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Transmitted drug resistance, selection of resistance mutations and moderate antiretroviral efficacy in HIV-2: analysis of the HIV-2 Belgium and Luxembourg database.

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Ruelle, Jean [UCL] Roman, François Vandenbroucke, Anne-Thérèse [UCL] Lambert, Christine Fransen, Katrien Goubau, Patrick [UCL]

BACKGROUND: Guidelines established for the treatment of HIV-1 infection and genotype interpretation do not apply for HIV-2. Data about antiretroviral (ARV) drug efficacy and resistance mutations is scarce. METHODS: Clinical data about HIV-2 infected patients in Belgium and Luxembourg were collected and the effect of ARV therapy on plasma viral load and CD4 counts were analysed. Viral RNA encoding for protease (PR) and reverse transcriptase (RT) from ARV-naïve and treated patients were sequenced. RESULTS: Sixty-five HIV-2 infected patients were included in this cohort. Twenty patients were treated with 25 different ARV combinations in a total of 34 regimens and six months after the start of ARV therapy, only one third achieved viral load suppression. All of these successful regimens bar one contained protease inhibitors (PIs). Mean CD4 gains in the group of viral load suppressors and the group of patients treated with PI-containing regimens were respectively significantly higher than in the group of non-suppressors and the group of PI-sparing regimens. The most frequent mutations selected under therapy (compared to HIV-2 ROD) were V71I, L90M and I89V within PR. Within RT, they were M184V, Q151M, V111I and K65R. All of these mutations, except K65R and M184V, were also found in variable proportions in ARV-naïve patients. CONCLUSION: Despite a high rate of ARV treatment failure, better virological and immunological results were achieved with PI-containing regimens. The analysis of polymorphic positions and HIV-2 specific mutations selected during therapy showed for the first time that transmission of drug resistant viruses has occurred in Belgium and Luxembourg. The high heterogeneity in ARV combinations reflects a lack of guidelines for the treatment of HIV-2 infection.

Document type Article de périodique (Journal article) – Journal Article, Research Support, Non-U.S. Gov't
Access type Accès libre
Publication date 2008
Journal information "BMC Infectious Diseases" - Vol. 8, p. 21 (2008)
Peer reviewed yes
Publisher BioMed Central Ltd. ((United Kingdom) London)
issn 1471-2334
e-issn 1471-2334
Publication status Publié
Affiliations UCL - MD/MIGE - Département de microbiologie, d'immunologie et de génétique
UCL - (SLuc) Service de microbiologie
MESH Subject Viral Load ; Registries ; RNA, Viral - chemistry ; Polymerase Chain Reaction ; Mutation - drug effects - genetics ; Molecular Sequence Data ; Middle Aged ; Male ; Luxembourg - epidemiology ; Humans ; HIV-2 - classification - drug effects - genetics ; HIV Reverse Transcriptase - genetics ; HIV Protease - genetics ; HIV Infections - drug therapy - ethnology - virology ; Genotype ; Female ; Drug Resistance, Multiple, Viral - drug effects - genetics ; Cohort Studies ; CD4 Lymphocyte Count ; Belgium - epidemiology ; Anti-Retroviral Agents - pharmacology - therapeutic use ; Aged ; Africa, Western - ethnology ; Adult
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Bibliographic reference Ruelle, Jean ; Roman, François ; Vandenbroucke, Anne-Thérèse ; Lambert, Christine ; Fransen, Katrien ; et. al. Transmitted drug resistance, selection of resistance mutations and moderate antiretroviral efficacy in HIV-2: analysis of the HIV-2 Belgium and Luxembourg database.. In: BMC Infectious Diseases, Vol. 8, p. 21 (2008)
Permanent URL http://hdl.handle.net/2078.1/11304