No HIV-1 molecular evolution on long-term antiretroviral therapy initiated during primary HIV-1 infection - Sorbonne Université
Journal Articles AIDS. Official journal of the international AIDS Society Year : 2020

No HIV-1 molecular evolution on long-term antiretroviral therapy initiated during primary HIV-1 infection

Abstract

Objective: Most studies about HIV-1 molecular evolution have shown the lack of viral evolution on effective antiretroviral therapy (ART), although controversial results have been documented. We therefore aimed to look for evidence of HIV-1 evolution in patients who initiated ART at the time of primary HIV-1 infection (PHI). Design: We included retrospectively 20 patients diagnosed at PHI, treated at the time of acute infection and with subsequent effective long-term suppressive ART (HIV viral load <20 copies/ml during at least 5 years without any blips). Methods: Longitudinal blood samples were deep sequenced using Illumina Miseq. Drug-resistance-associated mutations were retained at 2% cutoff and interpreted using the latest Agence Nationale de Recherches sur le Sida et les Hépatites Virales resistance algorithm. Viral evolution was established when temporal structure on maximum-likelihood phylogenetic tree and significant change over time of HIV-1 genetic diversity measured as the average pairwise distance was observed. Results: Emergences or disappearances of drug-resistance-associated mutations were detected in the blood cells during follow-up despite sustained virological control. In all patients, tree topologies showed an absence of segregation between sequences and blood viral populations from all time-points were intermingled. Comparison of the average pairwise distance showed the absence of significant viral diversity at the time of primary infection and afterwards during 5 years of full virological control under ART. Conclusion: Despite a slight variation of minority resistance-associated mutation variants, there was no clear evidence of viral evolution during a prolonged period of time in this population of highly controlled adult patients treated at time of PHI.
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hal-03182806 , version 1 (26-03-2021)

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Basma Abdi, Thuy Nguyen, Sophie Brouillet, Nathalie Desire, Sophie Sayon, et al.. No HIV-1 molecular evolution on long-term antiretroviral therapy initiated during primary HIV-1 infection. AIDS. Official journal of the international AIDS Society, 2020, 34 (12), pp.1745-1753. ⟨10.1097/QAD.0000000000002629⟩. ⟨hal-03182806⟩
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