RESUMEN
OBJECTIVES: We estimated the prevalence of transmitted-drug-resistance-associated mutations (TDRAMs) in antiretroviral-naive chronically HIV-1-infected patients. PATIENTS AND METHODS: TDRAMs were sought in samples from 660 diagnosed HIV-1-infected individuals in 2015/2016 in 33 HIV clinical centres. Weighted analyses, considering the number of patients followed in each centre, were used to derive representative estimates of the percentage of individuals with TDRAMs. Results were compared with those of the 2010/2011 survey (nâ=â661) using the same methodology. RESULTS: At inclusion, median CD4 cell counts and plasma HIV-1 RNA were 394 and 350/mm3 (Pâ=â0.056) and 4.6 and 4.6 log10 copies/mL (Pâ=â0.360) in the 2010/2011 survey and the 2015/2016 survey, respectively. The frequency of non-B subtypes increased from 42.9% in 2010/2011 to 54.8% in 2015/2016 (P < 0.001), including 23.4% and 30.6% of CRF02_AG (Pâ=â0.004). The prevalence of virus with protease or reverse-transcriptase TDRAMs was 9.0% (95% CIâ=â6.8-11.2) in 2010/2011 and 10.8% (95% CIâ=â8.4-13.2) in 2015/2016 (Pâ=â0.269). No significant increase was observed in integrase inhibitor TDRAMs (6.7% versus 9.2%, Pâ=â0.146). Multivariable analysis showed that men infected with the B subtype were the group with the highest risk of being infected with a resistant virus compared with others (adjusted ORâ=â2.2, 95% CIâ=â1.3-3.9). CONCLUSIONS: In France in 2015/2016, the overall prevalence of TDRAMs was 10.8% and stable compared with 9.0% in the 2010/2011 survey. Non-B subtypes dramatically increased after 2010. Men infected with B subtype were the group with the highest risk of being infected with a resistant virus, highlighting the need to re-emphasize safe sex messages.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Farmacorresistencia Viral/genética , Infecciones por VIH/transmisión , VIH-1/genética , Mutación , Adulto , Recuento de Linfocito CD4 , Enfermedad Crónica/epidemiología , Femenino , Francia/epidemiología , Genotipo , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Seropositividad para VIH/epidemiología , VIH-1/clasificación , VIH-1/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , ARN Viral/sangreAsunto(s)
Proteínas Bacterianas/metabolismo , Infecciones por Salmonella/epidemiología , Infecciones por Salmonella/microbiología , Salmonella enterica/enzimología , beta-Lactamasas/metabolismo , África del Norte/epidemiología , Anciano , Animales , Antibacterianos , Farmacorresistencia Bacteriana , Electroforesis en Gel de Campo Pulsado , Femenino , Genes Bacterianos , Genotipo , Humanos , Integrones , Masculino , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Salmonella enterica/aislamiento & purificación , SerogrupoRESUMEN
We report a patient who developed during HIV primary infection a symptomatic mixed cryoglobulinemia. The patient suffered from arthralgias, vascular purpura of the legs, and proteinuria. Cryoglobulinemia progressively disappeared in several months after HAART.