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Walter A, Rudler M, Olivas P, Moga L, Trépo E, Robic MA, Ollivier-Hourmand I, Baiges A, Sutter O, Bouzbib C, Peron JM, Le Pennec V, Ganne-Carrié N, Garcia-Pagán JC, Mallet M, Larrue H, Dao T, Thabut D, Hernández-Gea V, Nault JC, Bureau C, Allaire M, Betancourt F, Garcia‐Criado MA, Magaz M, Métivier S, Musikas M, Reverter E, Ripoll E. Combination of Model for End-Stage Liver Disease and Lactate Predicts Death in Patients Treated With Salvage Transjugular Intrahepatic Portosystemic Shunt for Refractory Variceal Bleeding. Hepatology 2021; 74:2085-2101. [PMID: 34018627 DOI: 10.1002/hep.31913] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 08/14/2020] [Revised: 04/19/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Data about the prognosis of salvage transjugular intrahepatic portosystemic shunt (TIPS) using covered stents for refractory variceal bleeding caused by portal hypertension are scarce. We aimed to assess survival and to identify predictors of mortality in these patients. APPROACH AND RESULTS One hundred sixty-four patients with cirrhosis from five centers treated with salvage TIPS between 2007 and 2017 were retrospectively divided into a derivation cohort (83 patients) and a validation cohort (81 patients). Comparisons were performed using the Mann-Whitney and Fischer's exact test. Six-week overall survival (OS) was correlated with variables on the day of the TIPS using Kaplan-Meier curves with log-rank test and univariate/multivariate analyses using the Cox model. Eighty-three patients were included in the derivation cohort (male, 78%; age, 55 years, alcohol-associated cirrhosis, 88%; Model for End-Stage Liver Disease [MELD], 19 [15-27]; arterial lactate, 3.7 mmol/L [2.0-8.3]). Six-week OS rate was 58%. At multivariate analysis, the MELD score (OR, 1.064; 95% CI, 1.005-1.126; P = 0.028) and arterial lactate (OR, 1.063; 95% CI, 1.013-1.114; P = 0.032) were associated with 6-week OS. Six-week OS rates were 100% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 5% in patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. The 81 patients of the validation cohort had similar MELD and arterial lactate level but lower creatinine level (94 vs 106 µmol/L, P = 0.008); 6-week OS was 67%. Six-week OS rates were 86% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 10% for patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. In the overall cohort, rebleeding rate was 15.8% at 6 weeks, and the acute-on-chronic liver failure grade (OR, 1.699; 95% CI, 1.056-1.663; P = 0.040) was independently associated with rebleeding. CONCLUSIONS After salvage TIPS, 6-week mortality remains high and can be predicted by MELD score and lactate. Survival rate at 6 weeks was >85% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15, while mortality was >90% for lactate ≥12 mmol/L and/or MELD score ≥ 30.
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Affiliation(s)
- Aurélie Walter
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France
| | - Marika Rudler
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Pol Olivas
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucile Moga
- Service d'Hépatologie, Hôpital Beaujon, Hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance-publique Hôpitaux de Paris, Clichy, France
| | - Eric Trépo
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Anna Baiges
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Olivier Sutter
- Service de Radiologie, Hôpital Jean Verdier, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Bondy, France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'universités et établissements Sorbonne Paris cité, Paris, France
| | - Charlotte Bouzbib
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France.,Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, Unité de soins intensifs d'hépatologie, Service d'hépato-gastroentérologie, Inserm, Centre de recherche Saint-Antoine, Sorbonne université, Groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Jean Marie Peron
- Service d'hépato-gastro-entérologie, CHU Toulouse, Toulouse, France
| | | | - Nathalie Ganne-Carrié
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France.,Unité mixte de Recherche 1138, Équipe FunGeS, Institut National de la Santé et de la Recherche médicale, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | - Juan Carlos Garcia-Pagán
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Maxime Mallet
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Hélène Larrue
- Service d'hépato-gastro-entérologie, CHU Toulouse, Toulouse, France
| | - Thong Dao
- Service d'hépato-gastroentérologie et de nutrition, CHU Côte de Nacre, Caen, France
| | - Dominique Thabut
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France.,Unité mixte de Recherche S 938, Institut National de la Santé et de la Recherche médicale/CDR Saint-Antoine & Institute of Cardiometabolism and Nutrition, Paris, France
| | - Virginia Hernández-Gea
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Jean-Charles Nault
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France.,Unité mixte de Recherche 1138, Équipe FunGeS, Institut National de la Santé et de la Recherche médicale, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | | | - Manon Allaire
- Service d'hépato-gastroentérologie et de nutrition, CHU Côte de Nacre, Caen, France.,Unité mixte de Recherche 1149, Centre de Recherche sur l'inflammation, Faculté de Médecine Bichat, Paris, France
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Abravanel F, Lhomme S, Trémeaux P, Migueres M, Harter A, Haslé C, Bruel P, Alric L, Métivier S, Raymond S, Izopet J. Performance of the Xpert HBV Viral Load assay versus the Aptima Quant assay for quantifying hepatitis B virus DNA. Diagn Microbiol Infect Dis 2019; 96:114946. [PMID: 31771903 DOI: 10.1016/j.diagmicrobio.2019.114946] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 02/02/2023]
Abstract
Quantification of HBV DNA is used for initiating and monitoring antiviral treatment. We have evaluated the Xpert HBV Viral Load (VL) assay on the GeneXpert instrument. We estimated its limit of detection to be 7.5 IU/mL. Reproducibility was 1.1-12.7% as assessed by the coefficients of variation for 3 different samples. The assay was linear from 2 to 8 log10 IU/mL for HBV genotypes A to F. Its clinical performance was evaluated by testing prospectively 100 HBV DNA-positive samples with the Xpert HBV VL and Aptima Quant HBV assays. The results from the 2 assays were correlated, with a modest bias (-0.10 log10 IU/mL) between them by Bland-Altman analysis. Patient monitoring with 80 samples performed with both assays gave similar patient profiles with trends in the same direction. The Xpert HBV Viral load assay is reliable enough for quantifying HBV DNA in clinical practice.
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Affiliation(s)
- Florence Abravanel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France.
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Pauline Trémeaux
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Marion Migueres
- CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Agnès Harter
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Catherine Haslé
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Patrick Bruel
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France
| | - Laurent Alric
- CHU Toulouse, Hôpital Purpan, Fédération digestive, F-31300, France
| | - Sophie Métivier
- CHU Toulouse, Hôpital Purpan, Fédération digestive, F-31300, France
| | - Stéphanie Raymond
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Jacques Izopet
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
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3
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de Lédinghen V, Laforest C, Hézode C, Pol S, Renault A, Alric L, Larrey D, Métivier S, Tran A, Jézéquel C, Samuel D, Zoulim F, Tual C, Pailhé A, Gibowski S, Bourlière M, Bellissant E, Pawlotsky JM. Retreatment With Sofosbuvir Plus Grazoprevir/Elbasvir Plus Ribavirin of Patients With Hepatitis C Virus Genotype 1 or 4 Who Previously Failed an NS5A- or NS3-Containing Regimen: The ANRS HC34 REVENGE Study. Clin Infect Dis 2019; 66:1013-1018. [PMID: 29077864 DOI: 10.1093/cid/cix916] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022] Open
Abstract
Background Failure to achieve sustained virological response (SVR) with hepatitis C virus (HCV) direct-acting antiviral (DAA)-based regimens is commonly associated with emergence of resistance-associated substitutions (RASs). Retreatment of patients who failed prior DAAs remains challenging. The aim of this prospective and randomized study was to evaluate the efficacy (primary endpoint: SVR 12 weeks after end of treatment [SVR12]) and safety of sofosbuvir + grazoprevir/elbasvir + ribavirin for 16 or 24 weeks in patients who had failed to achieve SVR on previous NS5A- or NS3-based therapy and with evidence of RASs at failure. Methods Patients were chronically infected with HCV genotype 1 or 4. Most of them had advanced fibrosis or compensated cirrhosis (liver stiffness 5.8-48.8 kPa). Results All patients achieved HCV RNA below the lower limit of quantification (either target detected [unquantifiable] or target not detected) during treatment. SVR12 was achieved by 25 of 26 patients. The only patient who did not reach SVR was a patient who died, but HCV RNA was negative at this time (5 weeks after stopping treatment). No patient discontinued treatment because of adverse events or virological failure. Globally, treatment was well tolerated. Conclusions Our findings support the concept of retreating with sofosbuvir + grazoprevir/elbasvir + ribavirin, for 16 weeks, genotype 1 or 4 DAA-experienced patients with proven NS5A or NS3 RASs. Clinical Trials Registration NCT02647632.
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Affiliation(s)
- Victor de Lédinghen
- Hepatology Unit, University Hospital, CHU Bordeaux, Pessac.,INSERM, Université Bordeaux, UMR1053 Bordeaux Research in Translational Oncology, BaRITOn
| | | | - Christophe Hézode
- Service d'Hépatologie, CHU Henri-Mondor, AP-HP, Université Paris-Est, INSERM U955, Créteil
| | - Stanislas Pol
- Université Paris Descartes, Hepatology Department, Cochin Hospital, APHP, INSERM U1223, UMS-20 and Center for Translational Science, Institut Pasteur
| | - Alain Renault
- CHU Rennes, Service Pharmacologie, and INSERM, CIC 1414.,Université Rennes 1, Faculté de médecine, laboratoire de pharmacologie
| | - Laurent Alric
- Department of Internal Medicine and Digestive Diseases, CHU Purpan, UMR 152, IRD Toulouse 3 University
| | | | | | - Albert Tran
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, "Hepatic Complications in Obesity," and University Hospital of Nice, Digestive Centre, Cedex
| | | | | | - Fabien Zoulim
- Hepatology Unit, Hospices Civils de Lyon, and INSERM U1052, Paris
| | | | | | | | | | - Eric Bellissant
- CHU Rennes, Service Pharmacologie, and INSERM, CIC 1414.,Université Rennes 1, Faculté de médecine, laboratoire de pharmacologie
| | - Jean-Michel Pawlotsky
- National Reference Center for Viral Hepatitis B, C, and D, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, and INSERM U955, Créteil, France
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4
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Halfon P, Scholtès C, Izopet J, Larrat S, Trimoulet P, Zoulim F, Alric L, Métivier S, Leroy V, Ouzan D, de Lédinghen V, Mohamed S, Pénaranda G, Khiri H, Thélu MA, Plauzolles A, Chiche L, Bourlière M, Abravanel F. Baseline and post-treatment hepatitis C NS5A resistance in relapsed patients from a multicentric real-life cohort. Antivir Ther 2019; 23:307-314. [PMID: 28730994 DOI: 10.3851/imp3184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent data have suggested that failure to achieve sustained virological response with direct-acting antiviral therapy is usually due to relapse and is primarily associated with the emergence of resistance-associated substitutions. The aim of this study was to investigate the prevalence and characterization of non-structural-5A resistance-associated substitutions in patients infected with HCV genotypes 1, 3 and 4 treated by direct-acting antiviral therapy, including anti-non-structural-5A, and to characterize the pre-existing resistance-associated substitutions in subjects treated with anti-non-structural-5A inhibitors. METHODS From January 2014 to March 2016, 2,995 patients infected with HCV genotypes 1, 3 and 4 were exposed to non-structural-5A inhibitors. Sequencing results at the time of virological failure were available for 61 patients; sequencing at baseline was available for 35 of these patients. RESULTS Among the 35 patients with sequencing results available at baseline, 15 had no resistance-associated substitution, 16 had only one resistance-associated substitution, and 4 had more than one resistance-associated substitution. Resistance-associated substitutions were harbored in 57% of the sequences in the non-structural-5A region. Among the 61 patients sequenced at virological failure, 50 (82%) patients presented at least one resistance-associated substitutions inducing a high level of resistance to non-structural-5A inhibitors (>10-fold resistance). CONCLUSIONS This pooled analysis suggests that non-structural-5A resistance-associated substitutions screening should be recommended when considering retreatment with a non-structural-5A inhibitor regimen in patients who have previously experienced failed non-structural-5A treatment.
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Affiliation(s)
- Philippe Halfon
- Laboratoire Alphabio, Marseille, France.,Hôpital Européen, Marseille, France
| | | | | | | | | | | | - Laurent Alric
- CHU Toulouse Purpan, UMR 152 IRD Toulouse 3, Toulouse, France
| | | | | | - Denis Ouzan
- Institut Arnault Tzanck, Saint-Laurent-du-Var, France
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5
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Halfon P, Scholtès C, Izopet J, Larrat S, Trimoulet P, Zoulim F, Alric L, Métivier S, Leroy V, Ouzan D, de Lédinghen V, Mohamed S, Pénaranda G, Khiri H, Thélu MA, Plauzolles A, Chiche L, Bourlière M, Abravanel F. Retreatment with direct-acting antivirals of genotypes 1-3-4 hepatitis C patients who failed an anti-NS5A regimen in real world. J Hepatol 2018; 68:595-597. [PMID: 28987520 DOI: 10.1016/j.jhep.2017.09.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/21/2017] [Accepted: 09/24/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Philippe Halfon
- Laboratoire Alphabio, Marseille, France; Hôpital Européen, Marseille, France.
| | | | | | | | | | | | - Laurent Alric
- CHU Toulouse Purpan, UMR 152 IRD Toulouse 3, Toulouse, France
| | | | | | - Denis Ouzan
- Institut Arnault Tzanck, Saint Laurent du Var, France
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Fontaine H, Maynard M, Bouix C, Carrieri MP, Botta-Fridlund D, D'Alteroche L, Conti F, Pageaux GP, Leroy V, Métivier S, Anty R, Durand F, Canva V, Vilotitch A, Lebray P, Alric L, Duvoux C, Petrov-Sanchez V, Beaulieux F, Wellems C, Paul C, Roque-Afonso AM, Roche B, Pradat P, Samuel D, Duclos-Vallée JC. Efficacy and safety of boceprevir-based triple therapy in HCV cirrhotic patients awaiting liver transplantation (ANRS HC29 BOCEPRETRANSPLANT). Clin Res Hepatol Gastroenterol 2017; 41:56-65. [PMID: 27554134 DOI: 10.1016/j.clinre.2016.06.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 06/14/2016] [Accepted: 06/24/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS In this French multicentre, open-label study, we analyzed the efficacy, safety and patient-reported outcomes of a boceprevir-based triple therapy in HCV genotype 1 cirrhotic patients awaiting liver transplantation (LT). METHODS Patients received PEG-IFN/ribavirin (RBV) for 48 weeks (W) and boceprevir from W4 to W48 or until LT. RESULTS Fifty-one patients (80% males, median age: 56 years) were included. Fifty-seven percent had hepatocellular carcinoma and 43% end-stage liver disease. At enrolment, the median MELD score was 9 (range: 6-18); the Child-Pugh score was A in 65%, B in 35% and C in 2%. Therapy was discontinued because of severe adverse events (SAEs) in 39% of cases and virological inefficacy in 24%. 16% of patients had undetectable HCV RNA 24 weeks after the end of treatment (SVR24). LT was performed in 18 patients (35%). HCV RNA was undetectable in 16.6% at LT. Seven patients (14%) died and three deaths were attributed to treatment. SAEs (n=129) were observed in 84% of patients. Twenty-four percent of patients developed severe infections. Albumin<35g/L was independently associated with severe infection. Compared with baseline values, a significant decrease (P=0.02) of the physical dimension of health-related quality of life was observed between W4 and W24. The mean (95% CI) number of self-reported symptoms doubled during treatment (from 6.3 [4.8-7.7] to 11.8 [9.3-14.3]; P<0.001). CONCLUSIONS The safety of the PEG-IFN/RBV/boceprevir combination is poor in patients awaiting LT, with a high risk of severe infection. Moreover, the limited efficacy confirms the indication for IFN-free combinations in these patients.
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Affiliation(s)
- Hélène Fontaine
- Université Paris Descartes, Inserm USM20, Institut Pasteur, Assistance publique-Hôpitaux de Paris, service d'hépatologie, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - Marianne Maynard
- Department of hepatology, hôpital de la Croix-Rousse, hospices civils de Lyon, Lyon, France
| | - Cécile Bouix
- Department of hepatology, hôpital de la Croix-Rousse, hospices civils de Lyon, Lyon, France
| | - Maria Patrizia Carrieri
- Inserm, UMR912 (SESSTIM), Marseille, France; Aix Marseille université, UMR_S912, IRD, Marseille, France; Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur (ORS PACA), Marseille, France
| | | | - Louis D'Alteroche
- Department of Hepatology and Gastroenterology, Trousseau Hospital, Tours, France
| | - Filomena Conti
- Department of Hepatology, Saint-Antoine Hospital, Paris, France
| | - Georges-Philippe Pageaux
- Fédération médico-chirurgicale des maladies de l'appareil digestif, Saint-Eloi, Montpellier, France
| | - Vincent Leroy
- Department of Hepatology and Gastroenterology, La Tronche Hospital, Grenoble, France
| | - Sophie Métivier
- Department of Hepatology and Gastroenterology, Purpan Hospital, Toulouse, France
| | | | - François Durand
- Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France
| | - Valérie Canva
- Department of Hepatology and Gastroenterology, Claude-Huriez Hospital, Lille, France
| | - Antoine Vilotitch
- Inserm, UMR912 (SESSTIM), Marseille, France; Aix Marseille université, UMR_S912, IRD, Marseille, France; Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur (ORS PACA), Marseille, France
| | - Pascal Lebray
- Department of Hepatology and Gastroenterology, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Christophe Duvoux
- Hepatology and Gastroenterology, Henri-Mondor Hospital, Créteil, France
| | - Ventzislava Petrov-Sanchez
- Unit for Basic and Clinical research on Viral Hepatitis, ANRS (France REcherche Nord & sud Sida-HIV Hépatites [FRENSH]), Paris, France
| | - Frédérik Beaulieux
- Department of hepatology, hôpital de la Croix-Rousse, hospices civils de Lyon, Lyon, France
| | - Célia Wellems
- Department of hepatology, hôpital de la Croix-Rousse, hospices civils de Lyon, Lyon, France
| | - Christelle Paul
- Clinical Trial Safety Office, ANRS (France REcherche Nord & sud Sida-HIV Hépatites [FRENSH]), Paris, France
| | - Anne-Marie Roque-Afonso
- AP-HP, Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm, Unit 1193, Université Paris-Sud, UMR-S1193, DHU Hepatinov, Villejuif, France
| | - Bruno Roche
- AP-HP, Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm, Unit 1193, Université Paris-Sud, UMR-S1193, DHU Hepatinov, Villejuif, France
| | - Pierre Pradat
- Department of hepatology, hôpital de la Croix-Rousse, hospices civils de Lyon, Lyon, France
| | - Didier Samuel
- AP-HP, Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm, Unit 1193, Université Paris-Sud, UMR-S1193, DHU Hepatinov, Villejuif, France
| | - Jean-Charles Duclos-Vallée
- AP-HP, Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm, Unit 1193, Université Paris-Sud, UMR-S1193, DHU Hepatinov, Villejuif, France
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Abravanel F, Métivier S, Chauveau M, Péron JM, Izopet J. Transmission of HCV NS5A Inhibitor-Resistant Variants Among HIV-Infected Men Who Have Sex With Men. Clin Infect Dis 2016; 63:1271-1272. [PMID: 27506681 DOI: 10.1093/cid/ciw554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Florence Abravanel
- Centre Hospitalier Universitaire Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E Institut National de la Santé et de la Recherche Médicale, U1043, Centre de Physiopathologie de Toulouse Purpan
| | | | | | | | - Jacques Izopet
- Centre Hospitalier Universitaire Toulouse, Hôpital Purpan, Laboratoire de virologie, National Reference Center for Hepatitis E Institut National de la Santé et de la Recherche Médicale, U1043, Centre de Physiopathologie de Toulouse Purpan
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8
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Kamar N, Marion O, Rostaing L, Cointault O, Ribes D, Lavayssière L, Esposito L, Del Bello A, Métivier S, Barange K, Izopet J, Alric L. Efficacy and Safety of Sofosbuvir-Based Antiviral Therapy to Treat Hepatitis C Virus Infection After Kidney Transplantation. Am J Transplant 2016; 16:1474-9. [PMID: 26587971 DOI: 10.1111/ajt.13518] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/11/2015] [Accepted: 08/30/2015] [Indexed: 01/25/2023]
Abstract
There is no approved therapy for hepatitis C virus (HCV) infection after kidney transplantation, and no data regarding the use of new-generation direct antiviral agents (DAAs) have been published so far. The aims of this pilot study were to assess the efficacy and safety of an interferon-free sofosbuvir-based regimen to treat chronic HCV infection in kidney transplant recipients. Twenty-five kidney transplant recipients with chronic HCV infection were given, for 12 (n = 19) or 24 weeks (n = 6), sofosbuvir plus ribavirin (n = 3); sofosbuvir plus daclatasvir (n = 4); sofosbuvir plus simeprevir, with (n = 1) or without ribavirin (n = 6); sofosbuvir plus ledipasvir, with (n = 1) or without ribavirin (n = 9); and sofosbuvir plus pegylated-interferon plus ribavirin (n = 1). A rapid virological response, defined by undetectable viremia at week 4 after starting DAA therapy, was observed in 22 of the 25 patients (88%). At the end of therapy, HCV RNA was undetectable in all patients. At 4 and 12 weeks after completing DAA therapy, all had a sustained virological response. The tolerance to anti-HCV therapy was excellent and no adverse event was observed. A significant decrease in calcineurin inhibitor levels was observed after HCV clearance. New-generation oral DAAs are efficient and safe to treat HCV infection after kidney transplantation.
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Affiliation(s)
- N Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - O Marion
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - L Rostaing
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - O Cointault
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - D Ribes
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - L Lavayssière
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - L Esposito
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - A Del Bello
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France
| | - S Métivier
- Department of Hepatology and Gastroenterology, Toulouse, France
| | - K Barange
- Department of Hepatology and Gastroenterology, Toulouse, France
| | - J Izopet
- INSERM U1043, IFR-BMT, CHU Purpan, Toulouse, France.,Université Paul Sabatier, Toulouse, France.,Laboratory of Virology, CHU Purpan, Toulouse, France
| | - L Alric
- Université Paul Sabatier, Toulouse, France.,MR 152 IRD-Toulouse 3 University, Toulouse, France.,Internal Medicine-Digestive Department, CHU Purpan, Toulouse, France
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9
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Bailly F, Virlogeux V, Dufour C, Pradat P, Hézode C, Larrey D, Alric L, Samuel D, Bourlière M, Métivier S, Zarski JP, Fontaine H, Loustaud-Ratti V, Serfaty L, Bronowicki JP, Carrat F, Zoulim F. Early virological assessment during telaprevir- or boceprevir-based triple therapy in hepatitis C cirrhotic patients who failed a previous interferon based regimen - The ANRS CO20-CUPIC study. Clin Res Hepatol Gastroenterol 2015; 39:443-50. [PMID: 25636238 DOI: 10.1016/j.clinre.2014.12.007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/09/2014] [Accepted: 12/15/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE To assess within the ANRS CO20-CUPIC cohort whether the viral load (VL) at week 2/week 6 for telaprevir/boceprevir-based triple therapy, respectively, was predictive of sustained virological response (SVR) in patients with hepatitis C virus (HCV) infection and to study the relevance of this measurement to early diagnose drug resistance. METHODS Observational study of HCV genotype 1 patients with compensated cirrhosis (Child-Pugh A), non-responders to a prior course of interferon (IFN)-based therapy and who started triple therapy. Patients received either 12 weeks of telaprevir in combination with PEG-IFN/ribavirin (RBV), then 36 weeks of PEG-IFN/RBV, or 4 weeks of PEG-IFN/RBV, then 44 weeks of PEG-IFN/RBV and boceprevir. RESULTS A total of 262 patients were analyzed. For telaprevir-treated patients, 28% had undetectable VL at W2 of whom 81% achieved SVR12 whereas 67% had undetectable VL at W4 of whom 67% achieved SVR12. For boceprevir-treated patients 20% had undetectable VL at W6 and 86% of them achieved SVR12 whereas 36% had undetectable VL at W8 among whom 73% achieved SVR12. Five telaprevir-treated patients had a VL increase between W2 and W4 after a decrease between D0 and W2. Four of them did not achieve SVR12. Similarly, six boceprevir-treated patients had a VL increase between W6 and W8 after a decrease between D0 and W6. Five did not reach SVR12. CONCLUSIONS The assessment of HCV RNA level after two weeks of triple therapy in cirrhotic non-responder patients is a good predictor of SVR. This assessment was useful to do an early diagnosis of viral breakthrough.
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Affiliation(s)
- François Bailly
- Department of Hepatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Inserm U1052, 69003 Lyon, France; Université Lyon I, 69622 Villeurbanne, France
| | - Victor Virlogeux
- Department of Hepatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; École Normale Supérieure, 69007 Lyon, France
| | - Cécilie Dufour
- Inserm UMR-S 707, Université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France
| | - Pierre Pradat
- Department of Hepatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Inserm U1052, 69003 Lyon, France; Université Lyon I, 69622 Villeurbanne, France
| | | | - Dominique Larrey
- Hépato-gastroentérologie, CHU de Montpellier, Hôpital Saint-Éloi, 34090 Montpellier, France
| | - Laurent Alric
- Pôle Digestif, CHU Purpan, UMR 152, Université Toulouse 3, 31059 Toulouse, France
| | - Didier Samuel
- Centre Hépato-Biliaire, AP-HP Hôpital Paul-Brousse, 94870 Villejuif, France; Unité 785, Inserm, 94870 Villejuif, France; Université Paris-Sud, 94270 Le Kremlin-Bicêtre, France
| | - Marc Bourlière
- Department of Hepatology and Gastroenterology, Hôpital Saint-Joseph, 13285 Marseille, France
| | - Sophie Métivier
- Pôle Digestif-Gastro-entérologie-Hépatologie, CHU Purpan, 31059 Toulouse, France
| | - Jean-Pierre Zarski
- Clinique universitaire d'Hépato-Gastroentérologie, CHRU Michallon, 38043 Grenoble, France
| | - Hélène Fontaine
- Hôpital Cochin, AP-HP, Université Paris-René Descartes, Inserm U1016, 75014 Paris, France
| | | | - Lawrence Serfaty
- Hépato-gastro-entérologie orienté en hépatologie, CHU Saint-Antoine, 75012 Paris, France
| | - Jean-Pierre Bronowicki
- Department of Hepatology and Gastroenterology, CHU de Nancy, Université de Lorraine, Inserm U954, 54500 Vandœuvre-lès-Nancy, France
| | - Fabrice Carrat
- Inserm UMR-S 707, Université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France
| | - Fabien Zoulim
- Department of Hepatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Inserm U1052, 69003 Lyon, France; Université Lyon I, 69622 Villeurbanne, France.
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10
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Berlioux P, Robic MA, Poirson H, Métivier S, Otal P, Barret C, Lopez F, Péron JM, Vinel JP, Bureau C. Pre-transjugular intrahepatic portosystemic shunts (TIPS) prediction of post-TIPS overt hepatic encephalopathy: the critical flicker frequency is more accurate than psychometric tests. Hepatology 2014; 59:622-9. [PMID: 24620380 DOI: 10.1002/hep.26684] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [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] [Indexed: 12/31/2022]
Abstract
UNLABELLED Transjugular intrahepatic portosystemic shunts (TIPS) is a second-line treatment because of an increased incidence of overt hepatic encephalopathy (OHE). A better selection of patients to decrease this risk is needed and one promising approach could be the detection of minimal hepatic encephalopathy (MHE). The aim of the present prospective study was to determine whether pre-TIPS minimal hepatic encephalopathy was predictive of post-TIPS OHE and to compare Psychometric Hepatic Encephalopathy Sum Score(PHES) and the Critical Flicker Frequency (CFF) in this setting. From May 2008 to January 2011, 54 consecutive patients treated with TIPS were included. PHES and CFF were performed 1 to 7 days before and after TIPS at months 1, 3, 6, 9, and 12 or until liver transplantation or death. Before TIPS, MHE was detected by PHES and CFF in 33% and 39% of patients, respectively. After the TIPS procedure, 19 patients (35%) experienced a total of 64 episodes of OHE. OHE developed significantly more often inpatients for whom an indication for TIPS had been refractory ascites, with a history of OHE or of renal failure, lower hemoglobin level, or MHE as diagnosed by CFF. Post-TIPS OHE was more accurately predicted by CFF than by PHES. Absence of MHE at CFF had a good negative predictive value (91%) for the risk of post-TIPS recurrent OHE, defined as the occurrence of three or more episodes of OHE or of one episode which lasted more than 15 days. The absence of pre-TIPS history of OHE and a CFF value equal to or greater than 39 Hz had a 100% negative predictive value for post-TIPS recurrent OHE. CONCLUSION Aiming to decrease the rate of post-TIPS HE, the use of CFF could help selecting patients for TIPS.
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Affiliation(s)
- Pierre Berlioux
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Marie Angèle Robic
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Hélène Poirson
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Sophie Métivier
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Philippe Otal
- Service de radiologie Hopital Rangueil CHU Toulouse et Université Paul Sabatier; Toulouse France
| | - Carine Barret
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Frédéric Lopez
- Plateforme de Protéomique I2MC Inserm Rangueil Toulouse; France
| | - Jean Marie Péron
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Jean Pierre Vinel
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
| | - Christophe Bureau
- Service d'hépato-gastro-entérologie CHU Toulouse Hopital Purpan et Université Paul Sabatier; Toulouse France
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11
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Nicot F, Alric L, Barange K, Métivier S, Dramard JM, Combis JM, Castan B, Meurisse JJ, Payen JL, Garipuy D, Desmorat H, Peron JM, Thebault S, Morin T, Renou C, Barel P, Guerin B, Imbert Y, Sire S, Sauné K, Chatelut E, Izopet J. Influence of HCV genotype 1 subtypes on the virus response to PEG interferon alpha-2a plus ribavirin therapy. J Med Virol 2011; 83:437-44. [PMID: 21264864 DOI: 10.1002/jmv.21976] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
New factors that influence the viral response in HCV non-genotype 2/3 patients must be identified in order to optimize anti-HCV treatment. This multicenter prospective study evaluates the influence of HCV variability and pharmacological parameters on the virological response of these patients to pegylated interferon α2a (peg-IFN-α2a: 180 µg/week) and ribavirin (RBV; 800-1,200 mg/day) for 48 weeks. HCV subtypes were identified by sequencing the NS5B region. Serum RBV and peg-IFN-α2a concentrations were measured at weeks 4 and 12. The 115 patients (67 men; median age = 49, range 31-76) included 64 who had never been treated and 27 co-infected with HIV. The mean baseline HCV RNA was 6.30 ± 0.06 log IU/ml and the HCV genotypes were: G1 (n = 93) with 1a (n = 37) and 1b (n = 50), G4 (n = 20) and G5 (n = 2). Most patients (79/108; 73%) had an early virological response. Independent predictors of an early virological response were interferon naive patients (OR= 2.98, 95% CI: 1.15-7.72) and RBV of >2,200 ng/ml at week 12 (OR = 3.41, 95% CI: 1.31-8.90). Forty of 104 patients (38%) had a sustained virological response. The only independent predictors of a sustained virological response were subtype 1b (OR = 6.82, 95% CI: 1.7-26.8), and HCV RNA <15 IU/ml at week 12 (OR = 25, 95% CI: 6.4-97.6). Thus a serum RBV concentration of >2,200 ng/ml was associated with an early virological response and patients infected with HCV subtype 1b had a better chance of a sustained virological response than did those infected with subtype 1a.
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Affiliation(s)
- F Nicot
- CHU Toulouse, IFB Purpan, Laboratoire de Virologie, Toulouse, France
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12
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Bureau C, Métivier S, D'Amico M, Péron JM, Otal P, Pagan JCG, Chabbert V, Chagneau-Derrode C, Procopet B, Rousseau H, Bosch J, Vinel JP. Serum bilirubin and platelet count: a simple predictive model for survival in patients with refractory ascites treated by TIPS. J Hepatol 2011; 54:901-7. [PMID: 21145798 DOI: 10.1016/j.jhep.2010.08.025] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [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: 04/12/2010] [Revised: 08/02/2010] [Accepted: 08/09/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Refractory ascites in patients with cirrhosis is associated with poor survival. TIPS is more effective than paracentesis for the prevention of recurrence of ascites but increases the risk of encephalopathy while survival remains unchanged. A more accurate selection of the patients might improve these results. The aim of the present study was to identify parameters of prognostic value for survival in patients with refractory ascites treated with TIPS. METHODS One hundred and five consecutive French patients with cirrhosis and refractory ascites treated with TIPS were used to assess parameters associated with 1-year survival. The model was then tested in two different cohorts: a local and prospective one including 40 patients from Toulouse, France, and an external one including 48 patients from Barcelona, Spain. RESULTS The actuarial rate of survival in the first 105 patients was 60% at 1 year. Using multivariate analysis, only lower bilirubin levels and higher platelet counts were independently associated with survival. The actuarial 1-year survival rate in patients with both a platelet count above 75×10(9)/L and a bilirubin level lower than 50 μmol/L [3mg/dl] was 73.1% as compared to 31.2%, in patients with a platelet count below 75×10(9)/L or a bilirubin level higher than 50 μmol/L. These results were confirmed in the two different validation cohorts. CONCLUSIONS The combination of a bilirubin level below 50 μmol/L and a platelet count above 75×10(9)/L is predictive of survival in patients with refractory ascites treated with TIPS. This simple score could be used at bedside to help choose the best therapeutic options.
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Affiliation(s)
- Christophe Bureau
- Service d'Hepato-gastro-enterologie, Fédération Digestive, CHU Toulouse Purpan, 31059 Toulouse cedex, France.
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13
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Henquell C, Guglielmini J, Verbeeck J, Mahul A, Thibault V, Lebray P, Laperche S, Trimoulet P, Foucher J, Le Guillou-Guillemette H, Fouchard-Hubert I, Legrand-Abravanel F, Métivier S, Gaudy C, D’Alteroche L, Rosenberg AR, Podevin P, Plantier JC, Riachi G, Saoudin H, Coppere H, André E, Gournay J, Feray C, Vallet S, Nousbaum JB, Baazia Y, Roulot D, Alain S, Loustaud-Ratti V, Schvoerer E, Habersetzer F, Pérez-Serra RJ, Gourari S, Mirand A, Odent-Malaure H, Garraud O, Izopet J, Bommelaer G, Peigue-Lafeuille H, van Ranst M, Abergel A, Bailly JL. Evolutionary history of hepatitis C virus genotype 5a in France, a multicenter ANRS study. Infection, Genetics and Evolution 2011; 11:496-503. [DOI: 10.1016/j.meegid.2010.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 12/22/2010] [Accepted: 12/29/2010] [Indexed: 01/01/2023]
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14
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Alric L, Izopet J, Métivier S, Théult S, Tkaczuk J, Pipy B, Vinel J, Duffaut M. Essai RIFIL2-ANRS HC07: Étude pilote au coursde l'hépatite chronique virale C de l'efficacité d'une trithérapie par interleukine-2-intérferonα2a-ribavirine chez les patients infectés par un génotype 1 non répondeurs à une bithérapie par IFN-ribavirine avec des lésions histologiques modérées à sévères. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80079-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Busato F, Grasset D, Métivier S, Bordères C, Puech N, Seigneuric C. Co-infection VIH-VHC : attention aux mitochondries! Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)80296-4] [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: 11/25/2022]
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Busato F, Grasset D, Métivier S, Chausseray F, Selves J, Seigneuric C. Insuffisance hépatique terminale au cours d'une maladie de Randall sans manifestation rénale symptomatique. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83540-2] [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: 11/15/2022]
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Louvel D, Musso S, Métivier S, Croizet O, Rouquet RM, Massip P, Escourrou J, Frexinos J. Idiopathic esophageal ulceration associated with human immunodeficiency virus infection: efficacy of thalidomide treatment. Endoscopy 1996; 28:471-2. [PMID: 8858251 DOI: 10.1055/s-2007-1005525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- D Louvel
- Gastroenterology Unit, Centre Hospitalier Universitaire Rangueil, Toulouse, France
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