Ferré Valentine M, Bitty-Anderson Alexandra M, Peytavin Gilles, Lê Minh P, Dagnra Claver A, Coppée Romain, Gbeasor-Komlanvi Fifonsi A, Descamps Diane, Charpentier Charlotte, Ekouevi Didier K
Université Paris Cité, Inserm UMR_1137, IAME, Paris, France.
Service de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
J Med Virol. 2023 Feb;95(2):e28535. doi: 10.1002/jmv.28535.
No data about antiretroviral (ARV) treatment coverage and virological response are available among key populations (female sex workers [FSW] and Men having Sex with Men [MSM]) in Togo. This study aimed to both describe Human Immunodeficiency Virus (HIV) immunovirological status and evaluate the pertinence of an original algorithm combining pharmacology (PK) and viral load (VL) to identify subjects at risk of ARV drug resistance. A cross-sectional multicentric study was conducted in 2017 in Togo. Our PK-virological algorithm (PK-VA) defines subjects at risk of resistance when exhibiting both detectable plasma drug concentrations and VL > 200 c/mL. Among the 123 FSW and 136 MSM included, 50% and 66% were receiving ARV, with 69% and 80% of them successfully-treated, respectively. Genotypes showed drug-resistance mutation in 58% and 63% of nonvirologically controlled (VL > 200 c/mL) ARV-treated FSW and MSM, respectively. PK-VA would have enabled to save 75% and 72% of genotypic tests, for FSW and MSM, respectively. We reported first data about HIV care cascade among key populations in Togo, highlighting they are tested for HIV but linkage to care remains a concern. Furthermore, 70%-80% of ARV-treated participants experienced virological success. In limited resources settings, where genotyping tests are beyond reach, PK-VA might be an easiest solution to sort out patients needing ARV adaptation due to resistance.
在多哥的重点人群（女性性工作者[FSW]和男男性行为者[MSM]）中，尚无关于抗逆转录病毒（ARV）治疗覆盖率和病毒学反应的数据。本研究旨在描述人类免疫缺陷病毒（HIV）免疫病毒学状态，并评估一种结合药理学（PK）和病毒载量（VL）的原创算法在识别有ARV耐药风险受试者方面的相关性。2017年在多哥进行了一项横断面多中心研究。我们的PK-病毒学算法（PK-VA）将同时出现可检测血浆药物浓度和VL>200 c/mL的受试者定义为有耐药风险。在纳入的123名FSW和136名MSM中，分别有50%和66%正在接受ARV治疗，其中分别有69%和80%得到成功治疗。基因型显示，在未实现病毒学控制（VL>200 c/mL）的接受ARV治疗的FSW和MSM中，分别有58%和63%存在耐药突变。PK-VA分别可为FSW和MSM节省75%和72%的基因分型检测。我们报告了多哥重点人群中HIV治疗流程的首批数据，强调他们接受了HIV检测，但与治疗的联系仍然是一个问题。此外，70%-80%接受ARV治疗的参与者获得了病毒学成功。在资源有限、无法进行基因分型检测的环境中，PK-VA可能是筛选出因耐药而需要调整ARV治疗方案患者的最简单解决方案。
