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Ramière C, Charre C, Miailhes P, Bailly F, Radenne S, Uhres AC, Brochier C, Godinot M, Chiarello P, Pradat P, Cotte L, Augustin-Normand C, François B, Biron F, Boibieux A, Brochier C, Braun E, Brunel F, Charre C, Chiarello P, Chidiac C, Cotte L, Ferry T, Godinot M, Guillaud O, Koffi J, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Pradat P, Radenne S, Ramière C, Schlienger I, Scholtes C, Schuffenecker I, Tardy JC, Trabaud MA, Uhres AC. Patterns of Hepatitis C Virus Transmission in Human Immunodeficiency Virus (HIV)-infected and HIV-negative Men Who Have Sex With Men. Clin Infect Dis 2020; 69:2127-2135. [PMID: 30810158 DOI: 10.1093/cid/ciz160] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 09/11/2018] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sexually transmitted acute hepatitis C virus (HCV) infections (AHIs) have been mainly described in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Cases in HIV-negative MSM are scarce. We describe the epidemic of AHI in HIV-infected and HIV-negative MSM in Lyon, France. METHODS All cases of AHI diagnosed in MSM in Lyon University Hospital from 2014 to 2017 were included. AHI incidence was determined in HIV-infected and in preexposure prophylaxis (PrEP)-using MSM. Transmission clusters were identified by construction of phylogenetic trees based on HCV NS5B (genotype 1a/4d) or NS5A (genotype 3a) Sanger sequencing. RESULTS From 2014 to 2017, 108 AHIs (80 first infections, 28 reinfections) were reported in 96 MSM (HIV-infected, 72; HIV-negative, 24). AHI incidence rose from 1.1/100 person-years (95 confidence interval [CI], 0.7-1.7) in 2014 to 2.4/100 person-years (95 CI, 1.1-2.6) in 2017 in HIV-infected MSM (P = .05) and from 0.3/100 person-years (95 CI, 0.06-1.0) in 2016 to 3.4/100 person-years (95 CI, 2.0-5.5) in 2017 in PrEP users (P < .001). Eleven clusters were identified. All clusters included HIV-infected MSM; 6 also included HIV-negative MSM. All clusters started with ≥1 HIV-infected MSM. Risk factor distribution varied among clusters. CONCLUSIONS AHI incidence increased in both HIV-infected and HIV-negative MSM. Cluster analysis suggests initial transmission from HIV-infected to HIV-negative MSM through chemsex and traumatic sexual practices, leading to mixed patterns of transmission regardless of HIV status and no overlap with the general population.
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Affiliation(s)
- Christophe Ramière
- Virology Laboratory, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Centre International de Recherche en Infectiologie, INSERM, CNRS UMR, Lyon, France.,University of Lyon, Université Claude Bernard Lyon, Villeurbanne, France
| | - Caroline Charre
- Virology Laboratory, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,University of Lyon, Université Claude Bernard Lyon, Villeurbanne, France.,INSERM U1052, Lyon, France
| | - Patrick Miailhes
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - François Bailly
- Hepatology Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Sylvie Radenne
- Hepatology Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Anne-Claire Uhres
- Pharmacy, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Corinne Brochier
- Clinical Research Centre, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Matthieu Godinot
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Pierre Chiarello
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Pierre Pradat
- Clinical Research Centre, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Laurent Cotte
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,INSERM U1052, Lyon, France
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Virlogeux V, Pradat P, Hartig-Lavie K, Bailly F, Maynard M, Ouziel G, Poinsot D, Lebossé F, Ecochard M, Radenne S, Benmakhlouf S, Koffi J, Lack P, Scholtes C, Uhres AC, Ducerf C, Mabrut JY, Rode A, Levrero M, Combet C, Merle P, Zoulim F. Direct-acting antiviral therapy decreases hepatocellular carcinoma recurrence rate in cirrhotic patients with chronic hepatitis C. Liver Int 2017; 37:1122-1127. [PMID: 28423231 DOI: 10.1111/liv.13456] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 01/17/2017] [Accepted: 04/10/2017] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND AIMS Arrival of direct-acting antiviral agents against hepatitis C virus with high-sustained virological response rates and very few side effects has drastically changed the management of hepatitis C virus infection. The impact of direct-acting antiviral exposure on hepatocellular carcinoma recurrence after a first remission in patients with advanced fibrosis remains to be clarified. METHODS 68 consecutive hepatitis C virus patients with a first hepatocellular carcinoma diagnosis and under remission, subsequently treated or not with a direct-acting antiviral combination, were included. Clinical, biological and virological data were collected at first hepatocellular carcinoma diagnosis, at remission and during the surveillance period. RESULTS All patients were cirrhotic. Median age was 62 years and 76% of patients were male. Twenty-three patients (34%) were treated with direct-acting antivirals and 96% of them achieved sustained virological response. Median time between hepatocellular carcinoma remission and direct-acting antivirals initiation was 7.2 months (IQR: 3.6-13.5; range: 0.3-71.4) and median time between direct-acting antivirals start and hepatocellular carcinoma recurrence was 13.0 months (IQR: 9.2-19.6; range: 3.0-24.7). Recurrence rate was 1.7/100 person-months among treated patients vs 4.2/100 person-months among untreated patients (P=.008). In multivariate survival analysis, the hazard ratio for hepatocellular carcinoma recurrence after direct-acting antivirals exposure was 0.24 (95% confidence interval: 0.10-0.55; P<.001). CONCLUSIONS Hepatocellular carcinoma recurrence rate was significantly lower among patients treated with direct-acting antivirals compared with untreated patients. Given the potential impact of our observation, large-scale prospective cohort studies are needed to confirm these results.
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Affiliation(s)
- Victor Virlogeux
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Pradat
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Kerstin Hartig-Lavie
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - François Bailly
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Marianne Maynard
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Guillaume Ouziel
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Domitille Poinsot
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Fanny Lebossé
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Ecochard
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Sylvie Radenne
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Samir Benmakhlouf
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Joseph Koffi
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Lack
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Caroline Scholtes
- Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France.,Department of Virology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Anne-Claire Uhres
- Department of Pharmacology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Christian Ducerf
- Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France.,Department of General Surgery and Liver Transplantation, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Jean-Yves Mabrut
- Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France.,Department of General Surgery and Liver Transplantation, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Agnès Rode
- Department of Radiology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Massimo Levrero
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Christophe Combet
- Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Merle
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
| | - Fabien Zoulim
- Department of Hepatology, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, CNRS 5286, Inserm 1052, Université Claude Bernard Lyon 1, Lyon, France
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