TITLE

Pitfalls of HIV genotypic tropism testing after treatment interruption

AUTHOR(S)
Wirden, Marc; Soulié, Cathia; Fourati, Slim; Valantin, Marc Antoine; Simon, Anne; Ktorza, Nadine; Tubiana, Roland; Bonmarchand, Manuela; Schneider, Luminita; Calvez, Vincent; Katlama, Christine; Marcelin, Anne-Genevieve
PUB. DATE
January 2013
SOURCE
Journal of Antimicrobial Chemotherapy (JAC);Jan2013, Vol. 68 Issue 1, p188
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives The genotypic method is reliable enough for the determination of tropism and largely preferred in Europe. However, careful interpretation is essential when assessing HIV genotypic resistance during treatment interruption (TI) due to the possible disappearance of resistant strains. The results of HIV genotypic tropism testing in such a context remain unknown. Methods First, we studied changes in tropism in patients included in a structured TI assay: the Reverse study. Second, we investigated the unexpected tropism switches from X4 to R5 recorded in our routine database. Results Tropism determination was possible in 21 patients of the Reverse study, 9 of whom had an X4 virus (43%) at baseline. Two patients displayed a change of tropism during TI, both switching from X4 to R5. Regarding the database investigation, 7 of the 222 patients with at least two plasma tropism determinations recorded in the database displayed a switch from X4 to R5. TI due to non-compliance at the time of the tropism change was reported for five of these seven patients. Conclusions We have shown that the redistribution of the HIV population caused by TI could potentially result in X4 viruses becoming undetected and inappropriate prescription of a CCR5 receptor antagonist. Therefore, genotypic tropism results should be interpreted with caution in such a context.
ACCESSION #
84555795

 

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