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Session 56 Poster Session Acute Infection: Resistance, Fitness, and Transmission Session Time: 4:30-6:30 pm Room 4E-F

369-M. Survey of Genotypic Drug Resistance and Molecular Epidemiology of Virus from Patients with HIV-1 Primary Infection in 2000 in France M. L. Chaix*1, D. Descamps2, M. Harzic3, V. Schneider4, C. Deveau5, I. Pellegrin6, C. Tamalet7, B. Masquelier6, C. Rouzioux1, L. Meyer5, F. Brun-Vezinet2, and D. Costagliola8 for the ANRS AC11 Resistance Group Cohort PRIMO and PRIMSTOP Study Groups 1Hosp. Necker, Paris; 2Hosp. Bichat, Paris; 3Hosp. Versailles; 4Hosp. Rotschild, Paris; 5INSERM U292, Kremlin-Bicêtre; 6Hosp. Pellegrin, Bordeaux; 7Hosp. La Timone Marseille; and 8SC4 INSERM, Paris, France Background: Our objective was to survey the evolution of the prevalence of virus with genotypic antiretroviral resistance among French patients who presented with HIV primary infection during the year 2000. Methods: Pre-treatment plasma samples were tested for genotypic resistance at time of acute infection in 98 patients recruited all over France in different laboratories of the AC11 Resistance group (n=48), in the PRIMO Cohort study (n=36), and in the PRIMSTOP study (n=14). The risk factors for infection were homosexual or bisexual contact for 55% of the patients, heterosexual contact for 37% and 8% not yet documented. Results: 11% of patients (11/98 [95% CI: 6-20]) presented with mutations associated with resistance to at least 1 antiretroviral drug. The distribution of the resistance mutations was as follows: to NRTIs in 8/98 (8% [95% CI: 4-16]; 1 to 3TC, 3 to ZDV+ddC, and 4 to ZDV with resistance profile suggesting a reversion back to wild type), and to NNRTIs in 5/98 (5% [95% CI: 2-12]; 1 x K103N, 1 x Y188L, 1 x Y188C, 2 x Y181C). Primary resistance mutations to protease inhibitors were detected in 6/98 (6%, [95% CI: 2-14]; L90M, V82A). 5 patients out of the 98 (5% [95% CI: 2-12]) presented with virus mutations associated with multi drug resistance to 2 or 3 classes of antiretroviral drugs. Conclusions: Phylogenetic analysis and response to initial therapy are in progress. Such epidemiological surveys must continue to see if these trends persist and if there are any important differences with other countries.

©2002 9th Conference on Retroviruses and Opportunistic Infections