Clinical, epidemiological and treatment failure data among HIV-1 non-B-infected patients in the Spanish AIDS Research Network Cohort

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• 作者：Esther Torrecilla Garcí ; a^a ; Gonzalo Yebra Sanz^a ; Teresa Llá ; cer-Delicado^a ; Rafael Rubio Garcí ; a^b ; Juan Gonzá ; lez-Garcí ; a^c ; Federico Garcí ; a Garcí ; a^d ; José ; Ló ; pez-Aldeguer^e ; Ví ; ctor Asensi Á ; lvarez^f ; Á ; frica Holguí ; n Ferná ; ndez^a ; ^{africa.holguin@salud.madrid.org" class="auth_mail" title="E-mail the corresponding author} ; Cohort of the Spanish AIDS Research Network (CoRIS)
• 关键词：CoRIS ; HIV-1 ; Non-B variants ; Antiretroviral treatment (ART) ; Therapeutic failure (TF) to first ART ; Epidemiology
• 刊名：Enfermedades Infecciosas y Microbiología Clínica
• 出版年：2016
• 出版时间：June-July 2016
• 年：2016
• 卷：34
• 期：6
• 页码：353-360
• 全文大小：641 K

文摘

The prevalence of HIV-1 non-B variants is increasing in Spain, showing a higher number of transmitted drug resistance mutations (TDR) since 2002. This study presents the features of non-B-infected patients enrolled in the cohort of antiretroviral treatment (ART) naïve HIV-infected patients included in the Research Network on HIV/AIDS (CoRIS).

Methods

The study includes a selected group of HIV-1 non-B-infected subjects from 670 subjects with pol sequences collected from 2004 to 2008 in the CoRIS cohort. Epidemiological-clinical-virological data were analyzed since cohort entry until October 2011, considering the presence or absence of treatment failure (TF).

Results

Eighty two non-B infected subjects with known HIV-1 variants were selected from 2004 to 2008 in the CoRIS cohort, being mainly female, immigrants, infected by recombinant viruses, and by heterosexual route. They had an intermediate TDR rate (9.4%), a high rate of TF (25.6%), of losses to follow-up (35%), of coinfections (32.9%), and baseline CD4+ counts ≥350 cells/mm³ (61.8%). Non-B subjects with TF showed higher rates of heterosexual infection (85.7% vs. 69.5%, p < 0.05), tuberculosis (30.8% vs. 9.1%, p = 0.10) and hepatitis C (23.8% vs. 13.9%, p = 0.34) coinfections and lower rates of syphilis (0% vs. 21.9%, p < 0.05), and had more frequently received first-line ART including protease inhibitors (PIs) than patients without TF (70% vs. 30%, p < 0.05). Interestingly, infection with non-B variants reduced the risk of TDR to nucleoside reverse transcriptase inhibitors and increased the risk to PIs.

Conclusion

HIV-1 non-B-infected patients in Spain had a particular epidemiological and clinical profile that should be considered during their clinical management.