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del Giudice P, Reverte M, Giraudon E, Durant J, Ahmed Abdoulah S, Jaulhac B, Poirier JP. First case of documented Lyme borreliosis in the Alpes-Maritimes department of South-Eastern France: Erythema chronicum migrans associated with Borrelia afzelii. Ann Dermatol Venereol 2022; 149:146-147. [DOI: 10.1016/j.annder.2021.12.003] [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] [Received: 05/04/2021] [Revised: 06/16/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
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Affiliation(s)
- D. J. Amit
- Hebrew University of Jerusalem, Israel
- Universita' di Roma ‘La Sapienza’, Italy
| | | | - B. Denby
- Italian National Institute for Nuclear Physics, Italy
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del Giudice P. Photothérapie dynamique et dermatoses infectieuses : un intérêt modeste. Ann Dermatol Venereol 2015; 142:727-8. [DOI: 10.1016/j.annder.2015.10.581] [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: 11/26/2022]
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Clevenbergh P, Bozonnat MC, Kirstetter M, Durant J, Cua E, del Giudice P, Montagne N, Simonet P. Variable virological outcomes according to the center providing antiretroviral therapy within the PharmAdapt clinical trial. HIV Clin Trials 2003; 4:84-91. [PMID: 12671775 DOI: 10.1310/788w-paub-8e8q-y7l5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Differences in virological response between HIV-infected patients at different study centers were analyzed as a substudy of PharmAdapt, a multicenter prospective randomized study to evaluate the utility of therapeutic drug monitoring after a genotypic-based treatment adaptation. RESULTS After 12 weeks, the percentage of patients participating in PharmAdapt with HIV RNA < 200 copies/mL ranged from 17% to 69% between centers providing antiretroviral care. In a multivariate analysis, independent factors predictive of viral load <200 HIV RNA copies/mL at Week 12 included: lower baseline viral load, lower nonnucleoside reverse transcriptase inhibitor resistance, lower protease inhibitor resistance, and the center providing antiretroviral therapy. To evaluate the final factor, study sites were divided into two groups based on Week 12 HIV RNA values above or below the median. CONCLUSION Using this definition, observed differences between centers included the use of stavudine, abacavir-, and/or efavirenz-based regimens and use of online expert advice.
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del Giudice P, Mary-Krause M, Pradier C, Grabar S, Dellamonica P, Marty P, Gastaut JA, Costagliola D, Rosenthal E. Impact of highly active antiretroviral therapy on the incidence of visceral leishmaniasis in a French cohort of patients infected with human immunodeficiency virus. J Infect Dis 2002; 186:1366-70. [PMID: 12402211 DOI: 10.1086/344325] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2002] [Revised: 07/08/2002] [Indexed: 11/03/2022] Open
Abstract
The incidence of human immunodeficiency virus (HIV)-Leishmania coinfections in France was estimated on the basis of the French Hospital Database on HIV, and risk factors for the occurrence of visceral leishmaniasis (VL) were analyzed by a multivariate Cox model. VL was diagnosed in 165 of 55,626 HIV-infected patients followed since 1992. The incidence of VL decreased from 11.6+/-1.2 per 10,000 persons-years before 1996 to 6.3+/-0.7 per 10,000 persons-years after 1996, the year when highly active antiretroviral therapy (HAART) was initiated in France. The relative hazard (RH) for development of VL was higher in (1) intravenous drug users versus other transmission groups (RH=1.56; 95% CI, 1.13-2.15), (2) patients living in southern France versus those living in northern France (RH=3.36; 95% CI, 2.44-4.61), and (3) patients who had a CD4 cell count of </=50/mm(3) during their follow-up versus those who did not (RH=6.45; 95% CI, 4.27-9.75) but was lower in (4) patients who received antiretroviral therapy including >/=3 drugs versus those who did not (RH=0.41; 95% CI, 0.26-0.65). We found a significant decrease in the incidence of HIV-Leishmania coinfections after 1996, associated with the introduction of HAART in France.
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Affiliation(s)
- P del Giudice
- Unité de Maladies Infectieuses et Dermatologie, Hôpital Bonnet, Fréjus, France.
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Rosenthal E, Marty P, del Giudice P, Pradier C, Ceppi C, Gastaut JA, Le Fichoux Y, Cassuto JP. HIV and Leishmania coinfection: a review of 91 cases with focus on atypical locations of Leishmania. Clin Infect Dis 2000; 31:1093-5. [PMID: 11049794 DOI: 10.1086/318135] [Citation(s) in RCA: 90] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A retrospective study was conducted in France in 1998 to determine the clinical features of visceral leishmaniasis (VL) in 91 patients infected cocomitantly with human immunodeficiency virus. Our data suggest that the clinical manifestations of VL may be influenced by the immunological status, with atypical locations of Leishmania amastigotes more frequently found in severely immunocompromised patients. In such patients, the involvement of atypical locations may lead to the discovery of VL.
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Affiliation(s)
- E Rosenthal
- Department of Internal Medicine/Hematology, Nice University Hospital, Nice, France.
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Clevenbergh P, Durant J, Halfon P, del Giudice P, Mondain V, Montagne N, Schapiro JM, Boucher CA, Dellamonica P. Persisting long-term benefit of genotype-guided treatment for HIV-infected patients failing HAART. The Viradapt Study: week 48 follow-up. Antivir Ther 2000; 5:65-70. [PMID: 10846595] [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: 02/16/2023]
Abstract
OBJECTIVE We report the 12 months follow-up of the patients who participated in the Viradapt study. METHODS A total of 108 HIV-infected patients failing antiretroviral (ARV) therapy (HIV RNA > 10,000 copies/ml, therapy > 6 months with nucleoside reverse transcriptase inhibitors, > 3 months with protease inhibitors (PIs) were randomized into two arms: standard of care in the control arm, and treatment according to the resistance mutations in the protease and reverse transcriptase genes in the study arm. After the first 6 months of the randomized study, open-label, genotype-guided treatment was offered in both arms. A multivariate analysis was performed to assess the predictive factors of treatment success (HIV RNA < 200 copies/ml). RESULTS The two arms were comparable in terms of risk factors, age, sex, previous treatments, CD4 cell count and log10 HIV-1 RNA at baseline. At week 24, an interim combined analysis showed a statistically significant difference in the drop in viral load at months 3 and 6 (P = 0.015, repeated measures analysis of variance) in favour of the genotype group. Patients in both arms were then offered open-label genotyping. Genotype analysis was performed every 3 months, and treatment changes could accordingly be made. As some of the patients in the control arm had already progressed to months 9 or 12, only 69% (30/43) of these patients received genotype-guided treatment changes. In the genotype arm, the mean drop in HIV RNA of 1.15 log10 copies/ml, obtained at month 6, persisted at months 9 and 12 (1.15 log10 copies/ml +/- 0.17). In the control arm, an additional drop in HIV RNA to 0.98 log10 +/- 0.22 copies/ml was observed by month 12. In control patients receiving open-label genotype, the percentage of patients with HIV-1 RNA levels below detection limit (200 copies/ml) rose from 14% at month 6 to 30.5% at month 12. This percentage in the study arm remained stable at 31.3% and 30% at months 9 and 12, respectively. Genotype-guided therapy, primary protease mutations and PI plasma concentrations were significantly correlated with virological success. CONCLUSION In this heavily pretreated patient population, genotype-guided therapy resulted in a sustained reduction in HIV RNA of greater than one log10 throughout a 1 year follow-up period. Performance of genotype-guided therapy may have contributed to the additional viral load reduction seen in patients in the control group who received open-label genotyping after the 6 months point. Multivariate analysis showed that the presence of primary protease mutations, performance of genotype-guided treatment changes and PI plasma concentrations independently affected virological response.
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Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France.
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Clevenbergh P, Durant J, Halfon P, del Giudice P, Mondain V, Montagne N, Schapiro JM, Boucher CAB, Dellamonica P. Persisting Long-Term Benefit of Genotype-Guided Treatment for HIV-Infected Patients Failing Haart. The Viradapt Study: Week 48 Follow-Up. Antivir Ther 2000. [DOI: 10.1177/135965350000500102] [Citation(s) in RCA: 9] [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] [Indexed: 11/16/2022]
Abstract
Objective We report the 12 months follow-up of the patients who participated in the Viradapt study. Methods A total of 108 HIV-infected patients failing antiretroviral (ARV) therapy (HIV RNA >10000 copies/ml, therapy >6 months with nucleoside reverse transcriptase inhibitors, >3 months with protease inhibitors (PIs) were randomized into two arms: standard of care in the control arm, and treatment according to the resistance mutations in the protease and reverse transcriptase genes in the study arm. After the first 6 months of the randomized study, open-label, genotype-guided treatment was offered in both arms. A multivariate analysis was performed to assess the predictive factors of treatment success (HIV RNA <200 copies/ml). Results The two arms were comparable in terms of risk factors, age, sex, previous treatments, CD4 cell count and log10 HIV-1 RNA at baseline. At week 24, an interim combined analysis showed a statistically significant difference in the drop in viral load at months 3 and 6 ( P=0.015, repeated measures analysis of variance) in favour of the genotype group. Patients in both arms were then offered open-label genotyping. Genotype analysis was performed every 3 months, and treatment changes could accordingly be made. As some of the patients in the control arm had already progressed to months 9 or 12, only 69% (30/43) of these patients received genotype-guided treatment changes. In the genotype arm, the mean drop in HIV RNA of 1.15 log10 copies/ml, obtained at month 6, persisted at months 9 and 12 (1.15 log10 copies/ml ±0.17). In the control arm, an additional drop in HIV RNA to 0.98 log10 ±0.22 copies/ml was observed by month 12. In control patients receiving open-label genotype, the percentage of patients with HIV-1 RNA levels below detection limit (200 copies/ml) rose from 14% at month 6 to 30.5% at month 12. This percentage in the study arm remained stable at 31.3% and 30% at months 9 and 12, respectively. Genotype-guided therapy, primary protease mutations and PI plasma concentrations were significantly correlated with virological success. Conclusions In this heavily pretreated patient population, genotype-guided therapy resulted in a sustained reduction in HIV RNA of greater than one log10 throughout a 1 year follow-up period. Performance of genotype-guided therapy may have contributed to the additional viral load reduction seen in patients in the control group who received open-label genotyping after the 6 month point. Multivariate analysis showed that the presence of primary protease mutations, performance of genotype-guided treatment changes and PI plasma concentrations independently affected virological response.
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Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France
| | - J Durant
- Department of Infectious Diseases, Nice University Hospital, France
| | - P Halfon
- Virology Department, Alphabio, Marseille, France
| | - P del Giudice
- Department of Infectious Diseases, Nice University Hospital, France
| | - V Mondain
- Department of Infectious Diseases, Nice University Hospital, France
| | | | - JM Schapiro
- National Haemophilia Centre, Tel Hashomer, Israel
| | - CAB Boucher
- Virology Department, University Hospital, Utrecht, The Netherlands
| | - P Dellamonica
- Department of Infectious Diseases, Nice University Hospital, France
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del Giudice P, Bernard E, Perrin C, Bernardin G, Fouché R, Boissy C, Durant J, Dellamonica P. Unusual cutaneous manifestations of miliary tuberculosis. Clin Infect Dis 2000; 30:201-4. [PMID: 10619756 DOI: 10.1086/313587] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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: 12/14/2022] Open
Abstract
Cutaneous manifestations of miliary tuberculosis are extremely rare. We describe a 62-year-old woman with leukopenia who developed infiltrated dermal-hypodermal and ulcerative cutaneous lesions during the course of miliary tuberculosis. Miliary tuberculosis was diagnosed when Mycobacterium tuberculosis bacilli were isolated by cultures of the bronchoalveolar lavage fluid and blood and when acid-fast bacilli were detected on histopathologic examination of hepatic, pulmonary, and cutaneous biopsy specimens. With the increasing incidence of immunocompromised patients, unusual presentations of tuberculosis may be observed more often. Acute miliary tuberculosis of the skin is an exceptional manifestation that is due to acute hematogenous dissemination of M. tuberculosis to the skin. We describe a patient who had unusual cutaneous manifestations of miliary tuberculosis.
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Affiliation(s)
- P del Giudice
- Unité des Maladies Infectieuse et Dermatologie, Hôpital Bonnet, 83608 Fréjus, France.
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del Giudice P, Durant J, Counillon E, Mondain V, Bernard E, Roger PM, Dellamonica P. Mycobacterial cutaneous manifestations: a new sign of immune restoration syndrome in patients with acquired immunodeficiency syndrome. Arch Dermatol 1999; 135:1129-30. [PMID: 10490130 DOI: 10.1001/archderm.135.9.1129] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Marty P, Lacour JP, Pratlong F, Perrin C, del Giudice P, Le Fichoux Y. [Localized cutaneous leishmaniasis due to Leishmania infantum MON-1 contracted in northern Algeria]. Bull Soc Pathol Exot 1998; 91:146-7. [PMID: 9642468] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Classically, the agent of the sporadic skin leishmaniasis in Northern Algeria is Leishmania infantum MON-24. This paper reports the first documented observation of localized cutaneous leishmaniasis due to Leishmania infantum zymodeme MON-1 in Northern Algeria. The interest of using the Western blot serological analysis to guide the diagnosis and the usefulness of the hamster inoculation to isolate Leishmania from pauciparasitized lesion is demonstrated.
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Affiliation(s)
- P Marty
- Groupe de recherche en immunopathologie de la leishmaniose, Faculté de médecine, Nice, France
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del Giudice P, Bernard E, Pinier Y, Dellamonica P. Cutaneous infection due to Mycobacterium gordonae in a human immunodeficiency virus-infected patient. Clin Infect Dis 1998; 26:1486-7. [PMID: 9636901 DOI: 10.1086/517662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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del Giudice P, Marty P, Lacour JP, Perrin C, Pratlong F, Haas H, Dellamonica P, Le Fichoux Y. Cutaneous leishmaniasis due to Leishmania infantum. Case reports and literature review. Arch Dermatol 1998; 134:193-8. [PMID: 9487211 DOI: 10.1001/archderm.134.2.193] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Leishmania infantum recently has been identified as a possible agent of cutaneous leishmaniasis (CL). This species has been isolated from cutaneous lesions of patients from the Mediterranean Basin. However, little is known about the clinical, biological, or therapeutic features of this newly recognized CL. OBSERVATIONS Six patients aged 9 months to 85 years in southeastern France were found to have autochthonous leishmaniasis. Parasitological identification showed that the agent was L infantum, zymodemes Montpellier-1 for 2 patients and Montpellier-24 for 1 patient. Five patients who underwent testing with a Western blot assay were found to have antibodies against 4 antigens with molecular masses of 18, 21, 23, and 31 kd. Five patients were successfully treated with local injections of N-methylglucamine, and 1 patient was successfully treated with topical paromomycin sulfate. No patient had visceral disease at diagnosis or after follow-up. CONCLUSIONS Recent data provide increasing evidence that L infantum is an important agent of CL. In southwestern Europe, this species is the only agent that has long been identified from autochthonous CL. Leishmania infantum should be considered an agent of CL in areas in which visceral leishmaniasis is endemic. Western blot assay could be a useful test for the diagnosis, but precise parasitological identification is important to having a better knowledge of the disease. The relationships between CL and the visceral disease have to be explored.
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Affiliation(s)
- P del Giudice
- Department of Infectious Diseases, Center Hospitalier Universitaire de Nice, France
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del Giudice P, Sainte Marie D, Gérard Y, Couppié P, Pradinaud R. Is crusted (Norwegian) scabies a marker of adult T cell leukemia/lymphoma in human T lymphotropic virus type I-seropositive patients? J Infect Dis 1997; 176:1090-2. [PMID: 9333174 DOI: 10.1086/516518] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [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: 02/05/2023] Open
Abstract
Human T cell lymphotropic virus type I (HTLV-I)-induced immunosuppression has been suggested to explain the occurrence of crusted scabies in HTLV-I-infected patients. HTLV-I is the etiologic agent of adult T cell leukemia/lymphoma (ATL). Crusted scabies diagnosed in 6 HTLV-I-seropositive patients was studied to look for an association with ATL. Four of the 6 either had concomitant ATL when crusted scabies was diagnosed or developed ATL a few months later. These findings suggest that the occurrence of crusted scabies in patients seropositive for HTLV-I could represent a sign of marked immunosuppression related to ATL.
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Affiliation(s)
- P del Giudice
- Department of Dermatology, Hôpital Général de Cayenne, French Guiana
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del Giudice P, Marty P, Kubar J, Le Fichoux Y. Cutaneous leishmaniasis in the north of Italy. Int J Dermatol 1997; 36:79-80. [PMID: 9071629 DOI: 10.1111/j.1365-4362.1997.tb03316.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Gérard Y, Couppié P, del Giudice P, Mille H, Cuchet T, Sainte-Marie D, Pradinaud R. [Disseminated histoplasmosis: 2 cases in patients with human immunodeficiency virus infection in French Guiana]. Rev Med Interne 1995; 16:767-70. [PMID: 8525157 DOI: 10.1016/0248-8663(96)80786-7] [Citation(s) in RCA: 4] [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: 01/31/2023]
Abstract
The authors report two cases of disseminated histoplasmosis occurring in HIV-infected patients living in French Guiana. The first case was an acute disseminated histoplasmosis with a rapid fatal evolution. The second case was diagnosed on a mucosal localisation, and improved under itraconazole therapy. These two cases show the diversity of the clinical course of this opportunistic infection. The authors focus on the difficulty of the diagnosis and the need for direct microscopic examination to identify histoplasma and to enable a swift therapeutic intervention.
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Affiliation(s)
- Y Gérard
- Service de dermato-vénéréo-léprologie, centre hospitalier, Cayenne, Guyane, France
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