病毒学
生物
逆转录酶
一致性
基因型
抗药性
DNA
核糖核酸
病毒
基因
免疫学
遗传学
作者
Clotilde Allavena,Audrey Rodallec,A. Leplat,Nolwenn Hall,Caroline Luco,L. Le Guen,C Bernaud,Sabelline Bouchez,Élisabeth André-Garnier,David Boutoille,Valentine Marie Ferré,François Raffi
标识
DOI:10.1016/j.jviromet.2017.10.016
摘要
Switch of antiretroviral therapy in virologically suppressed HIV-infected patients is frequent, to prevent toxicities, for simplification or convenience reasons. Pretherapeutic genotypic resistance testing on RNA can be lacking in some patients, which could enhance the risk of virologic failure, if resistance-associated mutations of the new regimen are not taken into account. Proviral DNA resistance testing in 69 virologically suppressed patients on antiretroviral treatment with no history of virological failure were pair-wised compared with pre-ART plasma RNA resistance testing. The median time between plasma (RNA testing) and whole blood (proviral DNA testing) was 47 months (IQR 29–63). A stop codon was evidenced in 23% (16/69) of proviral DNA sequences; these strains were considered as defective, non-replicative, and not taken into consideration. Within the non defective strains, concordance rate between plasma RNA and non-defective proviral DNA was high both on protease (194/220 concordant resistance-associated mutations = 88%) and reverse transcriptase (28/37 concordant resistance-associated mutations = 76%) genes. This study supports that proviral DNA testing might be an informative tool before switching antiretrovirals in virologically suppressed patients with no history of virological failure, but the interpretation should be restricted to non-defective viruses.
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