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Grabar S, Potard V, Piroth L, Abgrall S, Bernard L, Allavena C, Caby F, de Truchis P, Duvivier C, Enel P, Katlama C, Khuong MA, Launay O, Matheron S, Melica G, Melliez H, Meynard JL, Pavie J, Slama L, Bregigeon S, Tattevin P, Capeau J, Costagliola D. Striking differences in weight gain after cART initiation depending on early or advanced presentation: results from the ANRS CO4 FHDH cohort. J Antimicrob Chemother 2023; 78:757-768. [PMID: 36683307 DOI: 10.1093/jac/dkad007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Many studies have reported weight gain in ART-naive people living with HIV (PWH) initiating an integrase strand-transfer inhibitor-based regimen. We studied the impact of early or advanced presentation and that of individual drugs in PWH initiating combined ART (cART) between 2012 and 2018. METHODS From the French Hospital Database HIV cohort, we assessed factors associated with a weight gain ≥10%, weight change after cART initiation or BMI increase ≥5 kg/m2 up to 30 months. The analyses were conducted overall, and among PWH with early (primary infection or CD4 >350/mm3 and viral load <100 000 copies/mL, without AIDS) and advanced presentation (AIDS or CD4 <200/mm3, not during primary infection). RESULTS At 30 months, 34.5% (95% CI: 33.5-35.6) of the 12 773 PWH had a weight gain ≥10%, with 20.9% (95% CI: 19.6-22.2) among the 5794 with early presentation and 63.1% (95% CI: 60.9-65.3) among the 3106 with advanced presentation. Weight gain was 2.8 kg (95% CI: 2.0-3.7) for those with early presentation and 9.7 kg (95% CI: 8.4-11.1) for those with advanced presentation. Most weight gain occurred in the first 12 months. Underweight and obese PWH were at significantly higher risk of a BMI increase ≥5 kg/m2 than normal-weight PWH. Results differed within classes and by outcome. Raltegravir and dolutegravir were consistently associated with greater weight gain than the other third agents. Tenofovir alafenamide was also associated with higher weight gain than tenofovir disoproxil or abacavir. CONCLUSIONS After initiating cART, PWH with early presentation exhibited a small weight gain, whereas it was large among those with advanced presentation. The choice of ART should account for the risk of weight gain, especially for PWH who present with advanced disease and/or are obese.
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Affiliation(s)
- Sophie Grabar
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital St Antoine, F75012, Paris, France
| | - Valérie Potard
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75013, Paris, France
| | - Lionel Piroth
- Infectious Diseases Department, CHU Dijon, and Inserm CIC 1432 Université de Bourgogne, Dijon, France
| | - Sophie Abgrall
- AP-HP, Hôpital Béclère, Service de Médecine Interne, Clamart, and Université Paris-Saclay, CESP INSERM U1018, Le Kremlin-Bicêtre, France
| | | | - Clotilde Allavena
- Infectious Diseases Department, INSERM EA1413, CHU de Nantes, Nantes, France
| | - Fabienne Caby
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75013, Paris, France.,Unité VIH-IST, Service d'Immuno-Hematologie, Hôpital Victor Dupouy, Argenteuil, France
| | - Pierre de Truchis
- AP-HP Hôpital Raymond Poincaré, Université Paris-Saclay, Garches, France
| | - Claudine Duvivier
- AP-HP, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France.,IHU Imagine, Paris, France.,Institut Cochin-CNRS 8104-INSERM U1016, Université Paris Cité, Paris, France.,Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Patricia Enel
- Assistance Publique-Hôpitaux de Marseille, Public Health Department, Marseille, and Aix-Marseille University, CEReSS, Health Service Research and Quality of Life Center, Marseille, France
| | - Christine Katlama
- AP-HP, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, and AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Odile Launay
- Université Paris-Cité, AP-HP, Hôpital Cochin, INSERM, CIC 1417, Paris, France
| | - Sophie Matheron
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, GHU Paris Nord, AP-HP, Paris, France
| | - Giovanna Melica
- Clinical Immunology and Infectious Diseases Department, Henri Mondor Hospital, Creteil, France
| | - Hugues Melliez
- Médecine Interne, Hôpital Riaumont, 62 800, Liévin, France
| | - Jean-Luc Meynard
- AP-HP, Department of Infectious Diseases, Saint-Antoine Hospital, Paris, France
| | - Juliette Pavie
- Department of Immunology and Infectious Diseases, AP-HP Hôtel-Dieu, Paris, France
| | - Laurence Slama
- Infectious Diseases Unit, Hôtel Dieu Hospital, APHP, Paris, France
| | - Sylvie Bregigeon
- Aix-Marseille Université, APHM, Hôpital Sainte-Marguerite, Marseille, France
| | - Pierre Tattevin
- Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes, France
| | - Jacqueline Capeau
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), Institute of Cardiometabolism and Nutrition (ICAN), F75012, Paris, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75013, Paris, France
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Demontès M, Eymard Duvernay S, Allavena C, Jovelin T, Reynes J, Hentzien M, Ravaux I, Delobel P, Bregigeon S, Rey D, Ferry T, Gagneux-Brunon A, Robineau O, Pugliese P, Duvivier C, Cabié A, Chirouze C, Jacomet C, Lamaury I, Merrien D, Hoen B, Hocqueloux L, Cheret A, Katlama C, Arvieux C, Krolak-Salmon P, Makinson A. Multimorbidity in Elderly Persons According to the Year of Diagnosis of Human Immunodeficiency Virus Infection: A Cross-sectional Dat'AIDS Cohort Study. Clin Infect Dis 2021; 71:2880-2888. [PMID: 31813982 DOI: 10.1093/cid/ciz1171] [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: 08/02/2019] [Accepted: 12/07/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND We assessed prevalence of multimorbidity (MM) according to year of human immunodeficiency virus (HIV) diagnosis in elderly people living with HIV (PLWH). METHODS This was a cross-sectional study of MM in PLWH aged ≥70 years from the Dat'AIDS French multicenter cohort. MM was defined as at least 3 coexistent morbidities of high blood pressure, diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardiovascular and cerebrovascular disease, obesity, undernutrition, or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV diagnosis (1983-1996, 1997-2006, and 2007-2018). The secondary analysis evaluated MM as a continuous outcome, and a sensitivity analysis excluded PLWH with nadir CD4 count <200 cells/μL. RESULTS Between January 2017 and September 2018, 2476 PLWH were included. Median age was 73 years, 75% were men, median CD4 count was 578 cells/μL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, hepatitis C and hepatitis B virus coinfection, group of exposure, nadir CD4 count, CD4:CD8 ratio, and last CD4 level, calendar period of diagnosis was not associated with MM (P = .169). MM was associated with older age, CD4/CD8 ratio <0.8, and nadir CD4 count <200 cells/μL. Similar results were found with secondary and sensitivity analyses. CONCLUSIONS MM prevalence was high and increased with age, low CD4/CD8 ratio, and nadir CD4 count <200 cells/μL but was not associated with calendar periods of HIV diagnosis. Known duration of HIV diagnosis does not seem to be a criterion for selecting elderly PLWH at risk of MM.
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Affiliation(s)
- Marie Demontès
- Memory Clinical and Research Center of Lyon, Lyon Institute for Elderly, Hospices civils de Lyon, Université Lyon, Inserm, Lyon, France
| | - Sabrina Eymard Duvernay
- University of Montpellier, Unité TransVIHMI, France Institute of Research for Development Unité Mixte Internationale (UMI) 233, Inserm U1175, Montpellier, France
| | - Clotilde Allavena
- Infectious Diseases Department, University of Nantes, Centre hospitalier universitaire Hôtel Dieu, Nantes, France
| | - Thomas Jovelin
- Infectious Diseases Department, University of Nantes, Centre hospitalier universitaire Hôtel Dieu, Nantes, France
| | - Jacques Reynes
- Infectious and Tropical Diseases Department, Montpellier University Hospital, and UMI 233, Inserm U1175, Montpellier, France
| | - Maxime Hentzien
- Reims Teaching Hospitals, Robert Debré Hospital, Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Reims, France
| | - Isabelle Ravaux
- Aix Marseille Université, Centre Nationale de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD), Inserm, Assistance Publique-Hôpitaux de Marseille (AP-HM), Unité de Recherche sur les Maladies Infectieuses, Institut Hospitalo-Universitaire (IHU) Méditerranée-Infection, Marseille, France
| | - Pierre Delobel
- Infectious and Tropical Diseases Department Inserm, Unité Mixte de Recherche (UMR) 1043, Toulouse, France
| | - Sylvie Bregigeon
- Aix Marseille Universiteé, AP-HM Sainte-Marguerite, Marseille, France
| | - David Rey
- University Hospitals of Strasbourg, Nouvel Hôpital Civil, Human Immunodeficiency Virus Care Center, Strasbourg, France
| | - Tristan Ferry
- Infectious Diseases Department, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France
| | - Amandine Gagneux-Brunon
- Department of Infectious and Tropical Diseases, Centre hospitalier universitaire Saint-Etienne, Groupe Immunité des Muqueuses et Agents Pathogènes, Jean Monnet University, University of Lyon, Saint-Etienne, France
| | - Olivier Robineau
- Infectious Diseases Department, Gustave Drion Hospital, Tourcoing, France
| | - Pascal Pugliese
- Infectious Diseases Department, University of Nice, Centre hospitalier universitaire L'Archet, Nice, France
| | - Claudine Duvivier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, Infectious and Tropical Diseases Department, Institut Pasteur, Centre Médical de l'Institut Pasteur, Infectious Diseases Centre Necker-Pasteur, IHU Imagine, Institut Cochin, CNRS 8104, Inserm U1016, Paris, France
| | - André Cabié
- Clinical Investigation Centre, Antilles Guyane, Inserm 1424 and Infectious and Tropical Diseases Department, Centre Hospitalier Universitaire de la Martinique and University of the Antilles, Equipe d'Acceuil, Fort-de-France, France
| | - Catherine Chirouze
- Infectious and Tropical Diseases Department, Centre Hospitalier Regional Universitaire Besançon, UMR CNRS 6249 Bourgogne Franche Comté University, Besançon, France
| | - Christine Jacomet
- Infectious Diseases Department, Centre hospitalier universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Lamaury
- Department of Infectious and Tropical Diseases, Dermatology, Internal Medicine, University Hospital Guadeloupe, Pointe-à-Pitre, France
| | - Dominique Merrien
- Internal Medicine Department, Centre Hospitalier Vendée (CHD) Vendée, La Roche-sur-Yon, France
| | - Bruno Hoen
- Infectious and Tropical Diseases Department, Centre Hospitalier Regional Universitaire Besançon, UMR CNRS 6249 Bourgogne Franche Comté University, Besançon, France
| | - Laurent Hocqueloux
- Department of Infectious and Tropical Diseases, Centre hospitalier universitaire d'Orléans-La Source, Orléans, France
| | - Antoine Cheret
- Internal Medicine Department, Centre hospitalier universitaire Bicètre, Bicètre, France.,University of Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Katlama
- Sorbonne Université, Inserm, Pierre Louis Institute of Epidemiology and Public Health, Unité Mixte de Recherche en Santé 1136, AP -HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Department of Infectious and Tropical Diseases, Paris, France
| | - Cédric Arvieux
- Centre hospitalier universitaire Rennes, Infectious Diseases and Intensive Care Unit, Rennes, France
| | - Pierre Krolak-Salmon
- Memory Clinical and Research Center of Lyon, Lyon Institute for Elderly, Hospices civils de Lyon, Université Lyon, Inserm, Lyon, France
| | - Alain Makinson
- Infectious and Tropical Diseases Department, Montpellier University Hospital, and UMI 233, Inserm U1175, Montpellier, France
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Néant N, Lê MP, Bouazza N, Gattacceca F, Yazdanpanah Y, Dhiver C, Bregigeon S, Mokhtari S, Peytavin G, Tamalet C, Descamps D, Lacarelle B, Solas C. Usefulness of therapeutic drug monitoring of rilpivirine and its relationship with virologic response and resistance in a cohort of naive and pretreated HIV-infected patients. Br J Clin Pharmacol 2020; 86:2404-2413. [PMID: 32374049 PMCID: PMC7688528 DOI: 10.1111/bcp.14344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/11/2019] [Revised: 04/07/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022] Open
Abstract
AIMS The purpose of this study was to assess the antiviral activity of the rilpivirine/emtricitabine/tenofovir disoproxil fumarate combination and to describe the pharmacokinetics of rilpivirine and its association with resistance in clinical routine. METHODS A retrospective multicentre cohort study was performed in both naive and pretreated HIV patients receiving the once-daily rilpivirine/emtricitabine/tenofovir disoproxil fumarate regimen. Immuno-virologic and resistance data, and rilpivirine plasma trough concentrations were collected over the follow-up. Statistical analyses were performed to evaluate the relationship between rilpivirine pharmacokinetics and virological response. Receiver operating characteristic (ROC) curve analysis was performed to determine the best target rilpivirine trough concentration. RESULTS Overall, 379 patients were included. After a median follow-up of 28 months, 26% of patients discontinued mainly due to toxicity and the virological success rate was 65.7%. Virological failure occurred in 5% of patients. A significant proportion of patients with HIV-RNA > 40 copies/mL displayed rilpivirine plasma trough concentrations below the currently used 50 ng/mL efficacy threshold at both M6 (28%) and M12 (31%), in agreement with a significant lower median rilpivirine plasma trough concentration compared with patients virologically suppressed. Half of the patients with virologic failure who acquired rilpivirine resistance mutations had at least one suboptimal rilpivirine trough concentration. The optimal target for rilpivirine trough concentration was 70 ng/mL (sensitivity 75.4%; specificity 61.5%). CONCLUSIONS This study shows the impact of rilpivirine plasma trough concentration on both virological response and the emergence of rilpivirine mutations. Moreover, our results suggest that a higher target of rilpivirine trough concentration could be proposed in clinical practice.
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Affiliation(s)
- Nadège Néant
- Laboratoire de Pharmacocinétique et ToxicologieAix Marseille Univ, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La TimoneMarseilleF‐13005France
| | - Minh Patrick Lê
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Pharmacologie‐Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Naïm Bouazza
- Université Paris DescartesEA7323, Sorbonne Paris CitéFrance
- Unité de Recherche Clinique Paris Descartes Necker Cochin, AP‐HPFrance
- CIC‐1419 Inserm, Cochin‐NeckerParisFrance
| | | | - Yazdan Yazdanpanah
- Univ Paris Diderot, APHP, IAME‐UMR 1137, Hôpital Bichat‐Claude Bernard, Service des Maladies Infectieuses et TropicalesParisF‐75018France
| | - Catherine Dhiver
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Sylvie Bregigeon
- APHM, Hôpital Sainte‐MargueriteService d'Immuno‐hématologie cliniqueMarseilleF‐13009France
| | - Saadia Mokhtari
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Gilles Peytavin
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Pharmacologie‐Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Catherine Tamalet
- IHU Méditerranée Infection, Aix Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleF‐13005France
| | - Diane Descamps
- APHP, Hôpital Bichat‐Claude Bernard, Laboratoire de Virologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERMParisF‐75018France
| | - Bruno Lacarelle
- Laboratoire de Pharmacocinétique et ToxicologieAix Marseille Univ, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La TimoneMarseilleF‐13005France
| | - Caroline Solas
- Aix Marseille Univ, APHM, INSERM 1207, IRD 190, UVE, Hôpital La Timone, Laboratoire de Pharmacocinétique et ToxicologieMarseilleF‐13005France
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4
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Bregigeon S, Obry-Roguet V, Delpierre C, Cotte L, Duvivier C, Pugliese P, Abel S, Huleux T, Poizot-Martin I. Impact de la zone géographique de résidence dans la prévalence du surpoids et de l’obésité au sein de la cohorte Dat’AIDS. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Néant N, Solas C, Bouazza N, Lê MP, Yazdanpanah Y, Dhiver C, Bregigeon S, Mokhtari S, Peytavin G, Tamalet C, Descamps D, Lacarelle B, Gattacceca F. Concentration-response model of rilpivirine in a cohort of HIV-1-infected naive and pre-treated patients. J Antimicrob Chemother 2020; 74:1992-2002. [PMID: 31225609 DOI: 10.1093/jac/dkz141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rilpivirine is widely prescribed in people living with HIV. Although trough plasma concentrations have been associated with virological response, the drug pharmacodynamics remain incompletely characterized. OBJECTIVES To develop the first pharmacodynamic model of rilpivirine in order to establish the rilpivirine concentration-response relationship for future treatment optimization. METHODS A retrospective observational study was conducted in patients receiving the once-daily rilpivirine/tenofovir disoproxil fumarate/emtricitabine regimen. Individual rilpivirine trough plasma concentrations over time were predicted using a previous pharmacokinetic model. An established susceptible, infected, recovered model was used to describe HIV dynamics without assuming disease steady-state. Population analysis was performed with MONOLIX 2018 software. Simulations of the viral load evolution as a function of time and rilpivirine trough plasma concentration were performed. RESULTS Overall, 60 naive and 39 pre-treated patients were included with a follow-up ranging from 2 to 37 months. The final model adequately described the data and the pharmacodynamic parameters were estimated with a good precision. The population typical value of rilpivirine EC50 was estimated at 65 ng/mL. A higher infection rate constant of CD4 cells for HIV-1 was obtained in pre-treated patients. Consequently, the time to obtain virological suppression was longer in pre-treated than in naive patients. CONCLUSIONS The concentration-response relationship of rilpivirine was satisfactorily described for the first time using an original population pharmacodynamic model. Simulations performed using the final model showed that the currently used 50 ng/mL rilpivirine trough plasma concentration efficacy target might need revision upwards, particularly in pre-treated patients.
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Affiliation(s)
- Nadège Néant
- Aix Marseille Université, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille, France
| | - Caroline Solas
- Aix Marseille Université, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille, France
| | - Naïm Bouazza
- Université Paris Descartes, EA7323 Sorbonne Paris Cité, Paris, France.,Unité de Recherche Clinique Paris Descartes Necker Cochin, AP-HP, Paris, France.,CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - Minh Patrick Lê
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, Paris, France
| | - Yazdan Yazdanpanah
- Université Paris Diderot, APHP, IAME-UMR 1137, Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris, France
| | - Catherine Dhiver
- IHU Méditerranée Infection, Aix-Marseille Université, AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, Marseille, France
| | - Sylvie Bregigeon
- APHM, Hôpital Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France
| | - Saadia Mokhtari
- IHU Méditerranée Infection, Aix-Marseille Université, AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, Marseille, France
| | - Gilles Peytavin
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, Paris, France
| | - Catherine Tamalet
- IHU Méditerranée Infection, Aix-Marseille Université, AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, Marseille, France
| | - Diane Descamps
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, Paris, France
| | - Bruno Lacarelle
- Aix Marseille Université, APHM, INSERM, CNRS, CRCM SMARTc, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille, France
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Gantner P, Allavena C, Duvivier C, Cabie A, Reynes J, Makinson A, Ravaux I, Bregigeon S, Cotte L, Rey D. Post-exposure prophylaxis completion and condom use in the context of potential sexual exposure to HIV. HIV Med 2020; 21:463-469. [PMID: 32558205 DOI: 10.1111/hiv.12880] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Post-exposure prophylaxis (PEP) care remains a challenge for individuals with potential sexual exposure to HIV in terms of PEP completion and ongoing risk behaviours. METHODS A retrospective analysis was carried out on data from the French Dat'AIDS prevention cohort (NCT03795376) for individuals evaluated for PEP between 2004 and 2017. A multivariable analysis was performed of predictors of both PEP completion and condom use [odds ratios (ORs)] and their associated probabilities (P, with P > 95% being clinically relevant). RESULTS Overall, 29 060 sexual exposures to HIV were evaluated for PEP [36% in men who have sex with men (MSM) and 64% in heterosexuals]. Overall, 12 different PEP regimens were offered in 19 240 cases (46%). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) was the preferred backbone (n = 14 304; 74%). We observed a shift from boosted protease inhibitor-based regimens to nonnucleoside reverse transcriptase inhibitor- or integrase inhibitor-based regimens in recent years. Overall, 20% of PEP prescriptions were prematurely discontinued. Older age, MSM, intercourse with a sex worker, rape and intercourse with a known HIV-infected source patient were factors associated with increased rates of PEP completion (OR > 1; P > 98%). None of the 12 PEP regimens was associated with premature discontinuation. We also found 12 774 cases of unprotected sexual intercourse (48%). Condom use decreased (OR < 1; P > 99%) with the year of exposure, and was lower in MSM and rape victims. Condom use increased (OR > 1, P > 99%) with age, and was higher in those who had intercourse with a sex worker or with a female partner and in those with knowledge of the partner's HIV status. CONCLUSIONS We provide new insights into how rates of condom use and PEP completion might be improved in those receiving PEP by targeting certain groups of individuals for interventions. In particular, youth and MSM at risk should be linked in a prevention-to-care continuum.
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Affiliation(s)
- P Gantner
- Molecular Virology Department, Strasbourg University Hospital, Strasbourg, France.,INSERM, UMR-S U1109, Strasbourg University, Strasbourg, France
| | - C Allavena
- Infectious Diseases Department, Hôtel-Dieu Hospital, Nantes, France
| | - C Duvivier
- Infectious Diseases Department, Necker-Pasteur Infectiology Center, AP-HP-Necker Hospital, Paris, France.,Necker-Pasteur Infectiology Center, Medical Center of Pasteur Institute, Paris, France.,Paris Descartes University, EA7327, Sorbonne Paris Cité, Paris, France.,IHU Imagine, Paris, France
| | - A Cabie
- Infectious Diseases Department, Inserm CIC1424, Antilles University EA 4537, CHU de Martinique, Martinique, France
| | - J Reynes
- Infectious Diseases Department, Inserm U1175, CHU Montpellier, Montpellier, France
| | - A Makinson
- Infectious Diseases Department, Inserm U1175, CHU Montpellier, Montpellier, France
| | - I Ravaux
- AP-HM, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - S Bregigeon
- AP-HM, Clinical Immuno-Hematology Department, CHU Sainte-Marguerite, Marseille, France
| | - L Cotte
- Infectious Diseases Department, Croix Rousse Hospital, Lyon, France
| | - D Rey
- Le Trait d'Union, HIV-Infection Care Center, Strasbourg University Hospital, Strasbourg, France
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7
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Cuzin L, Pugliese P, Katlama C, Bani-Sadr F, Ferry T, Rey D, Lourenco J, Bregigeon S, Allavena C, Reynes J, Cabié A. Integrase strand transfer inhibitors and neuropsychiatric adverse events in a large prospective cohort. J Antimicrob Chemother 2020; 74:754-760. [PMID: 30534993 DOI: 10.1093/jac/dky497] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/02/2018] [Accepted: 11/08/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To analyse the frequency and causes of treatment discontinuation in patients who were treated with an integrase strand transfer inhibitor (INSTI), with a focus on neuropsychiatric adverse events (NPAEs). METHODS Patients in 18 HIV reference centres in France were prospectively included in the Dat'AIDS cohort. Data were collected from all patients starting an INSTI-containing regimen between 1 January 2006 and 31 December 2016. All causes of INSTI-containing regimen discontinuations were analysed, and patients' characteristics related to discontinuation due to NPAEs were sought. RESULTS INSTIs were prescribed to 21315 patients: 6274 received dolutegravir, 3421 received elvitegravir boosted by cobicistat, and 11620 received raltegravir. Discontinuation was observed in 12.5%, 20.2% and 50.9% of the dolutegravir-, elvitegravir- and raltegravir-treated patients, respectively (P < 0.001). Discontinuation for NPAEs occurred in 2.7%, 1.3% and 1.7% of the dolutegravir-, elvitegravir-, and raltegravir-treated patients, respectively (P < 0.001). In the multivariate analysis, discontinuation for NPAEs was related to dolutegravir versus elvitegravir (HR = 2.27; 95% CI 1.63-3.17; P < 0.0001) and versus raltegravir (HR = 2.46; 95% CI 2.00-3.40; P < 0.0001), but neither gender (HR for women = 1.19; 95% CI 0.97-1.46; P = 0.09) nor age (P = 0.12) was related. The association with abacavir was not retained in the final model. CONCLUSIONS Although discontinuation for side effects was less frequent with dolutegravir than with boosted elvitegravir, discontinuation for NPAEs, although rare (2.7%), was more frequent with dolutegravir. No patient characteristic was found to be associated with these side effects in this very large population.
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Affiliation(s)
- Lise Cuzin
- Infectious and Tropical Diseases, Martinique University Hospital, Fort-de-France, France.,INSERM UMR1027, Toulouse University, Toulouse, France
| | - Pascal Pugliese
- Infectious Diseases Department, Nice University Hospital, Nice, France
| | - Christine Katlama
- Sorbonne Univ., UPMC Univ Paris 06-UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.,AP-HP, Infectious Diseases Department, APHP Pitié Salpêtrière Hospital, Paris, France
| | - Firouzé Bani-Sadr
- Reims Champagne-Ardenne University, EA-4684/SFR CAPSANTE, Reims, France.,Tropical and Infectious Diseases Department, University Hospital Reims, Reims, France
| | - Tristan Ferry
- Infectious Disease Unit, Hospices Civils de Lyon, Lyon, France.,Claude Bernard Lyon 1 University, CIRI, INSERM U1111, Lyon, France
| | - David Rey
- HIV Infection Care Centre, University Hospital, Strasbourg, France
| | - Jeremy Lourenco
- Infectious Diseases Department, AP-HP-Necker Hospital, Paris, France
| | - Sylvie Bregigeon
- Aix Marseille University, APHM Sainte-Marguerite, Marseille, France
| | - Clotilde Allavena
- Infectious Diseases Department, Nantes University Hospital, Nantes, France.,UIC 1413 INSERM, Nantes, France
| | - Jacques Reynes
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France.,INSERM U1175, IRD UMI233, Montpellier University, Montpellier, France
| | - André Cabié
- Infectious and Tropical Diseases, Martinique University Hospital, Fort-de-France, France.,INSERM CIC1424, Fort-de-France, France
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8
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Delfosse A, Martin A, Obry-Roguet V, Lions C, Martinet P, Robert J, Bregigeon S, Laroche H, Poizot-Martin I. Dépistage des IST en pratique courante : à chaque âge son IST ! Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Enel P, Retornaz F, Ravaux I, Jaureguiberry JPD, Philibert P, Allegre T, Chadapaud S, Cohen-Valensi R, Granet-Brunello P, Pelissier L, Pichancourt G, Bregigeon S, Tollinchi F, Darque A, Petit N. Factors associated with social deprivation among older persons living with HIV. AIDS Care 2018; 31:809-815. [PMID: 30466319 DOI: 10.1080/09540121.2018.1549719] [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: 01/19/2023]
Abstract
Aging persons living with HIV may develop multiple health problems, including comorbidities, and altered physical and mental health, earlier than non-infected people. They may also experience social deprivation. We assessed the prevalence of social deprivation and its relationship with health indicators in older persons living with HIV. An 18-month, multicenter, cross-sectional study was carried out between 2013 and 2014 focusing on patients ≥50-years of age followed-up in 12 dedicated HIV medical hospital units located in the South of France and involved the VISAGE study group. Social deprivation was measured with the EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centers) score (ES) and defined as ES ≥30.17. The following data were recorded: health indicators (gender, age, body mass index), comorbidities, frailty markers, socioeconomic, behavioral and age-related variables. Among 509 patients recruited, 494 completed the ES social deprivation evaluation. Mean age was 58.5 ± 7.0 years and 72.9% were male. The prevalence of social deprivation was 49.0%. Multivariable logistic regression analysis showed that higher social deprivation was significantly linked to alcohol consumption (OR = 4.07 [95%CI: 1.23-13.48]), risk of depression (OR = 3.59 [95%CI: 2.26-5.70]), chronic obstructive pulmonary disease (OR = 3.10 [95%CI: 1.36-7.09]), hepatitis C (OR = 1.96 [95%CI: 1.10-3.52]), and chronic pain (OR = 1.11 [95%CI: 1.01-1.21]). Social deprivation was not related to HIV status. Our study showed that not only did older patients with HIV suffer from social deprivation, but they also received little support from social workers. Physicians should be aware of this situation and should systematically evaluate social deprivation in order to provide comprehensive targeted care involving global, social, and psychological support to reduce the burden of social deprivation.
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Affiliation(s)
- Patricia Enel
- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France.,b Department of Public Health , Self-Perceived Health Assessment Research Unit EA3279, Aix-Marseille University , Marseille , France
| | - Frederique Retornaz
- b Department of Public Health , Self-Perceived Health Assessment Research Unit EA3279, Aix-Marseille University , Marseille , France.,c Silvermed Institute and Division of Geriatric Medicine , State Geriatric Center , Marseille , France.,d Department of Internal Medicine and Infectious Diseases , European hospital , Marseille , France
| | - Isabelle Ravaux
- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France.,e Institut Hospitalo-Universitaire Méditerranée Infection , Marseille , France
| | | | - Patrick Philibert
- d Department of Internal Medicine and Infectious Diseases , European hospital , Marseille , France
| | - Thierry Allegre
- g Department of Internal Medicine and Hemato-Oncology , Aix-en-Provence public hospital , Aix-en-Provence , France
| | - Stephane Chadapaud
- h Department of Internal Medicine , Hyères-les-Palmiers public hospital , Hyères-les-Palmiers , France
| | | | - Patricia Granet-Brunello
- j Department of Cardiology and Pneumology , Digne-les-Bains public hospital , Digne-les-Bains , France
| | | | - Gilles Pichancourt
- l Department of Clinical Hematology and Medical Oncology , Avignon public hospital , Avignon , France
| | - Sylvie Bregigeon
- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France
| | - Frank Tollinchi
- m Department of Dermatology , Saint-Joseph foundation hospital , Marseille , France
| | - Albert Darque
- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France
| | - Nathalie Petit
- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France
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- a Assistance Publique, Hôpitaux de Marseille (AP-HM) , Marseille , France
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10
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Gobert A, Veyri M, Lavolé A, Montaudié H, Cloarec N, Doucet L, Gounant V, Massiani MA, Helissey C, Bregigeon S, Chouaid C, Poulet CH, Dewolf M, Kerjouan M, Beaucaire-Danel S, Brosseau S, Le Garff G, Garrait V, Marcelin AG, Spano JP. Tolerance and efficacy of immune-checkpoint inhibitors for cancer in people living with HIV (PWHIV). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Poizot-Martin I, Obry-Roguet V, Zaegel-Faucher O, Lions C, Cano C, Ivanova A, Ritleng A, Debreux C, Bregigeon S. HIV infection and care pathway: From guidelines to clinical practice. Med Mal Infect 2018; 49:23-33. [PMID: 30195462 DOI: 10.1016/j.medmal.2018.07.005] [Citation(s) in RCA: 1] [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] [Received: 11/24/2017] [Revised: 01/31/2018] [Accepted: 07/24/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To quantify within a cohort of HIV-infected individuals the number of medical visits and procedures to be carried out according to comorbidities and risk factors to implement a personalized care pathway. PATIENTS AND METHODS Retrospective study of 915 patients consulting from January 1 to December 31, 2016 at an outpatient unit of multidisciplinary consultations, using an electronic patient record. We built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. The frequency of comorbidities was measured according to gender, transmission risk group, and nadir CD4 (<or>200/mm3). RESULTS Patients were mostly men (median age: 52 years), of whom 16% were aged≥60 years. Viral load was<40 copies/mL in 93.5% of treated patients and CD4 cell count≥500/mm3 for 73%. Overall, 74.5% of patients had at least one comorbidity. The number of comorbidities was similar in men and women but was significantly higher in patients with a nadir CD4 <200/mm3 and increased with age (irrespective of gender). The minimum number of consultations to be scheduled per year was 8123: 70% for the management of comorbidities with an average of six consultations/year/patient. Overall, 53% of patients should attend a proctology consultation. The minimum number of paramedical procedures to be performed was 5115. CONCLUSION The implementation of a personalized multidisciplinary management within a single facility seems to be a suitable care model to address the needs of HIV-infected individuals.
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Affiliation(s)
- I Poizot-Martin
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France; INSERM, IRD, SESSTIM, sciences économiques & Sociales de la Santé & Traitement de l'Information Médicale, AP-HM Sainte-Marguerite, service d'Immuno-hématologie clinique, biostatistique et technologies de l'information et de la communication, Aix Marseille Université, AP-HM, 13009 Marseille, France.
| | - V Obry-Roguet
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - O Zaegel-Faucher
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Lions
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Cano
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - A Ivanova
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - A Ritleng
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Debreux
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - S Bregigeon
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
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12
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Tamalet C, Tissot-Dupont H, Motte A, Tourrès C, Dhiver C, Ravaux I, Poizot-Martin I, Dieng T, Tomei C, Bregigeon S, Zaegel-Faucher O, Laroche H, Aherfi S, Mokhtari S, Chaudet H, Ménard A, Brouqui P, Stein A, Colson P. Emergence of uncommon HIV-1 non-B subtypes and circulating recombinant forms and trends in transmission of antiretroviral drug resistance in patients with primary infection during the 2013-2015 period in Marseille, Southeastern France. J Med Virol 2018; 90:1559-1567. [PMID: 29797570 DOI: 10.1002/jmv.25228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 05/12/2018] [Indexed: 11/06/2022]
Abstract
Primary HIV-1 infections (PHI) with non-B subtypes are increasing in developed countries while transmission of HIV-1 harboring antiretroviral resistance-associated mutations (RAMs) remains a concern. This study assessed non-B HIV-1 subtypes and RAMs prevalence among patients with PHI in university hospitals of Marseille, Southeastern France, in 2005-2015 (11 years). HIV-1 sequences were obtained by in-house protocols from 115 patients with PHI, including 38 for the 2013-2015 period. On the basis of the phylogenetic analysis of the reverse transcriptase region, non-B subtypes were identified in 31% of these patients. They included 3 different subtypes (3A, 1C, 4F), 23 circulating recombinant forms (CRFs) (CRF02_AG, best BLAST hits being CRF 36_cpx and CRF30 in 7 and 1 cases, respectively), and 5 unclassified sequences (U). Non-B subtypes proportion increased significantly, particularly in 2011-2013 vs in 2005-2010 (P = .03). CRF02_AG viruses largely predominated in 2005-2013 whereas atypical strains more difficult to classify and undetermined recombinants emerged recently (2014-2015). The prevalence of protease, nucleos(t)ide reverse transcriptase, and first-generation nonnucleoside reverse transcriptase inhibitors-associated RAMs were 1.7% (World Health Organization [WHO] list, 2009/2.6% International AIDS Society [IAS] list, 2017), 5.2%/4.3%, and 5.2%/5.2%, respectively. Etravirine/rilpivirine-associated RAM (IAS) prevalence was 4.3%. Men who have sex with men (MSM) were more frequently infected with drug-resistant viruses than other patients (26% vs 7%; P = .011). The recent increase of these rare HIV-1 strains and the spread of drug-resistant HIV-1 among MSM in Southeastern France might be considered when implementing prevention strategies and starting therapies.
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Affiliation(s)
- Catherine Tamalet
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Hervé Tissot-Dupont
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Anne Motte
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Christian Tourrès
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Catherine Dhiver
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Isabelle Ravaux
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Isabelle Poizot-Martin
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Immuno-Hématologie Clinique, Hôpital Sainte-Marguerite, Marseille, France.,INSERM U912 SESSTIM, Aix Marseille Université, Marseille, France
| | - Thérèse Dieng
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Christelle Tomei
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Sylvie Bregigeon
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Immuno-Hématologie Clinique, Hôpital Sainte-Marguerite, Marseille, France.,INSERM U912 SESSTIM, Aix Marseille Université, Marseille, France
| | - Olivia Zaegel-Faucher
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Immuno-Hématologie Clinique, Hôpital Sainte-Marguerite, Marseille, France.,INSERM U912 SESSTIM, Aix Marseille Université, Marseille, France
| | - Hélène Laroche
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Immuno-Hématologie Clinique, Hôpital Sainte-Marguerite, Marseille, France.,INSERM U912 SESSTIM, Aix Marseille Université, Marseille, France
| | - Sarah Aherfi
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Saadia Mokhtari
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Hervé Chaudet
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Immuno-Hématologie Clinique, Hôpital Sainte-Marguerite, Marseille, France
| | - Amelie Ménard
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Philippe Brouqui
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Andreas Stein
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
| | - Philippe Colson
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France
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13
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Abstract
As HIV-infected patients grow older, some accumulate multiple health problems earlier than the noninfected ones in particular frailty phenotypes. Patients with frailty phenotype are at higher risk of adverse outcomes (worsening mobility, disability, hospitalization, and death within three years).Our study aimed to evaluate prevalence of frailty in elderly HIV-infected patients and to assess whether frailty is associated with HIV and geriatric factors, comorbidities, and precariousness in a French cohort of older HIV infected.This 18-month cross-sectional multicenter study carried in 2013 to 2014 had involved 502 HIV-infected patients aged 50 years and older, cared in 18 HIV-dedicated hospital medical units, located in South of France.Prevalence of frailty was 6.3% and of pre-frailty 57.2%. Low physical activity and weakness were the main frailty markers, respectively 49.4% and 19.9%. In univariate models, precariousness, duration of HIV antiretroviral treatment >15 years, 2 comorbidities or more, risk of depression, activities of daily living disability, and presence of pain were significantly associated with frail and pre-frail phenotype. Multivariate logistic regression analyses showed that only pain was significantly different between frail and pre frail phenotype versus non frail phenotype (odds ratio = 1.2; P = .002).Our study is the first showing a significant association between pain and frailty phenotype in older patients infected by HIV. As frailty phenotype could be potentially reversible, a better understanding of the underlying determinant is warranted. Further studies are needed to confirm these first findings.
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Affiliation(s)
- Nathalie Petit
- Department of Internal, Geriatric and Therapeutic Medicine, University Hospital Center AP-HM
| | - Patricia Enel
- HIV regional network COREVIH, University Hospital Center AP-HM
- Center for Studies and Research on Health Services and Quality of Life EA3279, Aix-Marseille University
| | - Isabelle Ravaux
- HIV regional network COREVIH, University Hospital Center AP-HM
- University Hospital Institute for Infectious and Tropical Diseases, IHU Méditerranée Infection
| | - Albert Darque
- HIV regional network COREVIH, University Hospital Center AP-HM
- Hospital Pharmacy, University Hospital Center AP-HM
| | - Karine Baumstarck
- Center for Studies and Research on Health Services and Quality of Life EA3279, Aix-Marseille University
| | - Sylvie Bregigeon
- Department of Clinical Immuno-Hematology, University Hospital Center AP-HM
| | - Frédérique Retornaz
- Center for Studies and Research on Health Services and Quality of Life EA3279, Aix-Marseille University
- Silvermed Institute and Division of Geriatric Medicine, State Geriatric Centre
- Department of Internal Medicine and Infectious Diseases, European Hospital, Marseille, France
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14
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Solas C, Bregigeon S, Faucher‐Zaegel O, Quaranta S, Obry‐Roguet V, Tamalet C, Lacarelle B, Poizot‐Martin I. Ledipasvir and tenofovir drug interaction in human immunodeficiency virus-hepatitis C virus coinfected patients: Impact on tenofovir trough concentrations and renal safety. Br J Clin Pharmacol 2018; 84:404-409. [PMID: 29028125 PMCID: PMC5777437 DOI: 10.1111/bcp.13450] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/19/2017] [Revised: 09/13/2017] [Accepted: 10/05/2017] [Indexed: 01/15/2023] Open
Abstract
We evaluate the impact of ledipasvir on both tenofovir plasma trough concentration and estimated glomerular renal function in human immunodeficiency virus-hepatitis C virus coinfected patients receiving a tenofovir-based antiretroviral regimen and treated with ledipasvir/sofosbuvir. Twenty-six patients [81% male, median age: 51 years; hepatitis C virus genotype 1(75%)/4(15%)] were included. Tenofovir trough concentration (interquartile range) increased from 78 ng ml-1 (53-110) at baseline to 141 ng ml-1 (72-176) at 1 month (P = 0.003). No significant difference on estimated glomerular renal function using both Cockroft-Gault and Modification of Diet in Renal Disease formulae, respectively, [median (interquartile range)] was observed between baseline [101.3 ml min-1 (91.1-114.1); 95.6 ml min-1 (86.5-111.2)], 1 month [102.4 ml min-1 (89.8-112.9), P = 0.26; 92.5 ml min-1 (88.1-114.3), P = 0.27], end-of-treatment [96.5 ml min-1 (82.4-115.4), P = 0.39; 95.4 ml min-1 (84.2-105.4), P = 0.16] and 12 weeks after the end of treatment [100.5 ml min-1 (83.3-111.9), P = 0.24; 93.4 ml min-1 (82.2-103.5), P = 0.16]. Three patients progressed from chronic kidney disease stage 1 to stage 2 at 12 weeks post-treatment. A significant increase in tenofovir exposure through P-glycoprotein inhibition by ledipasvir was confirmed without significant impact on glomerular renal function in our population with normal renal function or mild renal impairment.
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Affiliation(s)
- Caroline Solas
- Aix‐Marseille Univ, CRO2 ‐ INSERM, UMR911MarseilleFrance
- APHM, Hôpital La Timone, Laboratoire de Pharmacocinétique et ToxicologieMarseilleFrance
| | - Sylvie Bregigeon
- APHM Sainte‐Marguerite, Service d'Immuno‐hématologie cliniqueMarseilleFrance
| | | | - Sylvie Quaranta
- APHM, Hôpital La Timone, Laboratoire de Pharmacocinétique et ToxicologieMarseilleFrance
| | | | - Catherine Tamalet
- IHU Méditerranée Infection, Aix‐Marseille Univ., AP‐HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095MarseilleFrance
| | - Bruno Lacarelle
- Aix‐Marseille Univ, CRO2 ‐ INSERM, UMR911MarseilleFrance
- APHM, Hôpital La Timone, Laboratoire de Pharmacocinétique et ToxicologieMarseilleFrance
| | - Isabelle Poizot‐Martin
- APHM Sainte‐Marguerite, Service d'Immuno‐hématologie cliniqueMarseilleFrance
- INSERM U912 (SESSTIM)MarseilleFrance
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15
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Néant N, Gattacceca F, Lê MP, Yazdanpanah Y, Dhiver C, Bregigeon S, Mokhtari S, Peytavin G, Tamalet C, Descamps D, Lacarelle B, Solas C. Population pharmacokinetics of Rilpivirine in HIV-1-infected patients treated with the single-tablet regimen rilpivirine/tenofovir/emtricitabine. Eur J Clin Pharmacol 2018; 74:473-481. [PMID: 29374296 DOI: 10.1007/s00228-017-2405-1] [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] [Received: 09/26/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Rilpivirine, prescribed for the treatment of HIV infection, presents an important inter-individual pharmacokinetic variability. We aimed to determine population pharmacokinetic parameters of rilpivirine in adult HIV-infected patients and quantify their inter-individual variability. METHODS We conducted a multicenter, retrospective, and observational study in patients treated with the once-daily rilpivirine/tenofovir disoproxil fumarate/emtricitabine regimen. As part of routine therapeutic drug monitoring, rilpivirine concentrations were measured by UPLC-MS/MS. Population pharmacokinetic analysis was performed using NONMEM software. Once the compartmental and random effects models were selected, covariates were tested to explain the inter-individual variability in pharmacokinetic parameters. The final model qualification was performed by both statistical and graphical methods. RESULTS We included 379 patients, resulting in the analysis of 779 rilpivirine plasma concentrations. Of the observed trough individual plasma concentrations, 24.4% were below the 50 ng/ml minimal effective concentration. A one-compartment model with first-order absorption best described the data. The estimated fixed effect for plasma apparent clearance and distribution volume were 9 L/h and 321 L, respectively, resulting in a half-life of 25.2 h. The common inter-individual variability for both parameters was 34.1% at both the first and the second occasions. The inter-individual variability of clearance was 30.3%. CONCLUSIONS Our results showed a terminal half-life lower than reported and a high proportion of patients with suboptimal rilpivirine concentrations, which highlights the interest of using therapeutic drug monitoring in clinical practice. The population analysis performed with data from "real-life" conditions resulted in reliable post hoc estimates of pharmacokinetic parameters, suitable for individualization of dosing regimen.
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Affiliation(s)
- Nadège Néant
- INSERM U911-CRO2 SMARTc, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
| | - Florence Gattacceca
- INSERM U911-CRO2 SMARTc, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Minh Patrick Lê
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, 75018, Paris, France
| | - Yazdan Yazdanpanah
- APHP, IAME-UMR 1137, Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Univ Paris Diderot, 75018, Paris, France
| | - Catherine Dhiver
- IHU Méditerranée Infection, Aix Marseille Univ., AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, 13005, Marseille, France
| | - Sylvie Bregigeon
- APHM, Hôpital Sainte-Marguerite, Service d'Immuno-hématologie clinique, 13009, Marseille, France
| | - Saadia Mokhtari
- IHU Méditerranée Infection, Aix Marseille Univ., AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, 13005, Marseille, France
| | - Gilles Peytavin
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmaco-Toxicologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, 75018, Paris, France
| | - Catherine Tamalet
- IHU Méditerranée Infection, Aix Marseille Univ., AP-HM, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, 13005, Marseille, France
| | - Diane Descamps
- APHP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité and INSERM, 75018, Paris, France
| | - Bruno Lacarelle
- INSERM U911-CRO2 SMARTc, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Aix-Marseille Univ, APHM, INSERM U911-CRO2, SMARTc, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, 13005, Marseille, France
| | - Caroline Solas
- INSERM U911-CRO2 SMARTc, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Aix-Marseille Univ, APHM, INSERM U911-CRO2, SMARTc, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, 13005, Marseille, France
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Cloarec N, Solas C, Ladaique A, Tamalet C, Zaegel-Faucher O, Bregigeon S, Canet B, Cano CE, Poizot-Martin I. Sub-therapeutic darunavir concentration and garlic consumption; a «Mediterranean» drug-food interaction, about 2 cases. Eur J Clin Pharmacol 2017; 73:1331-1333. [DOI: 10.1007/s00228-017-2300-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
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17
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Laroche H, Lions C, Solas C, Carrieri P, Zaegel O, Bregigeon S, Tamalet C, Ressiot E, Obry V, Poizot-martin I. Éradication de l’hépatite C chronique active en pratique : bilan à 12 mois. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Taton A, Colson P, Dhiver C, Ruiz JM, Bregigeon S, Tomei C, Ressiot E, Menard A, Poizot-Martin I, Ravaux I, Lacarelle B, Solas C. Daclatasvir plasma concentration assessment in HIV-HCV-coinfected real-life patients. Antivir Ther 2017; 22:731-733. [PMID: 28362269 DOI: 10.3851/imp3163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Audrey Taton
- AP-HM Hôpital de la Timone, Service de Pharmacocinétique et Toxicologie, Marseille, France
| | - Philippe Colson
- IHU Méditerranée Infection, Aix Marseille Université, AP-HM Hôpital de la Timone, Fédération de Bactériologie-Virologie-Hygiène, URMITE UM 63 CNRS 7278 IRD 198 INSERM 1095, Marseille, France
| | - Catherine Dhiver
- Aix Marseille Université, AP-HM Hôpital de La Conception, Service de Maladies Infectieuses, Marseille, France
| | - Jean-Marie Ruiz
- AP-HM Centre Pénitentiaire de Marseille, Hôpitaux Sud, Service de Médecine en Milieu Pénitentiaire, Marseille, France
| | - Sylvie Bregigeon
- AP-HM Hôpital Sainte Marguerite, Service d'Immuno-Hématologie Clinique, Marseille, France
| | - Christelle Tomei
- Aix Marseille Université, AP-HM Hôpital de La Conception, Service de Maladies Infectieuses, Marseille, France
| | - Emmanuelle Ressiot
- AP-HM Hôpital de La Timone, Service d'Hépato-gastro-entérologie, Marseille, France
| | - Amélie Menard
- Aix Marseille Université, AP-HM Hôpital de La Conception, Service de Maladies Infectieuses, Marseille, France
| | - Isabelle Poizot-Martin
- Aix Marseille Université, AP-HM Hôpital Sainte Marguerite, Service d'Immuno-Hématologie Clinique, INSERM U912 SESSTIM, Marseille, France
| | - Isabelle Ravaux
- Aix Marseille Université, AP-HM Hôpital de La Conception, Service de Maladies Infectieuses, Marseille, France
| | - Bruno Lacarelle
- Aix Marseille Université, AP-HM Hôpital de la Timone, Service de Pharmacocinétique et Toxicologie, CRO2 INSERM U911, Marseille, France
| | - Caroline Solas
- Aix Marseille Université, AP-HM Hôpital de la Timone, Service de Pharmacocinétique et Toxicologie, CRO2 INSERM U911, Marseille, France
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Bregigeon S, Solas C, Faucher O, Obry-Roguet V, Tamalet C, Poizot-Martin I. Impact of tenofovir dose adjustment on both estimated glomerular filtration rate and tenofovir trough concentration. Antivir Ther 2017; 22:529-533. [PMID: 28195560 DOI: 10.3851/imp3137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tenofovir disoproxil fumarate (TDF)-based regimen is a treatment option for HIV-infected patients. TDF dose adjustment is recommended in patients with impaired renal function. We assessed the impact of TDF dose adjustment on renal function and tenofovir trough concentration. METHODS Fourteen HIV patients for whom TDF dose was adjusted (1 tablet/48 h) because of estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, and/or due to a tenofovir trough concentration >90 ng/ml between 2006 and 2013 were selected. The eGFR was measured at baseline and 3, 6 and 12 months after TDF dose adjustment. RESULTS A 50% TDF dose reduction resulted in a significant increase of the eGFR 3 months after dose adjustment (61.1 versus 72.8 ml/min/1.73 m2; P=0.003). Concomitantly, tenofovir trough concentration decreased from 175 to 66 ng/ml (P=0.009). Antiviral efficacy was maintained in all patients. CONCLUSIONS TDF dose adjustment combined with therapeutic drug monitoring may be useful especially in patients at risk of kidney dysfunction.
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Affiliation(s)
- Sylvie Bregigeon
- Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France
| | - Caroline Solas
- Aix-Marseille University, APHM La Timone, Pharmacocinétique et Toxicologie, INSERM S_911 CRO2-SMARTc, Marseille, France
| | - Olivia Faucher
- Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France
| | - Véronique Obry-Roguet
- Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France
| | - Catherine Tamalet
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, APHM Timone, Marseille, France
| | - Isabelle Poizot-Martin
- Aix-Marseille University, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France.,INSERM U912 (SESSTIM), Marseille, France
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20
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Renard S, Borentain P, Salaun E, Benhaourech S, Maille B, Darque A, Bregigeon S, Colson P, Laugier D, Gaubert MR, Habib G. Severe Pulmonary Arterial Hypertension in Patients Treated for Hepatitis C With Sofosbuvir. Chest 2016; 149:e69-73. [PMID: 26965976 DOI: 10.1016/j.chest.2015.09.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/15/2015] [Accepted: 09/01/2015] [Indexed: 12/16/2022] Open
Abstract
Development of direct-acting antiviral agents against hepatitis C virus (HCV) has changed the management of chronic HCV infection. We report three cases of newly diagnosed or exacerbated pulmonary arterial hypertension (PAH) in patients treated with sofosbuvir. All patients had PAH-associated comorbidities (HIV coinfection in two, portal hypertension in one) and one was already being treated for PAH. At admission, all patients presented with syncope, World Health Organization functional class IV, right-sided heart failure, and extremely severe hemodynamic parameters. After specific PAH therapy, the clinical and hemodynamic properties for all patients were improved. Severity and acuteness of PAH, as well as chronology, could suggest a causal link between HCV treatment and PAH onset. We hypothesize that suppression of HCV replication promotes a decrease in vasodilatory inflammatory mediators leading to worsening of underlying PAH. The current report suggests that sofosbuvir-based therapy may be associated with severe PAH.
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Affiliation(s)
- Sébastien Renard
- Department of Cardiology, PAH Regional Expert Center, Hôpital de la Timone, Marseille, France.
| | - Patrick Borentain
- Department of Hepato-Gastroenterology, Hôpital de la Timone, Marseille, France
| | - Erwan Salaun
- Department of Cardiology, PAH Regional Expert Center, Hôpital de la Timone, Marseille, France
| | - Sanaa Benhaourech
- Department of Cardiology, PAH Regional Expert Center, Hôpital de la Timone, Marseille, France
| | - Baptiste Maille
- Department of Cardiology, PAH Regional Expert Center, Hôpital de la Timone, Marseille, France
| | - Albert Darque
- Central Pharmacy Service, Hôpital de la Conception, Marseille, France
| | - Sylvie Bregigeon
- Department of Immuno-hematology, Hôpital Sainte Marguerite, Marseille, France
| | - Philippe Colson
- Institut hospitalo-universitaire Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique - Hôpitaux de Marseille, Marseille, France; Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses Tropicales et Emergentes, UM63, CNRS 7278, IRD 198, Institut National de la Santé et de la Recherche Medicale U1095, Facultés de Médecine et de Pharmacie, Marseille, France
| | - Delphine Laugier
- Regional Center of Pharmacovigilance, Provence-Alpes-Côte d'Azur-Corse, Hôpital Sainte Marguerite, Marseille, France
| | - Martine Reynaud Gaubert
- Department of Pneumology, PAH Regional Expert Center, Hôpital Nord, Chemin des Bourrely, Marseille, France
| | - Gilbert Habib
- Department of Cardiology, PAH Regional Expert Center, Hôpital de la Timone, Marseille, France
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Aherfi S, Glazunova O, Borentain P, Botta-Fridlund D, Chiche L, Bregigeon S, Motte A, Tamalet C, Colson P. Hepatitis C virus of subtype 2l in Marseille, southeastern France. Intervirology 2015; 58:6-13. [PMID: 25592333 DOI: 10.1159/000369015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The rate of eradication of chronic hepatitis C considerably increases with direct-acting antiviral agents, particularly hepatitis C virus (HCV) polymerase inhibitors. While implementing full-length HCV NS5B polymerase sequencing in our clinical microbiology laboratory, we identified atypical HCV sequences, classified as subtype 2l, from 2 patients. HCV-2l NS5B polymerase sequences were detected from 5 and 14 additional patients by screening our laboratory hepatitis virus sequence database and the NCBI GenBank sequence database. Phylogenetic analyses show unambiguously that all HCV-2l sequences are clustered apart from HCV 2 non-l sequences, which compose a second cluster. Mean (±SD) nucleotide identity between near full-length NS5B fragments of subtype 2l was 93.4 ± 0.8% (range: 92.4-95.1). Of note, all HCV-2l sequences obtained in our laboratory and in other centers were from serum samples collected in France. Analysis of the HCV-2l NS5B polymerase amino acid sequences at 30 positions critical for interaction with or resistance to HCV polymerase inhibitors showed specific patterns.
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Affiliation(s)
- Sarah Aherfi
- URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, Facultés de Médecine et de Pharmacie, Aix-Marseille University, Marseille, France
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22
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Aherfi S, Solas C, Motte A, Moreau J, Borentain P, Mokhtari S, Botta-Fridlund D, Dhiver C, Portal I, Ruiz JM, Ravaux I, Bregigeon S, Poizot-Martin I, Stein A, Gérolami R, Brouqui P, Tamalet C, Colson P. Hepatitis C virus NS3 protease genotyping and drug concentration determination during triple therapy with telaprevir or boceprevir for chronic infection with genotype 1 viruses, southeastern France. J Med Virol 2014; 86:1868-76. [PMID: 25052594 DOI: 10.1002/jmv.24016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 02/01/2023]
Abstract
Telaprevir and boceprevir, the two first hepatitis C virus (HCV) NS3 protease inhibitors (PIs), considerably increase rates of sustained virologic response in association with pegylated interferon and ribavirin in chronic HCV genotype 1 infections. The 30 first patients treated by telaprevir or boceprevir including anti-HCV therapies since 2011 in Marseille University hospitals, France, were monitored. HCV loads and plasmatic concentrations of telaprevir and boceprevir were determined on sequential blood samples. HCV NS3 protease gene population sequencing was performed at baseline of treatment and in case of treatment failure. Fifteen patients (including 7 co-infected with HIV) received telaprevir and the other 15 patients (including 4 co-infected with HIV) received boceprevir. At baseline, HCV NS3 protease from six patients harbored amino acid substitutions associated with PI-resistance. Treatment failure occurred at week 12 for 7 patients. Amino acid substitutions associated with PI-resistance were observed in six of these cases. HCV NS3 R155K and T54A/S mutants, all of genotype 1a, were found from four patients. Median (interquartile range) plasma concentrations were 3,092 ng/ml (2,320-3,525) for telaprevir and 486 ng/ml (265-619) for boceprevir. For HIV-HCV co-infected patients, median concentrations were 3,162 ng/ml (2,270-4,232) for telaprevir and 374 ng/ml (229-519) for boceprevir. Plasma drug concentration monitoring revealed undetectable concentrations for two patients at week 4, and probable non-adherence to therapy for another patient. These findings indicate that routine HCV NS3 protease sequencing and plasma PI concentration monitoring might be helpful to characterize cases of therapy failure, at a cost dramatically low compared to that of anti-HCV therapy.
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Affiliation(s)
- Sarah Aherfi
- Fondation Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Marseille, France; Aix-Marseille Univ., Facultés de Médecine et de Pharmacie, URMITE UM63 CNRS 7278 IRD 198 INSERM U1095, Marseille, France
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Bergamaschi V, Faucher O, Ressiot E, Bregigeon S, Obry V, Tamalet C, Poizot-Martin I. C-08: Impact de la charge virale HPV16 dans l’évolution d’une dysplasie anale. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70134-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cloarec N, Faucher O, Bregigeon S, Brunet C, Tamalet C, Cano C, Poizot Martin I. Kaposi's sarcoma in a treated and well-controlled HIV infected patient: Discussion on the role of immunosenescence. HIV & AIDS Review 2014. [DOI: 10.1016/j.hivar.2014.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Tamalet C, Obry-Roguet V, Ressiot E, Bregigeon S, Del Grande J, Poizot-Martin I. Distribution of human papillomavirus genotypes, assessment of HPV 16 and 18 viral load and anal related lesions in HIV positive patients: a cross-sectional analysis. J Med Virol 2013; 86:419-25. [PMID: 24154930 DOI: 10.1002/jmv.23831] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 11/10/2022]
Abstract
Natural history of anal intraepithelial neoplasia and anal cancer is not fully understood. Factors associated with cytological abnormalities and predictors of progression to high-grade anal intraepithelial neoplasia still deserve investigation. The aim of this cross-sectional study was to assess the prevalence of HPV types, the relationship between HPV genotypes, HPV 16/18 viral load and cytological abnormalities in male and female HIV-infected patients. One hundred and twenty-two (72.6%) patients were infected with HPV, 75 (61%) had multiple HPV infection, and 94 (77%) had high-risk HPV infection. The most frequently identified HPV types were HPV 16 (64%), HPV 6 (39%), HPV 18 (31%), HPV 53 (14.7%), HPV 33 (10.6%), HPV 11 (8.2%), HPV 70 (5.7%), and HPV 61 (4.9%). The HPV types which were most frequently found in combination were HPV 6 + 16 (9.8%), 6 + 16 + 18 (8.2%), 16 + 18 (6.6%), 6 + 18 (4.9%), 16 + 33 (3.3%), 16 + 53 (3.3%). Median HPV16 and 18 viral loads were 6.1 log10 copies/10(6) cells [IQR 5.0-7.3] and 6.1 log10 copies/10(6) cells [IQR 5.7-6.0], respectively. Male gender (P = 0.03, OR: 1.2 [1.0-1.4]) and homo/bisexual transmission routes (P = 0.044, OR: 1.4 [1.0-1.9]) were associated with HPV 16 infection. An HPV 16 viral load cut-off ≥5.3 log10 copies/10(6) cells and a CD4+ cell count ≤200/µl were independent factors associated with abnormal cytology. In the absence of national consensus guidelines, a strict regular follow-up at shorter intervals is recommended for HIV-infected patients with abnormal cytology, especially low grade squamous intraepithelial lesions, an HPV 16 viral load ≥5.3 log/10(6) cells and a CD4+ cell count ≤200/µl.
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Affiliation(s)
- Catherine Tamalet
- Department of Clinical Microbiology IHU and CNRS-URMITE, UMR 7278 Timone University Hospital Marseille, France
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Colson P, Bregigeon S, Tourres C, Solas C, Poizot-Martin I, Tamalet C. Relapse of hepatitis C virus after 14 months of sustained virological response following pegylated-interferon alpha plus ribavirin therapy in a human immunodeficiency virus type 1 infected patient. J Clin Virol 2013; 58:309-14. [DOI: 10.1016/j.jcv.2013.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 01/29/2023]
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Daigre J, Mendjel M, Bregigeon S, Tamalet C. A multidisciplinary staff for the optimisation of therapy in HIV-infected patients treated for cancer. Retrovirology 2012. [PMCID: PMC3360264 DOI: 10.1186/1742-4690-9-s1-p66] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Julie Daigre
- APHM La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille, France
| | - Meriem Mendjel
- APHM La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille, France
| | - Sylvie Bregigeon
- APHM Sainte Marguerite, Service d’Immunohématologie clinique, CISIH, Marseille, France
| | - Catherine Tamalet
- Pole des Maladies Infectieuses et tropicales Clinique et Biologique, Fédération de Bactériologie Hygiène Virologie, Marseille, France
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Bregigeon S, Menard A, Faucher O, Tamalet C, Solas C, Obry-Roguet V, Poizot-Martin I. Impact of maraviroc on immune restoration in an advanced stage HIV-infected patient. Retrovirology 2010. [PMCID: PMC3315977 DOI: 10.1186/1742-4690-7-s1-p59] [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: 11/10/2022] Open
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29
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Bregigeon S, Canet B, Obry-Roguet V, Menard A, Poizot-Martin I. Educational intervention and HIV infection: preliminary results. Retrovirology 2010. [PMCID: PMC3316042 DOI: 10.1186/1742-4690-7-s1-p92] [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: 11/20/2022] Open
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