Title :

Virological Outcome After Choice of Antiretroviral Regimen Guided by Proviral HIV-1 DNA Genotyping in a Real-Life Cohort of HIV-Infected Patients.

Author(s) :

Meybeck, Agnès [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Alidjinou, Enagnon-Kazali [Auteur]
Laboratoire de virologie - ULR 3610
Huleux, Thomas [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Boucher, Anne [Auteur]
Centre Hospitalier de Tourcoing
Tetart, Macha [Auteur]
Centre Hospitalier de Tourcoing
Choisy, Philippe [Auteur]
Centre Hospitalier de Tourcoing
Bocket, Laurence [Auteur]
Laboratoire de virologie - ULR 3610
Ajana, Faiza [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Robineau, Olivier [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Journal title :

AIDS Patient Care and STDs

Abbreviated title :

AIDS Patient Care STDS

Volume number :

34

Pages :

51-58

Publication date :

2020-02-15

ISSN :

1557-7449

English keyword(s) :

HIV-1
proviral DNA
genotypic resistance test
virological failure
virological suppression

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Issues have been raised concerning clinical relevance of HIV-1 proviral DNA genotypic resistance test (DNA GRT). To assess impact of DNA GRT on choice of antiretroviral therapy (ART) and subsequent virological outcome, we ...
Show more >Issues have been raised concerning clinical relevance of HIV-1 proviral DNA genotypic resistance test (DNA GRT). To assess impact of DNA GRT on choice of antiretroviral therapy (ART) and subsequent virological outcome, we retrospectively reviewed decision-making and viral load (VL) evolution following DNA GRT performed in our center between January 2012 and December 2017, except those prescribed within the framework of a clinical trial. A total of 304 DNA GRTs were included, 185 (62%) performed in a context of virological success. Only 34% of tests were followed by ART change, more frequently in situation of virological success (39% vs. 26%, p = 0.02). In this situation, ART change guided by DNA GRT led to VL >20 copies/mL after 6 months in 5% of cases. In multivariate analysis, higher HIV DNA quantification (p = 0.01) was associated with occurrence of viremia. A higher nadir of CD4 count (p = 0.04) and a longer time with VL <20 copies/mL (p = 0.04) were independently associated with a lower risk of viremia. In situation of low-level viremia, ART change guided by DNA GRT led to VL <20 copies/mL after 6 months in 52% of cases, while decision to maintain the same treatment led to VL <20 copies/mL in 74% of cases. In multivariate analysis, longer time with VL >20 copies/mL (p = 0.02) was associated with persistence of virological replication. In conclusion, in situation of virological success, use of DNA GRT in addition to analysis of historical RNA GRT to guide ART optimization appears safe. Its prescription framework in situation of low-level viremia deserves to be better defined.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• Laboratoire de virologie - ULR 3610
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T09:24:04Z
2024-01-09T10:23:44Z