{"title":"法国随访的 HIV-1/O 和 HIV-1/M 患者对 cART 的免疫学和病毒学反应的比较。","authors":"Guillemette Unal, Rémonie Seng, Elodie Alessandri-Gradt, Lorraine Plessis, Mathilde Ghislain, Cécile Goujard, Marie Leoz, Jean-Christophe Plantier, Laurence Meyer","doi":"10.1093/jac/dkae475","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Therapeutic outcomes for patients infected by genetically divergent HIV-1/O are not well-known due to scarce data and the lack of an appropriate comparison with patients infected by pandemic HIV-1/M. We aimed to compare the immunological and virological response to cART between HIV-1/O and HIV-1/M patients followed in France.</p><p><strong>Methods: </strong>All naïve HIV-1/O subjects initiating cART in France in ANRS-ORIVAO study were compared to naïve HIV-1/M subjects initiating cART in ANRS-COPANA cohort. Piecewise linear mixed-effect models and Kaplan-Meier survival curves were used to analyse immunological and virological response to cART overall (65 HIV-1/O versus 279 HIV-1/M), then only in patients initiating 2INTI + 1PI/r.</p><p><strong>Results: </strong>Plasma viral load (pVL) at treatment initiation was 0.6 log10 copies/mL lower in HIV-1/O than in HIV-1/M patients (P = 0.004) in the overall population, but there was no difference in the time to pVL < 200 cp/mL after cART initiation (log rank test, P = 0.57). Meanwhile, baseline CD4 counts were lower in HIV-1/O (median 180/mm3) than HIV-1/M (248/mm3) patients (P = 0.001). At 4 months, the increase in CD4 counts did not differ (P = 0.96) between groups but remained lower in HIV-1/O patients beyond 4 months of treatment (P = 0.04).In PI/r population, baseline pVL was 1 log10 copies/mL lower for HIV-1/O than HIV-1/M patients, leading to significantly faster attainment of pVL < 200 cp/mL (log rank test: P < 0.001); immunological response to cART was similar.</p><p><strong>Conclusions: </strong>HIV-1/O and HIV-1/M immunological and virological responses to cART did not differ when epidemiological characteristics of the patients were taken into account. In France, treating HIV-1/O following HIV-1/M guidelines leads to similar therapeutic outcomes.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of the immunological and virological responses to cART between HIV-1/O and HIV-1/M patients followed up in France.\",\"authors\":\"Guillemette Unal, Rémonie Seng, Elodie Alessandri-Gradt, Lorraine Plessis, Mathilde Ghislain, Cécile Goujard, Marie Leoz, Jean-Christophe Plantier, Laurence Meyer\",\"doi\":\"10.1093/jac/dkae475\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Therapeutic outcomes for patients infected by genetically divergent HIV-1/O are not well-known due to scarce data and the lack of an appropriate comparison with patients infected by pandemic HIV-1/M. We aimed to compare the immunological and virological response to cART between HIV-1/O and HIV-1/M patients followed in France.</p><p><strong>Methods: </strong>All naïve HIV-1/O subjects initiating cART in France in ANRS-ORIVAO study were compared to naïve HIV-1/M subjects initiating cART in ANRS-COPANA cohort. Piecewise linear mixed-effect models and Kaplan-Meier survival curves were used to analyse immunological and virological response to cART overall (65 HIV-1/O versus 279 HIV-1/M), then only in patients initiating 2INTI + 1PI/r.</p><p><strong>Results: </strong>Plasma viral load (pVL) at treatment initiation was 0.6 log10 copies/mL lower in HIV-1/O than in HIV-1/M patients (P = 0.004) in the overall population, but there was no difference in the time to pVL < 200 cp/mL after cART initiation (log rank test, P = 0.57). Meanwhile, baseline CD4 counts were lower in HIV-1/O (median 180/mm3) than HIV-1/M (248/mm3) patients (P = 0.001). At 4 months, the increase in CD4 counts did not differ (P = 0.96) between groups but remained lower in HIV-1/O patients beyond 4 months of treatment (P = 0.04).In PI/r population, baseline pVL was 1 log10 copies/mL lower for HIV-1/O than HIV-1/M patients, leading to significantly faster attainment of pVL < 200 cp/mL (log rank test: P < 0.001); immunological response to cART was similar.</p><p><strong>Conclusions: </strong>HIV-1/O and HIV-1/M immunological and virological responses to cART did not differ when epidemiological characteristics of the patients were taken into account. In France, treating HIV-1/O following HIV-1/M guidelines leads to similar therapeutic outcomes.</p>\",\"PeriodicalId\":14969,\"journal\":{\"name\":\"Journal of Antimicrobial Chemotherapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-01-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Antimicrobial Chemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jac/dkae475\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Antimicrobial Chemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jac/dkae475","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Comparison of the immunological and virological responses to cART between HIV-1/O and HIV-1/M patients followed up in France.
Background: Therapeutic outcomes for patients infected by genetically divergent HIV-1/O are not well-known due to scarce data and the lack of an appropriate comparison with patients infected by pandemic HIV-1/M. We aimed to compare the immunological and virological response to cART between HIV-1/O and HIV-1/M patients followed in France.
Methods: All naïve HIV-1/O subjects initiating cART in France in ANRS-ORIVAO study were compared to naïve HIV-1/M subjects initiating cART in ANRS-COPANA cohort. Piecewise linear mixed-effect models and Kaplan-Meier survival curves were used to analyse immunological and virological response to cART overall (65 HIV-1/O versus 279 HIV-1/M), then only in patients initiating 2INTI + 1PI/r.
Results: Plasma viral load (pVL) at treatment initiation was 0.6 log10 copies/mL lower in HIV-1/O than in HIV-1/M patients (P = 0.004) in the overall population, but there was no difference in the time to pVL < 200 cp/mL after cART initiation (log rank test, P = 0.57). Meanwhile, baseline CD4 counts were lower in HIV-1/O (median 180/mm3) than HIV-1/M (248/mm3) patients (P = 0.001). At 4 months, the increase in CD4 counts did not differ (P = 0.96) between groups but remained lower in HIV-1/O patients beyond 4 months of treatment (P = 0.04).In PI/r population, baseline pVL was 1 log10 copies/mL lower for HIV-1/O than HIV-1/M patients, leading to significantly faster attainment of pVL < 200 cp/mL (log rank test: P < 0.001); immunological response to cART was similar.
Conclusions: HIV-1/O and HIV-1/M immunological and virological responses to cART did not differ when epidemiological characteristics of the patients were taken into account. In France, treating HIV-1/O following HIV-1/M guidelines leads to similar therapeutic outcomes.
期刊介绍：
The Journal publishes articles that further knowledge and advance the science and application of antimicrobial chemotherapy with antibiotics and antifungal, antiviral and antiprotozoal agents. The Journal publishes primarily in human medicine, and articles in veterinary medicine likely to have an impact on global health.
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