Table 3.
Description of patients with virologic failure
| Patients with virologic failure n=13 | Previous ART (just before switching) | Previous ART duration | VL at failure (copies/mL) | VL confirmation | Time of VF after the switch | Previous VF§ | Previous INSTI exposure | Previous genotypic test | Genotypic test at VF | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| NRTI RAMs | INSTI RAMs | NRTI RAMs | INSTI RAMs | ||||||||
| VL>50 copies/mL between W0 and W48 leading to treatment discontinuation | |||||||||||
| Patient 01 | TDF/FTC+ ATV/r | 3.7 years | 10257 | 418 | 1.5 months | Yes | Yes | L74V, M184V | N155H | L74V, M184V | N155H |
| Patient 02 | TDF/FTC+DRV/r | 3 years | 65679 | 110664 | 5 months | No | No | T215N/Y/S, M184V | ND | L74V, M184V | N155H |
| Patient 03 | TDF/FTC+DRV/r | 3 years | 77 | 180370 | 3 months | No | No |
T215A/C/D/E/G/H T215I/L/N/S/V |
ND | 41L,M184V,T215Y | L74F/I,Q148H/R/K |
| Patient 04 | TDF/FTC+DRV/r | 7 months | 37791 | 16041 | 2 months | Yes | Yes | None | None | NA | NA |
| VL>50 copies/mL between W0 and W48 without treatment discontinuation (or LTFU) | |||||||||||
| Patient 05* | TDF/FTC+ ATV/r | 8 months | 2918 | ND | 4 months | NA | No | M184V | ND | ND | ND |
| Patient 06* | TDF/FTC+DRV/r | 1 year | 60 | 112 | 2 months | NA | No | ND | ND | ND | ND |
| Patient 07* | TDF/FTC+DRV/r | 2.2 years | 112 | ND | 5 months | NA | No | NA | NA | ND | ND |
| Patient 08** | TDF/FTC+RAL | 4 years | 91 | 158 | 6 months | Yes | Yes | NA | NA | ND | ND |
| Vl>50 copies/mL at W48 | |||||||||||
| Patient 09 | TDF/FTC+RAL | 2.3 years | 453 | 149 | 11 months | No | Yes | None | None | No amplification | No amplification |
| Patient 10 | TDF/FTC+FPV/r | 7 years | 6830 | 4990 | 12 months | Yes | No | D67N, K70R,L74V,M184V/I,T215Y/F, K219Q/E | ND | D67N, K70R,M184V/I,S215F, K219Q/E | N155H |
| Patient 11 | ABC/3TC+ATV | 9 years | 169 | 594 | 12 months | NA | No | NA | NA | D67N, K70R,M184V/I,K219Q/E | N155H |
| Patient 12 | TDF/FTC+ ATV/r | 9 months | 3339 | 22957 | 12 months | Yes | No | None | None | None | None |
| Patient 13 | TDF/FTC/EFV | 2.5 years | 1767 | ND | 12 months | Yes | No | None | ND | ND | ND |
ART antiretroviral therapy, INSTI integrase strand inhibitor, NRTI nucleoside reverse transcriptase inhibitor, RAM resistance associated mutations, VL viral load, VF virologic failure; NA information not available in the data base, ND not done, LTFU lost to follow-up
TDF/FTC tenofovir/emtricitabine, EFV efavirenz, DRV/r darunavir boosted with ritonavir, ATV atazanavir, ATV/r atazanavir boosted with ritonavir, RAL raltegravir, FPV/r fosamprenavir boosted with ritonavir
§Previous VF based on the mention in the patient’s therapeutic history that ART was changed because of VF
*These patients were lost to follow-up after the diagnosis of VF but patient 7 never stopped treatment and returned to his center in sept 2017 with undetectable HIV RNA while still on E/C/F/TDF
**This patient continued E/C/F/TDF for an additional year but with persistent low levels viraemia. 18 months later, INSTI associated resistance was confirmed and the patient switched to PI/r