Author: "Sylvie Abel" / Topic: business - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Sylvie Abel"' showing total 37 results

Start Over Author "Sylvie Abel" Topic business

37 results on '"Sylvie Abel"'

1. Dolutegravir-based dual maintenance regimens combined with lamivudine/emtricitabine or rilpivirine: risk of virological failure in a real-life setting

Author: Caroline Lions, N Biezunski, Sophie Matheron, Romain Guery, Pierre-Marie Roger, Caroline Charlier, Mathieu Dupont, Line Meddeb, Philippe Van de Perre, V Joly, R Lecomte, Matthieu Revest, Claudine Duvivier, B Lefèvre, M Delestan, H Laurichesse, H Marty, F Lemaitre, Martine Valette, Marc-Antoine Valantin, A S Ritleng, A Ménard, Eric Cua, M. Alvarez, A Raoux, M P Bouillon, A Sève, A Brebion, Claire Triffault-Fillit, Sylvie Bregigeon, M Carles, O. Aubry, S Hénard, P. Dellamonica, A Charmillon, E Alidjinou, V Brodard, M Tetart, F Raffi, Paul-Henri Consigny, O Lesens, C Brunet-Cartier, I Lamaury, S Giaché, Amandine Gagneux-Brunon, Jacques Reynes, Karine Sauné, Clotilde Allavena, Q Lepiller, Véronique Reliquet, C Louisin, I Perbost, Jean-Luc Berger, B Prouvost-Keller, Eric Delaporte, Isabelle Lamaury, C Gubavu, L Fagour, Laurent Cotte, G Gaube, Elina Teicher, Faouzi Souala, C Blanc, Dominique Merrien, Isabelle Poizot-Martin, C Drobacheff-Thiébaut, T May, P Richard, M A Trabaud, M Bistoquet, C Klotz, Samira Fafi-Kremer, M Marcel, Charlotte Charpentier, L Lelièvre, K Risso, Sandrine Pierre-François, S Ferrando, S Breaud, S Bevilacqua, A Montoya Ferrer, T Rojas-Rojas, D Boucher, Yazdan Yazdanpanah, Olivier Lortholary, Philippe Colson, Anne-Sophie Brunel, F-Xavier Lescure, Christelle Tomei, M Martin-Degioanni, Eric Rosenthal, Philippe Bossi, Patrick Miailhes, Kevin Bouiller, Lise Cuzin, A Foltzer, F Boulard, Michel Vidal, V Mondain, H Colson, J Pasquier, I Kmiec, F Alby-Laurent, R Agher, A Cabié, Guillaume Martin-Blondel, L Hocqueloux, M Colin, A Madrid, Faiza Ajana, J M Livrozet, V Rio, Karima Amazzough, C Merle de Boever, M Digumber, Thomas Perpoint, A Cheret, Laurence Bocket, Z Julia, Virginie Ferré, M Pradier, M Poisson-Vannier, A Legoff, M J Soavi, Y Quertainmont, Marine Morrier, Christian Chidiac, F Touam, O Zaegel-Faucher, A Marquise, G Benabdelmoumen, Florence Ader, T Guimard, M C Receveur, J C Tardy, P Morineau, K Guitteaud, D. Rey, S Leautez, Catherine Chirouze, Benoit Tressières, A. Ivanova, C Charre, J Reynes, Christian Pradier, Catherine Dhiver, Laurent Boyer, E Frentiu, David Rey, C Allavena, Anne Motte, Tristan Ferry, C Pronier, M. Hentzien, C Rouzaud, O Cabras, K Jidar, F Najioullah, C Clavel, M Orticoni, S Patrat-Delon, M Cavellec, Cécile Herrmann-Storck, V Baclet, Jade Ghosn, M Perry, S Wehrlen-Pugliese, J. M. Chapplain, R Palich, Laurent Hocqueloux, A Maillard, C Deschanvres, O Deradji, F. Lucht, A Grégoire, Veronique Joly, R Ouissa, C Daniel, N Mrozek, D Chirio, O Bollangier, J Bavay, P. Le Turnier, A Maka, C Rioux, Colin Deschanvres, C Brochier, Elisabeth Botelho-Nevers, A Meybeck, C Ceppi, J Lourenco, François Bénézit, Thomas Jovelin, G Zouzou, N Tissot, N. Viget, F Brunel-Dalmas, Brigitte Montes, N Chellum Rungen, K Rome, David Boutoille, B Bigeard, I Fabre, N Oran, M Lefebvre, P Point, C Etienne, Diane Descamps, G Thomas, S Le Gac, Cyrille Delpierre, Pierre Tattevin, M Godinot, P Fischer, C Aumeran, C Boulard, Elisabeth André-Garnier, J Sinteff, V Ronat, F Goehringer, Romain Palich, Luminita Schneider, I Touitou, Eric Billaud, P Thill, Catherine Varache, Olivier Robineau, I Jaquet, Roland Landman, Cédric Arvieux, B. Bonnet, V Rzepecki, Olivier Grossi, Christian Rabaud, L Laine, F Louni, C Cheneau, S Markowicz, Hélène Laroche, A Gervais, C Bernard-Henry, E Goncalvez, N Lerolle, M André, D Lambert, André Boibieux, L. Porte, S Bouchez, E Paredes, E Aïssi, V. Le Moing, S Degroodt, Sylvie Abel, André Cabié, B Lafon-Desmurs, O Babre, M Baldeyrou, C Debreux, A Rodallec, Pierre Delobel, V Icard, Agathe Becker, Edouard Tuaillon, Hervé Tissot-Dupont, M Mokhtari, C Morlat, I Alcaraz, Anne Frésard, O Cannesson, Elodie Curlier, P Chiarello, S. Roux, F Bani-Sadr, François Raffi, Florent Valour, M Piffaut, M Priester, A. Belkhir, J Romaru, Cécile Goujard, A Castro, G Cessot, A Mirand, C Pouderoux, A Brunet, C Michelangeli, Y N’guyen, Patrice Muret, Elisa Demonchy, Christine Jacomet, D Makhloufi, E Jeanmaire, Marialuisa Partisani, Véronique Obry-Roguet, J Turmel, C Mélounou, J. Durant, Christine Katlama, P Parize, O Robineau, S Seang, F. Bozon, S Galie, Alexa Debard, E de Mautort, C Duvivier, Fanny Lanternier, Alain Makinson, A Barrail-Tran, C Aguilar, A Naqvi, Rodolphe Garraffo, N Meftah, C Biron, A de Monte, Pascal Pugliese, V Corbin, S Jaureguiberry, E Lafont, L Hustache Mathieu, R Colarino, Isabelle Ravaux, C Henquell, Benoit Pilmis, M Grégoire, P Lansalot, E Ressiot, T. Huleux, Olivier Baud, S Sécher, R Dupin de Majoubert, J Leporrier, L Cuzin, E Chevalier, M Poinot, R Tubiana, S Lariven, A Boucher, N Atoui, Firouzé Bani-Sadr, T Prazuck, M Ducassou, Gilles Peytavin, A Soria, B J Gaborit, Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Dat’AIDS Study Group, Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Les Hôptaux universitaires de Strasbourg (HUS), CHU Strasbourg, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Gustave Dron [Tourcoing], Institut Pasteur [Paris] (IP), Centre Hospitalier Régional d'Orléans (CHRO), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de la Martinique [Fort de France], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], CHU Clermont-Ferrand, and Université Clermont Auvergne (UCA)
Subjects: Microbiology (medical), medicine.medical_specialty, Anti-HIV Agents, Pyridones, MESH: Piperazines, HIV Infections, Emtricitabine, Piperazines, law.invention, chemistry.chemical_compound, Randomized controlled trial, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, MESH: Pyridones, Oxazines, MESH: Emtricitabine, Humans, Medicine, Pharmacology (medical), MESH: Anti-HIV Agents, Pharmacology, MESH: Heterocyclic Compounds, 3-Ring, MESH: Humans, business.industry, Rilpivirine, Lamivudine, MESH: HIV Infections, Viral Load, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Virological failure, Regimen, Infectious Diseases, chemistry, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Dolutegravir, Cohort, MESH: Rilpivirine, business, MESH: Viral Load, Heterocyclic Compounds, 3-Ring, MESH: Oxazines, medicine.drug, MESH: Lamivudine
Abstract: Background Maintenance ART with dolutegravir-based dual regimens have proved their efficacy among HIV-1-infected subjects in randomized trials. However, real-life data are scarce, with limited populations and follow-up. Objectives We assessed virological failure (VF) and resistance-associated mutations (RAMs) on dolutegravir maintenance regimens in combination with rilpivirine or with lamivudine or emtricitabine (xTC) and analysed the factors associated with VF. Methods Between 2014 and 2018, all HIV-1-infected adults included in the Dat’AIDS cohort and starting dolutegravir/rilpivirine or dolutegravir/xTC as a maintenance dolutegravir-based dual regimen were selected. VF was defined as two consecutive HIV RNA values >50 copies/mL or a single value >400 copies/mL. We compared cumulative genotypes before initiation of a maintenance dolutegravir-based dual regimen with genotype at VF. Results We analysed 1374 subjects (799 on dolutegravir/rilpivirine and 575 on dolutegravir/xTC) with a median follow-up of 20 months (IQR = 11–31) and 19 months (IQR = 11–31), respectively. VF occurred in 3.8% (n = 30) of dolutegravir/rilpivirine subjects and 2.6% (n = 15) of dolutegravir/xTC subjects. Among subjects receiving dolutegravir/rilpivirine, two genotypes harboured emerging RAMs at VF: E138K on NNRTI (n = 1); and E138K+K101E on NNRTI and N155H on INSTI (n = 1). Among subjects receiving dolutegravir/xTC, no new RAM was detected. The only predictive factor of VF on dolutegravir/rilpivirine was the history of failure on an NNRTI-based regimen (adjusted HR = 2.97, 95% CI = 1.28–6.93). No factor was associated with VF on dolutegravir/xTC. Conclusions In this large real-life cohort, dolutegravir/rilpivirine and dolutegravir/xTC sustained virological suppression and were associated with a low rate of VF and RAM emergence. Careful virological screening is essential before switching to dolutegravir/rilpivirine in virologically suppressed patients with a history of NNRTI therapy.
Published: 2022
Full Text: View/download PDF

2. Genotype distribution of cervical HPV among Caribbean women in a population-based study in Martinique: The DEPIPAPUFR study

Author: Fatiha Najioullah, Marie-José Dorival, Clarisse Joachim, Christiane Dispagne, Jonathan Macni, Sylvie Abel, Caroline Sulpicy, Huguette Charpentier-Baltide, Danièle Sainte-Rose, Béatrice Salomon-Frechou, Moustapha Dieye, Jacqueline Véronique-Baudin, Maurice Pré, Maurice Marquet, Gaëlle Wan-Ajouhu, Eustase Janky, Didier Riethmuller, Raymond Cesaire, DEPIPAPUFR study group, CHU de Martinique, Pôle de Biologie - Pathologie, Laboratoire de Virologie, Martinique, France, Laboratoire de Pathologie SERAL, Fort-de-France, Martinique, France., Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier], CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF1441 Registre Général des cancers de la Martinique, Martinique, France, Residence de Cluny, Martinique, France, CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF1441 Registre Général des cancers de la Martinique, Martinique, France., Service de Maladies Infectieuses et Tropicales, CHU de Martinique, Martinique, France., Laboratoire de Pathologie SERAL, Fort-de-France, Martinique, France, Rue Victor Schoelcher, Martinique, France, CHU de Martinique, Martinique, France., Avenue François Mitterand, Martinique, France, Centre Hospitalier Angoulême, Angoulême, France, All Lauriers, Le Robert, Martinique, France, Route de Redoute, Martinique, France., Cancer et Environnement Localisation Tête et Cou [UR5_1] (CELTEC), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA), Service de Gynécologie Obstétrique, CHRU de Besançon - Hôpital Jean Minjoz, Besançon, France, and BONIZEC, Sandrine
Subjects: Viral Diseases, Epidemiology, [SDV]Life Sciences [q-bio], Uterine Cervical Neoplasms, Pathology and Laboratory Medicine, Cervical Cancer, Geographical locations, Medical Conditions, Genotype, Medicine and Health Sciences, Papillomaviridae, Early Detection of Cancer, Cervical cancer, education.field_of_study, Human papillomavirus 16, Multidisciplinary, Obstetrics, Middle Aged, [SDV] Life Sciences [q-bio], Infectious Diseases, Caribbean Region, Oncology, Medical Microbiology, Viral Pathogens, Cohort, Viruses, Medicine, Female, Sample collection, Pathogens, Cervical/vaginal smear, Martinique, Cancer Screening, Cancer Epidemiology, Research Article, Adult, medicine.medical_specialty, Human Papillomavirus Infection, Papillomaviruses, Science, Urology, Population, Sexually Transmitted Diseases, Microbiology, Specimen Handling, Young Adult, Signs and Symptoms, Diagnostic Medicine, medicine, Cancer Detection and Diagnosis, Humans, education, Microbial Pathogens, Caribbean, Biology and life sciences, business.industry, Genitourinary Infections, Papillomavirus Infections, Organisms, Human Papillomavirus, Cancers and Neoplasms, Cell Biology, medicine.disease, North America, Lesions, People and places, Clinical Medicine, business, DNA viruses, Cytology, Ascus, Gynecological Tumors
Abstract: The Caribbean ranks seventh among the world regions most affected by cervical cancer. HPV-prevalence and genotype distributions also differ from regions. Knowledge of HPV genotype profiles is important for patients care and HPV vaccination implementation. The objective of this study was to describe HPV genotype distribution and risk factors in a population-based cohort of women in Martinique. In this study, 1312 women were included and underwent cervical cancer screening with successful sample collection between 2009 and 2014. Sociodemographic and clinical variables were recorded. Cytological examination of cervical vaginal smear was performed and classified(Bethesda). Detection of HPV DNA was performed with the PapilloCheck© Kit from Greiner Bio-one. Genotypes were analyzed for18 high-risk HPV (hrHPV) and 6low-risk HPV(lrHPV) types. A total of 1075 women were included with a mean age of 49.1±10.5 years. HPV prevalence was 27.6% (297/1075) with 19.4% (209/1075) women with only hrHPV, 5.3% (57/1075) with only lrHPV. Multiple infections (hrHPV/lrHPV) were detected in 31/240 cases of hrHPV (12.9%). A total of 353 hrHPV genotypes were analyzed; the most common HPV types were HPV51 (11.0%), HPV68 (10.8%), HPV53 (9.1%) and HPV 52 (7.1%). HPV16 and HPV18 represented respectively 4.8% and 4.0% of hrHPV genotypes. Abnormal cytology was observed in 34 cases (3.2%), with 14 ASCUS (1.3%), 10 LSIL (0.9%), 5 HSIL (0.5%), 3 ASC-H (0.3%) and 2 AGC (0.2%). Fifteen (44.1%) were hrHPV and 4 (14.7%) lrHPV; 7 cases of hrPHV were in the age-group 25–34 years. Among 1041cases of normal cytology, 225 had positive hrHPV detection (21.6%). This is the first population-based study of HPV profiles in our country, and we found a high prevalence of hrHPV. The most common genotypes were HPV51, 68, 53. These results could serve for cancer vaccination strategies and HPV surveillance in Martinique.
Published: 2021
Full Text: View/download PDF

3. Seroprevalence of chikungunya virus infection among HIV-infected adults in French Caribbean Islands of Martinique and Guadeloupe in 2015: A cross-sectional study

Author: Cédric Laouénan, Bruno Hoen, Raymond Césaire, Elodie Curlier, Adrien Staelen, Ingrid Vingadassalom, Cécile Herrmann-Storck, Sandrine Pierre-François, Sébastien Breurec, Janick Jean-Marie, Laurence Fagour, Sylvie Abel, André Cabié, BONIZEC, Sandrine, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU de la Martinique [Fort de France], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-CHU de la Martinique [Fort de France], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, and CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA)
Subjects: RNA viruses, Male, Viral Diseases, Topography, Epidemiology, [SDV]Life Sciences [q-bio], RC955-962, HIV Infections, medicine.disease_cause, Pathology and Laboratory Medicine, Geographical locations, Serology, Disease Outbreaks, 0302 clinical medicine, Medical Conditions, Seroepidemiologic Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Arctic medicine. Tropical medicine, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Chikungunya, Prospective Studies, Guadeloupe, Islands, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Chikungunya Virus, Headache, virus diseases, Middle Aged, Arthralgia, 3. Good health, Infectious Diseases, Medical Microbiology, Viral Pathogens, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Population study, Female, medicine.symptom, Pathogens, Public aspects of medicine, RA1-1270, Martinique, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, Fever, Alphaviruses, 030231 tropical medicine, Population, Asymptomatic, Microbiology, Togaviruses, 03 medical and health sciences, Internal medicine, parasitic diseases, Seroprevalence, Humans, education, Microbial Pathogens, Caribbean, Landforms, Biology and life sciences, business.industry, Public Health, Environmental and Occupational Health, Organisms, Outbreak, Chikungunya Infection, Geomorphology, Myalgia, Exanthema, Tropical Diseases, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, North America, Earth Sciences, Chikungunya Fever, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, People and places, business
Abstract: Background In 2014, a first outbreak of chikungunya hit the Caribbean area where chikungunya virus (CHIKV) had never circulated before. Methodology/Principal findings We conducted a cross-sectional study to measure the seroprevalence of CHIKV immediately after the end of the 2014 outbreak in HIV-infected people followed up in two clinical cohorts at the University hospitals of Guadeloupe and Martinique. Study patients were identified during the first months of 2015 and randomly selected to match the age and sex distribution of the general population in the two islands. They were invited to complete a survey that explored the symptoms consistent with chikungunya they could have developed during 2014 and to have a blood sample drawn for CHIKV serology. The study population consisted of 377 patients (198 in Martinique and 179 in Guadeloupe, 178 men and 199 women), 182 of whom reported they had developed symptoms consistent with chikungunya. CHIKV serology was positive in 230 patients, which accounted for an overall seroprevalence rate of 61% [95%CI 56–66], with only 153 patients who reported symptoms consistent with chikungunya. Most frequent symptoms included arthralgia (94.1%), fever (73.2%), myalgia (53.6%), headache (45.8%), and skin rash (26.1%). Conclusions/Significance This study showed that the seroprevalence of CHIKV infection was 61% after the 2014 outbreak, with one third of asymptomatic infections. Trial registration ClinicalTrials.gov NCT 02553369., Author summary After the termination of the first documented outbreak of chikungunya in the Caribbean in 2014, the seroprevalence rate of CHIKV infection in French West Indies was estimated at 61% [95% CI 56.0–65.8] in a population-matched cohort of HIV-infected patients. This high seroprevalence may explain the abrupt and persistent cessation CHIKV circulation in these territories. One third of participants had not developed clinical symptoms of chikungunya.
Published: 2021
Full Text: View/download PDF

4. Incidence of diabetes in HIV-infected patients treated with first-line integrase strand transfer inhibitors: a French multicentre retrospective study

Author: P Fischer, C Aumeran, V Ronat, L Laine, S Bouchez, André Cabié, D Lambert, Eric Cua, J Pasquier, F Touam, Laurent Hocqueloux, A Maillard, O Deradji, Charlotte Charpentier, Véronique Avettand-Fenoel, Catherine Tamalet, Anne Frésard, Elodie Curlier, M Batard, S Ferrando, S Breaud, Philippe Bossi, C Pronier, C Gubavu, M Martin-Degiovani, Samira Fafi-Kremer, A. Duréault, Christian Pradier, A Montoya Ferrer, M Piffaut, Faiza Ajana, V Rio, A Maka, C Biron, Pierre Delobel, A de Monte, P Choisy, L Lelièvre, K Risso, N. Viget, Q Lepiller, Véronique Reliquet, I Perbost, Laurence Bocket, C Rioux, G Thomas, O. Aubry, L. Porte, Cédric Arvieux, Thomas Jovelin, Elisabeth Botelho-Nevers, Pierre-Marie Roger, C Etienne, David Boutoille, S Le Gac, Caroline Charlier, Virginie Ferré, M Pradier, M C Receveur, Isabelle Ravaux, Philippe Colson, K Rome, O Lesens, C Brunet-Cartier, A Meybeck, Romain Palich, P Martinet, V. Le Moing, C Ceppi, Hélène Laroche, I Lamaury, V Brodard, N Oran, M Lefebvre, P Morineau, K Guitteaud, M Bistoquet, Diane Descamps, O Cabras, Amandine Gagneux-Brunon, Brigitte Montes, Olivier Robineau, I Jaquet, Roland Landman, C Cheneau, V Mondain, Caroline Lions, Olivier Grossi, Laurent Boyer, C Debreux, M André, A Rodallec, Philippe Van de Perre, Jade Ghosn, Clotilde Allavena, Sylvie Abel, Karine Sauné, F Louni, F Boulard, Luminita Schneider, Dominique Merrien, D Chirio, S Pillet, Mathieu Dupont, A Motte, F Lemaitre, C Guennoun, Benoît Henry, S Sausse, Michel Vidal, M Mokhtari, O Zaegel-Faucher, Eric Rosenthal, Isabelle Poizot-Martin, Faouzi Souala, Matthieu Revest, M Baldeyrou, S Patrat-Delon, Jacques Reynes, M Cavellec, Laurent Cotte, C Michelangeli, François Danion, M Priester, Axel Ursenbach, C Mackoumbou-Nkouka, Thomas Perpoint, A Cheret, P Geneau de Lamarlière, Christian Rabaud, Agathe Becker, Tristan Ferry, A. Ivanova, Elina Teicher, T Bonijoly, F-Xavier Lescure, O Bollangier, A S Ritleng, Patrick Miailhes, A Gervais, Y N’guyen, Patrice Muret, Elisa Demonchy, Vincent Max, I Alcaraz, N Meftah, M P Bouillon, S Degroodt, A Foltzer, Laurent Hustache-Mathieu, Jean-Luc Berger, A Ménard, J Prouteau, B. Bonnet, Kevin Bouiller, Lise Cuzin, Christian Chidiac, R Agher, S Leautez, Catherine Chirouze, M Poinot, R Tubiana, E Aïssi, O Babre, J Lourenco, Benoit Tressières, C Clavel, Cécile Goujard, A Brunet, Claire Triffault-Fillit, F Raffi, E Sidani, Anne-Sophie Brunel, A Madrid, B Prouvost-Keller, Eric Delaporte, M J Soavi, J. M. Chapplain, M Orticoni, Pascal Pugliese, V Corbin, Pierre Tattevin, C Boulard, Véronique Obry-Roguet, P. Loubet, Paul-Henri Consigny, Elisabeth André-Garnier, J Sinteff, S Lariven, A Boucher, N Lerolle, C Blanc, Y Quertainmont, Sylvie Bregigeon, Bruno Hoen, André Boibieux, S Casanova, N Atoui, C Dhiver, N Biezunski, R Ouissa, M. Hentzien, C Bernard-Henry, Sophie Matheron, Cécile Herrmann-Storck, Firouzé Bani-Sadr, I Touitou, Eric Billaud, I Kmiec, Benoit Pilmis, T Prazuck, Romain Guery, Karima Amazzough, C Merle de Boever, Marine Morrier, T Guimard, M Poisson-Vanier, H Laurichesse, Catherine Varache, J Goesch, Guillaume Martin-Blondel, Z Julia, M Ducassou, F. Lucht, B Lafon-Desmurs, Martine Valette, A Sève, Marc-Antoine Valantin, G Zouzou, A Barrail-Tran, M Delestan, M. Alvarez, A Naqvi, Colin Deschanvres, A Raoux, L Meddeb, Rodolphe Garraffo, C Daniel, T May, A. Galinier, François Bénézit, Yazdan Yazdanpanah, Veronique Joly, Olivier Lortholary, C Louisin, K Jidar, I Fabre, Cyrille Delpierre, Christine Katlama, P Parize, S Galie, Claudine Duvivier, P. Dellamonica, L Osei, C Drobacheff-Thiébaut, Sandrine Pierre-François, G Cessot, C. Tomei, F. Biron, Christine Jacomet, G Benabdelmoumen, Florence Ader, David Rey, Marialuisa Partisani, J Turmel, J. Durant, S Seang, F. Bozon, M Illiaquer, N Hall, Edouard Tuaillon, S. Roux, Florent Valour, A. Belkhir, Marine Maurel, V Baclet, N Mrozek, Olivier Baud, S Sécher, P Letertre-Gibert, Alexa Debard, E de Mautort, Fanny Lanternier, Alain Makinson, H. Tissot Dupont, P Lansalot, E Ressiot, T. Huleux, S Wehrlen-Pugliese, M Landon, C Brochier, C Bernaud, Gilles Peytavin, A Soria, Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Service de pharmacologie, Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Universitaire de Reims (CHU Reims), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre Hospitalier Universitaire de Reims (CHU Reims), Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP), Université Jean Monnet [Saint-Étienne] (UJM), School of Civil and Environmental Engineering [Sydney], University of New South Wales [Sydney] (UNSW), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Integrase inhibitor, HIV Infections, HIV Integrase, Diabetes Therapy, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Diabetes mellitus, medicine, Diabetes Mellitus, Humans, Pharmacology (medical), 030212 general & internal medicine, HIV Integrase Inhibitors, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Pharmacology, Integrases, business.industry, Incidence, Retrospective cohort study, Raltegravir, medicine.disease, Comorbidity, 3. Good health, 030104 developmental biology, Infectious Diseases, chemistry, Dolutegravir, business, medicine.drug, Cohort study
Abstract: BackgroundIntegrase strand transfer inhibitors (INSTIs) are increasingly used in patients living with HIV due to their safety, effectiveness and high genetic barrier. However, an association with weight gain has recently been suggested and several cases of diabetes mellitus have been reported with raltegravir and dolutegravir. The long-time metabolic impact of these recent molecules remains unclear.ObjectivesTo assess if an INSTI as a third agent is statistically associated with new-onset diabetes mellitus compared with an NNRTI or a PI.Patients and methodsPatients undergoing first-line combined ART (cART) without diabetes at baseline were retrospectively included from the Dat’AIDS French cohort study (ClinicalTrials.gov NCT02898987). Incident diabetes mellitus was defined as a notification of new diabetes in the medical history, a glycated haemoglobin (HbA1c) level superior to 7.5% or the start of a diabetes therapy following the initiation of ART.ResultsFrom 2009 to 2017, 19 462 patients were included, among which 265 cases of diabetes mellitus occurred. Multivariate and survival analyses did not highlight an increase in new-onset diabetes in patients undergoing cART with an INSTI as a third agent compared with an NNRTI or a PI. BMI >30 kg/m2, age >37 years old (in survival analysis), black race or Hispanic ethnicity, arterial hypertension and AIDS were associated with a higher proportion of incident diabetes.ConclusionsINSTIs were not statistically associated with new-onset diabetes. However, clinicians should remain aware of this possible metabolic comorbidity, particularly in patients with a high BMI and older patients.
Published: 2020
Full Text: View/download PDF

5. Reaching the Second and Third Joint United Nations Programme on Human Immunodeficiency Virus (HIV)/AIDS 90-90-90 Targets Is Accompanied by a Dramatic Reduction in Primary HIV Infection and in Recent HIV Infections in a Large French Nationwide HIV Cohort

Author: Claudine Duvivier, Clotilde Allavena, J Lippmann, P. Dellamonica, A Soria, Sandrine Pierre-François, B J Gaborit, Isabelle Poizot-Martin, Anne Frésard, Elodie Curlier, F. Biron, Eric Cua, M Saadia Mokhtari, I Luquet Besson, C Gubavu, Caroline Lions, Laurent Cotte, C. Tomei, Elina Teicher, Faouzi Souala, Karima Amazzough, C Merle de Boever, Romain Palich, C Brochier, Véronique Reliquet, Patrick Miailhes, M Priester, Samira Fafi-Kremer, Mathieu Dupont, M Piffaut, I. Schlienger, C Bernaud, A S Ritleng, F-Xavier Lescure, C Cheneau, L Lelièvre, C Biron, Adrien Le Guillou, Alexa Debard, Marc-Antoine Valantin, Gilles Peytavin, S Lariven, G Benabdelmoumen, Florence Ader, I Kmiec, I Fabre, Cyrille Delpierre, C. Longuet, François Raffi, A de Monte, M. Alvarez, David Rey, A Boucher, M. Valette, E de Mautort, Jean-Luc Berger, H Bertone, Bruno Hoen, M Poisson-Vanier, Pascal Pugliese, Virginie Ferré, M Pradier, Z Julia, Nathalie Dournon, M Baldeyrou, N Biezunski, Caroline Charlier, J Goesch, J Pasquier, M P Bouillon, Cécile Goujard, Sophie Matheron, V. Le Moing, Romain Guery, N. Viget, N Atoui, C Dhiver, A Meybeck, Fanny Lanternier, F Touam, Tristan Ferry, M Carta Padovani, G Thomas, C Ceppi, A Brunet, Alain Makinson, Isabelle Ravaux, Laurent Hocqueloux, A Maillard, Firouzé Bani-Sadr, P. Loubet, Laurent Boyer, O Deradji, I Alcaraz, T Prazuck, A Rodallec, F Lemaitre, B Lafon-Desmurs, J Turmel, A Sève, Benoit Pilmis, A Gervais, C. Augustin-Normand, D Chirio, Brigitte Montes, Cédric Arvieux, V Brodard, M Delestan, E Aïssi, C Louisin, Christian Chidiac, M Ducassou, S Leautez, Catherine Chirouze, M André, Dominique Merrien, Q Gardiennet, P Fischer, Sylvie Abel, Guillaume Martin-Blondel, Benoît Henry, H. Tissot Dupont, S Patrat-Delon, A Ménard, E. Billaud, Malikhone Chansombat, K Jidar, Karine Sauné, Colin Deschanvres, V. Gueripel, M Cavellec, K. Schepers, C Pronier, R Ouissa, P Choisy, A Cheret, A. Belkhir, P Parize, A Barrail-Tran, B. Bonnet, C Mackoumbou-Nkouka, A. Galinier, M Monclar, P Lansalot, S Bouchez, C Guennoun, N Meftah, C Brunet-Cartier, Pierre Tattevin, J. Durant, E Ressiot, T. Huleux, François Bénézit, C Boulard, M Poinot, Elisabeth André-Garnier, J Sinteff, André Cabié, Charlotte Charpentier, L Meddeb, Rodolphe Garraffo, M Batard, D. Lebrun, R Tubiana, M J Soavi, I Lamaury, Philippe Bossi, Y Quertainmont, S Galie, C Michelangeli, François Danion, N Lerolle, Y N’guyen, Amandine Gagneux-Brunon, Elisa Demonchy, Christine Katlama, C Bernard-Henry, V Mondain, S Seang, David Boutoille, P. Le Turnier, Faiza Ajana, André Boibieux, J Koffi, L. Porte, Laurence Bocket, O Bollangier, A Maka, S Sécher, Marine Morrier, T Guimard, Matthieu Revest, C Godard, C Rioux, C Etienne, M Illiaquer, O. Aubry, N Hall, Paul-Henri Consigny, C Blanc, P Morineau, K Guitteaud, T. Perpoint, G Cessot, V Baclet, Lise Cuzin, T May, E Braun, Marialuisa Partisani, Veronique Joly, Jacques Reynes, Olivier Lortholary, C Blanco-Betancourt, Philippe Van de Perre, D Lambert, Moustapha Dramé, S Ferrando, S Breaud, A Montoya Ferrer, Yazdan Yazdanpanah, M. Hentzien, Cécile Herrmann-Storck, A. Duréault, A. Ivanova, F. Lucht, Pierre Delobel, Thomas Jovelin, J. M. Chapplain, Olivier Robineau, Roland Landman, Olivier Grossi, F Louni, Elisabeth Botelho-Nevers, J Lourenco, M Lefebvre, Diane Descamps, Luminita Schneider, R Agher, M Orticoni, D Rahli, S Degroodt, CHU de la Martinique [Fort de France], Centre Hospitalier Universitaire de Nice (CHU Nice), Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Department of Infectious Diseases [Nantes], Hôtel-Dieu de Nantes, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Infectious Diseases and Tropical Medicine Unit [Fort-de-France, Martinique], Centre Hospitalier Universitaire de Reims (CHU Reims), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Département de maladies infectieuses, and Hospices Civils de Lyon (HCL)
Subjects: 0301 basic medicine, Microbiology (medical), Cart, medicine.medical_specialty, Longitudinal study, business.industry, Public health, Incidence (epidemiology), medicine.disease, 030112 virology, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Interquartile range, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Epidemiology, Cohort, Medicine, 030212 general & internal medicine, business
Abstract: Background In late 2013, France was one of the first countries to recommend initiation of combination antiretroviral therapy (cART) irrespective of CD4 cell count. Methods To assess the impact of achieving the second and third Joint United Nations Programme on HIV/AIDS 90-90-90 targets (ie, 90% of diagnosed people on sustained cART, and, of those, 90% virologically controlled) on human immunodeficiency virus (HIV) incidence, we conducted a longitudinal study to describe the epidemiology of primary HIV infection (PHI) and/or recent HIV infection (patients with CD4 cell count ≥500/mm3 at HIV diagnosis; (PRHI) between 2007 and 2017 in a large French multicenter cohort. To identify changes in trends in PHI and PRHI, we used single breakpoint linear segmented regression analysis. Results During the study period, 61 822 patients were followed in the Dat’AIDS cohort; 2027 (10.0%) had PHI and 7314 (36.1%) had PRHI. The second and third targets were reached in 2014 and 2013, respectively. The median delay between HIV diagnosis and cART initiation decreased from 9.07 (interquartile range [IQR], 1.39–33.47) months in 2007 to 0.77 (IQR, 0.37–1.60) months in 2017. A decrease in PHI (−35.1%) and PRHI (−25.4%) was observed starting in 2013. The breakpoints for PHI and PRHI were 2012.6 (95% confidence interval [CI], 2010.8–2014.4) and 2013.1 (95% CI, 2011.3–2014.8), respectively. Conclusions Our findings show that the achievements of 2 public health targets in France and the early initiation of cART were accompanied by a reduction of about one-third in PHI and PRHI between 2013 and 2017. Clinical Trials Registration NCT02898987.
Published: 2020
Full Text: View/download PDF

6. Health informatics support for outbreak management: How to respond without an electronic health record?

Author: Moustapha Dramé, Hossein Mehdaoui, Papa Gueye, Sandrine Pierre-François, Sylvie Abel, Fatiha Najioullah, Emmanuelle Sylvestre, André Cabié, Cyrille Chabartier, Elsa Cecilia-Joseph, René Michel Thuny, Yannick Brouste, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU de la Martinique [Fort de France], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre d'Investigation Clinique Antilles Guyane [Cayenne, Guyane française], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], MQ0019176, European Regional Development Fund ERDF and the Martinique Territorial Authority, Jonchère, Laurent, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Health informatics, 2019-20 coronavirus outbreak, 020205 medical informatics, AcademicSubjects/SCI01060, Pneumonia, Viral, 02 engineering and technology, Digital Divide, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Electronic health record, Pandemic, Correspondence, 0202 electrical engineering, electronic engineering, information engineering, medicine, Electronic Health Records, Humans, Martinique, 030212 general & internal medicine, Digital divide, Pandemics, ComputingMilieux_MISCELLANEOUS, AcademicSubjects/MED00580, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Internet, business.industry, pandemic, Outbreak, COVID-19, medicine.disease, Triage, 3. Good health, Databases as Topic, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Electronic Health Record, Medical emergency, AcademicSubjects/SCI01530, business, Coronavirus Infections, Medical Informatics
Abstract: International audience
Published: 2020
Full Text: View/download PDF

7. The effects of chikungunya virus infection on people living with HIV during the 2014 Martinique outbreak

Author: Lise Cuzin, Sabine Molcard, Fatiha Najioullah, Laurence Fagour, Raymond Césaire, André Cabié, Mathilde Pircher, Sandrine Pierre-François, Lauren Brunier-Agot, Sylvie Abel, Edwin Pitono, Infectious Diseases and Tropical Medicine Unit [Fort-de-France, Martinique], CHU de la Martinique [Fort de France], Unit of Physical and Rehabilitation Medicine [Fort-de-France, Martinique], Department of Rheumatology [Fort-de-France, Martinique], Laboratoire de Virologie [Fort-de-France, Martinique], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), and Bodescot, Myriam
Subjects: RNA viruses, Male, Viral Diseases, Pulmonology, Epidemiology, HIV Infections, medicine.disease_cause, Pathology and Laboratory Medicine, Geographical locations, Disease Outbreaks, White Blood Cells, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Animal Cells, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Chikungunya, Young adult, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, education.field_of_study, Multidisciplinary, Chikungunya Virus, T Cells, virus diseases, Middle Aged, 3. Good health, Infectious Diseases, Medical Microbiology, Viral Pathogens, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, HIV clinical manifestations, Female, Pathogens, Cellular Types, Martinique, Viral load, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, Adolescent, Science, Alphaviruses, Immune Cells, 030231 tropical medicine, Population, Immunology, Cytotoxic T cells, Microbiology, Virus, Togaviruses, 03 medical and health sciences, Young Adult, Internal medicine, Humans, education, Microbial Pathogens, Caribbean, Blood Cells, Biology and life sciences, business.industry, Organisms, Outbreak, Chikungunya Infection, Cell Biology, Tropical Diseases, Diagnostic medicine, Respiratory Infections, North America, Chronic Disease, Chikungunya Fever, People and places, business
Abstract: International audience; Our objective was to describe the clinical presentation of chikungunya virus (CHIKV) infection in patients living with HIV (PLHIV) during the 2014 Martinique outbreak. During the outbreak and the 6 following months, all PLHIV coming in our unit for a medical evaluation answered questions about potential CHIKV related symptoms, and had blood tests to assess the diagnosis. For patients coming in at the acute phase of infection, we are able to provide and analyze CD4+, CD8+ T-cells and HIV viral load evolution before, during and after CHIK infection. Among the 1 003 PLHIV in care in the center at the time of the outbreak, 188 (94 men and 94 women) had confirmed (following the WHO definition) CHIKV infection. Clinical presentation was common in 63% of the cases, severe and atypical forms were scarce. During the acute phase, CD4+ and CD8+ T-cells (evaluated in 30 PLHIV, 15 men and 15 women) absolute numbers dropped significantly, but returned to pre-CHIKV values after the acute phase. Reassuringly, CD4 and CD8 T cells proportions did not decrease during the acute phase. CHIKV infection had no significant impact on this anti-retroviral treated population.
Published: 2020
Full Text: View/download PDF

8. Outbreak of Chikungunya in the French Caribbean Islands of Martinique and Guadeloupe: Findings from a Hospital-Based Surveillance System (2013–2015)

Author: Marie-José Romagne, Frédérique Dorléans, Elise Daudens-Vaysse, Annabel Preira, Laurence Fagour, Stéphanie Guyomard, Frédérique de Saint-Alary, Jacques Rosine, Isabelle Lamaury, Ghislain Leduc, Alexandra Septfons, Magguy Davidas, Marie-Claire Paty, A. Blateau, Sylvie Cassadou, K. Schepers, Fatiha Najioullah, Séverine Rochais, Cécile Herrmann-Storck, Luisiane Carvalho, Martine Ledrans, Amandine Vaidie, André Cabié, Patrick Saint-Martin, Mathilde Melin, Ruth Troudard, Bruno Hoen, Raymond Césaire, Sylvie Boa, Yvette Adélaïde, and Sylvie Abel
Subjects: medicine.medical_specialty, Pediatrics, 030231 tropical medicine, Population, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Virology, Medicine, 030212 general & internal medicine, Chikungunya, education, education.field_of_study, business.industry, Transmission (medicine), Public health, Medical record, Outbreak, virus diseases, Articles, 3. Good health, Infectious Diseases, Public hospital, Parasitology, business, Martinique
Abstract: Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.
Published: 2018

9. Assessing Zika Virus Transmission within Households during an Outbreak in Martinique, 2015-2016

Author: Minerva Cervantes, Sylvie Abel, Henrik Salje, Simon Cauchemez, Alice Monthieux, Fatiha Najioullah, Raymond Césaire, Cédric Laouénan, Mathilde Pircher, Pierre Gallian, André Cabié, Alessio Andronico, Isabelle Calmont, Anthony Cousien, Xavier de Lamballerie, Sandrine Pierre-François, Quirine A. ten Bosch, Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), CHU de la Martinique [Fort de France], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, This work was supported by the European Union’s Horizon 2020 Programme through ZIKAlliance (grant 734548), the Investissements d’Avenir program, the Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases program (ANR-10-LABX-62-IBEID), the Models of Infectious Disease Agent Study of the National Institute of General Medical Sciences, the AXA Research Fund, the INCEPTION project (PIA/ANR-16-CONV-0005). The CARBO cohort was fund by the French Ministry of Health (Soutien Exceptionnel à la Recherche et à l’Innovation) and the protocol was prepared with the help of the INSERM Research and Action Targeting Emerging Infectious Disease (REACTing) network., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), European Project: 734548,ZIKAlliance(2016), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Salje, Henrik [0000-0003-3626-4254], Apollo - University of Cambridge Repository, Dubois Frid, Caroline, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs - - INCEPTION2016 - ANR-16-CONV-0005 - CONV - VALID, and A global alliance for Zika virus control and prevention - ZIKAlliance - 2016-10-01 - 2019-09-30 - 734548 - VALID
Subjects: Male, asymptomatic infections, Practice of Epidemiology, Epidemiology, [SDV]Life Sciences [q-bio], law.invention, Zika virus, Disease Outbreaks, 0302 clinical medicine, law, Aedes, Pregnancy, Risk Factors, household transmission, Credible interval, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, 0303 health sciences, education.field_of_study, Family Characteristics, biology, Zika Virus Infection, 3. Good health, [SDV] Life Sciences [q-bio], Transmission (mechanics), Female, medicine.symptom, Martinique, endocrine system, Population, Mosquito Vectors, Asymptomatic, final size model, 03 medical and health sciences, Disease Transmission, Infectious, Seroprevalence, Animals, Humans, education, 030304 developmental biology, business.industry, Outbreak, biology.organism_classification, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract: Since 2015, Zika virus (ZIKV) has caused large epidemics in the Americas. Households are natural targets for control interventions, but quantification of the contribution of household transmission to overall spread is needed to guide policy. We developed a modeling framework to evaluate this contribution and key epidemic features of the ZIKV epidemic in Martinique in 2015–2016 from the joint analysis of a household transmission study (n = 68 households), a study among symptomatic pregnant women (n = 281), and seroprevalence surveys of blood donors (n = 457). We estimated that the probability of mosquito-mediated within-household transmission (from an infected member to a susceptible one) was 21% (95% credible interval (CrI): 5, 51), and the overall probability of infection from outside the household (i.e., in the community) was 39% (95% CrI: 27, 50). Overall, 50% (95% CrI: 43, 58) of the population was infected, with 22% (95% CrI: 5, 46) of infections acquired in households and 40% (95% CrI: 23, 56) being asymptomatic. The probability of presenting with Zika-like symptoms due to another cause was 16% (95% CrI: 10, 23). This study characterized the contribution of household transmission in ZIKV epidemics, demonstrating the benefits of integrating multiple data sets to gain more insight into epidemic dynamics.
Published: 2019
Full Text: View/download PDF

10. High prevalence of human papillomavirus infection in HIV-infected women living in French Antilles and French Guiana

Author: Raymond Césaire, Akua Codjo-Sodokine, Fatiha Najioullah, Jean-Luc Voluménie, C Clavel, Déborah Chiappetta, Sylvie Abel, S. Stegmann-Planchard, Mathieu Nacher, Vincent Vantilcke, Dominique Catherine, Vincent Molinié, Laetitia Accrombessi, Gabriel Carles, Sandrine Pierre-François, Tania Vaz, Myriam El Guedj, André Cabié, and Janick Jean-Marie
Subjects: RNA viruses, Viral Diseases, European People, Cross-sectional study, HIV Infections, Pathology and Laboratory Medicine, Cervical Cancer, 0302 clinical medicine, Immunodeficiency Viruses, Genotype, Medicine and Health Sciences, Prevalence, Ethnicities, Public and Occupational Health, French People, 030212 general & internal medicine, Guadeloupe, Papillomaviridae, Cervical cancer, education.field_of_study, Multidisciplinary, HPV infection, virus diseases, HIV diagnosis and management, Middle Aged, Vaccination and Immunization, female genital diseases and pregnancy complications, French Guiana, Infectious Diseases, Oncology, Anti-Retroviral Agents, Medical Microbiology, Viral Pathogens, 030220 oncology & carcinogenesis, Viruses, RNA, Viral, Medicine, Female, Pathogens, Research Article, Adult, Human Papillomavirus Infection, medicine.medical_specialty, Papillomaviruses, Alcohol Drinking, Urology, Science, Immunology, Population, Sexually Transmitted Diseases, Antiretroviral Therapy, Lower risk, Microbiology, 03 medical and health sciences, Antiviral Therapy, Internal medicine, Retroviruses, medicine, Humans, Human papillomavirus, education, Microbial Pathogens, Genitourinary Infections, business.industry, Public health, Lentivirus, Papillomavirus Infections, Organisms, Biology and Life Sciences, HIV, Human Papillomavirus, Cancers and Neoplasms, medicine.disease, Diagnostic medicine, Cross-Sectional Studies, People and Places, HIV-1, Population Groupings, Preventive Medicine, DNA viruses, business, Gynecological Tumors
Abstract: An association between HIV infection and cervical cancer, a major public health issue worldwide, has been reported. The aim of this study was to estimate the prevalence of human papillomavirus (HPV) infection and the distribution of HPV genotypes in HIV-infected women living in French Antilles and Guiana and to determine HIV-related characteristics associated with HPV infection. This cross-sectional study included 439 HIV-infected women who were followed between January 2011 and May 2014. Variables related to HIV infections were collected, and cervical samples were analysed to determine HPV genotypes. The median age of the population was 46 years. Estimated prevalence of HPV and high-risk (HR)-HPV infection were 50.1% IC95 [45.4-54.7] and 42% IC95 [37.3-46.6], respectively. HR-HPV 16, 52, 53 or intermediate risk-HPV-68 were found in 25% to 30% of the HPV-infected patients. Gynaecological screening revealed abnormal cervical smear in 24% and 42% of HR-HPV-negative and HPV-positive women, respectively (p = 0.003). Approximately 90% of women were on antiretroviral therapy (ART). Demographic characteristics associated with a higher prevalence of HPV infection included alcohol consumption. Regarding HIV-related characteristics, current therapy on ART, its duration, and undetectable plasma concentrations of RNA-HIV1 were associated with a lower risk of HPV infection. Infection rate with HR-HPV was higher than what is commonly reported in HIV-negative women worldwide and was more likely in women with incomplete HIV suppression. These results highlight the need for supporting adherence to ART, cervical cytology, HPV testing and HPV vaccination.
Published: 2019

11. Factors associated with deaths from suicide in a French nationwide HIV-infected cohort

Author: Maxime HENTZIEN, Isabelle Poizot-Martin, Tristan Ferry, Firouzé BANI-SADR, Pierre Delobel, Cyrille Delpierre, Bruno MARCHOU, Florence ADER, André Cabié, Sylvie ABEL, Guillaume Martin-Blondel, Moustapha Dramé, Département de Médecine Interne, Immunologie clinique et maladies infectieuses [CHU Reims], Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Service de Maladies Infectieuses [Nice], Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Département d'Hématologie [APHM - Assistance Publique - Hôpitaux de Marseille], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Pédiatrie et maladies infectieuses [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Psychiatrie pour Adultes [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Département de la recherche et de la santé publique [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital universitaire Robert Debré [Reims], Santé publique, vieillissement, qualité de vie et réadaptation des sujets fragiles - EA 3797 (SPVQVRSF), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Dat'AIDS Study Group : Dellamonica P, Cuzin L, Yazdanpanah Y, Raffi F, Cabié A, Garraffo R, Delpierre C, Allavena C, Katlama C, Hoen B, Peytavin G, Jacomet C, Rey D, Delobel P, Cheret A, Chidiac C, Isnard-Bagnis C, Cotte L, Peyramond D, Joly V, Jovelin T, Saune K, Roger PM, Chirouze C, May T, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Carta-Padovani M, Ducassou MJ, Jaquet I, Galie S, Galinier A, Martinet P, Landon M, Ritleng AS, Ivanova A, Blanco-Betancourt C, Debreux C, Lions C, Alvarez M, Biezunski N, Debard A, Fourcade C, Marchou B, Martin-Blondel G, Porte L, Mularczyk M, Garipuy D, Lepain I, Marcel M, Metsu D, Puntis E, Bentz L, Ceppi C, Cua E, Cottalorda J, Durant J, Ferrando S, Fuzibet JG, Mondain V, Naqvi A, Perbost I, Pillet S, Prouvost-Keller B, Pradier C, Wehrlen-Pugliese S, Rosenthal E, Biron C, Bonnet B, Bouchez S, Boutoille D, Khatchatourian L, Brunet C, Hall N, Bernaud C, Morineau P, Reliquet V, Aubry O, Point P, Besnier M, Hüe H, Cavellec M, Soria A, Sécher S, André-Garnier E, Rodallec A, Ferré V, Leguen L, Lefebvre M, Grossi O, Choisy P, Agher R, Abel S, Pierre-François S, Liautaud B, Fischer P, Partisani M, Cheneau C, Priester M, Bernard-Henry C, Batard ML, E Mautort E, Gardiennet Q, Berger JL, N'Guyen Y, Lambert D, Lebrun D, Migault C, Kmiec I, Brodard V, Ferry T, Ader F, Biron F, Boibieux A, Miailhes P, Perpoint T, Schlienger I, Lippmann J, Braun E, Koffi J, Longuet C, Guéripel V, Augustin-Normand C, Brochier C, Degroodt S., CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), CHU Fort de France-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, and Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]
Subjects: 0301 basic medicine, medicine.medical_specialty, Population, Alcohol abuse, Suicide prevention, 03 medical and health sciences, 0302 clinical medicine, Psychiatric history, Acquired immunodeficiency syndrome (AIDS), Epidemiology, medicine, Pharmacology (medical), 030212 general & internal medicine, education, education.field_of_study, business.industry, Health Policy, medicine.disease, 030112 virology, 3. Good health, Infectious Diseases, Psychotropic drug, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract: International audience; OBJECTIVES:People living with HIV (PLHIV) are at a higher risk of dying by suicide than the general population. Epidemiological data regarding determinants of suicide in PLHIV are scarce. The aim of this study was thus to study demographic, socio-economic, psychiatric history and immunovirological characteristics associated with death from suicide in the French multicenter Dat'AIDS cohort, from January 2000 to July 2013.METHODS:This was a nested case-control study. All deceased PLHIV during the study period who died by suicide and whose medical files could be checked were included as cases. Controls were selected using incidence density sampling. For each case, up to four controls were selected among all actively followed PLHIV at the index date (date of death of cases). Controls were matched for time from HIV diagnosis (5-year periods) and clinical centre.RESULTS:Seventy cases and 279 controls were included in the study. By multivariable analysis, the factors significantly associated with death from suicide were: not having children, active or substituted drug consumption, alcohol intake > 20 g/day or history of alcohol abuse, history of depressive disorder and/or of attempted suicide, and psychotropic drug intake. Conversely, age, gender, country of birth, positive HCV serology and HIV-related factors, such as AIDS status, use of combination antiretroviral therapy (cART), nadir and current CD4 counts and HIV viral load, were not significantly associated with the risk of death from suicide.CONCLUSIONS:In the cART era, HIV-related factors are not associated with a higher risk of suicide mortality. Suicide prevention measures should target PLHIV with the psychological morbidities observed in our cohort
Published: 2018
Full Text: View/download PDF

12. Dual treatment with lopinavir–ritonavir plus lamivudine versus triple treatment with lopinavir–ritonavir plus lamivudine or emtricitabine and a second nucleos(t)ide reverse transcriptase inhibitor for maintenance of HIV-1 viral suppression (OLE): a randomised, open-label, non-inferiority trial

Author: Federico Pulido, Esteban Ribera, ANTONIO OCAMPO HERMIDA, Ignacio Pérez Valero, Josep Mallolas Masferrer, Maria Milagro Montero, Vicente Estrada, Juan González-García, Maria Luisa Montes, Vicente Boix, Marta Montero, Pablo Ryan, Esperanza Merino de Lucas, Jesús Troya García, José Ignacio Bernardino, André Cabié, Maria De Lagarde, Sylvie ABEL, Rafael Rubio García, Jordi Navarro, Hernando Knobel, Jose Luis Casado, Jose Arribas, and Joaquín Portilla
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, Population, Lopinavir/ritonavir, HIV Infections, Emtricitabine, Deoxycytidine, Gastroenterology, Lopinavir, Maintenance Chemotherapy, Internal medicine, medicine, Humans, education, education.field_of_study, Ritonavir, Reverse-transcriptase inhibitor, business.industry, virus diseases, Lamivudine, HIV Protease Inhibitors, Middle Aged, Viral Load, Hepatitis B, medicine.disease, CD4 Lymphocyte Count, Intention to Treat Analysis, Surgery, Infectious Diseases, HIV-1, RNA, Viral, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, business, medicine.drug
Abstract: Summary Background Our objective was to assess therapeutic non-inferiority of dual treatment with lopinavir–ritonavir and lamivudine to triple treatment with lopinavir–ritonavir plus two nucleos(t)ides for maintenance of HIV-1 viral suppression. Methods In this randomised, open-label, non-inferiority trial, we recruited patients from 32 HIV units in hospitals in Spain and France. Eligible patients were HIV-infected adults (aged ≥18 years) with HIV-1 RNA of less than 50 copies per mL, for at least 6 months on triple treatment with lopinavir–ritonavir (twice daily) plus lamivudine or emtricitabine and a second nucleos(t)ide, with no resistance or virological failure to these drugs, and no positive hepatitis B serum surface antigen. Investigators at each centre randomly assigned patients (1:1; block size of four; stratified by time to suppression [ 1 year] and nadir CD4 cell count [ 100 cells per μL]; computer-generated random sequence) to continue triple treatment or switch to dual treatment (oral lopinavir 400 mg and oral ritonavir 100 mg twice daily plus oral lamivudine 300 mg once daily). The primary endpoint was response to treatment in the intention-to-treat population (all randomised patients) at 48 weeks. The non-inferiority margin was 12%. This study is registered with ClinicalTrials.gov, number NCT01471821. Findings Between Oct 1, 2011, and April 1, 2013, we randomly assigned 250 participants to continue triple treatment (127 [51%] patients) or switch to dual treatment (123 [49%] patients). In the intention-to-treat population, 110 (86·6%) of 127 patients in the triple-treatment group responded to treatment versus 108 (87·8%) of 123 in the dual-treatment group (difference −1·2% [95% CI −9·6 to 7·3]; p=0·92), meeting the criteria for non-inferiority. Serious adverse events occurred in eight (7%) patients in the triple-treatment group and five (4%) in the dual-treatment group (p=0·515), and study drug discontinuations due to adverse events occurred in four (3%) in the triple-treatment group and one (1%) in the dual-treatment group (p=0·223). Interpretation Dual treatment with lopinavir–ritonavir plus lamivudine has non-inferior therapeutic efficacy and is similarly tolerated to triple treatment. Funding AbbVie and Red Tematica Cooperativa de Investigacion en Sida.
Published: 2015
Full Text: View/download PDF

13. Risk of Diabetes in HIV-infected Patients Is Associated with Cirrhosis but Not with Chronic HCV Coinfection in a French Nationwide HIV Cohort

Author: Maxime HENTZIEN, Isabelle Poizot-Martin, Tristan Ferry, Firouzé BANI-SADR, Pierre Delobel, Cyrille Delpierre, Bruno MARCHOU, Florence ADER, André Cabié, Sylvie ABEL, Guillaume Martin-Blondel, Moustapha Dramé, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Reims (CHU Reims), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Service d'infectiologie [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Population, HIV Infections, Hepacivirus, Lower risk, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Internal medicine, Diabetes Mellitus, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, education, education.field_of_study, Hepatology, business.industry, Coinfection, Incidence, Gastroenterology, virus diseases, HIV, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, digestive system diseases, CD4 Lymphocyte Count, Cohort, 030211 gastroenterology & hepatology, Female, France, business, Viral load, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study
Abstract: BACKGROUND Both human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections have been reportedly associated with a higher risk of diabetes mellitus (DM) but results are conflicting. AIMS To determine whether there is an association between chronic HCV and the incidence of DM, and to study the role of factors such as cirrhosis, IFN-based HCV therapy, sustained virologic response (SVR) and chronic HBV infection among patients living with HIV (PLHIV) followed in a large French multicentre cohort in the combination antiretroviral therapy (cART) era. METHODS All PLHIV followed up in the Dat'AIDS cohort were eligible. Cox models for survival analysis were used to study the time to occurrence of DM. RESULTS Among 28 699 PLHIV, 4004 patients had chronic HCV infection. The mean duration of HCV follow-up was 12.5 ± 8.1 years. The rate ratio of DM was 2.74 per 1000 person-years. By multivariate analysis, increasing age, body mass index>25, AIDS status, nadir CD4 cell count ≤200/mm3 , detectable HIV viral load and cirrhosis (HR 2.26 95% CI 1.14-1.18; P
Published: 2018
Full Text: View/download PDF

14. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study

Author: Benoît, Rozé, Fatiha, Najioullah, Jean-Louis, Fergé, Frédérique, Dorléans, Kossivi, Apetse, Jose-Luis, Barnay, Elise, Daudens-Vaysse, Yannick, Brouste, Raymond, Césaire, Laurence, Fagour, Ruddy, Valentino, Martine, Ledrans, Hossein, Mehdaoui, Sylvie, Abel, Isabelle, Leparc-Goffart, Aissatou, Signate, André, Cabié, Rosalie, Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité de soins intensifs [CHU Martinique], Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Unité Régionale Antilles Guyane [Saint-Maurice] (Agence Nationale de la Santé Publique ), Département d'Electrophysiologie [Fort de France, Martinique], Unité de Réhabilitation [Fort de France, Martinique], Hôpital Le Lamentin Bourg [CHU de la Martinique], Service d'Urgence [Fort de France, Martinique], Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), This research was sponsored by University Hospital of Martinique (UHM) for regulatory and ethic submission and supported by the Clinical Research Hospital Program from the French Ministry of Health (PHRC 2009, NCT01099852). This research was support by the French network for Research and Action targeting emerging infectious diseases (REACTING)., Guillain-Barré Syndrome Zika Working Group of Martiniquea : Gwenole Jean Abgrall, Véronique Aïm, Alessandro Arrigo, Philippe Cabre, Cyrille Chabartier, Sylvie Colombani, Julien Cuziat, Christophe Deligny, Nicole Desbois, Anne-Laure Dessoy, Gaëlle Dunoyer, Régis Duvauferrier, N’Guyen Duc, Mireille Edimonana, Pierre Garrigou, Stéphane Gaucher, Sarah Gourgoudou, Karine Guitteaud, Patrick Hochedez, Gwladys Ivanes, Yolène Jacquens, Sandrine Julié, Armelle Jean-Etienne, Séverine Jeannin, Joux Julien, Pasquier Jérémie, Jean- Louis Lamaignère, Ingrid Laudarin, Maud Le Gall, Véronique Legris- Allusson, Mehdi Mejdoubi, Corinne Michel, Franck Michel, Charline Miossec, Florence Moinet, Cervantes Minerva, Claude Olive, Pascale Olive, Karine Pailla, Céline Paysant, Sandrine Pierre-François, Mathilde Pircher, Katlyne Polomat, Alain Putot, Patrick René-Corail, Dabor Resiere, Christiane Richer, Jean-Romain Risson, Karen Rome, Marie Sabia, Michel Schloesser, Pauline Simonnet-Vigeral, Rafaelle Théodose, Rosalie Vilain., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and BUISINE, Soline
Subjects: Microbiology (medical), Male, Pediatrics, medicine.medical_specialty, 030231 tropical medicine, Guillain-Barre Syndrome, Zika virus, Serology, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intensive care, Medicine, Humans, Martinique, Prospective Studies, Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, Guillain-Barre syndrome, business.industry, Outbreak, Retrospective cohort study, vector-borne infections, Zika Virus, Middle Aged, Zika virus infection, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Guillain-Barré syndrome, 3. Good health, Infectious Diseases, outbreaks, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Etiology, Female, business, 030217 neurology & neurosurgery
Abstract: International audience; Background: Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016.Methods: We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS.Results: Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease.Conclusions: ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.
Published: 2017
Full Text: View/download PDF

15. New Surge of Syphilis among Patients Living with Human Immunodeficiency Virus in Martinique in 2015

Author: Alain Putot, Nicole Desbois, Ingrid Laudarin, Patrick Hochedez, Charline Miossec, K Guitteaud, Sylvie Abel, André Cabié, Benoît Rozé, Sandrine Pierre-François, Mathilde Pircher, Rosalie Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Laboratoire de Parasitologie Mycologie Immunologie [Fort de France], CHU Fort de France, Parasitologie-Mycologie Fort de France, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), This work was funded by Centre Hospitalier Universitaire de Martinique, France, CHU Fort de France-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Subjects: 0301 basic medicine, Adult, Male, Sexual Behavior, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Medicine, Humans, Martinique, 030212 general & internal medicine, Syphilis, business.industry, Incidence (epidemiology), Outbreak, virus diseases, Articles, medicine.disease, 3. Good health, Infectious Diseases, Sexual behavior, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Parasitology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract: International audience; A syphilis outbreak began in Martinique, French Antilles, in 2004, initially among men who had sex with men (MSM) and who were living with human immunodeficiency virus (HIV). The outbreak subsequently affected all groups at risk, leading to a first epidemic peak in 2008. After an initial decrease, the outbreak started growing again in 2014 among patients living with HIV with unprecedented incidence among MSM. Herein, we describe the change in medical and social parameters of the outbreak since 2005.
Published: 2017
Full Text: View/download PDF

16. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources

Author: Raymond Césaire, Marême Thioune, Charline Miossec, Séverine Da Cunha, Jean-Marie Bolivard, André Cabié, Lise Cuzin, Mathilde Pircher, Laurence Fagour, Sylvie Abel, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité Médicale Pénitentiaire [Fort-de-France, Martinique], Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], Centre Hospitalier Universitaire de la Martinique - CHU Martinique, Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
Subjects: Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Population, lcsh:Medicine, HIV Infections, Prison, World Health Organization, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Mass Screening, Medicine, Martinique, Syphilis, 030212 general & internal medicine, Young adult, lcsh:Science, education, Mass screening, media_common, Human T-lymphotropic virus 1, education.field_of_study, 030505 public health, Multidisciplinary, business.industry, Prisoners, lcsh:R, virus diseases, Hepatitis B, medicine.disease, HTLV-I Infections, Hepatitis C, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Prisons, Family medicine, Population study, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Observational study, 0305 other medical science, business
Abstract: Background The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. Methods This is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. Results In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. Conclusions HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.
Published: 2018
Full Text: View/download PDF

17. Predictors of severe manifestations in a cohort of adult dengue patients

Author: Fatiha Najioullah, Lian F. Thomas, Victor Moravie, Philippe Quénel, Jacques Rosine, Yannick Brouste, Yves Hatchuel, Raymond Césaire, Sylvie Abel, François Besnier, André Cabié, Stéphane Kaidomar, and Patrick Hochedez
Subjects: Adult, Male, medicine.medical_specialty, Abdominal pain, Adolescent, Hepatitis, Viral, Human, Dengue fever, Dengue, Young Adult, Virology, Internal medicine, medicine, Humans, Intensive care medicine, Aged, Aged, 80 and over, Hepatitis, business.industry, Mortality rate, Middle Aged, Prognosis, medicine.disease, Thrombocytopenia, Infectious Diseases, Cohort, Female, medicine.symptom, business, Viral hepatitis, Martinique, Cohort study
Abstract: Background Key symptoms observed during the febrile phase of dengue may identify patients who are likely to progress to severe disease. Objectives To test this hypothesis, we examined the relationships between symptoms reported by patients at presentation and the development of severe outcomes. Study design Retrospective analysis of data recorded prospectively in 560 adult dengue patients admitted to an emergency department. A logistic regression analysis was used to quantify the association between symptoms reported at presentation and outcome. Results Plasma leakage was observed in 95 patients (17%), severe thrombocytopenia (platelet counts 9 /L) in 93 patients (16.6%) and acute hepatitis in 42 patients (7.5%). Severe thrombocytopenia developed in 57% of patients with plasma leakage and 40.5% of patients with hepatitis. Patients who developed a plasma leakage syndrome were older, mainly male, and reported more often an abdominal pain and a cough. Diarrhea and taking paracetamol >60 mg/kg/day before admission were associated with the development of acute hepatitis. Seven patients died. The mortality rate was 6/95 (6.3%) in patients who developed plasma leakage, 3/42 (7.1%) in patients who developed hepatitis, 5/93 (5.4%) in patients with severe thrombocytopenia, and 3/12 (25%) in the patients who demonstrated together all these severe manifestations. Conclusion Plasma leakage, severe thrombocytopenia and acute hepatitis identified subgroups of adult dengue patients with increased mortality rates. Key symptoms reported by the patients at presentation such as abdominal pain, cough or diarrhea were significantly associated with the development of severe manifestations and should be considered as warning signs.
Published: 2010
Full Text: View/download PDF

18. Reemergence of Syphilis in Martinique, 2001–2008

Author: Christian Derancourt, Annick Cavelier, R. Théodose, Bernard Liautaud, Sandrine Pierre-François, Patrick Hochedez, André Cabié, Pascale Richard, Sylvie Abel, Bruno Rollin, Raymond Hélénon, Danielle Quist, and Nicole Desbois
Subjects: Adult, Male, Microbiology (medical), medicine.medical_specialty, Epidemiology, Sexual Behavior, media_common.quotation_subject, lcsh:Medicine, HIV Infections, Disease Outbreaks, lcsh:Infectious and parasitic diseases, medicine, Humans, Martinique, lcsh:RC109-216, Homosexuality, Syphilis, bacteria, media_common, crack cocaine, Caribbean, reemergence, outbreak, business.industry, Incidence (epidemiology), Public health, lcsh:R, Dispatch, Outbreak, homosexuality, medicine.disease, Infectious Diseases, Heterosexuality, Immunology, Female, business, Demography
Abstract: Syphilis reemerged in Martinique in 2004 and initially affected 3 HIV-infected patients. By March 2008, syphilis was diagnosed for 37 men and 18 women. As of October 31, 2009, this outbreak had not yet been brought under control. It initially affected mainly men who had sex with men before it spread to heterosexual persons, minority group members, and crack cocaine users.
Published: 2010

19. Prospective observational study of low thresholds for platelet transfusion in adult dengue patients

Author: Fatiha Najioullah, Sarah Schmitt, B. Kerob-Bauchet, Yves Plumelle, François Besnier, Pascale Richard, Jean Philippe King, Victor Moravie, Lian F. Thomas, Christiane Fonteau, Stéphane Kaidomar, André Cabié, Raymond Césaire, Yannick Brouste, Hossein Mehdaoui, and Sylvie Abel
Subjects: Adult, Male, medicine.medical_specialty, Blood transfusion, Adolescent, medicine.medical_treatment, Immunology, Platelet Transfusion, Dengue fever, Dengue, Young Adult, Internal medicine, Intensive care, Humans, Immunology and Allergy, Medicine, Prospective Studies, Young adult, Prospective cohort study, Aged, Aged, 80 and over, Platelet Count, business.industry, Hematology, Emergency department, Middle Aged, medicine.disease, Surgery, Platelet transfusion, Female, business, Martinique
Abstract: Background The practice of platelet (PLT) transfusions has been adopted into the standard clinical practice in many dengue-endemic countries. Because many patients were found to have received unnecessary PLT transfusions, the development of guidelines for the management of dengue patients with thrombocytopenia has become a necessity. Study design and methods An emergency department-based prospective observational study was conducted in Martinique during a dengue outbreak in adult patients presenting with an acute febrile illness. Patients with severe bleeding and/or who underwent invasive intensive care procedures or emergency surgery were given PLT transfusion to achieve PLT counts of more than 50 x 10(9)/L. PLT transfusion was also considered for patients with PLT counts of less than 5 x 10(9)/L and for those with associated risk factors and PLT counts of less than 20 x 10(9)/L. Results A total of 350 patients were admitted with confirmed dengue infections. Most of them had secondary serotype-2 infections. PLT counts of less than 50 x 10(9)/L were recorded in 165 patients (47.1%). PLT transfusion was administered to 9 patients with thrombocytopenia. The indications included severe bleeding (5 cases), invasive procedures (3 cases), emergency surgery (1 case), and/or associated risk factors (2 cases). The median time duration from the onset of fever to PLT transfusion was 6 days (range, 4-10 days). The median amount of PLTs transfused was 3.66 x 10(11) (range, 2.8 x 10(11)-13.2 x 10(11)). The median PLT yield was +12.4% (range, -3.9% to +67.1%). Three patients died. All other patients recovered during the second week after the onset of fever. Conclusion A restrictive strategy for PLT transfusion based on clinical features and low PLT count thresholds proved to be feasible and safe for adult dengue patients.
Published: 2009
Full Text: View/download PDF

20. Tests de dépistage rapides du VIH dans des consultations de dépistage anonyme et gratuit aux Antilles

Author: Sandrine Pierre-François, Sylvie Abel, André Cabié, F. Bissuel, Laure Paturel, and P. Huc
Subjects: Gynecology, Health services, medicine.medical_specialty, Infectious Diseases, business.industry, Research methodology, Medical screening, Human immunodeficiency virus (HIV), medicine, Program activities, medicine.disease_cause, business, West indies
Abstract: Resume Objectif Aux Antilles, le depistage de l’infection VIH est souvent trop tardif et merite d’etre renforce. Les tests de depistage rapides (TDR) font partie des outils utilisables pour atteindre cet objectif. Nous avons evalue la faisabilite et l’acceptabilite d’un TDR en consultation de depistage anonyme et gratuit. Methodes Apres avoir prealablement verifie sa fiabilite en laboratoire sur plus de 20 000 prelevements, un TDR (Determine HIV-1 + 2®) a ete propose sur place aux usagers des centres de depistage de Fort-de-France et Saint-Martin en plus des tests habituels. Resultats Entre octobre 2007 et mai 2008, 373 TDR ont ete realises, dont quatre furent confirmes positifs. Le resultat du TDR a pu etre rendu a 99,4 % des personnes testees, contre seulement 89,4 % des personnes n’ayant eu qu’un test classique. Le taux de renoncement au resultat differe des tests classiques etait plus eleve chez les personnes ayant eu aussi un TDR : 22,2 % versus 10,6 %. Conclusions Nos resultats montrent que les TDR apportent un benefice en matiere de connaissance du resultat par la personne testee. Il faudra cependant insister aupres des usagers sur la necessite de venir chercher les resultats des tests classiques afin de ne pas meconnaitre une infection sexuellement transmissible associee ou une infection aigue a VIH.
Published: 2009
Full Text: View/download PDF

21. Anicteric cholestasis among HIV infected patients with syphilis

Author: R. Théodose, Sylvie Abel, Sandrine Pierre-François, André Cabié, Nicole Desbois, Guillaume Béraud, and Bernard Liautaud
Subjects: Adult, Male, Microbiology (medical), Sexually transmitted disease, Pediatrics, medicine.medical_specialty, Endemic Diseases, HIV Infections, Cholestasis, Acquired immunodeficiency syndrome (AIDS), Prevalence, medicine, Humans, Martinique, Syphilis, Sida, General Immunology and Microbiology, biology, business.industry, gamma-Glutamyltransferase, General Medicine, Alkaline Phosphatase, medicine.disease, biology.organism_classification, Infectious Diseases, Liver, Immunology, Female, Viral disease, business, Treponematosis
Abstract: In Martinique, among 9 HIV carriers recently diagnosed with early syphilis, 7 had biologic cholestasis. Less than half of the patients had been diagnosed on clinical grounds for syphilis (cutaneous eruption or syphilis in partner), whereas most of them were diagnosed on a systematic screening of HIV infected patients.
Published: 2009
Full Text: View/download PDF

22. Clinical Syndrome and Therapy

Author: Sylvie Abel and André Cabié
Subjects: myalgia, Nosology, Pediatrics, medicine.medical_specialty, business.industry, Arthritis, Context (language use), Disease, medicine.disease, medicine.disease_cause, Quality of life, medicine, Maculopapular rash, Chikungunya, medicine.symptom, business
Abstract: Chikungunya virus (CHIKV) is an emerging alphavirus transmitted to humans by Aedes mosquitoes. CHIKV infection is most often symptomatic and the symptoms last from a few days to several years. Experts in France have defined three clinical stages: acute stage (from the first day on which the first symptoms appear (D1) up to day 21 (D21)); post-acute stage (from D21 to the end of the third month); and chronic stage (after 3 months). In the acute stage a high-grade fever occurs suddenly, along with inflammatory arthralgia and arthritis with periarticular edema and sometimes severe pain. Other typical symptoms are: myalgia, headache, backache, macular to maculopapular rash, and lymphadenopathy. Atypical and severe manifestations can occur, such as maternal–neonatal transmission in viremic women during childbirth. Infected neonates exhibit severe manifestations in 50 % of cases. So far, no specific therapeutic agent to treat infected persons is available and the treatment is symptomatic. The main characteristic of the post-acute stage is the persistence or the occurrence of multiple and polymorphic manifestations dominated by inflammatory manifestations. An accurate semiotic analysis allows defining the diagnostic workup that determines the optimization of treatment. In the post-acute stage the objective of treatment is to relieve the patient of pain and inflammation and to limit the consequences of the inflammatory process. The treatment is primarily based on analgesics and nonsteroidal anti-inflammatory drugs. The benefit of physical medicine depends on lesion assessment and the disease’s overall impact (pain, autonomy, quality of life). The expected benefits are pain relief, preserving the range of motion, and muscle tone. In the chronic stage, the diagnostic approach consists of qualifying the nosology of each patient according to the presence or absence of inflammatory symptoms. Chronic inflammatory rheumatisms (CIR) are different from musculoskeletal disorders (MSD). The former has the most severe functional prognosis; the latter are by far the most frequent (95 %). The management of post-chikungunya CIR, with or without joint destruction, systematically requires the advice of a rheumatologist, at best in the context of a multidisciplinary meeting. The management of MSD persisting after 3 months is based on the same principles as the management of post-acute presentations.
Published: 2016
Full Text: View/download PDF

23. A multifaceted intervention designed to improve medical management of moderate to advanced chronic kidney disease in HIV-infected patients: a cluster randomised trial

Author: P Brazille, Johan Chanal, N. de Castro, B. Lefebvre, Sophie Abgrall, N Petit, M Marcou, Pascal Pugliese, A Parrot, F Meier, Yazdan Yazdanpanah, A Signori-Schmuck, Hana Selinger-Leneman, Pierre Delobel, F Touam, A Cros, Claire Rouzaud, Philippe Bossi, J. P. Faller, Jean-Marc Mauboussin, Faiza Ajana, V Perronne, V Chambrin, Olivier Lortholary, Laurent Alric, V. Gendrin, C Sautron, K Benhadj, H Gil, C Lascoux, F Raffi, JE Kahn, Michel Vidal, J. J. Laurichesse, O Ruyer, F Brunel, Pascal Chavanet, J. Durant, J. M. Chapplain, T. Perpoint, D Blanc, S Casanova, Frédéric Méchaï, P Poubeau, M Benomar, David Zucman, P Fischer, H Fischer, V Ronat, D Coban, Elisabeth Rouveix, H. Berthé, E Roveix, Corinne Isnard-Bagnis, Aurélie Fillion, P Loulergue, Jennifer M. Rohan, Isabelle Ravaux, Catherine Michel, C Faudon, Jacques Gilquin, J. M. Livrozet, Christian Chidiac, G Wartel, Patricia Enel, G. Beck-Wirth, I Prade, O. Derradji, Jean-Paul Viard, Cécile Goujard, R Cohen Valensi, M Batard, Jean-Luc Meynard, G Camuset, Jacques Cadranel, Christian Pradier, S Gohier, Jean-François Bergmann, Francis Barin, D. Makhloufi, Philippe Gerhardt, A Canestri, Lionel Piroth, S Greffe, N Biezunski, C Bolliot, L Toko, G Mboungou, Jérôme Moreau, Valérie Potard, H Masson, Eric Rosenthal, Jacques Reynes, André Cabié, Gilles Pialoux, P Granet Brunello, F Durand, Véronique Obry-Roguet, Jade Ghosn, V Walter, P Gazalet, O Boulat, P M Girard, A Ménard, M. Môle, G Martin Blondel, M Hamidi, C Lupin, P Druart, Sophie Matheron, Catherine Chirouze, P. De Truchis, Laurent Cotte, P. Del Giudice, Caroline Dupont, Anne Frésard, C Jung, V Payssan, M Saidani, C. Chesnel, Véronique Joly, S Abgrall, B Wifaq, Bruno Hoen, I Fabre, E Pannier Metzger, M Beyrne, Christian Rabaud, C. Gaud, Pierre Durieux, S Makhloufi, Eric Billaud, Jean-Marc Lacombe, T Akpan, PY Dides, Dominique Mathez, V Delcey, P. Sellier, A Naqvi, Amanda Lopes, Laurent Hustache-Mathieu, C Bartoli, V Marcou, Murielle Mary-Krause, Elisabeth Botelho-Nevers, K Samar, Hervé Tissot-Dupont, M Ruquet, Laurence Weiss, Boue F, Philippe Morand, I Lamaury, L Meddeb, Nadia Valin, M Delestan, N. Jacquemet, N Méaux-Ruault, A Gergely, M. Blanc, M Sordage, L Sutton, Dominique Costagliola, V Thomas, PH Consigny, G Cessot, C Le Jeunne, A Freire Maresca, A Greder Belan, Jean-Pierre Morini, G Astier, D. Martin, Pierre-Marie Roger, E Bourzam, G Melica-Gregoire, Nicolas Vignier, B. Taverne, P. Leclercq, M. Sebire, A Adda, A Meybeck, MG Lebrette, André Boibieux, T. Allegre, Nicolas Dupin, M. Parrinello, S Roussin-Bretagne, Christine Jacomet, Laurence Gérard, Jean Deleuze, A S Ritleng, M Raho-Moussa, Marialuisa Partisani, Daniel Vittecoq, M André, Albert Sotto, Pierre Tattevin, S Marque Juillet, Antolini-Bouvenot, Sylvie Abel, M Guivarch, S Lang, P. Honoré, A Lavolé, C. Majerholc, Gilles Hittinger, Marguerite Guiguet, N Magy-Bertrand, Alain Lafeuillade, Elina Teicher, JM Riou, B Slama, Sophie Grabar, N. Viget, P Genet, Faouzi Souala, X. Duval, Lise Cuzin, B. Marchou, D Bonnabel, O. Faucher, S Stegmann, C Veyssier-Belot, I Perbost, K Bourdic, Cédric Arvieux, V Masse, L Pellissier, Giovanna Melica, S Lariven, S Chebrek, H Zerazhi, G Philip, Hugues Melliez, D Marigot-Outtandy, Mark Bloch, E Fourn, E. Billaud, J. Gerbe, C Dhiver, Benveniste O, Delphine Bonnet, D. Quinsat, V Daneluzzi, E Haustraete, P Guet, Dominique Salmon, Christophe Rioux, E Duvallon, E. Mortier, G Borgherini, P Goubin, D. Costagliola, Renaud Verdon, M J Soavi, A. Simon, F Zeng, Aba Mahamat, Mathieu Nacher, P Colardelle, F Granier, E Hope-Rapp, M. Poupard, V Vanticlke, M P Bouillon, C Clavel, Ml Lucas, P. Chiarello, Fabienne Caby, G Jacques, Juliette Pavie, MP Pietri, Blandine Denis, P. Miailhes, Sylvie Bregigeon, B Mouchet, Marie-Aude Khuong-Josses, P Thibaut, Antoine Rachas, H Laurichesse, Sylvie Dargere, C Godin Collet, Odile Launay, Jacques Gasnault, Clotilde Allavena, C. Dumont, Isabelle Poizot-Martin, M. Ratajczak, A. Maignan, A Brunon-Gagneux, Olivier Epaulard, A Therby, Tristan Ferry, E Reimann, Laurent Boyer, Régine Doncesco, Eric Cua, K Risso, Claudine Duvivier, Leila Adriouch, W. Rozenbaum, Christian Perronne, R Sambuc, I Kansau, J. F. Faucher, Florence Huber, J. M. Ruiz, Ma Khuong, Sandrine Pierre-François, Laurence Lievre, G Breton, J.-M. Molina, C. Tomei, M Guiguet, A Proust, L Fonquernie, D. Bornarel, David Rey, Isabelle Rouanet, C Guglielminotti, Jérôme Tourret, V. Reliquet, A Palacin, C Cheneau, Eric Oksenhendler, P Féret, B Montoya, V Lambry, N Hall, Jean-Daniel Lelièvre, Delphine Croisier, C Ricaud, M Ptak, Pierre Couppié, S Mokhtari, Y Welker, R Rodet, T May, Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Ecologie et Evolution des Microorganismes (EEM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS, 2009, the French Ministry of Health, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Ecologie et Evolution des Microorganismes ( EEM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, and Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]
Subjects: Male, Microbiology (medical), Nephrology, medicine.medical_specialty, HIV Infections, urologic and male genital diseases, law.invention, Randomized controlled trial, law, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Internal medicine, Humans, Medicine, Cluster randomised controlled trial, Aged, business.industry, Guideline, Middle Aged, medicine.disease, HIV infection, Confidence interval, 3. Good health, clinical practice, Clinical trial, Treatment Outcome, Infectious Diseases, Blood pressure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Practice Guidelines as Topic, Physical therapy, cluster randomized trial, Kidney Failure, Chronic, Female, business, chronic kidney disease, Glomerular Filtration Rate, Kidney disease
Abstract: International audience; Background - Chronic kidney disease (CKD) is frequent in individuals infected with human immunodeficiency virus (HIV). Progression to end-stage renal disease can be slowed by appropriate medical management. Methods - To assess whether active promotion of guidelines improves CKD management, we conducted a cluster randomized controlled trial within the French Hospital Database on HIV (FHDH-ANRS CO4). We randomized 46 centers participating in the FHDH to either simple information on guideline availability or active promotion with a multifaceted and repeated intervention comprising reminders and audit feedback and targeting of local opinion leaders carried out between April 2009 and April 2010. Outcome measure was CKD management adequacy assessed before and 2 years after the beginning of the intervention in HIV-infected patients with moderate to severe CKD. CKD management was considered adequate in case of referral to a nephrologist or if proteinuria, blood pressure, low-density lipoprotein cholesterol level, and glycemia had been measured during the previous year and medications had been prescribed when necessary. Results - Three hundred six patients were enrolled, of whom 238 (78%) completed the 2 years of follow-up. During the study period, the percentage of patients receiving adequate CKD management improved from 64.1% to 70.4% (+6.3%) in the active arm and from 68.3% to 75.6% (+7.3%) in the control arm (adjusted mean difference, -0.7 percentage points [95% confidence interval: -9.2 to 7.9]; P = .95). The biggest impact of active promotion was on the management of proteinuria and blood pressure. Conclusions - Adequate compliance with CKD management guidelines improved slightly between 2009 and 2011, with no difference between the simple information and active promotion arms. Clinical trials registration - CCTIRS 10.150 and CNIL DR-2010-379.
Published: 2015
Full Text: View/download PDF

24. Boosted Lopinavir- Versus Boosted Atazanavir-Containing Regimens and Immunologic, Virologic, and Clinical Outcomes: A Prospective Study of HIV-Infected Individuals in High-Income Countries

Author: Isabel Hurtado, Santiago Pérez-Hoyos, Consuelo Viladés, Adilia Warris, Federico Pulido, Eva Calabuig, Oscar Murillo Rubio, Dimitrios Paraskevis, Julia Del amo, Pablo Barreiro, INMA JARRIN, Arantza Sanvisens, Enrique Bernal Morell, Roberto Muga, Mariona Xercavins, Jean-Francois Bergmann, Aba Mahamat, Ignacio Pérez Valero, DAVID DALMAU, Clifford Leen, Dominique Costagliola, Jim Young, Vicente Soriano, Montserrat Vargas Laguna, Marcela Guevara, Soraya Boucherit, Jesus Castilla, Jean-Marie Michot, José A. Oteo, Maria Jose Amengual, Vicente Boix, Jonathan Sterne, Valerie Delpech, Jane Anderson, Alexandra Montoliu, Esperanza Merino de Lucas, Sophie Matheron, Michael Kozal, Caroline Sabin, André Cabié, Susana Monge, Luis Fernando Lopez.Cortes, Sylvie ABEL, Cedric Arvieux, Félix Gutiérrez, Bart Rijnders, Eulalia Valle-Garay, Juan Berenguer, Carmen Cabellos, Amy Justice, Felipe García, Joaquín Portilla, Mariana Gerschenson, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Global Health, Graduate School, Other departments, Infectious diseases, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Center of Experimental and Molecular Medicine, Dermatology, Medical Microbiology and Infection Prevention, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Medische Microbiologie, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R4 - Health Inequities and Societal Participation, and Interne Geneeskunde
Subjects: Male, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], HIV Infections, Cohort Studies, chemistry.chemical_compound, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, immune system diseases, Antiretroviral Therapy, Highly Active, Medicine, Prospective Studies, Cooperative Behavior, Prospective cohort study, atazanavir, Hazard ratio, virus diseases, Lopinavir, Middle Aged, Viral Load, Europe, Treatment Outcome, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, HIV/AIDS, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Viral load, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, Atazanavir Sulfate, Young Adult, Internal medicine, Humans, observational studies, business.industry, Developed Countries, HIV, mortality, United States, CD4 Lymphocyte Count, Atazanavir, lopinavir, Regimen, chemistry, Immunology, business
Abstract: Current clinical guidelines consider regimens consisting of either ritonavir-boosted atazanavir or ritonavir-boosted lopinavir and a nucleoside reverse transcriptase inhibitor (NRTI) backbone among their recommended and alternative first-line antiretroviral regimens. However, these guidelines are based on limited evidence from randomized clinical trials and clinical experience.We compared these regimens with respect to clinical, immunologic, and virologic outcomes using data from prospective studies of human immunodeficiency virus (HIV)-infected individuals in Europe and the United States in the HIV-CAUSAL Collaboration, 2004-2013. Antiretroviral therapy-naive and AIDS-free individuals were followed from the time they started a lopinavir or an atazanavir regimen. We estimated the 'intention-to-treat' effect for atazanavir vs lopinavir regimens on each of the outcomes.A total of 6668 individuals started a lopinavir regimen (213 deaths, 457 AIDS-defining illnesses or deaths), and 4301 individuals started an atazanavir regimen (83 deaths, 157 AIDS-defining illnesses or deaths). The adjusted intention-to-treat hazard ratios for atazanavir vs lopinavir regimens were 0.70 (95% confidence interval [CI], .53-.91) for death, 0.67 (95% CI, .55-.82) for AIDS-defining illness or death, and 0.91 (95% CI, .84-.99) for virologic failure at 12 months. The mean 12-month increase in CD4 count was 8.15 (95% CI, -.13 to 16.43) cells/?L higher in the atazanavir group. Estimates differed by NRTI backbone.Our estimates are consistent with a lower mortality, a lower incidence of AIDS-defining illness, a greater 12-month increase in CD4 cell count, and a smaller risk of virologic failure at 12 months for atazanavir compared with lopinavir regimens.? The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
Published: 2015
Full Text: View/download PDF

25. Prise en charge des patients infectés par le VIH aux urgences à l'heure de la multithérapie

Author: François Besnier, J.R. Longhi, G. Sobesky, J. Ketterle, André Cabié, and Sylvie Abel
Subjects: Pediatrics, medicine.medical_specialty, biology, business.industry, Retrospective cohort study, Critical Care and Intensive Care Medicine, medicine.disease, biology.organism_classification, Surgery, Pneumonia, Acquired immunodeficiency syndrome (AIDS), Medical advice, medicine, Viral disease, Sida, Adverse effect, business, Martinique
Abstract: Summary Purpose of the study To describe the characteristics of patients with human immunodeficiency virus (HIV) admitted to the emergency unit of the University Hospital of Fort-de-France in 1997. Methods We conducted a retrospective study of HIV infected patients admitted at the emergency unit during the first semester of 1997. Results Our study included 59 patients, with a mean age of 41.4 years. The sex ratio (men/women) was 1.81, and 40% had AIDS. The mean CD4 count was 280 ± 337 × 106 /L. About two-thirds of the patients were regularly consulting the hospital. One-third had never been to the hospital at all. One infected patient in four did not mention his pathology while consulting the emergency unit. Pneumocystis carinii pneumonia and toxoplasmic encephalitis were the most frequently diagnosed opportunistic pathologies (nine out of 14), more often among patients without regular follow-up (seven out of nine). Five patients (10%) came for medical advice concerning an adverse effect of the treatment. Conclusions The evolution of HIV infection of patients is significant. It appears that now emergency unit physicians have to face two main categories of HIV infected patients: patients regularly under medical advice and treatment also seeking advice for secondary effects of their treatment, and non-treated patients consulting for opportunistic infections.
Published: 1999
Full Text: View/download PDF

26. Biomarkers and bacterial pneumonia risk in patients with treated HIV infection:a case-control study

Author: Federico Pulido, Janak Koirala, Carlos Brites, Pablo Okhuysen, DAVID DALMAU, Clifford Leen, Ken Kunisaki, TANIA REUTER, Brian Angus, Matti Ristola, Lars Østergaard, Sean Emery, Angèle Gayet-Ageron, Michael Kozal, André Cabié, Sylvie ABEL, Nicholas Andrew Medland, and Philippa Easterbrook
Subjects: Male, Pulmonology, Epidemiology, lcsh:Medicine, HIV Infections, Biochemistry, BIOMARCADORES, 0302 clinical medicine, Community-acquired pneumonia, Risk Factors, Medicine, Uteroglobin, 030212 general & internal medicine, lcsh:Science, Lung, Multidisciplinary, biology, Hepatitis B, Middle Aged, C-Reactive Proteins, Pulmonary Surfactant-Associated Protein D, 3. Good health, Lower Respiratory Tract Infections, C-Reactive Protein, HIV epidemiology, Biomarker (medicine), Infectious diseases, HIV clinical manifestations, Biological Markers, Female, Research Article, Adult, medicine.medical_specialty, Clinical Research Design, Anti-HIV Agents, Viral diseases, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Pneumonia, Bacterial, Humans, ddc:610, Biology, business.industry, Interleukin-6, C-reactive protein, lcsh:R, Case-control study, Bacterial pneumonia, Proteins, HIV, medicine.disease, Pneumonia, Biomarker Epidemiology, 030228 respiratory system, Case-Control Studies, Immunology, Respiratory Infections, biology.protein, lcsh:Q, business, Biomarkers
Abstract: Background: Despite advances in HIV treatment, bacterial pneumonia continues to cause considerable morbidity and mortality in patients with HIV infection. Studies of biomarker associations with bacterial pneumonia risk in treated HIV-infected patients do not currently exist. Methods: We performed a nested, matched, case-control study among participants randomized to continuous combination antiretroviral therapy (cART) in the Strategies for Management of Antiretroviral Therapy trial. Patients who developed bacterial pneumonia (cases) and patients without bacterial pneumonia (controls) were matched 1:1 on clinical center, smoking status, age, and baseline cART use. Baseline levels of Club Cell Secretory Protein 16 (CC16), Surfactant Protein D (SP-D), C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer were compared between cases and controls. Results: Cases (n = 72) and controls (n = 72) were 25.7% female, 51.4% black, 65.3% current smokers, 9.7% diabetic, 36.1% co-infected with Hepatitis B/C, and 75.0% were on cART at baseline. Median (IQR) age was 45 (41, 51) years with CD4+ count of 553 (436, 690) cells/mm3. Baseline CC16 and SP-D were similar between cases and controls, but hsCRP was significantly higher in cases than controls (2.94 µg/mL in cases vs. 1.93 µg/mL in controls; p = 0.02). IL-6 and d-dimer levels were also higher in cases compared to controls, though differences were not statistically significant (p-value 0.06 and 0.10, respectively). Conclusions: In patients with cART-treated HIV infection, higher levels of systemic inflammatory markers were associated with increased bacterial pneumonia risk, while two pulmonary-specific inflammatory biomarkers, CC16 and SP-D, were not associated with bacterial pneumonia risk.
Published: 2013
Full Text: View/download PDF

27. Neurotropism of arboviruses seen by a physiatric view, Martiniquaises experiences through epidemics of Dengue, Chikungunya and Zika

Author: Jose-Luis Barnay, Emilie Javelle, Sylvie Abel, Patrick René-Corail, Odile Troisgros, and André Cabié
Subjects: medicine.medical_specialty, business.industry, Neurotropism, Rehabilitation, Outbreak, Myelitis, Disease, medicine.disease, medicine.disease_cause, Virology, Dengue fever, Hemorrhagic Fevers, medicine, Orthopedics and Sports Medicine, Chikungunya, Intensive care medicine, business, Meningitis
Abstract: Opinion/Feedback Arboviruses cause very recurrent epidemics, the oldest Dengue, known especially outside the flu-like syndrome with high fever mainly impacting vulnerable populations, may be responsible for severe hemorrhagic fevers, but also a few cases of Guillain-Barre syndrome. In 2014, the French Antilles occurred an outbreak of Chikungunya, following that of the Reunion's outbreak. During this period have been described, the articular and musculo-squellettic lesions, responsible for loss of autonomy in populations already carriers of chronic inflammatory joint damage or mechanical, but also a heavy impact on the autonomy of elderly and frail people. The Reunion experience has allowed the French Antilles to prepare for managing this epidemic by implementing an algorithm based on precise stripping algic and incapacitating phenomena. The role of the MPR in this dismemberment will allows distinguish true neurogenic damage to types of complex pain syndrome, combining autonomic neuropathy syndromes and tables of small fibers at the crossroads between diagnostic of arthropathy of periarthropaties, synovitis, tenosynovitis and tunnel syndrome on the rise during this epidemic period. And other complications such as bladder and sphincter disorders, and increase of spastic tables in patients suffering from chronic neurological disease. The reach of virus Zika shows an increased incidence of Guillain-Barre syndrome, brings interrogation with the appearance of atypical neurological damage such as myelitis, meningitis, cerebellites showing well this neurotropism. There are also atypical presentation on the neuro-urology plan that raises the question of the pathophysiology of such viruses. As has been the case for the Chikungunya, the overall vision of the MPR will allow better interpretation of pathological phenomena helping the understanding of the pathophysiology of these arboviruses. But it also plays a role in measuring the impact of emerging diseases on the autonomy of individuals.
Published: 2016
Full Text: View/download PDF

28. Impact of antiretroviral therapy on tuberculosis incidence among HIV-positive patients in high-income countries

Author: Isabel Hurtado, Consuelo Viladés, Federico Pulido, Dimitrios Paraskevis, INMA JARRIN, VICTORIA HERNANDO, Enrique Bernal Morell, Louisa Gnatiuc Friedrichs, Mar Masiá, Roberto Muga, Jean-Francois Bergmann, Aba Mahamat, Debora Alvarez-del Arco, Concepción Cepeda, Clifford Leen, Dominique Costagliola, Vicente Soriano, Montserrat Vargas Laguna, Marcela Guevara, Soraya Boucherit, Jesus Castilla, José A. Oteo, Moreno-Cuerda Victor, Jonathan Sterne, Valerie Delpech, Rafael Hervás Gómez, Alexandra Montoliu, Victoria Sánchez-Hellín, Sophie Matheron, Angèle Gayet-Ageron, Michael Kozal, Caroline Sabin, André Cabié, Luis Fernando Lopez.Cortes, Paz Sobrino-Vegas, Sylvie ABEL, Cedric Arvieux, Bart Rijnders, Elisa De Lazzari, Philippa Easterbrook, Carmen Cabellos, Felipe García, Mariana Gerschenson, HIV-CAUSAL Collaboration, National Institutes of Health (grants R01-AI073127 and U10-AA013566), The HIV-CAUSAL Collaboration, Other departments, Amsterdam institute for Infection and Immunity, Infectious diseases, Other Research, Obstetrics and Gynaecology, Graduate School, Amsterdam Public Health, General Internal Medicine, Paediatric Infectious Diseases / Rheumatology / Immunology, Global Health, Center of Experimental and Molecular Medicine, and Medical Microbiology and Infection Prevention
Subjects: Male, MESH: Mycobacterium tuberculosis, MESH: CD4 Lymphocyte Count, HIV Infections, Pneumocystis carinii, Cohort Studies, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Immune Reconstitution Inflammatory Syndrome, HIV Seropositivity, MESH: Tuberculosis, Viral, 030212 general & internal medicine, MESH: Incidence, MESH: Anti-HIV Agents, MESH: Cohort Studies, Pneumocystis jirovecii, 0303 health sciences, MESH: Middle Aged, biology, MESH: AIDS-Related Opportunistic Infections, Incidence (epidemiology), Incidence, Pneumonia, Pneumocystis, Hazard ratio, virus diseases, MESH: HIV Infections, Middle Aged, Viral Load, 3. Good health, Pathogenesis and modulation of inflammation [N4i 1], Europe, Infectious Diseases, MESH: RNA, Viral, Combination, Cohort, MESH: Immune Reconstitution Inflammatory Syndrome, RNA, Viral, HIV/AIDS, Drug Therapy, Combination, Female, Poverty-related infectious diseases Infectious diseases and international health [N4i 3], MESH: Viral Load, Viral load, Microbiology (medical), Cart, Adult, medicine.medical_specialty, Tuberculosis, Anti-HIV Agents, Auto-immunity, transplantation and immunotherapy [N4i 4], Invasive mycoses and compromised host [N4i 2], Mycobacterium tuberculosis, 03 medical and health sciences, MESH: HIV Seropositivity, Drug Therapy, Immune reconstitution inflammatory syndrome, MESH: Pneumocystis jirovecii, Internal medicine, mental disorders, medicine, MESH: United States, Humans, MESH: Developed Countries, MESH: Humans, AIDS-Related Opportunistic Infections, Pneumocystis, 030306 microbiology, business.industry, Developed Countries, Poverty-related infectious diseases [N4i 3], MESH: Adult, Pneumonia, medicine.disease, biology.organism_classification, MESH: Male, United States, CD4 Lymphocyte Count, MESH: Drug Therapy, Combination, Immunology, RNA, MESH: Europe, business, MESH: Female, MESH: Pneumonia, Pneumocystis
Abstract: Contains fulltext : 108229.pdf (Publisher’s version ) (Closed access) BACKGROUND: The lower tuberculosis incidence reported in human immunodeficiency virus (HIV)-positive individuals receiving combined antiretroviral therapy (cART) is difficult to interpret causally. Furthermore, the role of unmasking immune reconstitution inflammatory syndrome (IRIS) is unclear. We aim to estimate the effect of cART on tuberculosis incidence in HIV-positive individuals in high-income countries. METHODS: The HIV-CAUSAL Collaboration consisted of 12 cohorts from the United States and Europe of HIV-positive, ART-naive, AIDS-free individuals aged ≥18 years with baseline CD4 cell count and HIV RNA levels followed up from 1996 through 2007. We estimated hazard ratios (HRs) for cART versus no cART, adjusted for time-varying CD4 cell count and HIV RNA level via inverse probability weighting. RESULTS: Of 65 121 individuals, 712 developed tuberculosis over 28 months of median follow-up (incidence, 3.0 cases per 1000 person-years). The HR for tuberculosis for cART versus no cART was 0.56 (95% confidence interval [CI], 0.44-0.72) overall, 1.04 (95% CI, 0.64-1.68) for individuals aged >50 years, and 1.46 (95% CI, 0.70-3.04) for people with a CD4 cell count of 50 years old, respectively, and 2.30 (95% CI, 1.03-5.14) for people with a CD4 cell count of 50 years old or with CD4 cell counts of
Published: 2012
Full Text: View/download PDF

29. Outbreak of Leptospirosis after a Race in the Tropical Forest of Martinique

Author: Philippe Quénel, Jacques Rosine, Patrick Hochedez, Mathieu Picardeau, André Cabié, Rafaelle Théodose, Sylvie Abel, and Pascale Bourhy
Subjects: Adult, Male, Veterinary medicine, Prevalence, Incubation period, Disease Outbreaks, Trees, Leptospira, Risk Factors, Virology, medicine, Humans, Leptospirosis, Martinique, Subclinical infection, Respiratory distress, biology, business.industry, Outbreak, Articles, Middle Aged, medicine.disease, biology.organism_classification, Infectious Diseases, Parasitology, Female, business, Sports
Abstract: Many wild and domestic animals serve as reservoirs for pathogenic Leptospira strains and contaminate the environment by shedding the organisms in their urine. Humans are usually infected through abraded skin or mucous membrane contact with water contaminated by the urine of animal reservoirs, and less frequently by direct contact with animals or their urine. The mean incubation period is 10 days, with a usual range of 2–20 days. 1 Clinical manifestations are protean and the spectrum of symptoms range from subclinical or mild anicteric febrile illness to acute renal failure. Weil’s disease and respiratory distress syndrome are associated with high mortality. 1 Over the preceding decades, ecotourism and sporting events in tropical and sub-tropical areas have become more popular among travelers and athletes. These recreational activities in tropical areas have served to increase the risk of human exposure to these pathogens and consequently outbreaks of leptospirosis have been reported in these settings. 3, 4
Published: 2011

30. Inferior clinical outcome of the CD4+ cell count-guided antiretroviral treatment interruption strategy in the SMART study: role of CD4+ Cell counts and HIV RNA levels during follow-up

Author: Federico Pulido, Graciela Guaragna, Janak Koirala, STEPHEN OBRIEN, Sharon Walmsley, Carlos Brites, Blake McGee, Jens Lundgren, Pablo Okhuysen, DAVID DALMAU, Clifford Leen, George Kinghorn, Giuseppe Tambussi, Matti Ristola, Lorenzo Magenta, Professor Amit Kumar, Lars Østergaard, Sean Emery, Thomas Benfield, Angèle Gayet-Ageron, Alejandro Krolewiecki, Michael Kozal, André Cabié, Sylvie ABEL, Rafael Rubio García, Martyn French, Jonathan Anderson, Nicholas Andrew Medland, Matthew Goetz, Philippa Easterbrook, Barnaby Young, and ANASTASIA ANTONIADOU
Subjects: Oncology, medicine.medical_specialty, Anti-HIV Agents, AIDS-Related Opportunistic Infections, Cell, HIV Infections, Disease, Drug Administration Schedule, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Immunology and Allergy, Humans, Immunodeficiency, Proportional Hazards Models, Proportional hazards model, business.industry, Absolute risk reduction, HIV, medicine.disease, CD4 Lymphocyte Count, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, Relative risk, Immunology, RNA, Viral, business
Abstract: Background and methodsThe SMART study compared 2 strategies for using antiretroviral therapy—drug conservation (DC) and viral suppression (VS)—in 5472 human immunodeficiency virus (HIV)–infected patients with CD4+ cell counts >350 cells/μL. Rates and predictors of opportunistic disease or death (OD/death) and the relative risk (RR) in DC versus VS groups according to the latest CD4+ cell count and HIV RNA level are reported ResultsDuring a mean of 16 months of follow-up, DC patients spent more time with a latest CD4+ cell count 400 copies/mL (71% vs. 28%) and had a higher rate of OD/death (3.4 vs. 1.3/100 person-years) than VS patients. For periods of follow-up with a CD4+ cell count ConclusionsThe higher risk of OD/death in DC patients was associated with (1) spending more follow-up time with relative immunodeficiency and (2) living longer with uncontrolled HIV replication even at higher CD4+ cell counts. Ongoing HIV replication at a given CD4+ cell count places patients at an excess risk of OD/death Trial registrationClinicalTrials.gov identifier: NCT00027352
Published: 2008
Full Text: View/download PDF

31. Major clinical outcomes in antiretroviral therapy (ART)-naive participants and in those not receiving ART at baseline in the SMART study

Author: Federico Pulido, Graciela Guaragna, Janak Koirala, STEPHEN OBRIEN, Sharon Walmsley, Blake McGee, Pablo Okhuysen, DAVID DALMAU, Clifford Leen, Matthew Law, George Kinghorn, Giuseppe Tambussi, Matti Ristola, Lorenzo Magenta, Professor Amit Kumar, Lars Østergaard, Sean Emery, Thomas Benfield, Angèle Gayet-Ageron, Alejandro Krolewiecki, Michael Kozal, André Cabié, Sylvie ABEL, Rafael Rubio García, Martyn French, Nicholas Andrew Medland, Matthew Goetz, Philippa Easterbrook, and ANASTASIA ANTONIADOU
Subjects: HPTN 052, Adult, Male, medicine.medical_specialty, HIV/*immunology, Anti-HIV Agents, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, Kaplan-Meier Estimate, medicine.disease_cause, Drug Administration Schedule, law.invention, Cohort Studies, Randomized controlled trial, Acquired immunodeficiency syndrome (AIDS), law, Internal medicine, medicine, Immunology and Allergy, Humans, Kaplan-Meiers Estimate, AIDS-Related Opportunistic Infections, business.industry, HIV, Anti-HIV Agents/*administration & dosage, Middle Aged, medicine.disease, Antiretroviral therapy, CD4 Lymphocyte Count, Institutional repository, Infectious Diseases, Treatment Outcome, AIDS-Related Opportunistic Infections/immunology/mortality, Immunology, Female, business, HIV Infections/*drug therapy/immunology/mortality/virology, Cohort study
Abstract: Udgivelsesdato: 2008-Apr-15 BACKGROUND: The SMART study randomized 5,472 human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts >350 cells/microL to intermittent antiretroviral therapy (ART; the drug conservation [DC] group) versus continuous ART (the viral suppression [VS] group). In the DC group, participants started ART when the CD4+ cell count was or= 6 months (n=228) were analyzed. The following clinical outcomes were assessed: (i) opportunistic disease (OD) or death from any cause (OD/death); (ii) OD (fatal or nonfatal); (iii) serious non-AIDS events (cardiovascular, renal, and hepatic disease plus non-AIDS-defining cancers) and non-OD deaths; and (iv) the composite of outcomes (ii) and (iii). RESULTS: A total of 477 participants (228 in the DC group and 249 in the VS group) were followed (mean, 18 months). For outcome (iv), 21 and 6 events occurred in the DC (7 in ART-naive participants and 14 in those who had not received ART for >or= 6 months) and VS (2 in ART-naive participants and 4 in those who had not received ART for 6 months) groups, respectively. Hazard ratios for DC vs. VS by outcome category were as follows: outcome (i), 3.47 (95% confidence interval [CI], 1.26-9.56; p=.02); outcome (ii), 3.26 (95% CI, 1.04-10.25; p=.04); outcome (iii), 7.02 (95% CI, 1.57-31.38; p=.01); and outcome (iv), 4.19 (95% CI, 1.69-10.39; p=.002 ). CONCLUSIONS: Initiation of ART at CD4+ cell counts >350 cells/microL compared with
Published: 2008
Full Text: View/download PDF

32. Immune reconstitution inflammatory syndrome associated with HIV and leprosy

Author: Hélène Voinchet, Raymond Hélénon, M. Roussel, Dominique Sainte-Marie, André Cabié, Sylvie Abel, Pierre Couppié, and Michel Huerre
Subjects: Male, Opportunistic infection, Anti-HIV Agents, medicine.medical_treatment, HIV Infections, Leprostatic Agents, Dermatology, Autoimmune Diseases, Diagnosis, Differential, Acquired immunodeficiency syndrome (AIDS), Immune reconstitution inflammatory syndrome, Immunopathology, Leprosy, medicine, Humans, AIDS-Related Opportunistic Infections, business.industry, Immunosuppression, General Medicine, Middle Aged, medicine.disease, Immunology, Female, Viral disease, business, Martinique
Abstract: Background Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection that occurs in human immunodeficiency virus (HIV)–positive patients with profound immunosuppression during the reconstitution of the immune system in the initial months of highly active antiretroviral treatment. Observations We describe 3 cases of leprosy occurring in patients treated with a combination of 3 antiretroviral drugs who fulfilled the criteria for IRIS. A reactional state occurred in all 3 cases. Two of the 3 patients presented an unusual ulcerous progression of the lesions not generally observed in cases of leprosy. The outcome was favorable in all 3 cases. The frequency of IRIS associated with leprosy in French Guiana and Martinique is estimated at 3 cases per 1000 HIV-positive patients receiving highly active antiretroviral treatment. Conclusion Leprosy should be recognized as an IRIS-associated infection with possibility of atypical presentation.
Published: 2004

33. Impact of rapid HIV testing on the return rate for routine test results in sexually transmitted infection testing centres

Author: F. Bissuel, Laure Paturel, André Cabié, P. Huc, and Sylvie Abel
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Time Factors, West Indies, Voluntary counseling and testing, Human immunodeficiency virus (HIV), HIV Infections, Dermatology, Hiv testing, medicine.disease_cause, Ambulatory Care Facilities, medicine, Humans, Mass Screening, Pharmacology (medical), Prospective cohort study, Aged, business.industry, Public Health, Environmental and Occupational Health, virus diseases, Middle Aged, Confidence interval, Test (assessment), Infectious Diseases, Relative risk, Feasibility Studies, Female, business, Martinique
Abstract: To strengthen HIV screening in the French West Indies (FWI), we evaluated the feasibility of rapid tests in sexually transmitted infection (STI) testing centres. Rapid testing was offered to each user ahead of the standard screening tests. Between October 2007 and December 2008, 847 users had HIV rapid testing, and 1724 users did not have rapid testing. The results of rapid testing were returned to 99.1% of testers. However, clients who underwent rapid testing were significantly more likely than others to have not returned to get the results of their standard screening tests (for HIV and other STIs): 27.4% versus 14.0% with a relative risk of 1.96 (95% confidence interval [CI] 1.67–2.30, P < 0.0001). Rapid HIV testing has the capacity to reduce the return rates for confirmatory results of HIV testing and other STIs.
Published: 2011
Full Text: View/download PDF

34. Occupational transmission of human immunodeficiency virus and hepatitis C virus after a punch

Author: Raymond Césaire, Sylvie Abel, Danielle Cales-Quist, Guy Sobesky, Odile Béra, and André Cabié
Subjects: Microbiology (medical), Male, viruses, Hepatitis C virus, Poison control, HIV Infections, Hepacivirus, Violence, medicine.disease_cause, Virus, Acquired immunodeficiency syndrome (AIDS), Occupational Exposure, medicine, Humans, Sida, Hepatitis B virus, biology, business.industry, Transmission (medicine), virus diseases, Middle Aged, medicine.disease, biology.organism_classification, Virology, Hepatitis C, Police, Infectious Diseases, Immunology, HIV-1, Viral disease, business
Abstract: Although the simultaneous transmission of either human immunodeficiency virus (HIV) and hepatitis C virus or HIV and hepatitis B virus from a single source has already been described, this is the first case of transmission to occur after a blow with the fist.
Published: 2000

35. Mycobacterial Lymphadenitis after Initiation of Highly Active Antiretroviral Therapy

Author: André Cabié, A. Brebion, Nicole Desbois, Guy Sobesky, and Sylvie Abel
Subjects: Adult, Microbiology (medical), medicine.medical_specialty, Anti-HIV Agents, Antitubercular Agents, HIV Infections, Medical microbiology, Acquired immunodeficiency syndrome (AIDS), Lymphadenitis, medicine, Humans, Tuberculosis, Mycobacterial lymphadenitis, Sida, Mycobacterium avium-intracellulare Infection, biology, business.industry, General Medicine, Mycobacterium avium Complex, medicine.disease, biology.organism_classification, Virology, Antiretroviral therapy, Infectious Diseases, Immunology, Drug Therapy, Combination, Viral disease, business
Published: 1998
Full Text: View/download PDF

36. Risk for opportunistic disease and death after reinitiating continuous antiretroviral therapy in patients with HIV previously receiving episodic therapy: A randomized trial

Author: Federico Pulido, Graciela Guaragna, Janak Koirala, STEPHEN OBRIEN, Sharon Walmsley, Blake McGee, Jennifer Hoy, Jens Lundgren, Pablo Okhuysen, DAVID DALMAU, Clifford Leen, George Kinghorn, Giuseppe Tambussi, Matti Ristola, Lorenzo Magenta, Professor Amit Kumar, Lars Østergaard, Sean Emery, Angèle Gayet-Ageron, Alejandro Krolewiecki, Michael Kozal, André Cabié, Sylvie ABEL, Rafael Rubio García, Nicholas Andrew Medland, Matthew Goetz, Philippa Easterbrook, Barnaby Young, and ANASTASIA ANTONIADOU
Subjects: medicine.medical_specialty, Anti-HIV Agents, AIDS-Related Opportunistic Infections, HIV Infections, Kaplan-Meier Estimate, Disease, HIV Infections/*drug therapy/immunology/virology, Drug Administration Schedule, law.invention, Randomized controlled trial, Risk Factors, law, Internal medicine, Internal Medicine, medicine, Humans, In patient, RNA, Viral/blood, business.industry, Hazard ratio, Absolute risk reduction, HIV, Anti-HIV Agents/*administration & dosage, General Medicine, Viral Load, CD4 Lymphocyte Count, Institutional repository, Immunology, HIV/genetics, RNA, Viral, business, Viral load, AIDS-Related Opportunistic Infections/*etiology, Follow-Up Studies
Abstract: BACKGROUND: Episodic use of antiretroviral therapy guided by CD4+ cell counts is inferior to continuous antiretroviral therapy. OBJECTIVE: To determine whether reinitiating continuous antiretroviral therapy in patients who received episodic treatment reduces excess risk for opportunistic disease or death. DESIGN: Randomized, controlled trial. SETTING: Sites in 33 countries. PATIENTS: 5472 HIV-infected individuals with CD4(+) cell counts greater than 0.350 x 10(9) cells/L enrolled from January 2002 to January 2006. INTERVENTION: Episodic or continuous antiretroviral therapy initially, followed by continuous therapy in participants previously assigned to episodic treatment. MEASUREMENTS: Opportunistic disease or death was the primary outcome. RESULTS: Eighteen months after the recommendation to reinitiate continuous therapy, mean CD4+ cell counts were 0.152 x 10(9) cells/L (95% CI, 0.136 to 0.167 x 10(9) cells/L) less in participants previously assigned to episodic treatment (P > 0.001). The proportion of follow-up time spent with CD4+ cell counts of 0.500 x 10(9) cells/L or more and HIV RNA levels of 400 copies/mL or less was 29% for participants initially assigned to episodic therapy and 66% for those assigned to continuous therapy. Participants who reinitiated continuous therapy experienced rapid suppression of HIV RNA levels (89.7% with HIV RNA levels > or =400 copies/mL after 6 months), but CD4+ cell counts after 6 months remained 0.140 x 10(9) cells/L below baseline. The hazard ratio (episodic versus continuous treatment) for opportunistic disease or death decreased after the recommendation to reinitiate continuous therapy (from 2.5 [CI, 1.8 to 3.5] to 1.4 [CI, 1.0 to 2.0]; P = 0.033 for difference). The residual excess risk was attributable to failure to reinitiate therapy by some participants and slow recovery of CD4+ cell counts for those who reinitiated therapy. LIMITATION: Follow-up was too short to assess the full effect of switching from episodic t continuous antiretroviral therapy. CONCLUSION: Reinitiating continuous antiretroviral therapy in patients previously assigned to episodic treatment reduced excess risk for opportunistic disease or death, but excess risk remained. Episodic antiretroviral therapy, as used in the SMART study, should be avoided.

37. Cotrimoxazole for treatment of cerebral toxoplasmosis: an observational cohort study during 1994-2006

Author: Sylvie Abel, Bernard Liautaud, Sandrine Pierre-François, André Cabié, Guillaume Béraud, Didier Smadja, and Adeline Foltzer
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, Antiprotozoal Agents, Cohort Studies, Virology, Internal medicine, Antiretroviral Therapy, Highly Active, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Humans, Adverse effect, Antibacterial agent, First episode, Acquired Immunodeficiency Syndrome, business.industry, Sulfamethoxazole, Incidence (epidemiology), medicine.disease, Trimethoprim, Surgery, Infectious Diseases, Toxoplasmosis, Cerebral, Parasitology, Female, business, Encephalitis, medicine.drug, Cohort study
Abstract: Cotrimoxazole (trimethoprim/sulfamethoxazole [TMP-SMX]) is an alternative treatment for toxoplasmic encephalitis because it is inexpensive, well-tolerated, and as effective as pyrimethamine-sulfadiazine, which is the first-line drug regimen). We report results of a large cohort study of patients with acquired immunodeficiency syndrome who were treated for toxoplasmic encephalitis with cotrimoxazole. The mean follow-up period was more than three years. Our results confirm that cotrimoxazole is effective (85.5%), with a relatively low incidence of side effects (22%; 7.4% requiring treatment interruption). Relapse occurred in 30.1% of the patients at a mean +/- SD of 7.8 +/- 16.2 months after the first episode. The only risk factor for relapse was poor treatment and/or prophylaxis adherence. Mortality was significantly higher (P < 0.05) before 1996 than after 1996 (the era of highly active antiretroviral therapy). There was a non-significant trend towards a higher rate of relapse among patients treated before 1996 (P = 0.06). Consequently, cotrimoxazole could be a first-line drug regimen for curative treatment and prophylaxis of toxoplasmic encephalitis.

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Journal

Database

Publisher

37 results on '"Sylvie Abel"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources