Skip Navigation LinksHome > May 15, 2014 - Volume 28 - Issue 8 > Genotypic resistance profiles of HIV-2-treated patients in W...
doi: 10.1097/QAD.0000000000000244
Clinical Science

Genotypic resistance profiles of HIV-2-treated patients in West Africa

Charpentier, Charlottea; Eholié, Sergeb,c,d; Anglaret, Xavierd,e,f; Bertine, Mélaniea; Rouzioux, Christineg; Avettand-Fenoël, Véroniqueg; Messou, Eugènec,d; Minga, Albertd; Damond, Florencea; Plantier, Jean-Christopheh; Dabis, Françoise,f; Peytavin, Gillesi; Brun-Vézinet, Françoisea; Ekouevi, Didier K.d,e,f,j; the IeDEA West Africa Collaboration

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Objective: To assess the virological response, genotypic resistance profiles, and antiretroviral plasma concentrations in HIV-2 antiretroviral-treated (antiretroviral therapy, ART) patients in Côte d‘Ivoire.

Methods: A cross-sectional survey was conducted among HIV-2 patients receiving ART. Plasma HIV-2 viral load was performed using the Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS) assay. Protease and reverse transcriptase sequencing was performed using in-house methods and antiretroviral plasma concentrations were assessed using ultra performance liquid chromatography combined with tandem mass spectrometry.

Results: One hundred and forty-five HIV-2-treated patients were enrolled with a median CD4+ cell count of 360 cells/μl (interquartile range, IQR = 215–528). Median duration of ART was 4 years (IQR = 2–7) and 74% of patients displayed viral load less than 50 copies/ml. Median plasma HIV-2 RNA among patients with viral load more than 50 copies/ml was 3016 copies/ml (IQR = 436–5156). Most patients (84%) received a lopinavir/ritonavir-based regimen. HIV-2 resistance mutations to nucleoside reverse transcriptase inhibitors and protease inhibitors were detected in 21 of 25 (84%) and 20 of 29 (69%) samples, respectively. The most prevalent nucleoside reverse transcriptase inhibitor resistance mutations were M184I/V (90%), Q151M (24%), and S215F/Y (24%). The most prevalent protease inhibitor resistance mutations were V47A (60%) and I54M (30%). Median CD4+ cell counts were 434 cells/μl (292–573) and 204 cells/μl (122–281) in patients with viral load less than 50 copies/ml and those exhibiting virological failure (P < 0.0001), respectively. The proportions of patients with adequate antiretroviral plasma concentrations were 81 and 93% in patients displaying virological failure and in those with viral load less than 50 copies/ml, respectively (P = 0.046), suggesting good treatment adherence.

Conclusion: We observed adequate drug plasma concentrations and virological suppression in a high proportion of HIV-2-infected patients. However, in cases of virological failure, the limited HIV-2 therapeutic arsenal and cross-resistance dramatically reduced treatment options.

© 2014 Lippincott Williams & Wilkins, Inc.


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