1
|
Pourcher V, Capeau J, Dudoit Y, Boccara F, Soulié C, Ndoadoumgue AL, Charlotte F, Fellahi S, Bastard JP, Béréziat V, Lagathu C, Marcelin AG, Peytavin G, Boutron-Ruault MC, Tubbax C, D'Avout D'Auerstaedt A, Valantin MA, Schneider L, Costagliola D, Katlama C, Assoumou L, Pourcher G. Comparison of HIV-Infected and Noninfected Patients Undergoing Bariatric Surgery: The ObeVIH Study. J Acquir Immune Defic Syndr 2022; 90:240-248. [PMID: 35185138 DOI: 10.1097/qai.0000000000002939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to compare clinical characteristics and adipose/liver tissue histology analysis in HIV-infected and HIV-uninfected subjects undergoing bariatric surgery. DESIGN This was a cross-sectional study of HIV-infected subjects undergoing single-port sleeve gastrectomy with prospective enrolment and frequency age (±5 years), sex, and body mass index (BMI, ± 5 kg/m2) matched on HIV-uninfected subjects. METHODS This study was conducted at a single clinical site at Pitié-Salpêtrière hospital-Paris-France comprising 19 HIV-uninfected and 21 HIV-infected subjects with plasma VL < 20 copies/mL, all with a BMI > 40 kg/m2 or >35 kg/m2 with comorbidities. Histology of subcutaneous and visceral abdominal adipose tissue (SCAT/VAT) and liver biopsies was collected during single-port sleeve gastrectomy. Outcomes included anthropometric characteristics, comorbidities, cardiovascular parameters, adipose tissue, and liver histology. RESULTS The age of HIV-infected participants was (median, interquartile range IQR) 48 y (42-51), with 76.2% females, a BMI of 41.4 kg/m2 (37.3-44.4), an antiretroviral duration of 16 y (8-21), current integrase strand transfer inhibitor (INSTI)-based regimen in 15 participants and non-INSTI regimen in 6 participants, and a CD4 count of 864/mm3 (560-1066). The age of controls was 43 y (37-51), with 78.9% females and a BMI of 39.2 kg/m2 (36.3-42.6). Anthropometric characteristics, comorbidities, and cardiovascular parameters did not differ according to HIV status and INSTI treatment. The number of macrophage crown-like structures in SCAT was lower in INSTI-treated participants than in HIV-uninfected participants (P = 0.02) and non-INSTI-treated HIV-infected subjects (P = 0.07). Hepatic steatosis and liver disease severity global score were lower in INSTI-treated participants than in non-INSTI-treated HIV-infected participants (P = 0.05 and P = 0.04, respectively). CONCLUSIONS HIV-infected and HIV-uninfected subjects undergoing bariatric surgery presented a similar profile regarding anthropometric measures, cardiovascular parameters, and comorbidities. However, INSTI-treated participants presented milder SCAT and liver alterations than non-INSTI-treated participants.
Collapse
Affiliation(s)
- V Pourcher
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - J Capeau
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Y Dudoit
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - F Boccara
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Sorbonne Université, GRC n°22, C MV-Complications Cardiovasculaires et Métaboliques chez les patients vivant avec le Virus de l'immunodéficience humaine, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Saint-Antoine Service de Cardiologie, Paris, France
| | - C Soulié
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- Laboratoire de Virologie, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - A L Ndoadoumgue
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - F Charlotte
- Service d'anatomie pathologique, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - S Fellahi
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Department of Biochemistry-Pharmacology-Molecular Biology, APHP, Hôpital Henri-Mondor, Université Paris Est Créteil, France
| | - J P Bastard
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Department of Biochemistry-Pharmacology-Molecular Biology, APHP, Hôpital Henri-Mondor, Université Paris Est Créteil, France
| | - V Béréziat
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - C Lagathu
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), RHU CARMMA, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - A G Marcelin
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- Laboratoire de Virologie, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - G Peytavin
- APHP, Service de Pharmacologie and Toxicologie, Hôpital Bichat, IAME, Inserm UMR 1137, UF301, Université de Paris, Paris, France
| | - M C Boutron-Ruault
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
- Obesity Center, Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France; and
| | - C Tubbax
- Obesity Center, Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France; and
| | - A D'Avout D'Auerstaedt
- Obesity Center, Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France; and
| | - M A Valantin
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - L Schneider
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - D Costagliola
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - C Katlama
- Sorbonne Université, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, Paris, France
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - L Assoumou
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - G Pourcher
- Obesity Center, Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France; and
- Centre de Recherche en Epidémiologie et Santé des Population (CESP), Inserm, Paris-Saclay University, France
| |
Collapse
|
2
|
Seang S, Itani O, Monsel G, Abdi B, Marcelin AG, Valantin MA, Palich R, Fayçal A, Pourcher V, Katlama C, Tubiana R. Long COVID-19 symptoms: clinical characteristics and recovery rate among non-severe outpatients over a six-month follow-up. Infect Dis Now 2022; 52:165-169. [PMID: 35158095 PMCID: PMC8832844 DOI: 10.1016/j.idnow.2022.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/08/2021] [Accepted: 02/08/2022] [Indexed: 01/08/2023]
Abstract
Background To describe persistent symptoms in long COVID-19 non-severe outpatients and report the 6-month clinical recovery (CR) rate. Methods Observational study enrolling outpatients (≥ 18 years) with confirmed non-severe COVID-19 (positive nasopharyngeal RT-PCR or presence of SARS-CoV-2 antibodies) who consulted for persistent symptoms after the first pandemic wave (March-May 2020). CR was assessed at the 6-month visit and defined as complete (no symptom), partial (persistent symptoms of lower intensity) or lack of recovery (no improvement). Results Sixty-three patients (79% women, mean age: 48 years) enrolled; main symptoms (mean 81 days after acute infection): asthenia/myalgia (77%), dyspnea (51%), headaches (35%), cough (33%). At 6 months (n = 56), 30% had complete, 57% partial, and 13% lack of recovery. The proportion of patients with > 2 persistent symptoms was 26% at 6 months (main symptoms: dyspnea [54%] and asthenia/myalgia [46%]). Conclusion We observed a slow but high recovery rate at 6 months among these outpatients.
Collapse
Affiliation(s)
- S Seang
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France.
| | - O Itani
- AP-HP, Infectious Diseases department, Pitié-Salpêtrière hospital, Paris, France
| | - G Monsel
- AP-HP, Infectious Diseases department, Pitié-Salpêtrière hospital, Paris, France
| | - B Abdi
- Sorbonne University, Virology department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - A-G Marcelin
- Sorbonne University, Virology department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - M-A Valantin
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - R Palich
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - A Fayçal
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - V Pourcher
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - C Katlama
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| | - R Tubiana
- Sorbonne University, Infectious Diseases department, Pitié-Salpêtrière hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute (iPLESP), INSERM 1136, Paris, France
| |
Collapse
|
3
|
Palich R, Wirden M, Peytavin G, Lê MP, Seang S, Abdi B, Schneider L, Tubiana R, Valantin MA, Paccoud O, Soulié C, Calvez V, Katlama C, Marcelin AG. Persistent low-level viraemia in antiretroviral treatment-experienced patients is not linked to viral resistance or inadequate drug concentrations. J Antimicrob Chemother 2021; 75:2981-2985. [PMID: 32642769 DOI: 10.1093/jac/dkaa273] [Citation(s) in RCA: 5] [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] [Received: 01/13/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess genotypic sensitivity scores (GSSs), plasma antiretroviral concentrations (PACs) and immunovirological outcomes at Week 96 (W96) in patients with persistent low-level viraemia (LLV). METHODS On 1 January 2017, we analysed data from patients on three-drug regimens with persistent LLV defined as at least two consecutive plasma viral loads (pVLs) between 21 and 200 copies/mL (including one pVL of ≥50 copies/mL), at the Pitié-Salpêtrière Hospital. Outcomes were: GSS, PACs and HIV-DNA load at study entry; and virological status and proportion of patients with resistance-associated mutations (RAMs) at W96. RESULTS Fifty-seven patients were included, with median age of 52.6 years (IQR 45.2-57.9), last CD4 count of 658 cells/mm3 (IQR 462-909) and total ART duration of 10.2 years (IQR 5.7-15.2). LLV duration was 14.0 months (IQR 5.5-22.3). GSS was 3 in 46/57 (81%) patients and PACs were adequate in 53/57 (93%) patients. Median total HIV-DNA was 2.65 log10 copies/106 cells (IQR 2.44-2.86). During follow-up, 26/57 (46%) had experienced ART modifications. At W96, 38/57 (67%) patients remained with LLV, 15/60 (26%) had achieved confirmed pVL of <20 copies/mL and 4/57 (7%) had virological failure. The four virological failures were due to three ART interruptions and one incomplete adherence (selection of Y181C RAM). No factors (patient characteristics at study entry, GSS, PACs, total HIV-DNA load and ART modification) were associated with W96 viral outcome, except for time from HIV diagnosis and the LLV duration at study entry. CONCLUSIONS A substantial number of patients harbouring LLV had no resistance to ART and adequate PACs. Two-thirds of these patients remained with this LLV status.
Collapse
Affiliation(s)
- R Palich
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M Wirden
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - G Peytavin
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - M-P Lê
- Bichat University Hospital, AP-HP, Pharmacology and Toxicology Department, IAME, INSERM 1137, Paris, France
| | - S Seang
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - B Abdi
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - L Schneider
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Tubiana
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M-A Valantin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - O Paccoud
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Soulié
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - V Calvez
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - A-G Marcelin
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Department of Virology, F-75013 Paris, France
| |
Collapse
|
4
|
Tebano G, Soulié C, Schneider L, Blanc C, Agher R, Seang S, Valantin MA, Palich R, Tubiana R, Peytavin G, Marcelin AG, Assoumou L, Katlama C. Long-term follow-up of HIV-infected patients on dolutegravir monotherapy. J Antimicrob Chemother 2021; 75:675-680. [PMID: 31800056 DOI: 10.1093/jac/dkz478] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/06/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, dolutegravir monotherapy has been explored as a drug-reduced regimen for HIV patients. METHODS This was a retrospective observational study, including patients virologically suppressed for ≥6 months, without previous virological failure (VF) under integrase inhibitors (INIs), who had been switched to dolutegravir monotherapy (50 mg/day). The primary aim was to report the proportion of VF at week 48 (W48) and week 96 (W96) of dolutegravir monotherapy. The evolution from baseline to W48 of residual viraemia on ultra-deep sequencing and HIV DNA was also evaluated. RESULTS Sixty-one patients were included. Prior to switching to dolutegravir monotherapy, they had a median (IQR) of 15.4 (6.5-19.9) years of antiretroviral exposure, 5.8 (3.2-10.3) years of viral suppression and 687 (461-848) CD4+ cells/mm3. They remained on dolutegravir monotherapy for a median (IQR) of 100 (29-148) weeks. Forty-two out of 61 patients (68.9%) reached W48 and 32 out of 61 patients (52.5%) reached W96. VF occurred in three patients, with the emergence of INI resistance. VF occurred before W24 and in patients pre-exposed to INIs. At W48, the probability of VF (Kaplan-Meier analysis) was 5.6% (95% CI = 1.8%-16.4%). The same result was obtained at W96. Detectable residual viraemia did not increase and median HIV DNA did not change significantly (2.4 log/106 cells at baseline and 2.3 log/106 cells at W48). Dolutegravir plasma concentration was above the IC90 in 41/41 samples, from 22 patients. CONCLUSIONS Long-term follow-up showed a low risk of VF under dolutegravir monotherapy, in a selected population of patients with previous long-term virological suppression and low HIV reservoir.
Collapse
Affiliation(s)
- G Tebano
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Soulié
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Laboratoire de Virologie, F75013 Paris, France
| | - L Schneider
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - C Blanc
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Agher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - S Seang
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - M A Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - R Tubiana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| | - G Peytavin
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie-Toxicologie; IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, Paris, France
| | - A G Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Laboratoire de Virologie, F75013 Paris, France
| | - L Assoumou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), F-75013 Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, F-75013 Paris, France
| |
Collapse
|
5
|
Cousyn L, Sellem B, Palich R, Bendetowicz D, Agher R, Delorme C, Tubiana R, Valantin MA, Seang S, Schneider L, Fayçal A, Dudoit Y, Abdi B, Ndoadoumgue A, Assoumou L, Katlama C. Olfactory and gustatory dysfunctions in COVID-19 outpatients: A prospective cohort study. Infect Dis Now 2021; 51:440-444. [PMID: 33766735 PMCID: PMC7983360 DOI: 10.1016/j.idnow.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To describe the characteristics, evolution and risk factors for long-term persistence of olfactory and gustatory dysfunctions (OGD) in COVID-19 outpatients. PATIENTS AND METHODS We conducted a prospective study in SARS-CoV-2 infected outpatients with OGD. Weekly phone interviews were set up starting from COVID-19 onset symptoms and over the course of 60 days, using standardized questionnaires that included a detailed description of general symptoms and OGD. The primary outcome was the proportion of patients with complete recovery of OGD at D30. Rate and time to recovery of OGD, as well as risk factors for late recovery (>30 days), were evaluated using Cox regression models. RESULTS Ninety-eight outpatients were included. The median time to onset of OGD after first COVID-19 symptoms was 2 days (IQR 0-4). The 30-day recovery rate from OGD was 67.5% (95% CI 57.1-75.4) and the estimated median time of OGD recovery was 20 days (95% CI 13-26). Risk factors for late recovery of OGD were a complete loss of smell or taste at diagnosis (HR=0.26, 95% CI 0.12-0.56, P=0.0005) and age over 40 years (HR=0.56, 95% CI 0.36-0.89, P=0.01). CONCLUSIONS COVID-19 patients with complete loss of smell or taste and over age 40 are more likely to develop persistent OGD and should rapidly receive sensorial rehabilitation.
Collapse
Affiliation(s)
- L Cousyn
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Paris Brain Institute (Inserm, CNRS, Sorbonne Université), Paris, France.
| | - B Sellem
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - R Palich
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - D Bendetowicz
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Paris Brain Institute (Inserm, CNRS, Sorbonne Université), Paris, France
| | - R Agher
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - C Delorme
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - R Tubiana
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - M-A Valantin
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - S Seang
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - L Schneider
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - A Fayçal
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Y Dudoit
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - B Abdi
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France; Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - A Ndoadoumgue
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - L Assoumou
- Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - C Katlama
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Inserm, Sorbonne Université, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | | |
Collapse
|
6
|
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.
Collapse
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
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Noël L, Tubiana R, Simon A, Valantin MA, Palich R, Blanc C, Katlama C, Marcelin AG, Calvez V, Todesco E. Low immune response rate of HIV-infected patients to a single injection of hepatitis A vaccine. Infect Dis Now 2020; 51:94-96. [PMID: 33022294 DOI: 10.1016/j.medmal.2020.09.016] [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: 03/29/2020] [Revised: 04/01/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We aimed to evaluate the immune response of HIV-1 positive patients to a single injection of HAV vaccine in a context of vaccine shortage during the 2017 European outbreak. METHODS We retrospectively enrolled all HIV-1 positive patients vaccinated by a single injection of HAV vaccine Vaqta 50®. HAV serology was performed before and>30 days after the vaccine injection. RESULTS Among the 73 patients, HIV-1 viral load was≤50 copies/mL in 93.2% of the cases. Medians of CD4 and median ratio of T CD4/CD8 cells were 658/mm3 and 0.9, respectively. A low immune response rate (59.7%) was observed among the patients. Responders had a significantly higher CD4/CD8 cell ratio than non-responders. CONCLUSIONS A serologic control should be recommended in this population in the event of a single injection vaccination schedule. During routine follow-up, and prior to any untoward event, physicians should assess the vaccination coverage of HIV-infected patients.
Collapse
Affiliation(s)
- L Noël
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - R Tubiana
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - A Simon
- Service de médecine interne, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - M-A Valantin
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - R Palich
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - C Blanc
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - C Katlama
- Inserm, service de maladies infectieuses et tropicales, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - A-G Marcelin
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - V Calvez
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France
| | - E Todesco
- Inserm, laboratoire de virologie, institut Pierre-Louis d'épidémiologie et de Santé Publique (iPLESP), hôpital Pitié-Salpêtrière, Sorbonne Université, AP-HP, 75013 Paris, France.
| |
Collapse
|
8
|
Gaillet A, Calin R, Flandre P, Tubiana R, Valantin MA, Caumes E, Katlama C, Pourcher V. Increased risk of IRIS-associated tuberculosis in HIV-infected patients receiving Integrase Inhibitors. Infect Dis Now 2020; 51:90-93. [PMID: 33007401 DOI: 10.1016/j.medmal.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tuberculosis is associated with a risk of immune reconstitution inflammatory syndrome (IRIS) after ART initiation. METHODS Data from all patients with newly diagnosed tuberculosis disease and uncontrolled HIV infection from 1997 to 2017 in a French center were retrospectively collected. We evaluated the incidence of tuberculosis-IRIS in patients initiating ART with or without integrase inhibitors (INSTI) RESULTS: Fifty-five patients were included: 21 receiving an INSTI regimen and 34 a non-INSTI regimen. Except with regard to ART regimen, the two groups were comparable (median CD4 of 85/mm3). The overall percentage of IRIS was 34% (19/55), with 52% IRIS in INSTI regimen and 23% in non-INSTI regimen respectively (P=0.04). In a multivariate logistic model, we observed an increased risk of IRIS in the INSTI regimen compared to the non-INSTI, with an OR at 3.33 [95% CI, 1.01-11.1] (P=0.05) CONCLUSIONS: ART containing integrase inhibitors could be associated with increased incidence of TB-associated IRIS.
Collapse
Affiliation(s)
- A Gaillet
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France.
| | - R Calin
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - P Flandre
- Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - R Tubiana
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - M-A Valantin
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - E Caumes
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - C Katlama
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| | - V Pourcher
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Department of Infectious Diseases, Pitie-Salpetriere Hospital, 47-83 Boulevard de l'Hôpital, Paris 75013, France; Inserm UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Université, Paris, France
| |
Collapse
|
9
|
Nouchi A, Nguyen T, Valantin MA, Simon A, Sayon S, Agher R, Calvez V, Katlama C, Marcelin AG, Soulie C. Dynamics of drug resistance-associated mutations in HIV-1 DNA reverse transcriptase sequence during effective ART. J Antimicrob Chemother 2019; 73:2141-2146. [PMID: 29846589 DOI: 10.1093/jac/dky130] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/18/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the dynamics of HIV-1 variants archived in cells harbouring drug resistance-associated mutations (DRAMs) to lamivudine/emtricitabine, etravirine and rilpivirine in patients under effective ART free from selective pressure on these DRAMs, in order to assess the possibility of recycling molecules with resistance history. Patients and methods We studied 25 patients with at least one DRAM to lamivudine/emtricitabine, etravirine and/or rilpivirine identified on an RNA sequence in their history and with virological control for at least 5 years under a regimen excluding all drugs from the resistant class. Longitudinal ultra-deep sequencing (UDS) and Sanger sequencing of the reverse transcriptase region were performed on cell-associated HIV-1 DNA samples taken over the 5 years of follow-up. Results Viral variants harbouring the analysed DRAMs were no longer detected by UDS over the 5 years in 72% of patients, with viruses susceptible to the molecules of interest found after 5 years in 80% of patients with UDS and in 88% of patients with Sanger. Residual viraemia with <50 copies/mL was detected in 52% of patients. The median HIV DNA level remained stable (2.4 at baseline versus 2.1 log10 copies/106 cells 5 years later). Conclusions These results show a clear trend towards clearance of archived DRAMs to reverse transcriptase inhibitors in cell-associated HIV-1 DNA after a long period of virological control, free from therapeutic selective pressure on these DRAMs, reflecting probable residual replication in some reservoirs of the fittest viruses and leading to persistent evolution of the archived HIV-1 DNA resistance profile.
Collapse
Affiliation(s)
- A Nouchi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - T Nguyen
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - M A Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Service de maladies infectieuses, Paris, France
| | - A Simon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Service de médecine interne, Paris, France
| | - S Sayon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - R Agher
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Service de maladies infectieuses, Paris, France
| | - V Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - C Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Service de maladies infectieuses, Paris, France
| | - A G Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| | - C Soulie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié Salpêtrière, Laboratoire de virologie, Paris, France
| |
Collapse
|
10
|
Boccara F, Lang S, Ederhy S, Soulat-Dufour L, Adavane-Scheuble S, Ancedy Y, Chauvet M, Nhan P, Meynard JL, Valantin MA, Slama L, Pialoux G, Katlama C, Girard PM, Cohen A. P5338Atherosclerotic cardiovascular events in people living with Human Immunodeficiency Virus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/14/2022] Open
Abstract
Abstract
Background
People living with Human Immunodeficiency Virus (PLWHIV) under antiretrovirals have an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. The risk factors associated with ASCVD events in this high risk population are various including traditional vascular risk factors and specific HIV-related factors. However their respective influence is questionable.
Purpose
Our aim was to determine the incidence of ASCVD events in a large cohort of PLWHIV and to identify the risk factors associated.
Methods
We conducted a longitudinal observational cohort study of asymptomatic PLWHIV at high risk of ASCVD addressed to our preventive cardiovascular unit for non-invasive cardiovascular evaluation. The first ASCVD event was censored and included CV death, acute coronary syndromes, coronary and peripheral revascularizations (PCI or CABG or endarterectomy or limb procedures) and ischemic strokes.
Results
From January 2003 to December 2014, 763 consecutive asymptomatic PLWHIV were enrolled (mean age of 51.3±8.3 years, 87% men, 90% were free of known coronary artery disease, mean Left ventricular ejection fraction 60%). At baseline, traditional CV risk factors were as follow: 54% had dyslipidemia, 43% hypertension, 35% were active smokers, 22% had family history of CAD and 11% were diabetics. Statins were prescribed in 38% of the cohort, aspirin in 14%, clopidogrel in 14% betablockers in 14%, RAS blockers in 32%, Calcium channel blockers in 8%. At baseline, median duration of HIV seropositivity was 19.8 years (14.0–23.6), 94% were under ARV predominantly protease inhibitors (68%). Median CD4 cell count was 545/mm3 (404–745) and 92% had undetectable HIV viral load. During a median follow up of 5.8 years (3.7–8.7), 58 (7.3%) subjects had a first ASCVD event (incidence of 12.70 [9.78–16.51] per 1000 persons-years) including 5 cardiovascular deaths, 14 ACS, 20 coronary revascularizations, 13 peripheral vascular procedures and 6 strokes) with a median time of occurrence of 3.1 years (1.5–5.1). CV death (first and second ASCVD events) occurred in 8 patients (22%) after CV death related to malignancies (33%) but before deaths related to unexplained causes (21%), infectious disease (13%), liver disease (8%) and suicides (3%). Coronary events including coronary death, MI, and coronary revascularization occurred in 39 patients (5.2%); Incidence of 8.28 [6.00–11.43] per 1000 persons-years. Conventional multivariate Cox model shows that age and tobacco were the independent risk factors associated with ACSVD events [Hazard ratio (HR) 1.04, 95% CI 0.99–1.09, p=0.05 and HR 2.17, 95% CI 1.07–4.38, p=0.03].
Conclusion
Traditional vascular risk factors (age and active smoking) are associated with the occurrence of ASCVD events predominantly coronary artery disease in our observational cohort of asymptomatic PLWIHV at high risk for ASCVD. Cardiovascular prevention including tobacco cease action is mandatory in the aging HIV population.
Collapse
Affiliation(s)
- F Boccara
- AP-HP - Hospital Saint Antoine, Paris, France
| | - S Lang
- AP-HP - Hospital Saint Antoine, Paris, France
| | - S Ederhy
- AP-HP - Hospital Saint Antoine, Paris, France
| | | | | | - Y Ancedy
- AP-HP - Hospital Saint Antoine, Paris, France
| | - M Chauvet
- AP-HP - Hospital Saint Antoine, Paris, France
| | - P Nhan
- AP-HP - Hospital Saint Antoine, Paris, France
| | - J L Meynard
- AP-HP - Hospital Saint Antoine, Paris, France
| | - M A Valantin
- Hospital Pitie-Salpetriere, Infectious Diseases Department, Paris, France
| | - L Slama
- Hospital Pitie-Salpetriere, Infectious Diseases Department, Paris, France
| | - G Pialoux
- Hospital Tenon, Infectious Diseases Department, Paris, France
| | - C Katlama
- Hospital Pitie-Salpetriere, Infectious Diseases Department, Paris, France
| | - P M Girard
- AP-HP - Hospital Saint Antoine, Paris, France
| | - A Cohen
- AP-HP - Hospital Saint Antoine, Paris, France
| |
Collapse
|
11
|
Seang S, Schneider L, Nguyen T, Lê MP, Soulie C, Calin R, Caby F, Valantin MA, Tubiana R, Assoumou L, Marcelin AG, Peytavin G, Katlama C. Darunavir/ritonavir monotherapy at a low dose (600/100 mg/day) in HIV-1-infected individuals with suppressed HIV viraemia. J Antimicrob Chemother 2019; 73:490-493. [PMID: 29216346 DOI: 10.1093/jac/dkx417] [Citation(s) in RCA: 6] [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] [Received: 07/20/2017] [Accepted: 10/13/2017] [Indexed: 11/14/2022] Open
Abstract
Background Darunavir/ritonavir is a potent PI with a high genetic barrier and pharmacological robustness favourably investigated as monotherapy. Whether darunavir could be dose reduced in the context of monotherapy deserves investigation. Methods Patients with HIV suppressed viraemia (plasma viral load <50 copies/mL for 12 months) under ART who had switched to darunavir/ritonavir monotherapy at 600/100 mg/day between 2013 and 2015 were included in this observational 48 week single-centre study. The primary outcome was the proportion of patients with virological success (defined as plasma viral load <50 copies/mL) at week 24. Secondary outcomes included treatment strategy success and resistance. Results Thirty-one patients were included with the following baseline characteristics [median (IQR)]: age 52 years (47-57), CD4+ 649 cells/mm3 (463-813), ART duration 16.3 years (9.2-22.3), nadir CD4+ 195 cells/mm3 (144-261) and duration of HIV suppression 7.8 years (4.8-9.7). Prior to switch, ART consisted of PI monotherapy for 28 of 31 patients [darunavir/ritonavir 800/100 mg/day (n = 26), lopinavir/ritonavir (n = 1) and atazanavir/ritonavir (n = 1)] and a triple drug regimen for 3 of 31 patients. Within the 48 weeks of follow-up, no virological failure occurred and two patients discontinued 600/100 mg of darunavir/ritonavir due to side effects at week 16 and 40, leading to a virological suppression rate of 100% (95% CI = 89-100) at weeks 24 and 48. Strategy success rates were 96.8% (95% CI = 83.3-99.9) at week 24 and 93.5% (95% CI = 78.6-99.2) at week 48. Median (IQR) Ctrough values of 800/100 mg of darunavir/ritonavir and 600/100 mg of darunavir/ritonavir were 1537 ng/mL (1286-1724) and 1255 ng/mL (873-2161), respectively. Conclusions A lower dose of darunavir/ritonavir used as monotherapy (600/100 mg/day) was highly effective in virologically suppressed HIV-infected patients. Further studies are needed to confirm these data.
Collapse
Affiliation(s)
- S Seang
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - L Schneider
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - T Nguyen
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
- Hospital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - M P Lê
- Pharmaco-Toxicology Department, APHP, Bichat-Claude Bernard Hospital, University Paris Diderot, Sorbonne, Paris Cité, IAME, INSERM UMR 1137, Paris, France
| | - C Soulie
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
- Hospital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - R Calin
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - F Caby
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - M-A Valantin
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - R Tubiana
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - L Assoumou
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - A-G Marcelin
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
- Hospital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - G Peytavin
- Pharmaco-Toxicology Department, APHP, Bichat-Claude Bernard Hospital, University Paris Diderot, Sorbonne, Paris Cité, IAME, INSERM UMR 1137, Paris, France
| | - C Katlama
- Hospital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
- Sorbonne University, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| |
Collapse
|
12
|
Hentzien M, Cabie A, Pugliese P, Billaud É, Poizot-Martin I, Duvivier C, Valantin MA, Kaladjian A, Dramé M, Bani-Sadr F. Factors associated with deaths from suicide in a French nationwide HIV-infected cohort. HIV Med 2018; 19:551-558. [PMID: 29856132 DOI: 10.1111/hiv.12633] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES People living with HIV (PLHIV) are at a higher risk of dying by suicide than the general population. Epidemiological data regarding determinants of suicide in PLHIV are scarce. The aim of this study was thus to study demographic, socio-economic, psychiatric history and immunovirological characteristics associated with death from suicide in the French multicenter Dat'AIDS cohort, from January 2000 to July 2013. METHODS This was a nested case-control study. All deceased PLHIV during the study period who died by suicide and whose medical files could be checked were included as cases. Controls were selected using incidence density sampling. For each case, up to four controls were selected among all actively followed PLHIV at the index date (date of death of cases). Controls were matched for time from HIV diagnosis (5-year periods) and clinical centre. RESULTS Seventy cases and 279 controls were included in the study. By multivariable analysis, the factors significantly associated with death from suicide were: not having children, active or substituted drug consumption, alcohol intake > 20 g/day or history of alcohol abuse, history of depressive disorder and/or of attempted suicide, and psychotropic drug intake. Conversely, age, gender, country of birth, positive HCV serology and HIV-related factors, such as AIDS status, use of combination antiretroviral therapy (cART), nadir and current CD4 counts and HIV viral load, were not significantly associated with the risk of death from suicide. CONCLUSIONS In the cART era, HIV-related factors are not associated with a higher risk of suicide mortality. Suicide prevention measures should target PLHIV with the psychological morbidities observed in our cohort.
Collapse
Affiliation(s)
- M Hentzien
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - A Cabie
- Infectious and Tropical Diseases Unit, INSERM CIC1424, University Hospital of Martinique, Fort de France, France
| | - P Pugliese
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - É Billaud
- Department of Infectious Diseases, Nantes University Hospital, Nantes, France
| | - I Poizot-Martin
- Immuno-Hematology Clinic, Marseille University Hospital, Marseille, France
- INSERM U912 (SESSTIM), Aix Marseille University, Marseille, France
| | - C Duvivier
- Assistance Publique des Hôpitaux de Paris, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Paris, France
| | - M-A Valantin
- Department of Infectious Diseases, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - A Kaladjian
- Department of Adult Psychiatry, Reims University Hospital, Reims, France
| | - M Dramé
- Department of Research and Public Health, Reims University Hospital, Reims, France
- Faculty of Medicine, EA 3797, University of Reims Champagne-Ardenne, Reims, France
| | - F Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, University of Reims Champagne-Ardenne, Reims, France
- EA-4684/SFR CAP-SANTE, University of Reims Champagne-Ardenne, Reims, France
| |
Collapse
|
13
|
Rosenthal E, Fougerou-Leurent C, Renault A, Carrieri MP, Marcellin F, Garraffo R, Teicher E, Aumaitre H, Lacombe K, Bailly F, Billaud E, Chevaliez S, Dominguez S, Valantin MA, Reynes J, Naqvi A, Cotte L, Metivier S, Leroy V, Dupon M, Allegre T, De Truchis P, Jeantils V, Chas J, Salmon-Ceron D, Morlat P, Neau D, Perré P, Piroth L, Pol S, Bourlière M, Pageaux GP, Alric L, Zucman D, Girard PM, Poizot-Martin I, Yazdanpanah Y, Raffi F, Pabic EL, Tual C, Pailhé A, Amri I, Bellissant E, Molina JM. Efficacy, safety and patient-reported outcomes of ledipasvir/sofosbuvir in NS3/4A protease inhibitor-experienced individuals with hepatitis C virus genotype 1 and HIV coinfection with and without cirrhosis (ANRS HC31 SOFTRIH study). HIV Med 2017; 19:227-237. [PMID: 29214737 DOI: 10.1111/hiv.12571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Studies evaluating the efficacy and safety of the fixed-dose combination ledipasvir (LDV)/sofosbuvir (SOF) in patients coinfected with HIV-1 and hepatitis C virus (HCV) have mainly included treatment-naïve patients without cirrhosis. We aimed to evaluate the efficacy and safety of this combination in treatment-experienced patients with and without cirrhosis. METHODS We conducted a multicentre, open-label, double-arm, nonrandomized study in patients coinfected with HIV-1 and HCV genotype 1 with and without cirrhosis, who had good viral suppression on their antiretroviral regimens. All patients were pretreated with a first-generation NS3/4A protease inhibitor (PI) plus pegylated interferon/ribavirin. Patients received a fixed-dose combination of LDV/SOF for 12 weeks, or for 24 weeks if cirrhosis was present. The primary endpoint was a sustained virological response (SVR) 12 weeks after the end of therapy. Secondary endpoints included safety, pharmacokinetics and patient-reported outcomes. RESULTS Of the 68 patients enrolled, 39.7% had cirrhosis. Sixty-five patients [95.6%; 95% confidence interval (CI): 87.6-99.1%; P < 0.0001] achieved an SVR, with similar rates of SVR in those with and without cirrhosis. Tolerance was satisfactory, with mainly grade 1 or 2 adverse events. Among patient-reported outcomes, only fatigue significantly decreased at the end of treatment compared with baseline [odds ratio (OR): 0.36; 95% CI: 0.14-0.96; P = 0.04]. Mean tenofovir area under the plasma concentration-time curve (AUC) at week 4 was high, with mean ± SD AUC variation between baseline and week 4 higher in cirrhotic than in noncirrhotic patients (3261.57 ± 1920.47 ng/mL vs. 1576.15 ± 911.97 ng/mL, respectively; P = 0.03). Mild proteinuria (54.4%), hypophosphataemia (50.0%), blood bicarbonate decrease (29.4%) and hypokalaemia (13.2%) were reported. The serum creatinine level was not modified. CONCLUSIONS LDV/SOF provided a high SVR rate in PI-experienced subjects coinfected with HCV genotype 1 and HIV-1, including patients with cirrhosis.
Collapse
Affiliation(s)
- E Rosenthal
- Internal Medicine Department, CHU de Nice, Hôpital Archet 1, Nice, France
| | - C Fougerou-Leurent
- Pharmacology Department, CHU Rennes, Rennes, France.,Inserm, CIC1414, Rennes, France
| | - A Renault
- Inserm, CIC1414, Rennes, France.,Pharmacology Laboratory, Faculté de Médecine, Univ Rennes 1, Rennes, France
| | - M P Carrieri
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Inserm, IRD, Aix Marseille Univ, Marseille, France.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - F Marcellin
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Inserm, IRD, Aix Marseille Univ, Marseille, France.,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - R Garraffo
- Clinical Pharmacology and Toxicology Department, CHU de Nice, Nice, France
| | - E Teicher
- Infectious Diseases Department, APHP, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - H Aumaitre
- Infectious and Tropical Diseases Department, Hôpital de Perpignan, Perpignan, France
| | - K Lacombe
- Infectious Diseases Department, APHP, Hôpital Saint Antoine, Paris, France
| | - F Bailly
- Hepatology Department, HCL, Hôpital de la Croix-Rousse, Lyon, France
| | - E Billaud
- Infectious Diseases Department, CHU Nantes, Nantes, France
| | - S Chevaliez
- Virology Department, APHP, Hôpital Henri Mondor, Créteil, France
| | - S Dominguez
- Clinical Immunology Department, APHP, Hôpital Henri Mondor, Créteil, France
| | - M A Valantin
- Infectious Diseases Department, APHP, Hôpital La Pitié Salpêtrière, Paris, France
| | - J Reynes
- Infectious Diseases Department, CHU Montpellier, Montpellier, France
| | - A Naqvi
- Infectious Diseases Department, CHU de Nice, Hôpital Archet 1, Nice, France
| | - L Cotte
- Infectious Diseases Department, HCL, Hôpital de la Croix-Rousse, Lyon, France
| | - S Metivier
- Hepatogastroenterology Department, CHU Toulouse, Toulouse, France
| | - V Leroy
- Hepatogastroenterology Department, CHU Grenoble, Grenoble, France
| | - M Dupon
- Infectious Diseases Department, CHU Bordeaux, Bordeaux, France
| | - T Allegre
- Hemato Oncology Department, CH du Pays d'Aix, Aix-en-Provence, France
| | - P De Truchis
- Infectious Diseases Department, APHP, Hôpital R Poincaré, Garches, France
| | - V Jeantils
- Infectious Diseases Department, APHP, Hôpital J Verdier, Bondy, France
| | - J Chas
- Infectious and Tropical Diseases Department, APHP, Hôpital Tenon, Paris, France
| | - D Salmon-Ceron
- Infectious Diseases Department, APHP, Hôpital Cochin, Paris, France
| | - P Morlat
- Internal Medicine and Infectious Diseases Department, CHU Bordeaux, Bordeaux, France
| | - D Neau
- Infectious and Tropical Diseases Department, CHU Bordeaux, Bordeaux, France
| | - P Perré
- Internal Medicine Department, CHD Vendée, La Roche sur Yon, France
| | - L Piroth
- Infectious Diseases Department, CHU Dijon, Dijon, France
| | - S Pol
- Hepato-Gastroenterology Department, APHP, Hôpital Cochin, Paris, France
| | - M Bourlière
- Hepatogastroenterology Department, Hôpital Saint Joseph, Marseille, France
| | - G P Pageaux
- Hepatogastroenterology Department, CHU Montpellier, Montpellier, France
| | - L Alric
- Internal Medicine Department, CHU Toulouse, Toulouse, France
| | - D Zucman
- Internal Medicine Department, Hôpital Foch, Suresne, France
| | - P M Girard
- Infectious Diseases Department, APHP, Hôpital Saint Antoine, Paris, France
| | - I Poizot-Martin
- Immuno and Clinical Hematology department, APHM Sainte-Marguerite, Aix Marseille Univ, Marseille, France.,Inserm U912 (SESSTIM), Marseille, France
| | - Y Yazdanpanah
- Infectious and Tropical Diseases Department, APHP, Hôpital Bichat, Paris, France
| | - F Raffi
- Infectious Diseases Department, CHU Nantes, Nantes, France
| | - E Le Pabic
- Pharmacology Department, CHU Rennes, Rennes, France.,Inserm, CIC1414, Rennes, France
| | - C Tual
- Pharmacology Department, CHU Rennes, Rennes, France.,Inserm, CIC1414, Rennes, France
| | - A Pailhé
- Unité de Recherche Clinique et Fondamentale sur les Hépatites Virales, ANRS (France Recherche Nord & Sud Sida-hiv Hépatites), Paris, France
| | - I Amri
- Unité de Recherche Clinique et Fondamentale sur les Hépatites Virales, ANRS (France Recherche Nord & Sud Sida-hiv Hépatites), Paris, France
| | - E Bellissant
- Pharmacology Department, CHU Rennes, Rennes, France.,Inserm, CIC1414, Rennes, France.,Pharmacology Laboratory, Faculté de Médecine, Univ Rennes 1, Rennes, France
| | - J M Molina
- Hepatogastroenterology Department, APHP, Hôpital Saint Louis, Paris, France
| | | |
Collapse
|
14
|
Ailioaie O, Arzouk N, Valantin MA, Tourret J, Calin RO, Turinici M, Mircescu G, Barrou B. Infectious complications in HIV-infected kidney transplant recipients. Int J STD AIDS 2017; 29:341-349. [PMID: 28862528 DOI: 10.1177/0956462417726213] [Citation(s) in RCA: 9] [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] [Indexed: 11/17/2022]
Abstract
Renal transplantation is now a viable alternative for dialysis in HIV-infected patients who achieve good immunovirological control with current antiretroviral therapy regimens available. However, there are few studies that analyze the incidence of post-transplant infections in this population. In this study, a retrospective analysis of data files of 24 HIV-infected kidney transplant (KT) recipients was undertaken, matched to 21 non-infected controls. All patients received induction with anti-interleukin-2 antibodies and were followed in the Pitié-Salpêtrière Hospital in Paris, France. The rate of incidence of post-transplant infections was 23.58 and 26.98/100 patient-years, in HIV-infected and HIV-negative groups (relative risk [RR]: 0.90; 95% confidence interval [CI]: 0.58-1.39; p = 0.63). In HIV-infected KT recipients, bacterial infections were the most frequent (67.7%), followed by viral (14.7%) and fungal and parasitic infections (8.8%). Similar trends were seen in the control group. Incidence of opportunistic infections was similar in HIV-infected KT recipients and controls (38.2 vs. 26.5%; p = 0.44). There were three post-transplant HIV reactivations in two patients, secondary to poor adherence to medication. HIV status did not influence survival, but infections increased the risk of unfavorable outcome. Incidence of post-transplant infections was similar in HIV-infected KT recipients and controls. Infections, but not HIV status, had adverse effects on patient and graft survival.
Collapse
Affiliation(s)
- O Ailioaie
- 1 Renal Transplant Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| | - N Arzouk
- 1 Renal Transplant Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| | - M A Valantin
- 2 Infectious Diseases Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| | - J Tourret
- 1 Renal Transplant Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| | - R O Calin
- 2 Infectious Diseases Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| | - M Turinici
- 3 Biostatistics Department, 26930 Public Assistance of Paris Hospitals , Paris, France
| | - G Mircescu
- 4 "Dr. C. Davila" Teaching Hospital of Nephrology, Bucharest, Romania
| | - B Barrou
- 1 Renal Transplant Department, 26933 Pitié-Salpêtriere Hospital , Paris, France
| |
Collapse
|
15
|
Michel L, Lions C, Winnock M, Lang JP, Loko MA, Rosenthal E, Marchou B, Valantin MA, Morlat P, Roux P, Sogni P, Spire B, Poizot-Martin I, Lacombe K, Lascoux-Combe C, Duvivier C, Neau D, Dabis F, Salmon-Ceron D, Carrieri MP. Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort]. HIV Med 2017; 17:758-765. [PMID: 27187027 DOI: 10.1111/hiv.12382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. METHODS The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). RESULTS Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. CONCLUSIONS Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders.
Collapse
Affiliation(s)
- L Michel
- Inserm U1178, Paris, France. .,UMRS1178, Paris-Sud University and Paris Descartes University, Paris, France. .,Centre Pierre Nicole, French Red Cross, Paris, France.
| | - C Lions
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | | | - J-P Lang
- CHRU Strasbourg, Strasbourg, France
| | | | | | | | - M-A Valantin
- Groupe Hospitalier La Pitié Salpêtrière, Paris, France
| | - P Morlat
- Hôpital Saint-André, Bordeaux, France
| | - P Roux
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | - P Sogni
- Hôpital Cochin, Paris, France
| | - B Spire
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | | | - K Lacombe
- Hôpital Saint-Antoine, Paris, France
| | | | | | - D Neau
- Hôpital Pellegrin, Bordeaux, France
| | - F Dabis
- Inserm U897, Bordeaux, France
| | | | - M P Carrieri
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | | |
Collapse
|
16
|
Gantner P, Cuzin L, Allavena C, Cabie A, Pugliese P, Valantin MA, Bani-Sadr F, Joly V, Ferry T, Poizot-Martin I, Garraffo R, Peytavin G, Fafi-Kremer S, Rey D. Efficacy and safety of dolutegravir and rilpivirine dual therapy as a simplification strategy: a cohort study. HIV Med 2017; 18:704-708. [DOI: 10.1111/hiv.12506] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P Gantner
- Virology Laboratory; Hôpitaux Universitaires de Strasbourg; Strasbourg France
| | - L Cuzin
- INSERM; UMR 1027; Toulouse France
- Université de Toulouse III; Toulouse France
- CHU Toulouse; COREVIH Toulouse; Toulouse France
| | - C Allavena
- Infectious Diseases Department; CHU de Nantes; Nantes France
| | - A Cabie
- Infectious Diseases Department; CHU de Fort-de-France; Martinique France
| | - P Pugliese
- Infectious Diseases Department; CHU de Nice; Nice France
| | - M-A Valantin
- Infectious Diseases Department; APHP Hôpital Pitié Salpêtrière; Paris France
- Institut Pierre Louis d'épidémiologie et de Santé Publique (UMRS 1136); UPMC Univ Paris 06; INSERM; Sorbonne Universités; Paris France
| | - F Bani-Sadr
- Infectious Diseases Department; CHU de Reims; Reims France
| | - V Joly
- Infectious Diseases Department; APHP Hôpital Bichat; Paris France
| | - T Ferry
- Infectious Diseases Department; Hospices civils de Lyon; Lyon France
| | - I Poizot-Martin
- APHM Hôpital Sainte-Marguerite; Immuno-Hematology Clinic; Aix-Marseille University; Marseille France
| | - R Garraffo
- Pharmacology Laboratory; CHU de Nice; Nice France
| | - G Peytavin
- AP-HP; Pharmacology Laboratory; Hôpital Bichat-Claude Bernard; Paris France
- IAME; UMR 1137; Sorbonne Paris Cité, INSERM; Université Paris Diderot; Paris France
| | - S Fafi-Kremer
- Virology Laboratory; Hôpitaux Universitaires de Strasbourg; Strasbourg France
| | - D Rey
- Le Trait d'Union; HIV-Infection Care Center; Hôpitaux Universitaires de Strasbourg; Strasbourg France
| | | |
Collapse
|
17
|
Katlama C, Soulié C, Caby F, Denis A, Blanc C, Schneider L, Valantin MA, Tubiana R, Kirstetter M, Valdenassi E, Nguyen T, Peytavin G, Calvez V, Marcelin AG. Dolutegravir as monotherapy in HIV-1-infected individuals with suppressed HIV viraemia. J Antimicrob Chemother 2016; 71:2646-50. [PMID: 27287235 DOI: 10.1093/jac/dkw186] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/22/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Reducing drug burden is a key challenge for achieving lifelong suppressive HIV therapy. Dolutegravir, with a high potency, long half-life and high genetic barrier, offers potential for monotherapy. METHODS This observational single-centre study enrolled all patients with HIV RNA (viral load) <50 copies/mL for at least 12 months, with CD4 >350 cells/mm(3) and with no failure under integrase inhibitor therapy who had switched from suppressive ART to dolutegravir monotherapy (50 mg/day). Primary outcome was proportion of patients with viral load <50 copies/mL at week 24. RESULTS Twenty-eight patients treated for a median ART duration of 17 years (IQR 11-20), virally suppressed for a median of 79 months (IQR 42-95) and with a median CD4 count of 624 cells/mm(3) (IQR 524-761), were enrolled. Baseline ART consisted of a three-drug (n = 10), two-drug (n = 10) or single-drug (n = 8) regimen with integrase inhibitor exposure in 13 patients. The proportion of patients maintaining viral load <50 copies/mL was 96% (95% CI 79%-100%) at week 4, 100% (95% CI = 85%-100%) at week 8, 93% (95% CI 76%-99%) at week 12 and 92% (75-99) at week 24. Three patients (3.70%; 95% CI 3.4%-10.8%) with prior integrase inhibitor experience had HIV RNA rebound with the presence of resistance mutations. Genotyping of HIV DNA using the Sanger method or ultradeep sequencing showed no integrase inhibitor resistance-associated mutations (RAMs) except for the mutation 74I in a patient on a suppressive elvitegravir regimen. The median within- and between-subject variability of dolutegravir C24 was 25% and 34%, respectively. Nine patients with a year of follow-up remained virally suppressed. CONCLUSIONS Dolutegravir has the potency to be further investigated as a single ART in randomized studies, particularly in patients with no prior exposure to integrase inhibitors.
Collapse
Affiliation(s)
- C Katlama
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - C Soulié
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France Hôpital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - F Caby
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - A Denis
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
| | - C Blanc
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - L Schneider
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - M-A Valantin
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - R Tubiana
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France
| | - M Kirstetter
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
| | - E Valdenassi
- Hôpital Pitié-Salpêtrière, Infectious Diseases Department, 75013 Paris, France
| | - Thuy Nguyen
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France Hôpital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - G Peytavin
- Pharmaco-Toxicology Department, APHP, Bichat-Claude Bernard Hospital, Université Paris Diderot, Sorbonne Paris Cité, IAME, INSERM UMR 1137, Paris, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France Hôpital Pitié-Salpêtrière, Department of Virology, Paris, France
| | - A-G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), 75013 Paris, France Hôpital Pitié-Salpêtrière, Department of Virology, Paris, France
| |
Collapse
|
18
|
Hentzien M, Dramé M, Allavena C, Jacomet C, Valantin MA, Cabié A, Cuzin L, Rey D, Pugliese P, Bani-Sadr F. Impact of Age-related Comorbidities on Five-year Overall Mortality among Elderly HIV-Infected Patients in the Late HAART Era--Role of Chronic Renal Disease. J Nutr Health Aging 2016; 20:408-14. [PMID: 26999241 DOI: 10.1007/s12603-015-0608-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 10/22/2022]
Abstract
OBJECTIVES To identify main prognostic factors for 5-year mortality among age-related comorbidities (ARCs) in older people living with HIV (PLHIV). DESIGN A prospective, multicentre cohort study with a 5-year follow-up period in the late HAART era (from January 2008 to December 2012). SETTING The Dat'AIDS cohort involving 12 French hospitals. PARTICIPANTS All actively followed HIV-1 infected patients aged 60 or older. MEASUREMENTS The study endpoint was all-cause five-year mortality. The following ARCs were considered: chronic renal disease, cardiovascular diseases, cancer, chronic pulmonary disease, cirrhosis, diabetes and nutritional status. Hepatitis C (HCV), hepatitis B (HBV) co-infection and sociodemographic characteristics were also evaluated. Cox's Proportional Hazards model was used for multivariate analysis. RESULTS Among 1415 PLHIV aged 60 or more patients included, mean age was 66±5.5 years; 154 died (mortality rate 2.47/100 patient-years). The most prevalent ARCs were chronic renal disease (20.1%), diabetes (14.2%) and cardiovascular diseases (12.2%). By multivariate analysis, chronic renal disease (adjusted hazard ratio (aHR)=2.25; 95% confidence interval (CI) [1.58-2.21]; p<10-4), cardiovascular diseases (aHR=2.40; 95%CI[1.64-3.52]; p<10-4), non-HIV related cancer (aHR=1.91; 95%CI[1.20-3.05]; p=0.007), cirrhosis (aHR=2.99; 95%CI[1.68-5.33]; p<10-3), HCV co-infection (aHR=2.00; 95%CI[1.18-3.38]; p=0.009), low body mass index (aHR=2.42; 95%CI[1.46-4.01]; p<10-3) and CD4 cell count < 200 cells/µl (aHR=2.23; 95%CI[1.36-3.65]; p=0.002) were independently associated with 5 year mortality. CONCLUSION Due to a high prevalence, chronic renal disease and cardiovascular disease are main prognostic factors for 5-year mortality among aged PLHIV.
Collapse
Affiliation(s)
- M Hentzien
- Maxime Hentzien, Service de médecine interne, maladies infectieuses, immunologie Clinique, CHU Robert Debré, Avenue du général Koenig, 51092 Reims, France, Telephone number: (+33) 3 26 78 71 89, Fax number: (+33) 3 26 78 40 90, E-mail address:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Spano JP, Poizot-Martin I, Costagliola D, Boué F, Rosmorduc O, Lavolé A, Choquet S, Heudel PE, Leblond V, Gabarre J, Valantin MA, Solas C, Guihot A, Carcelain G, Autran B, Katlama C, Quéro L. Non-AIDS-related malignancies: expert consensus review and practical applications from the multidisciplinary CANCERVIH Working Group. Ann Oncol 2015; 27:397-408. [PMID: 26681686 DOI: 10.1093/annonc/mdv606] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 06/10/2015] [Accepted: 12/01/2015] [Indexed: 01/01/2023] Open
Abstract
Malignancies represent a major cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients. The introduction of combined antiretroviral therapy has modified the spectrum of malignancies in HIV infection with a decreased incidence of acquired immunodeficiency syndrome (AIDS) malignancies such as Kaposi's sarcoma and non-Hodgkin's lymphoma due to partial immune recovery and an increase in non-AIDS-defining malignancies due to prolonged survival. Management of HIV-infected patients with cancer requires a multidisciplinary approach, involving both oncologists and HIV physicians to optimally manage both diseases and drug interactions between anticancer and anti-HIV drugs. The French CANCERVIH group presents here a review and an experience of managing non-AIDS malignancies in HIV-infected individuals.
Collapse
Affiliation(s)
- J-P Spano
- Department of Medical Oncology, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, AP-HP, Paris INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé publique, Paris Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC Université Paris 06, Paris
| | - I Poizot-Martin
- Clinical Immunohaematology Service, Université Aix-Marseille, AP-HM Sainte-Marguerite, Marseille INSERM, U912 (SESSTIM), Marseille
| | - D Costagliola
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé publique, Paris Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC Université Paris 06, Paris
| | - F Boué
- Department of Internal Medicine and Immunology, Hôpital Antoine Béclère, Clamart Faculty of Medicine, Université Paris-Sud, Le Kremlin-Bicêtre
| | - O Rosmorduc
- Faculty of Medicine, Sorbonne Universités, UMPC Université Paris 06, Paris Hepatology Service, Hôpital Saint-Antoine, Paris
| | - A Lavolé
- Pneumology Service, Hôpital Tenon, Paris
| | - S Choquet
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé publique, Paris Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC Université Paris 06, Paris Department of Hematology, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris
| | - P-E Heudel
- Medical Oncology Service, Centre Léon Bérard, Lyon
| | - V Leblond
- Faculty of Medicine, Sorbonne Universités, UMPC Université Paris 06, Paris Department of Hematology, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris Centre for Research in Immunology and Infectious Diseases, Sorbonne Universités, UPMC Université Paris 06, Paris
| | - J Gabarre
- Department of Hematology, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris
| | - M-A Valantin
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé publique, Paris Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC Université Paris 06, Paris Department of Infectious Diseases, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris
| | - C Solas
- Laboratory of Pharmacokinetics and Toxicology, Hôpital de La Timone, Marseille
| | - A Guihot
- Faculty of Medicine, Sorbonne Universités, UMPC Université Paris 06, Paris Department of Immunology, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris
| | - G Carcelain
- Faculty of Medicine, Sorbonne Universités, UMPC Université Paris 06, Paris Centre for Research in Immunology and Infectious Diseases, Sorbonne Universités, UPMC Université Paris 06, Paris
| | - B Autran
- Faculty of Medicine, Sorbonne Universités, UMPC Université Paris 06, Paris Centre for Research in Immunology and Infectious Diseases, Sorbonne Universités, UPMC Université Paris 06, Paris
| | - C Katlama
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé publique, Paris Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC Université Paris 06, Paris Department of Infectious Diseases, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris
| | - L Quéro
- Department of Oncology and Radiotherapy, Hôpital Saint Louis, Paris INSERM UMR_S 965, Université Paris Denis Diderot, Paris, France
| |
Collapse
|
20
|
Salmon D, Bani-Sadr F, Gilbert C, Rosenthal E, Valantin MA, Simon A, Neau D, Morlat P, Loko MA, Wittkop L, Dabis F. HCV viral load at baseline and at week 4 of telaprevir/boceprevir based triple therapies are associated with virological outcome in HIV/hepatitis C co-infected patients. J Clin Virol 2015; 73:32-35. [PMID: 26528903 DOI: 10.1016/j.jcv.2015.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/14/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND As first generation HCV-specific protease inhibitors, boceprevir (BOC) or telaprevir (TVR) can achieve 60% to 70% sustained virological response (SVR) for HCV infected patients with genotype 1 infections, they could remain temporary a therapeutic option in patients living in resources limited countries with limited access to the new anti-HCV direct acting antiviral (DAA) drugs, such as sofosbuvir. OBJECTIVES AND STUDY DESIGN Here we evaluated in a routine practice setting, the treatment responses, tolerance and factors associated with SVR of a triple therapy with BOC or TVR, combined with pegylated interferon and ribavirin (PegIFN/RBV) in HIV/HCV co-infected patients, included in a large cohort of HIV/HCV coinfected patients (ANRS CO13-HEPAVIH). RESULTS Among the 89 HIV/HCV coinfected patients treated, 65% of whom were previous non-responders to PegIFN/RBV therapy, 65%, 55% and 41% had at baseline genotype 1a, a high baseline HCV-RNA (≥800,000 IU/ml) and a cirrhosis, respectively. The SVR12 rate was 63% overall, 53% for BOC-based regimen and 66% for TVR-based regimen. In multivariate analysis, two factors were significantly associated with HCV SVR: HCV viral load <800,000 IU/mL at treatment initiation versus ≥800,000 IU/mL (OR 4.403, 95% CI 1.29-15.04; p=0.018) and virological response at W4 (HCV-RNA undetectable after 4 weeks of triple therapy) (OR 3.35, 95% CI 1.07-10.48; p=0.038). CONCLUSIONS Overall SVR12 was 63% and our results suggest that HIV/HCV coinfected patients with low HCV viral load (<800,000 IU/mL) and undetectable HCV-RNA after 4 weeks of triple therapy with TVR or BOC-based regimen have a higher probability of treatment success.
Collapse
Affiliation(s)
- D Salmon
- Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP-Université Paris Descartes, Paris, France
| | - F Bani-Sadr
- Service des Maladies Infectieuses et Tropicales, CHU Reims, Université Champagne Ardenne, Reims, France.
| | - C Gilbert
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - E Rosenthal
- Service de Médecine Interne, Hôpital de l'Archet, Nice, France
| | - M A Valantin
- Service des Maladies Infectieuses et Tropicales, Hôpital Pitié Salpêtrière-APHP, Paris, France
| | - A Simon
- Service de Médecine Interne, Hôpital Pitié Salpêtrière-APHP, Paris, France
| | - D Neau
- Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France
| | - P Morlat
- Service de Médecine Interne et Maladies Infectieuses, CHU de Bordeaux, Bordeaux, France
| | - M A Loko
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - L Wittkop
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | - F Dabis
- INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France
| | | |
Collapse
|
21
|
Seang S, Fourati S, Keita Y, Blanc C, Tubiana R, Schneider L, Valantin MA, Caby F, Calin R, Lambert-Niclot S, Marcelin AG, Calvez V, Costagliola D, Katlama C. Rapid plasma viral suppression in naive HIV-infected patients with high CD4 cells and low viraemia initiating a dual nucleoside reverse transcriptase inhibitor strategy: a proof-of-concept study. J Antimicrob Chemother 2014; 69:3356-9. [PMID: 25056835 DOI: 10.1093/jac/dku265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate whether a dual nucleoside reverse transcriptase inhibitor (NRTI) strategy can control HIV replication in antiviral therapy (ART)-naive HIV-infected patients with a high CD4 cell count and a low viral load (VL). METHODS This observational study included all HIV-infected treatment-naive patients with a CD4 cell count >300 cells/mm(3), a plasma HIV RNA between 1000 copies/mL and 30,000 copies/mL and wild-type virus who initiated dual NRTI ART between January 2008 and December 2012. HIV RNA and CD4 cell count were assessed at Day 0, Week (W) 4, W12, W24 and W48. The primary endpoint was the proportion of patients with a plasma VL (pVL) <50 copies/mL at W24. RESULTS Twenty patients were included. The median (IQR) baseline characteristics were: time since HIV diagnosis, 25 months (8-66 months); CD4 cell count, 592 cells/mm(3) (405-798 cells/mm(3)); HIV RNA, 10,395 copies/mL (4106-16,566 copies/mL); and HIV DNA, 464 copies/10(6) peripheral blood mononuclear cells (195-1168 copies/10(6) PBMC). Nineteen patients received tenofovir/emtricitabine and one patient received abacavir/lamivudine. At W12, 88% of the patients with available data (n = 16/18, 95% CI 0.65-0.99) had a pVL <50 copies/mL. Overall, the proportion of patients with a pVL <50 copies/mL was 100% (n = 20/20, 95% CI 0.83-1.0) at W24 and 95% (n = 18/19, 95% CI 0.74-0.99) at W48 (with one patient lost to follow-up and one patient with poor treatment compliance). The median increase in CD4 cells was 83 cells/mm(3) (40-310 cells/mm(3)). There was no discontinuation of antiretroviral therapy for any reason such as lack of efficacy or toxicity. CONCLUSIONS This pilot study suggests that, in patients with a high CD4 cell count and a low VL, a dual NRTI strategy may represent a potentially effective treatment strategy to control HIV replication. This needs to be confirmed in larger controlled clinical studies.
Collapse
Affiliation(s)
- S Seang
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - S Fourati
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France AP-HP, Virology Department, Pitié Salpêtrière University Hospital, Paris, France
| | - Y Keita
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - C Blanc
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - R Tubiana
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - L Schneider
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - M A Valantin
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - F Caby
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - R Calin
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - S Lambert-Niclot
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France AP-HP, Virology Department, Pitié Salpêtrière University Hospital, Paris, France
| | - A-G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France AP-HP, Virology Department, Pitié Salpêtrière University Hospital, Paris, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France AP-HP, Virology Department, Pitié Salpêtrière University Hospital, Paris, France
| | - D Costagliola
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - C Katlama
- AP-HP, Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institute Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| |
Collapse
|
22
|
Caby F, Schneider L, Blanc C, Soulié C, Tindel M, Peytavin G, Agher R, Valantin MA, Tubiana R, Wirden M, Calvez V, Marcelin AG, Katlama C. Efficacy of raltegravir switching strategies in HIV-infected patients with suppressed viraemia according to the genotypic sensitivity score. Infection 2013; 42:295-301. [PMID: 24155032 DOI: 10.1007/s15010-013-0542-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND PURPOSE The lack of antiretroviral (ARV) backbone activity associated with raltegravir has been proposed as the main explanation for virological relapse observed in patients with undetectable viraemia who are switched from a ritonavir-boosted protease inhibitor (PI) to raltegravir. However ARV activity remains difficult to assess in this context. The aim of our study was to precisely assess the ARV backbone activity in patients with undetectable viraemia who underwent raltegravir switching strategies and to evaluate the efficacy of such switching strategies based on the genotypic sensitivity score (GSS). METHODS Patients with a plasma human immunodeficiency virus type 1 (HIV-1) RNA level of <50 copies/mL on a stable two ARV-class regimen were enrolled if they switched one of their ARV drugs to raltegravir 400 mg twice daily. The GSS was calculated using a genotyping test performed on the HIV-1 RNA of the last plasma measurement with a HIV-1 RNA level of >50 copies/mL before the switch and on the results of all previous genotyping tests. The primary endpoint was the proportion of patients with a plasma HIV-1 RNA level of <50 copies/mL at week 24. RESULTS Fifty-six patients were enrolled in this study. The proportion of patients with a plasma HIV-1 RNA level of <50 copies/mL at week 24 was 92.9 % (range 83.0-97.2 %) in the intent-to-treat analysis and 98.1 % (90.0-99.7 %) in per-protocol analysis. When the backbone was fully active, the proportion was 100.0 % (86.7-100.0 %) at week 24 and week 48 in the per-protocol analysis. We observed a decrease in plasma total cholesterol and triglycerides of -12.7 % (p = 0.005) and -26.5 % (p = 0.001), respectively. CONCLUSIONS Raltegravir switching strategies are effective when the associated backbone is fully active according to the GSS. In the context of undetectable viraemia, where ARV activity remains difficult to assess, the determination of the GSS requires the entire ARV history of the patient and all previous HIV-RNA genotyping test results.
Collapse
Affiliation(s)
- F Caby
- Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, 47/83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France,
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Semaille C, Le Strat Y, Chiron E, Chemlal K, Valantin MA, Serre P, Caté L, Barbier C, Jauffret-Roustide M. Prevalence of human immunodeficiency virus and hepatitis C virus among French prison inmates in 2010: a challenge for public health policy. ACTA ACUST UNITED AC 2013; 18. [PMID: 23870097 DOI: 10.2807/1560-7917.es2013.18.28.20524] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We evaluated prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among prison inmates in France in 2010, in a cross-sectional single-day study based on a two-stage design. Sampling favoured larger establishments and included all types of prisons. Establishments were stratified by geographical region. Estimates were adjusted by post-stratification of the total population of inmates in France. From 60,975 inmates in all 188 prisons on the sampling day, 2,154 were selected from 27 prisons, and 1,876 questionnaires completed. HIV prevalence was estimated at 2.0% (95% confidence interval (CI): 0.9–4.2), 2.6% (95% CI: 0.7–8.8) in women and 2.0% (95% CI: 0.9–4.3) in men; 75% of inmates were receiving treatment for HIV. HCV prevalence was estimated at 4.8% (95% CI: 3.5–6.5) and was higher for women (11.8%; 95% CI: 8.5–16.1) than men (4.5%; 95% CI: 3.3–6.3). Almost half of HCV-infected inmates had chronic hepatitis C and 44% were receiving or had received treatment. HIV and HCV prevalence was six times higher than in the general population, and 2.5% of inmates had viraemic hepatitis C. The moment of incarceration provides an ideal opportunity for testing and treating, limiting spread of HCV and improving patients' prognosis.
Collapse
Affiliation(s)
- C Semaille
- Institut de Veille Sanitaire, Saint-Maurice, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Valantin MA, Kolta S, Flandre P, Algarte Genin M, Meynard JL, Ponscarme D, Slama L, Cuzin L, de Kerviler E, Inaoui R, Katlama C. Body fat distribution in HIV-infected patients treated for 96 weeks with darunavir/ritonavir monotherapy versus darunavir/ritonavir plus nucleoside reverse transcriptase inhibitors: the MONOI-ANRS136 substudy. HIV Med 2012; 13:505-15. [PMID: 22416798 DOI: 10.1111/j.1468-1293.2012.01004.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate fat tissue distribution in HIV-infected patients with suppressed viraemia treated with darunavir/ritonavir (darunavir/r) monotherapy versus darunavir/r triple therapy. METHODS This study was a substudy of the randomized, multicentre, open-label MONOI-ANRS 136 trial. Body fat distribution and metabolic parameters were measured at baseline, week 48 and week 96. RESULTS In total, 156 patients of the 225 initially enrolled in the MONOI trial participated in this study, 75 in the darunavir/r monotherapy arm and 81 in the darunavir/r triple-therapy arm. The median limb fat increase from baseline was +0.34 kg [interquartile range (IQR) -0.040 to +1.140 kg; P < 0.001] at week 48 and +0.33 kg (IQR -0.14 to +1.26 kg; P = 0.001) at week 96 in the monotherapy arm, while there was no change (-0.02 kg; IQR -0.53 to +0.52 kg) at week 48 and then an increase of +0.23 kg (IQR -0.45 to +0.87 kg; P = 0.046) at week 96 in the triple-therapy arm. The two arms differed significantly at week 48 (P = 0.001) but not at week 96. The median increase in trunk fat was +0.73 kg (IQR -0.24 to +1.60 kg; P < 0.001) and 0.60 kg (IQR -0.41 to +1.49 kg; P = 0.03) at week 48 and +1.16 kg (IQR -0.17 to +2.75 kg; P < 0.001) and +0.90 kg (IQR -0.51 to +2.34 kg; P = 0.001) at week 96 in the monotherapy and triple-therapy arms, respectively, with no difference between arms. At week 96, the only biological change was a glucose level elevation in the monotherapy arm (median +4.0 mg/dL; IQR -4.0 to +7.0 mg/dL) compared with the triple-therapy arm (P = 0.012). CONCLUSIONS Overall, body fat tissue increased in patients on darunavir/r monotherapy and triple therapy, with no difference between the arms over 96 weeks. The only difference found was a delayed increase in limb fat tissue in the triple-therapy arm compared with the monotherapy arm in the first year.
Collapse
Affiliation(s)
- M A Valantin
- INSERM UMR-S 943 and University Pierre and Marie Curie (UPMC), Paris, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Valantin MA, Lambert-Niclot S, Flandre P, Morand-Joubert L, Cabiè A, Meynard JL, Ponscarme D, Ajana F, Slama L, Curjol A, Cuzin L, Schneider L, Taburet AM, Marcelin AG, Katlama C. Long-term efficacy of darunavir/ritonavir monotherapy in patients with HIV-1 viral suppression: week 96 results from the MONOI ANRS 136 study. J Antimicrob Chemother 2011; 67:691-5. [PMID: 22160145 DOI: 10.1093/jac/dkr504] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Long-term results at week 96 are needed to evaluate the capacity of the darunavir/ritonavir monotherapy strategy to maintain a sustained control of the HIV-1 viral load. METHODS MONOI is a prospective, open-label, non-inferiority, randomized, 96 week trial comparing darunavir/ritonavir monotherapy versus a darunavir/ritonavir triple-therapy strategy to maintain HIV-1 viral load suppression in HIV-1-infected patients. CLINICAL TRIAL REGISTRATION NCT00412551. RESULTS From 225 randomized patients, 219 patients reached the 48 week follow-up and 211 reached the 96 week follow-up (106 patients in the darunavir monotherapy arm and 105 in the darunavir triple-therapy arm). Baseline characteristics were well balanced between the two treatment groups. At week 96, in intent-to-treat analysis, 91/103 patients (88%, 95% CI 81-94) allocated to the darunavir/ritonavir monotherapy arm and 87/104 patients (84%, 95% CI 75-90) allocated to the darunavir triple-therapy arm achieved an HIV-1 viral load <50 copies/mL, with no statistical difference between the two groups. Throughout the 96 week follow-up, 66/112 patients (59%, 95% CI 49-68) and 79/113 patients (70%, 95% CI 61-78) consistently had HIV-1 RNA <50 copies/mL with darunavir/ritonavir monotherapy and darunavir/ritonavir triple therapy, respectively. CONCLUSIONS The MONOI study establishes darunavir/ritonavir monotherapy as durable and efficacious for maintaining virological suppression in HIV-1 patients. Darunavir/ritonavir monotherapy should be considered as a (tailored) treatment option for standard triple-therapy patients who have had a substantial period of viral suppression.
Collapse
Affiliation(s)
- M A Valantin
- INSERM UMR-S 943 and University Pierre and Marie Curie (UPMC) Paris VI, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Cuzin L, Allavena C, Levy-Bachelot L, Valantin MA, Mellliez H, Pugliese P, Poizot-Martin I, Duvivier C, Finkielsztejn L, Abel S. Tolerance and durability of abacavir/lamivudine (ABC/3TC)-containing regimens: results from a large prospective French cohort. J Int AIDS Soc 2010. [PMCID: PMC3113047 DOI: 10.1186/1758-2652-13-s4-p44] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
27
|
Michel L, Villes V, Dabis F, Spire B, Winnock M, Loko MA, Poizot-Martin I, Valantin MA, Bonnard P, Salmon-Céron D, Carrieri MP. Role of treatment for depressive symptoms in relieving the impact of fatigue in HIV-HCV co-infected patients: ANRS Co13 Hepavih, France, 2006-2008. J Viral Hepat 2010; 17:650-60. [PMID: 20002565 DOI: 10.1111/j.1365-2893.2009.01223.x] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Fatigue is a major component of quality of life (QOL) and is associated with depression in HIV-HCV co-infected individuals. We investigated whether treating depressive symptoms (DS) could mitigate the impact of fatigue on daily functioning in co-infected patients, even those at an advanced stage of disease. The analysis was conducted on enrollment data of 328 HIV-HCV co-infected patients recruited in the French nationwide ANRS CO 13 HEPAVIH cohort. Data collection was based on medical records and self-administered questionnaires which included items on socio-behavioural data, the fatigue impact scale (FIS) in three domains (cognitive, physical and social functioning), depressive symptoms (CES-D classification) and use of treatments for depressive symptoms (TDS). After multiple adjustment for gender and unemployment, CD4 cell count <200 per mm(3) was associated with a negative impact of fatigue on the physical functioning dimension (P = 0.002). A higher number of symptoms causing discomfort significantly predicted a higher impact of fatigue on all three dimensions (P < 0.001). This was also true for patients with DS receiving TDS when compared with those with no DS but receiving TDS. A significant decreasing linear trend (P < 0.001) of the impact of fatigue was found across the categories 'DS/TDS', 'DS/no TDS', 'no DS/TDS' and 'no DS/no TDS'. Despite limitations related to the cross-sectional nature of this study, our results suggest that routine screening and treatment for DS can reduce the impact of fatigue on the daily functioning of HIV-HCV co-infected patients and relieve the burden of their dual infection.
Collapse
|
28
|
Billault C, Duvivier C, Valantin MA, Arzouk N, Mercadal L, Ourahma S, Fehri K, Van Glabeke E, Vaessen C, Barrou B. Kidney transplantation in HIV-positive patients: report of our first 7 cases. Transplant Proc 2010; 41:3301-4. [PMID: 19857735 DOI: 10.1016/j.transproceed.2009.08.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Infection with human immunodeficiency virus (HIV) is associated with end-stage renal disease (ESRD). Although many teams initially were reluctant to offer kidney transplantation as a therapeutic option in HIV-positive patients with ESRD, new drug regimens introduced in the late 1990s have dramatically improved the life expectancy in these patients. OBJECTIVE To report the results of the first 7 kidney transplantation procedures in HIV-positive patients at our institution. PATIENTS AND METHODS Patients were selected to minimize the risks of HIV disease progression, opportunistic infections, and tumors. Protease-inhibitor therapies were suspended because of possible interaction with immunosuppression drugs. The induction regimen did not include lymphocyte-depleting drugs. After undergoing transplantation, patients were monitored by the transplantation and infectious disease teams. RESULTS To date, all patients are alive with functioning grafts. We did not observe any episodes of acute rejection, and there were few adverse events. Drug tolerance was good for both immunosuppression and antiretroviral therapies. CONCLUSION Kidney transplantation in HIV-positive patients with ESRD is warranted. Provided that patients are carefully selected, good results can be achieved with few adverse events, episodes of acute rejection, and drug interactions. Posttransplantation, these patients must be closely monitored by both the transplantation and infectious diseases teams to ensure optimal management.
Collapse
Affiliation(s)
- C Billault
- Service d'Urologie et de Transplantation Rénale, Hôpital de la Pitié Salpêtrière, 75013 Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Valantin MA, Bittar R, de Truchis P, Bollens D, Slama L, Giral P, Bonnefont-Rousselot D, Pétour P, Aubron-Olivier C, Costagliola D, Katlama C. Switching the nucleoside reverse transcriptase inhibitor backbone to tenofovir disoproxil fumarate + emtricitabine promptly improves triglycerides and low-density lipoprotein cholesterol in dyslipidaemic patients. J Antimicrob Chemother 2010; 65:556-61. [PMID: 20053692 DOI: 10.1093/jac/dkp462] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the impact of switching to tenofovir disoproxil fumarate + emtricitabine on lipid parameters. METHODS HIV-infected patients with plasma viral load <400 copies/mL, fasted triglycerides from 2.3 to 11.4 mmol/L and/or fasted low-density lipoprotein (LDL)-cholesterol >4.1 mmol/L were randomized to switch the nucleoside reverse transcriptase inhibitor (NRTI) backbone to fixed-dose combination tenofovir disoproxil fumarate + emtricitabine or to maintain the baseline antiretroviral regimen (the control group). The study has been registered with ClinicalTrials.gov under the identifier NCT00323492. RESULTS Ninety-one patients were included in the intent-to-treat (ITT) analysis with triglycerides 2.4 mmol/L and LDL-cholesterol 4.0 mmol/L (median values). At week 12, the median changes from baseline of triglycerides were -0.5 mmol/L (-25%; n = 46) and -0.1 mmol/L (-6%; n = 45) in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.034) [95% confidence interval (CI): -0.9 to -0.0]. Similarly for LDL-cholesterol, changes of -0.4 mmol/L (-9%) and -0.1 mmol/L (-1%) were observed in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.031) [95% CI: -0.7 to -0.0]. The proportion of patients with LDL-cholesterol >4.1 mmol/L decreased from 48% at baseline to 26% at week 12 in the tenofovir disoproxil fumarate + emtricitabine group versus no change in the control group. No virological failure was observed during the study. CONCLUSIONS Switching to tenofovir disoproxil fumarate + emtricitabine in dyslipidaemic HIV-infected patients improves triglycerides and LDL-cholesterol.
Collapse
Affiliation(s)
- M A Valantin
- Department of Infectious Diseases, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Pugliese P, Cuzin L, Cabié A, Poizot-Martin I, Allavena C, Duvivier C, El Guedj M, de la Tribonnière X, Valantin MA, Dellamonica P. A large French prospective cohort of HIV-infected patients: the Nadis Cohort. HIV Med 2009; 10:504-11. [PMID: 19486189 DOI: 10.1111/j.1468-1293.2009.00719.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this article is to describe the development of a dynamic French cohort of HIV-infected patients, the methodological issues and decisions made, and the characteristics of the patients currently enrolled. METHODS Data are collected during medical encounters. Data quality is ensured by automated checks during data capture, by regular controls, by annual assessments, and by ad hoc processes before any scientific analysis is performed. RESULTS In September 2007, 10,458 patients representing 59,383 patient-years of follow-up were followed in our centres, including 446 with a first HIV diagnosis in the past year. Among these recently diagnosed patients, 25.6% presented with late diagnosis. Our cohort included 3017 women (28.8%). The women were less likely to be receiving highly active antiretroviral therapy (HAART) than men, and when treated were less likely to be receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Our network includes medical centres in overseas territories (1105 patients living overseas). In this particular population, women represented 38.5% of the patients, and the probable route of infection was heterosexual in 75.7% of the patients. Despite epidemiological and social disparities, more patients had nondetectable viral loads when receiving HAART in overseas departments than in metropolitan France. CONCLUSION The Nadis Cohort represents a collaboration of major French HIV treatment centres. In September 2007, the cohort database contained up-to-date information on more than 10,000 patients, of whom a significant proportion were women. As a consequence of the choices made when building the cohort and the efforts made to ensure the quality of the database, scientific studies are regularly performed using this cohort.
Collapse
Affiliation(s)
- Pascal Pugliese
- Nice University - Sofia Antipolis, Hôpital l'Archet, Nice, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Pugliese P, Cuzin L, Cabié A, Poizot-Martin I, Allavena C, Duvivier C, El Guedj M, de la Tribonnière X, Valantin MA, Dellamonica P. A large French prospective cohort of HIV-infected patients: the Nadis Cohort. HIV Med 2009; 14:509-15. [PMID: 19486189 DOI: 10.1111/hiv.12041] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The aim of this article is to describe the development of a dynamic French cohort of HIV-infected patients, the methodological issues and decisions made, and the characteristics of the patients currently enrolled. METHODS Data are collected during medical encounters. Data quality is ensured by automated checks during data capture, by regular controls, by annual assessments, and by ad hoc processes before any scientific analysis is performed. RESULTS In September 2007, 10,458 patients representing 59,383 patient-years of follow-up were followed in our centres, including 446 with a first HIV diagnosis in the past year. Among these recently diagnosed patients, 25.6% presented with late diagnosis. Our cohort included 3017 women (28.8%). The women were less likely to be receiving highly active antiretroviral therapy (HAART) than men, and when treated were less likely to be receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Our network includes medical centres in overseas territories (1105 patients living overseas). In this particular population, women represented 38.5% of the patients, and the probable route of infection was heterosexual in 75.7% of the patients. Despite epidemiological and social disparities, more patients had nondetectable viral loads when receiving HAART in overseas departments than in metropolitan France. CONCLUSION The Nadis Cohort represents a collaboration of major French HIV treatment centres. In September 2007, the cohort database contained up-to-date information on more than 10,000 patients, of whom a significant proportion were women. As a consequence of the choices made when building the cohort and the efforts made to ensure the quality of the database, scientific studies are regularly performed using this cohort.
Collapse
Affiliation(s)
- Pascal Pugliese
- Nice University - Sofia Antipolis, Hôpital l'Archet, Nice, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Valantin MA, Lanoy E, Bentata M, Kalmykova O, Boutekadjirt A, Allavena C, Rozenbaum W, Peytavin G, Amellal B, Calvez V, Costagliola D, Katlama C. Recovery of fat following a switch to nucleoside reverse transcriptase inhibitor-sparing therapy in patients with lipoatrophy: results from the 96-week randomized ANRS 108 NoNuke Trial. HIV Med 2008; 9:625-35. [PMID: 18624724 DOI: 10.1111/j.1468-1293.2008.00606.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the impact on peripheral fat tissue of a nucleoside reverse transcriptase inhibitor (NRTI)-sparing regimen in lipoatrophic HIV-1 infected patients. METHODS This 96-week prospective, randomized study compared lipoatrophic patients switched to an NRTI-sparing regimen with patients remaining on an NRTI-containing regimen. The primary endpoint was the change in thigh subcutaneous fat tissue volume between baseline and week 48, as assessed by computerized tomography. RESULTS One hundred patients were included, 50 in each arm. At baseline, patients had been on highly active antiretroviral therapy (HAART) for a median time of 6.6 years (4.9-9.7); 71% of the patients had received thymidine analogues [stavudine (37%), zidovudine (34%)]. The mean change in fat volume between baseline and week 48 significantly favoured the NRTI-sparing arm over the NRTI-maintaining arm in the intent-to-treat analysis, with a last-observation-carried-forward approach [+34 cm(3); 95% confidence interval (CI) 5-63 cm(3); P=0.002]. This was confirmed in the intent-to-treat analysis of available data, with a mean difference of +109 cm(3) (95% CI 34-185 cm(3)) at week 96 (n=53; P=0.001). This corresponded to increases of 12 and 30% in fat volume at weeks 48 and 96, respectively, in the NRTI-sparing arm. CONCLUSIONS Switching from an effective NRTI-containing regimen to an NRTI-sparing regimen preserves immunovirological status and increases subcutaneous fat volume at weeks 48 and 96.
Collapse
Affiliation(s)
- M A Valantin
- Department of Clinical Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Martinez V, Dieu TA NT, Guiget M, Mokhtari Z, Valantin MA, Charlotte F, Bertheau P, Molina JM, Katlama C, Caumes E. Frequency of hepatic steatosis in HIV and hepatitis C co-infected patients treated by antiretroviral therapy during 1995 to 2008. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p269] [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: 11/10/2022] Open
|
34
|
Allavena C, Flandre P, Pugliese P, Valantin MA, Izopet J, Garraffo R, Poizot I, Cabie A, Yazdanpanah Y, Cuzin L, Duvivier C, Katlama C, Dellamonica P. Tipranavir in highly ARV-experienced patients: efficacy and tolerability results from the French prospective NADIS cohort. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p26] [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: 11/10/2022] Open
|
35
|
Schnuriger A, Dominguez S, Valantin MA, Tubiana R, Duvivier C, Ghosn J, Simon A, Katlama C, Thibault V. Intérêt d'un nouveau test combiné antigène–anticorps pour le dépistage de l'infection par le virus de l'hépatite C : réduction de la fenêtre sérologique au cours de l'hépatite C aiguë chez le sujet co-infecté par le VIH. ACTA ACUST UNITED AC 2006; 54:578-86. [PMID: 17030457 DOI: 10.1016/j.patbio.2006.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 07/27/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to determine the clinical benefit of a new combined antigen-antibody immunoenzymatic assay (Monolisa HCV Ag-Ab Ultra, Biorad) in the setting of acute HCV infection in HIV infected patients. PATIENTS AND METHODS The performance of this assay was first evaluated in 160 HIV positive samples from uninfected and chronically HCV infected patients. To assess the performance of the Ag-Ab assay in the context of acute hepatitis C, 94 stored frozen serums from 20 recently diagnosed cases were retrospectively tested for HCV-RNA and presence of anti-HCV antibodies, in parallel with the new assay. RESULTS In HIV infected patients, the sensitivity and specificity of the Ultra assay was 100% with a strong discrimination between positive and negative samples. In HCV acutely infected patients, the Ag-Ab assay significantly reduced the seronegative period, allowing an earlier diagnosis compared to a 3rd generation ELISA in 65% of the cases. The combined assay became positive on the same bleed as the first HCV-RNA detection for 13 patients out of 20. Nevertheless, in one case, characterized by an absence of seroconversion over one year but a continuous viral replication above 1 million IU/ml, the combined assay did not improve HCV infection diagnosis. CONCLUSION Use of this new assay as a first line screening would significantly reduce the long seronegative window period seen in HCV infection allowing earlier HCV diagnosis and rapid clinical management. However, in case of clinical acute hepatitis C, sensitive HCV-RNA detection should remain the gold standard.
Collapse
Affiliation(s)
- A Schnuriger
- Service de virologie, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Schnuriger A, Dominguez S, Valantin MA, Tubiana R, Duvivier C, Ghosn J, Simon A, Katlama C, Thibault V. Early detection of hepatitis C virus infection by use of a new combined antigen-antibody detection assay: potential use for high-risk individuals. J Clin Microbiol 2006; 44:1561-3. [PMID: 16597894 PMCID: PMC1448659 DOI: 10.1128/jcm.44.4.1561-1563.2006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [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: 12/28/2022] Open
Abstract
The performance of a new combined antigen-antibody assay (Monolisa HCV Ag-Ab Ultra; Bio-Rad Laboratories) was evaluated in the context of acute hepatitis C in human immunodeficiency virus-infected patients. The combined assay became positive as early as the first PCR and earlier than a third-generation enzyme-linked immunosorbent assay in 65% of the cases. Reduction of the long period of HCV seronegativity should improve the diagnosis of hepatitis C infection, especially in high-risk populations.
Collapse
Affiliation(s)
- A Schnuriger
- Department of Virology, Hôpital La Pitié-Salpêtrière, 83, Boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Gambotti L, Batisse D, Colin-de-Verdiere N, Delaroque-Astagneau E, Desenclos JC, Dominguez S, Dupont C, Duval X, Gervais A, Ghosn J, Larsen C, Pol S, Serpaggi J, Simon A, Valantin MA, Velter A. Acute hepatitis C infection in HIV positive men who have sex with men in Paris, France, 2001-2004. Euro Surveill 2005; 10:115-7. [PMID: 16077209] [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: 05/03/2023] Open
Abstract
In mid-2004, three Parisian hospital wards informed the Institut de veille sanitaire of recent acute hepatitis C in HIV-infected (HIV+) men who had sex with men (MSM). These cases for whom none of the usual bloodborne routes for hepatitis C (HCV) transmission was found, reported having had unprotected sex. In October 2004, we conducted a retrospective investigation in Parisian hospital wards to explore HCV modes of transmission in recent acute hepatitis C in HIV+ MSM. Patient demographics, clinical and biological status of HIV infection, reasons for HCV testing, sexual behaviour and risk factors for HCV transmission within the 6 months before hepatitis onset were collected from medical records. An anonymous self-administered questionnaire on sexual behaviour within the six months before hepatitis onset was also offered to all cases. We identified 29 cases of acute hepatitis C in HIV+ MSM with onset from April 2001 to October 2004. HIV infection was asymptomatic for 76%. Median age at hepatitis C onset was 40 (28-54) years. In all records, were noted unprotected anal sex, fisting in 21% and a concomitant sexually transmitted infection (STI) in 41%. Median time between HIV diagnosis and HCV infection was 6.5 years (0-22). From the 11 self-administered questionnaires completed, 10 reported an STI, 8 'hard' sexual practices, 6 bleeding during sex and 5 fisting. HCV transmission probably occurred through bleeding during unprotected traumatic anal sex among HIV+ MSM and may be facilitated by STI mucosal lesions. This report stresses the continuous need to strongly advocate safer sex to MSM.
Collapse
Affiliation(s)
- L Gambotti
- Institut de veille sanitaire, Saint-Maurice, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Ghosn J, Pierre-François S, Thibault V, Duvivier C, Tubiana R, Simon A, Valantin MA, Dominguez S, Caumes E, Katlama C. Acute hepatitis C in HIV-infected men who have sex with men. HIV Med 2004; 5:303-6. [PMID: 15236621 DOI: 10.1111/j.1468-1293.2004.00225.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [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: 12/09/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is usually transmitted via the parenteral route, but there are widely discrepant findings on its possible sexual transmission. Thus there are no recommendations concerning protected sex for couples in which only one partner is HCV-infected. Whether HIV or other sexually transmitted diseases could favour HCV transmission remains unclear, but recent data suggesting an increasing incidence of acute HCV in HIV-infected men underline the major public health implications of this issue. CASE REPORTS Between June 2002 and July 2003, five HIV-infected homosexually active men presented with primary (n=4) and secondary (n=1) syphilis and concomitant abnormal liver function tests revealing acute asymptomatic HCV seroconversion. Other causes of acute viral hepatitis were inquired into and excluded. Highly at-risk sexual behaviour, including unprotected anal intercourse and unsafe oral sex, with concomitant syphilis, was found to be the only identifiable important risk factor for transmission of HCV. CONCLUSIONS Sexual transmission may be fuelling a significant increase in HCV seroconversions among HIV-infected men who have highly risky sexual behaviours. Given the recent data suggesting the spread of sexually transmitted infections among HIV-infected gay men, specific recommendations concerning safe sex are urgently needed.
Collapse
Affiliation(s)
- J Ghosn
- Département des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Pitié-Salpétrière, Paris, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
van Leth F, Conway B, Laplumé H, Martin D, Fisher M, Jelaska A, Wit FW, Lange JMA, Laplumé H, Lasala MB, Losso MH, Bogdanowicz E, Lattes R, Krolewiecki A, Zala C, Orcese C, Terlizzi S, Duran A, Ebensrteijn J, Bloch M, Russell O, Russell DB, Roth NR, Eu B, Austin D, Gowers A, Quan D, Demonty J, Peleman R, Vandercam B, Vogelaers D, van der Gucht B, van Wanzeele F, Moutschen MM, Badaro R, Grinsztejn B, Schechter M, Uip D, Netto EN, Coelho SS, Badaró F, Pilotto JH, Schubach A, Barros ML, Leite OHM, Kiffer CRV, Wunsch CT, Nunes D, Catalani A, de Cassia Alves LR, Dossin TJ, D'Alló de Oliveira MT, Martini S, Conway B, de Wet JJ, Montaner JSG, Murphy C, Woodfall B, Sestak P, Phillips P, Montessori V, Harris M, Tesiorowski A, Willoughby B, Voigt R, Farley J, Reynolds R, Devlaming S, Livrozet JM, Rozenbaum W, Sereni D, Valantin MA, Lascoux C, Milpied B, Brunet C, Billaud E, Huart A, Reliquet V, Charonnat MF, Sicot M, Esnault JL, Slama L, Staszewski S, Bickel M, Lazanas MK, Stavrianeas N, Mangafas N, Zagoreos I, Kourkounti S, Paparizos V, Botsi C, Clarke S, Brannigan E, Boyle N, Chiriani A, Leoncini F, Montella F, Francesco L, Ambu S, Farese A, Gargiulo M, Di Sora F, Lavria F, Folgori F, Beniowski M, Boron Kaczmarska A, Halota W, Prokopowicz D, Bander DB, Leszuzyszyn-Pynka MLP, Wnuk AW, Bakowska E, Pulik P, Flisiak R, Wiercinska-Drapalo A, Mularska E, Witor A, Antunes F, Sarmento RSE, Doroana M, Horta AA, Vasconcelos O, Andrews SM, Huisamen CB, Johnson D, Martin O, Bekker LG, Maartens G, Wilson D, Visagie CJ, David NJ, Rattley M, Nettleship E, Martin DJ, Keyser V, Moraites TM, Moorhouse MA, Pitt JA, Orrell CJ, Bester C, Parboosing R, Moodley P, Gathiram V, Woolf D, Bernasconi E, Magenta L, Cardiello P, Kroon E, Ungsedhapand C, Fisher M, Wilkins EGL, Stockwell E, Day J, Daintith RS, Perry N, Timaeus C, Intosh-Roffet JM, Powell A, Youle M, Tyrer M, Madge S, Drinkwater A, Cuthbertson Z, Carroll A, Becker S, Katner H, Rimland D, Saag MS, Thompson M, Witt M, Aguilar MM, LaVoy A, Illeman M, Guerrero M, Gatell J, Belsey E, Hirschel B, Potarca A, Cronenberg M, Kreekel L, Meester R, Khodabaks J, Botma HJ, Esrhir N, Farida I, Feenstra M, Jansen K, Klotz A, Mulder M, Ruiter G, Bass CB, Pluymers E, de Vlegelaer E, Leeneman (VCL) R, Carlier H, van Steenberge E, Hall D. Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz. Antivir Ther 2004. [DOI: 10.1177/135965350400900512] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL). Design A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine. Methods Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance. Results The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV ( P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively ( P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event. Conclusions First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.
Collapse
Affiliation(s)
| | - Frank van Leth
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Brian Conway
- University of British Columbia, Vancouver, BC, Canada
| | - Hector Laplumé
- Hospital Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Des Martin
- Toga Laboratories, Edenvale, South Africa
| | - Martin Fisher
- Brighton and Sussex University Hospitals, Brighton, UK
| | - Ante Jelaska
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Conn., USA
| | - Ferdinand W Wit
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joep MA Lange
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Delaugerre C, Valantin MA, Mouroux M, Bonmarchand M, Carcelain G, Duvivier C, Tubiana R, Simon A, Bricaire F, Agut H, Autran B, Katlama C, Calvez V. Re-occurrence of HIV-1 drug mutations after treatment re-initiation following interruption in patients with multiple treatment failure. AIDS 2001; 15:2189-91. [PMID: 11684940 DOI: 10.1097/00002030-200111090-00016] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [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
Antiretroviral treatment interruption in 20 extensively pre-treated HIV-1 patients with treatment failure led to genotype viral reversion of at least one class of drug-mutation resistance in half of the patients. The only predictive factor of reversion was found to be the duration of interruption. The outgrowth of residual wild-type virus seems not to be a true genetic reversion because drug mutations are detected rapidly at salvage therapy re-initiation.
Collapse
Affiliation(s)
- C Delaugerre
- Department of Virology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Mouroux M, Descamps D, Izopet J, Yvon A, Delaugerre C, Matheron S, Coutellier A, Valantin MA, Bonmarchand M, Agut H, Massip P, Costagliola D, Katlama C, Brun-Vezinet F, Calvez V. Low-rate emergence of thymidine analogue mutations and multi-drug resistance mutations in the HIV-1 reverse transcriptase gene in therapy-naive patients receiving stavudine plus lamivudine combination therapy. Antivir Ther 2001; 6:179-83. [PMID: 11808752] [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: 02/23/2023]
Abstract
OBJECTIVES Mutations usually associated with zidovudine exposure have been observed in zidovudine-naive patients treated by stavudine in combination. These mutations were named thymidine analogue mutations (TAMs). This fact, combined with phenotypical and biochemical findings provided additional evidence for cross-resistance between zidovudine and stavudine. A recent genotypic study in naive patients receiving stavudine/didanosine combination showed emergence of TAMs and a multidrug-resistance mutation (MDR), Q151M, in 36 and 10% of cases, respectively. Stavudine plus lamivudine is one of the most used binucleoside associations in the antiretroviral combinations. The objective of this study was to assess the genotypic changes in the HIV-1 reverse transcriptase (RT) gene in antiretroviral-naive patients treated by stavudine plus lamivudine. METHODS We analysed the RT gene of 44 HIV-1 patients, naive of antiretroviral therapy, who were treated for 24 or 48 weeks with stavudine/lamivudine. RESULTS At the end of the follow-up, all patients acquired the lamivudine-associated mutation M184V. Only two subjects (4.5%) developed a TAM (T215Y; M41L), one subject developed a V75T/A mutation and one subject developed the particular MDR pattern F116Y, Q151M. CONCLUSIONS Our study clearly demonstrated that naive subjects treated with stavudine/lamivudine for 24-48 weeks selected a low rate of TAMs and MDR Q151M. One hypothesis explaining these results could be the development of the M184V mutation.
Collapse
Affiliation(s)
- M Mouroux
- Department of Virology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Baril L, Beucler I, Valantin MA, Bruckert E, Bonnefont-Rousselot D, Coutellier A, Caumes E, Katlama C, Bricaire F. Low lipolytic enzyme activity in patients with severe hypertriglyceridemia on highly active antiretroviral therapy. AIDS 2001; 15:415-7. [PMID: 11273223 DOI: 10.1097/00002030-200102160-00016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L Baril
- Département de Maladies Infectieuses et de Médecine Tropicale, H pital de la Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Mouroux M, Izopet J, Descamps D, Delaugerre C, Yvon-Groussin A, Angleraud F, Coutellier A, Bonmarchand M, Valantin MA, Matheron S, Agut H, Katlama C, Brun-Vezinet F, Calvez V. [Conditions of "thymidine analog mutations" (TAMs) in naive patients treated with different combinations of d4T]. Pathol Biol (Paris) 2000; 48:508-12. [PMID: 10949850] [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: 02/17/2023]
Abstract
Recently, d4T/ddI combination has been associated with the selection of thymidine analogue mutations (TAMs) in 50% of patients with a detectable viral load after 6 to 12 months of this bi-therapy (ALBI, STADI and BMS A1460 tests). We evaluated the rate of selection of the TAMs in naive patients with a viral load of > 200 copies/mL after: 6 months to 1 year of d4T/3TC bi-therapy (group 1); 1 year or more of a treatment including d4T/3TC (group 2); and more than 6 months of tri-therapy including d4T/ddI (group 3). The reverse transcriptase gene has ben studied in 33 patients in group 1, 17 patients in group 2 and ten patients in group 3. For the latter patients, the tri-therapies were as follows: d4T/ddI/PI (n = 5), d4T/ddI/NNRTI (n = 4), d4T/ddI/NRTI (n = 1). For the group 1 patients, at baseline, two patients already had TAMs. At M6, all the patients acquired the 3TC-associated mutations, M184V. Only one patient selected a MDR mutation profile (F116Y, Q151M). At M12, 26 of 33 plasmas were analysed. Only one patient selected one TAM (T215Y). For the group 2 patients, only three patients selected TAMs after more than 30 months of treatment. For the group 3 patients, at baseline, only one patient already harbored TAMs. None of the other patients had selected TAMs. In patients who received d4T/ddI/3TC, only the M184V, the 3TC-associated mutation, was selected. In conclusion, stavudine in association with 3TC selected a low rate of TAMs; in patients receiving a treatment including d4T/3TC, time of exposure to stavudine seemed to be an important parameter for the selection of TAMs; and in contrast to results obtained on d4T/ddI, tri-therapies including d4T/ddI did not select any TAMs, whatever the combination (NRTI, NNRTI, PI).
Collapse
Affiliation(s)
- M Mouroux
- Laboratoire de virologie, hôpital Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Mouroux M, Bossi P, Yvon-Groussin A, Delaugerre C, Valantin MA, Tubiana R, Coutellier A, Bonmarchand M, Bricaire F, Katlama C, Agut H, Huraux JM, Calvez V. [Polymorphism of protease genes in patients infected with HIV-1 and response to therapy including a protease inhibitor]. Pathol Biol (Paris) 1999; 47:549-52. [PMID: 10418038] [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: 02/13/2023]
Abstract
Protease inhibitors (PIs) are recently introduced drugs that have improved the survival of HIV-infected patients when given in combination with two reverse transcriptase inhibitors. The HIV-1 protease gene is naturally highly polymorphic. Selection pressure due to IP use can result in major or minor resistance-associated mutations (RAMs). This study investigated whether presence before IP therapy of minor RAMs on the protease gene predicts the virological response. Of the 58 PI-naive patients included in the study, 12 had received two nucleoside reverse transcriptor inhibitors, 14 had received indinavir, 16 ritonavir, and 28 saquinavir-SGC. Viral load was measured on D0 (prior to PI initiation) and at M3 and M6 (Roche Monitor 1.5 with 200 and 20 copies/ml as the thresholds). The protease gene was fully sequenced on D0 using the ABI 377 automatic sequencer after RNA amplification by nested RT-PCR. None of the viral strains exhibited major mutations, but 57 of 58 (98%) had at least one minor mutation (median number of substitutions, 4), 60% had 1 to 4 substitutions, and 40% had 5 to 9 substitutions. Substitutions seen with a prevalence > 20% were located at codons 15, 35, 37, 41, 63, and 77. Numbers of substitutions at M3 and M6 were not correlated with viral load or the nature of the PI used, and neither were they significantly different between patients with more or fewer than 20 copies/ml. These data suggest that the protease genotype at PI initiation does not predict the efficacy of a regimen including a PI and is of no assistance in deciding whether or not to include a PI in a triple combination regimen.
Collapse
Affiliation(s)
- M Mouroux
- Service de Virologie, Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Bochet MV, Jacquiaud C, Valantin MA, Katlama C, Deray G. Renal insufficiency induced by ritonavir in HIV-infected patients. Am J Med 1998; 105:457. [PMID: 9831435] [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: 02/09/2023]
|
46
|
Katlama C, Valantin MA, Matheron S, Coutellier A, Calvez V, Descamps D, Longuet C, Bonmarchand M, Tubiana R, De Sa M, Lancar R, Agut H, Brun-Vezinet F, Costagliola D. Efficacy and tolerability of stavudine plus lamivudine in treatment-naive and treatment-experienced patients with HIV-1 infection. Ann Intern Med 1998; 129:525-31. [PMID: 9758571 DOI: 10.7326/0003-4819-129-7-199810010-00003] [Citation(s) in RCA: 36] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A combination of two nucleoside analogues is currently the core of any antiretroviral regimen for HIV-1 infection. Stavudine plus lamivudine has shown an additive effect in vitro, as well as an absence of overlapping toxicity and cross-resistance. OBJECTIVE To evaluate the antiviral efficacy of stavudine plus lamivudine in treatment-naive patients and in patients previously treated with other nucleoside reverse transcriptase inhibitors. DESIGN Prospective, open-label pilot study. SETTING Three urban clinical centers in Paris. PATIENTS 83 patients with CD4+ cell counts between 50 and 400 cells/mm3 (42 treatment-naive and 41 treatment-experienced patients). INTERVENTIONS Stavudine, 40 mg twice daily (30 mg twice daily in patients with a body weight < or = 60 kg), and lamivudine, 150 mg twice daily. MEASUREMENTS Primary end points for efficacy included changes in plasma viral load and CD4+ cell count at 24 weeks compared with baseline. RESULTS Therapy with stavudine plus lamivudine resulted in a median decrease of 1.66 log10 (10(1.66)) (range, -3.04 to -0.79 log10) in plasma HIV-1 RNA; the median increase in CD4+ cell count was 108 cells/mm3 (range, -58 to 406 cells/mm3) at week 24 in treatment-naive patients. In treatment-experienced patients, the median reduction in plasma HIV-1 RNA was 0.55 log10 (range, -2.86 to 0.52 log10), and the median increase in CD4+ cell count was 46 cells/mm3 (range, -188 to 311 cells/mm3). The percentages of patients with less than 3000 HIV-1 RNA copies/mL and less than 400 copies/mL at 24 weeks were, respectively, 57% (95% CI, 41% to 72%) and 26% (CI, 12% to 40%) among treatment-naive patients and 22% (CI, 10% to 38%) and 5% (CI, 1% to 17%) among treatment-experienced patients. Of 82 patients, 14 (17%) experienced grade 3 or 4 toxicity and 2 discontinued therapy because of intolerance toward treatment. CONCLUSION Stavudine plus lamivudine seems to have a potent antiviral effect in treatment-naive and treatment-experienced patients. No major drug-limiting toxicity was found. This two-nucleoside combination should be considered in multidrug therapy for HIV.
Collapse
Affiliation(s)
- C Katlama
- Hôpital Pitié-Salpêtrière, and INSERM SC4, Institut Saint Antoine de Recherche en Santé, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Granier F, Valantin MA. [5th Conference on Opportunistic Retrovirus Infections in HIV: contribution of anti-retroviral combinations]. Presse Med 1998; 27:622-3. [PMID: 9767939] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
|
48
|
|