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Oxford University Press, Journal of Antimicrobial Chemotherapy, 2(70), p. 566-572, 2014

DOI: 10.1093/jac/dku419

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Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Journal article published in 2014 by A. de Rougemont, P. Yéni, Cathia Soulie, Véronique Schneider, Laurence Morand-Joubert, Diane Descamps, Maxime Grude, Stéphanie Raymond, E. Lagier, H. Le Guillou, Mary-Anne Trabaud, D. Bettinger, Veronique Schneider, H. Fleury, Constance Delaugerre and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performed.