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Devos S, Bonnet F, Hessamfar M, Neau D, Vareil MO, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Dabis F, Wittkop L, Barger D, Blanco P, Bouchet S, Breilh D, Desjardin S, Gaborieau V, Gimbert A, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Pellegrin I, Perrier A, Petrov-Sanchez V, Bernard N, Bronnimann D, Chaussade H, Dondia D, Faure I, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Nguyen D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Labasse-Depis M, Lacassin F, Barret A, Castan B, Koffi J, Saunier A, Zabbe JB, Dumondin G, Beraud G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Ngo Bell C, Carpentier C, Tumiotto C, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lai WH, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M. Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV). BMC Infect Dis 2023; 23:16. [PMID: 36624391 PMCID: PMC9830769 DOI: 10.1186/s12879-022-07963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France. METHODS A multi-centric, cross-sectional analysis was conducted in 2018-19 in the QuAliV study-ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio. RESULTS 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] - 0.383, - 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI - 0.343, 0.012] in multivariable analysis (p = 0.068). CONCLUSIONS Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation. TRIAL REGISTRATION NUMBER NCT03296202.
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Affiliation(s)
- Sophie Devos
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Fabrice Bonnet
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Mojgan Hessamfar
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Didier Neau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Marc-Olivier Vareil
- grid.418076.c0000 0001 0226 3611Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, 13 Avenue de l’interne Jacques Loëb, BP 8, 64109 Bayonne Cedex, France
| | - Olivier Leleux
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Charles Cazanave
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Nicolas Rouanes
- Centre Hospitalier de Périgueux, Service de Médecine Polyvalente, 80 Av. Georges Pompidou, 22400 Périgueux, France
| | - Pierre Duffau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.4444.00000 0001 2112 9282Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Estibaliz Lazaro
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne, 1 Avenue de Magellan, 33600 Pessac, France
| | - François Dabis
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Linda Wittkop
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,Univ. Bordeaux, INSERM, INRIA, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.508062.90000 0004 8511 8605CHU de Bordeaux, Service d’information médicale, INSERM, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Diana Barger
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
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Blanc P, Bonnet F, Leleux O, Perrier A, Bessede E, Pereyre S, Cazanave C, Neau D, Vareil MO, Lazaro E, Duffau P, Saunier A, André K, Wittkop L, Vandenhende MA, Blanco P, Bonnet F, Bouchet S, Breilh D, Cazanave C, Desjardin S, Gaborieau V, Gimbert A, Hessamfar M, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Lazaro E, Leleux O, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Neau D, Pellegrin I, Perrier A, Petrov-Sanchez V, Vareil MO, Wittkop L, Bernard N, Bonnet F, Bronnimann D, Chaussade H, Dondia D, Duffau P, Faure I, Hessamfar M, Mercié P, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Cazanave C, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Neau D, Nguyen D, Malvy D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Lazaro E, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Vareil MO, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Gerard Y, Labasse-Depis M, Lacassin F, Barret A, Courtault C, Castan B, Koffi J, Rouanes N, Saunier A, Zabbe JB, Dumondin G, Gaborieau V, Gerard Y, Beraud G, Le Moal G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Bell CN, Pasdeloup T, Pasdeloup T, Blanco P, Pellegrin I, Carpentier C, Pellegrin I, Bellecave P, Lafon ME, Tumiotto C, Bouchet S, Breilh D, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lawson-Ayayi S, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M, Leleux O, Perrier A, Peyrouny-Mazeau A. Severe bacterial non-AIDS infections in persons with HIV: the epidemiology and evolution of antibiotic resistance over an 18-year period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-Aquitaine cohort. Clin Infect Dis 2023; 76:1814-1821. [PMID: 36610063 DOI: 10.1093/cid/ciac978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Severe non-AIDS bacterial infections (SBIs) are one of the leading causes of hospital admissions among persons with HIV (PWH) in regions with high ART coverage. METHODS This large prospective cohort study of PWH examined the types of infections, bacterial documentation, and evolution of antibiotic resistance among PWH hospitalized with SBIs over an 18-year period. RESULTS Between 2000 and 2017, 459 PWH had at least one SBI with bacterial documentation. Among the 847 SBIs, there were 280 cases of bacteremia, 269 cases of pneumonia, and 240 urinary tract infections. The 1025 isolated bacteria included Enterobacteriaceae (n = 394; mainly Escherichia coli), Staphylococcus aureus (n = 153) and Streptococcus pneumoniae (n = 82). The proportion of S. pneumoniae as the causative agent in pneumonia and bacteremia decreased sharply over time, from 34% to 8% and from 21 to 3%, respectively.The overall antibiotic resistance of S. aureus and S. pneumoniae decreased progressively but it increased for Enterobacteriaceae (from 24% to 48% for amoxicillin-clavulanate, from 4 to 18% for cefotaxime, and from 5% to 27% for ciprofloxacin). Cotrimoxazole prophylaxis was associated with higher nonsusceptibility of S. pneumoniae to amoxicillin and erythromycin, higher nonsusceptibility of Enterobacteriaceae to beta-lactams and fluoroquinolones, and a higher risk of extended-spectrum β-lactamase producing Enterobacteriaceae. CONCLUSIONS The bacterial resistance pattern among PWH between 2014 and 2017 was broadly similar to that in the general population, with the exception of a higher resistance profile of Enterobacteriaceae to fluoroquinolones. The use of cotrimoxazole as prophylaxis was associated with an increased risk of antibiotic resistance.
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Affiliation(s)
- Peggy Blanc
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Olivier Leleux
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Adélaïde Perrier
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Emilie Bessede
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Sabine Pereyre
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, UMR 5234 Fundamental Microbiology and Pathogenicity, F-33000 Bordeaux, France
| | - Charles Cazanave
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Marc-Olivier Vareil
- Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, F-64109 Bayonne, France
| | - Estibaliz Lazaro
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque, F-33600 Pessac, France
| | - Pierre Duffau
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique, Hôpital Saint-André, UMR 5164, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, F-33000 Bordeaux, France
| | - Aurélie Saunier
- Centre Hospitalier de Périgueux, Service de Médecine Interne, F-24000 Périgueux, France
| | - Katell André
- Centre Hospitalier de Dax, Service de Maladies Infectieuses, F-40100 Dax, France
| | - Linda Wittkop
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, F-33000, Bordeaux, France.,INRIA SISTM Team, F-33405, Talence, France.,Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
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Lahouati M, Mériglier E, Martin L, Bouchet S, Desclaux A, Bonnet F. COVID-19 infection also occurs in patients taking hydroxychloroquine. J Antimicrob Chemother 2020; 75:2014-2015. [PMID: 32417904 PMCID: PMC7239161 DOI: 10.1093/jac/dkaa193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- M Lahouati
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France.,CHU de Bordeaux, Hôpital Saint-André, Service de Pharmacie Clinique, F-33000 Bordeaux, France
| | - E Mériglier
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France
| | - L Martin
- CHU de Bordeaux, Hôpital Pellegrin, Service de Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
| | - S Bouchet
- CHU de Bordeaux, Hôpital Pellegrin, Service de Pharmacologie, F-33000 Bordeaux, France
| | - A Desclaux
- CHU de Bordeaux, Hôpital Pellegrin, Service de Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
| | - F Bonnet
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France.,Université de Bordeaux, Bordeaux Population Health, INSERM U1219, F-33000 Bordeaux, France
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