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HIV virus: a highly resistant strain detected in Toulouse

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A highly resistant HIV strain has been identified in Toulouse in a 23-year-old patient. Without being alarming, researchers from the Department of Infectious Diseases and Tropical Diseases at Toulouse University Hospital find the case worrying.

The case is unusual enough to appeal to specialists in infectious diseases. In the fall of 2019, the team from the Department of Infectious and Tropical Diseases (SMIT) at Toulouse University Hospital identified a highly resistant HIV strain in a 23-year-old patient.
“His virus was multidrug-resistant, meaning it does not respond to any of the antiretrovirals in the four large families conventionally used in triple therapy,”

; explains Professor Pierre Delobel, head of the Department of Infectious and Tropical Diseases at CHU de Toulouse.
“It is not uncommon to find resistant HIV strains, but they are usually identified in patients with older infections. In these chronic patients, the virus mutates and adapts to treatment. But in general, these resistant viruses have mutated so much that they have lost their ability to transmit. There, our patient from Toulouse is infected for the first time. This is the first time such a resistant strain has been transmitted, the specialist in infectious diseases continues.

“A transmission link holds us, that’s what’s worrying”

The news therefore does not come from the discovery of a multi-resistant strain but from its ability to transmit. Toulouse virologists then transmit their results to the network of French virologists to search for identical viruses. The same resistant strain is seen in another 54-year-old patient living in Occitania, infected with HIV for more than 20 years and in whom the virus has mutated, it is the “source patient”.
“We know that these two people have not had contact with each other. Therefore, the source patient has contaminated at least one other person with this multi-resistant strain and this or these individuals have contaminated others like our patient from Toulouse. One or more links escape us and that is what is worrying, adds Professor Pierre Delobel.
As a result, all virology laboratories in France but also in Catalonia have been alerted to identify any other cases. The discovery was published in the British medical journal The Lancet and was the subject of a report for Public Health France.
“We are not alarmists, just vigilant. This shows that research in HIV must continue to find new treatments, concludes Professor Pierre Delobel.
The source patient, whose disease is developing, underwent a clinical trial to take advantage of a new molecule associated with a triple therapy from a family other than the one that followed until then.
In the case of the 23-year-old Toulouse patient, “he is currently under surveillance because he has triggered a good antiviral immune response,” the infectious specialist specifies.
The two patients know that they are contagious and have agreed to use the condom because PrEP (Pre-Exposure Prophylaxis) which their partner can take to avoid contamination does not work on this particular HIV strain.

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