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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Couffignal C, Kolta S, Flamant M, Cazanave C, Haymann JP, Mentré F, Duval X, Leport C, Raffi F, Chêne G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vézinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Hardel L, Reboud P, Couffin-Cadiergues S, Marchand L, Assuied A, Carrieri P, Habak S, Couturier F, Jadand C, Perrier A, Préau M, Protopopescu C, Schmit J, Chennebault J, Faller J, Magy-Bertrand N, Chirouze C, Humbert P, Longy-Boursier, Neau D, Granier P, Ansart S, Verdon R, Merrien D, Chevojon P, Sobel A, Levy Y, Piroth L, Perronne C, Froguel E, Ceccaldi J, Chidiac C, Grégoire V, Reynes J, Fuzibet JG, Arsac P, Bouvet E, Bricaire F, Monsonego J, Girard P, Guillevin L, Herson S, Molina J, Pialoux G, Sain O, Sellier P, Roblot F, Bani-Sadr F, Michelet C, Lucht F, Debord C, Martin T, De Jaureguiberry J, Bernard L. Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy. AIDS Res Hum Retroviruses 2020; 36:399-405. [PMID: 31891665 DOI: 10.1089/aid.2019.0229] [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] [Indexed: 11/13/2022] Open
Abstract
We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm3. Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score (p = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.
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Affiliation(s)
- Camille Couffignal
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Sami Kolta
- Department of Rheumatology, University Hospital Cochin, Assistance Publique–Hôpitaux de Paris, INSERM UMR-1153, Paris, France
| | - Martin Flamant
- Department of Physiology, University Hospital Bichat, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Charles Cazanave
- Infectious Diseases Department, University Hospital Bordeaux, Bordeaux, France
| | - Jean-Philippe Haymann
- Department of Physiology, University Hospital Tenon, and INSERM UMR_S1155, Paris, France
| | - France Mentré
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Xavier Duval
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, and INSERM CIC1425, Paris, France
| | - Catherine Leport
- Unité COREB (Coordination du Risque Epidémique et Biologique), Assistance Publique–Hôpitaux de Paris, Paris, France
| | - François Raffi
- Infectious Diseases Department, University Hospital Hotel-Dieu, and INSERM CIC 1413, University of Nantes, Nantes, France
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Gourguechon C, Capelle AL, Maus E, Boubrit Y, Claudé M, Cluet-Dennetière S, Merrien D. Polymyosite révélant une leucémie aiguë myéloïde. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.239] [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: 11/26/2022]
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Masquelier B, Taieb A, Reigadas S, Marchou B, Cheneau C, Spire B, Charpentier C, Leport C, Raffi F, Chene G, Descamps D, Leport C, Raffi F, Chene G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vezinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Duval X, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Reboud P, Couffin-Cadiergues S, Marchand L, Bouteloup V, Bouhnik AD, Brunet-Francois C, Caron V, Carrieri MP, Courcoul M, Couturier F, Hardel L, Iordache L, Kurkdji P, Martiren S, Preau M, Protopopescu C, Surzyn J, Taieb A, Villes V, Schmit JL, Chennebault JM, Faller JP, Mgy-Bertrand N, Hoen B, Drobachef, Bouchaud O, Dupon M, Longy-Boursier, Morlat P, Ragnaud JM, Granier P, Garre M, Verdon R, Merrien D, Devidas A, Sobel A, Piroth L, Perronne C, Froguel E, Ceccaldi J, Peyramond D, Allard C, Reynes J, May T, Raffi F, Fuzibet JG, Dellamonica P, Arsac P, Bouvet E, Bricaire F, Bergmann P, Cabane J, Monsonego J, Girard PM, Guillevin L, Herson S, Leport C, Meyohas MC, Molina JM, Pialoux G, Salmon D, Roblot P, Jaussaud R, Michelet C, Lucht F, Debord T, Rey D, De Jaureguiberry JP, Marchou B, Bernard L. Cellular HIV-1 DNA quantification and short-term and long-term response to antiretroviral therapy. J Antimicrob Chemother 2011; 66:1582-9. [DOI: 10.1093/jac/dkr153] [Citation(s) in RCA: 10] [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] [Indexed: 12/20/2022] Open
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Amoura Z, Georgin-Lavialle S, Haroche J, Merrien D, Brocheriou I, Beaufils H, Piette JC. Collapsing glomerulopathy in systemic autoimmune disorders: a case occurring in the course of full blown systemic lupus erythematosus. Ann Rheum Dis 2006; 65:277-8. [PMID: 16410539 PMCID: PMC1798030 DOI: 10.1136/ard.2004.033464] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- A Billet
- Service de médecine interne et pathologie infectieuse, centre hospitalier de Compiègne, 8, avenue Henri-Adnot, 60321 Compiègne cedex, France.
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Affiliation(s)
- G Perrier
- Service de Chirurgie Digestive et Générale, Hôpital Tenon - Paris
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Denis-Delpierre N, Merrien D, Billaud E, Besnier JM, Duhamel E, Hutin P, Andrieux F, Delaunay C, Rogez JP, Arsac P, Chennebault JM, Raffi F. [Multifocal tuberculosis. Apropos of 49 cases in the midwest region. GERICCO (Group for Epidemiology and Research in Clinical Infections of the Central West of France), 1991-1993]. Pathol Biol (Paris) 1998; 46:375-9. [PMID: 9769864] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Diffuse or multifocal tuberculosis (TB) accounts for 9% to 10% of cases of extrapulmonary TB and carries a poor prognosis with a mortality rate of 16% to 25%. Forty-nine cases of multifocal TB defined as involvement of two extrapulmonary sites with or without pulmonary TB were reviewed. Mean patient age (+/- SD) was 50 +/- 18 years. Twenty-three per cent of patients were immigrants. A history of TB and contact with a TB patient were found in 23% and 18% of cases, respectively. Of the 52% of immunocompromised patients, 38% were HIV-positive. The skin tuberculin test was positive in 67% of cases. Mean time from symptom onset to admission was 80 +/- 77 days (median, 58 days). The 49 patients had a total of 128 TB foci. Six patients had positive blood cultures. The tubercle bacillus was recovered from the extrapulmonary sites in 88% of cases. Mean treatment duration was nine months. Recovery from the TB was achieved in 64% of cases. The overall mortality rate was 47%, and 33% of patients died as the direct result of TB. Most deaths occurred in immunocompromised patients. A high index of suspicion for multifocal TB should be maintained in immunocompromised patients, even those who test negative for the HIV.
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Affiliation(s)
- N Denis-Delpierre
- Service de Médecine Interne, Maladies Infectieuses et Tropicales, Hôtel Dieu, CHU Nantes, France
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Denis-Delpierre N, Merrien D, Billaud E, Besnier JM, Duhamel E, Hutin P, Andrieux F, Delaunay C, Rogez JP, Arsac P, Chennebault JM, Raffi F. [Extrapulmonary tuberculosis in the central western region. Retrospective study of 217 cases (Gericco 1991-1993)]. Presse Med 1998; 27:341-6. [PMID: 9767996] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES To analyze the epidemiological, clinical and diagnostic characteristics of extrapulmonary tuberculosis in western France observed from 1991 to 1993 in different patients populations (HIV+ infected patients, immunosuppressed non-HIV infected patients, non-immunosuppressed patients) and according to various localizations (lymph nodes, bone and joints, genital organs, nervous system and meninges, miliary disease). METHODS This retrospective study included 217 cases of extrapulmonary tuberculosis diagnosed from 1991 to 1993 in western France by GERICCO (Groupe d'Epidémiologie et de Recherche en Infectiologie Clinique du Centre-Ouest). Demographic, clinical, biological, microbiological and radiographic characteristics as well as clinical course on specific therapy were assessed. RESULTS Extrapulmonary tuberculosis generally occurred most often in immunosuppressed patients but 34% of cases were observed in people without any underlying disease or risk factors. Delay to diagnosis was especially long in the non-immunosuppressed patients (mean = 96 days) but shorter in the HIV-infected patients (mean = 59 days). It was shorter in case of nervous system involvement (mean = 52 days) or military disease (mean = 80 days) than in bone and joints (mean = 120 days) and lymph nodes (mean = 102 days). Microbiologically proven tuberculosis represented only 75% of cases despite numerous investigations. Overall prognosis was good except in nervous system and meninges localizations. Failures were mainly due to death in immunosuppressed patients. CONCLUSION Extrapulmonary tuberculosis remains frequent even in patients lacking risk factors. In 50% of cases, confirmation of diagnosis takes more than one month. In case of doubt, clinicians should not wait for laboratory results before implementing empirical specific therapy.
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Abstract
Thrombotic microangiopathy (TMA) has been rarely described in HIV-infected patients. We report four cases of TMA during HIV infection and we analyse clinical, biological, etiologic, therapeutic and evolutive aspects of these four cases. Initial symptomatology is non specific and diagnosis is often delayed. Peripheric thrombopenia with haemolytic anemia and renal failure must be suggestive of the diagnosis. TMA can be present at any stage of HIV infection. Physiopathological mechanism of TMA during HIV infection remains unclear. These cases lead to suspect the role of opportunistic infections, neoplasia or HIV directly by endothelial injury or indirectly by cytokines secretion. Therapy of TMA is not different from non-HIV patients. Improvement with treatment must be obtained but long-term prognosis remains poor in account of HIV infection.
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Affiliation(s)
- E Ninin
- Service de médecine interne, Hôtel-Dieu, Nantes, France
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Marfaing-Koka A, Aubin JT, Grangeot-Keros L, Portier A, Benattar C, Merrien D, Agut H, Aucouturier P, Autran B, Wijdenes J. In vivo role of IL-6 on the viral load and on immunological abnormalities of HIV-infected patients. J Acquir Immune Defic Syndr Hum Retrovirol 1996; 11:59-68. [PMID: 8528734 DOI: 10.1097/00042560-199601010-00008] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In vitro experiments have suggested that interleukin (IL)-6 may contribute to human immunodeficiency virus (HIV) burden and to immunological abnormalities in HIV-infected patients. We had the opportunity to directly address this question in vivo through the virological and immunological monitoring of HIV-infected patients treated with an anti-IL-6 monoclonal antibody (mAb) for a lymphoma (ANRS 018 trial). Sixteen courses of anti-IL-6 mAb administration, performed in 11 patients, were studied. All patients were at a late stage of HIV infection. The HIV load and the immunological status were determined at the initiation of each course and at its end, 21 days later. The mAb induced no significant change of HIV load, as evaluated by p24 antigenemia, plasma viremia, and quantification of circulating HIV RNA by reverse transcriptase-polymerase chain reaction and branched DNA techniques. The anti-IL-6 mAb also did not affect CD4+, CD8+, and CD19+ circulating cell counts, nor the serum concentrations of sIL-2R and of sCD8. In contrast, the mAb completely abrogated acute-phase reaction, as demonstrated by the normalization of C-reactive protein and fibrinogen circulating levels (p = 0.013 and p = 0.008, respectively). It increased serum albumin concentration. The latter effect was restricted to patients with a spontaneously low albuminemia (p = 0.01). It decreased B-lymphocyte hyperactivity, as reflected by decreased IgG and IgA serum levels (p = 0.008 and p < 0.001, respectively), and by a decreased production of IgG in vitro (p = 0.017). In contrast, the IgM hyperproduction was not affected by the mAb. Therefore, increased IL-6 production in HIV-infected patients at a late stage of the infection may not stimulate HIV replication in vivo, but it may represent a key mechanism contributing to the metabolic and immunological dysbalance of the disease.
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Affiliation(s)
- A Marfaing-Koka
- INSERM U131, Institut Paris-Sud sur les Cytokines, Clamart, France
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Raffi F, Merrien D, Le Pape P, Reliquet V. Use of an Itraconazole/allopurinol combination for the treatment of visceral leishmaniasis in a patient with AIDS. Clin Infect Dis 1995; 21:1338-9. [PMID: 8589174 DOI: 10.1093/clinids/21.5.1338] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- F Raffi
- Infectious Diseases and Parasitology Laboratory, University Hospital, Nantes, France
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Richard P, Delangle MH, Merrien D, Barillé S, Reynaud A, Minozzi C, Richet H. Fluoroquinolone use and fluoroquinolone resistance: is there an association? Clin Infect Dis 1994; 19:54-9. [PMID: 7948558 DOI: 10.1093/clinids/19.1.54] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.2] [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: 01/28/2023] Open
Abstract
In an assessment of potential risk factors for nosocomial infections caused by fluoroquinolone-resistant gram-negative organisms, 68 patients who developed a nosocomial infection caused by a fluoroquinolone-resistant gram-negative bacillus were compared with 191 patients who developed a nosocomial infection caused by a fluoroquinolone-susceptible gram-negative bacillus. A history of previous infection, immunosuppression, prior receipt of fluoroquinolones, and hospitalization on the burn unit were independent risk factors. Except for immunosuppression, the same risk factors were identified when the 50 patients whose isolates were resistant to fluoroquinolones, aminoglycosides, and beta-lactam antibiotics were compared with the 95 patients whose isolates were susceptible to all of these classes of antimicrobial agents. The identification of hospitalization on the burn unit as a risk factor was attributable to an outbreak of infections caused by a resistant strain of Pseudomonas aeruginosa during the study period. The occurrence of nosocomial outbreaks and the selective pressure of fluoroquinolone use were the main exogenous risk factors involved in the emergence of resistance to fluoroquinolones.
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Affiliation(s)
- P Richard
- Laboratoire de Bactériologie A. Centre Hospitalo-Universitaire Hôtel-Dieu, Nantes, France
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Emilie D, Fior R, Jarrousse B, Marfaing-Koka A, Merrien D, Devergne O, Crevon MC, Maillot MC, Galanaud P. Cytokines in HIV infection. Int J Immunopharmacol 1994; 16:391-6. [PMID: 7927984 DOI: 10.1016/0192-0561(94)90026-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Human immunodeficiency virus infection leads to a deregulated production of a number of cytokines. Some of them (IL-1, IL-6, TNF-alpha, interferon-gamma) are produced in increased amounts in vivo, whereas the production of IL-2 is decreased. This latter abnormality plays a pivotal role in the establishment of the immunodeficiency. Some cytokines (IL-1, IL-6, TNF-alpha) stimulate the in vitro replication of HIV, whereas others (mainly the interferons) inhibit it. The effect of cytokines in vivo in the spreading of HIV remains, however, largely unknown. Cytokines may also be involved in the development of many clinical manifestations associated with HIV infection. IL-1, IL-6 and TNF-alpha may play a role in tissue damages associated with opportunistic infections, in HIV-related encephalopathy and in cachexia. Cytokines, mainly IL-6, IL-10 and IL-13, may stimulate the growth of malignant cells during Kaposi sarcoma or lymphomas. Better knowledge of the role of cytokines during HIV infection should allow new therapeutic approaches based on the use of either recombinant cytokines or specific antagonists, with the aim of limiting both HIV spreading and the clinical manifestations of this infection.
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Hamidou M, Tiab M, Jego P, Canfrere I, Merrien D, Grolleau J. Fièvre Q avec anticorps anticardiolipine simulant une maladie de Still de l'adulte. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80494-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Emilie D, Navratil E, Reynes M, Samuel D, Devergne O, Merrien D, Petit MA, Galanaud P. In situ activation of B lymphocytes in hepatitis B virus-induced fulminant hepatitis. Eur J Med 1992; 1:431-3. [PMID: 1341484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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18
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Raffi F, Boudart D, Merrien D, Barrier JH. Fibronectin in HIV-infected patients: a prospective study. Eur J Med 1992; 1:308-10. [PMID: 1341613] [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] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fibronectin, a non-specific opsonin involved in the clearance of microorganisms, is thought to play a role in various infectious disease processes. Its diagnostic value as a biological marker of infection and/or prognosis in human immunodeficiency virus (HIV) patients is questionable. We conducted a prospective study to evaluate plasma fibronectin levels in patients with HIV infection at different stages of the disease. Eighty-one consecutive HIV-infected patients seen in our department were evaluated clinically and biologically. Classifications according to the Centers for Disease Control (CDC) stages were: Group II (n = 22), Group III (n = 17), acquired immunodeficiency syndrome (AIDS) (n = 17) and AIDS related complex (n = 25). Plasma fibronectin levels were measured by a radial immunodiffusion assay. Plasma fibronectin levels were not different between HIV-infected patients (344 +/- 128 mg/L) and controls (n = 20, 335 +/- 45 mg/L). Among the 81 patients, plasma fibronectin levels were within normal value in 79%, with no significant difference of mean plasma fibronectin between the different CDC groups. No correlation was found between plasma fibronectin and other biological parameters including CD4+ cells, p24 antigen, beta-2-microglobulin. Furthermore, no correlation was noted between fibronectin and complement levels or presence of circulating immune complexes. These results suggest that plasma fibronectin is not a useful marker in patients with HIV infection.
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Affiliation(s)
- F Raffi
- Internal Medicine Department, Hôtel-Dieu, Nantes, France
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Raffi F, Merrien D, Mussini J, Billaud E, Barrier J. Polymorphisme anatomo-clinique des vascularites liées au VIH. Existe-t-il un mécanisme auto-immun ? Rev Med Interne 1992. [DOI: 10.1016/s0248-8663(05)81559-0] [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: 11/26/2022]
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Merrien D, Raffi F, Barrier J. Septicémies à Yersinia : rôle favorisant de la surcharge en fer. Med Mal Infect 1991. [DOI: 10.1016/s0399-077x(05)80908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Raffi F, Magadur G, Fiche M, Merrien D, Barrier JH, Grolleau JY. Pleural involvement in hairy cell leukemia response to recombinant interferon-alpha. Chest 1990; 98:1544. [PMID: 2245718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Merrien D, Raffi F, Barbier JH. [Febrile purpura disclosing primary cytomegalovirus infection]. Presse Med 1990; 19:1681-2. [PMID: 2174159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Hamidou M, Raffi F, Merrien D, Nomballais M, Dupas B, Noquet, Barrier J. Une curieuse tumeur: l'ostéolyse post-traumatique du pubis. Rev Med Interne 1990. [DOI: 10.1016/s0248-8663(05)82110-1] [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: 10/25/2022]
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Barrier J, Lucas-Vidallon C, Peltier P, Raffi F, Litoux P, Magadur G, Merrien D, Beurrier P, Grolleau J. Clairance pulmonaire du 99m Tc DTPA. Intérêt diagnostique et pronostique au cours des collagénoses à potentiel fibrosant pulmonaire. Rev Med Interne 1990. [DOI: 10.1016/s0248-8663(05)81945-9] [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: 11/15/2022]
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