1. Persistent low-level viraemia in antiretroviral treatment-experienced patients is not linked to viral resistance or inadequate drug concentrations
- Author
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B. Abdi, Marc-Antoine Valantin, Sophie Seang, Romain Palich, Gilles Peytavin, Vincent Calvez, Marc Wirden, Cathia Soulié, A G Marcelin, Olivier Paccoud, Minh Patrick Lê, Roland Tubiana, Christine Katlama, and Luminita Schneider
- Subjects
Microbiology (medical) ,Drug ,medicine.medical_specialty ,Anti-HIV Agents ,media_common.quotation_subject ,Patient characteristics ,HIV Infections ,Viremia ,Drug resistance ,Viral resistance ,Antiretroviral Therapy, Highly Active ,Internal medicine ,Drug Resistance, Viral ,Antiretroviral treatment ,Humans ,Medicine ,Pharmacology (medical) ,In patient ,media_common ,Pharmacology ,business.industry ,Middle Aged ,Viral Load ,medicine.disease ,CD4 Lymphocyte Count ,Infectious Diseases ,Anti-Retroviral Agents ,Pharmaceutical Preparations ,HIV-1 ,business ,Viral load - Abstract
Objectives To assess genotypic sensitivity scores (GSSs), plasma antiretroviral concentrations (PACs) and immunovirological outcomes at Week 96 (W96) in patients with persistent low-level viraemia (LLV). Methods On 1 January 2017, we analysed data from patients on three-drug regimens with persistent LLV defined as at least two consecutive plasma viral loads (pVLs) between 21 and 200 copies/mL (including one pVL of ≥50 copies/mL), at the Pitié-Salpêtrière Hospital. Outcomes were: GSS, PACs and HIV-DNA load at study entry; and virological status and proportion of patients with resistance-associated mutations (RAMs) at W96. Results Fifty-seven patients were included, with median age of 52.6 years (IQR 45.2–57.9), last CD4 count of 658 cells/mm3 (IQR 462–909) and total ART duration of 10.2 years (IQR 5.7–15.2). LLV duration was 14.0 months (IQR 5.5–22.3). GSS was 3 in 46/57 (81%) patients and PACs were adequate in 53/57 (93%) patients. Median total HIV-DNA was 2.65 log10 copies/106 cells (IQR 2.44–2.86). During follow-up, 26/57 (46%) had experienced ART modifications. At W96, 38/57 (67%) patients remained with LLV, 15/60 (26%) had achieved confirmed pVL of Conclusions A substantial number of patients harbouring LLV had no resistance to ART and adequate PACs. Two-thirds of these patients remained with this LLV status.
- Published
- 2020