1
|
Lamoureux C, Drak Alsibai K, Pradinaud R, Sainte-Marie D, Couppie P, Blaizot R. Kaposi Sarcoma with Mucocutaneous Involvement in French Guiana: An Epidemiological Study between 1969 and 2019. Acta Derm Venereol 2022; 102:adv00709. [DOI: 10.2340/actadv.v102.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Data on Kaposi sarcoma in French Guiana are scarce and out of date. This territory presents unique epidemiological features. The objectives of this retrospective study were to analyse the clinical features, outcome and incidence of the different forms of Kaposi sarcoma in patients diagnosed between 1969 and 2019. The study population comprised a total of 52 patients. Clinical forms included epidemic Kaposi sarcoma (n=30), endemic (n=18), iatrogenic (n=2), classic (n=1) and unclassified Kaposi sarcoma (n=1). The mean annual incidence rate of epidemic Kaposi reached a peak in the 1990s (0.93/100,000) then decreased in the 2000s (0.33/100,000), while the incidence of endemic Kaposi sarcoma reached a peak in the 1980s (0.82/100,000) before decreasing in the 2000s (0.12/100,000). Factors associated with the epidemic form were: sexual intercourse between men (p=0.0054) and Haitian origin (p=0.035). The presence of nodules and/or tumour, lesions limited to the lower limbs, and age >65 years were associated with the endemic form. While Creole populations seem to be as affected by endemic Kaposi sarcoma as their African counterparts, the dynamics of Kaposi sarcoma in French Guiana are now dominated by the epidemic form.
Collapse
|
2
|
Nacher M, Leitao TS, Gómez BL, Couppié P, Adenis A, Damasceno L, Demar M, Samayoa B, Cáceres DH, Pradinaud R, Sousa ADQ, Arathoon E, Restrepo A. The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers. J Fungi (Basel) 2019; 5:jof5020051. [PMID: 31212897 PMCID: PMC6617033 DOI: 10.3390/jof5020051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 11/17/2022] Open
Abstract
Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical “awakening” to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.
Collapse
|
3
|
Ouedraogo E, Blaizot R, Douine M, Nacher M, Sainte-Marie D, Caumes E, Pradinaud R, Couppie P. Évolution du traitement de l’infection à Mycobacterium ulcerans en Guyane de 1971 à 2015. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Douine M, Gozlan R, Nacher M, Dufour J, Reynaud Y, Elguero E, Combe M, Velvin C, Chevillon C, Berlioz-Arthaud A, Labbé S, Sainte-Marie D, Guégan JF, Pradinaud R, Couppié P. L’infection à Mycobacterium ulcerans (ulcère de Buruli) en Guyane ; transition d’un profil épidémiologique africain vers un profil australien. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Douine M, Gozlan R, Nacher M, Dufour J, Reynaud Y, Elguero E, Combe M, Velvin CJ, Chevillon C, Berlioz-Arthaud A, Labbé S, Sainte-Marie D, Guégan JF, Pradinaud R, Couppié P. Mycobacterium ulcerans infection (Buruli ulcer) in French Guiana, South America, 1969-2013: an epidemiological study. Lancet Planet Health 2017; 1:e65-e73. [PMID: 29851583 DOI: 10.1016/s2542-5196(17)30009-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Mycobacterium ulcerans infection is the third most common mycobacterial disease in the world after tuberculosis and leprosy. To date, transmission pathways from its environmental reservoir to humans are still unknown. In South America, French Guiana has the highest reported number of M ulcerans infections across the continent. This empirical study aimed to characterise the epidemiology of M ulcerans infection in French Guiana between 1969 and 2013. METHODS Data were collected prospectively mainly by two dermatologists at Cayenne Hospital's dermatology department between Jan 1, 1969, and Dec 31, 2013, for age, date of diagnosis, sex, residence, location of the lesion, type of lesion, associated symptoms, and diagnostic method (smear, culture, PCR, or histology) for all confirmed and suspected cases of M ulcerans. We obtained population data from censuses. We calculated mean M ulcerans infection incidences, presented as the number of cases per 100 000 person-years. FINDINGS 245 patients with M ulcerans infections were reported at Cayenne Hospital's dermatology department during the study period. M ulcerans infection incidence decreased over time, from 6·07 infections per 100 000 person-years (95% CI 4·46-7·67) in 1969-83 to 4·77 infections per 100 000 person-years (3·75-5·79) in 1984-98 and to 3·49 infections per 100 000 person-years (2·83-4·16) in 1999-2013. The proportion of children with infections also declined with time, from 42 (76%) of 55 patients in 1969-83 to 26 (31%) of 84 in 1984-98 and to 22 (21%) of 106 in 1999-2013. Most cases occurred in coastal areas surrounded by marshy savannah (incidence of 21·08 per 100 000 person-years in Sinnamary and 21·18 per 100 000 person-years in Mana). Lesions mainly affected limbs (lower limbs 161 [66%] patients; upper limbs 60 [24%] patients). We diagnosed no bone infections. INTERPRETATION The decrease of M ulcerans infection incidence and the proportion of children with infections over a 45 year period in this ultra-peripheral French territory might have been mostly driven by improving living conditions, prophylactic recommendations, and access to health care. FUNDING Agence Nationale de la Recherche.
Collapse
|
6
|
Nacher M, Carme B, Sainte Marie D, Couppié P, Clyti E, Guibert P, Pradinaud R. Influence of clinical presentation on the efficacy of a short course of pentamidine in the treatment of cutaneous leishmaniasis in French Guiana. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.2001.11813645] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
7
|
Carme B, Aznar C, Pradinaud R. Absence of a proven resurgence of Chagas disease or cutaneous leishmaniasis in French Guiana over the last two decades. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.2001.11813677] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
8
|
Clyti E, Caumes E, Deligny C, Sainte-Marie D, Couppie P, Pradinaud R. Folliculite ankylostomienne en Guyane française. Ann Dermatol Venereol 2016; 143:665-666. [DOI: 10.1016/j.annder.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/18/2016] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
|
9
|
Linck V, Sambourg E, Demar M, Graille J, Blanchet D, Darrigade AS, Dufour J, Sainte-Marie D, Pradinaud R, Labbe S, Aznar C, Couppie P. La lobomycose en Guyane française : à propos de 20 observations. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Roussel M, Nacher M, Frémont G, Rotureau B, Clyti E, Sainte-Marie D, Carme B, Pradinaud R, Couppié P. Comparison between one and two injections of pentamidine isethionate, at 7 mg/kg in each injection, in the treatment of cutaneous leishmaniasis in French Guiana. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 100:307-14. [PMID: 16762111 DOI: 10.1179/136485906x105561] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In a retrospective study set in French Guiana, the efficacy and tolerance of the intramuscular treatment of cutaneous leishmaniasis (CL) with a single injection of pentamidine isethionate, at 7 mg/kg, were compared with those observed, earlier, using two such injections (given 48 h apart). Although 83.6% of the 281 patients given two injections each were cured, the single-injection protocol was generally as effective, curing 78.8% of 137 patients. The single-injection protocol was also associated with fewer adverse effects than the two-injection. In the treatment of "difficult" cases (those with satellite papules or relatively high numbers of amastigotes in their lesions), however, the two-injection protocol appeared significantly more effective than the single-injection. In French Guiana, therefore, patients with CL should be given one injection with pentamidine isethionate and only be given a second, 48 h later, if they have satellite papules and/or relatively high numbers of amastigotes in their lesions.
Collapse
|
11
|
Bommenel T, Launay O, Meynard JL, Gilquin J, Katlama C, Lascaux AS, Mahamat A, Martinez V, Pradier C, Rouveix E, Simon A, Costagliola D, Abgrall S, Abgrall S, Barin F, Bentata M, Billaud E, Boue F, Burty C, Cabie A, Costagliola D, Cotte L, de Truchis P, Duval X, Duvivier C, Enel P, Gasnault J, Gaud C, Gilquin J, Grabar S, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary-Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorge F, Poizot-Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot-Dupont H, Viard JP, Viget N, Brosseau M, Salomon V, Jacquemet N, Guiguet M, Lanoy E, Lievre L, Selinger-Leneman H, Lacombe JM, Potard V, Bricaire F, Herson S, Desplanque N, Girard PM, Meyohas MC, Picard O, Cadranel J, Mayaud C, Clauvel JP, Decazes JM, Gerard L, Molina JM, Diemer M, Sellier P, Honore P, Jeantils V, Tassi S, Mechali D, Taverne B, Bouvet E, Crickx B, Ecobichon JL, Picard-Dahan C, Yeni P, Berthe H, Dupont C, Chandemerle C, Mortier E, Tisne-Dessus D, Weiss L, Salmon D, Auperin I, Roudiere L, Fior R, Delfraissy JF, Goujard C, Jung C, Lesprit P, Vittecoq D, Fraisse P, Rey D, Beck-Wirth G, Stahl JP, Lecercq P, Gourdon F, Laurichesse H, Fresard A, Lucht F, Bazin C, Verdon R, Chavanet P, Arvieux C, Michelet C, Choutet P, Goudeau A, Maitre MF, Hoen B, Elinger P, Faller JP, Borsa-Lebas F, Caron F, Daures JP, May T, Rabaud C, Berger JL, Remy G, Arlet-Suau E, Cuzin L, Massip P, Thiercelin Legrand MF, Pontonnier G, Yasdanpanah Y, Dellamonica P, Pugliese P, Aleksandrowicz K, Quinsat D, Ravaux I, Delmont JP, Moreau J, Gastaut JA, Retornaz F, Soubeyrand J, Galinier A, Ruiz JM, Allegre T, Blanc PA, Bonnet-Montchardon D, Lepeu G, Granet-Brunello P, Esterni JP, Pelissier L, Cohen-Valensi R, Nezri M, Chapadaud S, Laffeuillade A, Raffi F, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Trepo C, Strobel M, Bissuel F, Pradinaud R, Sobesky M, Contant M. Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir. J Antimicrob Chemother 2011; 66:1869-77. [DOI: 10.1093/jac/dkr208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
12
|
Deligny C, Sainte-Marie D, Clyti E, Couppié P, Arfi S, Piette JC, Pradinaud R. Faible incidence du lupus systémique en Guyane française : rôle du paludisme ? Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
13
|
Clyti E, Deligny C, Versapuech J, Couppie P, Gessain A, Pradinaud R. [Acral crusted scabies in two HTLV1-infected patients]. Ann Dermatol Venereol 2010; 137:232-3. [PMID: 20227570 DOI: 10.1016/j.annder.2010.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 12/18/2009] [Indexed: 10/19/2022]
|
14
|
Deligny C, Clyti E, Sainte-Marie D, Couppie P, Huong DLT, Piette JC, Arfi S, Pradinaud R. Incidence of chronic cutaneous lupus erythematosus in French Guiana: A retrospective population-based study. Arthritis Care Res (Hoboken) 2010; 62:279-82. [DOI: 10.1002/acr.20079] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
15
|
Clyti E, Couppie P, Pradinaud R, del Giudice P, Sainte-Marie D, Nacher M, Deligny C. An Urban Epidemic of Human Myiasis Caused by Dermatobia hominis in French Guiana. Am J Trop Med Hyg 2008. [DOI: 10.4269/ajtmh.2008.79.797] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
16
|
Clyti E, Deligny C, Nacher M, Del Giudice P, Sainte-Marie D, Pradinaud R, Couppie P. An urban epidemic of human myiasis caused by Dermatobia hominis in French Guiana. Am J Trop Med Hyg 2008; 79:797-798. [PMID: 18981525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
We report the onset of an urban epidemic of human myiasis caused by Dermatobia hominis. To our knowledge, this is the first urban epidemic described for D. hominis. The epidemic was most likely related to exceptional weather conditions and notably high rainfall in January 2000, which may have facilitated the maturation of the pupae.
Collapse
|
17
|
Clyti E, Pages F, Pradinaud R. [Update on Dermatobia hominis: South American furuncular myiasis]. MEDECINE TROPICALE : REVUE DU CORPS DE SANTE COLONIAL 2008; 68:7-10. [PMID: 18478762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Furuncular myiasis is an infestation of the skin caused by Dermatobia hominis larvae known as "ver macaque" in French Guyana, "berne" in Brazil, "torsalo" in Colombia, or "human botfly" in English-language literature. It has identical features in man and domestic mammals. The primary lesion consists of a boil-like inflammatory papule with a central punctum exuding a serosanguinous discharge. The respiratory sinus of the D. hominis larvae may be visible through the punctum. Myiasis secondary to D. hominis accounts for 10% of imported tropical dermatosis observed in Paris. Diagnosis of furuncular myiasis should be considered in any patient with a history of travel or residence in an endemic area. Treatment depends mainly on mechanical removal that may be facilitated by injection of lidocaine into the lesion or prior application of a 1% solution of ivermectin.
Collapse
|
18
|
Clyti E, Klisnik J, Sainte-Marie D, Pradinaud R, Couppié P. Placards papulo-croûteux prurigineux des régions malaires. Ann Dermatol Venereol 2007; 134:79-80. [PMID: 17384555 DOI: 10.1016/s0151-9638(07)89001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Pradinaud R. C10 - L’infection à Mycobacterium ulcerans ne doit plus être restreinte à l’impropre appellation « ulcère de Buruli ». Ann Dermatol Venereol 2007. [DOI: 10.1016/s0151-9638(07)89031-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Clyti E, Nacher M, Sainte-Marie D, Pradinaud R, Couppie P. Ivermectin treatment of three cases of demodecidosis during human immunodeficiency virus infection. Int J Dermatol 2006; 45:1066-8. [PMID: 16961510 DOI: 10.1111/j.1365-4632.2006.02924.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Demodecidosis is an ectoparasitosis that is infrequently observed in subjects with human immunodeficiency virus (HIV) infection. It has a rosacea-like presentation. We present three cases in patients with acquired immunodeficiency syndrome (AIDS). Two of these patients had a profuse eruption, and all three cases were cured by ivermectin. The single-dose treatment could be repeated in cases of subsequent recurrence. Ivermectin thus seems to be a good alternative in the treatment of demodecidosis in patients with HIV infection.
Collapse
|
21
|
Costagliola D, Potard V, Duvivier C, Pradier C, Dupont C, Salmon D, Duval X, Billaud E, Boué F, Costagliola D, Duval X, Duvivier C, Enel P, Fournier S, Gasnault J, Gaud C, Gilquin J, Grabar S, Khuong MA, Lang JM, Mary-Krause M, Matheron S, Meyohas MC, Pialoux G, Poizot-Martin I, Pradier C, Rouveix E, Salmon-Ceron D, Sobel A, Tattevin P, Tissot-Dupont H, Yasdanpanah Y, Aronica E, Tirard-Fleury V, Tortay I, Abgrall S, Costagliola D, Grabar S, Guiguet M, Lanoy E, Leneman H, Lièvre L, Mary-Krause M, Potard V, Saidi S, Matheron S, Vildé JL, Leport C, Yeni P, Bouvet E, Gaudebout C, Crickx B, Picard-Dahan C, Weiss L, Tisne-Dessus D, Tarnier-Cochin GH, Sicard D, Salmon D, Gilquin J, Auperin I, Viard JP, Roudière L, Boué F, Fior R, Delfraissy JF, Goujard C, Lesprit P, Jung C, Meyohas MC, Meynard JL, Picard O, Desplanque N, Cadranel J, Mayaud C, Pialoux JF, Rozenbaum W, Bricaire F, Katlama C, Herson S, Simon A, Decazes JM, Molina JM, Clauvel JF, Gerard L, Widal GHLF, Sellier P, Diemer M, Dupont C, Berthé H, Saïag P, Mortier E, Chandemerle C, de Truchis P, Bentata M, Honoré P, Tassi S, Jeantils V, Mechali D, Taverne B, Laurichesse H, Gourdon F, Lucht JF, Fresard A, de Dijon C, de Belfort CH, Faller JP, Eglinger P, Bazin C, Verdon R, de Grenoble C, de Lyon C, Peyramond D, Boibieux A, Touraine JL, Livrozet JM, Trepo C, Cotte L, Ravaux I, Tissot-Dupont H, Delmont JP, Moreau J, Gastaut JA, Poizot-Martin I, Soubeyrand J, Retornaz F, Blanc PA, Allegre T, Galinier A, Ruiz JM, d'Arles CH, d'Avignon CH, Lepeu G, Granet-Brunello P, Pelissier L, Esterni JP, de Martigues CH, Nezri M, Cohen-Valensi R, Laffeuillade A, Chadapaud S, de Nîmes JRCHG, May T, Rabaud C, Raffi F, Billaud E, Pradier C, Pugliese P, Michelet C, Arvieux C, Caron F, Borsa-Lebas F, Lang JM, Rey D, de Mulhouse PFCH, Massip P, Cuzin L, Arlet-Suau E, Legrand MFT, Rangueil CHU, de Tourcoing CH, Yasdanpanah Y, Sobesky M, Pradinaud R, Gaud C, Contant M. Impact of Newly Available Drugs on Clinical Progression in Patients with Virological Failure after Exposure to Three Classes of Antiretrovirals. Antivir Ther 2005. [DOI: 10.1177/135965350501000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To study the prognosis of HIV-infected patients with virological failure after exposure to three classes of antiretroviral drugs (ARVs). Design Cohort study. Setting: French Hospital Database on HIV. Patients Patients previously exposed to at least two nucleoside reverse transcriptase inhibitors (NRTIs), two protease inhibitors and one non-NRTI, with viral load (VL) values of >5000 copies/ml after the exposure criteria were met and a new treatment initiated between 1998 and 2001 with VL >5000 copies/ml. Main outcome measures Risk of new AIDS-defining-events (ADEs) or death from first introduction of a drug never used before occurring between 1998 and 2001 defined as baseline. Results The main baseline characteristics of the 1092 patients were: previous ADE in 49% of cases, median CD4 cell count 181 μl, median VL 4.9 log10 copies/ml, median duration of ARV therapy 5.0 years and previous exposure to a median of nine ARVs. The crude progression rates were 20.1/100 patient-years among patients included in 1998, 15.1 in 1999, 11.1 in 2000 and 8.6 in 2001. After adjustment for baseline characteristics, the calendar year of inclusion was associated with the risk of clinical progression ( P<0.001). When the types of newly available drugs used at baseline or during follow-up were introduced into the model, year of inclusion was no longer associated with the risk of clinical progression ( P=0.42), while exposure to amprenavir/r, lopinavir/r, abacavir or tenofovir was associated with a lower risk. Conclusions The clinical prognosis of heavily pretreated patients experiencing virological failure improved between 1998 and 2001, mainly thanks to the use of newly available drugs with more favourable resistance profiles.
Collapse
|
22
|
Couppié P, Clyti E, Sobesky M, Bissuel F, Del Giudice P, Sainte-Marie D, Dedet JP, Carme B, Pradinaud R. Comparative study of cutaneous leishmaniasis in human immunodeficiency virus (HIV)-infected patients and non-HIV-infected patients in French Guiana. Br J Dermatol 2005; 151:1165-71. [PMID: 15606511 DOI: 10.1111/j.1365-2133.2004.06226.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Few data are available on cutaneous leishmaniasis caused by dermotropic species in human immunodeficiency virus (HIV)-infected patients. OBJECTIVES To describe nine cases of cutaneous leishmaniasis in HIV+ patients and to compare their clinical features and their response to treatment with those of HIV- patients with the forms of leishmaniasis commonly found in French Guiana. METHODS A case-control study was carried out between July 1994 and December 2000 in French Guiana. We compared the following variables in nine HIV-infected patients with leishmaniasis and 27 matched controls: clinical type of leishmaniasis, number of lesions, presence of lymphangitis and adenopathy, the rate of recovery after treatment, and recurrence or reinfection. RESULTS Eight of the HIV-infected patients had localized cutaneous leishmaniasis and one had mucocutaneous leishmaniasis. All of the controls had localized cutaneous leishmaniasis. Leishmania guyanensis was the only species isolated from HIV-infected subjects. HIV-Leishmania coinfected patients had a higher rate of recurrence or reinfection (P < 0.02) and a lower rate of recovery after one treatment cycle with pentamidine (P < 0.02) than did HIV- subjects. The CD4+ lymphocyte counts exceeded 200 mm(-3) in all HIV+ patients at the time of the diagnosis with leishmaniasis. CONCLUSIONS In French Guiana, cutaneous leishmaniasis in moderately immunosuppressed HIV-infected subjects (> 200 CD4+ T cells mm(-3)) is characterized by a higher rate of recurrence or reinfection and is more difficult to treat than that in HIV- subjects.
Collapse
|
23
|
Pradinaud R. [The mycobacterium infection cannot be called "Buruli ulcer" any longer]. BULLETIN DE LA SOCIETE DE PATHOLOGIE EXOTIQUE (1990) 2005; 98:26-7. [PMID: 15915969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
|
24
|
Prévot G, Marsollier L, Carbonelle B, Pradinaud R, Coupié P, Sainte-Marie D, Bourreau E, Launois P. [Diagnosis of Mycobacterium ulcerans infections in French Guiana]. Presse Med 2005; 33:1516. [PMID: 15614174 DOI: 10.1016/s0755-4982(04)98974-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
THE SITUATION: Buruli's ulcer is a severe necrotic cutaneous infection due to Mycobacterium ulcerans. It is a major public health problem in developing countries. FROM A CLINICAL POINT OF VIEW: The early stage of the infection corresponds to a painless cutaneous nodule, whereas the late stage corresponds to ulceration with detachment of the edges. There is currently no other treatment than surgical excision combined with heat therapy. FROM A DIAGNOSTIC POINT OF VIEW: Three methods can be used: direct examination of swabs stained according to Ziehl-Neelsen's method, culture in specific medium at 32 degrees C and the polymerization chain reaction assay (PCR). The latter is the technique of choice.
Collapse
|
25
|
Sarazin F, Sainte-Marie D, Demar M, Aznar C, Sarrouy J, Pradinaud R, Carme B, Couppié P. Paracoccidioïdomycose cutanéo-muqueuse Premier cas diagnostiqué en Guyane Française. Ann Dermatol Venereol 2005; 132:136-9. [PMID: 15798564 DOI: 10.1016/s0151-9638(05)79225-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Paracoccidio-domycosisis a deep mycosis due to a dimorphic fungus:Paracoccidioides brasiliensis. The principle endemic country is Brazil. We describe the first case of paracoccidio-domycosis, in its cutaneous-mucosal form, diagnosed in French Guiana. OBSERVATION A 20 year-old Brazilian man, having mover to French Guiana a few months earlier, presented with multiple disseminated cutaneous lesions, predominating on the face, and composed of multiple nodules and two ulcerations. The clinical examination also revealed voluminous superficial lymph nodes and ulcerations of the pharynx and larynx. Direct examination, anatomopathology and culture of cutaneous biopsies revealed specific images of Paracoccidioides brasiliensis. HIV serology was negative. Treatment combining cotrimoxazole and itraconazole eliminated the lesions in one month. DISCUSSION Because the patient had just moved to Guiana, this observation probably corresponded to an imported disease. The principle differential diagnosis was leishmaniosis.
Collapse
|