脑脊液和血液中 HIV-1 整合酶抑制剂耐药性无差异。

No difference in HIV-1 integrase inhibitor resistance between CSF and blood compartments.

机构信息

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France.

Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France.

出版信息

J Antimicrob Chemother. 2021 May 12;76(6):1553-1557. doi: 10.1093/jac/dkab064.

DOI:10.1093/jac/dkab064

PMID:33693680

Abstract

BACKGROUND

Little is known about HIV-1 integrase inhibitor resistance in the CNS.

OBJECTIVES

This study aimed to evaluate integrase inhibitor resistance in CSF, as a marker of the CNS, and compare it with the resistance in plasma.

METHODS

HIV integrase was sequenced both in plasma and CSF for 59 HIV-1 patients. The clinical and biological data were collected from clinical routine care.

RESULTS

Among the 59 HIV-1 patients, 32 (54.2%) were under antiretroviral (ARV) treatment. The median (IQR) HIV-1 RNA in the plasma of viraemic patients was 5.32 (3.85-5.80) and 3.59 (2.16-4.50) log10 copies/mL versus 4.79 (3.56-5.25) and 3.80 (2.68-4.33) log10 copies/mL in the CSF of ARV-naive and ARV-treated patients, respectively. The patients were mainly infected with non-B subtypes (72.2%) with the most prevalent recombinant form being CRF02_AG (42.4%). The HIV-1 integrase sequences from CSF presented resistance mutations for 9/27 (33.3%) and 8/32 (25.0%) for ARV-naive (L74I, n = 3; L74I/M, n = 1; T97A, n = 1; E157Q, n = 4) and ARV-treated (L74I, n = 6; L74M, n = 1; T97A, n = 1; N155H, n = 1) patients, respectively. Integrase inhibitor resistance mutations in CSF were similar to those in plasma, except for 1/59 patients.

CONCLUSIONS

This work shows similar integrase inhibitor resistance profiles in the CNS and plasma in a population of HIV-1 viraemic patients.

摘要

背景

人们对中枢神经系统（CNS）中的 HIV-1 整合酶抑制剂耐药情况知之甚少。

目的

本研究旨在评估 CSF 中的整合酶抑制剂耐药情况，作为 CNS 的标志物，并将其与血浆中的耐药情况进行比较。

方法

对 59 例 HIV-1 患者的血浆和 CSF 中的 HIV 整合酶进行了测序。临床和生物学数据来自临床常规护理。

结果

在 59 例 HIV-1 患者中，32 例（54.2%）正在接受抗逆转录病毒（ARV）治疗。病毒血症患者的血浆中 HIV-1 RNA 中位数（IQR）为 5.32（3.85-5.80）和 3.59（2.16-4.50）log10 拷贝/mL，而 ARV 初治和 ARV 治疗患者的 CSF 中 HIV-1 RNA 中位数（IQR）分别为 4.79（3.56-5.25）和 3.80（2.68-4.33）log10 拷贝/mL。患者主要感染非 B 亚型（72.2%），最常见的重组形式为 CRF02_AG（42.4%）。CSF 中的 HIV-1 整合酶序列在 ARV 初治患者中出现耐药突变的比例为 9/27（33.3%），在 ARV 治疗患者中出现耐药突变的比例为 8/32（25.0%）（L74I，n=3；L74I/M，n=1；T97A，n=1；E157Q，n=4）和 ARV 治疗（L74I，n=6；L74M，n=1；T97A，n=1；N155H，n=1）患者。CSF 中的整合酶抑制剂耐药突变与血浆中的相似，除了 1 例患者外。