A, Lemaitre F, Maillard A, Morlat C, Patrat-Delon S, Poisson-Vannier M, Pronier C, Revest M, Sinteff J P, Souala F, Tattevin P, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Lucht F, Ronat V, Rey D, Cheneau C, Bernard-Henry C, De Mautort E, Fafi-Kremer S, Fischer P, Gantner P, Mélounou C, Partisani M, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Garnier C, Gaube G, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Aïssi E, Ajana F, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Derdour V, Gilbert M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Valette M, Viget N, Corvaisier G,
Affiliation:
1. Infectious and Tropical Diseases Unit, Martinique University Hospital , Fort de France, Martinique, French West Indies 2. CERPOP, Toulouse Paul Sabatier University, INSERM UMR1295 , Toulouse , France 3. Pierre Louis Epidemiology and Public Health Institute (IPLESP), Sorbonne University, INSERM UMR-S1136 , Paris , France 4. Infectious Diseases Department, EA1413, CHU Nantes , Nantes , France 5. Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136 , Paris , France 6. Infectious Diseases Department, AP-HP-Necker Hospital, Necker-Pasteur Infectiology Center, Paris , France 7. INSERM U1016, University Paris Cité, CNRS UMR8104, Institut Cochin, Paris , France 8. IHU Imagine, Institut Pasteur, Institut Pasteur Medical Center , Paris , France 9. Infectious and Tropical diseases Unit, Hospices Civils de Lyon, Croix Rousse Hospital , Lyon , France 10. Clinical Immuno-Hematological Unit, Sainte-Marguerite Hospital, University Hospital of Marseille (AP-HM) , Marseille , France 11. Department of Infectious Diseases, Côte d’Azur University, Centre Hospitalier Universitaire de Nice , Nice , France 12. CIC1424, INSERM, Fort-de-France , EFS Montpellier , France
Abstract
AbstractObjectivesTo analyse the occurrence of virological failure (VF) in patients starting ART with an integrase strand transfer inhibitor (INSTI)-based regimen in recent years, in relation with previous episodes of low-level viral load (LLVL).Patients and methodsPatients starting a first ART between 1 January 2015 and 31 December 2020 based on two NRTIs and one INSTI were included if after virological control (two measures of VL < 50 copies/mL) they had a minimum of two additional VL measurements. Cox models adjusted for sex, age, acquisition group, hepatitis B or C coinfection, place of birth, year of ART initiation, CD4+ T cells and VL at ART initiation, duration of known HIV infection and of ART regimen were used to assess the association between the time to VF and the occurrence of LLVL. ART regimen was evaluated as time-varying covariate.ResultsLLVL was described in 13.7% and VF in 11% of the 3302 patients. LLVL was associated with VF [adjusted HR (aHR) 1.76, 95% CI 1.28–2.41], as well as age (aHR 0.97/year, 95% CI 0.96–0.98), CD4+ T cell count at ART initiation (aHR 0.93, 95% CI 0.87–0.98), heterosexual transmission (aHR 1.76, 95% CI 1.30–2.37) and being born abroad (aHR 1.50, 95% CI 1.17–1.93).ConclusionsLLVL was related to VF. Even in the absence of subsequent failure, LLV episodes have a cost. Thus any VL value above 50 copies/mL should lead to enhanced adherence counselling.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)
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