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Lefeuvre C, De Pauw H, Le Duc Banaszuk AS, Pivert A, Ducancelle A, Rexand-Galais F, Arbyn M. Corrigendum: Study Protocol: Randomised Controlled Trial Assessing the Efficacy of Strategies Involving Self-Sampling in Cervical Cancer Screening. Int J Public Health 2024; 69:1607299. [PMID: 38698913 PMCID: PMC11063792 DOI: 10.3389/ijph.2024.1607299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
[This corrects the article DOI: 10.3389/ijph.2022.1604284.].
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Affiliation(s)
- Caroline Lefeuvre
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Hélène De Pauw
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Anne-Sophie Le Duc Banaszuk
- Centre Régional de Coordination de Dépistages des Cancers Pays de la Loire (CRCDC Pays de La Loire), Angers, France
| | - Adeline Pivert
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Alexandra Ducancelle
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Franck Rexand-Galais
- Laboratoire CLiPsy (BePsyLab), Faculté des Lettres, Langues et Sciences Humaines, Département Psychologie, Maison de la Recherche Germaine Tillon, Université d’Angers, Angers, France
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium
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Lefeuvre C, Ducancelle A. [Role of hepatitis B virus e protein and core protein in hepatocarcinogenesis]. Virologie (Montrouge) 2023; 27:320-332. [PMID: 38239027 DOI: 10.1684/vir.2023.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Chronic hepatitis B virus (HBV) infection is one of the most common factors associated with hepatocellular carcinoma (HCC). However, the pathogenesis of HBV-mediated hepatocarcinogenesis is not clearly defined. Persistence of HBV infection is associated with HCC pathogenesis, and various HBV proteins appear to be involved in promoting this persistence. Currently available data suggest that the core protein, a structural component of the viral nucleocapsid, and the HBe protein, a non-structural HBV protein that can act as both a tolerogen and an immunogen, play a potential role in the development of HCC. Research shows that both proteins are capable of disrupting various pathways involved in liver carcinogenesis, including the sustenance of proliferative signaling, resistance to cell death, tumor-promoting inflammation and avoid immune destruction. This review summarizes the various signaling pathways by which HBc and HBe proteins (and their precursors) can promote hepatocarcinogenesis.
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3
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Le Goff J, Le Duc-Banaszuk AS, Lefeuvre C, Pivert A, Ducancelle A, De Pauw H, Arbyn M, Vinay A, Rexand-Galais F. Acceptability to Healthcare Professionals of Home-Based HPV Self-Sampling for Cervical Screening: A French Qualitative Study Conducted in an Area with Low Access to Health Services. Cancers (Basel) 2023; 15:5163. [PMID: 37958337 PMCID: PMC10648237 DOI: 10.3390/cancers15215163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Self-sampling may improve participation in cervical cancer secondary prevention programs by women who do not respond or respond irregularly when invited to contact a health professional for the collection of a cervical specimen. It could also help resolve access problems in areas with a low physician density. The present qualitative study examined barriers to screening, effective screening strategies, and the advantages and disadvantages of sending women urine or vaginal self-sampling kits in two medically underserved administrative departments in France (Mayenne and Sarthe) showing low cervical screening coverage. As part of the CapU4 randomized trial, a team of psychologists investigated the attitudes and experiences of 59 healthcare professionals (gynecologists, general practitioners, and midwives) through semi-structured interviews. Results indicated that health professionals believe that self-sampling may address the issues of low physician density and underscreening by removing logistical, organizational, financial, and psychological obstacles. They confirmed trust in the use of vaginal self-sampling, with urine self-sampling as an alternative solution (e.g., for women with vaginismus). The health professionals also identified several limitations of the self-sampling kit that will need to be addressed in future screening campaigns (incomplete kit, complex instructions, poor anatomical knowledge, and obesity).
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Affiliation(s)
- Johane Le Goff
- University of Angers, CLIPSY, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
| | - Anne-Sophie Le Duc-Banaszuk
- Pays de la Loire Regional Cancer Screening Coordination Center (CRCDC Pays de La Loire), F-49000 Angers, France;
| | - Caroline Lefeuvre
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Adeline Pivert
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Alexandra Ducancelle
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Hélène De Pauw
- Cancer Epidemiology Unit, Belgian Cancer Center, Sciensano, 1050 Brussels, Belgium; (H.D.P.); (M.A.)
| | - Marc Arbyn
- Cancer Epidemiology Unit, Belgian Cancer Center, Sciensano, 1050 Brussels, Belgium; (H.D.P.); (M.A.)
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Aubeline Vinay
- University of Angers, CLIPSY, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
| | - Franck Rexand-Galais
- University of Angers, CLIPSY, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
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4
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Lefeuvre C, Roux M, Blanchard S, Le Guillou-Guillemette H, Boursier J, Lunel-Fabiani F, Jeannin P, Pivert A, Ducancelle A. Analysis of hepatic fibrosis markers in the serum of chronic hepatitis B patients according to basal core promoter/precore mutants. Sci Rep 2022; 12:10261. [PMID: 35715541 PMCID: PMC9205978 DOI: 10.1038/s41598-022-14285-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/03/2022] [Indexed: 12/29/2022] Open
Abstract
The A1762T/G1764A double mutant in the basal core promoter (BCP) region of the hepatitis B virus (HBV) is associated with severe hepatic lesions while the G1899A mutation with the double mutant is associated with a significant reduction in the risk of severe fibrosis. This study aims to measure a number of markers in the serum of patients with chronic HBV infection and to assess relationships between these markers and BCP/precore mutants with consideration of the stage of fibrosis. The serum levels of resistin, TGF-β1, MMP-1, TIMP-1, collagen IA1 and PDGF-BB, which are markers that are known to be involved in the process of hepatic fibrosis, were assayed. The serum levels of PDGF-BB and TIMP-1, and the mutation profile were independently associated with advanced fibrosis. A higher level of TIMP-1 was associated with advanced fibrosis regardless of the mutation status, and a higher level of PDGF-BB was associated with nonsevere fibrosis in patients infected with viruses harboring the A1762T/G1764A or A1762T/G1764A/G1899A mutations. Our results suggest an impact of the A1762T/G1764A mutant on the biological pathway related to TGF-β1 and PDGF-BB. In vitro studies are needed to understand the impact of these mutants on the serum secretion of markers involved in fibrosis severity.
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Affiliation(s)
| | - Marine Roux
- Univ Angers, HIFIH, SFR ICAT, F-49000, Angers, France
| | - Simon Blanchard
- Univ Angers, INSERM Unité 892, CNRS Unit 6299, F-49000, Angers, France
| | | | - Jérôme Boursier
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, F-49000, Angers, France
| | | | - Pascale Jeannin
- Univ Angers, INSERM Unité 892, CNRS Unit 6299, F-49000, Angers, France
| | - Adeline Pivert
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, F-49000, Angers, France
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Roger S, Fontana J, Ducancelle A, Le Guillou-Guillemette H, Canivet CM, Lefeuvre C. Acute hepatitis B in pregnancy with surprisingly rapid clearance of serum HBs antigen associated with a favourable outcome. Int J Infect Dis 2022; 118:141-143. [PMID: 35235825 DOI: 10.1016/j.ijid.2022.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022] Open
Abstract
Acute hepatitis B (AHB) is usually asymptomatic, but it can progress to chronic hepatitis B (HB) defined by HB surface antigen (HBsAg) persisting beyond 6 months. Nevertheless, the delay of HBsAg seroclearance is not well-defined. During pregnancy, the immune system of the pregnant women is altered and delayed HBsAg loss can be observed, leading to chronic infection. Here, we present an uncommon case of AHB in a pregnant woman in whom rapid HBsAg seroclearance (52 days after AHB) was associated with a favourable outcome (no injury to liver). This patient received tenofovir disoproxil fumarate promptly after diagnosis. The case raises questions about the use of antiviral treatment in AHB. This is generally not recommended in AHB, but it would be potentially useful in pregnant women to reduce the risk of chronic HB infection and could also prevent the transmission of the maternal precore mutation, thus reducing the significant risk of fulminant hepatitis in the infant. This case also highlights the impact of the hepatitis B virus (HBV) genotype and precore/core mutations on the clinical course of the disease.
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Affiliation(s)
- Steven Roger
- Department of Virology, Angers University Hospital, F-49000, Angers, France
| | - Julien Fontana
- Department of Hepato-Gastroenterology, Angers University Hospital, F-49000, Angers, France
| | - Alexandra Ducancelle
- Department of Virology, Angers University Hospital, F-49000, Angers, France; Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Hélène Le Guillou-Guillemette
- Department of Virology, Angers University Hospital, F-49000, Angers, France; Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Clémence M Canivet
- Department of Hepato-Gastroenterology, Angers University Hospital, F-49000, Angers, France; Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Caroline Lefeuvre
- Department of Virology, Angers University Hospital, F-49000, Angers, France; Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France.
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Lefeuvre C, De Pauw H, Le Duc Banaszuk AS, Pivert A, Ducancelle A, Rexand-Galais F, Arbyn M. Study Protocol: Randomised Controlled Trial Assessing the Efficacy of Strategies Involving Self-Sampling in Cervical Cancer Screening. Int J Public Health 2022; 67:1604284. [PMID: 35283720 PMCID: PMC8907121 DOI: 10.3389/ijph.2022.1604284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/26/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives: The cervical cancer screening coverage remains moderate (60%) in France. The aim of the study is to evaluate the efficacy of two experimental invitation strategies (offer of urine or vaginal self-sampling kits) to reach under-screened populations and compare them with the current invitation strategy in rural departments (low medical density and low participation rate) in France. Methods: The study is a randomised controlled trial with three arms: a control arm (conventional invitation letter) and two experimental arms (mailing of a urine or vaginal self-sampling kit). The target population includes women aged 30-65 years, who had no screening test recorded since more than 4 years and who did not respond to an invitation letter within 12 months before. The primary outcome measure is the participation rate in each arm. A team of psychologists will also investigate attitudes and experiences by semi-structured/focus-group interviews with voluntary CapU4 participants and with health professionals. Result and conclusion: CapU4 will identify effective strategies to reach women not responding to current screening invitations and will generate information about acceptance of self-sampling among women and health professionals.
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Affiliation(s)
- Caroline Lefeuvre
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Hélène De Pauw
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Anne-Sophie Le Duc Banaszuk
- Centre Régional de Coordination de Dépistages des Cancers Pays de la Loire (CRCDC Pays de La Loire), Angers, France
| | - Adeline Pivert
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Alexandra Ducancelle
- Université d’Angers, HIFIH, UPRES EA 3859, Angers, France
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Franck Rexand-Galais
- Laboratoire CLiPsy (BePsyLab), Faculté des Lettres, Langues et Sciences Humaines, Département Psychologie, Maison de la Recherche Germaine Tillon, Université d'Angers, Angers, France
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium
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Lefeuvre C, Pivert A, Przyrowski E, Bouthry E, Darviot E, Mahieu R, Lunel-Fabiani F, Ducancelle A, Le Guillou-Guillemette H. Comparison of performance between three SARS-CoV-2 molecular assays (Aptima™, Laboratory developed test-Fusion and R-GENE®) with a special attention on turn-around time, key point in the laboratory management. J Med Virol 2022; 94:3399-3403. [PMID: 35211992 PMCID: PMC9088664 DOI: 10.1002/jmv.27675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 11/11/2022]
Abstract
The emergence of SARS-CoV-2 highlights the importance of rapid diagnostic testing to identify individuals with SARS-CoV-2 infections and to limit the spread of the virus. Many molecular assays have commercially available to cope with this surging demand for timely diagnosis of COVID-19 cases, but identifying individuals requires accurate diagnostic tools. We compared the performance of three molecular SARS-CoV-2 assays: Aptima™ SARS-CoV-2 assay running on the Panther system (Hologic), an in-house assay (Laboratory Developed Test) running on the Fusion module of the Panther-Fusion system (LDT-Fusion, Hologic) and the R-GENE® SARS-CoV-2 assay (bioMérieux). In addition, we also evaluated the turn-around time. This parameter is crucial to manage the SARS-CoV-2 diagnosis and represents a key point in the quality management at the laboratory. Aptima™ and LDT-Fusion assays exhibited an excellent positive percent agreement (PPA) (100.0%), while the R-GENE® assay showed a slightly decreased PPA (98.2%). The Hologic assays have a higher throughput with less hands-on time (HOT) than the R-GENE® assays (24-25 vs 71 min). Both Hologic assays are used on a fully automated random-access testing system with on-demand testing capabilities that avoids run series unlike R-GENE® assay. Automated random-access testing systems should be preferred during periods of high SARS-CoV-2 prevalence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | | | - Elise Bouthry
- Virology Department, Angers University Hospital, Angers, France
| | - Estelle Darviot
- Paediatric Department, Angers University Hospital, Angers, France
| | - Rafaël Mahieu
- Department of Infectious Diseases, Angers University Hospital, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Hélène Le Guillou-Guillemette
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
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Shimakawa Y, Veillon P, Birguel J, Pivert A, Sauvage V, Guillou-Guillemette HL, Roger S, Njouom R, Ducancelle A, Amta P, Huraux JM, Adoukara JP, Lunel-Fabiani F. Residual risk of mother-to-child transmission of hepatitis B virus infection despite timely birth-dose vaccination in Cameroon (ANRS 12303): a single-centre, longitudinal observational study. The Lancet Global Health 2022; 10:e521-e529. [DOI: 10.1016/s2214-109x(22)00026-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/08/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
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Lefeuvre C, Le Guillou-Guillemette H, Ducancelle A. A Pleiotropic Role of the Hepatitis B Virus Core Protein in Hepatocarcinogenesis. Int J Mol Sci 2021; 22:ijms222413651. [PMID: 34948447 PMCID: PMC8707456 DOI: 10.3390/ijms222413651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic hepatitis B virus (HBV) infection is one of the most common factors associated with hepatocellular carcinoma (HCC), which is the sixth most prevalent cancer among all cancers worldwide. However, the pathogenesis of HBV-mediated hepatocarcinogenesis is unclear. Evidence currently available suggests that the HBV core protein (HBc) plays a potential role in the development of HCC, such as the HBV X protein. The core protein, which is the structural component of the viral nucleocapsid, contributes to almost every stage of the HBV life cycle and occupies diverse roles in HBV replication and pathogenesis. Recent studies have shown that HBc was able to disrupt various pathways involved in liver carcinogenesis: the signaling pathways implicated in migration and proliferation of hepatoma cells, apoptosis pathways, and cell metabolic pathways inducing the development of HCC; and the immune system, through the expression and production of proinflammatory cytokines. In addition, HBc can modulate normal functions of hepatocytes through disrupting human host gene expression by binding to promoter regions. This HBV protein also promotes HCC metastasis through epigenetic alterations, such as micro-RNA. This review focuses on the molecular pathogenesis of the HBc protein in HBV-induced HCC.
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Affiliation(s)
- Caroline Lefeuvre
- Laboratoire de Virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France; (H.L.G.-G.); (A.D.)
- HIFIH Laboratory UPRES EA3859, SFR ICAT 4208, Angers University, F-49000 Angers, France
- Correspondence:
| | - Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France; (H.L.G.-G.); (A.D.)
- HIFIH Laboratory UPRES EA3859, SFR ICAT 4208, Angers University, F-49000 Angers, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, Département de Biologie des Agents Infectieux, CHU Angers, F-49000 Angers, France; (H.L.G.-G.); (A.D.)
- HIFIH Laboratory UPRES EA3859, SFR ICAT 4208, Angers University, F-49000 Angers, France
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Roger S, Lefeuvre C, Pivert A, Ducancelle A, Savary D, Bouthry É, Le Guillou-Guillemette H. What is the true place of the SARS-CoV-2 rapid point-of-care antigen test in the hospital setting? Lessons learned from real life. J Med Virol 2021; 94:1723-1727. [PMID: 34873718 PMCID: PMC9015581 DOI: 10.1002/jmv.27505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/19/2021] [Accepted: 12/03/2021] [Indexed: 12/30/2022]
Abstract
To assist in the clinical management of patients and to support infection control, we tested the use of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) point‐of‐care antigen test (AgPOC) for unplanned hospitalization, coupled with a nucleic acid amplification test (NAAT) using specimens collected at the same time upon arrival. The aim of this study was to assess the performance of the AgPOC in this specific use compared to NAAT for SARS‐CoV‐2 diagnosis, in the context of the low prevalence of infection. For 5 months (between two peaks in France of the SARS‐CoV‐2 pandemic), all patients admitted who undertook the AgPOC/NAAT paired tests were included in the study. AgPOC performances were determined considering the clinical status and the delay of symptoms onset. NAAT and AgPOC results were available for 4425 subjects. AgPOC results showed a homogeneous specificity (>97%) but a low sensitivity at 45.8%. Considering the national guidelines, sensitivity dropped to 32.5% in cases of symptomatic patients with symptoms older than 5 days or more. This study shows the poor performance of AgPOC for entry screening of patients in hospitals. AgPOC may represent a useful tool in the hospital setting only if the use is restricted to patients with consistent symptoms less than 4 days old. SARS‐CoV‐2 point‐of‐care antigen tests (AgPOC) are poorly evaluated to screen patients for unplanned hospitalization. Performance of AgPOC showed low sensitivity in hospital setting. Use of AgPOC in hospital should be restricted to patients with consistent symptoms less than 4 days old.
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Affiliation(s)
- Steven Roger
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France
| | - Caroline Lefeuvre
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France.,Department of Virology, HIFIH, SFR ICAT, University of Angers, Angers, France
| | - Adeline Pivert
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France.,Department of Virology, HIFIH, SFR ICAT, University of Angers, Angers, France
| | - Alexandra Ducancelle
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France.,Department of Virology, HIFIH, SFR ICAT, University of Angers, Angers, France
| | - Dominique Savary
- Département de Médecine des Urgences, CHU Angers, Angers, France
| | - Élise Bouthry
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France.,Department of Virology, HIFIH, SFR ICAT, University of Angers, Angers, France
| | - Hélène Le Guillou-Guillemette
- Département de Biologie des Agents Infectieux, Laboratoire de Virologie, CHU Angers, Angers, France.,Department of Virology, HIFIH, SFR ICAT, University of Angers, Angers, France
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11
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Gilbert C, Lefeuvre C, Preisser L, Pivert A, Soleti R, Blanchard S, Delneste Y, Ducancelle A, Couez D, Jeannin P. Age-Related Expression of IFN-λ1 Versus IFN-I and Beta-Defensins in the Nasopharynx of SARS-CoV-2-Infected Individuals. Front Immunol 2021; 12:750279. [PMID: 34858406 PMCID: PMC8631500 DOI: 10.3389/fimmu.2021.750279] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 coronavirus infection induces heterogeneous symptoms, ranging from asymptomatic to lethal forms. Severe forms usually occur in the elderly and/or individuals with comorbidities. Children generally remain asymptomatic to primary infection, suggesting that they may have an effective local innate immune response. IFN-I and -III have non-redundant protective roles against SARS-CoV-2, although sometimes damaging the host. The expression and role of anti-viral peptides during SARS-CoV-2 infection have thus far been little studied. We aimed to identify the innate immune molecules present at the SARS-CoV-2 entry point. We analyzed the mRNA levels of type I (IFN-α and -β) and type III (IFN-λ1-3) interferons and selected antiviral peptides (i.e., β-defensins 1-3, α-defensins [HNP1-3, HD5] pentraxin-3, surfactant protein D, the cathelicidin LL-37 and interleukin-26) in nasopharyngeal swabs from 226 individuals of various ages, either infected with SARS-CoV-2 (symptomatic or asymptomatic) or negative for the virus. We observed that infection induced selective upregulation of IFN-λ1 expression in pediatric subjects (≤15 years), whereas IFN-α, IFN-β, IFN-λ2/λ3, and β-defensin 1-3 expression was unaffected. Conversely, infection triggered upregulation of IFN-α, IFN-β, IFN-λ2/λ3, and β-defensin 1-3 mRNA expression in adults (15-65 years) and the elderly (≥ 65 years), but without modulation of IFN-λ1. The expression of these innate molecules was not associated with gender or symptoms. Expression of the interferon-stimulated genes IFITM1 and IFITM3 was upregulated in SARS-CoV-2-positive subjects and reached similar levels in the three age groups. Finally, age-related differences in nasopharyngeal innate immunity were also observed in SARS-CoV-2-negative subjects. This study shows that the expression patterns of IFN-I/-III and certain anti-viral molecules in the nasopharyngeal mucosa of SARS-CoV-2-infected subjects differ with age and suggests that susceptibility to SARS-CoV-2 may be related to intrinsic differences in the nature of mucosal anti-viral innate immunity.
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Affiliation(s)
- Charly Gilbert
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
- Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France
| | - Caroline Lefeuvre
- Laboratory of Virology, Angers University Hospital, Angers, France
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, Angers, France
| | - Laurence Preisser
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
| | - Adeline Pivert
- Laboratory of Virology, Angers University Hospital, Angers, France
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, Angers, France
| | - Raffaella Soleti
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
| | - Simon Blanchard
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
- Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France
| | - Yves Delneste
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
- Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France
| | - Alexandra Ducancelle
- Laboratory of Virology, Angers University Hospital, Angers, France
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, Angers, France
| | - Dominique Couez
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
| | - Pascale Jeannin
- Univ Angers, Université de Nantes, CHU Angers, Inserm, CRCINA, SFR ICAT, Angers, France
- Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France
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12
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Dekervel M, Henry N, Torreggiani M, Pouteau LM, Imiela JP, Mellaza C, Garnier AS, Dujardin A, Asfar M, Ducancelle A, Paquin A, Blanchi S, Besson V, Piccoli GB, Augusto JF. Humoral response to a third injection of BNT162b2 vaccine in patients on maintenance haemodialysis. Clin Kidney J 2021; 14:2349-2355. [PMID: 34754430 PMCID: PMC8573007 DOI: 10.1093/ckj/sfab152] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/27/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Humoral response against sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after two doses of BNT162b2 (Pfizer-BioNTech) has been proven to be less intense in maintenance dialysis patients as compared with healthy subjects, leading the French authorities to recommend a third injection in this population. Here we investigated the response to the third injection in two cohorts of haemodialysis (HD) patients. METHODS Data from two prospective observational cohorts were collected. In the first ('systematic') cohort, patients from two HD centres (n = 66) received a third injection of BNT162b2, regardless of the response after two injections. In the second ('conditional') cohort, the injection was only prescribed to patients (n = 34) with no or low response to the previous two doses. In both cohorts, the third dose was injected 1-2 months after the second dose. Serology was performed after the second and third doses to assess anti-Spike immunoglobulin G (S IgG) antibody titre. RESULTS In the systematic cohort, anti-S IgG was found in 83.3 and 92.4% of patients after the second and third doses of BNT162b2, respectively. In this cohort, 6/11 (54.5%) and 20/21 (95.2%) patients switched from non-responder to low responder and from low responder to high responder, respectively. In low and high responders to two doses, 50/55 (90.9%) at least doubled their anti-S IgG titre. Similar trends were observed in the conditional cohort. CONCLUSIONS In maintenance HD patients, humoral response against SARS-CoV-2 was boosted after a third dose of BNT162b2, allowing seroconversion in more than half of non-responders. These data may support an intensified vaccination protocol with a third dose of BNT162b2 in dialysis patients.
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Affiliation(s)
- Marine Dekervel
- Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, Angers, France
| | - Nicolas Henry
- Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, Angers, France
- Service de Néphrologie, CH de Laval, Angers, France
| | | | | | | | | | - Anne-Sophie Garnier
- Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, Angers, France
| | | | - Marine Asfar
- Service de Gériatrie, CHU d’Angers, Angers, France
| | - Alexandra Ducancelle
- Virology Laboratory, Angers University Hospital, HIFIH Laboratory EA3859, Angers, France
| | - Axelle Paquin
- Laboratoire de Virologie, CH de Laval, Laval, France
| | - Sophie Blanchi
- Service de Maladies Infectieuses, CH Le Mans, Le Mans, France
| | - Virginie Besson
- Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, Angers, France
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Abstract
Hepatitis C virus (HCV) infection is a major cause of severe liver disease including chronic hepatitis, cirrhosis and hepatocellular carcinoma. The HCV burden in public health is estimated at about 71 million people worldwide by World Health Organization (WHO) with at least 400,000 people that died every year from HCV disease [1]. New hepatitis C treatments with oral direct-acting antivirals (DAAs) showing high rates of response, with short treatment duration [2] have been available. HCV can now be eradicated with minimal side effects. Unfortunately, there is no vaccine yet available, but the development of a safe prophylactic vaccine remains a medical priority [3]. For this purpose, Hepatitis B-C subviral envelope particles can be produced by industrialized procedure. It seems to be very promising as this HBV-HCV vaccine candidate has been shown to elicit a broadly cross neutralizing activity against HCV [4]. Despite this revolution in the HCV-treatment, one of major challenge to achieve a global eradication of HCV remains to reduce the under diagnosis. The low rate of diagnosis is a major obstacle in resources limited countries and is mainly due to the cost of molecular tools, that are essential to diagnose and follow chronic HCV infection. In another hand, the mild clinical symptoms observed in HCV chronic disease, may explain that the majority of HCV infected individuals are unaware of their infection, because HCV testing is not generalized, like it is for HIV. HCV was discovered in 1989 after many years of work, by several researchers, who recently obtained the Nobel price [5-7]. This major discovery allowed the description of the HCV genome and later on of the virus replication and cell cycle, and also, importantly, the development of diagnostic tests for the detection of HCV antibodies (Ab) and RNA who were a priority in transfusion. In this review, we will try to get into the virology and cell biology of HCV. Thereafter, we will discuss the different categories of laboratory tests to diagnose/explore HCV infected subjects.
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Affiliation(s)
- Steven Roger
- Laboratoire de Virologie, CHU Angers et Université d'Angers, Laboratoire HIFIH UFR Santé Département Médecine, SFR 4208-UPRES EA3859, BAT IBS - 4 rue Larrey, 49000 Angers, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, CHU Angers et Université d'Angers, Laboratoire HIFIH UFR Santé Département Médecine, SFR 4208-UPRES EA3859, BAT IBS - 4 rue Larrey, 49000 Angers, France
| | - Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers et Université d'Angers, Laboratoire HIFIH UFR Santé Département Médecine, SFR 4208-UPRES EA3859, BAT IBS - 4 rue Larrey, 49000 Angers, France
| | - Catherine Gaudy
- Service de Bactériologie-Virologie-Hygiène, CHRU de Tours, 37000 Tours, France; INSERM U1259, Université de Tours, 37000 Tours, France
| | - Françoise Lunel
- Laboratoire de Virologie, CHU Angers et Université d'Angers, Laboratoire HIFIH UFR Santé Département Médecine, SFR 4208-UPRES EA3859, BAT IBS - 4 rue Larrey, 49000 Angers, France.
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14
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Lefeuvre C, Pivert A, Tran CT, Lunel-Fabiani F, Ducancelle A, Le Guillou-Guillemette H. Practical approach to method verification in plasma and validation in cerebrospinal fluid under accreditation using a flexible scope in molecular virology: setting up the HIV, HBV and HCV Aptima™ Quant Dx assays. Clin Chem Lab Med 2021; 58:251-260. [PMID: 31539347 DOI: 10.1515/cclm-2019-0502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/22/2019] [Indexed: 12/11/2022]
Abstract
Background Our laboratory obtained the ISO 15189 accreditation for the plasmatic HIV-1, HBV and HCV viral load (VL) using the m2000 RealTime™ system, which was recently changed for the platform Panther®. Here, we discuss a strategy for performing method validation/verification very quickly. Methods We performed the mandatory (repeatability, internal quality assessment [IQA], measurement uncertainty [MU]) and optional technical verifications for CE/IVD assays using the flexible scope range A. We also performed the mandatory assays for the validation of HIV-1 VL in the cerebrospinal fluid (CSF) using the flexible scope range B. The change was checked by following up on the turnaround time (TAT). Results The coefficient of variation (CV%) for repeatability and IQA complied with the limit of 0.25 log. The MU results ranged from 0.04 to 0.25 log copies or IU/mL. The comparisons of methods showed excellent correlations (R2 = 0.96 for the three parameters) but a delayed centrifugation on HCV VL showed variations of up to 2 log IU/mL. An excellent linearity for HIV-1 in the CSF was obtained from 1.5 to 5 log copies/mL with R2 = 0.99. The TAT increased (84%-98%) in routine usage. Conclusions The three Aptima assays are well suited for routine laboratory use and can be integrated within less than 2 weeks in accordance with flexible scope range A. Our data allows us to confidently perform HIV-1 VL in CSF following flexible scope range B. Finally, we provide an organizational guide for flexible scope management in molecular virology within a short time frame.
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Affiliation(s)
- Caroline Lefeuvre
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Cong T Tran
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
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15
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Lefeuvre C, Croué A, Abgueguen P, Letzelter M, Ducancelle A, Grange P, Benhaddou N, Dupin N, Le Guillou‐Guillemette H, Le Clec'h C. Serological diagnosis of secondary syphilis in a Rituximab‐treated patient: an emerging diagnostic challenge? J Eur Acad Dermatol Venereol 2021; 35:e350-e352. [DOI: 10.1111/jdv.17126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/18/2020] [Accepted: 01/08/2021] [Indexed: 02/03/2023]
Affiliation(s)
- C. Lefeuvre
- Virology Department Angers University Hospital Angers France
| | - A. Croué
- Pathology Department Angers University Hospital Angers France
| | - P. Abgueguen
- Infectious Diseases Department Angers University Hospital Angers France
| | - M. Letzelter
- Dermatology Department Angers University Hospital Angers France
| | - A. Ducancelle
- Virology Department Angers University Hospital Angers France
| | - P. Grange
- French National Reference Center for Syphilis Cochin University Hospital Paris France
| | - N. Benhaddou
- French National Reference Center for Syphilis Cochin University Hospital Paris France
| | - N. Dupin
- French National Reference Center for Syphilis Cochin University Hospital Paris France
| | | | - C. Le Clec'h
- Dermatology Department Angers University Hospital Angers France
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16
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Lefeuvre C, Pivert A, Guillou-Guillemette HL, Lunel-Fabiani F, Veillon P, Le Duc-Banaszuk AS, Ducancelle A. Urinary HPV DNA testing as a tool for cervical cancer screening in women who are reluctant to have a Pap smear in France. J Infect 2020; 81:248-254. [DOI: 10.1016/j.jinf.2020.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 11/16/2022]
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17
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Roger S, Lefeuvre C, Grison M, Ducancelle A, Lunel-Fabiani F, Pivert A, Le Guillou-Guillemette H. Evaluation of the Aptima™ HBV Quant Dx assay for semi-quantitative HBV viral load from dried blood spots. J Clin Virol 2020; 129:104524. [PMID: 32629186 DOI: 10.1016/j.jcv.2020.104524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND The detection and quantification of hepatitis B virus (HBV) DNA from dried blood spots (DBS) is a major tool for chronic hepatitis B management in resource-limited settings. This strategy fits in perfectly with the hepatitis control plan promoted by the World Health Organization. However, few commercial methods are validated for viral load (VL) measurement on DBS. OBJECTIVES Our objective was to evaluate the performance of the HBV VL measurement of the Aptima™ HBV Quant Dx assay on DBS compared to plasma samples on the Panther® platform (Hologic). STUDY DESIGN 266 whole blood samples for routine measurement were included. Five spots of 75 μL of whole blood were loaded onto a card before centrifugation and plasma settling. RESULTS 149 samples were quantifiable and 117 were not detected. We achieved excellent linearity (r² = 0.994) over a wide range of measurements suitable for clinical practice, and a 95 % lower limit of detection (LLOD-95 %) at 2.65 log10 IU/mL (445 IU/mL). A good performance of this assay was observed for samples with HBV VL > LLOD-95 % and 100 % of samples were detected if HBV VL was above 2.95 log10 IU/mL. The correlation between the two matrices for quantitative VLs was good (r² = 0.978) with a very low bias (-0.002 log10 IU/mL). CONCLUSION The Aptima™ assay can properly detect and quantify HBV DNA in DBS, providing a satisfactory use in clinical monitoring and therapeutic decisions. DBS represents an excellent alternative to plasma, especially in resource-limited countries, while maintaining the performance and advantages of an automated technique.
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Affiliation(s)
- Steven Roger
- Virology Department, Angers University Hospital, Angers, France
| | - Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Marine Grison
- Virology Department, Angers University Hospital, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
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18
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Nicol T, Lefeuvre C, Serri O, Pivert A, Joubaud F, Dubée V, Kouatchet A, Ducancelle A, Lunel-Fabiani F, Le Guillou-Guillemette H. Assessment of SARS-CoV-2 serological tests for the diagnosis of COVID-19 through the evaluation of three immunoassays: Two automated immunoassays (Euroimmun and Abbott) and one rapid lateral flow immunoassay (NG Biotech). J Clin Virol 2020; 129:104511. [PMID: 32593133 PMCID: PMC7295485 DOI: 10.1016/j.jcv.2020.104511] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023]
Abstract
For IgG detection >14 days after symptoms onset was 100.0 % for all assays. Specificity for IgG was greater than 98 % for CLIA and LFIA compared to ELISA. LFIA (NG-Test®) is reliable and accurate to diagnose SARS-CoV-2 infection. Best agreement was observed between CLIA and LFIA assays (97 %; k = 0.936).
Background The emergence of new SARS-CoV-2 has promoted the development of new serological tests that could be complementary to RT-PCR. Nevertheless, the assessment of clinical performances of available tests is urgently required as their use has just been initiated for diagnose. Objectives The aim of this study was to assess the performance of three immunoassays for the detection of SARS-CoV-2 antibodies. Methods Two automated immunoassays (Abbott SARS-CoV-2 CLIA IgG and Euroimmun Anti-SARS-CoV-2 ELISA IgG/IgA assays) and one lateral flow immunoassay (LFIA NG-Test® IgG-IgM COVID-19) were tested. 293 specimens were analyzed from patients with a positive RT-PCR response, from patients with symptoms consistent with COVID-19 but exhibiting a negative response to the RT-PCR detection test, and from control group specimens. Days since symptoms onset were collected from clinical information sheet associated with respiratory tract samples. Results Overall sensitivity for IgG was equivalent (around 80 %) for CLIA, ELISA and LFIA. Sensitivity for IgG detection, >14 days after onset of symptoms, was 100.0 % for all assays. Overall specificity for IgG was greater for CLIA and LFIA (more than 98 %) compared to ELISA (95.8 %). Specificity was significantly different between IgA ELISA (78.9 %) and IgM LFIA (95.8 %) (p < 0.05). The best agreement was observed between CLIA and LFIA assays (97 %; k = 0.936). Conclusion Excellent sensitivity for IgG detection was obtained >14 days after onset of symptoms for all immunoassays. Specificity was also excellent for IgG CLIA and IgG LFIA. Our study shows that NG-Test® is reliable and accurate for routine use in clinical laboratories.
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Affiliation(s)
- Thomas Nicol
- Virology Department, Angers University Hospital, Angers, France
| | - Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Orianne Serri
- Virology Department, Angers University Hospital, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Joubaud
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Vincent Dubée
- Infectious Diseases and Tropical Medicine, University Hospital of Angers, Angers, France; Equipe ATIP AVENIR, CRCINA, INSERM, University of Nantes and Angers
| | - Achille Kouatchet
- Medical Intensive Care Department, University Hospital of Angers, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
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19
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Lefeuvre C, Behillil S, Triau S, Monteiro-Rodrigues A, Templier F, Tran CT, Le Guillou-Guillemette H, Lunel-Fabiani F, Enouf V, Ducancelle A. Fatal Myopericarditis Following an Influenza A (H3N2) Infection. Am J Case Rep 2018; 19:540-544. [PMID: 29735962 PMCID: PMC5967290 DOI: 10.12659/ajcr.908314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 14 Final Diagnosis: Myopericarditis Symptoms: Cardiac tamponade • dyspnea • pericardial effusion • tachycardia Medication: — Clinical Procedure: Cardiopulmonary resuscitation Specialty: Infectious Diseases
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Affiliation(s)
- Caroline Lefeuvre
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Sylvie Behillil
- Coordinating Center of the National Reference Center for Influenza Viruses, National Influenza Center (northern France), Pasteur Institute: Viral Genomics and Vaccination (CNRS UMR 3569), Paris Diderot University (Sorbonne Paris Cité University), Paris, France
| | - Stéphane Triau
- Department of Pathology, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - Antonio Monteiro-Rodrigues
- Department of Emergency, SAMU 49, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - François Templier
- Department of Emergency, SAMU 49, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - Cong Tri Tran
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Hélène Le Guillou-Guillemette
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Françoise Lunel-Fabiani
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Vincent Enouf
- Coordinating Center of the National Reference Center for Influenza Viruses, National Influenza Center (northern France), Pasteur Institute: Viral Genomics and Vaccination (CNRS UMR 3569), Paris Diderot University (Sorbonne Paris Cité University), Paris, France
| | - Alexandra Ducancelle
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Paris, France
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20
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Brochard C, Ducancelle A, Pivert A, Bodin M, Ricard A, Coron E, Couffon C, Dib N, Luet D, Musquer N, Rhun ML, Bertrais S, Michalak S, Lunel-Fabiani F, Cesbron-Metivier E, Caroli-Bosc FX. Human papillomavirus does not play a role in the Barrett esophagus: a French cohort. Dis Esophagus 2017; 30:1-7. [PMID: 28881904 DOI: 10.1093/dote/dox088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
The role of human papillomavirus (HPV) in Barrett's esophagus (BE) has been examined but remains unclear. The purpose of the study is to dispute the connection between HPV and BE in a prospective case-control study. Biopsies were performed above and inside the Barrett's segment for BE patients and in the distal third of the esophagus for control patients for histological interpretation and for virological analysis. Biopsies for virological analysis were placed in a virus transport medium and immediately frozen in liquid nitrogen. Virological analysis involved real-time PCR using the SyBr® green protocol with modified SPF10 general primers. A total of 180 patients (119 control and 61 BE, respectively) were included. In BE patients, 31, 18, and 12 patients had, respectively, no dysplasia, low-grade dysplasia, and high grade dysplasia. Overall, nine were found to be HPV positive: five were control patients and four BE patients. HPV positive status was not associated with BE. No factors were associated with HPV, in particular the degree of BE dysplasia. HPV infection appears unlikely to be significant in the etiology of BE compared with control patients. (ClinicalTrials.gov, Number NCT02549053).
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Affiliation(s)
- C Brochard
- Gastroenterology and Hepatology Department, University Hospital.,INSERM U991, Rennes.,INSERM U913.,Gastroenterology and Hepatology Department
| | | | | | | | - A Ricard
- Gastroenterology and Hepatology Department
| | - E Coron
- INSERM U913.,Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - C Couffon
- Gastroenterology and Hepatology Department
| | - N Dib
- Gastroenterology and Hepatology Department
| | - D Luet
- Gastroenterology and Hepatology Department
| | - N Musquer
- Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - M Le Rhun
- Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Michalak
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.,Pathology Department, University Hospital
| | - F Lunel-Fabiani
- Virology Department.,HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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Bertrais S, Boursier J, Ducancelle A, Oberti F, Fouchard-Hubert I, Moal V, Calès P. Prognostic durability of liver fibrosis tests and improvement in predictive performance for mortality by combining tests. J Gastroenterol Hepatol 2017; 32:1240-1249. [PMID: 27897323 DOI: 10.1111/jgh.13668] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/19/2016] [Accepted: 11/19/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM There is currently no recommended time interval between noninvasive fibrosis measurements for monitoring chronic liver diseases. We determined how long a single liver fibrosis evaluation may accurately predict mortality, and assessed whether combining tests improves prognostic performance. METHODS We included 1559 patients with chronic liver disease and available baseline liver stiffness measurement (LSM) by Fibroscan, aspartate aminotransferase to platelet ratio index (APRI), FIB-4, Hepascore, and FibroMeterV2G . RESULTS Median follow-up was 2.8 years during which 262 (16.8%) patients died, with 115 liver-related deaths. All fibrosis tests were able to predict mortality, although APRI (and FIB-4 for liver-related mortality) showed lower overall discriminative ability than the other tests (differences in Harrell's C-index: P < 0.050). According to time-dependent AUROCs, the time period with optimal predictive performance was 2-3 years in patients with no/mild fibrosis, 1 year in patients with significant fibrosis, and <6 months in cirrhotic patients even in those with a model of end-stage liver disease (MELD) score <15. Patients were then randomly split in training/testing sets. In the training set, blood tests and LSM were independent predictors of all-cause mortality. The best-fit multivariate model included age, sex, LSM, and FibroMeterV2G with C-index = 0.834 (95% confidence interval, 0.803-0.862). The prognostic model for liver-related mortality included the same covariates with C-index = 0.868 (0.831-0.902). In the testing set, the multivariate models had higher prognostic accuracy than FibroMeterV2G or LSM alone for all-cause mortality and FibroMeterV2G alone for liver-related mortality. CONCLUSIONS The prognostic durability of a single baseline fibrosis evaluation depends on the liver fibrosis level. Combining LSM with a blood fibrosis test improves mortality risk assessment.
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Affiliation(s)
| | - Jérôme Boursier
- HIFIH research unit, UBL University, Angers, France.,Department of Hepato-Gastroenterology, University Hospital, Angers, France
| | - Alexandra Ducancelle
- HIFIH research unit, UBL University, Angers, France.,Department of Virology, University Hospital, Angers, France
| | - Frédéric Oberti
- HIFIH research unit, UBL University, Angers, France.,Department of Hepato-Gastroenterology, University Hospital, Angers, France
| | - Isabelle Fouchard-Hubert
- HIFIH research unit, UBL University, Angers, France.,Department of Hepato-Gastroenterology, University Hospital, Angers, France
| | - Valérie Moal
- HIFIH research unit, UBL University, Angers, France.,Department of Biochemistry and Genetics, University Hospital, Angers, France
| | - Paul Calès
- HIFIH research unit, UBL University, Angers, France.,Department of Hepato-Gastroenterology, University Hospital, Angers, France
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22
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Le Guillou-Guillemette H, Pivert A, Bouthry E, Henquell C, Petsaris O, Ducancelle A, Veillon P, Vallet S, Alain S, Thibault V, Abravanel F, Rosenberg AA, André-Garnier E, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F, Lemaire C. Natural non-homologous recombination led to the emergence of a duplicated V3-NS5A region in HCV-1b strains associated with hepatocellular carcinoma. PLoS One 2017; 12:e0174651. [PMID: 28394908 PMCID: PMC5386276 DOI: 10.1371/journal.pone.0174651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/13/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The emergence of new strains in RNA viruses is mainly due to mutations or intra and inter-genotype homologous recombination. Non-homologous recombinations may be deleterious and are rarely detected. In previous studies, we identified HCV-1b strains bearing two tandemly repeated V3 regions in the NS5A gene without ORF disruption. This polymorphism may be associated with an unfavorable course of liver disease and possibly involved in liver carcinogenesis. Here we aimed at characterizing the origin of these mutant strains and identifying the evolutionary mechanism on which the V3 duplication relies. METHODS Direct sequencing of the entire NS5A and E1 genes was performed on 27 mutant strains. Quasispecies analyses in consecutive samples were also performed by cloning and sequencing the NS5A gene for all mutant and wild strains. We analyzed the mutant and wild-type sequence polymorphisms using Bayesian methods to infer the evolutionary history of and the molecular mechanism leading to the duplication-like event. RESULTS Quasispecies were entirely composed of exclusively mutant or wild-type strains respectively. Mutant quasispecies were found to have been present since contamination and had persisted for at least 10 years. This V3 duplication-like event appears to have resulted from non-homologous recombination between HCV-1b wild-type strains around 100 years ago. The association between increased liver disease severity and these HCV-1b mutants may explain their persistence in chronically infected patients. CONCLUSIONS These results emphasize the possible consequences of non-homologous recombination in the emergence and severity of new viral diseases.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Adeline Pivert
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Elise Bouthry
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | | | - Odile Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Pascal Veillon
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Sophie Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | | | | | - Florence Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Arielle A. Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, Paris, France
| | | | | | - Yazid Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France
| | - Pascale Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France
| | - Patrice André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France
| | | | | | - Sylvie Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Anne Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Hénia Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | | | | | | | | | - Jacques Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Christopher Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Françoise Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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23
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Ducancelle A, Pivert A, Bertrais S, Boursier J, Balan V, Veillon P, le Guillou-Guillemette H, Thibault V, Castelain S, Roquebert B, Coste-Burel M, Mackiewicz V, Schvoerer E, Larrat S, Maylin S, Alain S, Loustaud-Ratti V, Gordien E, Gozlan J, Brodard V, Chevaliez S, Calès P, Lunel-Fabiani F. Different precore/core mutations of hepatitis B interact with, limit, or favor liver fibrosis severity. J Gastroenterol Hepatol 2016; 31:1750-1756. [PMID: 26992056 DOI: 10.1111/jgh.13338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/03/2016] [Accepted: 03/06/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM The impact of basal core promoter (BCP) and precore (PC) mutants of the hepatitis B virus (HBV) on liver disease severity remains controversial. The aim of the present study was to screen BCP and PC mutations in 252 HBV surface antigen (HBsAg) positive carriers in France and to assess relationships between these mutations and severe fibrosis. METHODS Direct sequencing of the precore/core gene was used to detect A1762T/G1764A and G1757A mutations in the BCP and G1896A and G1899A mutations in the PC region. RESULTS The prevalences of A1762T/G1764A, G1757A, G1896A, and G1899A mutations were 34.1%, 38.7%, 54.9%, and 29.3% (P < 0.001), respectively. The independent predictors of severe fibrosis (≥F3 Metavir) were older age (P < 0.001), male gender (P = 0.012), elevated alanine aminotransferase (P < 0.001), and the double A1762T/G1764A mutant with no other mutations (P = 0.011). Interestingly, the association of the G1899A mutation with the double A1762T/G1764A mutant significantly counteracted the deleterious effect of the sole double A1762T/G1764A mutant (odds ratio [OR] = 0.28 vs. OR = 3.55, respectively, P = 0.028). CONCLUSIONS Patients with the A1762T/G1764A mutation have a higher risk of severe fibrosis. The G1899A mutation is a protective factor against severe fibrosis that counteracted the deleterious effect of the A1762T/G1764A mutation. Finally, host phenotypic and HBV genotypic markers independently predict fibrosis severity.
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Affiliation(s)
- Alexandra Ducancelle
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France.
| | - Adeline Pivert
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Sandrine Bertrais
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Jérôme Boursier
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Viorica Balan
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Pascal Veillon
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Hélène le Guillou-Guillemette
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Vincent Thibault
- Laboratory of Virology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France
| | - Sandrine Castelain
- Laboratory of Virology, Amiens University Hospital, and EA 4294, Amiens, France
| | - Bénédicte Roquebert
- Laboratory of Virology, Bichat Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - Marianne Coste-Burel
- Laboratory of Virology, Hôtel Dieu Hospital & LUNAM University, and EA4271, Nantes, France
| | - Vincent Mackiewicz
- Laboratory of Virology, Beaujon Hospital & University (HUPNVS), Paris, France
| | - Evelyne Schvoerer
- Laboratory of Virology, Nancy Hospital & University, Vandoeuvre-les-Nancy, France
| | - Sylvie Larrat
- Virology Department, Reference Center of Neuromuscular Disease, Grenoble University Hospital, La Tronche, France
| | - Sarah Maylin
- Laboratory of Virology, Saint Louis Hospital & University, Paris, France
| | - Sophie Alain
- Laboratory of Virology, UMR Inserm 1092, Dupuytren Hospital & University, Limoges, France
| | | | - Emmanuel Gordien
- Laboratory of Virology, University Hospital of Paris Seine-Saint-Denis, Avicenne, Associated with the National Reference Center for Viral Hepatitis B, C and Delta in France, Bobigny, France
| | - Joël Gozlan
- Laboratory of Virology, Saint Antoine University Hospital, Paris, France
| | | | - Stéphane Chevaliez
- Laboratory of Virology, Henri Mondor Hospital, National Reference Centre for Viral Hepatitis B, C and Delta, and Inserm U955, Créteil, France
| | - Paul Calès
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Françoise Lunel-Fabiani
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
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24
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Augusto JF, Garnier AS, Demiselle J, Langs V, Picquet J, Legall R, Sargentini C, Culty T, Poli C, Ammi M, Ducancelle A, Chevailler A, Duveau A, Subra JF, Sayegh J. Hypogammaglobulinemia and risk of severe infection in kidney transplant recipients. Transpl Infect Dis 2016; 18:741-751. [PMID: 27509578 DOI: 10.1111/tid.12593] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 05/30/2016] [Accepted: 06/24/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent data have outlined a link between hypogammaglobulinemia (HGG) and infection risk and suggested that HGG correction may decrease post-transplant infections. METHODS We analyzed the risk factors of HGG and the relationship between HGG and the risk of severe infection in a cohort of 318 kidney transplant recipients (KTR) who were transplanted between 2003 and 2013. Immunoglobulin (Ig) concentration was measured prospectively at day 15 (D15), month 6 (M6), month 12 (M12), and month 24 (M24) post transplant. RESULTS The prevalence of IgG HGG was 56% and 36.8% at D15 and M6, respectively. Age was the sole identified risk factors for D15 IgG HGG (odds ratio [OR] 1.02, P = 0.019). Risk factors for M6 IgG HGG were the presence of D15 IgG HGG (OR 6.41, P < 0.001) and treatment of acute rejection (OR 2.63, P = 0.014). Most infections occurred between D15 and M6 post transplant. Only age (hazard ratio 1.03, P < 0.001) was identified as a risk factor of infection between D15 and M6 post transplant. Survival free of infection (overall infections and bacterial or viral infections) did not differ significantly between patients with or without D15 IgG HGG. Only septicemia occurring between M6 and M12 post transplant was more frequently observed in patients with HGG. The low prevalence of severe HGG (<400 mg/dL) did not allow conclusions on the infectious risk associated with this patient subgroup. CONCLUSIONS This study does not support the existence of a strong link between post-transplant HGG and the risk of severe infections in KTR. Correction of HGG to minimize the risk of severe infections in KTR is thus questionable and needs to be reevaluated in prospective studies.
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Affiliation(s)
- J-F Augusto
- LUNAM Université, Angers, France. .,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France.
| | - A-S Garnier
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Demiselle
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - V Langs
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Picquet
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - R Legall
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - C Sargentini
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - T Culty
- LUNAM Université, Angers, France.,Service d'Urologie, Université Angers, CHU Angers, Angers, France
| | - C Poli
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - M Ammi
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - A Ducancelle
- LUNAM Université, Angers, France.,Laboratoire de Virologie, Université d'Angers, CHU Angers, Angers, France
| | - A Chevailler
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - A Duveau
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J-F Subra
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Sayegh
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
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25
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Bouachour T, Tran C, Leclech C, Ducancelle A, Lunel-Fabiani F. HEP-04 - Évaluation du test rapide d’orientation diagnostic (TROD) Multisure HCV Antibody Assay. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Veillon P, Fouchard-Hubert I, Larrey D, Dao MT, D'alteroche L, Boyer-Darrigand N, Picard N, Le Guillou-Guillemette H, Saulnier P, Ducancelle A, Loustaud-Ratti V, Lunel-Fabiani F. Does Epoetin Beta Still Have a Place in Peginterferon Alpha-2a Plus Ribavirin Treatment Strategies for Chronic Hepatitis C? J Interferon Cytokine Res 2016; 36:204-14. [PMID: 26700738 DOI: 10.1089/jir.2015.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
To investigate the impact of epoetin beta (EPO) on sustained virological response (SVR) in hepatitis C virus (HCV)-infected patients treated with peginterferon-ribavirin (RBV). Controlled, randomized, pragmatic multicenter study to assess 2 strategies, ie, the use (EPO group) or nonuse (control group) of EPO in terms of achieving SVR in treatment-naive, genotype non-2/non-3 HCV-infected patients receiving a 48-week treatment regimen of pegylated interferon α-2a (peg-IFN) plus RBV (randomization 2:1). The single-nucleotide polymorphisms of interferon lambda 3 (IFNL3) (rs12979860 and rs8099917), interferon lambda 4 (IFNL4) (ss469415590), and inosine triphosphatase (ITPA) (rs1127354 and rs7270101) were determined retrospectively. Two hundred twenty-seven patients were included in the study. In the global population (n = 227), the overall SVR rate was 52% (118/227). Nonresponse and relapse occurred in respectively 46/227 (20.3%) and 42/227 (18.5%) patients. In the intention-to-treat analysis, 55.5% of patients with anemia (n = 164) had a SVR, specifically 57.4% in the EPO group versus 52.4% in the control group, but the difference was not statistically significant. In the anemic population, independent factors associated with SVR were IFNL3 and IFNL4 polymorphisms, pretreatment HCV RNA level, iron level, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio. EPO has little impact on SVR in patients treated with peg-IFN+RBV and should be recommended only for patients with severe anemia.
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Affiliation(s)
- Pascal Veillon
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Isabelle Fouchard-Hubert
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
- 3 Department of Hepatology and Gastroenterology, University Hospital of Angers , Angers, France
| | - Dominique Larrey
- 4 Department of Hepatology and Transplantation, University Hospital of Montpellier , Montpellier, France
| | - Manh Thông Dao
- 5 Gastroenterology and Nutrition, University Hospital of Caen , Caen, France
| | - Louis D'alteroche
- 6 Department of Hepatology and Gastroenterology, University Hospital of Tours , Chambray-les-Tours, France
| | - Nathalie Boyer-Darrigand
- 7 Department of Hepatology, Physiopathology and Treatment of Viral Hepatitis, Hospital of Beaujon , Clichy, France
| | - Nicolas Picard
- 8 INSERM UMR-850, Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges , Limoges, France
| | - Hélène Le Guillou-Guillemette
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Patrick Saulnier
- 9 Micro and Nanomedecines biomimetics, INSERM UMRS 1066, University of Angers , Angers, France
| | - Alexandra Ducancelle
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Véronique Loustaud-Ratti
- 10 Department of Hepatology and Gastroenterology, University Hospital of Limoges , INSERM UMR 1092, Limoges, France
| | - Françoise Lunel-Fabiani
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
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27
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Boursier J, Ducancelle A, Vergniol J, Veillon P, Moal V, Dufour C, Bronowicki JP, Larrey D, Hézode C, Zoulim F, Fontaine H, Canva V, Poynard T, Allam S, De Lédinghen V. The CUPIC algorithm: an accurate model for the prediction of sustained viral response under telaprevir or boceprevir triple therapy in cirrhotic patients. J Viral Hepat 2015. [PMID: 26216230 DOI: 10.1111/jvh.12433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Triple therapy using boceprevir or telaprevir remains the reference treatment for genotype 1 chronic hepatitis C in countries where new interferon-free regimens have not yet become available. Antiviral treatment is highly required in cirrhotic patients, but they represent a difficult-to-treat population. We aimed to develop a simple algorithm for the prediction of sustained viral response (SVR) in cirrhotic patients treated with triple therapy. A total of 484 cirrhotic patients from the ANRS CO20 CUPIC cohort treated with triple therapy were randomly distributed into derivation and validation sets. A total of 52.1% of patients achieved SVR. In the derivation set, a D0 score for the prediction of SVR before treatment initiation included the following independent predictors collected at day 0: prior treatment response, gamma-GT, platelets, telaprevir treatment, viral load. To refine the prediction at the early phase of the treatment, a W4 score included as additional parameter the viral load collected at week 4. The D0 and W4 scores were combined in the CUPIC algorithm defining three subgroups: 'no treatment initiation or early stop at week 4', 'undetermined' and 'SVR highly probable'. In the validation set, the rates of SVR in these three subgroups were, respectively, 11.1%, 50.0% and 82.2% (P < 0.001). By replacing the variable 'prior treatment response' with 'IL28B genotype', another algorithm was derived for treatment-naïve patients with similar results. The CUPIC algorithm is an easy-to-use tool that helps physicians weigh their decision between immediately treating cirrhotic patients using boceprevir/telaprevir triple therapy or waiting for new drugs to become available in their country.
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Affiliation(s)
- J Boursier
- Department of Hepatology and Gastroenterology, CHU d'Angers, Angers, France.,HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France
| | - A Ducancelle
- HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France.,Virology Department, CHU d'Angers, Angers, France
| | - J Vergniol
- Department of Hepatology and Gastroenterology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - P Veillon
- Department of Hepatology and Gastroenterology, CHU d'Angers, Angers, France.,HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France.,Virology Department, CHU d'Angers, Angers, France
| | - V Moal
- HIFIH, UPRES 3859, SFR 4208, Université LUNAM, Angers, France.,Biochemistry Department, CHU d'Angers, Angers, France
| | - C Dufour
- Inserm UMR-S1136, Université Pierre-et-Marie-Curie Paris 6, Paris, France
| | - J-P Bronowicki
- Department of Hepatology and Gastroenterology, CHU de Nancy, Université de Lorraine, Inserm U954, Vandoeuvre-lès-Nancy, France
| | - D Larrey
- Liver Unit-IRB-INSERM1040, Hôpital Saint Eloi, CHU de Montpellier, Montpellier, France
| | - C Hézode
- Department of Hepatology and Gastroenterology, Hôpital Henri Mondor, AP-HP, Université Paris-Est, INSERM U955, Créteil, France
| | - F Zoulim
- Department of Hepatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, INSERM U1052, Lyon, France
| | - H Fontaine
- Department of Hepatology, Hôpital Cochin, AP-HP, Université Paris-René Descartes, Inserm U1016, Paris, France
| | - V Canva
- Department of Hepatology and Gastroenterology, Centre Hospitalier Régional et Universitaire Claude Huriez, Lille, France
| | - T Poynard
- Department of Hepatology and Gastroenterology, Groupe Hospitalier Pitié-Salpétrière AP-HP, Université Pierre et Marie Curie Paris 6, INSERM UMR-S938, Paris, France
| | - S Allam
- Unit for Basic and Clinical Research on Viral Hepatitis, ANRS (France REcherche Nord & sud Sida-HIV Hépatites-FRENSH), Paris, France
| | - V De Lédinghen
- Department of Hepatology and Gastroenterology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.,INSERM U1053, Université Bordeaux Segalen, Bordeaux, France
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Mahieu R, Lavigne C, Urbanski G, Fouchard Hubert I, Ducancelle A, Lunel-Fabiani F. Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement. Eur J Case Rep Intern Med 2015. [DOI: 10.12890/2015_000299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Rafael Mahieu
- Department of Infectious Diseases, Angers University Hospital
| | | | | | | | - Alexandra Ducancelle
- Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers
| | - Françoise Lunel-Fabiani
- Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers
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Le Guillou-Guillemette H, Ducancelle A, Bertrais S, Lemaire C, Pivert A, Veillon P, Bouthry E, Alain S, Thibault V, Abravanel F, Rosenberg AR, Henquell C, André-Garnier E, Petsaris O, Vallet S, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F. Identification of a duplicated V3 domain in NS5A associated with cirrhosis and hepatocellular carcinoma in HCV-1b patients. J Clin Virol 2015. [PMID: 26209408 DOI: 10.1016/j.jcv.2015.06.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The NS5A protein of the hepatitis C virus has been shown to be involved in the development of hepatocellular carcinoma. OBJECTIVES In a French multicenter study, we investigated the clinical and epidemiological features of a new HCV genotype 1b strain bearing a wide insertion into the V3 domain. STUDY DESIGN We studied NS5A gene sequences in 821 French patients infected with genotype 1b HCV. RESULTS We identified an uncharacterized V3 insertion without ORF disruption in 3.05% of the HCV sequences. The insertion comprised 31 amino-acids for the majority of patients; 3 patients had 27 amino-acids insertions and 1 had a 12 amino-acids insertion. Sequence identity between the 31 amino-acids insertions and the V3 domain ranged from 48 to 96% with E-values above 4e(-5), thus illustrating sequence homology and a partial gene duplication event that to our knowledge has never been reported in HCV. Moreover we showed the presence of the duplication at the time of infection and its persistence at least during 12 years in the entire quasispecies. No association was found with extrahepatic diseases. Conversely, patients with cirrhosis were two times more likely to have HCV with this genetic characteristic (p=0.04). Moreover, its prevalence increased with liver disease severity (from 3.0% in patients without cirrhosis to 9.4% in patients with both cirrhosis and HCC, p for trend=0.045). CONCLUSIONS We identified a duplicated V3 domain in the HCV-1b NS5A protein for the first time. The duplication may be associated with unfavorable evolution of liver disease including a possible involvement in liver carcinogenesis.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - A Ducancelle
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - C Lemaire
- IRHS, PRES LUNAM, SFR QUASAV, Angers, France.
| | - A Pivert
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - P Veillon
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - E Bouthry
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Alain
- Laboratoire de Virologie, CHU Limoges, France.
| | - V Thibault
- Laboratoire de Virologie, CHU Pitié-Salpêtrière, Paris, France.
| | - F Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - A R Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, EA 4474 "Hepatitis C Virology", Paris, France.
| | - C Henquell
- Laboratoire de Virologie, CHU Clermont-Ferrand, France.
| | | | - O Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - S Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - J B Bour
- Laboratoire de Virologie, CHU, Dijon, France.
| | - Y Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France.
| | - P Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France.
| | - P André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France.
| | - C Gaudy-Graffin
- Université François Rabelais, Inserm U966, CHU Tours, France.
| | - D Bettinger
- Laboratoire de Virologie, CHU Besançon, France.
| | - S Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - A Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - H Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - B Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - G Lagathu
- Laboratoire de Virologie, CHU Rennes, France.
| | | | - F Stoll-Keller
- Institut de Virologie, CHU Strasbourg, Inserm U748, Strasbourg, France.
| | - J M Pawlotsky
- Laboratoire de Virologie-Bactériologie, CHU Henri-Mondor, Créteil, France.
| | - J Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - C Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - F Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
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Orvain C, Ducancelle A, Eymerit-Morin C, Rousselet MC, Oberti F, Hunault-Berger M, Tanguy-Schmidt A. Severe viral hepatitis in a patient with chronic lymphocytic leukemia (CLL) complicated with autoimmune hemolytic anemia (AIHA), treated with steroids. J Clin Virol 2014; 62:66-8. [PMID: 25542474 DOI: 10.1016/j.jcv.2014.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 11/06/2014] [Accepted: 11/08/2014] [Indexed: 10/24/2022]
Abstract
Infectious complications are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL) due to impaired immunity secondary to the disease itself and to the immunosuppressive therapies administered to these patients. We report a 78-year-old woman with CLL who was treated with steroids for autoimmune hemolytic anemia (AIHA). A few weeks later, she was admitted for severe acute hepatitis with disseminated intravascular coagulation (DIC). Despite the symptomatic treatment of DIC, standard reanimation and probabilistic antibiotics, the patient died within 24h with severe hepatic failure. Autopsy was in favor of a disseminated viral infection with esophageal, hepatic and pulmonary cytopathologic lesions with acidophilic intranuclear inclusions suggestive of herpes virus, even though HSV 1 and 2, CMV and HHV6 PCRs were negative. This case of severe viral hepatitis with esophagitis occurring three weeks after the introduction of high-dose steroid treatment for AIHA in a CLL patient calls for anti-herpetic prophylaxis in such patients, immunodepressed by their diseases and the treatment they receive.
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Affiliation(s)
| | | | | | | | - Frederic Oberti
- CHU Angers, Service d'hépato-gastroentérologie, Angers, France
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Pivert A, Servant-Delmas A, Lunel-Fabiani F, Le Guillou-Guillemette H, Laperche S, Ducancelle A. Correlation between the promoter basal core and precore mutations and HBsAg quantification in French blood donors infected with hepatitis B virus. J Med Virol 2014; 87:529-35. [PMID: 25170961 DOI: 10.1002/jmv.24064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 12/12/2022]
Abstract
Hepatitis B virus (HBV) basal core promoter (BCP) and precore (PC) mutations, HBV viral load and HBV surface antigen (HBsAg) quantitation were screened to assess correlations between these HBV markers in asymptomatic chronic hepatitis B carriers in France. From January 2006 to July 2007, 200 sera were collected from patients who were discovered to be HBsAg-positive when they volunteered to give blood. Direct sequencing of precore/core gene was used to detect A1762T/G1764A mutations in the BCP and G1896A in the PC region. HBV viral load and HBsAg were quantified with two commercials assays. The prevalence of the BCP and PC mixed/mutants were 37% and 60% respectively (P = 0.0001). HBV DNA level and HBsAg titer were significantly lower in subjects harboring the mixed/mutant PC virus compared to those infected by the wild phenotype. No significant difference was observed in HBV viral loads of blood donors infected by wild or mixed/mutant BCP viruses. Mutant or mixed PC virus was associated with male gender, HBeAb-positive status and HBV/D and HBV/E genotypes. BCP mutations were associated with age, and both HBV/A-HBV/E genotypes.The genetic properties of HBV in this cohort showed that most of the blood donors had a negative HBeAg serological status and harbored the PC mutant phenotype in combination with low levels of both HBV DNA and HBsAg. As the study was conducted in healthy subjects who could be considered as asmptomatic carriers, these results suggest a possible protective effect of the G1896A mutation against severe liver lesions.
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Affiliation(s)
- A Pivert
- Laboratoire de virologie et Laboratoire HIFIH, UPRES EA 3859, University Hospital Angers, 4, rue Larrey, 49000, Angers, France
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Calès P, Boursier J, Ducancelle A, Oberti F, Hubert I, Hunault G, de Lédinghen V, Zarski JP, Salmon D, Lunel F. Improved fibrosis staging by elastometry and blood test in chronic hepatitis C. Liver Int 2014; 34:907-17. [PMID: 24102852 DOI: 10.1111/liv.12327] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 08/20/2013] [Indexed: 12/13/2022]
Abstract
AIMS Our main objective was to improve non-invasive fibrosis staging accuracy by resolving the limits of previous methods via new test combinations. Our secondary objectives were to improve staging precision, by developing a detailed fibrosis classification, and reliability (personalized accuracy) determination. METHODS All patients (729) included in the derivation population had chronic hepatitis C, liver biopsy, 6 blood tests and Fibroscan. Validation populations included 1584 patients. RESULTS The most accurate combination was provided by using most markers of FibroMeter and Fibroscan results targeted for significant fibrosis, i.e. 'E-FibroMeter'. Its classification accuracy (91.7%) and precision (assessed by F difference with Metavir: 0.62 ± 0.57) were better than those of FibroMeter (84.1%, P < 0.001; 0.72 ± 0.57, P < 0.001), Fibroscan (88.2%, P = 0.011; 0.68 ± 0.57, P = 0.020), and a previous CSF-SF classification of FibroMeter + Fibroscan (86.7%, P < 0.001; 0.65 ± 0.57, P = 0.044). The accuracy for fibrosis absence (F0) was increased, e.g. from 16.0% with Fibroscan to 75.0% with E-FibroMeter (P < 0.001). Cirrhosis sensitivity was improved, e.g. E-FibroMeter: 92.7% vs. Fibroscan: 83.3%, P = 0.004. The combination improved reliability by deleting unreliable results (accuracy <50%) observed with a single test (1.2% of patients) and increasing optimal reliability (accuracy ≥85%) from 80.4% of patients with Fibroscan (accuracy: 90.9%) to 94.2% of patients with E-FibroMeter (accuracy: 92.9%), P < 0.001. The patient rate with 100% predictive values for cirrhosis by the best combination was twice (36.2%) that of the best single test (FibroMeter: 16.2%, P < 0.001). CONCLUSION The new test combination increased: accuracy, globally and especially in patients without fibrosis, staging precision, cirrhosis prediction, and even reliability, thus offering improved fibrosis staging.
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Affiliation(s)
- Paul Calès
- Liver-Gastroenterology Department, CHU Angers, Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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Vandamme YM, Ducancelle A, Biere L, Viot N, Rouleau F, Delbos V, Abgueguen P. Myopericarditis complicated by pulmonary embolism in an immunocompetent patient with acute cytomegalovirus infection: a case report. BMC Res Notes 2014; 7:193. [PMID: 24678987 PMCID: PMC3999874 DOI: 10.1186/1756-0500-7-193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 03/04/2014] [Indexed: 12/25/2022] Open
Abstract
Background Primary acute cytomegalovirus infection in immunocompetent patients is common worldwide. Infection is most often asymptomatic or occurs sub-clinically with a self-limited mononucleosis-like syndrome. More rarely, the infection may lead to severe organ complications with pneumonia, myocarditis, pericarditis, colitis and hemolytic anemia. Recent cases of cytomegalovirus-associated thrombosis have also been reported sporadically in the medical literature. Case presentation We report here a case of simultaneous myopericarditis and pulmonary embolism in a 30-year-old man with no medical history. The patient was not immunocompromised. We discuss the possible role of acute cytomegalovirus infection in the induction of vascular damage and review relevant cases in the literature. Conclusion Thrombosis in patients with acute cytomegalovirus infection may be more frequent than is generally thought. Physicians need to be aware of the possible association between acute cytomegalovirus and thrombosis in immunocompetent patients, especially in the presence of severe systemic infection, as our case illustrates.
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Affiliation(s)
- Yves Marie Vandamme
- Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49933 Angers, Cedex 9, France.
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Ducancelle A, Legrand MC, Pivert A, Veillon P, Le Guillou-Guillemette H, De Brux MA, Beby-Defaux A, Agius G, Hantz S, Alain S, Catala L, Descamps P, Postec E, Caly H, Charles-Pétillon F, Labrousse F, Lunel F, Payan C. Interest of human papillomavirus DNA quantification and genotyping in paired cervical and urine samples to detect cervical lesions. Arch Gynecol Obstet 2014; 290:299-308. [PMID: 24622934 DOI: 10.1007/s00404-014-3191-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. PURPOSE To compare HPV viral loads and genotypes in paired cervical and urine samples, and to assess correlation between virological and cytological results in women seeking gynecological consultation. METHODS Paired urine and cervical specimens were collected and analyzed from 230 of 245 women participating in the previously described prospective PapU study. HPV DNA detection and quantification were performed using a real-time PCR method with short fragment PCR primers. Genotyping was carried out using the INNO-LiPA HPV genotyping assay. RESULTS The prevalence of HPV in the 230 paired urine and cervical smear samples was 42 and 49 %, respectively. Overall agreement for HPV positivity and negativity between the paired samples was 90 % (κ = 0.80). High HPV viral load in both cervical and urine samples was associated with cytological abnormalities. HPV-positive women were mostly infected with HR-HPV types. The agreement between high- and low-risk HPV (LR-HPV) detection in both samples was 97 % (κ = 0.95 for HR-HPV and κ = 0.97 for LR-HPV). CONCLUSIONS High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.
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Affiliation(s)
- A Ducancelle
- Laboratoire de Virologie, UPRES EA 3859, Centre Hospitalier Universitaire Angers, 4 rue Larrey, 49000, Angers, France,
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Lunel-Fabiani F, Masson C, Ducancelle A. Systemic diseases and biotherapies: understanding, evaluating, and preventing the risk of hepatitis B reactivation. Joint Bone Spine 2014; 81:478-84. [PMID: 24561021 DOI: 10.1016/j.jbspin.2014.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2014] [Indexed: 12/17/2022]
Abstract
Hepatitis B virus (HBV) reactivation can occur in chronic carriers of the HBV surface antigen (HBsAg) and constitutes a well-known complication of immunosuppressive therapy. HBV reactivation has also been reported after contact with the HBV. The increasing use of biological agents (TNFα antagonists, rituximab, abatacept, and tocilizumab) to treat systemic diseases has resulted in numerous publications about the risk of HBV reactivation. The relevant scientific societies have issued recommendations designed to prevent HBV reactivation. The main measures consist of screening for markers indicating chronic HBV infection (HBsAg) or HBV infection in the distant past (antibodies to the HBV core antigen) before initiating biological therapies, vaccinating marker-negative patients, and considering close follow-up or antiviral treatment before immunosuppressive treatment initiation or in the event of HBV reactivation. Here, we discuss the pathophysiological mechanisms underlying HBV reactivation during biological treatments, most notably in patients with occult HBV infection or markers for remote HBV infection, whose hepatocyte nuclei may contain a resistance form of HBV DNA known as covalently closed circular DNA (cccDNA). Assessment of the risk of reactivation relies on the HBV status, drugs used, and data from the literature. Finally, we discuss the various recommendations and modalities for HBV vaccination, preemptive treatment, and patient management, according to the level of risk and to the circumstances in which reactivation occurs.
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Affiliation(s)
- Françoise Lunel-Fabiani
- Laboratoire de virologie et laboratoire HIFIH, UPRES EA 3859, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Charles Masson
- Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - Alexandra Ducancelle
- Laboratoire de virologie et laboratoire HIFIH, UPRES EA 3859, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
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Mahieu R, Vandamme YM, Le Clec'h C, Ducancelle A, Kempf M, Pichard E, Abgueguen P. A 59-Year-Old Woman With Chronic Skin Lesions of the Leg. Clin Infect Dis 2013. [DOI: 10.1093/cid/cit667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mahieu R, Vandamme YM, Le Clec'h C, Ducancelle A, Kempf M, Pichard E, Abgueguen P. Photo Quiz. A 59-year-old woman with chronic skin lesions of the leg. Clin Infect Dis 2013; 57:1751, 1782. [PMID: 24280663 DOI: 10.1093/cid/cit661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ducancelle A, Abgueguen P, Birguel J, Mansour W, Pivert A, Le Guillou-Guillemette H, Sobnangou JJ, Rameau A, Huraux JM, Lunel-Fabiani F. High endemicity and low molecular diversity of hepatitis B virus infections in pregnant women in a rural district of North Cameroon. PLoS One 2013; 8:e80346. [PMID: 24265811 PMCID: PMC3827216 DOI: 10.1371/journal.pone.0080346] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/01/2013] [Indexed: 02/07/2023] Open
Abstract
Background A program, supported by the GEMHEP (Groupe d'étude Moléculaire des Hépatites), was established in 2007 in the sanitary district of Tokombéré, to prevent perinatal transmission of hepatitis B virus (HBV). It comprises screening for HBV surface antigen (HBsAg) in all pregnant women and vaccinating the newborn if tests are positive. Methods/Principal Findings 1276 women were enrolled in the study after providing informed consent. Demographic data and blood samples were available for 1267 of the enrolled patients. HBsAg was determined locally using a rapid test (Vikia HBsAg, Biomerieux). Tests for HBV and HDV virological markers (HBeAg, anti-HDV antibodies (Ab), HBV-DNA, HDV-RNA, HBV and HDV genotypes) were performed on the confirmed HBsAg-positive samples in the virology unit of the Angers University Hospital (France). HBsAg was found in 259 of the 1267 pregnant women (20.4%) between January 2009 and April 2010, of whom 59 were HBeAg-positive (22.7%) with high levels of HBV-DNA. Anti-HDV Ab were found in 19 (7.3%) of the HBsAg-positive women. The prevalence rates of HBsAg and HDV were not age-dependent whereas HBeAg carriers were statistically younger than non carriers. Basal core promoter (BCP) and precore (PC) mutations and genotypes were determined by sequencing. Of 120 amplified sequences, 119 belonged to HBV genotype E (HBV/E) and the 9 HDV strains belonged to HDV clade 1. In the PC region, 83/228 patients (36.4%) harbored a G1896A mutant or mixed phenotype virus. In the BCP region, the double mutation A1762T/G1764A and the G1757A substitution were detected respectively in 26/228 patients (11.4%) and 189/228 patients (82.8%). Conclusions Our results confirm the high prevalence and low molecular diversity of HBV in Far Northern Cameroon; more than 20% of the infected women were highly viremic, suggesting a high rate of HBV perinatal transmission and supporting the WHO recommendation to vaccinate at birth against hepatitis B.
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Affiliation(s)
- Alexandra Ducancelle
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
- * E-mail:
| | - Pierre Abgueguen
- Department of Infectious Diseases and Internal Medicine, Angers University Hospital, Angers Cedex 9, France
| | | | - Wael Mansour
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Adeline Pivert
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Hélène Le Guillou-Guillemette
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | | | - Amélie Rameau
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Jean-Marie Huraux
- Virology Laboratory, Hospital AP-HP Pitié-Salpêtrière, ER1 DETIV, University Paris VI Pierre et Marie Curie, France
| | - Françoise Lunel-Fabiani
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
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Fanello S, Plessise A, Baron C, Ducancelle A, Moulévrier P. Les médecins généralistes (MG) et la vaccination anti-papillomavirus. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Mansour W, Malick FZF, Sidiya A, Ishagh E, Chekaraou MA, Veillon P, Ducancelle A, Brichler S, Le Gal F, Lo B, Gordien E, Lunel-Fabiani F. Prevalence, risk factors, and molecular epidemiology of hepatitis B and hepatitis delta virus in pregnant women and in patients in Mauritania. J Med Virol 2012; 84:1186-98. [PMID: 22711346 DOI: 10.1002/jmv.23336] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
No recent data are available on hepatitis B virus (HBV) and hepatitis Delta virus (HDV) prevalence in Mauritania. One thousand twenty pregnant women and 946 patients visiting for routine checkups were screened for HBV and HDV infection. Demographic, epidemiological, ethnic, clinical, and biological data were recorded. HBV and HDV genotypes were determined by sequencing and phylogenetic analyses. In the pregnant women and patients cohorts, respectively, the prevalence of HBsAg (10.7% and 18.3%) and anti-HBcAb (66.3% and 76.5%) indicated high HBV endemicity. In pregnant women, exposure to HBV was significantly associated in multivariate analysis with education level, ethnicity, blood transfusion, and occupation. HDV antibodies (HDVAb) were found in 14.7% of pregnant women. In patients, HBsAg was found less frequently in females than in males. Again in multivariate analysis, exposure to HBV was significantly correlated with gender (males), and HDVAb positivity with age and gender. The HBV DNA viral load was >3 log IU/ml in only 10.1% of pregnant women and in 17.3% of patients. HDV-RNA was detectable in 21 (67.7%) of the 31 patients positive for HDVAb, and in 11 of the 16 pregnant women positive for HDVAb (68.8%). The most frequent HBV genotypes were: HBV/D, 53%; HBV/E, 35%; and HBV/A, 12%. Sub-genotyping revealed HBV/D1,/D7, and the recently described/D8. HDV genotypes were: HDV-1, 90.3% and HDV-5, 9.7%. This study confirms the high prevalence of HBV and HDV infections in Mauritania and demonstrates the high genetic diversity of HBV in this country.
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Affiliation(s)
- Wael Mansour
- Laboratory of Virology, Angers University Hospital, Angers, France
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Mansour W, Bollahi MA, Hamed CT, Brichler S, Le Gal F, Ducancelle A, Lô B, Gordien E, Rosenheim M, Lunel F. Virological and epidemiological features of hepatitis delta infection among blood donors in Nouakchott, Mauritania. J Clin Virol 2012; 55:12-6. [PMID: 22704272 DOI: 10.1016/j.jcv.2012.05.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/15/2012] [Accepted: 05/17/2012] [Indexed: 02/01/2023]
Abstract
BACKGROUND In Mauritania, some authors have described a possible high prevalence of hepatitis delta virus (HDV) infection in the 1990s in studies of small-size samples. OBJECTIVES The aims of our study were to assess the prevalence of HDV in HBsAg positive blood donors in Mauritania, to identify the main risk factors for HDV transmission and to analyze genetic diversity of HDV strains. STUDY DESIGN From October 2008 to December 2009, 11,100 consecutive blood donors were considered in this study. Among them, 1700 (15.3%) were HBsAg positive and 455 accepted to participate in this study. Demographic, epidemiological, ethnical, clinical and biological data were recorded. HDV screening, i.e., antibodies (HDVAb) and RNA (HDV-RNA) detection, was performed for all of them as well as HDV and HBV genotyping. RESULTS Ninety/455 (19.78%) donors were HDVAb positive and HDV-RNA was detectable in 56 (62.2%) of them. HDV infection was significantly associated with older age, number of marriages, military profession, residence in the desert and a history of hospitalization. The HDV genotypes of the circulating strains were HDV-1 (89.3%) and HDV-5 (10.7%). CONCLUSION HDV is highly endemic in Mauritanian blood donors indicating that a high number of them will develop chronic hepatitis, cirrhosis or hepatocellular carcinoma. Associated risk factors support nosocomial transmission of HDV. These data underline the need to reinforce HBV vaccination in newborns and in blood donors without HBV markers, together with screening for HDV in HBV-infected individuals.
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Affiliation(s)
- Wael Mansour
- Laboratoire de Virologie, CHU Angers, 4, rue Larrey, 49933 Angers Cedex 9, France
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Ducancelle A, Pivert A, Lunel-Fabiani F. [Basic core promoter and precore mutations of hepatitis B virus]. Virologie (Montrouge) 2011; 15:100-114. [PMID: 36151629 DOI: 10.1684/vir.2011.15785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Since hepatitis B virus (HBV) replication involves an error-prone reverse transcription step, the rate of nucleotide changes during replication is higher than that found in other DNA viruses. As a result, HBV has a "quasispecies" distribution in infected individuals. Such selection processes to allow the emergence of variant viruses, such as precore (PC) and basal core promoter (BCP) mutants. The dominant PC variant is a point mutation of G to A at nucleotide 1896 (G1896A) that produces a premature stop codon, which terminates translation of the precore protein, resulting in the lack of HBe-antigen synthesis. BCP variants at nucleotides 1762 (A1762T) and 1764 (G1764A) likewise impair the production of HBeAg but at the transcriptional rather than the translational level. The impact of mutations in the precore and basal core promoter regions of the HBV virus on the course of chronic liver disease is not well established.
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Affiliation(s)
- Alexandra Ducancelle
- CHU d'Angers, laboratoire de virologie, 4, rue Larrey, 49033 Angers Cedex, France
| | - Adeline Pivert
- CHU d'Angers, laboratoire de virologie, 4, rue Larrey, 49033 Angers Cedex, France
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Ducancelle A, Servant-Delmas A, Beuvelet T, Balan V, Pivert A, Maniez M, Laperche S, Lunel-Fabiani F. [Results of a novel real-time PCR, sequence analysis, Inno-LiPA line probe assays in the detection of hepatitis B virus G1896A precore mutation in French blood donors]. ACTA ACUST UNITED AC 2010; 59:e21-7. [PMID: 20843617 DOI: 10.1016/j.patbio.2010.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 07/29/2010] [Indexed: 12/31/2022]
Abstract
AIM To screen hepatitis B virus (HBV) genotypes and associated basal core promoter (BCP; T1762A/A1764) and precore (PC; A1896) mutations among the 100 HBV surface antigen (HBsAg) positive voluntary blood donors in France. METHODS HBV genotypes were determined by using direct sequence analysis. Three methods were used to detect G1896A mutation: non-commercial real-time PCR (PCRTR°, line probe assay (InnoLiPA HBV PreCore, INNOGENETICS(®)) and direct sequencing of precore gene. HBV viral load was quantified with two commercial real-time PCR (COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HBV Test/Roche and Real Time HBV/M2000/Abbott). RESULTS The mean age of donors was 30 (18-64). Patients were from Africa (42%), Europa (50%), and Asia (8%). HBV/D was the most predominant (37%) genotype followed by HBV/A (31%) and HBV/E (22%). PC and BCP mutants were found in 57% with Inno-LIPA HBV test and 59% with both PCRTR and sequencing methods. A significant difference in the viral load of blood donors with wild and PC mutants was observed with the Taqman Cobas real time PCR (3,19 Log(10) UI/ml versus 4,93 Log(10) UI/ml, p < 0.05). Precore phenotype determination was in agreement with the three PC mutation detection methods in 56% of cases. CONCLUSIONS Non-Caucasian genotype E was present in the French blood donors. PC mutation was more common than BCP mutations in this study. As HBV infected blood donors were more often asymptomatic carriers, we could speculate that the G1896A mutation may favour the asymptomatic state, supporting previous observations.
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Affiliation(s)
- A Ducancelle
- Laboratoire de virologie, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
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Abgueguen P, Delbos V, Ducancelle A, Jomaa S, Fanello S, Pichard E. Venous thrombosis in immunocompetent patients with acute cytomegalovirus infection: a complication that may be underestimated. Clin Microbiol Infect 2010; 16:851-4. [DOI: 10.1111/j.1469-0691.2009.03022.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lunel-Fabiani F, Duburcq X, Levayer T, Descamps F, Maniez-Montreuil M, Pivert A, Ducancelle A, Pouzet A, Marant L, Clèment A, Duhamel D, Leirens Y, Margotteau F, Falcou-Briatte R, Heinen C, Bouniort F, Taskar S, Artus A, Woodrum D, Flecheux O. Multi-center evaluation of the hepatitis B surface antigen (HBsAg) assay and HbsAg confirmatory assay for the family of Access immunoassay systems. Clin Lab 2010; 56:281-290. [PMID: 20857892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Accurate detection of Hepatitis B Surface Antigen (HBsAg) is an important aid in the diagnosis of patients infected with the hepatitis B virus (HBV). A multi-center study was conducted to characterize the performance of the HBsAg assay on the family of Access immunoassay systems from Beckman Coulter. METHODS The Access HBsAg assay was characterized in a multi-center study and compared to the Abbott AxSYM* and PRISM* HBsAg assays. The bioMérieux VIDAS* assay was used to resolve discrepant results. Reproducibility studies (intra-assay, inter-assay and inter-lot) were performed with pooled serum samples (negative sample, close to cut off, low, medium and high positive samples). Analytical sensitivity, subtype and genotype detection were studied with various commercial panels (SFTS panel, WHO 80/549, WHO 00/588, Teragenix HBV Genotype panel). A panel of recombinant HBsAg mutant proteins was tested to investigate reactivity towards genetic mutations. Clinical sensitivity was verified with seroconversion panels and samples from subjects with known HBV infection. Analytical specificity was studied with samples from patients with potential cross-reactive infections. Clinical specificity was validated among blood donors and a hospitalized population. RESULTS The imprecision was < 10%. Analytical sensitivity was < or = 0.1 ng/mL (SFTS panel), 0.020 PEI Units/mL (ad panel), 0.024 PEI Units/mL (ay panel), 0.092 IU/mL with WHO 80/549 and 0.056 IU/mL with WHO 00/588. All genotype samples and HBsAg mutants were reactive with the Access HBsAg assay. Seroconversion panels tested showed no significant difference with the reference method. Sensitivity for subjects with known HBV infection was 100%. No interference with potentially cross-reactive infections was observed after confirmatory testing. Specificity was 99.96% (100% after confirmatory testing) in a blood donor population and 99.5% (100% after confirmatory testing) in a hospitalized population. Excellent separation of positive and negative populations was observed. CONCLUSIONS The Access HBsAg and HBsAg Confirmatory assays meet all clinical and analytical performance requirements of assays for the detection of HBsAg.
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Mansour W, Ducancelle A, Le Gal F, Le Guillou-Guillemette H, Abgueguen P, Pivert A, Calès P, Gordien E, Lunel F. Resolution of chronic hepatitis Delta after 1 year of combined therapy with pegylated interferon, tenofovir and emtricitabine. J Clin Virol 2009; 47:97-9. [PMID: 19914127 DOI: 10.1016/j.jcv.2009.09.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 09/22/2009] [Accepted: 09/24/2009] [Indexed: 12/18/2022]
Abstract
BACKGROUND Hepatitis Delta virus (HDV) Infection has a worldwide distribution, with approximately 20 millions infected persons. Interferon (IFN) is the only approved drug for the treatment of HDV infection which is still a difficult to treat disease. OBJECTIVES To report a successful treatment of a patient with a chronic severe hepatitis Delta using combination therapy with Pegylated interferon (PegIFN), Tenofovir disoproxil fumarate (TDF) and Emtricitabine (FTC). STUDY DESIGN The patient, a 47 years -old male patient, originating from Dagestan (East Asia), suffered of chronic hepatitis Delta infection. The patient was HBsAg, HBeAg, and anti-Delta Ab (IgG) positive. Serum HBV-DNA level was elevated (more than 9 log UI/mL). Serum HDV-RNA level was up to 5.6 log (copies/ml). Genotypes HBV/D and HDV-1 were demonstrated. The liver histology revealed chronic active hepatitis (Metavir score: A2F2). The treatment was started with PegIFN (180 microg/week) for two months and then TDF (300 mg/day) (combined later with FTC) was added. RESULTS Sustained response was obtained after 10 months of treatment and was accompanied by the clearance of serum hepatitis B virus surface antigen with seroconversion to anti-HBs. CONCLUSION This case report suggests that Delta infection may co-exist with high replicative HBV infection and that combination therapy with PegIFN and nucleoside/tide analogues seems to be more effective than IFN alone. Given that only a single case is reported, further studies including more patients are warranted.
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Affiliation(s)
- Wael Mansour
- Laboratoire HIFIH UPRES EA 3859, Faculté de Médecine d'Angers, France
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Ducancelle A, Hantz S, Legrand MC, Alain S, Beby-Defaux A, Malbois C, Avenel M, De Brux MA, Charles F, Aspeele F, Catala L, Descamps P, Postec E, Collet M, Agius G, Lunel F, Payan C. OP5-6 Evaluation of human papillomavirus (HPV) by quantification and typing in paired urine and cervical samples of women with abnormal cytology. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(09)70070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ducancelle A, Payan C, Nicand E, Le Guillou H, Calès P, Lunel-Fabiani F. Intrafamilial hepatitis E in France. J Clin Virol 2007; 39:51-3. [PMID: 17409020 DOI: 10.1016/j.jcv.2007.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 02/27/2007] [Indexed: 11/18/2022]
Affiliation(s)
- A Ducancelle
- Laboratoire de Bactériologie-Virologie, CHU Angers, Paris
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Pivert A, Ducancelle A, Levayer T, Descamps F, Maniez-Montreuil M, Artus A, Heinen C, Woodrum D, Lunel-Fabiani F. P1175 Multi-centre evaluation of a new hepatitis B surface antigen (HBsAg) assay on the family of Access® immunoassay systems. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71015-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Payan C, Ducancelle A, Aboubaker MH, Caer J, Tapia M, Chauvin A, Peyronnet D, Le Hen E, Arab Z, Legrand MC, Tran A, Postec E, Tourmen F, Avenel M, Malbois C, De Brux MA, Descamps P, Lunel F. Human papillomavirus quantification in urine and cervical samples by using the Mx4000 and LightCycler general real-time PCR systems. J Clin Microbiol 2007; 45:897-901. [PMID: 17229868 PMCID: PMC1829135 DOI: 10.1128/jcm.02022-06] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During the last decade, growing efforts have focused on human papillomavirus (HPV) detection using liquid hybridization, conventional PCR, and real-time PCR-based methods to increase the overall proportion of patients participating in cervical cancer screening procedures. We proposed a new general HPV DNA real-time PCR on the Mx4000 (Stratagene) and LightCycler (Roche Diagnostics) systems usable for both cervical scrape specimens and urine samples. A linear range was obtained from 5 DNA copies to 8 log(10) DNA copies/ml, and intra- and interassay variations were between 1.8 and 4%. Cervical carcinoma and HPV DNA screening was performed in 333 individual women referred for gynecological examination at the university hospitals of Angers and Brest and enrolled in the PapU study. Among cervical specimens (n = 333), 45% were positive for HPV DNA, with a mean viral load at 5.00 log/ml (+/- 1.73). Among urine samples (n = 177), 37% were positive with a significant 50-fold-lower mean viral load (3.77 +/- 1.32 log/ml; P < 0.0001). Kappa agreement for HPV DNA between cervical and urine specimens was excellent (93%). Thus, we developed a highly sensitive and quantitative general HPV DNA real-time PCR method that allows mass screening of patients with HPV infection. The ongoing longitudinal and prospective multicenter PapU study should give us the opportunity to validate this method adapted to HPV DNA screening in urine samples in a larger population.
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