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Le Guillou-Guillemette H, Pivert A, ElBara A, Vall M, Sang CNW, Veillon P, Ducancelle A, Bollahi MA, Mohamed MS, Lunel-Fabiani F. Prevalence, clinical and virological characteristics and short-term prognosis of hepatitis delta infection among patients with HIV/HBV in Nouakchott, Mauritania. J Viral Hepat 2024. [PMID: 38771311 DOI: 10.1111/jvh.13950] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
Patients living with HIV infection (PLWH) are at risk of acquiring HBV and HDV. The present study aimed to determine the prevalence and characteristics of HIV-HDV-HBV tri-infection in comparison with HIV-HBV coinfection and to estimate severities and outcomes of associated liver diseases in Mauritanian PLWH. Two-hundred-ninety-two consecutive HBsAg-positive PLWH were included (mean age: 37 years). Clinical data were recorded. Anti-HDV antibodies, HBV and HDV viral loads (VLs) and genotype were determined. APRI, FIB-4 and FibroScan were performed to evaluate the severity of liver disease. The anti-HDV antibodies prevalence was 37% and HDV RNA was positive in 40.7% of patients. Genetic diversities were found with HDV genotype 1 (93%) and HBV genotypes D (42.5%) and E (38%). The HBV VL was detectable in 108 patients at inclusion, and mutations associated with HBV resistance were found in 20. For almost all variables studied, including FIB-4 and APRI scores, no significant differences were found between anti-HDV-Ab positive or negative patients. FibroScan examination, which was performed in 110 patients at end-of-follow-up showed higher, but NS values, in HDV positive patients. After a mean follow-up of 24.55 ± 8.01 months (n = 217 patients), a highly significant worsening of APRI and FIB-4 scores was found. Moreover, patients with HDV showed more severe liver disease progression despite an efficient therapy. In a substantial Mauritanian cohort of relatively young PLWH, we found high HDV prevalence and worsening liver disease. In high-risk countries, screening for HDV and providing appropriate follow-up and treatments are warranted in PLWH.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | | | | | | | - Pascal Veillon
- Virology Department, Angers University Hospital, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
| | | | | | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France
- HIFIH Laboratory EA 3859, Angers University, Angers, France
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Kania D, Nouhin J, Bollore K, Njouom R, Toni TD, Issiaka Maiga A, Toure-Kane C, Ngo-Giang-Huong N, Dagnra A, Chuong LE DH, Lunel-Fabiani F, Castera-Guy J, Rubbo PA, Pisoni A, Plantier JC, Tuaillon E. Development and field evaluation in African and Asian countries of an HBV PCR on open polyvalent platforms to determine treatment eligibility: results from the ANRS 12327 study. Clin Microbiol Infect 2024:S1198-743X(24)00236-2. [PMID: 38735369 DOI: 10.1016/j.cmi.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/12/2024] [Accepted: 05/05/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Widespread testing and treatment are essential to eliminate hepatitis B virus (HBV) infection as a public health concern. However, in resource-limited countries, access to HBV PCR is limited. In this study, we developed a quantitative HBV PCR assay on open molecular platforms and evaluate its performance in diagnosing clinically significant HBV DNA thresholds as defined by the World Health Organization (WHO) (2,000 IU/mL, 20,000 IU/mL, and 200,000 IU/mL). METHODS We implemented our HBV PCR test in seven African and Asian countries and France, using either an in-house laboratory method or a CE-IVD marked version of the PCR (Generic HBV Charge Virale, Biocentric). Results were compared to reference tests (Roche Cobas AmpliPrep/Cobas TaqMan and Abbott RealTime on Abbott m2000). RESULTS There was a good agreement between the HBV DNA results of 1015 samples tested by the PCR on open polyvalent platforms and the results from reference tests (mean difference [bias ± SD]: -0.3 ± 0.7 log10 IU/mL and -0.2 ± 0.9 log10 IU/mL when compared to Roche and Abbott tests, respectively). Kappa-Cohen agreements between the HBV PCR on open polyvalent platforms and the Roche/Abbott assays appeared almost perfect for HBV DNA levels ranged from >20,000 to 200,000 IU/mL and >200,000 IU/mL, substantial and moderate for HBV DNA levels ranged from 2,000 to 20,000 IU/mL when compared to Abbott and Roche, respectively. The assay's performance was consistent across genotypes A, B, C, D, and E. CONCLUSION This field evaluation showed that our HBV PCR test is a valuable alternative to proprietary PCR systems. PCR assays on open platforms contribute to expanding clinical laboratory solutions for diagnosing individuals who meet the viral load criteria for antiviral therapy (>20,000 IU/mL) and mother-to-child prophylaxis (>200,000 IU/mL).
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Affiliation(s)
- Dramane Kania
- Laboratoire de Virologie, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Janin Nouhin
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Karine Bollore
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, EFS, Université des Antilles, Montpellier, France
| | - Richard Njouom
- Virology Unit, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | | | - Almoustapha Issiaka Maiga
- University Research and Clinical Center, University of Sciences Techniques and Technologies of Bamako, Bamako, Mali
| | - Coumba Toure-Kane
- Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Senegal
| | - Nicole Ngo-Giang-Huong
- Institut de Recherche pour le Développement (IRD), UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai, Thaïlande
| | - Anoumou Dagnra
- Centre National de Référence VIH-IST/PNLS, BIOLIM, FMMP/UL, Lomé, Togo
| | - Duy Hoang Chuong LE
- Department of Biomedical, Food Analysis and Health Service, Ho Chi Minh City Pasteur Institute, Ho Chi Minh city, Vietnam
| | - Françoise Lunel-Fabiani
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Joany Castera-Guy
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, EFS, Université des Antilles, Montpellier, France
| | - Pierre-Alain Rubbo
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, EFS, Université des Antilles, Montpellier, France; Omunis, Montpellier, France
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, EFS, Université des Antilles, Montpellier, France; Department of Virology, CHU de Montpellier, Montpellier, France
| | | | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, EFS, Université des Antilles, Montpellier, France; Department of Virology, CHU de Montpellier, Montpellier, France.
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3
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Debsikréo N, Mankréo BL, Moukénet A, Ouangkake M, Mara N, Moussa AM, Toure-Kane NC, Lunel-Fabiani F. Prevalence of hepatitis B virus infection and its associated factors among students in N'Djamena, Chad. PLoS One 2024; 19:e0273589. [PMID: 38635501 PMCID: PMC11025733 DOI: 10.1371/journal.pone.0273589] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/05/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Infection by hepatitis B virus (HBV) is a major issue in public health. The prevalence of HBV in Chad is 12.4%, all age groups considered. Here, we aimed to determine the prevalence of HBV and its associated factors among university students in N'Djamena, the country's capital. METHODS A cross-sectional survey of students at either the University of N'djamena or Emi Koussi University was conducted from 3 to 23 July 2021. All participating students provided signed, informed consent and were included in the study consecutively. Blood samples were collected, and serum tested for hepatitis B surface antigen (HBsAg) using the Determine HBsAg rapid test kit, with confirmation of positive tests on an Abbott Architect i1000SR analyzer. Descriptive analysis and logistic regression were used to determine associations between the outcome variable and independent/covariate variables. RESULTS A total of 457 students with a median age of 24 years were included across different faculties. The prevalence of HBV infection was 14.87% (68/457). Most students (75%) were aged 25 years or less. Unprotected sex was reported by 64.9% of the students and multiple sexual partners by 53.6%. Furthermore, 45.7% of them reported having no knowledge of hepatitis B. Having an HBsAg-positive mother (AOR: 2.11), having a history of transcutaneous medical procedures (AOR: 2.97) and living with a family (AOR: 4.63) were significantly associated with HBV status. Age ≥26 years appeared as a protective factor (AOR = 0.41). CONCLUSION Our study detected a high, 14.87% prevalence of HBV infection among students in N'djamena, Chad, and shed light on its associated factors. HBV prevention strategies should include raising awareness among students, making full hepatitis vaccination mandatory before children begin school, promoting mass screening to identify and treat chronic HBV carriers and reduce transmission, and reducing the cost of vaccination.
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Affiliation(s)
- Nalda Debsikréo
- Cheikh Anta Diop University, Dakar, Senegal
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation, Dakar, Sénégal
| | | | - Azoukalné Moukénet
- Cheikh Anta Diop University, Dakar, Senegal
- University of N’Djamena, N’Djamena, Chad
| | | | | | - Ali Mahamat Moussa
- University of N’Djamena, N’Djamena, Chad
- Centre Hospitalier Universitaire la Référence, N’Djamena, Chad
| | - Ndèye Coumba Toure-Kane
- Cheikh Anta Diop University, Dakar, Senegal
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation, Dakar, Sénégal
| | - Françoise Lunel-Fabiani
- Centre Hospitalier Universitaire Angers, BAT IBS-4 rue Larrey, Angers, France
- Laboratoire HIFIH, UFR Santé département Médecine, SFR 4208-UPRES EA3859, Université d’Angers, Angers Cedex 01, France
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Lefeuvre C, Roux M, Blanchard S, Le Guillou-Guillemette H, Boursier J, Lunel-Fabiani F, Jeannin P, Pivert A, Ducancelle A. Analysis of hepatic fibrosis markers in the serum of chronic hepatitis B patients according to basal core promoter/precore mutants. Sci Rep 2022; 12:10261. [PMID: 35715541 PMCID: PMC9205978 DOI: 10.1038/s41598-022-14285-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/03/2022] [Indexed: 12/29/2022] Open
Abstract
The A1762T/G1764A double mutant in the basal core promoter (BCP) region of the hepatitis B virus (HBV) is associated with severe hepatic lesions while the G1899A mutation with the double mutant is associated with a significant reduction in the risk of severe fibrosis. This study aims to measure a number of markers in the serum of patients with chronic HBV infection and to assess relationships between these markers and BCP/precore mutants with consideration of the stage of fibrosis. The serum levels of resistin, TGF-β1, MMP-1, TIMP-1, collagen IA1 and PDGF-BB, which are markers that are known to be involved in the process of hepatic fibrosis, were assayed. The serum levels of PDGF-BB and TIMP-1, and the mutation profile were independently associated with advanced fibrosis. A higher level of TIMP-1 was associated with advanced fibrosis regardless of the mutation status, and a higher level of PDGF-BB was associated with nonsevere fibrosis in patients infected with viruses harboring the A1762T/G1764A or A1762T/G1764A/G1899A mutations. Our results suggest an impact of the A1762T/G1764A mutant on the biological pathway related to TGF-β1 and PDGF-BB. In vitro studies are needed to understand the impact of these mutants on the serum secretion of markers involved in fibrosis severity.
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Affiliation(s)
| | - Marine Roux
- Univ Angers, HIFIH, SFR ICAT, F-49000, Angers, France
| | - Simon Blanchard
- Univ Angers, INSERM Unité 892, CNRS Unit 6299, F-49000, Angers, France
| | | | - Jérôme Boursier
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, F-49000, Angers, France
| | | | - Pascale Jeannin
- Univ Angers, INSERM Unité 892, CNRS Unit 6299, F-49000, Angers, France
| | - Adeline Pivert
- Univ Angers, CHU Angers, HIFIH, SFR ICAT, F-49000, Angers, France
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5
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Lefeuvre C, Pivert A, Przyrowski E, Bouthry E, Darviot E, Mahieu R, Lunel-Fabiani F, Ducancelle A, Le Guillou-Guillemette H. Comparison of performance between three SARS-CoV-2 molecular assays (Aptima™, Laboratory developed test-Fusion and R-GENE®) with a special attention on turn-around time, key point in the laboratory management. J Med Virol 2022; 94:3399-3403. [PMID: 35211992 PMCID: PMC9088664 DOI: 10.1002/jmv.27675] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 11/11/2022]
Abstract
The emergence of SARS-CoV-2 highlights the importance of rapid diagnostic testing to identify individuals with SARS-CoV-2 infections and to limit the spread of the virus. Many molecular assays have commercially available to cope with this surging demand for timely diagnosis of COVID-19 cases, but identifying individuals requires accurate diagnostic tools. We compared the performance of three molecular SARS-CoV-2 assays: Aptima™ SARS-CoV-2 assay running on the Panther system (Hologic), an in-house assay (Laboratory Developed Test) running on the Fusion module of the Panther-Fusion system (LDT-Fusion, Hologic) and the R-GENE® SARS-CoV-2 assay (bioMérieux). In addition, we also evaluated the turn-around time. This parameter is crucial to manage the SARS-CoV-2 diagnosis and represents a key point in the quality management at the laboratory. Aptima™ and LDT-Fusion assays exhibited an excellent positive percent agreement (PPA) (100.0%), while the R-GENE® assay showed a slightly decreased PPA (98.2%). The Hologic assays have a higher throughput with less hands-on time (HOT) than the R-GENE® assays (24-25 vs 71 min). Both Hologic assays are used on a fully automated random-access testing system with on-demand testing capabilities that avoids run series unlike R-GENE® assay. Automated random-access testing systems should be preferred during periods of high SARS-CoV-2 prevalence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | | | - Elise Bouthry
- Virology Department, Angers University Hospital, Angers, France
| | - Estelle Darviot
- Paediatric Department, Angers University Hospital, Angers, France
| | - Rafaël Mahieu
- Department of Infectious Diseases, Angers University Hospital, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
| | - Hélène Le Guillou-Guillemette
- Virology Department, Angers University Hospital, Angers, France.,Univ Angers, HIFIH Laboratory EA 3859, F-49000, Angers, France
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Shimakawa Y, Veillon P, Birguel J, Pivert A, Sauvage V, Guillou-Guillemette HL, Roger S, Njouom R, Ducancelle A, Amta P, Huraux JM, Adoukara JP, Lunel-Fabiani F. Residual risk of mother-to-child transmission of hepatitis B virus infection despite timely birth-dose vaccination in Cameroon (ANRS 12303): a single-centre, longitudinal observational study. The Lancet Global Health 2022; 10:e521-e529. [DOI: 10.1016/s2214-109x(22)00026-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/08/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
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7
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Lefeuvre C, Pivert A, Tran CT, Lunel-Fabiani F, Ducancelle A, Le Guillou-Guillemette H. Practical approach to method verification in plasma and validation in cerebrospinal fluid under accreditation using a flexible scope in molecular virology: setting up the HIV, HBV and HCV Aptima™ Quant Dx assays. Clin Chem Lab Med 2021; 58:251-260. [PMID: 31539347 DOI: 10.1515/cclm-2019-0502] [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] [Received: 05/17/2019] [Accepted: 08/22/2019] [Indexed: 12/11/2022]
Abstract
Background Our laboratory obtained the ISO 15189 accreditation for the plasmatic HIV-1, HBV and HCV viral load (VL) using the m2000 RealTime™ system, which was recently changed for the platform Panther®. Here, we discuss a strategy for performing method validation/verification very quickly. Methods We performed the mandatory (repeatability, internal quality assessment [IQA], measurement uncertainty [MU]) and optional technical verifications for CE/IVD assays using the flexible scope range A. We also performed the mandatory assays for the validation of HIV-1 VL in the cerebrospinal fluid (CSF) using the flexible scope range B. The change was checked by following up on the turnaround time (TAT). Results The coefficient of variation (CV%) for repeatability and IQA complied with the limit of 0.25 log. The MU results ranged from 0.04 to 0.25 log copies or IU/mL. The comparisons of methods showed excellent correlations (R2 = 0.96 for the three parameters) but a delayed centrifugation on HCV VL showed variations of up to 2 log IU/mL. An excellent linearity for HIV-1 in the CSF was obtained from 1.5 to 5 log copies/mL with R2 = 0.99. The TAT increased (84%-98%) in routine usage. Conclusions The three Aptima assays are well suited for routine laboratory use and can be integrated within less than 2 weeks in accordance with flexible scope range A. Our data allows us to confidently perform HIV-1 VL in CSF following flexible scope range B. Finally, we provide an organizational guide for flexible scope management in molecular virology within a short time frame.
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Affiliation(s)
- Caroline Lefeuvre
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Cong T Tran
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, HIFIH Laboratory EA 3859, LUNAM, Angers, France
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8
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Boucheron P, Lu Y, Yoshida K, Zhao T, Funk AL, Lunel-Fabiani F, Guingané A, Tuaillon E, van Holten J, Chou R, Bulterys M, Shimakawa Y. Accuracy of HBeAg to identify pregnant women at risk of transmitting hepatitis B virus to their neonates: a systematic review and meta-analysis. Lancet Infect Dis 2020; 21:85-96. [PMID: 32805201 DOI: 10.1016/s1473-3099(20)30593-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/10/2020] [Accepted: 07/10/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) involves neonatal immunoprophylaxis, with a birth dose of hepatitis B vaccine and immune globulin, and provision of peripartum antiviral prophylaxis in highly viraemic women. However, access to assays to quantify HBV DNA levels remains inadequate in resource-poor settings. This study was commissioned by WHO and aimed to identify the HBV DNA threshold for MTCT, to assess the sensitivity and specificity of hepatitis B e antigen (HBeAg) testing to identify pregnant women with HBV DNA levels above this threshold, and to predict MTCT of HBV infection on the basis of HBeAg testing. METHODS For this systematic review and meta-analysis, we searched the PubMed, EMBASE, Scopus, CENTRAL, CNKI, and Wanfang databases for studies of pregnant women with chronic HBV infection without concurrent antiviral therapy, published between Jan 1, 2000, and April 3, 2019. Studies were eligible for inclusion if MTCT in mother-child pairs could be stratified by different levels of maternal HBV DNA during pregnancy, if maternal HBeAg status could be stratified by HBV DNA level, and if the MTCT status of infants could be stratified by maternal HBeAg status during pregnancy. Studies that selected pregnant women on the basis of HBeAg serostatus or HBV DNA levels were excluded. Aggregate data were extracted from eligible studies by use of a pre-piloted form; study authors were contacted to clarify any uncertainties about potential duplication or if crucial information was missing. To pool sensitivities and specificities of maternal HBeAg to identify highly viraemic women and to predict MTCT events, we used the DerSimonian-Laird bivariate random effects model. This study is registered with PROSPERO, CRD42019138227. FINDINGS Of 9007 articles identified, 67 articles (comprising 66 studies) met the inclusion criteria. The risk of MTCT despite infant immunoprophylaxis was negligible (0·04%, 95% CI 0·00-0·25) below a maternal HBV DNA level of 5·30 log10 IU/mL (200 000 IU/mL) and increased above this threshold. The pooled sensitivity of HBeAg testing to identify HBV DNA levels of 5·30 log10 IU/mL or greater in pregnant women was 88·2% (83·9-91·5) and pooled specificity was 92·6% (90·0-94·5). The pooled sensitivity of HBeAg testing in predicting MTCT of HBV infection despite infant immunoprophylaxis was 99·5% (95% CI 91·7-100) and pooled specificity was 62·2% (55·2-68·7). INTERPRETATION Maternal HBV DNA of 5·30 log10 IU/mL or greater appears to be the optimal threshold for MTCT of HBV infection despite infant immunoprophylaxis. HBeAg is accurate to identify women with HBV DNA levels above this threshold and has high sensitivity to predict cases of immunoprophylaxis failure. In areas where HBV DNA assays are unavailable, HBeAg can be used as an alternative to assess eligibility for antiviral prophylaxis. FUNDING World Health Organization.
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Affiliation(s)
- Pauline Boucheron
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Ying Lu
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
| | - Kyoko Yoshida
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tianshuo Zhao
- School of Public Health, Peking University, Beijing, China
| | - Anna L Funk
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Alice Guingané
- Département d'Hépato-gastroentérologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Edouard Tuaillon
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Judith van Holten
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
| | - Roger Chou
- Oregon Health & Science University, Portland, OR, USA
| | - Marc Bulterys
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland; US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
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Lefeuvre C, Pivert A, Guillou-Guillemette HL, Lunel-Fabiani F, Veillon P, Le Duc-Banaszuk AS, Ducancelle A. Urinary HPV DNA testing as a tool for cervical cancer screening in women who are reluctant to have a Pap smear in France. J Infect 2020; 81:248-254. [DOI: 10.1016/j.jinf.2020.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 11/16/2022]
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10
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Roger S, Lefeuvre C, Grison M, Ducancelle A, Lunel-Fabiani F, Pivert A, Le Guillou-Guillemette H. Evaluation of the Aptima™ HBV Quant Dx assay for semi-quantitative HBV viral load from dried blood spots. J Clin Virol 2020; 129:104524. [PMID: 32629186 DOI: 10.1016/j.jcv.2020.104524] [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: 01/30/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND The detection and quantification of hepatitis B virus (HBV) DNA from dried blood spots (DBS) is a major tool for chronic hepatitis B management in resource-limited settings. This strategy fits in perfectly with the hepatitis control plan promoted by the World Health Organization. However, few commercial methods are validated for viral load (VL) measurement on DBS. OBJECTIVES Our objective was to evaluate the performance of the HBV VL measurement of the Aptima™ HBV Quant Dx assay on DBS compared to plasma samples on the Panther® platform (Hologic). STUDY DESIGN 266 whole blood samples for routine measurement were included. Five spots of 75 μL of whole blood were loaded onto a card before centrifugation and plasma settling. RESULTS 149 samples were quantifiable and 117 were not detected. We achieved excellent linearity (r² = 0.994) over a wide range of measurements suitable for clinical practice, and a 95 % lower limit of detection (LLOD-95 %) at 2.65 log10 IU/mL (445 IU/mL). A good performance of this assay was observed for samples with HBV VL > LLOD-95 % and 100 % of samples were detected if HBV VL was above 2.95 log10 IU/mL. The correlation between the two matrices for quantitative VLs was good (r² = 0.978) with a very low bias (-0.002 log10 IU/mL). CONCLUSION The Aptima™ assay can properly detect and quantify HBV DNA in DBS, providing a satisfactory use in clinical monitoring and therapeutic decisions. DBS represents an excellent alternative to plasma, especially in resource-limited countries, while maintaining the performance and advantages of an automated technique.
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Affiliation(s)
- Steven Roger
- Virology Department, Angers University Hospital, Angers, France
| | - Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Marine Grison
- Virology Department, Angers University Hospital, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
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Nicol T, Lefeuvre C, Serri O, Pivert A, Joubaud F, Dubée V, Kouatchet A, Ducancelle A, Lunel-Fabiani F, Le Guillou-Guillemette H. Assessment of SARS-CoV-2 serological tests for the diagnosis of COVID-19 through the evaluation of three immunoassays: Two automated immunoassays (Euroimmun and Abbott) and one rapid lateral flow immunoassay (NG Biotech). J Clin Virol 2020; 129:104511. [PMID: 32593133 PMCID: PMC7295485 DOI: 10.1016/j.jcv.2020.104511] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023]
Abstract
For IgG detection >14 days after symptoms onset was 100.0 % for all assays. Specificity for IgG was greater than 98 % for CLIA and LFIA compared to ELISA. LFIA (NG-Test®) is reliable and accurate to diagnose SARS-CoV-2 infection. Best agreement was observed between CLIA and LFIA assays (97 %; k = 0.936).
Background The emergence of new SARS-CoV-2 has promoted the development of new serological tests that could be complementary to RT-PCR. Nevertheless, the assessment of clinical performances of available tests is urgently required as their use has just been initiated for diagnose. Objectives The aim of this study was to assess the performance of three immunoassays for the detection of SARS-CoV-2 antibodies. Methods Two automated immunoassays (Abbott SARS-CoV-2 CLIA IgG and Euroimmun Anti-SARS-CoV-2 ELISA IgG/IgA assays) and one lateral flow immunoassay (LFIA NG-Test® IgG-IgM COVID-19) were tested. 293 specimens were analyzed from patients with a positive RT-PCR response, from patients with symptoms consistent with COVID-19 but exhibiting a negative response to the RT-PCR detection test, and from control group specimens. Days since symptoms onset were collected from clinical information sheet associated with respiratory tract samples. Results Overall sensitivity for IgG was equivalent (around 80 %) for CLIA, ELISA and LFIA. Sensitivity for IgG detection, >14 days after onset of symptoms, was 100.0 % for all assays. Overall specificity for IgG was greater for CLIA and LFIA (more than 98 %) compared to ELISA (95.8 %). Specificity was significantly different between IgA ELISA (78.9 %) and IgM LFIA (95.8 %) (p < 0.05). The best agreement was observed between CLIA and LFIA assays (97 %; k = 0.936). Conclusion Excellent sensitivity for IgG detection was obtained >14 days after onset of symptoms for all immunoassays. Specificity was also excellent for IgG CLIA and IgG LFIA. Our study shows that NG-Test® is reliable and accurate for routine use in clinical laboratories.
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Affiliation(s)
- Thomas Nicol
- Virology Department, Angers University Hospital, Angers, France
| | - Caroline Lefeuvre
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Orianne Serri
- Virology Department, Angers University Hospital, Angers, France
| | - Adeline Pivert
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Joubaud
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Vincent Dubée
- Infectious Diseases and Tropical Medicine, University Hospital of Angers, Angers, France; Equipe ATIP AVENIR, CRCINA, INSERM, University of Nantes and Angers
| | - Achille Kouatchet
- Medical Intensive Care Department, University Hospital of Angers, Angers, France
| | - Alexandra Ducancelle
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
| | - Françoise Lunel-Fabiani
- Virology Department, Angers University Hospital, Angers, France; HIFIH Laboratory EA 3859, LUNAM, Angers, France
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Lefeuvre C, Behillil S, Triau S, Monteiro-Rodrigues A, Templier F, Tran CT, Le Guillou-Guillemette H, Lunel-Fabiani F, Enouf V, Ducancelle A. Fatal Myopericarditis Following an Influenza A (H3N2) Infection. Am J Case Rep 2018; 19:540-544. [PMID: 29735962 PMCID: PMC5967290 DOI: 10.12659/ajcr.908314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 14 Final Diagnosis: Myopericarditis Symptoms: Cardiac tamponade • dyspnea • pericardial effusion • tachycardia Medication: — Clinical Procedure: Cardiopulmonary resuscitation Specialty: Infectious Diseases
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Affiliation(s)
- Caroline Lefeuvre
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Sylvie Behillil
- Coordinating Center of the National Reference Center for Influenza Viruses, National Influenza Center (northern France), Pasteur Institute: Viral Genomics and Vaccination (CNRS UMR 3569), Paris Diderot University (Sorbonne Paris Cité University), Paris, France
| | - Stéphane Triau
- Department of Pathology, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - Antonio Monteiro-Rodrigues
- Department of Emergency, SAMU 49, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - François Templier
- Department of Emergency, SAMU 49, Angers University Hospital, UBL (Université Bretagne Loire), Angers, France
| | - Cong Tri Tran
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Hélène Le Guillou-Guillemette
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Françoise Lunel-Fabiani
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Angers, France
| | - Vincent Enouf
- Coordinating Center of the National Reference Center for Influenza Viruses, National Influenza Center (northern France), Pasteur Institute: Viral Genomics and Vaccination (CNRS UMR 3569), Paris Diderot University (Sorbonne Paris Cité University), Paris, France
| | - Alexandra Ducancelle
- Department of Virology, Angers University Hospital, HIFIH Laboratory (Hemodynamics, Interaction Fibrosis and Invasiveness Hepatic Tumor), UBL (Université Bretagne Loire), Paris, France
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13
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Loustaud-Ratti V, Maynard M, Thevenon S, Pradat P, Rousseau A, Alain S, Deny P, Gagnieu MC, Tran A, Dao T, Silvain C, Lunel-Fabiani F, Picard N, Zublena I, Marquet P, Trepo C. Efficiency and Safety of an Early Dose Adjustment of Ribavirin in Patients Infected With Hepatitis C Underexposed to the Drug and Treated With Peginterferon Ribavirin. Ther Drug Monit 2017; 38:684-692. [PMID: 27559840 DOI: 10.1097/ftd.0000000000000332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ribavirin exposure after the first dose (D0AUC0-4h) >1755 mcg·h·L is predictive of sustained virological response (SVR) in patients with hepatitis C treated with peginterferon and ribavirin. The aim of this study was to test the benefit of ribavirin early dose adjustment based on this target in naïve patients infected with genotype 1. METHODS A multicenter randomized controlled trial with two parallel groups; fixed-dose (FD) group: standard of care in 2010-2011, ie, peginterferon-α2a 180 mcg·wk and weight-based ribavirin 1000-1200 mg/d during 48 weeks; adapted-dose (AD) group: increase of ribavirin dose if D0AUC0-4h <1755 mcg·h·L. RESULTS A total of 221 patients were included, 110 in the AD group and 111 in the FD group with similar baseline characteristics. In the perprotocol analysis, SVR was higher in the AD group (55.1% versus 40.4%; P = 0.042), especially in patients with D0AUC0-4h <1755 mcg·h·L (54.3% versus 31.9%; P = 0.029). In the intention-to-treat analysis, the difference was not significant (50% versus 41%; P = 0.197). Ribavirin trough concentrations (C0s) at week 4 of treatment (intention-to-treat analysis) were higher in patients achieving SVR (2.06 versus 1.72 mg/L, P = 0.003). In the subgroup of patients with AUC0-4h <1755 mcg·h·L, 46% of patients with AD achieved a C0 >2.0 mg/L versus 22% of patients with FD (P = 0.013). Grade 1 anemia (but not other grades) was more frequent in the AD group (70% versus 48%, P = 0.001). The number of dose reductions or discontinuation of ribavirin was similar in both groups. CONCLUSIONS Early ribavirin dose adjustment increases SVR in patients underexposed to ribavirin without increasing grade II-IV anemia. Such a strategy could be useful in patients with no access to new antiviral drugs.
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Affiliation(s)
- Véronique Loustaud-Ratti
- *Service d'Hépatogastroentérologie, Hôpital Dupuytren, Limoges; †INSERM, U850, Université de Limoges, F-87000 Limoges; ‡Service d'Hépatologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon; §INSERM, U1092, Université de Limoges, F-87000 Limoges; ∥Laboratoire de Pharmacologie Spécialisée, Hôpital E. Herriot, Hospices Civils de Lyon, Lyon; ¶U1052, INSERM, Lyon; **Pôle de Référence Hépatite C, Hôpital Archet 2, Nice; ††Service d'Hépato-gastro-entérologie et nutrition, Hôpital de la Côte de Nacre, CAEN; ‡‡Service d'Hépato-gastro-entérologie, Centre Hospitalier Universitaire de Poitiers; §§Département Biologie des agents infectieux et pharmacotoxicologie-Virologie, Centre Hospitalier Universitaire d'Angers, Angers; ‖‖Direction de la Recherche Clinique et de l'Innovation, Hospices Civils de Lyon, Lyon, France; and ¶¶Laboratoire de Pharmacologie Médicale, Université de Limoges
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14
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Brochard C, Ducancelle A, Pivert A, Bodin M, Ricard A, Coron E, Couffon C, Dib N, Luet D, Musquer N, Rhun ML, Bertrais S, Michalak S, Lunel-Fabiani F, Cesbron-Metivier E, Caroli-Bosc FX. Human papillomavirus does not play a role in the Barrett esophagus: a French cohort. Dis Esophagus 2017; 30:1-7. [PMID: 28881904 DOI: 10.1093/dote/dox088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
The role of human papillomavirus (HPV) in Barrett's esophagus (BE) has been examined but remains unclear. The purpose of the study is to dispute the connection between HPV and BE in a prospective case-control study. Biopsies were performed above and inside the Barrett's segment for BE patients and in the distal third of the esophagus for control patients for histological interpretation and for virological analysis. Biopsies for virological analysis were placed in a virus transport medium and immediately frozen in liquid nitrogen. Virological analysis involved real-time PCR using the SyBr® green protocol with modified SPF10 general primers. A total of 180 patients (119 control and 61 BE, respectively) were included. In BE patients, 31, 18, and 12 patients had, respectively, no dysplasia, low-grade dysplasia, and high grade dysplasia. Overall, nine were found to be HPV positive: five were control patients and four BE patients. HPV positive status was not associated with BE. No factors were associated with HPV, in particular the degree of BE dysplasia. HPV infection appears unlikely to be significant in the etiology of BE compared with control patients. (ClinicalTrials.gov, Number NCT02549053).
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Affiliation(s)
- C Brochard
- Gastroenterology and Hepatology Department, University Hospital.,INSERM U991, Rennes.,INSERM U913.,Gastroenterology and Hepatology Department
| | | | | | | | - A Ricard
- Gastroenterology and Hepatology Department
| | - E Coron
- INSERM U913.,Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - C Couffon
- Gastroenterology and Hepatology Department
| | - N Dib
- Gastroenterology and Hepatology Department
| | - D Luet
- Gastroenterology and Hepatology Department
| | - N Musquer
- Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - M Le Rhun
- Gastroenterology, Hepatology and Nutritional Support, University Hospital, Nantes
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Michalak
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.,Pathology Department, University Hospital
| | - F Lunel-Fabiani
- Virology Department.,HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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15
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Le Guillou-Guillemette H, Pivert A, Bouthry E, Henquell C, Petsaris O, Ducancelle A, Veillon P, Vallet S, Alain S, Thibault V, Abravanel F, Rosenberg AA, André-Garnier E, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F, Lemaire C. Natural non-homologous recombination led to the emergence of a duplicated V3-NS5A region in HCV-1b strains associated with hepatocellular carcinoma. PLoS One 2017; 12:e0174651. [PMID: 28394908 PMCID: PMC5386276 DOI: 10.1371/journal.pone.0174651] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/13/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The emergence of new strains in RNA viruses is mainly due to mutations or intra and inter-genotype homologous recombination. Non-homologous recombinations may be deleterious and are rarely detected. In previous studies, we identified HCV-1b strains bearing two tandemly repeated V3 regions in the NS5A gene without ORF disruption. This polymorphism may be associated with an unfavorable course of liver disease and possibly involved in liver carcinogenesis. Here we aimed at characterizing the origin of these mutant strains and identifying the evolutionary mechanism on which the V3 duplication relies. METHODS Direct sequencing of the entire NS5A and E1 genes was performed on 27 mutant strains. Quasispecies analyses in consecutive samples were also performed by cloning and sequencing the NS5A gene for all mutant and wild strains. We analyzed the mutant and wild-type sequence polymorphisms using Bayesian methods to infer the evolutionary history of and the molecular mechanism leading to the duplication-like event. RESULTS Quasispecies were entirely composed of exclusively mutant or wild-type strains respectively. Mutant quasispecies were found to have been present since contamination and had persisted for at least 10 years. This V3 duplication-like event appears to have resulted from non-homologous recombination between HCV-1b wild-type strains around 100 years ago. The association between increased liver disease severity and these HCV-1b mutants may explain their persistence in chronically infected patients. CONCLUSIONS These results emphasize the possible consequences of non-homologous recombination in the emergence and severity of new viral diseases.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Adeline Pivert
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Elise Bouthry
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | | | - Odile Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Pascal Veillon
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Sophie Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | | | | | - Florence Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Arielle A. Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, Paris, France
| | | | | | - Yazid Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France
| | - Pascale Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France
| | - Patrice André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France
| | | | | | - Sylvie Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Anne Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Hénia Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | | | | | | | | | - Jacques Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Christopher Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Françoise Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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16
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Ducancelle A, Pivert A, Bertrais S, Boursier J, Balan V, Veillon P, le Guillou-Guillemette H, Thibault V, Castelain S, Roquebert B, Coste-Burel M, Mackiewicz V, Schvoerer E, Larrat S, Maylin S, Alain S, Loustaud-Ratti V, Gordien E, Gozlan J, Brodard V, Chevaliez S, Calès P, Lunel-Fabiani F. Different precore/core mutations of hepatitis B interact with, limit, or favor liver fibrosis severity. J Gastroenterol Hepatol 2016; 31:1750-1756. [PMID: 26992056 DOI: 10.1111/jgh.13338] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/03/2016] [Accepted: 03/06/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM The impact of basal core promoter (BCP) and precore (PC) mutants of the hepatitis B virus (HBV) on liver disease severity remains controversial. The aim of the present study was to screen BCP and PC mutations in 252 HBV surface antigen (HBsAg) positive carriers in France and to assess relationships between these mutations and severe fibrosis. METHODS Direct sequencing of the precore/core gene was used to detect A1762T/G1764A and G1757A mutations in the BCP and G1896A and G1899A mutations in the PC region. RESULTS The prevalences of A1762T/G1764A, G1757A, G1896A, and G1899A mutations were 34.1%, 38.7%, 54.9%, and 29.3% (P < 0.001), respectively. The independent predictors of severe fibrosis (≥F3 Metavir) were older age (P < 0.001), male gender (P = 0.012), elevated alanine aminotransferase (P < 0.001), and the double A1762T/G1764A mutant with no other mutations (P = 0.011). Interestingly, the association of the G1899A mutation with the double A1762T/G1764A mutant significantly counteracted the deleterious effect of the sole double A1762T/G1764A mutant (odds ratio [OR] = 0.28 vs. OR = 3.55, respectively, P = 0.028). CONCLUSIONS Patients with the A1762T/G1764A mutation have a higher risk of severe fibrosis. The G1899A mutation is a protective factor against severe fibrosis that counteracted the deleterious effect of the A1762T/G1764A mutation. Finally, host phenotypic and HBV genotypic markers independently predict fibrosis severity.
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Affiliation(s)
- Alexandra Ducancelle
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France.
| | - Adeline Pivert
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Sandrine Bertrais
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Jérôme Boursier
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Viorica Balan
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Pascal Veillon
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Hélène le Guillou-Guillemette
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Vincent Thibault
- Laboratory of Virology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France
| | - Sandrine Castelain
- Laboratory of Virology, Amiens University Hospital, and EA 4294, Amiens, France
| | - Bénédicte Roquebert
- Laboratory of Virology, Bichat Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - Marianne Coste-Burel
- Laboratory of Virology, Hôtel Dieu Hospital & LUNAM University, and EA4271, Nantes, France
| | - Vincent Mackiewicz
- Laboratory of Virology, Beaujon Hospital & University (HUPNVS), Paris, France
| | - Evelyne Schvoerer
- Laboratory of Virology, Nancy Hospital & University, Vandoeuvre-les-Nancy, France
| | - Sylvie Larrat
- Virology Department, Reference Center of Neuromuscular Disease, Grenoble University Hospital, La Tronche, France
| | - Sarah Maylin
- Laboratory of Virology, Saint Louis Hospital & University, Paris, France
| | - Sophie Alain
- Laboratory of Virology, UMR Inserm 1092, Dupuytren Hospital & University, Limoges, France
| | | | - Emmanuel Gordien
- Laboratory of Virology, University Hospital of Paris Seine-Saint-Denis, Avicenne, Associated with the National Reference Center for Viral Hepatitis B, C and Delta in France, Bobigny, France
| | - Joël Gozlan
- Laboratory of Virology, Saint Antoine University Hospital, Paris, France
| | | | - Stéphane Chevaliez
- Laboratory of Virology, Henri Mondor Hospital, National Reference Centre for Viral Hepatitis B, C and Delta, and Inserm U955, Créteil, France
| | - Paul Calès
- Liver-Gastroenterology Department, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
| | - Françoise Lunel-Fabiani
- Laboratory of Virology, University Hospital & LUNAM University and HIFIH laboratory, UPRES EA 3859, SFR 4208, Angers, France
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Bouachour T, Tran C, Leclech C, Ducancelle A, Lunel-Fabiani F. HEP-04 - Évaluation du test rapide d’orientation diagnostic (TROD) Multisure HCV Antibody Assay. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30381-x] [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: 10/21/2022]
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18
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Veillon P, Fouchard-Hubert I, Larrey D, Dao MT, D'alteroche L, Boyer-Darrigand N, Picard N, Le Guillou-Guillemette H, Saulnier P, Ducancelle A, Loustaud-Ratti V, Lunel-Fabiani F. Does Epoetin Beta Still Have a Place in Peginterferon Alpha-2a Plus Ribavirin Treatment Strategies for Chronic Hepatitis C? J Interferon Cytokine Res 2016; 36:204-14. [PMID: 26700738 DOI: 10.1089/jir.2015.0131] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
To investigate the impact of epoetin beta (EPO) on sustained virological response (SVR) in hepatitis C virus (HCV)-infected patients treated with peginterferon-ribavirin (RBV). Controlled, randomized, pragmatic multicenter study to assess 2 strategies, ie, the use (EPO group) or nonuse (control group) of EPO in terms of achieving SVR in treatment-naive, genotype non-2/non-3 HCV-infected patients receiving a 48-week treatment regimen of pegylated interferon α-2a (peg-IFN) plus RBV (randomization 2:1). The single-nucleotide polymorphisms of interferon lambda 3 (IFNL3) (rs12979860 and rs8099917), interferon lambda 4 (IFNL4) (ss469415590), and inosine triphosphatase (ITPA) (rs1127354 and rs7270101) were determined retrospectively. Two hundred twenty-seven patients were included in the study. In the global population (n = 227), the overall SVR rate was 52% (118/227). Nonresponse and relapse occurred in respectively 46/227 (20.3%) and 42/227 (18.5%) patients. In the intention-to-treat analysis, 55.5% of patients with anemia (n = 164) had a SVR, specifically 57.4% in the EPO group versus 52.4% in the control group, but the difference was not statistically significant. In the anemic population, independent factors associated with SVR were IFNL3 and IFNL4 polymorphisms, pretreatment HCV RNA level, iron level, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio. EPO has little impact on SVR in patients treated with peg-IFN+RBV and should be recommended only for patients with severe anemia.
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Affiliation(s)
- Pascal Veillon
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Isabelle Fouchard-Hubert
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
- 3 Department of Hepatology and Gastroenterology, University Hospital of Angers , Angers, France
| | - Dominique Larrey
- 4 Department of Hepatology and Transplantation, University Hospital of Montpellier , Montpellier, France
| | - Manh Thông Dao
- 5 Gastroenterology and Nutrition, University Hospital of Caen , Caen, France
| | - Louis D'alteroche
- 6 Department of Hepatology and Gastroenterology, University Hospital of Tours , Chambray-les-Tours, France
| | - Nathalie Boyer-Darrigand
- 7 Department of Hepatology, Physiopathology and Treatment of Viral Hepatitis, Hospital of Beaujon , Clichy, France
| | - Nicolas Picard
- 8 INSERM UMR-850, Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges , Limoges, France
| | - Hélène Le Guillou-Guillemette
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Patrick Saulnier
- 9 Micro and Nanomedecines biomimetics, INSERM UMRS 1066, University of Angers , Angers, France
| | - Alexandra Ducancelle
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
| | - Véronique Loustaud-Ratti
- 10 Department of Hepatology and Gastroenterology, University Hospital of Limoges , INSERM UMR 1092, Limoges, France
| | - Françoise Lunel-Fabiani
- 1 Department of Virology, University Hospital of Angers , Angers, France
- 2 HIFIH Research Unit, Faculty of Medicine, UPRES 3859, SFR 4208, University of Angers , Angers, France
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Mahieu R, Lavigne C, Urbanski G, Fouchard Hubert I, Ducancelle A, Lunel-Fabiani F. Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement. Eur J Case Rep Intern Med 2015. [DOI: 10.12890/2015_000299] [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] [Indexed: 11/05/2022] Open
Affiliation(s)
- Rafael Mahieu
- Department of Infectious Diseases, Angers University Hospital
| | | | | | | | - Alexandra Ducancelle
- Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers
| | - Françoise Lunel-Fabiani
- Department of Biology of Infectious agents, Angers University Hospital; Laboratory HIFIH UPRES EA 3859 Medical University of Angers
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20
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Miot C, Beaumont E, Duluc D, Le Guillou-Guillemette H, Preisser L, Garo E, Blanchard S, Hubert Fouchard I, Créminon C, Lamourette P, Fremaux I, Calès P, Lunel-Fabiani F, Boursier J, Braum O, Fickenscher H, Roingeard P, Delneste Y, Jeannin P. IL-26 is overexpressed in chronically HCV-infected patients and enhances TRAIL-mediated cytotoxicity and interferon production by human NK cells. Gut 2015; 64:1466-75. [PMID: 25183206 DOI: 10.1136/gutjnl-2013-306604] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 08/16/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Interleukin-26 (IL-26) is a member of the IL-10 cytokine family, first discovered based on its peculiar expression by virus-transformed T cells. IL-26 is overexpressed in chronic inflammation (rheumatoid arthritis and Crohn's disease) and induces proinflammatory cytokines by myeloid cells and some epithelial cells. We thus investigated the expression and potential role of IL-26 in chronic HCV infection, a pathology associated with chronic inflammation. DESIGN IL-26 was quantified in a cohort of chronically HCV-infected patients, naive of treatment and its expression in the liver biopsies investigated by immunohistochemistry. We also analysed the ability of IL-26 to modulate the activity of natural killer (NK) cells, which control HCV infection. RESULTS The serum levels of IL-26 are enhanced in chronically HCV-infected patients, mainly in those with severe liver inflammation. Immunohistochemistry reveals an intense IL-26 staining in liver lesions, mainly in infiltrating CD3+ cells. We also show that NK cells from healthy subjects and from HCV-infected patients are sensitive to IL-26. IL-26 upregulates membrane tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) expression on CD16- CD56(bright) NK cells, enabling them to kill HCV-infected hepatoma cells, with the same efficacy as interferon (IFN)-α-treated NK cells. IL-26 also induces the expression of the antiviral cytokines IFN-β and IFN-γ, and of the proinflammatory cytokines IL-1β and TNF-α by NK cells. CONCLUSIONS This study highlights IL-26 as a new player in the inflammatory and antiviral immune responses associated with chronic HCV infection.
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Affiliation(s)
- Charline Miot
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France Laboratoire d'Immunologie et Allergologie, CHU Angers, Angers, France
| | - Elodie Beaumont
- Université de Tours, Tours, France Inserm, Unité 966, Tours, France
| | - Dorothée Duluc
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France
| | | | - Laurence Preisser
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France
| | - Erwan Garo
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France
| | - Simon Blanchard
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France Laboratoire d'Immunologie et Allergologie, CHU Angers, Angers, France
| | | | - Christophe Créminon
- Service de Pharmacologie et d'Immunoanalyse, Commissariat à l'Energie Atomique Saclay, iBiTec-S, Gif sur Yvette, France
| | - Patricia Lamourette
- Service de Pharmacologie et d'Immunoanalyse, Commissariat à l'Energie Atomique Saclay, iBiTec-S, Gif sur Yvette, France
| | - Isabelle Fremaux
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France
| | - Paul Calès
- Université d'Angers, UPRES 3859, Angers, France Service d'Hépato-Gastroentérologie, CHU Angers, Angers, France
| | - Françoise Lunel-Fabiani
- Laboratoire de Bactériologie-Virologie, CHU Angers, Angers, France Université d'Angers, UPRES 3859, Angers, France
| | - Jérôme Boursier
- Service d'Hépato-Gastroentérologie, CHU Angers, Angers, France
| | - Oliver Braum
- Institute for Infection Medicine, Christian Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Helmut Fickenscher
- Institute for Infection Medicine, Christian Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - Yves Delneste
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France Laboratoire d'Immunologie et Allergologie, CHU Angers, Angers, France
| | - Pascale Jeannin
- Université d'Angers, Angers, France Inserm, Unité 892, Angers, France CNRS, Unité 6299, Angers, France Laboratoire d'Immunologie et Allergologie, CHU Angers, Angers, France
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21
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Le Guillou-Guillemette H, Ducancelle A, Bertrais S, Lemaire C, Pivert A, Veillon P, Bouthry E, Alain S, Thibault V, Abravanel F, Rosenberg AR, Henquell C, André-Garnier E, Petsaris O, Vallet S, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F. Identification of a duplicated V3 domain in NS5A associated with cirrhosis and hepatocellular carcinoma in HCV-1b patients. J Clin Virol 2015. [PMID: 26209408 DOI: 10.1016/j.jcv.2015.06.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The NS5A protein of the hepatitis C virus has been shown to be involved in the development of hepatocellular carcinoma. OBJECTIVES In a French multicenter study, we investigated the clinical and epidemiological features of a new HCV genotype 1b strain bearing a wide insertion into the V3 domain. STUDY DESIGN We studied NS5A gene sequences in 821 French patients infected with genotype 1b HCV. RESULTS We identified an uncharacterized V3 insertion without ORF disruption in 3.05% of the HCV sequences. The insertion comprised 31 amino-acids for the majority of patients; 3 patients had 27 amino-acids insertions and 1 had a 12 amino-acids insertion. Sequence identity between the 31 amino-acids insertions and the V3 domain ranged from 48 to 96% with E-values above 4e(-5), thus illustrating sequence homology and a partial gene duplication event that to our knowledge has never been reported in HCV. Moreover we showed the presence of the duplication at the time of infection and its persistence at least during 12 years in the entire quasispecies. No association was found with extrahepatic diseases. Conversely, patients with cirrhosis were two times more likely to have HCV with this genetic characteristic (p=0.04). Moreover, its prevalence increased with liver disease severity (from 3.0% in patients without cirrhosis to 9.4% in patients with both cirrhosis and HCC, p for trend=0.045). CONCLUSIONS We identified a duplicated V3 domain in the HCV-1b NS5A protein for the first time. The duplication may be associated with unfavorable evolution of liver disease including a possible involvement in liver carcinogenesis.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - A Ducancelle
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - C Lemaire
- IRHS, PRES LUNAM, SFR QUASAV, Angers, France.
| | - A Pivert
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - P Veillon
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - E Bouthry
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Alain
- Laboratoire de Virologie, CHU Limoges, France.
| | - V Thibault
- Laboratoire de Virologie, CHU Pitié-Salpêtrière, Paris, France.
| | - F Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - A R Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, EA 4474 "Hepatitis C Virology", Paris, France.
| | - C Henquell
- Laboratoire de Virologie, CHU Clermont-Ferrand, France.
| | | | - O Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - S Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - J B Bour
- Laboratoire de Virologie, CHU, Dijon, France.
| | - Y Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France.
| | - P Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France.
| | - P André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France.
| | - C Gaudy-Graffin
- Université François Rabelais, Inserm U966, CHU Tours, France.
| | - D Bettinger
- Laboratoire de Virologie, CHU Besançon, France.
| | - S Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - A Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - H Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - B Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - G Lagathu
- Laboratoire de Virologie, CHU Rennes, France.
| | | | - F Stoll-Keller
- Institut de Virologie, CHU Strasbourg, Inserm U748, Strasbourg, France.
| | - J M Pawlotsky
- Laboratoire de Virologie-Bactériologie, CHU Henri-Mondor, Créteil, France.
| | - J Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - C Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - F Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
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22
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Preisser L, Miot C, Le Guillou-Guillemette H, Beaumont E, Foucher ED, Garo E, Blanchard S, Frémaux I, Croué A, Fouchard I, Lunel-Fabiani F, Boursier J, Roingeard P, Calès P, Delneste Y, Jeannin P. IL-34 and macrophage colony-stimulating factor are overexpressed in hepatitis C virus fibrosis and induce profibrotic macrophages that promote collagen synthesis by hepatic stellate cells. Hepatology 2014; 60:1879-90. [PMID: 25066464 DOI: 10.1002/hep.27328] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [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: 01/06/2014] [Accepted: 07/21/2014] [Indexed: 12/14/2022]
Abstract
UNLABELLED Chronic hepatitis C virus (HCV) infection is characterized by progressive hepatic fibrosis, a process dependent on monocyte recruitment and accumulation into the liver. The mediators expressed in chronically injured liver that control the differentiation of human monocytes into profibrotic macrophages (Mφ) remain poorly defined. We report that chronically HCV-infected patients with high fibrosis stages have higher serum levels of macrophage colony-stimulating factor (M-CSF) and interleukin (IL)-34 than HCV-infected patients with lower fibrosis stages and healthy subjects. Immunohistochemistry reveals an intense expression of IL-34 and M-CSF by hepatocytes around liver lesions. In addition, HCV infection and inflammatory cytokines enhance the in vitro production of IL-34 and M-CSF by hepatocytes. We next analyzed the acquisition of profibrotic properties by Mφ generated with M-CSF (M-CSF-Mφ) or IL-34 (IL-34-Mφ). M-CSF and IL-34 up-regulate the expression, by differentiating monocytes, of chemokine (C-C motif) ligand (CCL)2, CCL4, C-C chemokine receptor (CCR)1, and CCR5, which are involved in monocyte recruitment/Mφ accumulation in liver lesions. M-CSF-Mφ and IL-34-Mφ also express the hepatic stellate cell (HSC) activators, platelet-derived growth factor, transforming growth factor beta, and galectin-3. IL-34-Mφ and M-CSF-Mφ induce type I collagen synthesis by HSCs, the main collagen-producing cells in liver fibrosis. IL-13, whose expression correlates with the fibrosis stage in HCV-infected patients, decreases the expression of the collagenase, matrix metalloproteinase 1, by IL-34-Mφ and M-CSF-Mφ, thereby enhancing collagen synthesis. By inhibiting the production of interferon-gamma (IFN-γ) by activated natural killer cells, IL-34-Mφ and M-CSF-Mφ prevent the IFN-γ-induced killing of HSCs. CONCLUSION These results identify M-CSF and IL-34 as potent profibrotic factors in HCV liver fibrosis.
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Affiliation(s)
- Laurence Preisser
- Université d'Angers, Angers, France, Inserm, Unité 892, Angers, France, and CNRS, Unité 6299, Angers, France
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23
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Pivert A, Servant-Delmas A, Lunel-Fabiani F, Le Guillou-Guillemette H, Laperche S, Ducancelle A. Correlation between the promoter basal core and precore mutations and HBsAg quantification in French blood donors infected with hepatitis B virus. J Med Virol 2014; 87:529-35. [PMID: 25170961 DOI: 10.1002/jmv.24064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 12/12/2022]
Abstract
Hepatitis B virus (HBV) basal core promoter (BCP) and precore (PC) mutations, HBV viral load and HBV surface antigen (HBsAg) quantitation were screened to assess correlations between these HBV markers in asymptomatic chronic hepatitis B carriers in France. From January 2006 to July 2007, 200 sera were collected from patients who were discovered to be HBsAg-positive when they volunteered to give blood. Direct sequencing of precore/core gene was used to detect A1762T/G1764A mutations in the BCP and G1896A in the PC region. HBV viral load and HBsAg were quantified with two commercials assays. The prevalence of the BCP and PC mixed/mutants were 37% and 60% respectively (P = 0.0001). HBV DNA level and HBsAg titer were significantly lower in subjects harboring the mixed/mutant PC virus compared to those infected by the wild phenotype. No significant difference was observed in HBV viral loads of blood donors infected by wild or mixed/mutant BCP viruses. Mutant or mixed PC virus was associated with male gender, HBeAb-positive status and HBV/D and HBV/E genotypes. BCP mutations were associated with age, and both HBV/A-HBV/E genotypes.The genetic properties of HBV in this cohort showed that most of the blood donors had a negative HBeAg serological status and harbored the PC mutant phenotype in combination with low levels of both HBV DNA and HBsAg. As the study was conducted in healthy subjects who could be considered as asmptomatic carriers, these results suggest a possible protective effect of the G1896A mutation against severe liver lesions.
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Affiliation(s)
- A Pivert
- Laboratoire de virologie et Laboratoire HIFIH, UPRES EA 3859, University Hospital Angers, 4, rue Larrey, 49000, Angers, France
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Twizeyimana E, Pichard E, Lunel-Fabiani F, Fanello S, De Martino SJ. Impact of serodiagnosis on the management of Lyme borreliosis at Angers University Hospital. Med Mal Infect 2014; 44:429-32. [PMID: 25156778 DOI: 10.1016/j.medmal.2014.07.011] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 05/22/2014] [Accepted: 07/19/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Lyme borreliosis (LB) is an emerging arthropod-borne disease the diagnosis of which is made on clinical and biological data. We assessed the Angers University Hospital physicians' management of LB, in case of positive serology, and estimated their compliance to European recommendations (EUCALB). METHODS We retrospectively included 75 cases with positive ELISA serologies confirmed by Western-Blot, performed at the Angers University Hospital between 2008 and 2012. RESULTS AND DISCUSSION There were 4 cases of early localized phase, 26 of early-disseminated phase (including 17 cases of neuroborreliosis), and one case of late phase. The curative management complied with EUCALB guidelines in 28 cases out of 31. CONCLUSION Serology remains a reference diagnostic tool for LB, as long as the practitioner is aware of the main clinical and biological criteria.
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Affiliation(s)
- E Twizeyimana
- Laboratoire de virologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9 France; Service des maladies infectieuses et tropicales, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France; CNR des Borrelia, hôpitaux universitaires de Strasbourg, 1, rue Koeberlé, 67000 Strasbourg, France.
| | - E Pichard
- Service des maladies infectieuses et tropicales, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - F Lunel-Fabiani
- Laboratoire de virologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9 France
| | - S Fanello
- Service des maladies infectieuses et tropicales, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - S J De Martino
- CNR des Borrelia, hôpitaux universitaires de Strasbourg, 1, rue Koeberlé, 67000 Strasbourg, France
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Lunel-Fabiani F, Masson C, Ducancelle A. Systemic diseases and biotherapies: understanding, evaluating, and preventing the risk of hepatitis B reactivation. Joint Bone Spine 2014; 81:478-84. [PMID: 24561021 DOI: 10.1016/j.jbspin.2014.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2014] [Indexed: 12/17/2022]
Abstract
Hepatitis B virus (HBV) reactivation can occur in chronic carriers of the HBV surface antigen (HBsAg) and constitutes a well-known complication of immunosuppressive therapy. HBV reactivation has also been reported after contact with the HBV. The increasing use of biological agents (TNFα antagonists, rituximab, abatacept, and tocilizumab) to treat systemic diseases has resulted in numerous publications about the risk of HBV reactivation. The relevant scientific societies have issued recommendations designed to prevent HBV reactivation. The main measures consist of screening for markers indicating chronic HBV infection (HBsAg) or HBV infection in the distant past (antibodies to the HBV core antigen) before initiating biological therapies, vaccinating marker-negative patients, and considering close follow-up or antiviral treatment before immunosuppressive treatment initiation or in the event of HBV reactivation. Here, we discuss the pathophysiological mechanisms underlying HBV reactivation during biological treatments, most notably in patients with occult HBV infection or markers for remote HBV infection, whose hepatocyte nuclei may contain a resistance form of HBV DNA known as covalently closed circular DNA (cccDNA). Assessment of the risk of reactivation relies on the HBV status, drugs used, and data from the literature. Finally, we discuss the various recommendations and modalities for HBV vaccination, preemptive treatment, and patient management, according to the level of risk and to the circumstances in which reactivation occurs.
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Affiliation(s)
- Françoise Lunel-Fabiani
- Laboratoire de virologie et laboratoire HIFIH, UPRES EA 3859, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Charles Masson
- Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - Alexandra Ducancelle
- Laboratoire de virologie et laboratoire HIFIH, UPRES EA 3859, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
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26
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Ducancelle A, Abgueguen P, Birguel J, Mansour W, Pivert A, Le Guillou-Guillemette H, Sobnangou JJ, Rameau A, Huraux JM, Lunel-Fabiani F. High endemicity and low molecular diversity of hepatitis B virus infections in pregnant women in a rural district of North Cameroon. PLoS One 2013; 8:e80346. [PMID: 24265811 PMCID: PMC3827216 DOI: 10.1371/journal.pone.0080346] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/01/2013] [Indexed: 02/07/2023] Open
Abstract
Background A program, supported by the GEMHEP (Groupe d'étude Moléculaire des Hépatites), was established in 2007 in the sanitary district of Tokombéré, to prevent perinatal transmission of hepatitis B virus (HBV). It comprises screening for HBV surface antigen (HBsAg) in all pregnant women and vaccinating the newborn if tests are positive. Methods/Principal Findings 1276 women were enrolled in the study after providing informed consent. Demographic data and blood samples were available for 1267 of the enrolled patients. HBsAg was determined locally using a rapid test (Vikia HBsAg, Biomerieux). Tests for HBV and HDV virological markers (HBeAg, anti-HDV antibodies (Ab), HBV-DNA, HDV-RNA, HBV and HDV genotypes) were performed on the confirmed HBsAg-positive samples in the virology unit of the Angers University Hospital (France). HBsAg was found in 259 of the 1267 pregnant women (20.4%) between January 2009 and April 2010, of whom 59 were HBeAg-positive (22.7%) with high levels of HBV-DNA. Anti-HDV Ab were found in 19 (7.3%) of the HBsAg-positive women. The prevalence rates of HBsAg and HDV were not age-dependent whereas HBeAg carriers were statistically younger than non carriers. Basal core promoter (BCP) and precore (PC) mutations and genotypes were determined by sequencing. Of 120 amplified sequences, 119 belonged to HBV genotype E (HBV/E) and the 9 HDV strains belonged to HDV clade 1. In the PC region, 83/228 patients (36.4%) harbored a G1896A mutant or mixed phenotype virus. In the BCP region, the double mutation A1762T/G1764A and the G1757A substitution were detected respectively in 26/228 patients (11.4%) and 189/228 patients (82.8%). Conclusions Our results confirm the high prevalence and low molecular diversity of HBV in Far Northern Cameroon; more than 20% of the infected women were highly viremic, suggesting a high rate of HBV perinatal transmission and supporting the WHO recommendation to vaccinate at birth against hepatitis B.
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Affiliation(s)
- Alexandra Ducancelle
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
- * E-mail:
| | - Pierre Abgueguen
- Department of Infectious Diseases and Internal Medicine, Angers University Hospital, Angers Cedex 9, France
| | | | - Wael Mansour
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Adeline Pivert
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Hélène Le Guillou-Guillemette
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | | | - Amélie Rameau
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
| | - Jean-Marie Huraux
- Virology Laboratory, Hospital AP-HP Pitié-Salpêtrière, ER1 DETIV, University Paris VI Pierre et Marie Curie, France
| | - Françoise Lunel-Fabiani
- Department of Bacteriology and Virology, Angers University Hospital, and HIFIH Laboratory, UPRES 3859, SFR 4208, Angers Cedex 9, France
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Mansour W, Malick FZF, Sidiya A, Ishagh E, Chekaraou MA, Veillon P, Ducancelle A, Brichler S, Le Gal F, Lo B, Gordien E, Lunel-Fabiani F. Prevalence, risk factors, and molecular epidemiology of hepatitis B and hepatitis delta virus in pregnant women and in patients in Mauritania. J Med Virol 2012; 84:1186-98. [PMID: 22711346 DOI: 10.1002/jmv.23336] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
No recent data are available on hepatitis B virus (HBV) and hepatitis Delta virus (HDV) prevalence in Mauritania. One thousand twenty pregnant women and 946 patients visiting for routine checkups were screened for HBV and HDV infection. Demographic, epidemiological, ethnic, clinical, and biological data were recorded. HBV and HDV genotypes were determined by sequencing and phylogenetic analyses. In the pregnant women and patients cohorts, respectively, the prevalence of HBsAg (10.7% and 18.3%) and anti-HBcAb (66.3% and 76.5%) indicated high HBV endemicity. In pregnant women, exposure to HBV was significantly associated in multivariate analysis with education level, ethnicity, blood transfusion, and occupation. HDV antibodies (HDVAb) were found in 14.7% of pregnant women. In patients, HBsAg was found less frequently in females than in males. Again in multivariate analysis, exposure to HBV was significantly correlated with gender (males), and HDVAb positivity with age and gender. The HBV DNA viral load was >3 log IU/ml in only 10.1% of pregnant women and in 17.3% of patients. HDV-RNA was detectable in 21 (67.7%) of the 31 patients positive for HDVAb, and in 11 of the 16 pregnant women positive for HDVAb (68.8%). The most frequent HBV genotypes were: HBV/D, 53%; HBV/E, 35%; and HBV/A, 12%. Sub-genotyping revealed HBV/D1,/D7, and the recently described/D8. HDV genotypes were: HDV-1, 90.3% and HDV-5, 9.7%. This study confirms the high prevalence of HBV and HDV infections in Mauritania and demonstrates the high genetic diversity of HBV in this country.
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Affiliation(s)
- Wael Mansour
- Laboratory of Virology, Angers University Hospital, Angers, France
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Ducancelle A, Pivert A, Lunel-Fabiani F. [Basic core promoter and precore mutations of hepatitis B virus]. Virologie (Montrouge) 2011; 15:100-114. [PMID: 36151629 DOI: 10.1684/vir.2011.15785] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Since hepatitis B virus (HBV) replication involves an error-prone reverse transcription step, the rate of nucleotide changes during replication is higher than that found in other DNA viruses. As a result, HBV has a "quasispecies" distribution in infected individuals. Such selection processes to allow the emergence of variant viruses, such as precore (PC) and basal core promoter (BCP) mutants. The dominant PC variant is a point mutation of G to A at nucleotide 1896 (G1896A) that produces a premature stop codon, which terminates translation of the precore protein, resulting in the lack of HBe-antigen synthesis. BCP variants at nucleotides 1762 (A1762T) and 1764 (G1764A) likewise impair the production of HBeAg but at the transcriptional rather than the translational level. The impact of mutations in the precore and basal core promoter regions of the HBV virus on the course of chronic liver disease is not well established.
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Affiliation(s)
- Alexandra Ducancelle
- CHU d'Angers, laboratoire de virologie, 4, rue Larrey, 49033 Angers Cedex, France
| | - Adeline Pivert
- CHU d'Angers, laboratoire de virologie, 4, rue Larrey, 49033 Angers Cedex, France
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Veillon P, Gallois Y, Moal V, Fouchard-Hubert I, Charles I, Larcher F, Dib N, Boursier J, Oberti F, Laafi J, Guéchot J, Balan V, Calès P, Lunel-Fabiani F. Assessment of new hyaluronic acid assays and their impact on FibroMeter scores. Clin Chim Acta 2010; 412:347-52. [PMID: 21075099 DOI: 10.1016/j.cca.2010.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 11/04/2010] [Accepted: 11/04/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND We compared three hyaluronic acid (HA) assays and analyzed the impact of their variations on FibroMeter scores. METHODS In a test group of 165 patients, HA levels were assessed with the commonly used ELISA assay from Corgenix, a new ELISA assay from Teco and an immunoturbidimetry assay from Wako, this latter tested across three different instruments. Five different FibroMeter scores were calculated. RESULTS Correlation across the three assays (r(s) between 0.969 and 0.995) was very good. Means of differences (d) were lower when the immunoturbidimetry assay was compared on different instruments: d between -3.4 and 2.0 μg/L. However, a higher value for HA measurement was observed with Corgenix assay, compared to the other two assays (Teco and Wako): d between 27.1 and 36.4 μg/L. The assessment also demonstrated that HA variations had very little impact on FibroMeter scores: 0.0117 for virus and 0.0416 for alcoholic fibrosis scores, and between 0.58 and 1.71 for the area of fibrosis (expressed in percentage). CONCLUSIONS The two new assays found lower values of HA, as compared to the Corgenix assay. However, these differences had very little impact on FibroMeter scores and had no impact on clinical evaluation of liver fibrosis.
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Affiliation(s)
- Pascal Veillon
- Virology Department, Angers University Hospital, Angers, France
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Ducancelle A, Servant-Delmas A, Beuvelet T, Balan V, Pivert A, Maniez M, Laperche S, Lunel-Fabiani F. [Results of a novel real-time PCR, sequence analysis, Inno-LiPA line probe assays in the detection of hepatitis B virus G1896A precore mutation in French blood donors]. ACTA ACUST UNITED AC 2010; 59:e21-7. [PMID: 20843617 DOI: 10.1016/j.patbio.2010.07.014] [Citation(s) in RCA: 5] [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] [Received: 06/30/2010] [Accepted: 07/29/2010] [Indexed: 12/31/2022]
Abstract
AIM To screen hepatitis B virus (HBV) genotypes and associated basal core promoter (BCP; T1762A/A1764) and precore (PC; A1896) mutations among the 100 HBV surface antigen (HBsAg) positive voluntary blood donors in France. METHODS HBV genotypes were determined by using direct sequence analysis. Three methods were used to detect G1896A mutation: non-commercial real-time PCR (PCRTR°, line probe assay (InnoLiPA HBV PreCore, INNOGENETICS(®)) and direct sequencing of precore gene. HBV viral load was quantified with two commercial real-time PCR (COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HBV Test/Roche and Real Time HBV/M2000/Abbott). RESULTS The mean age of donors was 30 (18-64). Patients were from Africa (42%), Europa (50%), and Asia (8%). HBV/D was the most predominant (37%) genotype followed by HBV/A (31%) and HBV/E (22%). PC and BCP mutants were found in 57% with Inno-LIPA HBV test and 59% with both PCRTR and sequencing methods. A significant difference in the viral load of blood donors with wild and PC mutants was observed with the Taqman Cobas real time PCR (3,19 Log(10) UI/ml versus 4,93 Log(10) UI/ml, p < 0.05). Precore phenotype determination was in agreement with the three PC mutation detection methods in 56% of cases. CONCLUSIONS Non-Caucasian genotype E was present in the French blood donors. PC mutation was more common than BCP mutations in this study. As HBV infected blood donors were more often asymptomatic carriers, we could speculate that the G1896A mutation may favour the asymptomatic state, supporting previous observations.
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Affiliation(s)
- A Ducancelle
- Laboratoire de virologie, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
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Lunel-Fabiani F, Duburcq X, Levayer T, Descamps F, Maniez-Montreuil M, Pivert A, Ducancelle A, Pouzet A, Marant L, Clèment A, Duhamel D, Leirens Y, Margotteau F, Falcou-Briatte R, Heinen C, Bouniort F, Taskar S, Artus A, Woodrum D, Flecheux O. Multi-center evaluation of the hepatitis B surface antigen (HBsAg) assay and HbsAg confirmatory assay for the family of Access immunoassay systems. Clin Lab 2010; 56:281-290. [PMID: 20857892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Accurate detection of Hepatitis B Surface Antigen (HBsAg) is an important aid in the diagnosis of patients infected with the hepatitis B virus (HBV). A multi-center study was conducted to characterize the performance of the HBsAg assay on the family of Access immunoassay systems from Beckman Coulter. METHODS The Access HBsAg assay was characterized in a multi-center study and compared to the Abbott AxSYM* and PRISM* HBsAg assays. The bioMérieux VIDAS* assay was used to resolve discrepant results. Reproducibility studies (intra-assay, inter-assay and inter-lot) were performed with pooled serum samples (negative sample, close to cut off, low, medium and high positive samples). Analytical sensitivity, subtype and genotype detection were studied with various commercial panels (SFTS panel, WHO 80/549, WHO 00/588, Teragenix HBV Genotype panel). A panel of recombinant HBsAg mutant proteins was tested to investigate reactivity towards genetic mutations. Clinical sensitivity was verified with seroconversion panels and samples from subjects with known HBV infection. Analytical specificity was studied with samples from patients with potential cross-reactive infections. Clinical specificity was validated among blood donors and a hospitalized population. RESULTS The imprecision was < 10%. Analytical sensitivity was < or = 0.1 ng/mL (SFTS panel), 0.020 PEI Units/mL (ad panel), 0.024 PEI Units/mL (ay panel), 0.092 IU/mL with WHO 80/549 and 0.056 IU/mL with WHO 00/588. All genotype samples and HBsAg mutants were reactive with the Access HBsAg assay. Seroconversion panels tested showed no significant difference with the reference method. Sensitivity for subjects with known HBV infection was 100%. No interference with potentially cross-reactive infections was observed after confirmatory testing. Specificity was 99.96% (100% after confirmatory testing) in a blood donor population and 99.5% (100% after confirmatory testing) in a hospitalized population. Excellent separation of positive and negative populations was observed. CONCLUSIONS The Access HBsAg and HBsAg Confirmatory assays meet all clinical and analytical performance requirements of assays for the detection of HBsAg.
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Legrand-Abravanel F, Colson P, Leguillou-Guillemette H, Alric L, Ravaux I, Lunel-Fabiani F, Bouviers-Alias M, Trimoulet P, Chaix ML, Hézode C, Foucher J, Fontaine H, Roque-Afonso AM, Gassin M, Schvoerer E, Gaudy C, Roche B, Doffoël M, D'Alteroche L, Vallet S, Baazia Y, Pozzetto B, Thibault V, Nousbaum JB, Roulot D, Coppere H, Poinard T, Payan C, Izopet J. Influence of the HCV subtype on the virological response to pegylated interferon and ribavirin therapy. J Med Virol 2009; 81:2029-35. [DOI: 10.1002/jmv.21583] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Piroth L, Carrat F, Larrat S, Goderel I, Martha B, Payan C, Lunel-Fabiani F, Bani-Sadr F, Perronne C, Cacoub P, Pol S, Morand P. Prevalence and impact of GBV-C, SEN-V and HBV occult infections in HIV-HCV co-infected patients on HCV therapy. J Hepatol 2008; 49:892-8. [PMID: 18752863 DOI: 10.1016/j.jhep.2008.06.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 05/29/2008] [Revised: 06/10/2008] [Accepted: 06/10/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND/AIMS It has been suggested that, in HIV-HCV co-infected patients, co-infections with other viruses may affect the response to HCV therapy. We aimed to assess the prevalence of GBV-C, SEN-V and occult HBV infections, their impact on HCV and HIV infections and on the response to HCV therapy in HIV-HCV co-infected patients. METHODS Three-hundred and sixty eight patients were tested before starting interferon-ribavirin for the presence of occult hepatitis B DNA, GBV-C RNA and SEN-V DNA by using real time PCR. Clinical, immunological, virological, histological characteristics and response to HCV therapy were compared according to the presence or not of each viral co-infection. RESULTS HBV DNA, GBV-C RNA and SEN-V DNA were found in 5 (1.4%, CI95%: 0.2-2.4%), 104 (29.9%, CI95%: 25.1-34.7%) and 209 patients (57.9%, CI95%: 52.8-63.0%), respectively. GBV-C positive patients had significantly higher CD4 count at baseline, during and after HCV therapy, even after stratification on antiretroviral treatment. No other significant difference was observed according to the presence or not of GBV-C or SEN-V co-infection, in particular regarding virological responses to HCV combination therapy. CONCLUSIONS There is no reason to withhold HCV therapy in HIV infected patients who have access to HAART, because of occult HBV, GBV-C or SEN-V co-infections.
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Affiliation(s)
- Lionel Piroth
- Service des Maladies Infectieuses, CHU Dijon, 10, Boulevard du Maréchal de Lattre de Tassigny, 21079 DIJON Cedex, France.
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Calès P, Veillon P, Konaté A, Mathieu E, Ternisien C, Chevailler A, Godon A, Gallois Y, Joubaud F, Hubert-Fouchard I, Oberti F, Réaud S, Hunault G, Mauriat F, Lunel-Fabiani F. Reproducibility of blood tests of liver fibrosis in clinical practice. Clin Biochem 2007; 41:10-8. [PMID: 17988658 DOI: 10.1016/j.clinbiochem.2007.08.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 07/13/2007] [Accepted: 08/09/2007] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the inter-laboratory reproducibility of blood test for liver fibrosis: FibroMeter, Fibrotest, APRI and their composites variables. DESIGN AND METHODS Four studies, including 147 patients, were performed: study #1 included 2 metachronous blood samples and 2 laboratories; studies #2, #3 and #4 included synchronous samples with assays delayed at day 1 in 12 laboratories, at day 0 in 10 laboratories and at day 0 or 1 in 2 laboratories, respectively. Agreement was evaluated by the intraclass correlation coefficient (r(ic)). RESULTS In studies #1, #2 and #4, r(ic) for FibroMeter was 0.893, 0.942 and 0.991, respectively. In study #3, the r(ic) were: FibroMeter: 0.963, Fibrotest: 0.984, APRI: 0.949. Large simulated variations in composite variables had a weak impact on FibroMeter. CONCLUSIONS When blood marker limits are controlled, inter-laboratory agreement of blood tests is excellent in clinical practice conditions. Blood tests are robust against the variability of composite blood variables.
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Affiliation(s)
- Paul Calès
- Laboratoire HIFIH, UPRES 3859, IFR 132, Université d'Angers, 49045 Angers Cedex, France
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35
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Le Guillou-Guillemette H, Vallet S, Gaudy-Graffin C, Payan C, Pivert A, Goudeau A, Lunel-Fabiani F. Genetic diversity of the hepatitis C virus: Impact and issues in the antiviral therapy. World J Gastroenterol 2007; 13:2416-26. [PMID: 17552024 PMCID: PMC4146759 DOI: 10.3748/wjg.v13.i17.2416] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The hepatitis C Virus (HCV) presents a high degree of genetic variability which is explained by the combination of a lack of proof reading by the RNA dependant RNA polymerase and a high level of viral replication. The resulting genetic polymorphism defines a classification in clades, genotypes, subtypes, isolates and quasispecies. This diversity is known to reflect the range of responses to Interferon therapy. The genotype is one of the predictive parameters currently used to define the antiviral treatment strategy and the chance of therapeutic success. Studies have also reported the potential impact of the viral genetic polymorphism in the outcome of antiviral therapy in patients infected by the same HCV genotype. Both structural and non structural genomic regions of HCV have been suggested to be involved in the Interferon pathway and the resistance to antiviral therapy. In this review, we first detail the viral basis of HCV diversity. Then, the HCV genetic regions that may be implicated in resistance to therapy are described, with a focus on the structural region encoded by the E2 gene and the non-structural genes NS3, NS5A and NS5B. Both mechanisms of the Interferon resistance and of the new antiviral drugs are described in this review.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratory of Virology, Department of Infectious Agents, University Hospital of Angers, 4 rue Larrey, 49933 Angers Cedex 9, France
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Bani-Sadr F, Denoeud L, Morand P, Lunel-Fabiani F, Pol S, Cacoub P, Perronne C, Carrat F. Early Virologic Failure in HIV-Coinfected Hepatitis C Patients Treated With the Peginterferon-Ribavirin Combination. J Acquir Immune Defic Syndr 2007; 45:123-5. [PMID: 17460476 DOI: 10.1097/qai.0b013e318040b2b6] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Ducancelle A, Payan C, Nicand E, Le Guillou H, Calès P, Lunel-Fabiani F. Intrafamilial hepatitis E in France. J Clin Virol 2007; 39:51-3. [PMID: 17409020 DOI: 10.1016/j.jcv.2007.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 02/27/2007] [Indexed: 11/18/2022]
Affiliation(s)
- A Ducancelle
- Laboratoire de Bactériologie-Virologie, CHU Angers, Paris
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Pivert A, Ducancelle A, Levayer T, Descamps F, Maniez-Montreuil M, Artus A, Heinen C, Woodrum D, Lunel-Fabiani F. P1175 Multi-centre evaluation of a new hepatitis B surface antigen (HBsAg) assay on the family of Access® immunoassay systems. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71015-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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39
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Lunel-Fabiani F, Calés P, Halfon P, Bacq Y, Leroy V, Rousselet M, Bourliére M, de Muret A, Gallois Y, Sturm N, Penaranda G, Bréchot M, Trocme C. P1886 Meta-analysis of blood scores for liverfibrosis in chronic hepatitis C. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71725-9] [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: 11/30/2022]
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40
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Thévenot T, Cadranel JF, Di Martino V, Pariente A, Causse X, Renou C, Hagege H, Denis J, Lunel-Fabiani F. A national French survey on the use of growth factors as adjuvant treatment of chronic hepatitis C. Hepatology 2007; 45:377-83. [PMID: 17256721 DOI: 10.1002/hep.21517] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
UNLABELLED We conducted a national retrospective survey on hospital practitioners to evaluate the magnitude of erythropoietin (EPO) or granulocyte colony-stimulating factor (G-CSF) prescriptions in patients treated for chronic hepatitis C. Four hundred seventy-one questionnaires were sent, and 274 practitioners (58.2%) responded. Forty-six percent of practitioners used EPO, and 31% used G-CSF. The total number of HCV-infected patients receiving antiviral therapy per year was estimated at 6,630 patients, of whom 8.8% and 4% received EPO and G-CSF, respectively. EPO-beta was the main EPO molecule prescribed at a median dose of 30,000 IU/wk (range: 2,000-80,000). The indications for prescribing EPO varied greatly, including "fragile patients" (34%), "low" Hb level (8-11 g/dL) (19%), "rapid decline" in Hb level (2-5 g/dL during the first month of therapy) (12%), and symptomatic anemic patients (7%). G-CSF was mainly prescribed for a "low" level of neutrophils ranging from 400 to 750 neutrophils/mm3. In multivariate analysis, independent predictors of EPO and G-CSF prescription were age of practitioner less than 45 years (EPO: OR = 1.96, P = 0.03; G-CSF: OR = 2.27, P = 0.004), practice in university hospital (EPO: OR = 5.89, P < 0.0001; G-CSF: OR = 2.39, P = 0.003), and the high number of CHC treated/year (EPO: OR = 6.18, P < 0.0001; G-CSF: OR = 2.58, P = 0.002). CONCLUSION Our survey reveals an important rate of EPO and G-CSF prescriptions but with considerable disparity in the schedule of injections, the molecules used, and above all the indications. The suitable role of EPO and G-CSF as complements to HCV therapy urgently needs to be clarified.
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Affiliation(s)
- Thierry Thévenot
- Service d'Hépatologie et de Soins Intensifs Digestifs, Hôpital Jean Minjoz, 25000 Besançon, France.
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41
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Thevenot T, Di Martino V, Lunel-Fabiani F, Vanlemmens C, Becker MC, Bronowicki JP, Bresson-Hadni S, Miguet JP. Traitements complémentaires de l’hépatite chronique virale C. ACTA ACUST UNITED AC 2006; 30:197-214. [PMID: 16565651 DOI: 10.1016/s0399-8320(06)73154-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Pegylated interferon and ribavirin combination therapy represent the standard-of-care treatment for chronic hepatitis C, that allows to cure more than half of the patients. However, the success of this bitherapy is in balance with numerous side effects, especially hematologic and psychiatric. This review is focused on complementary treatments (erythropoietin, G-CSF, vitamin E, glutathion, ursodeoxycholic acid and antidepressants) likely to bring a benefit in maintaining adequate interferon and ribavirin dosages and in improving quality of life. This analysis has been performed by using the Medline(R) data base and with data from laboratories which commercialized these molecules. Erythropoietin, G-CSF and antidepressants are the best tools to optimize the bitherapy in its dose and its duration while privileging the quality of life of HCV-infected patients.
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Affiliation(s)
- Thierry Thevenot
- Service d'Hépatologie et de Soins Intensifs Digestifs, Service d'Hépatologie, Hôpital Universitaire Jean Minjoz, Besançon.
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42
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Payan C, Ducancelle A, Aboubaker MH, Legrand M, Postec E, Tourmen F, Avenel-Audran M, Geoffrion H, Descamps P, Lunel-Fabiani F. Papillomavirus (HPV) DNA load evaluation in urine and cervical samples. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bani-Sadr F, Carrat F, Rosenthal E, Piroth L, Morand P, Lunel-Fabiani F, Bonarek M, Colin de Verdiere N, Pialoux G, Cacoub P, Pol S, Perronne C. Spontaneous hepatic decompensation in patients coinfected with HIV and hepatitis C virus during interferon-ribavirin combination treatment. Clin Infect Dis 2005; 41:1806-9. [PMID: 16288408 DOI: 10.1086/498312] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 08/02/2005] [Indexed: 01/29/2023] Open
Abstract
Spontaneous hepatic decompensation was observed in 7 of 383 patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who were receiving treatment with interferon and ribavirin. Multivariate analysis identified the following risk factors: didanosine use (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.2-102.3; P < .02), cirrhosis, (OR, 8.8; 95% CI, 1.2-104.2; P<.02), and elevated total bilirubin level (OR, 7.9; 95% CI, 1.08-93.3; P<.03). Didanosine should thus not be given to patients with cirrhosis, particularly when treatments for HCV and HIV infections have to be administered concomitantly.
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Affiliation(s)
- Firouzé Bani-Sadr
- INSERM U707, Faculte de Medecine Hopital Saint Antoine, Paris, France.
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Bani-Sadr F, Carrat F, Pol S, Hor R, Rosenthal E, Goujard C, Morand P, Lunel-Fabiani F, Salmon-Ceron D, Piroth L, Pialoux G, Bentata M, Cacoub P, Perronne C. Risk factors for symptomatic mitochondrial toxicity in HIV/hepatitis C virus-coinfected patients during interferon plus ribavirin-based therapy. J Acquir Immune Defic Syndr 2005; 40:47-52. [PMID: 16123681 DOI: 10.1097/01.qai.0000174649.51084.46] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the incidence, clinical features, and risk factors for symptomatic mitochondrial toxicity in HIV/hepatitis C virus (HCV)-coinfected patients receiving anti-HCV therapy. METHODS All cases of symptomatic mitochondrial toxicity reported in 416 patients participating in an open, randomized trial of peg-interferon alpha-2b plus ribavirin vs. interferon alpha-2b plus ribavirin for 48 weeks were reviewed. Associations with antiretroviral treatments and with clinical and laboratory findings were sought by univariate and multivariate analysis. RESULTS Eleven of the 383 patients who received at least 1 dose of anti-HCV treatment developed symptomatic mitochondrial toxicity (symptomatic hyperlactatemia and pancreatitis in 6 and 5 patients, respectively). All cases occurred in patients being treated for HIV infection, and the incidence of symptomatic mitochondrial toxicity was 47.5 per 1000 patient-years. In multivariate analysis, symptomatic mitochondrial toxicity was significantly associated with didanosine-containing antiretroviral regimens (odds ratio 46; 95% CI, 7.4 to infinity; P < 0.001), but not with stavudine or with nucleoside reverse transcriptase inhibitor regimens not containing didanosine. The incidence of symptomatic mitochondrial toxicity was 200.2 per 1000 patient-years in patients receiving didanosine. Demographic characteristics were not associated with symptomatic mitochondrial toxicity. CONCLUSIONS Coadministration of ribavirin with didanosine should be avoided. If unavoidable, patients should be monitored closely for mitochondrial toxicity. Didanosine should be suspended if clinical signs or symptoms of mitochondrial toxicity occur.
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Affiliation(s)
- Firouzé Bani-Sadr
- Groupe Hospitalier Universitaire Est, Université Paris 6, INSERM U444, France.
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Payan C, Roudot-Thoraval F, Marcellin P, Bled N, Duverlie G, Fouchard-Hubert I, Trimoulet P, Couzigou P, Cointe D, Chaput C, Henquell C, Abergel A, Pawlotsky JM, Hezode C, Coudé M, Blanchi A, Alain S, Loustaud-Ratti V, Chevallier P, Trepo C, Gerolami V, Portal I, Halfon P, Bourlière M, Bogard M, Plouvier E, Laffont C, Agius G, Silvain C, Brodard V, Thiefin G, Buffet-Janvresse C, Riachi G, Grattard F, Bourlet T, Stoll-Keller F, Doffoel M, Izopet J, Barange K, Martinot-Peignoux M, Branger M, Rosenberg A, Sogni P, Chaix ML, Pol S, Thibault V, Opolon P, Charrois A, Serfaty L, Fouqueray B, Grange JD, Lefrère JJ, Lunel-Fabiani F. Changing of hepatitis C virus genotype patterns in France at the beginning of the third millenium: The GEMHEP GenoCII Study. J Viral Hepat 2005; 12:405-13. [PMID: 15985012 DOI: 10.1111/j.1365-2893.2005.00605.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This cross-sectional study aimed to investigate, during a short period between 2000 and 2001, in a large population of patients with chronic hepatitis C, the epidemiological characteristics of hepatitis C virus (HCV) genotypes in France. Data from 26 referral centres, corresponding to 1769 patients with chronic hepatitis C were collected consecutively during a 6-month period. HCV genotyping in the 5'-non-coding region (NCR) was performed in each center using the line probe assay (LiPA, in 63% of cases), sequencing (25%) or primer-specific polymerase chain reaction (PCR) (12%). HCV genotypes 1a, 1b, 2, 3, 4, 5, non-subtyped 1 and mixed infection were found in 18, 27, 9, 21, 9, 3, 11 and 1% of our population, respectively. HCV genotype distribution was associated with gender, age, source and duration of infection, alanine aminotransferase (ALT) levels, cirrhosis, alcohol consumption, hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection. In multivariate analysis, only the source of infection was the independent factor significantly associated with genotype (P = 0.0001). In conclusion, this study shows a changing pattern of HCV genotypes in France, with i.v. drug abuse as the major risk factor, an increase of genotype 4, and to a lesser extent 1a and 5, and a decrease of genotypes 1b and 2. The modification of the HCV genotype pattern in France in the next 10 years may require new therapeutic strategies, and further survey studies.
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Affiliation(s)
- C Payan
- Laboratoire de Virologie, CHU Angers, France.
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46
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Carrat F, Bani-Sadr F, Pol S, Rosenthal E, Lunel-Fabiani F, Benzekri A, Morand P, Goujard C, Pialoux G, Piroth L, Salmon-Céron D, Degott C, Cacoub P, Perronne C. Pegylated interferon alfa-2b vs standard interferon alfa-2b, plus ribavirin, for chronic hepatitis C in HIV-infected patients: a randomized controlled trial. JAMA 2004; 292:2839-48. [PMID: 15598915 DOI: 10.1001/jama.292.23.2839] [Citation(s) in RCA: 682] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
CONTEXT Treatment of chronic hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-infected patients is a growing concern. Most data on the virologic efficacy and safety of the combination of peginterferon alfa-2b and ribavirin in coinfected patients come from uncontrolled studies. OBJECTIVE To study the safety and efficacy of peginterferon alfa-2b plus ribavirin vs standard interferon alfa-2b plus ribavirin in HIV-HCV coinfected patients. DESIGN AND SETTINGS A multicenter, randomized, parallel-group, open-label trial. Patients were enrolled from February 2000 to February 2002 and followed up for 72 weeks. PATIENTS Four hundred twelve HIV-HCV coinfected patients with detectable serum HCV-RNA, abnormal liver histology, a CD4 cell count of at least 200 x 10(6)/L, and stable plasma HIV-RNA. INTERVENTION Treatment with ribavirin 400 mg twice a day, orally, plus either peginterferon alfa-2b (1.5 microg/kg subcutaneous injection once a week) or standard interferon alfa-2b (3 million units of subcutaneous injection 3 times a week) for 48 weeks. MAIN OUTCOME MEASURES Sustained virologic response, defined by undetectable serum HCV-RNA at week 72. RESULTS More patients had sustained virologic responses in the peginterferon group than in the standard interferon group (27% vs 20%, P = .047). This difference between the treatments was found in patients with HCV genotype 1 or 4 infection (17% for peginterferon vs 6% for standard interferon, P = .006) but was not found in patients with HCV genotype 2, 3, or 5 (44% for peginterferon vs 43% for standard interferon, P = .88). Together, a decline in HCV-RNA of less than 2 log10 from baseline and detectable serum HCV-RNA at week 12 predicted 99% of treatment failures. Histologic activity diminished and fibrosis stabilized in virologic responders. The 2 regimens showed similar tolerability although dose modifications for clinical and biological events were more frequent with peginterferon. Eleven cases of pancreatitis or symptomatic hyperlactatemia were observed, all in patients receiving didanosine-containing antiretroviral regimens. CONCLUSION In combination with ribavirin, treatment with peginterferon alfa-2b is more effective than standard interferon alfa-2b for HCV infection in HIV-infected patients.
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Affiliation(s)
- Fabrice Carrat
- Groupe Hospitalier Universitaire Est, Université Paris 6, INSERM U444, Paris, France
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Lunel-Fabiani F, Fouchard-Hubert I, Gergely AE. [Use of erythropoietin in the treatment of anemia induced by ribavirin/interferon in patients with hepatitis C]. ACTA ACUST UNITED AC 2004; 51:520-4. [PMID: 14568602 DOI: 10.1016/s0369-8114(03)00169-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We are presenting 20 patients with hepatitis C, who developed anemia on interferon alpha-2b/ribavirin treatment and were treated with recombinant human c alpha. Median age was 43 years (range 25-72). Four patients received previous treatment. Interferon-alpha-2b was given at six million units three times a week to 10 patients and at three million units three times a week to five patients. PEG-interferon-alpha-2b (80-120 mug/week) was given to five patients. The dose of ribavirin was 800-1200 mg/day (19 patients) and 200 mg/day (one patient with renal failure). Duration of an interferon/ribavirin treatment was 6-12 months. Baseline median hemoglobin was 13.3 g/dl (range 12.2-15.8); median hemoglobin nadir: 9.8 g/dl (range 8.4-11.2). On erythropoietin, the hemoglobin increased to median 11.7 g/dl (range 9.6-12.8). The ribavirin dose had been decreased to 800 mg in four patients, to 600 mg in four patients, to 400 mg in one patient. Thirteen patients responded to interferon/ribavirin treatment, six patients (all genotype 1) did not. Of the 13 initial responders 11 had sustained response, one still under treatment and two patients relapsed. In conclusion, in our patients with chronic hepatitis C treated with interferon/ribavirin combination therapy, erythropoietin was beneficial in the treatment of ribavirin-induced anemia.
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Affiliation(s)
- F Lunel-Fabiani
- Institut Alfred-Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France.
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Lunel-Fabiani F, Payan C. [Virological tools for the diagnosis and follow up of hepatitis C: use and role of new tests]. Gastroenterol Clin Biol 2003; 27:718-26. [PMID: 14586244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Françoise Lunel-Fabiani
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, CHU Angers, 4, rue Larrey, 49033 Angers Cedex.
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Payan C, Raimbert A, Fouchard-Hubert I, Kouyoumdjian S, Lunel-Fabiani F. [Quantitative antibody analysis: use for the diagnosis of hepatitis C virus chronic infection]. Ann Biol Clin (Paris) 2003; 61:311-7. [PMID: 12805008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Hepatitis C virus (HCV) infection has been estimated in 600,000 subjects in France, with about 80 % of chronic infection. In the latter, anti-HCV antibodies and viral RNA are found together in patients blood. Today, only the use of polymerase chain reaction (PCR) technology allows the diagnosis of HCV chronic infection, confirmed by a positive PCR. However, PCR is a laborious and cost effective method. The aim of this study was to distinguish HCV chronic infection to past-infection or false reactivity only using the serology testing. Therefore, we looked for a correlation between the results of PCR, using the HCV Cobas Amplicor 2.0 assay, and the level of anti-HCV antibodies, assessed by the AxSYM HCV v.3.0 and expressed in signal/cutoff (s/co) ratio. We found using a panel of 200 sera issued from 181 patients, a significant variation of s/co ratios between PCR positive and negative patients (respectively, 87.76 +/- 27.18 vs 10.13 +/- 13.68 s/co, p < 0.0001), only in non treated or previously treated patients, non HIV coinfected, non renal transplanted or haemodialysis patients. An anti-HCV cutoff value at 34 s/co allows a predictive PCR results with 100 % sensitivity and 93.3 % specificity. Thus, for patients having a s/co equal or over 34, a positive PCR was found in 98.1 % of cases, allowing the diagnosis of HCV chronic infection (positive predictive value). Conversely, in patients with less than 34, HCV chronic infection can be excluded in 100 % of cases (negative predictive value). In conclusion, in most cases, the use of anti-HCV quantitative analysis in the AxSYM HCV v.3.0 assay could avoid PCR testing and facilitate the diagnosis of HCV chronic infection.
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Affiliation(s)
- C Payan
- Laboratoire de bactériologie-virologie, (réseau hépatite 49), CHU Angers, 4, rue Larrey, 49033 Angers cedex.
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50
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Bourlet T, Levy R, Laporte S, Blachier S, Bocket L, Cassuto G, Chollet L, Leruez-Ville M, Maertens A, Mousnier F, Pasquier C, Payan C, Pellegrin B, Schvoerer E, Zavadzki P, Chouteau J, Duverlie G, Izopet J, Lunel-Fabiani F, Pawlotsky JM, Profizi N, Rouzioux C, Stoll-Keller F, Thibault V, Wattré P, Pozzetto B. Multicenter quality control for the detection of hepatitis C virus RNA in seminal plasma specimens. J Clin Microbiol 2003; 41:789-93. [PMID: 12574284 PMCID: PMC149668 DOI: 10.1128/jcm.41.2.789-793.2003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The discrepant results available in the literature about the presence of hepatitis C virus (HCV) RNA in seminal plasma of men chronically infected by this agent are related, at least in part, to the molecular techniques used and particularly to the wide range of protocols dedicated to RNA extraction. In order to evaluate these protocols and to standardize the method of detection of HCV RNA in this fluid, a panel of coded specimens was tested blindly in 12 French laboratories; it included 14 seminal plasma specimens and four water controls spiked with HCV RNA ranging from 10 to 20000 IU/ml and two HCV-negative seminal plasma specimens. The extraction step was performed according to methods using either silica beads (NucliSens [Organon Teknika S.A., Fresnes, France]; RNA viral kit [Qiagen, Courtaboeuf, France]) or guanidinium thiocyanate (Amplicor HCV assay; Roche Diagnostics, Meylan, France), preceded or not by a centrifugation of the seminal plasma. For the amplification step, all the laboratories performed the same reverse transcription-PCR technique (Amplicor HCV Cobas assay). The percentage of correct results ranged from 53.3 to 100, the poorest results being obtained when no centrifugation step preceded the Amplicor extraction protocol. The rate of correct results was significantly higher in laboratories using a preliminary centrifugation of the specimen (P = 0.034 by chi-square test). By contrast, the overall number of correct results was not correlated to the initial volume of sample used for the test. These results allowed us to validate standardized techniques adapted to the performance of this test on a routine basis, especially in men infected with HCV and involved in programs of medically assisted reproduction.
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Affiliation(s)
- Thomas Bourlet
- Laboratoire de Bactériologie-Virologie, Unité de Pharmacologie Clinique, Faculté de Médecine, University of Saint-Etienne, Saint-Etienne, France.
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