Masquelier Bernard, Costagliola Dominique, Schmuck Anne, Cottalorda Jacqueline, Schneider Véronique, Izopet Jacques, Calvez Vincent, Descamps Diane, Poggi Cécile, Brun-Vézinet Françoise
Department of Virology, Bordeaux University Hospital, Paris, France.
J Med Virol. 2005 Aug;76(4):441-6. doi: 10.1002/jmv.20380.
The objective of the study was to estimate the prevalence of HIV-1 resistance to all drugs belonging to two or more antiretroviral drug (ARV) classes in treated patients in France. All genotyping assays performed in June 2001 and in November 2002 by the ANRS resistance laboratory network were analyzed by the ANRS algorithm. The 17 and 21 centers of the ANRS network participating in the study in 2001 and 2002, respectively, genotyped the viruses in plasma of 456 and 529 patients, respectively. In 2002, the proportions of patients harboring viruses fully resistant to one, two, and three ARV classes were 5.1%, 8.1%, and 2.5%, respectively. These results were similar to those obtained in 2001. In 2002, among the 56 patients with viruses completely resistant to at least two ARV classes, 98%, 96%, and 29% of patients had viruses with complete class resistance to NRTIs, NNRTIs, and PIs, respectively. Complete resistance to PIs was less frequent than full resistance to the other two ARV classes, and ritonavir-boosted amprenavir and lopinavir/r remained potentially active in respectively 71.4% and 42.9% of these 56 patients. In 2001 and 2002, respectively 30% of the 65 patients and 24% of the 56 patients with viruses completely resistant to at least two ARV classes were at an advanced stage of HIV disease, with CD4(+) cell counts below 200/microl and viral loads above 30 000 copies/ml. In France, the prevalence of HIV-1 viruses completely resistant to two or more ARV classes remained stable between 2001 and 2002. Resistance to RT inhibitors was more frequent than resistance to PIs in patients with viruses completely resistant to two or three classes of ARV.
该研究的目的是评估法国接受治疗的患者中，HIV-1对属于两种或更多抗逆转录病毒药物（ARV）类别的所有药物产生耐药性的流行情况。法国国家艾滋病研究机构（ANRS）耐药性实验室网络在2001年6月和2002年11月进行的所有基因分型检测，均通过ANRS算法进行分析。ANRS网络中分别参与2001年和2002年研究的17个和21个中心，对456例和529例患者血浆中的病毒进行了基因分型。2002年，对一类、二类和三类ARV药物完全耐药的患者比例分别为5.1%、8.1%和2.5%。这些结果与2001年获得的结果相似。2002年，在56例病毒对至少两类ARV药物完全耐药的患者中，分别有98%、96%和29%的患者病毒对核苷类逆转录酶抑制剂（NRTIs）、非核苷类逆转录酶抑制剂（NNRTIs）和蛋白酶抑制剂（PIs）完全耐药。对PIs的完全耐药比另外两类ARV药物的完全耐药更为少见，在这56例患者中，利托那韦增强的安普那韦和洛匹那韦/利托那韦分别在71.4%和42.9%的患者中仍具有潜在活性。在2001年和2002年，在病毒对至少两类ARV药物完全耐药的65例患者和56例患者中，分别有30%和24%处于HIV疾病晚期，CD4(+)细胞计数低于200/微升，病毒载量高于30000拷贝/毫升。在法国，2001年至2002年期间，HIV-1病毒对两类或更多类ARV药物完全耐药的流行率保持稳定。在病毒对两类或三类ARV药物完全耐药的患者中，对逆转录酶抑制剂的耐药比对PIs的耐药更为常见。
