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Besombes C, Mbrenga F, Malaka C, Gonofio E, Schaeffer L, Konamna X, Selekon B, Namsenei-Dankpea J, Gildas Lemon C, Landier J, von Platen C, Gessain A, Manuguerra JC, Fontanet A, Nakouné E. Investigation of a mpox outbreak in Central African Republic, 2021-2022. One Health 2023; 16:100523. [PMID: 36950196 PMCID: PMC9988319 DOI: 10.1016/j.onehlt.2023.100523] [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: 11/02/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Human monkeypox virus is spreading globally, and more information is required about its epidemiological and clinical disease characteristics in endemic countries. We report the investigation of an outbreak in November 2021 in Central African Republic (CAR). The primary case, a hunter, fell ill after contact with a non-human primate at the frontier between forest and savannah. The ensuing investigation in a small nearby town concerned two families and four waves of inter-human transmission, with 14 confirmed cases, 11 suspected cases and 17 non-infected contacts, and a secondary attack rate of 59.5% (25/42). Complications were observed in 12 of the 19 (63.2%) confirmed and suspected cases with available clinical follow-up data: eight cases of bronchopneumonia, two of severe dehydration, one corneal ulcer, one abscess, two cutaneous superinfections, and six cutaneous sequelae (cheloid scars, or depigmentation). There was one death, giving a case fatality ratio of 1/25 (4.0%) for confirmed and suspected cases. This outbreak, with the largest number of confirmed cases ever described in CAR, confirms the potential severity of the disease associated with clade I monkeypox viruses, and highlights the need for rapid control over virus circulation to prevent the further national and international spread of infection.
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Affiliation(s)
- C Besombes
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France
- Sorbonne Université, Paris, France
| | - F Mbrenga
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - C Malaka
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - E Gonofio
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - L Schaeffer
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France
| | - X Konamna
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - B Selekon
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - J Namsenei-Dankpea
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - C Gildas Lemon
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
| | - J Landier
- IRD, Aix Marseille Université, INSERM - SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - C von Platen
- Institut Pasteur Paris- Centre de Recherche Translationnelle- CC, France
| | - A Gessain
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France
- Université Paris Cité, CNRS UMR 3569 - Unité Épidémiologie et Physiopathologie des Virus Oncogènes, France
| | - J C Manuguerra
- Environment and Infectious Risk Research Unit, Laboratory for Urgent Response to Biological Threats (ERI-CIBU), France
| | - A Fontanet
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases, 75015 Paris, France
- Conservatoire National des Arts et Métiers, PACRI Unit, Paris, France
| | - E Nakouné
- Institut Pasteur, Bangui, République Centrafricaine - Department of Arboviruses, Emerging Viruses and zoonosis, Central African Republic
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Pomar L, Lambert V, Madec Y, Vouga M, Pomar C, Matheus S, Fontanet A, Panchaud A, Carles G, Baud D. Placental infection by Zika virus in French Guiana. Ultrasound Obstet Gynecol 2020; 56:740-748. [PMID: 31773804 DOI: 10.1002/uog.21936] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To describe placental findings on prenatal ultrasound and anatomopathological examination in women with Zika virus (ZIKV) infection, and to assess their association with congenital ZIKV infection and severe adverse outcome, defined as fetal loss or congenital Zika syndrome (CZS). METHODS This was a prospective study of pregnancies undergoing testing for maternal ZIKV infection at a center in French Guiana during the ZIKV epidemic. In ZIKV-positive women, congenital infection was defined as either a positive reverse transcription polymerase chain reaction result or identification of ZIKV-specific immunoglobulin-M in at least one placental, fetal or neonatal sample. Placental ZIKV-infection status was classified as non-exposed (placentae from non-infected women), exposed (placentae from ZIKV-infected women without congenital infection) or infected (placentae from ZIKV-infected women with proven congenital infection). Placentae were assessed by monthly prenatal ultrasound examinations, measuring placental thickness and umbilical artery Doppler parameters, and by anatomopathological examination after live birth or intrauterine death in women with ZIKV infection. The association of placental thickness during pregnancy and anatomopathological findings with the ZIKV status of the placenta was assessed. The association between placental findings and severe adverse outcome (CZS or fetal loss) in the infected group was also assessed. RESULTS Among 291 fetuses/neonates/placentae from women with proven ZIKV infection, congenital infection was confirmed in 76 cases, of which 16 resulted in CZS and 11 resulted in fetal loss. The 215 remaining placentae from ZIKV-positive women without evidence of congenital ZIKV infection represented the exposed group. A total of 334 placentae from ZIKV-negative pregnant women represented the non-exposed control group. Placentomegaly (placental thickness > 40 mm) was observed more frequently in infected placentae (39.5%) than in exposed placentae (17.2%) or controls (7.2%), even when adjusting for gestational age at diagnosis and comorbidities (adjusted hazard ratio (aHR), 2.02 (95% CI, 1.22-3.36) and aHR, 3.23 (95% CI, 1.86-5.61), respectively), and appeared earlier in infected placentae. In the infected group, placentomegaly was observed more frequently in cases of CZS (62.5%) or fetal loss (45.5%) than in those with asymptomatic congenital infection (30.6%) (aHR, 5.43 (95% CI, 2.17-13.56) and aHR, 4.95 (95% CI, 1.65-14.83), respectively). Abnormal umbilical artery Doppler was observed more frequently in cases of congenital infection resulting in fetal loss than in those with asymptomatic congenital infection (30.0% vs 6.1%; adjusted relative risk (aRR), 4.83 (95% CI, 1.09-20.64)). Infected placentae also exhibited a higher risk for any pathological anomaly than did exposed placentae (62.8% vs 21.6%; aRR, 2.60 (95% CI, 1.40-4.83)). CONCLUSIONS Early placentomegaly may represent the first sign of congenital infection in ZIKV-infected women, and should prompt enhanced follow-up of these pregnancies. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- L Pomar
- Materno-fetal and Obstetrics Research Unit, Department 'Femme-Mère-Enfant', University Hospital, Lausanne, Switzerland
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, France
| | - V Lambert
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, France
| | - Y Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - M Vouga
- Materno-fetal and Obstetrics Research Unit, Department 'Femme-Mère-Enfant', University Hospital, Lausanne, Switzerland
| | - C Pomar
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, France
| | - S Matheus
- Laboratory of Virology, National Reference Center for Arboviruses, Institut Pasteur, Cayenne; Environment and Infections Risks Unit, Institut Pasteur, Paris, France
| | - A Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | - A Panchaud
- Service of Pharmacy, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - G Carles
- Department of Obstetrics and Gynecology, Centre Hospitalier de l'Ouest Guyanais Franck Joly, Saint-Laurent-du-Maroni, France
| | - D Baud
- Materno-fetal and Obstetrics Research Unit, Department 'Femme-Mère-Enfant', University Hospital, Lausanne, Switzerland
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Bénézit F, Galmiche S, Jeanneau S, Scherpereel A, Fontanet A, Dinh A, Denis F, Lescure X. Intérêt d’une web application de triage médical dans la surveillance à l’échelle nationale de l’épidémie d’infections à SARS-Cov2. Med Mal Infect 2020. [PMCID: PMC7442059 DOI: 10.1016/j.medmal.2020.06.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction/Objectif La déclaration des cas d’infections à SARS-Cov-2 non graves a été initialement limitée par l’accès à la RT-PCR. Les données épidémiologiques en temps réel ont été fortement influencées par la situation hospitalière. Un triage médical par questionnaire internet est-il un outil d’estimation de la situation épidémiologique ? Matériels et méthodes Un questionnaire anonyme de 23 items à propos du terrain et des symptômes a été mis en place et publié sur le site maladiecoronavirus.fr. Les symptômes analysés étaient la fatigue, la toux, la fièvre, les courbatures, la dyspnée, l’anosmie, la diarrhée, les difficultés alimentaires. L’accès au questionnaire était libre, accessible depuis les moteurs de recherche internet habituels et évoqué dans certains médias grand public. Une analyse descriptive des questionnaires a été réalisée du 18 mars (au 3e jour de la date de publication du site internet), jusqu’au 12 juin 2020 inclus. Résultats Un total de 5 043 430 formulaires a été rempli intégralement dont 4 834 218 ayant une durée de saisie crédible de plus de 30 secondes (96 %). Sur les dates d’intérêt, 4 819 366 questionnaires ont été analysés. L’évolution des connexions correspond à un pic précoce, avec un maximum de questionnaire le 19/03/2020 (n = 971 939), une médiane de questionnaire quotidien de 9138 (IQR : 4263–19 986) et un nadir de 809 le 9 juin 2020 soit une décroissance de forme exponentielle. Les pics de déclaration quotidien par symptôme ont tous été le 22 mars en valeur absolue. A contrario, les pics de déclaration des symptômes en % de questionnaires quotidiens ont été respectivement pour la toux le 21/03 (43 %), la fièvre le 01/06 (37 %), l’anosmie le 23/03 (12 %), les courbatures le 07/06 (59 %), la diarrhée le 25/05 (29 %), la fatigue le 08/06 (54 %), les difficultés alimentaires le 25/05 (5 %). Le pourcentage d’utilisateurs déclarant une dyspnée au moindre effort présentait deux pics identique le 27/03 et le 05/04 (25 %). L’association toux + courbatures + fièvre et toux + dyspnée présentaient des pics respectifs le 04/04 (11 %) et le 27/03 (14 %). Seuls l’anosmie, la dyspnée, l’association toux + courbatures + fièvre et toux + dyspnée présentaient et un pic et une décroissance compatible avec l’évolution épidémique connue. Conclusion La faisabilité d’un recensement de symptômes anonymement à grande échelle est démontrée comme le montre le nombre de questionnaires obtenus. L’association des symptômes ou un symptôme plus spécifique comme l’anosmie ou la dyspnée semblent décrire une évolution compatible avec les données connues de l’épidémie.
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Chabrol A, Doumbia A, Tondeur L, Landman R, Fontanet A, Eholie S, Sylla B, Niyongabo T, Kakou A, Bouchaud O. Traitement par bithérapie orale de la cryptococcose méningée en Afrique : étude pilote avec fluconazole 1600mg et flucytosine (ANRS 12257). Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.063] [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]
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6
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Njouom R, Siffert I, Texier G, Lachenal G, Tejiokem MC, Pépin J, Fontanet A. The burden of hepatitis C virus in Cameroon: Spatial epidemiology and historical perspective. J Viral Hepat 2018. [PMID: 29533500 DOI: 10.1111/jvh.12894] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cameroon is thought to have one of the highest prevalences of hepatitis C virus (HCV) infection in the world (4.9% among adults). A marked cohort effect exists in several communities where ≈50% of the elderly are infected. Better assessment of HCV distribution is needed for planning treatment programmes. We tested for HCV antibodies 14 150 capillary blood samples collected during the 2011 Demographic and Health Survey, whose participants were representative of the Cameroonian population aged 15-49 (both genders) and 50-59 years (men only). Historical data on exposure to medical care were collected and factors associated with HCV assessed through logistic regression and geospatial analyses. To estimate prevalence in all persons aged ≥15 years, we used data from the survey for the 15-59 years fraction and modelled a cohort effect for older individuals. The nationwide HCV prevalence was 0.81% for the 15-49 years group, and 2.51% for all individuals aged ≥15 years. Only 0.2% of individuals aged 15-19 were seropositive. Among participants aged 15-44 years, HCV was associated with age, rural residence and, for males, with ritual circumcision. For those aged 45-59 years, HCV was associated with age and access to medical care in the late 1950s. Prevalence of HCV seropositivity in Cameroon is half of previous estimates. Nationwide surveys are essential to rationalize resources allocation. The high prevalence among older cohorts, a colonial legacy, has had little spillover into younger cohorts. HCV-free generations might be attainable in countries not plagued with intravenous drug abuse.
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Affiliation(s)
- R Njouom
- Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - I Siffert
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - G Texier
- Centre Pasteur du Cameroun, Yaoundé, Cameroon.,UMR VITROME, Aix Marseille Univ, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Marseille, France
| | | | | | - J Pépin
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | - A Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,Unité PACRI, Conservatoire National des Arts et Métiers, Paris, France
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Hoen B, Cabié A, Funk A, Herrmann C, Najioullah F, Schepers K, Douine M, Stegmann-Planchard S, Rousset D, Fontanet A. Issue des grossesses et anomalies congénitales dans une cohorte de 546 femmes enceintes ayant présenté une infection symptomatique à virus ZIKA (ZIKV) confirmée par PCR au cours de l’épidémie de Zika dans les territoires français d’Amérique (TFA). Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.056] [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: 11/25/2022]
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8
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El Kassas M, Funk AL, Salaheldin M, Shimakawa Y, Eltabbakh M, Jean K, El Tahan A, Sweedy AT, Afify S, Youssef NF, Esmat G, Fontanet A. Increased recurrence rates of hepatocellular carcinoma after DAA therapy in a hepatitis C-infected Egyptian cohort: A comparative analysis. J Viral Hepat 2018; 25:623-630. [PMID: 29274197 DOI: 10.1111/jvh.12854] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [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: 08/16/2017] [Accepted: 10/09/2017] [Indexed: 12/13/2022]
Abstract
In Egypt, hepatocellular carcinoma (HCC) is the most common form of cancer and direct-acting antivirals (DAA) are administered on a large scale to patients with chronic HCV infection to reduce the risk. In this unique setting, we aimed to determine the association of DAA exposure with early-phase HCC recurrence in patients with a history of HCV-related liver cancer. This was a prospective cohort study of an HCV-infected population from one Egyptian specialized HCC management centre starting from the time of successful HCC intervention. The incidence rates of HCC recurrence between DAA-exposed and nonexposed patients were compared, starting from date of HCC complete radiological response and censoring after 2 years. DAA exposure was treated as time varying. Two Poisson regressions models were used to control for potential differences in the exposed and nonexposed group; multivariable adjustment and balancing using inverse probability of treatment weighting (IPTW). We included 116 patients: 53 treated with DAAs and 63 not treated with DAAs. There was 37.7% and 25.4% recurrence in each group after a median of 16.0 and 23.0 months of follow-up, respectively. Poisson regression using IPTW demonstrated an association between DAAs and HCC recurrence with an incidence rate ratio of 3.83 (95% CI: 2.02-7.25), which was similar in the multivariable-adjusted model and various sensitivity analyses. These results add important evidence towards the possible role of DAAs in HCC recurrence and stress the need for further mechanistic studies and clinical trials to accurately confirm this role and to identify patient characteristics that may be associated with this event.
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Affiliation(s)
- M El Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - A L Funk
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
| | - M Salaheldin
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Y Shimakawa
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
| | - M Eltabbakh
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - K Jean
- Laboratoire MESuRS (EA 4628), Conservatoire National Des Arts et Métiers, Paris, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris, France
| | - A El Tahan
- New Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt
| | - A T Sweedy
- New Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt
| | - S Afify
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - N F Youssef
- Medical Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - G Esmat
- Endemic Medicine and Hepato-Gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Fontanet
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris, France
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9
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El Kassas M, Funk AL, Abd El Latif Y, Vasiliu A, Sherief A, Shimakawa Y, Youssef N, El Tahan A, Elbadry M, Farid AM, El Shazly Y, Doss W, Esmat G, Fontanet A. Letter: concordance of SVR4 and SVR12 following direct-acting anti-viral treatment in Egypt. Aliment Pharmacol Ther 2018; 47:1564-1566. [PMID: 29878419 DOI: 10.1111/apt.14628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M El Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - A L Funk
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
| | - Y Abd El Latif
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - A Vasiliu
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
| | - A Sherief
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Y Shimakawa
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France
| | - N Youssef
- Medical Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - A El Tahan
- New Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt
| | - M Elbadry
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Aswan University, Sahary City, Egypt
| | - A M Farid
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Y El Shazly
- Egyptian National Committee for Control of Viral Hepatitis, Cairo, Egypt
| | - W Doss
- Egyptian National Committee for Control of Viral Hepatitis, Cairo, Egypt
| | - G Esmat
- Egyptian National Committee for Control of Viral Hepatitis, Cairo, Egypt
| | - A Fontanet
- Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France.,Institut Pasteur, Conservatoire National des Arts et Métiers, Unité PACRI, Paris, France
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10
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Carpentier M, Gaete S, Herrmann C, Tressières B, Soubdhan-vingadassalom I, Lefèvre B, Schepers K, Deloumeaux J, Fontanet A, Hoen B. Cinétique des anticorps après infection aiguë à virus Zika (ZIKV) chez des femmes enceintes. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.087] [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: 10/14/2022]
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11
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Affiliation(s)
- T Dub
- Unit of Epidemiology of Emerging Diseases, Institut Pasteur, 25-28 rue du Docteur Roux, 75015 Paris, France
| | - A Fontanet
- Conservatoire National des Arts et Métiers (CNAM), Center for Global Health (CGH) and Unit of Epidemiology of Emerging Diseases, Institut Pasteur, 25-28 rue du Docteur Roux, 75015 Paris, France.
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12
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Riou J, Aït Ahmed M, Blake A, Vozlinsky S, Brichler S, Eholié S, Boëlle PY, Fontanet A. Hepatitis C virus seroprevalence in adults in Africa: a systematic review and meta-analysis. J Viral Hepat 2016; 23:244-55. [PMID: 26477881 DOI: 10.1111/jvh.12481] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [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: 08/18/2015] [Accepted: 08/27/2015] [Indexed: 12/13/2022]
Abstract
With the introduction of more efficient treatments for hepatitis C virus (HCV), improved epidemiological information is required at the country level to allow evidence-based policymaking for elaboration of national strategies and HCV resources planning. We present a systematic review with meta-analysis of HCV seroprevalence data in adults in African countries. We conducted a systematic review of all HCV seroprevalence estimates reported in African countries from 2000 to 2014 in MEDLINE, AJOL and grey literature. We assessed studies performed in the general population and among blood donors, pregnant women and HIV-positive patients. A meta-regression analysis was used to provide adjusted estimates of HCV seroprevalence in the general adult population in each country, accounting for the heterogeneity in sample age structure and population types in the included studies. We identified 775 national-level estimations, among which 184 were included. Estimates of HCV seroprevalence were produced for 38 countries, in addition to the results from nationwide representative surveys available in Egypt and Libya. Next to Egypt, which clearly stands out, the highest levels of seroprevalence were found in Middle Africa (e.g. Cameroon, Gabon and Angola) and some West African countries (e.g. Burkina Faso, Benin), and the largest absolute numbers of infected adults were found in Nigeria, Ethiopia and Democratic Republic of Congo. This study exposes the diversity of HCV epidemiology among African countries. Egypt and several countries of West and Middle Africa present a HCV burden that will require strong governmental commitment to promote efficient preventive and curative interventions.
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Affiliation(s)
- J Riou
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - M Aït Ahmed
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - A Blake
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - S Vozlinsky
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - S Brichler
- Service de Bactériologie, Virologie, Hygiène, laboratoire associé au Centre National de Référence des Hépatites B, C et Delta, Assitance Publique-Hôpitaux de Paris, Université, Sorbonne Paris Cité, Hôpital Avicenne, Bobigny, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - S Eholié
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - P-Y Boëlle
- Sorbonne Universités, Université Pierre et Marie Curie, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - A Fontanet
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France.,Conservatoire National des Arts et Métiers, Chaire Santé et Développement, Paris, France
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13
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Okasha O, Munier A, Delarocque-Astagneau E, El Houssinie M, Rafik M, Bassim H, Hamid MA, Mohamed MK, Fontanet A. Hepatitis C virus infection and risk factors in health-care workers at Ain Shams University Hospitals, Cairo, Egypt. East Mediterr Health J 2015; 21:199-212. [PMID: 26074220 DOI: 10.26719/2015.21.3.213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/22/2015] [Indexed: 11/09/2022]
Abstract
The objectives of this study were to document the background prevalence and incidence of HCV infection among HCWs in Ain Shams University Hospitals in Cairo and analyse the risk factors for HCV infection. A cross-sectional survey was conducted in 2008 among 1770 HCWs. Anti-HCV prevalence was age-standardized using the Cairo population. A prospective cohort was followed for a period of 18 months to estimate HCV incidence. The crude anti-HCV prevalence was 8.0% and the age-standardized seroprevalence was 8.1%. Risk factors independently associated with HCV seropositivity were: age, manual worker, history of blood transfusions and history of parenteral anti-schistosomiasis treatment. The estimated incidence of HCV infection was 7.3 per 1000 person-years. HCWs in this setting had a similar high HCV seroprevalence as the general population of greater Cairo.
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Affiliation(s)
- O Okasha
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - A Munier
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | | | - M El Houssinie
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M Rafik
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - H Bassim
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M Abdel Hamid
- Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.,Department of Microbiology, Faculty of Medicine, Minya University, Minya, Egypt
| | - M K Mohamed
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - A Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,Conservatoire National des Arts et Mériers, Paris, France
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14
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Okasha O, Munier A, Delarocque Astagneau E, El Houssinie M, Rafik M, Bassim H, Abdel Hamid M, Mohamed MK, Fontanet A. Hepatitis C virus infection and risk factors in health-care workers at Ain Shams University Hospitals, Cairo, Egypt. East Mediterr Health J 2015. [DOI: 10.26719/2015.21.3.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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15
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Bonnard P, Elsharkawy A, Zalata K, Delarocque-Astagneau E, Biard L, Le Fouler L, Hassan AB, Abdel-Hamid M, El-Daly M, Gamal ME, El Kassas M, Bedossa P, Carrat F, Fontanet A, Esmat G. Comparison of liver biopsy and noninvasive techniques for liver fibrosis assessment in patients infected with HCV-genotype 4 in Egypt. J Viral Hepat 2015; 22:245-53. [PMID: 25073725 DOI: 10.1111/jvh.12285] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 01/05/2014] [Accepted: 05/22/2014] [Indexed: 12/19/2022]
Abstract
In Egypt, as elsewhere, liver biopsy (LB) remains the gold standard to assess liver fibrosis in chronic hepatitis C (CHC) and is required to decide whether a treatment should be proposed. Many of its disadvantages have led to develop noninvasive methods to replace LB. These new methods should be evaluated in Egypt, where circulating virus genotype 4 (G4), increased body mass index and co-infection with schistosomiasis may interfere with liver fibrosis assessment. Egyptian CHC-infected patients with G4 underwent a LB, an elastometry measurement (Fibroscan(©)), and serum markers (APRI, Fib4 and Fibrotest(©)). Patients had to have a LB ≥15 mm length or ≥10 portal tracts with two pathologists blinded readings to be included in the analysis. Patients with hepatitis B virus co-infection were excluded. Three hundred and twelve patients are reported. The performance of each technique for distinguishing F0F1 vs F2F3F4 was compared. The area under receiver operating characteristic curves was 0.70, 0.76, 0.71 and 0.75 for APRI, Fib-4, Fibrotest© and Fibroscan©, respectively (no influence of schistosomiasis was noticed). An algorithm using the Fib4 for identifying patients with F2 stage or more reduced by nearly 90% the number of liver biopsies. Our results demonstrated that noninvasive techniques were feasible in Egypt, for CHC G4-infected patients. Because of its validity and its easiness to perform, we believe that Fib4 may be used to assess the F2 threshold, which decides whether treatment should be proposed or delayed.
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Affiliation(s)
- P Bonnard
- Infectious Diseases, Hôpital Tenon (AP-HP), Paris, France; Unité INSERM U707, UPMC, Paris, France
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16
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Obach D, Deuffic-Burban S, Esmat G, Anwar W, Dewedar S, Doss W, Fontanet A, Mohamed M, Yazdanpanah Y. Traitement immédiat ou différé chez les patients infectés par le VHC de génotype 4 dans un pays à ressources limitées : une analyse coût–efficacité en Égypte (ANRS 12215). Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.12.031] [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: 10/25/2022] Open
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17
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Breban R, Doss W, Esmat G, Elsayed M, Hellard M, Ayscue P, Albert M, Fontanet A, Mohamed MK. Quantifying current hepatitis C virus incidence in Egypt - Response to letter by Miller and Abu-Raddad. J Viral Hepat 2013; 20:668. [PMID: 23910653 DOI: 10.1111/jvh.12092] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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18
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Breban R, Doss W, Esmat G, Elsayed M, Hellard M, Ayscue P, Albert M, Fontanet A, Mohamed MK. Towards realistic estimates of HCV incidence in Egypt. J Viral Hepat 2013; 20:294-6. [PMID: 23490375 DOI: 10.1111/j.1365-2893.2012.01650.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 06/14/2012] [Indexed: 12/18/2022]
Abstract
Accurate incidence estimates are essential for quantifying hepatitis C virus (HCV) epidemic dynamics and monitoring the effectiveness of public health programmes, as well as for predicting future burden of disease and planning patient care. In Egypt, the country with the largest HCV epidemic worldwide, two modelling studies have estimated age-specific incidence rates that, applied to the age pyramid, would correspond to more than 500 000 Egyptians getting infected annually. This is in contrast to figures of the Egyptian Ministry of Health and Population that estimates new infections to be approximately 100 000 per year. We performed new analyses of nationwide data to examine the modelling assumptions that led to these estimates. Thus, we found that the key assumption of these models of a stationary epidemic is invalid. We propose an alternate approach to estimating incidence based on analysing cohort data; we find that the number of annual new infections is <150 000.
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Affiliation(s)
- R Breban
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France.
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19
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Abstract
Egypt is the country with the largest hepatitis C virus (HCV) epidemic in the world. In 2008, a Demographic Health Survey (DHS) was carried out in Egypt, providing for the first time a unique opportunity for HCV antibody testing on a nationwide representative sample of individuals. Consenting individuals answered a questionnaire on socio-demographic characteristics and iatrogenic exposures, before providing a blood sample for HCV antibody testing by enzyme-linked immunosorbent assay. Factors independently associated with HCV infection were examined through multivariate logistic regression models. Of 12 780 eligible subjects aged 15-59 years, 11 126 (87.1%) agreed to participate and provided a blood sample. HCV antibody prevalence nationwide was 14.7% (95% CI 13.9-15.5%) in this age group. HCV antibody prevalence gradually increased with age, reaching, in the 50-59 years age group, 46.3% and 30.8% in males and females, respectively. It was higher in males compared to females (17.4% versus 12.2%, respectively, P < 0.001), and in rural compared to urban areas (18.3% versus 10.3%, respectively, P < 0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti-schistosomiasis treatment, blood transfusion, and living outside of the Frontier Governorates were all significantly associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection. This study confirmed on a nationwide representative sample the very high HCV antibody prevalence in Egypt. It stresses the urgent need for strengthening prevention efforts, and bringing down the costs of antiviral drugs for countries like Egypt, where the people in the most precarious situations are also those most likely to be infected by the virus.
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Affiliation(s)
- J Guerra
- Institut Pasteur, Unité d'épidémiologie des maladies émergentes, Paris, France
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20
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Lefort A, Chartier L, Sendid B, Wolff M, Mainardi JL, Podglajen I, Desnos-Ollivier M, Fontanet A, Bretagne S, Lortholary O. Diagnosis, management and outcome of Candida endocarditis. Clin Microbiol Infect 2012; 18:E99-E109. [DOI: 10.1111/j.1469-0691.2012.03764.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [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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21
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Delarocque-Astagneau E, Abravanel F, Moshen A, Le Fouler L, Gad RR, El-Daly M, Ibrahim EM, El-Aidy S, Lashin T, El-Hoseiny M, Izopet J, Mohamed MK, Fontanet A, Abdel Hamid M. Epidemiological and virological characteristics of symptomatic acute hepatitis E in Greater Cairo, Egypt. Clin Microbiol Infect 2012; 18:982-8. [PMID: 22264267 DOI: 10.1111/j.1469-0691.2011.03727.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of the study was to describe the characteristics of acute hepatitis E in Greater Cairo. Patients with acute hepatitis E were identified through a surveillance of acute hepatitis using the following definition: recent (<3 weeks) onset of fever or jaundice, alanine aminotransferase at least three times the upper limit of normal (uln), negative markers for other causes of viral hepatitis and detectable hepatitis E virus (HEV) RNA. Comparison of the liver tests between acute hepatitis E and hepatitis A virus (HAV), case-control analysis (four sex-matched and age-matched (±1 year) HAV controls per case) to explore risk factors and phylogenetic analyses were performed. Of the 17 acute HEV patients identified between 2002 and 2007, 14 were male. Median age was 16 years (interquartile range 13-22). Compared with HAV (n = 68 sex-matched and ±1 year age-matched), HEV patients had higher bilirubin (mean (SD) 10.9 (5.7) uln versus 7.5 (4.4) uln, p 0.05) and aspartate aminotransferase levels (38.6 (27.1) uln versus 18.3 (18.1) uln, p 0.02). Co-infection (hepatitis C virus RNA or hepatitis B surface (HBs) -antigen positive/IgM anti-hepatitis B core (HBc) anitgen negative) was diagnosed in four patients. In univariate matched analysis (17 cases, 68 matched controls), HEV cases were more likely to live in a rural area than HAV controls (matched OR 7.9; 95% CI 2.0-30.4). Of the 16 isolates confirmed as genotype 1, 15 belonged to the same cluster with 94-98.5% identity in the open-reading frame 2 region. Our findings documented the sporadic nature of HEV in Greater Cairo, characterized a large number of Egyptian HEV genotype 1 strains and identified living in a rural area as a potential risk factor for infection.
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22
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Ceperuelo-Mallafré V, Escoté X, Viladés C, Peraire J, Domingo P, Solano E, Sirvent JJ, Pastor R, Tinahones F, Leal M, Richart C, Vendrell J, Vidal F, Alba V, Aguilar A, Auguet T, Chacón MR, López-Dupla M, Megia A, Miranda M, Olona M, Saurí A, Vargas M, Velasco I, Veloso S, Fontanet A, Gutiérrez M, Mateo G, Muñoz J, Sambeat MA. Zinc alpha-2 glycoprotein is implicated in dyslipidaemia in HIV-1-infected patients treated with antiretroviral drugs. HIV Med 2012; 13:297-303. [PMID: 22256965 DOI: 10.1111/j.1468-1293.2011.00976.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2011] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Treated HIV-1-infected patients with lipodystrophy often develop insulin resistance and proatherogenic dyslipidaemia. Zinc alpha-2 glycoprotein (ZAG) is a recently characterized adipokine which has been shown to be involved in the development of obesity and metabolic syndrome in uninfected subjects. We assessed the relationship between circulating ZAG levels and metabolic derangements in HIV-1-infected patients receiving antiretroviral drugs. METHODS Plasma ZAG levels were assessed in 222 individuals: 166 HIV-1-infected patients treated with antiretroviral drugs (77 with lipodystrophy and 89 without lipodystrophy) and 56 uninfected controls. Plasma ZAG levels were assessed by enzyme-linked immunosorbent assay (ELISA) and were correlated with fat distribution abnormalities and metabolic parameters. RESULTS HIV-1-infected patients had lower plasma ZAG levels compared with uninfected controls (P < 0.001). No differences were found in ZAG plasma levels according to the presence of lipodystrophy, components of the metabolic syndrome or type of antiretroviral treatment regimen. Circulating ZAG levels were strongly determined by high-density lipoprotein cholesterol (HDLc) in men (B = 0.644; P < 0.001) and showed a positive correlation with total cholesterol (r = 0.312; P < 0.001) and HDLc (r = 0.216; P = 0.005). CONCLUSIONS HIV-1-infected patients have lower plasma ZAG levels than uninfected controls. In infected patients, plasma ZAG levels are in close relationship with total cholesterol and HDLc.
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Affiliation(s)
- V Ceperuelo-Mallafré
- Joan XXIII University Hospital, IISPV, University Rovira i Virgili, Tarragona, Spain
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Saliba G, Kamouh W, Fontanet A, Le Bras J. Predictive factors of severe disease secondary to falciparum malaria among travelers. ACTA ACUST UNITED AC 2011; 59:230-3. [DOI: 10.1016/j.patbio.2010.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Accepted: 02/05/2010] [Indexed: 10/19/2022]
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24
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Vignier N, Esmat G, Elsharkawy A, Hassany M, Bonnard P, Delarocque-Astagneau E, Said M, Raafat R, El-Hoseiny M, Fontanet A, Mohamed MK, Vray M. Reproducibility of liver stiffness measurements in hepatitis C virus (HCV)-infected patients in Egypt. J Viral Hepat 2011; 18:e358-65. [PMID: 21692948 DOI: 10.1111/j.1365-2893.2010.01433.x] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Elastometry has demonstrated good accuracy, but little is known about its reproducibility. The aim of this study was to assess the intra- and inter-operator reproducibility of liver stiffness measurement among hepatitis C virus (HCV)-infected patients in Egypt. The study was conducted among HCV-infected patients referred for treatment evaluation in two hepatitis treatment centres of Cairo. Two operators took liver stiffness measurement two times per patient the same day. Intra- and inter-reproducibility were estimated by different methods: Bland and Altman graphics, variation coefficient, intraclass correlation coefficient and Kappa coefficient; 7.1 kPa was used as the threshold of significant (≥F2) fibrosis whenever needed. Fifty-eight patients were included in the study, and 216 measurements were taken. Failure rate was 7% and associated with overweight. For a value of 7.1 kPa, the inter-operator 95% limits of agreement were estimated at ±2.88 kPa. Intra- and inter-operator coefficients of variation ranged between 11% and 15%, intraclass correlation coefficients [95% confidence interval] between 0.94 [0.86-0.97] and 0.97 [0.95-0.99], and Kappa coefficients between 0.65 [0.44-0.88] and 0.92 [0.81-1.00]. The reliability of liver stiffness measurement is questionable when considering the decision to initiate antiviral therapy because of the percentage of discordance between measurements is notable, especially in the intermediate fibrosis stages.
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Affiliation(s)
- N Vignier
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
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25
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Fontanet A, Chalandon Y, Roosnek E, Mohty B, Passweg JR. Cotrimoxazole myelotoxicity in hematopoietic SCT recipients: time for reappraisal. Bone Marrow Transplant 2010; 46:1272-3. [DOI: 10.1038/bmt.2010.285] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Paez Jimenez A, Sharaf Eldin N, Rimlinger F, El-Daly M, El-Hariri H, El-Hoseiny M, Mohsen A, Mostafa A, Delarocque-Astagneau E, Abdel-Hamid M, Fontanet A, Mohamed MK, Thiers V. HCV iatrogenic and intrafamilial transmission in Greater Cairo, Egypt. Gut 2010; 59:1554-60. [PMID: 20947889 DOI: 10.1136/gut.2009.194266] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To document hepatitis C virus (HCV) intrafamilial transmission and assess its relative importance in comparison to other current modes of transmission in the country with the largest HCV epidemic in the world. HCV intrafamilial transmission was defined as HCV transmission among relatives living in the same household. DESIGN Case-control study. Cases were adult patients with acute hepatitis C diagnosed in two 'fever hospitals' of Cairo. Controls were adult patients with acute hepatitis A diagnosed in the same two hospitals, and family members of cases. All consenting household members of cases provided blood for HCV serological and RNA testing. Homology of viral sequences (NS5b region) within households was used to ascertain HCV intrafamilial transmission. Exposures at risk for HCV during the 1-6 months previous to onset of symptoms were assessed in all cases and controls. RESULTS From April 2002 to June 2007, 100 cases with acute hepatitis C, and 678 controls (416 household members and 262 patients with acute hepatitis A) were recruited in the study. Factors independently associated with HCV infection and their attributable fractions (AFs) were the following: having had a catheter (OR=5.0, 95% CI=1.4 to 17.8; AF=6.7%), an intravenous perfusion (OR=5.8, 95% CI=2.5 to 13.3; AF=20.1%), stitches (OR=2.0, 95% CI=1.3 to 6.6; AF=10.7%), gum treatment (OR=3.7, 95% CI=1.1 to 11.9; AF=3.8%) and being illiterate (OR=2.4, 95% CI=1.4 to 4.4). Of the 100 cases, 18 had viraemic HCV-infected household members. Three long-married (>15 years) couples were infected with virtually identical sequences and none of the three index patients reported any exposure at risk, suggesting HCV intra-familial transmission. CONCLUSION While three new HCV infections out of 100 could be linked to intra-familial transmission, parenteral iatrogenic transmission (dental care included) was accountable for 34.6% of these new infections. Thus, the relative contribution of intrafamilial transmission to HCV spread seems to be limited.
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Affiliation(s)
- A Paez Jimenez
- Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris Cedex 15, France
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27
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Lefort A, Chartier L, Podglajen I, Sendid B, Mainardi JL, Bretagne S, Fontanet A, Wolff M, Lortholary O. Étude nationale prospective sur les endocardites à Candida sp. (Mycendo). Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Lefrère JJ, Shiboski C, Fontanet A, Murphy EL. [Teaching transfusion medicine research in the francophone world]. Transfus Clin Biol 2009; 16:427-30. [PMID: 19640755 DOI: 10.1016/j.tracli.2009.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
Abstract
A two-week, French language, clinical research course in transfusion medicine has recently been created at the Pasteur Institute in Paris under the joint leadership of faculty members from the University of California San Francisco (UCSF), the Blood Systems Research Institute (BSRI) and the National Institute of Transfusion of Paris. The goal is to train transfusion professionals from the developing world to conduct clinical research that will contribute to improving the quality of care and safety in transfusion practices in their respective countries. The course provides training on clinical and epidemiological research methods and their potential applications in transfusion medicine. As part of the course, each student develops a study protocol that can be implemented in his/her blood center of hospital.
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Affiliation(s)
- J-J Lefrère
- Institut national de la transfusion sanguine, 6, rue Alexandre-Cabanel, 75015 Paris, France.
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Jimenez AP, El-Din NS, El-Hoseiny M, El-Daly M, Abdel-Hamid M, El Aidi S, Sultan Y, El-Sayed N, Mohamed MK, Fontanet A. Community transmission of hepatitis B virus in Egypt: results from a case-control study in Greater Cairo. Int J Epidemiol 2009; 38:757-65. [DOI: 10.1093/ije/dyp194] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Plancoulaine S, Mohamed MK, Arafa N, Bakr I, Rekacewicz C, Trégouët DA, Obach D, El Daly M, Thiers V, Féray C, Abdel-Hamid M, Abel L, Fontanet A. Dissection of familial correlations in hepatitis C virus (HCV) seroprevalence suggests intrafamilial viral transmission and genetic predisposition to infection. Gut 2008; 57:1268-74. [PMID: 18480169 DOI: 10.1136/gut.2007.140681] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Unsafe injections and transfusions used during treatments are considered to be responsible for many cases of transmission of hepatitis C virus (HCV) in developing countries, but cannot account for a substantial proportion of present infections. The aim of the present work was to investigate familial clustering of HCV infection in a population living in a highly endemic area. DESIGN, SETTING AND PARTICIPANTS A large seroepidemiological survey was conducted on 3994 subjects (age range, 2-88 years) from 475 familial clusters in an Egyptian rural area. Epidemiological methods appropriate for the analysis of correlated data were used to estimate risk factors and familial dependences for HCV infection. A phylogenetic analysis was conducted to investigate HCV strain similarities within and among families. MAIN OUTCOME MEASURES HCV familial correlations adjusted for known risk factors, similarities between viral strains. RESULTS Overall HCV seroprevalence was 12.3%, increasing with age. After adjustment for relevant risk factors, highly significant intrafamilial resemblances in HCV seroprevalence were obtained between father-offspring (odds ratio (OR) = 3.4 (95% confidence interval (CI), 1.8 to 6.2)), mother-offspring (OR = 3.8 (95% CI, 2.5 to 5.8)), and sibling-sibling (OR = 9.3 (95% CI, 4.9 to 17.6)), while a weaker dependence between spouses (OR = 2.2 (95% CI, 1.3 to 3.7)) was observed. Phylogenetic analysis showed greater HCV strain similarity between family members than between unrelated subjects, indicating that correlations can be explained, in part, by familial sources of virus transmission. In addition, refined dissection of correlations between first-degree relatives supported the role of host genes predisposing to HCV infection. CONCLUSIONS Current HCV infection in endemic countries has a strong familial component explained, at least partly, by specific modes of intrafamilial viral transmission and by genetic predisposition to infection.
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Affiliation(s)
- S Plancoulaine
- INSERM U550, Laboratoire de Génétique Humaine des Maladies Infectieuses, Faculté de Médecine Necker, 156 rue de Vaugirard, 75015 Paris, France.
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Peraire J, Miró O, Saumoy M, Domingo P, Pedrol E, Villarroya F, Martínez E, López-Dupla M, Garrabou G, Sambeat MA, Deig E, Villarroya J, Chacón MR, López S, Fontanet A, Holmstrom M, Giralt M, Gatell JM, Vidal F. HIV-1-infected long-term non-progressors have milder mitochondrial impairment and lower mitochondrially-driven apoptosis in peripheral blood mononuclear cells than typical progressors. Curr HIV Res 2007; 5:467-73. [PMID: 17896966 DOI: 10.2174/157016207781662452] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [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: 11/22/2022]
Abstract
Mitochondrial parameters in peripheral blood mononuclear cells (PBMC) and their relationship with mitochondrially-driven PBMC apoptosis were investigated in a group of HIV-1-infected long-term nonprogressors (LTNP) and compared with untreated asymptomatic HIV-1 infected typical progressors (TP) and uninfected healthy controls (HC). Twenty-six LTNP, 27 TP and 31 HC were evaluated. Studies were performed in PBMCs. Mitochondrial DNA content (mtDNA) was assessed by quantitative real-time PCR. Activities of mitochondrial respiratory chain complexes (MRC) II, III and IV were determined by spectrophotometry. Caspase-3 activity was assessed by fluorimetry, and caspase-9 activation and Bcl-2 levels were assessed by immunoblotting. mtDNA abundance (p<0.05), MRC complex II (p<0.001), complex III (p<0.01) and complex IV (p=0.01) were lower in the TP group than in the HC group. In the LTNP group these parameters were similar to those of the HC group except for complex II, which was decreased (p<0.01). The PBMC of TP showed the highest overall apoptotic activation, since their caspase-3 activity was greater than that of HC (p<0.05) and LTNP. In the case of LTNP, however, the difference was non-significant. Caspase-9 and the caspase-9/Bcl-2 ratio were both over-expressed in TP compared to HC (p<0.01) and LTNP (p<0.05). Both of these measurements indicate that mitochondrially-driven apoptosis in TP is greater than in LTNP and HC. A relationship between mitochondrial damage and apoptotic activation was found in TP. Mitochondrial damage is associated with increased PBMC apoptosis in patients with active HIV-1 replication (TP). These abnormalities are slight or not present in LTNP.
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Affiliation(s)
- Joaquim Peraire
- Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
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Marzouk D, Sass J, Bakr I, El Hosseiny M, Abdel-Hamid M, Rekacewicz C, Chaturvedi N, Mohamed MK, Fontanet A. Metabolic and cardiovascular risk profiles and hepatitis C virus infection in rural Egypt. Gut 2007; 56:1105-10. [PMID: 16956918 PMCID: PMC1955512 DOI: 10.1136/gut.2006.091983] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS To investigate the relationship between lipid profiles and diabetes with past and chronic hepatitis C virus (HCV) infection among village residents of Egypt. PATIENTS AND METHODS Fasting lipids and glucose profiles were compared among adults never infected with HCV (negative HCV antibodies), infected in the past (positive HCV antibodies and negative HCV RNA) and chronically infected (positive HCV antibodies and HCV RNA). RESULTS Of the 765 participants, 456 (59.6%) were female, and median age was 40 (range 25-88) years. Chronic HCV infection was present in 113 (14.8%) and past infection in 67 (8.8%). After adjustment for age and sex, participants with chronic HCV infection had lower plasma low density lipoproteins (LDL) cholesterol and triglyceride levels compared with those never infected (age and sex adjusted differences (95% CI) were -19.0 (-26.3 to -11.7) mg/dl and -26.2 (-39.0 to -13.3) mg/dl, respectively). In contrast, participants with cleared HCV infection had higher triglyceride levels compared with those never infected (age and sex adjusted difference (95% CI) was +16.0 (0.03 to 31.9) mg/dl). In multivariate analysis, participants with chronic HCV infection were more likely to have diabetes (OR 3.05, 95% CI 1.19 to 7.81) compared with those never infected, independent of LDL cholesterol levels. CONCLUSION In conclusion, this community based study has shown that in a single population, chronic HCV infection is associated with glucose intolerance and, despite that, a favourable lipid pattern. An intriguing finding was the high triglyceride levels observed among participants with past infection, suggesting that elevated triglycerides at the time of acute infection may facilitate viral clearance.
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Affiliation(s)
- D Marzouk
- Department of Community, Environmental and Occupational Medicine, Ain Shams University, Cairo, Egypt
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Fontanet A. [Cross-species transmission and emerging viral infections]. Virologie (Montrouge) 2006; 10:251-253. [PMID: 34731990 DOI: 10.1684/vir.2011.7060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- A Fontanet
- Unité d'épidémiologie des maladies émergentes, Institut Pasteur, 25 rue du Docteur-Roux, 75015 Paris
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Bakr I, Rekacewicz C, El Hosseiny M, Ismail S, El Daly M, El-Kafrawy S, Esmat G, Hamid MA, Mohamed MK, Fontanet A. Higher clearance of hepatitis C virus infection in females compared with males. Gut 2006; 55:1183-7. [PMID: 16434426 PMCID: PMC1856273 DOI: 10.1136/gut.2005.078147] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS According to the literature, 14-46% of subjects clear hepatitis C virus (HCV) from blood after infection. Controversy exists about sex differences in HCV clearance rates. PATIENTS AND METHODS We compared HCV clearance in males and females using data from a large population based study on HCV infection in Egypt. Definitions used in the paper were: cleared HCV infection (positive HCV antibody and negative HCV RNA test results) and chronic HCV infection (positive HCV antibody and positive HCV RNA test results). The study sample included 4720 village residents aged 18-65 years recruited through home based visits (n = 2425) or voluntary screening (n = 2295). RESULTS Overall, HCV antibody prevalence was 910/4720 (19.3% (95% confidence interval 18.2-20.4)). Of those with HCV antibodies (n = 910), 61.5% had chronic HCV infection. Compared with males, females were more likely to have cleared the virus (44.6% v 33.7%, respectively; p = 0.001). Control for age, schistosomiasis history, iatrogenic exposures, and sexual exposure to HCV did not alter the positive association between female sex and viral clearance. CONCLUSION This study provides strong evidence in favour of a higher HCV clearance rate in females compared with males.
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Affiliation(s)
- I Bakr
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Colle JH, Moreau JL, Fontanet A, Lambotte O, Joussemet M, Delfraissy JF, Thèze J. CD127 expression and regulation are altered in the memory CD8 T cells of HIV-infected patients--reversal by highly active anti-retroviral therapy (HAART). Clin Exp Immunol 2006; 143:398-403. [PMID: 16487237 PMCID: PMC1809599 DOI: 10.1111/j.1365-2249.2006.03022.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [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: 11/30/2022] Open
Abstract
HIV infection activates abnormally the immune system and the chronic phase is accompanied by marked alterations in the CD8 compartment. The expression of CD127 (IL-7R alpha chain) by memory CD8 T lymphocytes in HIV-infected patients is analysed and reported. The memory CD8 T cell subset was characterized by expression of CD45RA and CD27 markers, and CD127 cell surface expression was measured ex vivo by four-colour flow cytometry. HIV infection was associated with a fall in the proportion of CD127(+) cells among memory CD8 lymphocytes that resulted in a higher CD127(-) CD45RA(-)CD27(+) CD8 T cell count in HIV-infected patients. Diminished CD127 cell surface expression [mean fluorescence intensity (MFI)] by positive cells was also observed in this subset. The data suggest that these defects were reversed by highly active anti-retroviral therapy (HAART). The regulation of CD127 expression was also studied in vitro. Down-regulation of CD127 by interleukin (IL)-7 was observed in memory CD8 lymphocytes from healthy donors and HAART patients. Expression of CD127 by memory CD8 lymphocytes cultured in the absence of IL-7 confirmed that IL-7R regulation is altered in viraemic patients. Under the same experimental conditions, memory CD8 lymphocytes from HAART patients were shown to express CD127 at levels comparable to cells from healthy individuals. Altered CD127 cell surface expression and defective CD127 regulation in the memory CD8 T lymphocytes of HIV-infected patients are potential mechanisms by which these cells may be impeded in their physiological response to endogenous IL-7 stimulatory signals. Our data suggest that these defects are reversed during the immune reconstitution that follows HAART.
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Affiliation(s)
- J-H Colle
- Unité Immunogénétique Cellulaire, Département de Médecine Moléculaire, Institut Pasteur, 25-28 rue du Dr. Roux, 75724 Paris Cedex 15, France
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Vidal F, Peraire J, Domingo P, Broch M, Cairó M, Pedrol E, Montero M, Viladés C, Gutiérrez C, Sambeat MA, Fontanet A, Dalmau D, Deig E, Knobel H, Sirvent JJ, Richart C, Veloso S, Saumoy M, López-Dupla M, Olona M, Cadafalch J, Fuster M, Ochoa A, Soler A, Guelar A, González J. Polymorphism of RANTES chemokine gene promoter is not associated with long-term nonprogressive HIV-1 infection of more than 16 years. J Acquir Immune Defic Syndr 2006; 41:17-22. [PMID: 16340468 DOI: 10.1097/01.qai.0000188335.86466.ea] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 11/26/2022]
Abstract
To examine whether polymorphisms of the RANTES chemokine gene promoter are associated with long-term nonprogressive HIV-1 infection in white Spanish subjects, we performed a cross-sectional genetic association case-control study. Two-hundred sixty-seven white Spaniards were studied: 58 were HIV-1-infected long-term nonprogressors (LTNPs) of more than 16 years, 109 were HIV-1-infected usual progressors (UPs), and 100 were control subjects. Three RANTES single nucleotide polymorphisms (SNPs) at positions -28C>G, -109T>C, and -403G>A were assessed. The prevalence of the CCR5Delta 32 allele was also examined. Genotyping was performed using polymerase chain reaction and automatic sequencing analysis methods. Genotype and allele frequencies between the 3 groups were compared by the chi2 test and the Fisher exact test. The distribution of allelic variants of RANTES in controls, UPs, and LTNPs, respectively, was 3%, 2%, and 5% for -28G; 4%, 2%, and 2% for -109C; and 18%, 18%, and 18% for -403A (P = not significant). The differences were still nonsignificant when we exclusively analyzed individuals not carrying the CCR5Delta32 allele. We conclude that LTNP of more than 16 years is not associated with SNPs in the RANTES gene promoter in white Spanish HIV-1-infected subjects.
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Affiliation(s)
- Francesc Vidal
- Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.
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Vidal F, Viladés C, Domingo P, Broch M, Pedrol E, Dalmau D, Knobel H, Peraire J, Gutiérrez C, Sambeat MA, Fontanet A, Deig E, Cairó M, Montero M, Richart C, Mallal S. Spanish HIV-1-infected long-term nonprogressors of more than 15 years have an increased frequency of the CX3CR1 249I variant allele. J Acquir Immune Defic Syndr 2006; 40:527-31. [PMID: 16284527 DOI: 10.1097/01.qai.0000186362.50457.e0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [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: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The influence of the polymorphisms of the CX3CR1 chemokine receptor gene on the natural history of HIV-1 infection is controversial. This study aimed to determine whether functionally active CX3CR1 genetic variants are associated with long-term nonprogressive infection of >15 years in HIV-1-infected Spanish patients. PATIENTS AND METHODS Two single-nucleotide polymorphisms, V249I (G > A) and T280M (C > T), of the CX3CR1 gene were assessed in 271 Spaniards. These included 60 HIV-1-infected patients who were long-term nonprogressors (LTNPs) of >15 years, 109 HIV-1-infected patients who were usual progressors (UPs), and 102 control subjects. The CCR5Delta32 was also assessed. Genotyping was performed using polymerase chain reaction and automatic sequencing analysis methods on white cell DNA. Genotype and allele frequencies were compared by the chi test and the Fisher exact test. RESULTS The frequencies of the 249I variant allele were 42% for LTNPs, 24.5% for UPs, and 35% for healthy controls; the differences between LTNPs and UPs were significant (odds ratio 0.46; 95% CI: 0.27 to 0.75; P = 0.0017). For 280M the distribution was 16% for LTNPs, 14% for UPs, and 17% for healthy controls (P = NS). The haplotype 249I280T was significantly more common in LTNPs than in UPs (P = 0.0007). These results persisted after excluding from the analysis the individuals carrying the CCR5Delta32. CONCLUSIONS CX3CR1 249I variant allele is more frequent in Spanish HIV-1-infected LTNPs of >15 years. This effect is independent of the presence of the CCR5Delta32 allele.
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Affiliation(s)
- Francesc Vidal
- Hospital Universitari de Tarragona Joan XXIII and Universitat Rovira i Virgili, Tarragona, Catalonia, Spain.
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Ismail S, Mohamed M, Mansour H, Rekacewicz C, Gad R, El-Houssinie M, Sharaf El-Din N, El-Daly M, El-Kafrawy S, Abdel-Hamid M, Pol S, Fontanet A, Esmat G. P.244 Pegylated interferon alpha-2a for treatment of acute hepatitis C in Egypt (ANRS 1213 trial). J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80424-5] [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: 10/24/2022]
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Sharaf El-Din N, Rekacewicz C, Ismail S, Mansour H, El-Gafary M, El-Houssinie M, El-Daly M, El-Kafrawy S, Abdel-Hamid M, Mohamed M, Fontanet A. P.225 Spontaneous viral clearance in patients with acute hepatitis C in Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80405-1] [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: 11/25/2022]
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40
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Marzouk D, Sass J, Mohamed M, Bakr I, El-Houssinie M, Abdel-Hamid M, Rekacewicz C, Chaturvedi N, Fontanet A. P.205 Association between HCV infection and cardio-vascular risk factors in rural Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80385-9] [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: 10/24/2022]
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41
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Esmat G, ElMakhzangy H, Males S, Gad R, Rekacewicz C, Ismail S, Abdel-Hamid M, El-Daly M, Pol S, Fontanet A, Mohamed M. P.247 Prediction of treatment outcome in genotype 4 chronic hepatitis C patients during combined pegylated interferon alpha-2a and ribavirin therapy (ANRS 1211 trial). J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80427-0] [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: 11/24/2022]
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El-Daly M, Abdel Hamid M, El-Kafrawy S, Fontanet A, Rekacewicz C, Rimlinger F, Mohamed M, Thiers V. P.219 Phylogeny of HCV in a rural village of Egypt: intrafamilial comparison of sequences. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80399-9] [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: 10/24/2022]
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Mohamed M, Bakr I, El-Houssinie M, Arafa N, Hassan A, Ismail S, Anwar M, Attala M, Rekacewicz C, Zalata K, Abdel Hamid M, Esmat G, Fontanet A. P.226 HCV-related morbidity in a rural community of Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80406-3] [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: 10/24/2022]
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44
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Plancoulaine S, Mohamed M, Arafa N, Bakr I, Rekacewicz C, Obach D, Abdel-Hamid M, Abel L, Fontanet A. O.144 Intra-familial transmission of HCV infection in a rural area from Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80138-1] [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: 11/28/2022]
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45
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Eyob G, Guebrexabher H, Lemma E, Wolday D, Gebeyehu M, Abate G, Rigouts L, van Soolingen D, Fontanet A, Sanders E, Dorigo-Zetsma JW. Drug susceptibility of Mycobacterium tuberculosis in HIV-infected and -uninfected Ethiopians and its impact on outcome after 24 months of follow-up. Int J Tuberc Lung Dis 2004; 8:1388-91. [PMID: 15581212] [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: 05/01/2023] Open
Abstract
From a prospective cohort study on tuberculosis/human immunodeficiency virus (TB/HIV) interaction in Addis Ababa, Ethiopia, drug susceptibility results were available for 94 TB patients (46% HIV-infected). Resistance to one or more drug(s) was detected in 21 (22.3%) and multidrug resistance in five (5.3%) patients. Occurrence of resistance was not related to HIV status or outcome after 24 months of follow-up. However, among HIV-infected TB patients who died during follow-up, survival time in those with a resistant Mycobacterium tuberculosis strain was significantly shorter compared to those with a sensitive strain (6 vs. 13 months). Early detection of drug resistance and timely treatment change can therefore have a positive impact on survival in HIV-infected TB patients.
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Affiliation(s)
- G Eyob
- Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia
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46
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Sahlu T, de Wit TR, Tsegaye A, Mekonnen Y, Beyene A, Hailu B, Coutinho RA, Fontanet A. Low incidence of syphilis among factory workers in Ethiopia: effect of an intervention based on education and counselling. Sex Transm Infect 2002; 78:123-6. [PMID: 12081173 PMCID: PMC1744445 DOI: 10.1136/sti.78.2.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/03/2022] Open
Abstract
BACKGROUND The prevalence and incidence of syphilis infection were examined in a cohort study of factory workers in Ethiopia. METHOD Between February 1997 and March 1999, 409 men and 348 women were enrolled and followed in the cohort study. RESULTS The prevalence (95% CI) of past/current syphilis (positive TPPA serology) was 28.9% (25.7% to 32.3%), and factors associated with past/current syphilis were markers of risky sexual behaviours including HIV infection. In this cohort of factory workers subject to public information/education meetings, testing for HIV antibodies, and individual counselling, the incidence (97.5% one sided CI) of new syphilis infections was 0/691 = 0 (0 to 0.5) per 100 person years. CONCLUSION This study has documented a reduction in risky sexual behaviours and a low syphilis incidence among factory workers participating in a cohort study on HIV infection progression in Addis Ababa.
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Affiliation(s)
- T Sahlu
- Ethio-Netherlands AIDS Research Project, Ethiopian Health and Nutrition Research, Addis Ababa
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47
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Eyob G, Gebeyhu M, Goshu S, Girma M, Lemma E, Fontanet A. Increase in tuberculosis incidence among the staff working at the Tuberculosis Demonstration and Training Centre in Addis Ababa, Ethiopia: a retrospective cohort study (1989-1998). Int J Tuberc Lung Dis 2002; 6:85-8. [PMID: 11931406] [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: 02/24/2023] Open
Abstract
The incidence rate of tuberculosis was studied among the staff of the Tuberculosis Demonstration and Training Centre (TDTC) of Addis Ababa between 1989 and 1998, by reviewing all clinical charts of the 175 staff members for evidence of tuberculosis. During the study period, 24 cases of tuberculosis were diagnosed, including 12 who were bacteriologically confirmed. The incidence rate of tuberculosis increased from 1695 per 100000 person-years (py) in 1989 to 5556/100000 py in 1998 (test for trend, P < 0.001). Urgent measures are required for better protection of the staff from human immunodeficiency virus infection and tuberculosis.
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Affiliation(s)
- G Eyob
- Tuberculosis Demonstration and Training Center (TDTC), Addis Ababa, Ethiopia
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Aklilu M, Messele T, Tsegaye A, Biru T, Mariam DH, van Benthem B, Coutinho R, Rinke de Wit T, Fontanet A. Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia. AIDS 2001; 15:87-96. [PMID: 11192872 DOI: 10.1097/00002030-200101050-00013] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [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: 11/25/2022]
Abstract
OBJECTIVE To study the prevalence and risk factors for HIV infection among sex workers of Addis Ababa, Ethiopia. DESIGN AND METHODS Cross-sectional survey on socio-demographic characteristics, behaviours, and HIV serological status of sex workers attending two health centres of Addis Ababa. RESULTS HIV prevalence among sex workers was 274 of 372 (73.7%). Several factors were significantly associated with an increased risk of being HIV-infected [among others, working in 'shared rooms', high number of clients, use of injectable hormones, and positive Treponema pallidum particle agglutination (TPPA) serology], and others with a decreased risk (being born in Addis Ababa, high level of education, peer education on sex work, condom use, use of oral pill, and use of condoms for contraception). Of interest, sex workers who were using condoms for contraception were, compared with others, more likely to use condoms consistently (65 versus 24%, respectively; P < 0.001), and less likely to be HIV-infected (55 versus 86%, respectively; P < 0.001). In multivariate analysis [log-binomial model, giving estimates of the prevalence ratio (PR)], being born in Addis Ababa (PR = 0.74; 95% confidence interval (CI), 0.61-0.91), using condoms for contraception (PR = 0.73; 95% CI, 0.64-0.85), and a positive TPPA serology (PR = 1.21; 95% CI, 1.09-1.36), remained significantly associated with HIV infection. CONCLUSIONS HIV prevalence was remarkably high among sex workers of Addis Ababa. Condom use was higher, and HIV prevalence lower, in sex workers using condoms not only for prevention of HIV and sexually transmitted diseases, but also for contraceptive purpose. This finding is of particular interest for its implications for prevention strategies among sex workers in the developing world.
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Affiliation(s)
- M Aklilu
- Department of Community Health, Faculty of Medicine, Addis Ababa University, Ethiopa
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Abstract
Morbidity associated with totally implantable ports is common in patients with acquired immune deficiency syndrome (AIDS). More than half of the implanted devices will have at least one complication before its removal or the patient's death. Infectious complications are the most frequent. Two patients are reported here in whom staphylococcal infection of the totally implantable port occurred; one of the devices could be saved through the antibiotic lock technique. Infectious complications of totally implantable ports occur more commonly in patients who are neutropenic or who have low CD4 cell counts (<25 cells per microliter). When patients have chamber infection (the most frequent infectious complication) with or without secondary bacteremia, the antibiotic lock technique has proven useful for device sterilization.
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Affiliation(s)
- P Domingo
- Department of Internal Medicine (Infectious Diseases Unit), Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
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Bouchaud O, Muanza K, Le Bras J, Fontanet A, Danis M, Scott T, Goetschel A, Le Bras M, Chulay JD, Coulaud JP, Gentilini M, Monlun E. Atovaquone plus proguanil versus halofantrine for the treatment of imported acute uncomplicated Plasmodium falciparum malaria in non-immune adults: a randomized comparative trial. Am J Trop Med Hyg 2000. [DOI: 10.4269/ajtmh.2000.63.274] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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