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Rojas Rojas T, Poizot-Martin I, Rey D, Duvivier C, Bani-Sadr F, Cabie A, Delobel P, Jacomet C, Allavena C, Ferry T, Pugliese P, Valantin MA, Lamaury I, Hustache-Matthieu L, Fresard A, Houyou T, Huleux T, Cheret A, Makinson A, Obry-Roguet V, Lions C, Carrieri MP, Protopopescu C. Incidence of cervical, breast and colorectal cancers between 2010 and 2015 in people living with HIV in France. PLoS One 2022; 17:e0261069. [PMID: 35333883 PMCID: PMC8956191 DOI: 10.1371/journal.pone.0261069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program. SETTING This is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort. METHODS Standardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection. RESULTS The 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73). CONCLUSION The present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.
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Affiliation(s)
- Teresa Rojas Rojas
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Isabelle Poizot-Martin
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - David Rey
- Le Trait d’Union, HIV-Infection Care Center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker-Pasteur, IHU Imagine, Paris, France
- Institut Cochin—CNRS 8104—INSERM U1016—RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France
- Centre Médical de l’Institut Pasteur, Institut Pasteur, Paris, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - André Cabie
- Université des Antilles, CHU de Martinique, Fort-de-France, Martinique, France
| | - Pierre Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales-INSERM, UMR 1043- Université Toulouse III Paul Sabatier, Toulouse, France
| | - Christine Jacomet
- Clermont-Ferrand University Hospital Infectious and Tropical disease Department, Clermont Ferrand, France
| | - Clotilde Allavena
- Infectious Diseases Department, CHU Hôtel-Dieu, INSERM UIC 1413, CHU Nantes, Nantes, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | - Marc-Antoine Valantin
- GHPS Pitié Salpêtrière APHP, Infectious Diseases, Paris, France
- Sorbonne Universités UPMC Université Paris 6-INSERM-IPLESP, Paris, France
| | - Isabelle Lamaury
- Department of Infectious and Tropical Diseases, University Hospital of Pointe-à-Pitre, Pointe-à-Pitre, France
| | | | - Anne Fresard
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Tamazighth Houyou
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Thomas Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur—Centre Hospitalier G. DRON Tourcoing, Tourcoing, France
| | - Antoine Cheret
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Internal Medicine, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Alain Makinson
- Department of Infectious Diseases, Montpellier University Hospital, INSERM U1175/IRD UMI 233, Montpellier, France
| | - Véronique Obry-Roguet
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Caroline Lions
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Maria Patrizia Carrieri
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Camelia Protopopescu
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
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Barré T, Rojas Rojas T, Lacombe K, Protopopescu C, Poizot-Martin I, Nishimwe ML, Zucman D, Esterle L, Billaud E, Aumaitre H, Bouchaud O, Rey D, Piroth L, Salmon-Ceron D, Wittkop L, Sogni P, Carrieri MP, Serfaty L, Marcellin F. Cannabis use and reduced risk of elevated fatty liver index in HIV-HCV co-infected patients: a longitudinal analysis (ANRS CO13 HEPAVIH). Expert Rev Anti Infect Ther 2021; 19:1147-1156. [PMID: 33538612 DOI: 10.1080/14787210.2021.1884545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Cannabis use and elevated fatty liver index (FLI≥ 60) (a biomarker of hepatic steatosis in the general population) have been identified as predictors of HCV-related and overall mortality, respectively, in HIV-HCV co-infected patients. However, the relationship between cannabis use and the risk of elevated FLI has never been explored.Methods: Using five-year follow-up data from 997 HIV-HCV co-infected patients (ANRS CO13 HEPAVIH cohort), we analyzed the relationship between cannabis use and FLI using mixed-effects multivariable logistic (outcome: elevated FLI yes/no) and linear (outcome: continuous FLI) regression models.Results: At the last follow-up visit, 27.4% of patients reported regular or daily cannabis use and 27.8% had elevated FLI. After multivariable adjustment, regular or daily cannabis use was associated with a 55% lower risk of elevated FLI (adjusted odds ratio [95% confidence interval]: 0.45 [0.22; 0.94]; p = 0.033) and lower FLI values (adjusted model coefficient: -4.24 [-6.57; -1.91], p < 0.0001).Conclusions: Cannabis use is associated with a reduced risk of elevated fatty liver index in HIV-HCV co-infected patients. Further research is needed to confirm whether and how cannabinoids may inhibit the development of hepatic steatosis or other metabolic disorders in high-risk populations.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Teresa Rojas Rojas
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France.,APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France.,UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Marie Libérée Nishimwe
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - David Zucman
- Department of Internal Medicine, Réseau Ville Hôpital Val De Seine, Foch Hospital, Suresnes, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Bordeaux, France
| | - Eric Billaud
- Department of Infectious Disease, CHU Hôtel-Dieu, Nantes, France.,COREVIH Pays De La Loire, CHU Hôtel-Dieu, Nantes, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Avicenne Hospital, Bobigny, France.,Laboratoire d'Educations et Pratiques en Santé EA 3412, Université Sorbonne Paris Nord, Bobigny, France
| | - David Rey
- Le Trait d'Union, HIV-Infection Care Center, Hôpitaux Universitaires De Strasbourg, Strasbourg, France
| | - Lionel Piroth
- Department of Infectiology, Dijon University Hospital Center, Dijon, France.,INSERM-CIC 1342, Bourgogne University, Dijon, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses Et Tropicales, AP-HP, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Bordeaux, France.,Pole De Sante Publique, CHU De Bordeaux, Bordeaux, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U-1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, Hôpital Cochin, Assistance Publique - Hôpitaux De Paris, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Lawrence Serfaty
- Service d'Hépato-gastroentérologie, Hôpital Hautepierre, Hôpitaux Universitaires De Strasbourg, France.,INSERM UMR 938, Université Paris Sorbonne, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Poizot-Martin I, Lions C, Allavena C, Huleux T, Bani-Sadr F, Cheret A, Rey D, Duvivier C, Jacomet C, Ferry T, Cabie A, Fresard A, Pugliese P, Delobel P, Lamaury I, Chirouze C, Zaegel-Faucher O, Brégigeon S, Rojas Rojas T, Obry-Roguet V, Makinson A. Spectrum and Incidence Trends of AIDS- and Non-AIDS-Defining Cancers between 2010 and 2015 in the French Dat'AIDS Cohort. Cancer Epidemiol Biomarkers Prev 2020; 30:554-563. [PMID: 33310788 DOI: 10.1158/1055-9965.epi-20-1045] [Citation(s) in RCA: 16] [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: 07/09/2020] [Revised: 09/22/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cancer risk is higher in people living with HIV (PLWH) compared with the general population, and cancers related to age are expected to be most prevalent. METHODS We determined the spectrum and incidence rates of AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC) and of lung, Hodgkin lymphoma (HL), head and neck (HNC), colon-rectum, anal, liver, breast, prostate, and urinary bladder cancers between January 2010 and December 2015 in the French Dat'AIDS cohort. Incidence rates were calculated by year and compared using the χ 2 test for linear trend. Standardized incidence ratios [SIR (95% confidence interval)] were calculated relative to the French general population. RESULTS Among 44,642 patients, corresponding to 180,216.4 person-years (PY), 1,440 cancer cases occurred in 1,314 patients. ADC incidence was 191.4 (172.3-212.7)/105 PY and declined over time overall and in men, whereas NADC incidence was higher [548.8 (515.6-584.1)/105 PY] and did not change. In men, non-Hodgkin lymphoma was the most common cancer, but prostate cancer had the highest incidence among NADCs. Breast cancer was the most common cancer in women. SIRs were higher for cervical cancer [1.93 (1.18-3.14)], HNC in women [2.4 (1.4-4.2)], liver [overall: 3.8 (3.1-4.6); men: 3.2 (2.5-4.0); women: 12.9 (8.3-20.0)], and HL [overall: 13.8 (11.1-17.1); men: 16.2 (12.9-20.4); women: 6.2 (3.22-11.9)] but lower for lung [overall: 0.7 (0.6-0.9); men: 0.7 (0.5-0.8)], prostate [0.6 (0.5-0.7)], and breast cancers [0.6 (0.4-0.7)]. CONCLUSIONS Spectrum of NADCs has changed, with prostate and breast cancers becoming the most common despite their lower SIR. IMPACT These results confirm the need to maintain regular epidemiologic cancer monitoring in order to update screening guidelines.
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Affiliation(s)
- Isabelle Poizot-Martin
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, APHM Sainte-Marguerite, Service d'immuno-Hématologie Clinique, Marseille, France. .,Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Caroline Lions
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Clotilde Allavena
- Service des Maladies Infectieuses et Tropicales, CHU Hôtel-Dieu, Nantes, France
| | - Thomas Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur - Centre Hospitalier G. DRON Tourcoing, Tourcoing, France
| | - Firouze Bani-Sadr
- Département de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire, Reims, France
| | - Antoine Cheret
- Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, Service de Médecine Interne - Immunologie Clinique - Hôpital Bicêtre - AP-HP, Le Kremlin-Bicêtre, France
| | - David Rey
- Le Trait d'Union, Centre de Soins de l'infection par le VIH, Hôpitaux Universitaires, Strasbourg, France
| | - Claudine Duvivier
- APHP-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 - RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France.,Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Christine Jacomet
- Centre Hospitalier Universitaire de Clermont-Ferrand, Département des Maladies Infectieuses et Tropicales, Clermont-Ferrand, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - André Cabie
- CHU de Martinique, Fort-de-France, Université des Antilles, EA4537, Fort-de-France, Inserm CIC1424, CHU de Martinique, Fort-de-France, France
| | - Anne Fresard
- Centre Hospitalier Universitaire de Saint-Étienne, Département des Maladies Infectieuses et Tropicales, Saint-Etienne, France
| | | | - Pierre Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales, INSERM, UMR1043, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Isabelle Lamaury
- Département d'Infectiologie, Dermatologie et Immunologie Clinique, CHU Guadeloupe BP 465, Pointe-à-Pitre Cedex, France
| | - Catherine Chirouze
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Département des Maladies Infectieuses et Tropicales, Besançon, France
| | - Olivia Zaegel-Faucher
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Sylvie Brégigeon
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Teresa Rojas Rojas
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Véronique Obry-Roguet
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Alain Makinson
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, INSERM U1175/IRD UMI 233, Montpellier, France
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Barré T, Protopopescu C, Bani-Sadr F, Piroth L, Rojas Rojas T, Salmon-Ceron D, Wittkop L, Esterle L, Sogni P, Lacombe K, Chas J, Zaegel O, Chaix ML, Miailhes P, Serfaty L, Marcellin F, Carrieri MP. Elevated Fatty Liver Index as a Risk Factor for All-Cause Mortality in Human Immunodeficiency Virus-Hepatitis C Virus-Coinfected Patients (ANRS CO13 HEPAVIH Cohort Study). Hepatology 2020; 71:1182-1197. [PMID: 31466125 DOI: 10.1002/hep.30914] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-coinfected patients are at high risk of metabolic complications and liver-related events, which are both associated with hepatic steatosis and its progressive form, nonalcoholic steatohepatitis, a known risk factor for mortality. The fatty liver index (FLI), a noninvasive steatosis biomarker, has recently drawn attention for its clinical prognostic value, although its capacity to predict mortality risk in HIV-HCV-coinfected patients has never been investigated. Using a Cox proportional hazards model for mortality from all causes, with data from the French National Agency for Research on Aids and Viral Hepatitis CO13 HEPAVIH cohort (983 patients, 4,432 visits), we tested whether elevated FLI (≥60) was associated with all-cause mortality. APPROACH AND RESULTS After multiple adjustment, individuals with FLI ≥ 60 had almost double the risk of all-cause mortality (adjusted hazard ratio [95% confidence interval], 1.91 [1.17-3.12], P = 0.009), independently of the following factors: HCV cure (0.21 [0.07-0.61], P = 0.004), advanced fibrosis (1.77 [1.00-3.14], P = 0.05), history of hepatocellular carcinoma and/or liver transplantation (7.74 [3.82-15.69], P < 10-3 ), history of indirect clinical signs of cirrhosis (2.80 [1.22-6.41], P = 0.015), and HIV Centers for Disease Control and Prevention clinical stage C (2.88 [1.74-4.79], P < 10-3 ). CONCLUSIONS An elevated FLI (≥60) is a risk factor for all-cause mortality in HIV-HCV-coinfected patients independently of liver fibrosis and HCV cure. In the present era of nearly 100% HCV cure rates thanks to direct-acting antivirals, these findings encourage the more systematic use of noninvasive steatosis biomarkers to help identify coinfected patients with higher mortality risk.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Firouzé Bani-Sadr
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Reims, Hôpital Robert Debré, Reims, France.,Université Reims Champagne Ardenne, EA-4684/SFR CAP-SANTE, Reims, France
| | - Lionel Piroth
- Département d'infectiologie, CHU de Dijon, Inserm CIC 1432, Université de Bourgogne, Dijon, France
| | - Teresa Rojas Rojas
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Linda Wittkop
- Université de Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France.,Service d'information Médicale, CHU de Bordeaux, Pôle de santé publique, Bordeaux, France
| | - Laure Esterle
- Université de Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, AP-HP, Hôpital Cochin, Paris, France
| | - Karine Lacombe
- Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, AP-HP, Paris, France.,Sorbonne Universités, INSERM, UPMC Université de Paris 06, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Julie Chas
- Service Maladies Infectieuses et Tropicales, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Olivia Zaegel
- Service d'Immuno-Hématologie Clinique, Aix-Marseille Université, APHM Sainte-Marguerite, Marseille, France
| | - Marie-Laure Chaix
- Department of Virology, National Reference Centre for HIV, Denis Diderot-Paris 7 University, INSERM U941, APHP, Saint-Louis Hospital, Paris, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Lawrence Serfaty
- Service d'Hépato-gastroentérologie, Hôpital Hautepierre, Hôpitaux Universitaires de Strasbourg, INSERM UMR 938, Université Paris Sorbonne, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Maria Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Barré T, Marcellin F, Di Beo V, Delorme J, Rojas Rojas T, Mathurin P, Protopopescu C, Bailly F, Coste M, Authier N, Carrieri MP, Rolland B. Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS-FANTASIO study). Addiction 2020; 115:573-582. [PMID: 31595554 PMCID: PMC7027887 DOI: 10.1111/add.14820] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/11/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Although people who inject drugs (PWID) are the core at-risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, has been identified as a barrier to HCV treatment uptake in the general population. We investigated whether the arrival of new and well-tolerated HCV treatments (direct-acting antivirals: DAA) has improved HCV treatment uptake in French PWID compared with former treatments (pegylated interferon-based treatments: Peg-IFN). DESIGN Using discrete-time Cox proportional hazards models based on exhaustive care delivery data, we tested for associations between AUD (defined by AUD-related long-term illness status, diagnosis coding during hospitalization and/or AUD pharmacological treatment) and first HCV treatment delivery, after adjusting for gender, age, complementary universal health cover, liver disease severity and type of opioid agonist therapy (OAT) received. Separate analyses were performed for 2012-13 (Peg-IFN era) and 2014-16 (DAA era). SETTING France. PARTICIPANTS All French people chronically HCV-infected who received OAT at least once during 2012-16 and were covered by the national health insurance (n = 24 831). MEASUREMENTS Incidence rate of HCV treatment uptake, hazard ratios associated with AUD and other covariates. FINDINGS Incidence rate (IR) of HCV treatment uptake per 100 person-years was 6.56, confidence interval (CI) = 6.30-6.84; and IR = 5.70, 95% CI = 5.51-5.89 for Peg-IFN-based treatment (2012-13) and DAA (2014-16), respectively. After multiple adjustment, people with AUD not receiving related medication had 30 and 14% lower Peg-IFN-based treatment and DAA uptake, respectively, than those without AUD [hazard ratio (HR) = 0.70, 95% CI = 0.62-0.80 and HR = 0.86, 95% CI = 0.78-0.94]. No difference was observed between those treated for AUD and those without AUD. CONCLUSIONS Despite the benefits of direct-acting antiviral treatment, untreated alcohol use disorder appears to remain a major barrier to hepatitis C virus treatment access for people who inject drugs in France.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Fabienne Marcellin
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Vincent Di Beo
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Jessica Delorme
- CHU Clermont‐Ferrand, Neuro‐Dol, Service de pharmacologie médicale, Centres addictovigilance et pharmacovigilanceUniversité Clermont AuvergneClermont‐FerrandFrance
| | - Teresa Rojas Rojas
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Philippe Mathurin
- Service des maladies de l'appareil digestif, CHU LilleUniversité de LilleLilleFrance
| | - Camelia Protopopescu
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - François Bailly
- Service d'hépatologie et d'addictologie, Groupe hospitalier Nord, Hôpital de la Croix‐RousseLyonFrance
| | - Marion Coste
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Nicolas Authier
- CHU Clermont‐Ferrand, Neuro‐Dol, Service de pharmacologie médicale, Centres addictovigilance et pharmacovigilanceUniversité Clermont AuvergneClermont‐FerrandFrance
| | - Maria Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information MédicaleMarseilleFrance,ORS PACA, Observatoire Régional de la Santé Provence‐Alpes‐Côte d'AzurMarseilleFrance
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le VinatierUniversité de LyonBronFrance
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Rojas Rojas T, Bourdy G, Ruiz E, Cerapio JP, Pineau P, Gardon J, Doimi F, Deparis X, Deharo E, Bertani S. Herbal Medicine Practices of Patients With Liver Cancer in Peru: A Comprehensive Study Toward Integrative Cancer Management. Integr Cancer Ther 2016; 17:52-64. [PMID: 28088871 PMCID: PMC5950939 DOI: 10.1177/1534735416681642] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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] [Indexed: 12/29/2022] Open
Abstract
Rationale: The highest burden of liver cancer occurs in developing
countries, where the use of herbal medicine (HM) is still widespread. Despite
this trend, few studies have been conducted to report HM practices of patients
with a hepatic tumor in the developing world. Hence, this study aimed to
document the use of HM among patients with liver cancer in Peru. Study
Design and Methods: A comparative behavioral epidemiological survey
was conducted among liver cancer patients attending the National Cancer
Institute of Peru. Information was obtained by direct interviews based on a
semistructured questionnaire. The use of HM in Peruvian liver cancer patients
was reported, first, regarding general consumption prior to the onset of
disease, and second, after the appearance of symptoms that patients would relate
to their tumor. In parallel, general consumption of HM in noncancerous people
was assessed as a comparative figure. A correspondence analysis was performed to
reveal potential associations between the symptoms of cancer and the specific
use of HM. Results: Eighty-eight patients and 117 noncancerous
individuals participated in the survey. Overall, 68.3% of the people interviewed
claimed to use HM on a regular basis for general health preservation.
Furthermore, 56.8% of the patients turned to plants first to treat the disorders
for which they later came to the cancer care center. When compared with the
number of plant species used routinely (n = 78), a selection of plants was made
by patients in response to the symptoms of cancer (n = 46). At least 2 plant
species, Aloe vera and Morinda citrifolia,
were significantly associated with the treatment of liver cancer–related
symptoms in the patient group. Conclusions: The present study is
the first survey on the HM practices of patients with liver cancer in Latin
America and, more broadly, in the developing world. Our findings confirm that HM
remains one of the principal primary health care resources in Peru, even for a
severe disease like liver cancer. These traditional, complementary and
alternative medicine practices should be taken into consideration in Peruvian
health programs aiming to educate the population in cancer prevention and
treatment, as well as integrative cancer management.
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Affiliation(s)
| | | | - Eloy Ruiz
- 3 Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Juan-Pablo Cerapio
- 4 Sorbonne Universités, UPMC Univ Paris 06, Institut Pasteur, Paris, France
| | - Pascal Pineau
- 5 Institut Pasteur, Paris, France.,6 INSERM, U 993, Paris, France
| | - Jacques Gardon
- 7 Université de Montpellier, IRD, CNRS, UMR 5569, Montpellier, France
| | - Franco Doimi
- 3 Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Xavier Deparis
- 1 Aix-Marseille Université, IRD, INSERM, UMR 912, Marseille, France
| | - Eric Deharo
- 2 Université de Toulouse, IRD, UPS, UMR 152, Toulouse, France
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Chassagne F, Rojas Rojas T, Bertani S, Bourdy G, Eav S, Ruiz E, Pineau P, Deharo E. A 13-Year Retrospective Study on Primary Liver Cancer in Cambodia: A Strikingly High Hepatitis C Occurrence among Hepatocellular Carcinoma Cases. Oncology 2016; 91:106-16. [PMID: 27250992 DOI: 10.1159/000446398] [Citation(s) in RCA: 10] [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: 12/22/2015] [Accepted: 04/19/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Hepatocellular carcinoma (HCC) is the main type of primary liver cancer (PLC) worldwide, but cholangiocarcinoma (CCA) may be predominant in some specific regions of Southeast Asia. The aim of the present study was to delineate a pattern of Cambodian PLC patients attending the Calmette Hospital in the Cambodian capital Phnom Penh. MATERIALS AND METHODS A total of 553 medical charts diagnosing PLCs from January 2003 to May 2015 were obtained from both the Oncology and Hepato-Gastroenterology Departments of the Calmette Hospital. RESULTS HCC was the predominant type of PLC recorded, with 511 cases (92.4%), whereas CCA represented merely 7.6% (42 cases) of the overall series. Hepatitis B virus (HBV; 44.3%) and hepatitis C virus (HCV; 43%) infection rates were similar among the HCC patients, while small subsets of CCA patients were infected with HBV (15.4%) or HCV (11.5%). Most HCC (84%) and CCA (73.8%) patients received palliative treatment only. CONCLUSION The present study indicates that HCC is the main form of primary hepatic neoplasm among PLC patients attending a hospital in Cambodia. HBV and HCV infections represented equivalent burdens and major contributing factors to HCC. Therefore, the implementation of prevention programs for these infectious agents should become a priority for health policy makers in the country.
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Affiliation(s)
- François Chassagne
- IRD, UPS, UMR 152 PHARMA-DEV, Facultx00E9; des Sciences Pharmaceutiques, Universitx00E9; de Toulouse, Toulouse, France
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Ruiz E, Rojas Rojas T, Berrospi F, Chávez I, Luque C, Cano L, Doimi F, Pineau P, Deharo E, Bertani S. Hepatocellular carcinoma surgery outcomes in the developing world: A 20-year retrospective cohort study at the National Cancer Institute of Peru. Heliyon 2016; 2:e00052. [PMID: 27441236 PMCID: PMC4945847 DOI: 10.1016/j.heliyon.2015.e00052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 09/08/2015] [Revised: 10/31/2015] [Accepted: 12/03/2015] [Indexed: 12/18/2022] Open
Abstract
In the developing world, most patients with hepatocellular carcinoma present with advanced-stage disease, considered to be incurable based on current therapeutic algorithms. Here, we demonstrate that curative liver resection is achievable in a portion of Peruvian patients not addressed by these treatment algorithms. We conducted a retrospective cohort study of 253 hepatocellular carcinoma patients that underwent a curative hepatectomy between 1991 and 2011 at the National Cancer Institute of Peru. The median age of the cohort was 36 years, and merely 15.4% of the patients displayed cirrhosis. The average tumor size was over 14 cm in diameter, resulting in 76.3% of major hepatectomies performed. The 5- and 10-year survival probability estimates were 37.5% and 26.2%, respectively. Age (>44 vs. ≤44 years old; P = 0.005), tumor size (>10 cm vs. ≤10 cm in diameter; P = 0.009), cirrhosis (P < 0.001), satellite lesions (P < 0.001), macroscopic vascular invasion (P < 0.001), allogeneic blood transfusion (P = 0.011), and spontaneous rupture of the tumor (P = 0.006) were independent predictive factors for prognosis. Hepatocellular carcinomas in Peru are characterized by a distinct clinical presentation with notable features compared with those typically described throughout relevant literature. Despite a large number of advanced-stage hepatocellular carcinomas, the outcomes of liver resection observed in the present study were in good standing with the results previously described in other series. It thus appears that staging systems and associated therapeutic algorithms designed for use in the developed world remain inadequate in certain populations, especially in the context of Peruvian patients. Our findings suggest that clinicians in the developing world should reconsider management guidelines pertaining to hepatocellular carcinoma. Indeed, we hypothesize that, in developing countries, a strict adherence to these therapeutic algorithms might create a selection bias resulting in the dismissal of patients who could eventually be treated.
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Affiliation(s)
- Eloy Ruiz
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Cirugía en Abdomen, Lima, Peru
| | - Teresa Rojas Rojas
- Aix Marseille Université, UMR912 SESSTIM INSERM-IRD-AMU, Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France
| | - Francisco Berrospi
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Cirugía en Abdomen, Lima, Peru
| | - Ivan Chávez
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Cirugía en Abdomen, Lima, Peru
| | - Carlos Luque
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Cirugía en Abdomen, Lima, Peru
| | - Luis Cano
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Patología, Lima, Peru
| | - Franco Doimi
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Patología, Lima, Peru
| | - Pascal Pineau
- Institut Pasteur, Unité Organisation Nucléaire et Oncogenèse, Paris, France; Institut National de la Santé et de la Recherche Médicale, Paris U993, France
| | - Eric Deharo
- Université de Toulouse, UPS, UMR152 PHARMADEV, Université Toulouse 3, Toulouse, France; Institut de Recherche pour le Développement, UMR152 PHARMADEV, Vientiane, Laos
| | - Stéphane Bertani
- Université de Toulouse, UPS, UMR152 PHARMADEV, Université Toulouse 3, Toulouse, France; Institut de Recherche pour le Développement, UMR152 PHARMADEV, Lima, Peru
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Marchio A, Bertani S, Rojas Rojas T, Doimi F, Terris B, Deharo E, Dejean A, Ruiz E, Pineau P. A peculiar mutation spectrum emerging from young peruvian patients with hepatocellular carcinoma. PLoS One 2014; 9:e114912. [PMID: 25502816 PMCID: PMC4263719 DOI: 10.1371/journal.pone.0114912] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/15/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma usually afflicts individuals in their later years following longstanding liver disease. In Peru, hepatocellular carcinoma exists in a unique clinical presentation, which affects patients around age 25 with a normal, healthy liver. In order to deepen our understanding of the molecular processes ongoing in Peruvian liver tumors, mutation spectrum analysis was carried out on hepatocellular carcinomas from 80 Peruvian patients. Sequencing analysis focused on nine genes typically altered during liver carcinogenesis, i.e. ARID2, AXIN1, BRAF, CTNNB1, NFE2L2, H/K/N-RAS, and TP53. We also assessed the transcription level of factors involved in the control of the alpha-fetoprotein expression and the Hippo signaling pathway that controls contact inhibition in metazoans. The mutation spectrum of Peruvian patients was unique with a major class of alterations represented by Insertions/Deletions. There were no changes at hepatocellular carcinoma-associated mutation hotspots in more than half of the specimens analyzed. Furthermore, our findings support the theory of a consistent collapse in the Hippo axis, as well as an expression of the stemness factor NANOG in high alpha-fetoprotein-expressing hepatocellular carcinomas. These results confirm the specificity of Peruvian hepatocellular carcinoma at the molecular genetic level. The present study emphasizes the necessity to widen cancer research to include historically neglected patients from South America, and more broadly the Global South, where cancer genetics and tumor presentation are divergent from canonical neoplasms.
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Affiliation(s)
- Agnès Marchio
- Institut Pasteur, Unité Organisation Nucléaire et Oncogenèse, Paris, France
- INSERM, U993, Paris, France
| | - Stéphane Bertani
- Université de Toulouse, UPS, UMR152 PHARMADEV, Université Toulouse 3, Toulouse, France
- Institut de Recherche pour le Développement, UMR152 PHARMADEV, Lima, Peru
| | - Teresa Rojas Rojas
- Aix-Marseille Université, UMR912 SESSTIM INSERM-IRD-AMU, Centre d′Epidémiologie et de Santé Publique des Armées, Marseille, France
| | - Franco Doimi
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Patología, Banco de Tejidos Tumorales, Lima, Peru
| | - Benoît Terris
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service d'Anatomie et Cytologie Pathologiques, Paris, France
| | - Eric Deharo
- Université de Toulouse, UPS, UMR152 PHARMADEV, Université Toulouse 3, Toulouse, France
- Institut de Recherche pour le Développement, UMR152 PHARMADEV, Vientiane, Laos
| | - Anne Dejean
- Institut Pasteur, Unité Organisation Nucléaire et Oncogenèse, Paris, France
- INSERM, U993, Paris, France
| | - Eloy Ruiz
- Instituto Nacional de Enfermedades Neoplásicas, Departamento de Cirugía en Abdomen, Lima, Peru
| | - Pascal Pineau
- Institut Pasteur, Unité Organisation Nucléaire et Oncogenèse, Paris, France
- INSERM, U993, Paris, France
- * E-mail:
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