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Perfezou P, Hall N, Duthe JC, Abdi B, Seang S, Arvieux C, Lamaury I, Menard A, Marcelin AG, Katlama C, Palich R. Doravirine plus lamivudine two-drug regimen as maintenance antiretroviral therapy in people living with HIV: a French observational study. J Antimicrob Chemother 2023; 78:1929-1933. [PMID: 37303236 DOI: 10.1093/jac/dkad185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Two-drug regimens based on integrase strand transfer inhibitors (INSTIs) and boosted PIs have entered recommended ART. However, INSTIs and boosted PIs may not be suitable for all patients. We aimed to report our experience with doravirine/lamivudine as maintenance therapy in people living with HIV (PLWH) followed in French HIV settings. METHODS This observational study enrolled all adults who initiated doravirine/lamivudine between 1 September 2019 and 31 October 2021, in French HIV centres participating in the Dat'AIDS cohort. The primary outcome was the rate of virological success (plasma HIV-RNA < 50 copies/mL) at Week (W)48. Secondary outcomes included: rate of treatment discontinuation for non-virological reasons, evolution of CD4 count and CD4/CD8 ratio over follow-up. RESULTS Fifty patients were included, with 34 (68%) men; median age: 58 years (IQR 51-62), ART duration: 20 years (13-23), duration of virological suppression: 14 years (8-19), CD4 count: 784 cells/mm3 (636-889). Prior to switching, all had plasma HIV-RNA < 50 copies/mL. All but three were naive to doravirine, and 36 (72%) came from a three-drug regimen. Median follow-up was 79 weeks (IQR 60-96). Virological success rate at W48 was 98.0% (95% CI 89.4-99.9). One virological failure occurred at W18 (HIV-RNA = 101 copies/mL) in a patient who briefly discontinued doravirine/lamivudine due to intense nightmares; there was no resistance at baseline and no resistance emergence. There were three strategy discontinuations for adverse events (digestive disorders: n = 2; insomnia: n = 1). There was no significant change in CD4/CD8 ratio, while CD4 T cell count significantly increased. CONCLUSIONS These preliminary findings suggest that doravirine/lamivudine regimens can maintain high levels of viral suppression in highly ART-experienced PLWH with long-term viral suppression, and good CD4+ T cell count.
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Affiliation(s)
| | - Nolwenn Hall
- Public Health Center, Quimper Hospital, Quimper, France
| | | | - Basma Abdi
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Sophie Seang
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Cédric Arvieux
- Infectious Diseases and Intensive Care Unit, University Hospital, Rennes, France
| | - Isabelle Lamaury
- Infectious and Tropical Diseases Department, University Hospital of Guadeloupe, Pointe-à-Pitre, France
| | - Amélie Menard
- IHU-Méditerranée Infection, Aix Marseille University, AP-HM, Marseille, France
| | - Anne-Geneviève Marcelin
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Christine Katlama
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Romain Palich
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
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Jabet A, Dellière S, Seang S, Chermak A, Schneider L, Chiarabini T, Teboul A, Hickman G, Bozonnat A, Brin C, Favier M, Tamzali Y, Chasset F, Barete S, Hamane S, Benderdouche M, Moreno-Sabater A, Dannaoui E, Hennequin C, Fekkar A, Piarroux R, Normand AC, Monsel G. Sexually Transmitted Trichophyton mentagrophytes Genotype VII Infection among Men Who Have Sex with Men. Emerg Infect Dis 2023; 29:1411-1414. [PMID: 37347803 PMCID: PMC10310379 DOI: 10.3201/eid2907.230025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Transmission of dermatophytes, especially Trichophyton mentagrophytes genotype VII, during sexual intercourse has been recently reported. We report 13 such cases in France. All patients were male; 12 were men who have sex with men. Our findings suggest sexual transmission of this pathogen within a specific population, men who have sex with men.
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Sellem B, Abdi B, Lê M, Tubiana R, Valantin MA, Seang S, Schneider L, Fayçal A, Peytavin G, Soulié C, Marcelin AG, Katlama C, Pourcher V, Palich R. Intermittent Bictegravir/Emtricitabine/Tenofovir Alafenamide Treatment Maintains High Level of Viral Suppression in Virally Suppressed People Living with HIV. J Pers Med 2023; 13:jpm13040583. [PMID: 37108969 PMCID: PMC10145141 DOI: 10.3390/jpm13040583] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
In this observational study, we aimed to evaluate whether bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) administered 5 or 4 days a week is able to maintain viral suppression in people living with HIV (PLHIV). We enrolled 85 patients who initiated intermittent B/F/TAF between 28 November 2018 and 30 July 2020: median (IQR) age 52 years (46–59), duration of virological suppression 9 years (3–13), CD4 633/mm3 (461–781). Median follow-up was 101 weeks (82–111). The virological success rate (no virological failure [VF]: confirmed plasma viral load [pVL] ≥ 50 copies/mL, or single pVL ≥ 200 copies/mL, or ≥50 copies/mL with ART change) was 100% (95%CI 95.8–100) and the strategy success rate (pVL < 50 copies/mL with no ART regimen change) was 92.9% (95%CI 85.3–97.4) at W48. Two VF occurred at W49 and W70, in 2 patients self-reporting poor compliance. No resistance mutation emerged at time of VF. Eight patients presented strategy discontinuation for adverse events. There was no significant change in the CD4 count, residual viraemia rate, neither body weight during follow-up, but a slight increase in CD4/CD8 ratio (p = 0.02). In conclusion, our findings suggest that B/F/TAF administered 5 or 4 days a week could maintain the control of HIV replication in virologically suppressed PLHIV while reducing cumulative exposition of ART.
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Nouchi A, Brin C, Martin A, Favier M, Palich R, Wakim Y, Gavaud A, Seang S, Valantin MA, Bleibtreu A, Burrel S, Bérot V, Pourcher V, Monsel G. Prospective cohort of 70 consecutive cases of human monkeypox: Clinical description with focus on dermatological presentation. J Eur Acad Dermatol Venereol 2023; 37:e403-e405. [PMID: 36377334 DOI: 10.1111/jdv.18742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Agathe Nouchi
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,MonkeyPeauX Group, GrIDIST (Infectious and Sexually Transmitted Infections Group) of the French Society of Dermatology, Paris, France
| | - Cécile Brin
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,MonkeyPeauX Group, GrIDIST (Infectious and Sexually Transmitted Infections Group) of the French Society of Dermatology, Paris, France
| | - Abigail Martin
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Marion Favier
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Romain Palich
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Yara Wakim
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Ariane Gavaud
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Sophie Seang
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Marc-Antoine Valantin
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Alexandre Bleibtreu
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Sonia Burrel
- Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Vincent Bérot
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,MonkeyPeauX Group, GrIDIST (Infectious and Sexually Transmitted Infections Group) of the French Society of Dermatology, Paris, France
| | - Valérie Pourcher
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Gentiane Monsel
- Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,MonkeyPeauX Group, GrIDIST (Infectious and Sexually Transmitted Infections Group) of the French Society of Dermatology, Paris, France
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Palich R, Burrel S, Monsel G, Nouchi A, Bleibtreu A, Seang S, Bérot V, Brin C, Gavaud A, Wakim Y, Godefroy N, Fayçal A, Tamzali Y, Grunemwald T, Ohayon M, Todesco E, Leducq V, Marot S, Calvez V, Marcelin AG, Pourcher V. Viral loads in clinical samples of men with monkeypox virus infection: a French case series. Lancet Infect Dis 2023; 23:74-80. [PMID: 36183707 PMCID: PMC9534074 DOI: 10.1016/s1473-3099(22)00586-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Monkeypox virus (MPXV) is currently spreading among men who have sex with men, outside of sub-Saharan Africa, and close contact during sex seems to be one of the key pathways of viral transmission in the current outbreak. Our aim was to describe the distribution of MPXV in the human body, as it might play a role in its dissemination through sexual contact. METHODS The study population in this case series consisted of patients with confirmed MPXV infection attending the Pitié-Salpêtrière Hospital (Paris, France), who had been sampled from multiple anatomical sites, including skin, anus, throat, blood, urine, and semen, at diagnosis and 2 weeks later. We compared the proportion of positive samples and MPXV viral loads (given as PCR cycle thresholds [Ct]) between anatomical sites, and between day 0 (D0) and D14. FINDINGS Overall, 356 samples were collected between May 20 and June 13, 2022, from 50 men with a median age of 34 years (IQR 29-40). 22 (44%) of the 50 men were classified as HIV-negative on day (D)0, and 22 (44%) were living with HIV. At D0, MPXV detection was more frequent from skin (44 [88%] of 50), anus (30 [71%] of 42), and throat (36 [77%] of 47) than from blood (13 [29%] of 45), urine (nine [22%] of 41), or semen (13 [54%] of 24). Viral loads were significantly higher from skin lesions (Ct 19·8) and anal samples (Ct 20·9) than from throat (Ct 27·2), blood (Ct 32·8), urine (31·1), or semen samples (Ct 27·8). When analysing the 107 samples taken from 24 patients at D14, the proportion of positive samples strongly decreased between D0 and D14 at all sites: skin (four [22%] of 18), anus (two [9%] of 22), throat (none of 21), blood (one [5%] of 21), urine (none of 14), and semen (two [9%] of 11). INTERPRETATION These data contribute to a better understanding of how the virus might spread between sexual partners over a relatively short period of time. High MPXV viral loads from skin and mucosa, including genital and anal sites, suggest that transmission most likely occurs through direct body contact rather than through the respiratory route or contact with body fluids, which should help to refine the prevention messages delivered to individuals most exposed to the virus. FUNDING None.
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Affiliation(s)
- Romain Palich
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France,Correspondence to: Dr Romain Palich, Department of Infectious Diseases, Pierre Louis Epidemiological and Public Health Institute, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Sonia Burrel
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Gentiane Monsel
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Agathe Nouchi
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Alexandre Bleibtreu
- Pierre Louis Epidemiological and Public Health Institute, and Department of Infectious Diseases, Infectious Diseases Immunology Center (Cimi-Paris), INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Sophie Seang
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Vincent Bérot
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Cécile Brin
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Ariane Gavaud
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Yara Wakim
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Nagisa Godefroy
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Antoine Fayçal
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Yanis Tamzali
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Eve Todesco
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Valentin Leducq
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Stéphane Marot
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Vincent Calvez
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Anne-Geneviève Marcelin
- Department of Virology, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Valérie Pourcher
- Department of Infectious Diseases, INSERM, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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Seang S, Burrel S, Todesco E, Leducq V, Monsel G, Le Pluart D, Cordevant C, Pourcher V, Palich R. Evidence of human-to-dog transmission of monkeypox virus. Lancet 2022; 400:658-659. [PMID: 35963267 PMCID: PMC9536767 DOI: 10.1016/s0140-6736(22)01487-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Sophie Seang
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France.
| | - Sonia Burrel
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Eve Todesco
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Valentin Leducq
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Gentiane Monsel
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Diane Le Pluart
- Infectious Diseases Department, Bichat-Claude Bernard University Hospital, AP-HP, Paris, France
| | - Christophe Cordevant
- Strategy and Programmes Department, Research and Reference Division, Anses, Maisons-Alfort, France
| | - Valérie Pourcher
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Romain Palich
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
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Wirden M, Palich R, Abdi B, Valantin MA, Tubiana R, Schneider L, Seang S, Faycal A, Sellem B, Katlama C, Calvez V, Marcelin AG. More HIV-1 RNA detected and quantified with the Cobas 6800 system in patients on antiretroviral therapy. J Antimicrob Chemother 2022; 77:2251-2256. [PMID: 35640662 DOI: 10.1093/jac/dkac174] [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] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Target-detected (TD) results or low-level viraemia (LLV) can be observed in HIV-1 patients on ART, which regularly raises questions. OBJECTIVES We describe here the impact on HIV-1 RNA quantification of switching from the COBAS AmpliPrep/COBAS TaqMan (CAP/CTM) to the Cobas 6800 system (C6800), based on analyses of viraemia close to the lower limit of quantification (LLoQ). PATIENTS AND METHODS We retrospectively selected two groups of patients: 200 individuals whose viral loads (VLs) were consistently <50 copies/mL with CAP/CTM for at least 3 years before switching to C6800 (group 1), and 35 other patients with confirmed LLV when C6800 was in use (group 2). In both groups, we compared several consecutive VL results performed before and after the change of quantification assay. Analyses were performed with McNemar's paired tests or Fisher's exact tests. RESULTS In group 1, the frequency of TD results (below or above the LLoQ) increased significantly after the switch to C6800 for patients with <25% of results being TD for VLs performed with CAP/CTM (P < 0.0001). Significantly more patients had at least one VL ≥20 or ≥50 copies/mL with C6800, in both group 1 (37.0% versus 18.5%; P < 0.0001 and 6.5% versus 0%; P = 0.0009, respectively) and group 2 (100% versus 66%; P = 0.0015 and 97% versus 40%; P < 0.0001, respectively). CONCLUSIONS C6800 revealed residual or low-level HIV-1 RNA that was not detected with CAP/CTM, resulting in twice as many patients being found to have a VL ≥20 copies/mL. Physicians and patients should be aware of possible differences in results between assays, and it is crucial to specify the quantitative assay used in studies.
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Affiliation(s)
- Marc Wirden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Romain Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Basma Abdi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Marc Antoine Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Roland Tubiana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Luminita Schneider
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Sophie Seang
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Antoine Faycal
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Baptiste Sellem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Christine Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Infectious Diseases, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), F75013, Paris, France.,AP-HP, Pitié Salpêtrière Hospital, Department of Virology, Paris, France
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8
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Katlama C, Dudoit Y, Huyard J, Blanc C, Soulié C, Schneider L, Faycal A, Lenclume L, Hamani N, Qatib N, Tubiana R, Seang S, Sellem B, Costagliola D, Palich R, Valantin MA, Assoumou L. Household transmission of SARS-CoV-2 infection in the Paris/Ile-de-France area. Eur J Clin Microbiol Infect Dis 2022; 41:445-454. [PMID: 34997388 PMCID: PMC8741543 DOI: 10.1007/s10096-021-04345-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023]
Abstract
This st udy aims to evaluate the prevalence of SARS-CoV-2 antibodies in locked-down family households to determine viral dynamics and immunity acquisition. COVID-19 individuals and their households in lockdown under the same roof during early spring 2020 were interviewed and tested using rapid immunochromatographic lateral flow antibodies assays (LFA) between July and September 2020. Outcomes were secondary infection rate (SIR) among contacts, household infection rate, and predictors of transmission. We enrolled 87 households including 87 COVID-19 index cases (female 78.2%; median age: 47.0 years, IQR: 42.0-51.5) and 255 contacts (males: 52.9%; median age: 19.0 years, IQR: 11.0-43.5) consisting of their children (42%) or spouses/partners (28.2%). A total of 95/255 contacts were SARS-CoV-2 antibody positive leading to a SIR of 37.3% (95% confidence interval (CI): 31.3-43.5%). Viral transmission was observed in 54 households (62%). SARS-CoV-2 infection was asymptomatic in 33/95 (34.7%) of SARS-CoV-2-positive contacts. Independent predictors of virus transmission from index to contacts were housing surface area < 60 m2 (OR: 5.6 [1.1; 28.2] and a four-member family compared to five (OR: 3.6 [1.2; 10.3]). Households represent a high-risk setting for SARS-CoV-2 transmission through close contact within the family amplified by the number of family members and the housing surface area.
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Affiliation(s)
- Christine Katlama
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France.
- Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, AP-HP 47-83 Boulevard de l'hôpital, 75013, Paris, France.
| | - Yasmine Dudoit
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Julien Huyard
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
| | - Christine Blanc
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Cathia Soulié
- Department of Virology, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 75013, Paris, France
| | - Luminita Schneider
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Antoine Faycal
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Ludovic Lenclume
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Naima Hamani
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Naoual Qatib
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Roland Tubiana
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Sophie Seang
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Baptiste Sellem
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Dominique Costagliola
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
| | - Romain Palich
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne Université, 16 75013, Paris, France
| | - Lambert Assoumou
- INSERM, Pierre Louis Epidemiology and Public Health Institute (iPLESP), Sorbonne Université, 75013, Paris, France
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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.
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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
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10
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Palich R, Teyssou E, Sayon S, Abdi B, Soulie C, Cuzin L, Tubiana R, Valantin MA, Schneider L, Seang S, Wirden M, Pourcher V, Katlama C, Calvez V, Marcelin AG. Kinetics of archived M184V mutation in treatment-experienced virally suppressed HIV-infected patients. J Infect Dis 2021; 225:502-509. [PMID: 34415048 DOI: 10.1093/infdis/jiab413] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/17/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to assess the kinetics of drug-resistant viral variants (DRVs) harboring the M184V mutation in the proviral DNA of long-term virally suppressed patients, and factors associated with DRV persistence. METHODS HIV-DNA from blood cells stored in 2019 and 2016 was sequenced using both Sanger and ultradeep sequencing (SS and UDS, with a detection threshold of 1%) in ART-treated patients with HIV-RNA <50 copies/mL for at least 5 years, with past M184V mutation documented in HIV-RNA. RESULTS Among the 79 tested patients, by combining SS and UDS, the M184V was found to be absent in 26/79 (33%) patients (M184V- patients), and persisted in 53/79 (67%) (M184V+ patients). The M184V+ patients had a longer history of ART, a lower CD4 nadir and higher pretherapeutic HIV-RNA. Among the 37 patients with viral sequences assessed by UDS, the proportion of M184V+ DRVs significantly decreased between 2016 and 2019 (40% versus 14%, p=0.005). The persistence of M184V was associated with the duration and level of HIV-RNA replication under 3TC/FTC (p=0.0009 and p=0.009, respectively). CONCLUSION While it decreased over time in HIV-DNA, the M184V mutation was more frequently persistent in the HIV-DNA of more experienced patients with longer past replication under 3TC/FTC.
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Affiliation(s)
- Romain Palich
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France.,Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Elisa Teyssou
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Sophie Sayon
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Basma Abdi
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Cathia Soulie
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Lise Cuzin
- CERPOP, Toulouse University, Inserm UMR, UPS, Toulouse, France.,Martinique University Hospital, Infectious Diseases Department, Fort-de-France, France
| | - Roland Tubiana
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Marc-Antoine Valantin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Luminita Schneider
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Sophie Seang
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Marc Wirden
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Valérie Pourcher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Christine Katlama
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Vincent Calvez
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM, Paris, France
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Abdi B, Chebbi M, Wirden M, Teyssou E, Sayon S, Palich R, Seang S, Valantin MA, Simon A, Tubiana R, Katlama C, Calvez V, Marcelin AG, Soulie C. No difference in HIV-1 integrase inhibitor resistance between CSF and blood compartments. J Antimicrob Chemother 2021; 76:1553-1557. [PMID: 33693680 DOI: 10.1093/jac/dkab064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/10/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Little is known about HIV-1 integrase inhibitor resistance in the CNS. OBJECTIVES This study aimed to evaluate integrase inhibitor resistance in CSF, as a marker of the CNS, and compare it with the resistance in plasma. METHODS HIV integrase was sequenced both in plasma and CSF for 59 HIV-1 patients. The clinical and biological data were collected from clinical routine care. RESULTS Among the 59 HIV-1 patients, 32 (54.2%) were under antiretroviral (ARV) treatment. The median (IQR) HIV-1 RNA in the plasma of viraemic patients was 5.32 (3.85-5.80) and 3.59 (2.16-4.50) log10 copies/mL versus 4.79 (3.56-5.25) and 3.80 (2.68-4.33) log10 copies/mL in the CSF of ARV-naive and ARV-treated patients, respectively. The patients were mainly infected with non-B subtypes (72.2%) with the most prevalent recombinant form being CRF02_AG (42.4%). The HIV-1 integrase sequences from CSF presented resistance mutations for 9/27 (33.3%) and 8/32 (25.0%) for ARV-naive (L74I, n = 3; L74I/M, n = 1; T97A, n = 1; E157Q, n = 4) and ARV-treated (L74I, n = 6; L74M, n = 1; T97A, n = 1; N155H, n = 1) patients, respectively. Integrase inhibitor resistance mutations in CSF were similar to those in plasma, except for 1/59 patients. CONCLUSIONS This work shows similar integrase inhibitor resistance profiles in the CNS and plasma in a population of HIV-1 viraemic patients.
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Affiliation(s)
- Basma Abdi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Mouna Chebbi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Marc Wirden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Elisa Teyssou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Sophie Sayon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Romain Palich
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France
| | - Sophie Seang
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France
| | - Marc-Antoine Valantin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France
| | - Anne Simon
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Service de Médecine Interne, F75013 Paris, France
| | - Roland Tubiana
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France
| | - Christine Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Service de Maladies Infectieuses, F75013, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
| | - Cathia Soulie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Laboratoire de Virologie, F75013, Paris, France
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12
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Palich R, Abdi B, Wirden M, Lourida G, Tubiana R, Faycal A, Valantin MA, Schneider L, Seang S, Agher R, Simon A, Soulie C, Le MP, Peytavin G, Calvez V, Marcelin AG, Katlama C. Intermittent two-drug antiretroviral therapies maintain long-term viral suppression in real life in highly experienced HIV-infected patients. J Antimicrob Chemother 2021; 76:1893-1897. [PMID: 33855355 DOI: 10.1093/jac/dkab108] [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] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess in real life whether two-drug regimens (2-DRs) given 4-5 days a week in virally suppressed patients can maintain viral suppression over 48 and 96 weeks. METHODS This observational single-centre study enrolled all patients who initiated an intermittent 2-DR between 01/01/2016 and 30/06/2019. The primary outcome was the rate of virological failure (VF), defined as confirmed plasma viral load (pVL) ≥50 copies/mL or single pVL ≥50 copies/mL followed by ART change at week 48 (W48) and W96. Secondary outcomes were the 2-DR intermittent strategy success rate (pVL <50 copies/mL with no ART change), change in CD4 count, CD4/CD8 ratio and rate of residual viraemia. RESULTS Eighty-five patients were included; 67/85 (79%) were men, median age = 57 years (IQR = 50-63), CD4 nadir = 233 cells/mm3 (110-327), ART duration = 21 years (13-24), duration of virological suppression = 6.5 years (3.7-10.8) and CD4 count = 658 cells/mm3 (519-867). Intermittent 2-DRs consisted of integrase strand transfer inhibitor (INSTI)/NNRTI (58%), INSTI/NRTI (13%), two NRTIs (11%), PI/NRTI (7%) and other combinations (11%). The median follow-up was 90 weeks (IQR = 64-111). Overall, four VFs occurred, leading to a virological success rate of 98.8% (95% CI = 93.6-100) at W48 and 95.3% (95% CI = 88.4-98.7) at W96. Resuming the same 2-DR 7 days a week led to viral resuppression in three patients, whereas the M184V mutation emerged in one patient, leading to ART modification. There was no significant change in the CD4 count or residual viraemia rate, but a small increase in the CD4/CD8 ratio (P = 0.009) occurred over the study period. CONCLUSIONS This observational study shows the potential for intermittent 2-DRs to maintain a high virological success rate, which should be assessed in larger prospective randomized studies.
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Affiliation(s)
- Romain Palich
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Basma Abdi
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Marc Wirden
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Giota Lourida
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Roland Tubiana
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Antoine Faycal
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Marc-Antoine Valantin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Luminita Schneider
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Sophie Seang
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Rachid Agher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Anne Simon
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Cathia Soulie
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Minh-Patrick Le
- Bichat Claude Bernard Hospital, Pharmacology-Toxicology Department, AP-HP, INSERM, UMRS 1144, Université de Paris, Paris, France
| | - Gilles Peytavin
- Bichat Claude Bernard Hospital, Pharmacology-Toxicology Department, AP-HP, IAME, INSERM, UMRS 1137, Université de Paris, Paris, France
| | - Vincent Calvez
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
| | - Christine Katlama
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France
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13
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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.
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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
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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.
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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
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15
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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.
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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
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Davido B, Seang S, Barizien N, Tubiana R, de Truchis P. 'Post-COVID-19 chronic symptoms' - Author's reply. Clin Microbiol Infect 2020; 27:495-496. [PMID: 32898714 PMCID: PMC7474820 DOI: 10.1016/j.cmi.2020.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Benjamin Davido
- Maladies Infectieuses, Hôpital Universitaire Raymond-Poincaré, AP-HP, Garches, France.
| | - Sophie Seang
- Maladies Infectieuses, Hôpital Universitaire Pitié Salpêtrière, AP-HP, Paris, France
| | - Nicolas Barizien
- Médecine Physique et Réadaptation, Hôpital Foch, Suresnes, France
| | - Roland Tubiana
- Maladies Infectieuses, Hôpital Universitaire Pitié Salpêtrière, AP-HP, Paris, France
| | - Pierre de Truchis
- Maladies Infectieuses, Hôpital Universitaire Raymond-Poincaré, AP-HP, Garches, France
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Seang S, Ktorza N, Monsel G, Abdi B, Marcelin A, Valantin M, Pourcher V, Caumes E, Katlama C, Tubiana R. Description clinique et diagnostique sérologique des patients présentant des symptômes persistants après suspicion d’infection à SARS-COV-2. Med Mal Infect 2020. [PMCID: PMC7442070 DOI: 10.1016/j.medmal.2020.06.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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.
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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
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Seang S, Kelesidis T, Huynh D, Park S, Moe AA, Currier JS, Lake JE. Low Levels of Endothelial Progenitor Cells and Their Association with Systemic Inflammation and Monocyte Activation in Older HIV-Infected Men. AIDS Res Hum Retroviruses 2018; 34:39-45. [PMID: 29226690 DOI: 10.1089/aid.2017.0057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Endothelial progenitor cells (EPCs) repair damaged vascular endothelium, and low circulating EPC levels have been associated with cardiovascular disease (CVD). CD34+/KDR+ EPCs are commonly reported in the literature and CD34+/CD133+/KDR+ EPCs are rare in circulation but highly specific for endothelial lineage. HIV-infected (HIV+) adults have chronic inflammation and increased CVD risk, but the relationship between CVD, vascular inflammation, and EPCs in HIV remains unclear. In a pilot study, EPCs were measured in 57 HIV+ men [≥50 years old, HIV-1 RNA <50 copies/ml on antiretroviral therapy (ART)] by real-time flow cytometry using cellular immaturity (CD34 and/or CD133) and endothelial commitment (KDR) markers. Fasting inflammatory biomarker levels were measured by ELISA. Median age was 57 years; CD4+ T lymphocyte count was 570 cells/mm3. Prevalent CVD risk factors included 16% diabetes, 28% hypertension, 53% dyslipidemia, and 33% smoking. Median (interquartile range) EPC values were CD34+/KDR+ 0.1 (0.0-0.9) cells/105 peripheral blood mononuclear cells (PBMCs) and CD34+/CD133+/KDR+ 0.1 (0.0-0.9) cells/105 PBMCs. We observed a high prevalence of undetectable CD34+/KDR+ (40%) and CD34+/CD133+/KDR+ EPCs (44%). Men with undetectable EPCs were more likely to have ≥2 CVD risk factors, lower interleukin-6 (IL-6), and higher sCD163 levels. In these older HIV+ men on suppressive ART, CD34+/KDR+ and CD34+/CD133+/KDR+ EPC levels were low and often undetectable. Undetectable EPC levels were associated with greater CVD risk factor burden, lower IL-6 (consistent with decreased EPC production stimulus), and higher sCD163 (consistent with monocyte activation and prior CVD associations) levels, suggesting a potential relationship between EPCs and atherosclerotic burden in this population.
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Affiliation(s)
- Sophie Seang
- Infectious Diseases Department, AP-HP Pitié-Salpêtrière Hospital, Paris, France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne University, UPMC Univ Paris 06INSERM, Paris, France
| | - Theodoros Kelesidis
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Diana Huynh
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Sangeun Park
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ardis A. Moe
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Judith S. Currier
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Jordan E. Lake
- University of Texas Health Science Center at Houston, Houston, Texas
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Seang S, Somasunderam A, Nigalye M, Somsouk M, Schacker TW, Sanchez JL, Hunt PW, Utay NS, Lake JE. Circulating LOXL 2 Levels Reflect Severity of Intestinal Fibrosis and GALT CD4 + T Lymphocyte Depletion in Treated HIV Infection. Pathog Immun 2017; 2:239-252. [PMID: 28782046 PMCID: PMC5542020 DOI: 10.20411/pai.v2i2.180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Incomplete immune reconstitution may occur despite successful antiretroviral therapy (ART). Gut-associated lymphoid tissue (GALT) fibrosis may contribute via local CD4+ T lymphocyte depletion, intestinal barrier disruption, microbial translocation, and immune activation. METHODS In a cross-sectional analysis, we measured circulating fibrosis biomarker levels on cryopreserved plasma from adult HIV-infected (HIV+) SCOPE study participants on suppressive ART who also had fibrosis quantification on recto-sigmoid biopsies. Relationships among biomarker levels, clinical and demographic variables, GALT lymphoid aggregate (LA) collagen deposition, and LA CD4+ T lymphocyte density were analyzed using simple regression. Biomarker levels were also compared to levels in HIV+ viremic SCOPE participants and a convenience sample of HIV-uninfected (HIV-) samples. RESULTS HIV+ aviremic participants (n = 39) were 92% male and 41% non-white, with median age 48 years, CD4+ T lymphocyte count 277 cells/mm3, and 17 years since HIV diagnosis. Most biomarkers were lower in HIV- (n = 36) vs HIV+ aviremic individuals, although CXCL4 levels were higher. HIV+ viremic individuals (N = 18) had higher median TGF-β3, CIC-C1Q, and TIMP-1 (P < 0.05) and lower LOXL2 levels (P = 0.08) than HIV+ aviremic individuals. Only higher LOXL2 levels correlated with more GALT collagen deposition (R = 0.44, P= 0.008) and lower LA CD4+ T lymphocyte density (R = -0.32, P = 0.05) among aviremic individuals. CONCLUSIONS Circulating LOXL2 levels may be a noninvasive measure of intestinal fibrosis and GALT CD4+ T lymphocyte depletion in treated HIV infection. LOXL2 crosslinks elastin and collagen, and elevated LOXL2 levels occur in pathologic states, making LOXL2 inhibition a potential interventional target for intestinal fibrosis and its sequelae.
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Affiliation(s)
- Sophie Seang
- Pitie Salpetrière Hospital, University Pierre et Marie Curie, Paris, FRANCE and INSERM UMR-S943
| | | | | | - Ma Somsouk
- University of California, San Francisco, California
| | | | | | | | | | - Jordan E. Lake
- University of Texas Health Science Center at Houston, Houston, Texas
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Lake J, Seang S, Kelesidis T, Currier J. Endothelial Progenitor Cell Production Is Suppressed and Associated With Systemic Inflammation and Monocyte Activation in Older Human Immunodeficiency Virus (HIV)-Infected Men. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw194.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jordan Lake
- Department of Medicine, University of California, Los Angeles, Los Angeles, California
| | | | | | - Judith Currier
- University of California, Los Angeles, Los Angeles, California
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Lake JE, Seang S, Kelesidis T, Currier JS, Yang OO. Telmisartan increases vascular reparative capacity in older HIV-infected adults: a pilot study. HIV Clin Trials 2016; 17:225-232. [PMID: 27658740 DOI: 10.1080/15284336.2016.1234222] [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] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) are bone marrow-derived cells that contribute to vascular repair. EPCs may be reduced in HIV-infected (HIV+) persons, contributing to cardiovascular disease (CVD). Telmisartan is an angiotensin receptor blocker that increases EPCs in HIV-uninfected adults. OBJECTIVE To assess telmisartan's effects on EPC number and immunophenotype in older HIV + adults at risk for CVD. METHODS HIV + persons ≥50 years old with HIV-1 RNA < 50 copies/mL on suppressive antiretroviral therapy and ≥1 CVD risk factor participated in a prospective, open-label, pilot study of oral telmisartan 80 mg daily for 12 weeks. Using CD34 and CD133 as markers of early maturity and KDR as a marker of endothelial lineage commitment, EPCs were quantified via flow cytometry and defined as viable CD3-/CD33-/CD19-/glycophorin- cells of four immunophenotypes: CD133+/KDR+, CD34+/KDR+, CD34+/CD133+, or CD34+/KDR+/CD133+. The primary endpoint was a 12-week change in EPC subsets (NCT01578772). RESULTS Seventeen participants (88% men, median age 60 years and peripheral CD4+ T lymphocyte count 625 cells/mm3) enrolled and completed the study. After 6 and 12 weeks of telmisartan, frequencies of all EPC immunophenotypes were higher than baseline (all p < 0.10 except week 12 CD133+/KDR+ EPC, p = 0.13). Participants with lower baseline EPC levels had the largest gains. Additionally, the percentage of CD34+ cells with endothelial commitment (KDR+) increased. CONCLUSIONS Our data suggest that telmisartan use is associated with an increase in circulating EPCs in older HIV + individuals with CVD risk factors. Further controlled studies are needed to assess whether EPC increases translate to a reduction in CVD risk in this population.
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Affiliation(s)
- Jordan E Lake
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Sophie Seang
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Theodoros Kelesidis
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Judith S Currier
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA
| | - Otto O Yang
- a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA.,b Department of Microbiology, Immunology, and Molecular Genetics , University of California , Los Angeles , CA , USA.,c AIDS Healthcare Foundation , Los Angeles , CA , USA
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Seang S, Lake JE, Tian F, Anastos K, Cohen MH, Tien PC. Oral Glucose Tolerance Testing identifies HIV+ infected women with Diabetes Mellitus (DM) not captured by standard DM definition. J AIDS Clin Res 2016; 7:545. [PMID: 27066296 PMCID: PMC4825684 DOI: 10.4172/2155-6113.1000545] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE HIV-infected (HIV+) individuals may have differential risk of diabetes mellitus (DM) compared to the general population, and the optimal diagnostic algorithm for DM in HIV+ persons remains unclear. We aimed to assess the utility of oral glucose tolerance testing (OGTT) for DM diagnosis in a cohort of women with or at risk for HIV infection. METHODS Using American Diabetic Association DM definitions, DM prevalence and incidence were assessed among women enrolled in the Women's Interagency HIV Study. DM was defined by 2-hour OGTT ≥ 200 mg/dL (DM_OGTT) or a clinical definition (DM_C) that included any of the following: (i) anti-diabetic medication use or self-reported DM confirmed by either fasting glucose (FG) ≥126 mg/dL or HbA1c ≥ 6.5%, (ii) FG ≥ 126 mg/dL confirmed by a second FG ≥ 126 mg/dL or HbA1c 6.5%, or (iii) HbA1c 6.5% confirmed by FG ≥ 126 mg/dL cohort. RESULTS Overall, 390 women (285 HIV+, median age 43 years; 105 HIV-, median age 37 years) were enrolled between 2003-2006. Over half of all women were African American. Using DM_C, DM prevalence rates were 5.6% and 2.8% among HIV+ and HIV- women, respectively. Among HIV+ women, adding DM_OGTT to DM_C increased DM prevalence from 5.6% to 7.4%, a 31% increase in the number of diabetes cases diagnosed (p=0.02). In HIV- women, no additional cases were diagnosed by DM-OGTT. CONCLUSION In HIV+ women, OGTT identified DM cases that were not identified by a standardized clinical definition. Further investigation is needed to determine whether OGTT should be considered as an adjunctive tool for DM diagnosis in the setting of HIV infection.
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Affiliation(s)
- Sophie Seang
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA
| | - Jordan E Lake
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA
| | | | - Kathryn Anastos
- Department of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Mardge H Cohen
- Departments of Medicine, Cook County Health & Hospital System, and Rush University, Chicago, Illinois, USA
| | - Phyllis C Tien
- Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA
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Lake JE, Seang S, Kelesidis T, Liao DH, Hodis HN, Stein JH, Currier JS. Telmisartan to reduce cardiovascular risk in older HIV-infected adults: a pilot study. HIV Clin Trials 2015; 16:197-206. [PMID: 26360501 DOI: 10.1179/1945577115y.0000000006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND HIV-infected persons are at increased cardiovascular disease (CVD) risk, but traditional CVD therapies are understudied in this population. Telmisartan is an angiotensin receptor blocker (ARB) and peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonist that improves endothelial function and cardiovascular mortality in HIV-uninfected populations. We assessed the effects of telmisartan on endothelial function in older HIV-infected persons at risk for CVD in a small pilot study. METHODS HIV-infected individuals≥50 years old on suppressive antiretroviral therapy (ART) with ≥1 traditional CVD risk factor received open-label telmisartan 80 mg daily for 6 weeks. Brachial artery flow-mediated dilation (FMD) measured endothelial function. The primary endpoint was 6-week change in maximum relative FMD. RESULTS Seventeen participants enrolled; 16 completed all evaluations (88% men, 65% non-White, median age 60 years, CD4+T lymphocyte count 625 cells/mm3). Antiretroviral therapy included 71% protease inhibitor (PI), 29% non-nucleoside reverse transcriptase inhibitor (NNRTI), 29% integrase inhibitor, 65% tenofovir, and 29% abacavir. Cardiovascular disease risk factor prevalence included 76% hyperlipidemia, 65% hypertension, 18% smoking, and 12% diabetes mellitus. After 6 weeks, statistically significant blood pressure changes were observed (systolic-16.0 mmHg, diastolic-6.0 mmHg) without significant changes in FMD. In subset analyses, FMD increased more among abacavir-treated, PI-treated, and non-smoking participants. CONCLUSIONS No significant FMD changes were observed after 6 weeks of telmisartan therapy; however, abacavir- and PI-treated participants and non-smokers showed greater FMD increases. Additional studies are needed to explore the effects of telmisartan on endothelial function among HIV-infected individuals with traditional CVD and/or ART-specific risk factors.
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Campillo-Gimenez L, Casulli S, Dudoit Y, Seang S, Carcelain G, Lambert-Niclot S, Appay V, Autran B, Tubiana R, Elbim C. Neutrophils in antiretroviral therapy-controlled HIV demonstrate hyperactivation associated with a specific IL-17/IL-22 environment. J Allergy Clin Immunol 2014; 134:1142-52.e5. [PMID: 25042982 DOI: 10.1016/j.jaci.2014.05.040] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/30/2014] [Accepted: 05/30/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite control of HIV infection under antiretroviral therapy (ART), immune T-cell activation persists in patients with controlled HIV infection, who are at higher risk of inflammatory diseases than the general population. PMNs play a key role in host defenses against invading microorganisms but also potentiate inflammatory reactions in cases of excessive or misdirected responses. OBJECTIVE The aim of our study was to analyze PMN functions in 60 ART-treated and controlled HIV-infected patients (viral load, <20 RNA copies/mL; CD4 count, ≥ 350 cells/mm(3)) with (HIV[I] group) and without (HIV[NI] group) diseases related to an inflammatory process and to compare them with 22 healthy control subjects. METHODS Flow cytometry was used to evaluate PMN functions in whole-blood conditions. We studied in parallel the activation markers of T lymphocytes and monocytes and the proinflammatory cytokine environment. RESULTS Blood samples from HIV-infected patients revealed basal PMN hyperactivation associated with deregulation of the apoptosis/necrosis equilibrium. Interestingly, this hyperactivation was greater in HIV(I) than HIV(NI) patients and contrasted with a lack of monocyte activation in both groups. The percentage of circulating cells producing IL-17 was also significantly higher in HIV-infected patients than in control subjects and was positively correlated with markers of basal PMN activation. In addition, the detection of IL-22 overproduction in HIV(NI) patients suggests that it might contribute to counteracting chronic inflammatory processes during HIV infection. CONCLUSIONS This study thus demonstrates the presence of highly activated PMNs in HIV-infected patients receiving effective ART and the association of these cells with a specific IL-17/IL-22 environment.
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Affiliation(s)
- Laure Campillo-Gimenez
- Sorbonne University, UPMC University Paris 06, Paris, France; INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France
| | - Sarah Casulli
- Sorbonne University, UPMC University Paris 06, Paris, France; INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France
| | - Yasmine Dudoit
- AP-HP, Hôpital Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, Paris, France; Sorbonne University, UPMC University Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Sophie Seang
- AP-HP, Hôpital Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, Paris, France; Sorbonne University, UPMC University Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Guislaine Carcelain
- INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire d'Immunologie Cellulaire et Tissulaire, Paris, France
| | - Sidonie Lambert-Niclot
- Sorbonne University, UPMC University Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de Virologie, Paris, France
| | - Victor Appay
- INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France
| | - Brigitte Autran
- INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire d'Immunologie Cellulaire et Tissulaire, Paris, France
| | - Roland Tubiana
- AP-HP, Hôpital Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, Paris, France; Sorbonne University, UPMC University Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Carole Elbim
- Sorbonne University, UPMC University Paris 06, Paris, France; INSERM, Centre d'Immunologie et des Maladies Infectieuses, UMR-S CR7, INSERM U1135, Paris, France.
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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.
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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
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Seang S, Boutolleau D, Burrel S, Regnier S, Epelboin L, Voujon D, Valantin MA, Katlama C, Agut H, Caumes E. Long-term follow-up of HIV-infected patients once diagnosed with acyclovir-resistant herpes simplex virus infection. Int J STD AIDS 2014; 25:676-82. [PMID: 24535691 DOI: 10.1177/0956462413518034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 11/27/2013] [Indexed: 11/15/2022]
Abstract
Acyclovir-resistant herpes simplex virus (HSV) infection is common in immunocompromised patients, but the course of such infection is little known. We describe the long-term follow-up of HIV-infected patients diagnosed once with acyclovir-resistant HSV infections. We retrospectively studied all HIV-infected patients between 2000 and 2010 diagnosed with virologically confirmed acyclovir-resistant HSV infection. Patients' socio-demographic and immunovirological characteristics were described. Response to foscarnet or cidofovir and recurrences were reported. Among 5295 HIV-infected patients, 13 (0.2%) were once diagnosed with an acyclovir-resistant HSV infection. Twelve patients were men, nine patients were of African origin. All patients reported previous acyclovir exposure and median CD4 count was 183 cells/mm(3) Ten patients presented exclusively with cutaneous lesions. Initially, 11 patients were treated with foscarnet and two with cidofovir. The median follow-up was 67 months (6-145). All patients recurred, 10 presenting at least one acyclovir-resistant HSV recurrence. The median number of acyclovir-resistant HSV recurrences per patient was 2 (0 - 5). Regarding the first and second recurrences, 7/13 (54%) and 5/11 (45%) HSV clinical isolates exhibited resistance to acyclovir, respectively. Acyclovir-resistant HSV infection prevalence was low in our cohort. The rate of acyclovir-resistant HSV episodes averaged 50% during the two first recurrences.
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Affiliation(s)
- Sophie Seang
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France
| | - David Boutolleau
- UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Sonia Burrel
- UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Stephanie Regnier
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France
| | - Loic Epelboin
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France
| | - Delphine Voujon
- Virology Department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France
| | - Christine Katlama
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France
| | - Henri Agut
- UPMC Univ Paris, Paris, France Virology Department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Eric Caumes
- Department of Infectious Diseases, Pitié-Salpêtrière University Hospital, Paris, France INSERM UMR-S943 and University Pierre and Marie Curie, Paris, France UPMC Univ Paris, Paris, France
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29
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Burrel S, Abrao EP, Désiré N, Seang S, Caumes E, Agut H, Boutolleau D. Detection of a new variant of herpes simplex virus type 2 among HIV-1-infected individuals. J Clin Virol 2013; 57:267-9. [PMID: 23567026 DOI: 10.1016/j.jcv.2013.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/01/2013] [Accepted: 03/02/2013] [Indexed: 01/13/2023]
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30
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Seang S, Thibault V, Valantin MA, Katlama C. Adjustment of antiretroviral regimen may lead to HBV reactivation even in patients with past HBV infection serological profile. J Infect Chemother 2013; 19:987-9. [PMID: 23380971 DOI: 10.1007/s10156-013-0560-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022]
Abstract
We report a reactivation of hepatitis B virus (HBV) in an human immunodeficiency virus (HIV) patient despite a serological profile of past HBV infection with anti-HBs and anti-HBc antibodies, following the interruption of tenofovir/emtricitabine. In HBV-HIV co-infected patients, close monitoring of HBV viral load and serological markers is required for antiretroviral management, particularly after interruption of drugs active for HBV.
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Affiliation(s)
- Sophie Seang
- INSERM UMR-S 943 and University Pierre and Marie Curie (UPMC) Paris VI, Paris, France,
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31
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Couzigou C, Seang S, Morand-Joubert L, Roque-Afonso AM, Escaut L, Vittecoq D. Efficacy of etravirine for treatment of acute HIV meningoencephalitis. Clin Infect Dis 2009; 48:e62-5. [PMID: 19193114 DOI: 10.1086/597109] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We describe a patient with human immunodeficiency virus (HIV) and hepatitis C virus coinfection who experienced recurrent episodes of acute HIV meningoencephalitis. The addition of etravirine to the therapeutic regimen completely resolved symptoms, and HIV was no longer detected in cerebrospinal spinal fluid specimens. Etravirine has a satisfactory safety profile and, in this case, was a durable alternative therapy for HIV meningoencephalitis.
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Affiliation(s)
- Carine Couzigou
- Services des Maladies Infectieuses et Tropicales and Virologie, Assistance Publique-Hôpital de Paris, Hôpital Paul Brousse, Villejuif, France. )
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