A cohort study of treatment-experienced HIV-1-infected patients treated with raltegravir: factors associated with virological response and mutations selected at failure. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue International Journal of Antimicrobial Agents Année : 2013

A cohort study of treatment-experienced HIV-1-infected patients treated with raltegravir: factors associated with virological response and mutations selected at failure.

Corinne Amiel
  • Fonction : Auteur
Jacques Izopet
Ali Si-Mohamed
  • Fonction : Auteur
Cécile Henquell
  • Fonction : Auteur
Delphine Desbois
  • Fonction : Auteur
Anne Signori-Schmuck
  • Fonction : Auteur
Sabine Yerly
  • Fonction : Auteur
Mary-Anne Trabaud

Résumé

This study aimed to identify factors associated with virological response (VR) to raltegravir (RAL)-containing regimens in 468 treatment-experienced but integrase inhibitor-naive HIV-1 patients receiving a RAL-containing regimen. VR was defined at Month 6 (M6) as HIV-1 RNA viral load (VL) <50 copies/mL. The impacts on VR of baseline integrase mutations, VL, CD4 count, genotypic sensitivity score for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors, and the number of new antiretrovirals used for the first time associated with RAL were investigated. For patients with VL >50 copies/mL at M6, integrase mutations selected were characterised. Median baseline VL was 4.2 log(10)copies/mL (IQR 3.3-4.9 log(10) copies/mL) and CD4 count was 219 cells/mm(3) (IQR 96-368 cells/mm(3)). At M6, 71% of patients were responders. In multivariate analysis, baseline VL and CD4 count and ≥ 2 new antiretrovirals among darunavir, etravirine, maraviroc and enfuvirtide were associated with VR to RAL. Neither HIV-1 subtype nor baseline integrase polymorphisms were associated with VR to RAL. Among 63 failing patients at M6, selection of ≥ 1 change in the integrase gene was observed in 49 (77.8%), and 27/63 (42.9%) were considered as RAL-associated resistance mutations. Factors independently associated with the occurrence of ≥ 1 RAL-associated resistance mutation were VL at failure >3 log(10) and having no new drugs associated with RAL. RAL showed great potency in treatment-experienced patients. The number of new drugs associated with RAL was an important factor associated with VR. HIV-1 subtype and baseline integrase polymorphisms do not influence the RAL VR.

Dates et versions

hal-00875083 , version 1 (21-10-2013)

Identifiants

Citer

Anne-Geneviève Marcelin, Constance Delaugerre, Céline Beaudoux, Diane Descamps, Laurence Morand-Joubert, et al.. A cohort study of treatment-experienced HIV-1-infected patients treated with raltegravir: factors associated with virological response and mutations selected at failure.. International Journal of Antimicrobial Agents, 2013, 42 (1), pp.42-7. ⟨10.1016/j.ijantimicag.2013.02.016⟩. ⟨hal-00875083⟩
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