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1. Increased liver stiffness is associated with mortality in HIV/HCV coinfected subjects: The French nationwide ANRS CO13 HEPAVIH cohort study.

Author

Sarah Shili-Masmoudi, Philippe Sogni, Victor de Ledinghen, Laure Esterle, Marc-Antoine Valantin, Isabelle Poizot-Martin, Anne Simon, Eric Rosenthal, Karine Lacombe, Gilles Pialoux, Olivier Bouchaud, Anne Gervais-Hasenknoff, Cécile Goujard, Lionel Piroth, David Zucman, Stéphanie Dominguez, François Raffi, Laurent Alric, Firouzé Bani-Sadr, Caroline Lascoux-Combe, Daniel Garipuy, Patrick Miailhes, Daniel Vittecoq, Claudine Duvivier, Hugues Aumaître, Didier Neau, Philippe Morlat, François Dabis, Dominique Salmon, Linda Wittkop, and ANRS CO13 HEPAVIH study group

Subjects
Medicine, Science
Abstract

BACKGROUND:The association between liver stiffness measurements (LSM) and mortality has not been fully described. In particular the effect of LSM on all-cause mortality taking sustained virological response (SVR) into account needs further study. METHODS:HIV/HCV participants in the French nation-wide, prospective, multicenter ANRS CO13 HEPAVIH cohort, with ≥1 LSM by FibroScan (FS) and a detectable HCV RNA when the first valid FS was performed were included. Cox proportional hazards models with delayed entry were performed to determine factors associated with all-cause mortality. LSM and SVR were considered as time dependent covariates. RESULTS:1,062 patients were included from 2005 to 2015 (69.8% men, median age 45.7 years (IQR 42.4-49.1)). 21.7% had baseline LSM >12.5 kPa. Median follow-up was 4.9 years (IQR 3.2-6.1). 727 (68.5%) were ever treated for HCV: 189 of them (26.0%) achieved SVR. 76 deaths were observed (26 liver-related, 10 HIV-related, 29 non-liver-non-HIV-related, 11 of unknown cause). At the age of 50, the mortality rate was 4.5% for patients with LSM ≤12.5 kPa and 10.8% for patients with LSM >12.5 kPa. LSM >12.5 kPa (adjusted Hazard Ratio [aHR] = 3.35 [2.06; 5.45], p12.5 kPa was strongly associated with all-cause mortality independently of SVR and other important covariates. Our results suggest that close follow-up of these patients should remain a priority even after achieving SVR.

Published
2019
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2. Factors associated with non-AIDS-defining cancers and non HCV-liver related cancers in HIV/HCV-coinfected patients- ANRS-CO13 HEPAVIH cohort.

Author

Oumar Billa, Mathieu Chalouni, Dominique Salmon, Isabelle Poizot-Martin, Camille Gilbert, Christine Katlama, Didier Neau, Julie Chas, Philippe Morlat, Karine Lacombe, Alissa Naqvi, Karl Barange, Anne Gervais, Olivier Bouchaud, Eric Rosenthal, Caroline Lascoux-Combe, Daniel Garipuy, Laurent Alric, Stéphanie Dominguez, Daniel Vittecoq, Cécile Goujard, Claudine Duvivier, Hugues Aumaitre, Patrick Miailhes, David Zucman, Anne Simon, Estibaliz Lazaro, François Raffi, Laure Esterle, Linda Wittkop, Firouzé Bani-Sadr, and ANRS CO13 HEPAVIH Study Group

Subjects
Medicine, Science
Abstract

Compared to the general population, HIV-infected patients are at higher risk of developing non-AIDS-defining cancers. Chronic HCV infection has also been associated with a higher risk than that of the general population of developing cancers other than hepatocarcinoma. Evaluation of the impact of HCV-related factors on non-AIDS-defining and non HCV-liver (NANL) related cancers among HIV/HCV co-infected patients are scarce. The aim of this study was to identify the impact of HIV/HCV clinical characteristics on NANL related cancers in a large cohort of HIV/HCV-coinfected patients followed from 2005 to 2017. Cox proportional hazards models with delayed entry were used to estimate factors associated with NANL related cancer. Among 1391 patients followed for a median of 5 years, 60 patients developed NANL related cancers, yielding an incidence rate of 8.9 per 1000 person-years (95% CI, [6.6-11.1]). By final multivariable analysis, after adjustment for sex, tobacco or alcohol consumption, baseline CD4 cell count and HCV sustained viral response (SVR), age and a longer duration since HIV diagnosis were independently associated with a higher risk of NANL related cancer (aHR for each additional year 1.10, 95% CI 1.06-1.14, p

Published
2018
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3. Atherosclerotic Cardiovascular Events in Patients Infected With Human Immunodeficiency Virus and Hepatitis C Virus

Author

Didier Neau, Camille Gilbert, Anne Gervais, Laure Esterle, Linda Wittkop, Laurent Alric, Lionel Piroth, Eric Rosenthal, Alissa Naqvi, François Dabis, Jose-Luis Lopez-Zaragoza, Dominique Salmon Ceron, Philippe Sogni, Julie Chas, Alexandre Cinaud, Christine Katlama, Anne Simon, Patrick Miailhes, Daniel Garipuy, Isabelle Poizot-Martin, Olivier Bouchaud, Karine Lacombe, Mathieu Chalouni, Marc Arthur Loko, Karl Barange, Franck Boccara, Firouzé Bani-Sadr, François Boué, François Raffi, Caroline Lascoux-Combe, David Zucman, Philippe Morlat, Claudine Duvivier, Hugues Aumaitre, Cécile Goujard, Estibaliz Lazaro, Boun Kim Tan, David Rey, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpitaux Universitaires Paris Centre (CHU Paris Centre), Université Paris Descartes - Paris 5 (UPD5), Team MORPH3EUS (INSERM U1219 - UB - ISPED), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB), Hôtel-Dieu, 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), 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), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, CHU Tenon [AP-HP], Hôpital Saint-André, Hôpital l'Archet, Université de Nice Sophia-Antipolis (UNSA), CHU Saint-Antoine [AP-HP], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Avicenne [AP-HP], Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hopital Saint-Louis [AP-HP] (AP-HP), Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Saclay, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Saint Jean de Perpignan, Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Henri Mondor, Hôpital Foch [Suresnes], Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), AP-HP - Hôpital Antoine Béclère [Clamart], Hôpital universitaire Robert Debré [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), Immunité Innée - Innate Immunity, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université Sorbonne Paris Cité (USPC), Pathologies biliaires, fibrose et cancer du foie [CRSA], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Malbec, Odile, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, and Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH)

Subjects
Microbiology (medical), Adult, Male, hepatitis C virus, medicine.medical_specialty, [SDV]Life Sciences [q-bio], HIV Infections, Hepacivirus, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Sida, biology, business.industry, Proportional hazards model, Incidence (epidemiology), cardiovascular, Hazard ratio, HIV, Middle Aged, medicine.disease, biology.organism_classification, Hepatitis C, coinfection, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Cardiovascular Diseases, Cohort, Coinfection, Female, atherosclerosis, business, Viral load
Abstract

Background An increased risk of cardiovascular disease (CVD) was reported in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), without identifying factors associated with atherosclerotic CVD (ASCVD) events. Methods HIV-HCV coinfected patients were enrolled in the Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS) CO13 HEPAVIH nationwide cohort. Primary outcome was total ASCVD events. Secondary outcomes were coronary and/or cerebral ASCVD events, and peripheral artery disease (PAD) ASCVD events. Incidences were estimated using the Aalen-Johansen method. Factors associated with ASCVD were identified using cause-specific Cox proportional hazards models. Results At baseline, median age of the study population (N = 1213) was 45.4 (interquartile range [IQR] 42.1−49.0) years and 70.3% were men. After a median follow-up of 5.1 (IQR 3.9−7.0) years, the incidence was 6.98 (95% confidence interval [CI], 5.19−9.38) per 1000 person-years for total ASCVD events, 4.01 (2.78−6.00) for coronary and/or cerebral events, and 3.17 (2.05−4.92) for PAD ASCVD events. Aging (hazard ratio [HR] 1.06; 95% CI, 1.01−1.12), prior CVD (HR 8.48; 95% CI, 3.14−22.91), high total cholesterol (HR 1.43; 95% CI, 1.11−1.83), high-density lipoprotein cholesterol (HR 0.22; 95% CI, 0.08−0.63), statin use (HR 3.31; 95% CI, 1.31−8.38), and high alcohol intake (HR 3.18; 95% CI, 1.35−7.52) were independently associated with total ASCVD events, whereas undetectable baseline viral load (HR 0.41, 95% CI, 0.18−0.96) was associated with coronary and/or cerebral events. Conclusions HIV-HCV coinfected patients experienced a high incidence of ASCVD events. Some traditional cardiovascular risk factors were the main determinants of ASCVD. Controlling cholesterol abnormalities and maintaining undetectable HIV RNA are essential to control cardiovascular risk.

Published
2021
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4. Étude observationnelle de l’évolution sur trois ans de la densité osseuse de 215 patients vivant avec le VIH, traités, avec ou sans Ténofovir, à distance de l’induction thérapeutique

Author

Stéphane Sire, Daniel Garipuy, Fabrice Marion-Latard, Jacques Bernard, Cyrille Delpierre, Martine Obadia, Patrice Massip, Lise Cuzin, Eric Bonnet, Christian Aquilina, and Pauline Lansalot-Matras

Subjects
0301 basic medicine, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, 030106 microbiology, 030212 general & internal medicine
Abstract

Resume Objectif Comparer l’evolution de densite osseuse, a distance de l’induction therapeutique, de patients infectes par le VIH, traites avec Tenofovir versus sans Tenofovir. Methodes Nous avons compare deux groupes : patients sous Tenofovir versus sans Tenofovir, selectionnes parmi des patients infectes par le VIH, sous traitement continu depuis plus d’un an, ayant eu au moins deux osteodensitometries a plus d’un an d’intervalle. Les criteres de jugement principaux etaient les variations de densite osseuse lombaire (DOL), de densite osseuse corps entier et la variation osseuse individuelle significative de DOL (perte osseuse quand baisse > 0,04 g/cm 2 ). Differentes variables interferant avec la composition corporelle et la prescription de Tenofovir ont ete recueillies via le dossier medical informatise NADIS. Resultats Notre population comprenait 215 patients, 49 femmes et 166 hommes ; 112 patients sous Tenofovir, 103 patients sans ; suivis trois ans en moyenne. Le groupe sous Tenofovir a eu une perte moyenne de DOL de 0,008 g/cm 2 , contre un gain de 0,009 g/cm 2 pour le groupe sans Tenofovir ( p = 0,01). Un total de 22,7 % des patients sous Tenofovir ont eu une perte osseuse individuelle de DOL, contre 13 % des patients sans Tenofovir ( p = 0,07). En regression logistique multivariee, le fait d’etre sous Tenofovir augmentait le risque d’avoir une perte osseuse de DOL, avec un odds ratio de 2,42 (intervalle de confiance a 95 % : 1,03–5,66, p = 0,042). Conclusion Dans notre travail, meme a distance de l’induction therapeutique, la prise de Tenofovir reste associee a une perte de densite osseuse.

Published
2018
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5. Liver stiffness and fibrosis-4 alone better predict liver events compared with aspartate aminotransferase to platelet ratio index in a cohort of human immunodeficiency virus and hepatitis C virus co-infected patients from ANRS CO13 HEPAVIH cohort

Author

Laurent Alric, Christine Katlama, Lionel Piroth, Julie Chas, Karine Lacombe, Linda Wittkop, Alissa Naqvi, Eric Rosenthal, Philippe Sogni, Laure Esterle, Didier Neau, Daniel Vittecoq, Dominique Salmon, Isabelle Poizot-Martin, Philippe Morlat, Daniel Garipuy, Karl Barange, Caroline Lascoux-Combe, Anne Gervais, Patrick Miailhes, Mathieu Chalouni, Hugues Aumaitre, Olivier Bouchaud, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Service des maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies Infectieuses et Tropicales [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU Bordeaux [Bordeaux], Service des maladies infectieuses [CH Perpignan], Centre Hospitalier Saint Jean de Perpignan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de Maladies Infectieuses et Tropicales [CHU Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de maladies infectieuses et tropicales [CHU Avicenne], Hôpital Avicenne [AP-HP], Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Hôpital Saint-André, Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôpital l'Archet, Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Hôpital Joseph Ducuing, Service de Gastro-entérologie - Hépatologie [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Maladies infectieuses et tropicales [CHU Tenon], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Hôpital Joseph Ducuing - Varsovie [Toulouse] (HJD), Pôle Maladies de l'appareil digestif [CHU Toulouse], HAL AMU, Administrateur, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Liver Cirrhosis, Male, Cirrhosis, HIV Infections, medicine.disease_cause, Gastroenterology, 0302 clinical medicine, Stage (cooking), 10. No inequality, noninvasive markers, Coinfection, Liver Neoplasms, Age Factors, Alanine Transaminase, Hepatitis C, Middle Aged, 3. Good health, Liver, 030220 oncology & carcinogenesis, Cohort, liver-related events, Elasticity Imaging Techniques, Female, 030211 gastroenterology & hepatology, Gastrointestinal Hemorrhage, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatorenal Syndrome, Hepatitis C virus, Esophageal and Gastric Varices, Risk Assessment, 03 medical and health sciences, Insulin resistance, Internal medicine, medicine, Humans, Aspartate Aminotransferases, Hepatology, Receiver operating characteristic, Platelet Count, business.industry, prediction, Hepatitis C, Chronic, medicine.disease, human immunodeficiency virus/hepatitis C virus co-infection, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Hepatic Encephalopathy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

International audience; Objectives HIV/hepatitis C virus (HCV) co-infection leads to major complications, and noninvasive markers developed to stage liver fibrosis could be used as prognostic markers. We aimed to compare the performances of liver stiffness (LS), fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI) to predict liver-related events in HIV/HCV co-infected patients.Patients and methods HIV/HCV co-infected patients from the ANRS CO13 HEPAVIH cohort were included if they had LS, FIB-4, and APRI measurements done in a window of 3 months. Primary outcome was the time between inclusion and occurrence of a liver-related event. Univariable and multivariable Fine and Gray models were performed. Predictive performances were compared by the area under the receiver operating characteristic (AUROC) differences after correction of optimistic by bootstrap samples. Best cutoffs to predict liver-related events were estimated by sensitivity and specificity maximization.Results A total of 998 patients were included. Overall, 70.7% were men. Their median age was 46.8 years. According to LS value, 204 (20.4%) patients had cirrhosis. Overall, 39 patients experienced at least one liver-related event. In univariable analysis, LS AUROC curve was significantly superior to FIB-4 and APRI AUROC curves, being 87.9, 78.2, and 75.0%, respectively. After adjustment on age, CD4 levels, and insulin resistance, no differences were observed. The best cutoffs to identify patients at low or high risk of liver-related events were below 8.5, 1.00, and 0.35 and above 16.5, 4.00, and 1.75 for LS, FIB-4, and APRI, respectively.Conclusion To predict HCV-related events, APRI had lower performance than LS and FIB-4. FIB-4 is as good as LS to predict HCV-related events, suggesting that it can be used for the management of HIV/HCV co-infected patients and replace LS.

Published
2019
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6. Factors associated with non-AIDS-defining cancers and non HCV-liver related cancers in HIV/HCV-coinfected patients- ANRS-CO13 HEPAVIH cohort

Author

Patrick Miailhes, Mathieu Chalouni, Eric Rosenthal, Hugues Aumaitre, Estibaliz Lazaro, Daniel Garipuy, François Raffi, Daniel Vittecoq, Cécile Goujard, Firouzé Bani-Sadr, Linda Wittkop, Alissa Naqvi, Oumar Billa, Dominique Salmon, Olivier Bouchaud, Karl Barange, David Zucman, Claudine Duvivier, Isabelle Poizot-Martin, Caroline Lascoux-Combe, Anne Simon, Karine Lacombe, Laurent Alric, Philippe Morlat, Stéphanie Dominguez, Didier Neau, Julie Chas, Christine Katlama, Laure Esterle, Camille Gilbert, Anne Gervais, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), 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), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service des Maladies Infectieuses et Tropicales A [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université de Bordeaux (UB), CHU Bordeaux [Bordeaux], Hôpital Pellegrin, CHU Tenon [AP-HP], Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, CHU Saint-Antoine [AP-HP], Service d'infectiologie [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service des maladies infectieuses et tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Avicenne [AP-HP], Hôpital Archet 2 [Nice] (CHU), Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), DILTEC - Didactique des langues, des textes et des cultures - EA 2288 (DILTEC), Université Sorbonne Nouvelle - Paris 3, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Saint Jean de Perpignan, 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), Hôpital Foch [Suresnes], Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire de Reims (CHU Reims), 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), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Gestionnaire, Hal Sorbonne Université, Service de 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), Service de Maladies infectieuses et tropicales [CHU Tenon], Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], Université Fédérale Toulouse Midi-Pyrénées, Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales [CHU Tenon], CHU Toulouse [Toulouse], Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Nice Sophia Antipolis (... - 2019) (UNS), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service des maladies infectieuses et tropicales [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Hôpital Purpan [Toulouse], Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Institut de Recherche pour le Développement (IRD), and Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière]

Subjects
Oncology, Liver Cirrhosis, Male, HIV Infections, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk Factors, Medicine, Public and Occupational Health, Prospective Studies, Prospective cohort study, education.field_of_study, Multidisciplinary, Alcohol Consumption, Pharmaceutics, Coinfection, Liver Diseases, Liver Neoplasms, virus diseases, HIV diagnosis and management, Viral Load, Middle Aged, Vaccination and Immunization, Hepatitis C, 3. Good health, Cirrhosis, 030220 oncology & carcinogenesis, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infectious diseases, 030211 gastroenterology & hepatology, Female, Viral load, Research Article, Adult, medicine.medical_specialty, Science, Population, Immunology, Antiretroviral Therapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Gastroenterology and Hepatology, Viral diseases, Microbiology, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), [SDV.CAN] Life Sciences [q-bio]/Cancer, Drug Therapy, Antiviral Therapy, Internal medicine, Virology, Cancer Detection and Diagnosis, Humans, education, Nutrition, Medicine and health sciences, business.industry, Proportional hazards model, Cancer, Biology and Life Sciences, medicine.disease, Diagnostic medicine, digestive system diseases, Diet, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Preventive Medicine, business, Viral Transmission and Infection
Abstract

International audience; Compared to the general population, HIV-infected patients are at higher risk of developing non-AIDS-defining cancers. Chronic HCV infection has also been associated with a higher risk than that of the general population of developing cancers other than hepatocarcinoma. Evaluation of the impact of HCV-related factors on non-AIDS-defining and non HCV-liver (NANL) related cancers among HIV/HCV co-infected patients are scarce. The aim of this study was to identify the impact of HIV/HCV clinical characteristics on NANL related cancers in a large cohort of HIV/HCV-coinfected patients followed from 2005 to 2017. Cox proportional hazards models with delayed entry were used to estimate factors associated with NANL related cancer. Among 1391 patients followed for a median of 5 years, 60 patients developed NANL related cancers, yielding an incidence rate of 8.9 per 1000 person-years (95% CI, [6.6-11.1]). By final multivariable analysis, after adjustment for sex, tobacco or alcohol consumption, baseline CD4 cell count and HCV sustained viral response (SVR), age and a longer duration since HIV diagnosis were independently associated with a higher risk of NANL related cancer (aHR for each additional year 1.10, 95% CI 1.06-1.14, p

Published
2018
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7. Antiretroviral Therapy and Sustained Virological Response to HCV Therapy are Associated with Slower Liver Fibrosis Progression in HIV–HCV-Coinfected Patients: Study from the Anrs Co 13 Hepavih Cohort

Author

Marc-Arthur, Loko, Firouze, Bani-Sadr, Marc-Antoine, Valantin, Caroline, Lascoux-Combe, Hélène, Fontaine, Philippe, Bonnard, Anne, Gervais, Olivier, Bouchaud, Daniel, Garipuy, Yann, Quertainmont, Daniel, Vittecoq, Michka Shoai, Tehrani, Maria, Winnock, François, Dabis, Dominique, Salmon, and M, Winnock

Subjects
Adult, Liver Cirrhosis, Male, Oncology, medicine.medical_specialty, Time Factors, Liver fibrosis, Human immunodeficiency virus (HIV), HIV Infections, Hcv therapy, Hepacivirus, medicine.disease_cause, Cohort Studies, Virological response, Risk Factors, Liver stiffness, Internal medicine, Humans, Medicine, Pharmacology (medical), Pharmacology, Coinfection, business.industry, HIV, Alanine Transaminase, Hepatitis C, Chronic, Middle Aged, Viral Load, Antiretroviral therapy, CD4 Lymphocyte Count, Logistic Models, Treatment Outcome, Infectious Diseases, Anti-Retroviral Agents, Liver, Cohort, Disease Progression, RNA, Viral, Female, business, Follow-Up Studies
Abstract

Background The aim of this study was to describe changes in repeated liver stiffness (LS) measurements and to assess the determinants of increase in LS in HIV– HCV-coinfected patients. Methods HIV–HCV-coinfected adults enrolled in the ANRS CO 13 HEPAVIH cohort, for whom two results of LS, evaluated over ≥24 months, were available. Patients with unreliable LS results were not included. LS was measured at baseline and every year thereafter. Determinants of LS increase were assessed using linear (primary outcome: last LS minus first LS value) and logistic (secondary outcome: ≥30% increase in the initial LS value) regression analyses. Results A total of 313 patients (mean age 45 years, 67.4% male) were included. Overall, 93.9% were receiving antiretroviral treatment (ART). The mean baseline CD4+ T-cell count was 471 cells/mm3 and 72.2% of patients had undetectable plasma HIV RNA. The mean interval between the first and last LS measurements was 33.5 months. No significant difference was found between baseline and follow-up mean LS values ( P=0.39). However, a decrease of ≥30% in LS was observed in 48 (15.3%) patients and an increase of ≥30% in 64 (20.5%) patients. In multivariate linear and logistic analyses, excessive alcohol intake (P coefficient 6.8; P=0.0006) and high HCV viral load (OR 1.7, 95% CI 1.1, 2.5; P=0.01) were independently associated with an increase in LS, whereas time on ART>114.5 months (OR 0.5, 95% CI 0.3, 0.9; P=0.03) and achievement of sustained virological response (OR 0.1, 95% CI 0.01, 0.9; P=0.04) were independently associated with no increase in LS. Conclusions Our findings show that long-term ART and achieving sustained virological response in HIV-HCV-coinfected patients are both significantly associated with lack of increase in LS over a 33-month period.

Published
2012
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8. Increased liver stiffness is associated with mortality in HIV/HCV coinfected subjects: The French nationwide ANRS CO13 HEPAVIH cohort study

Author

Cécile Goujard, Patrick Miailhes, Firouzé Bani-Sadr, Laure Esterle, Anne Simon, Daniel Vittecoq, Karine Lacombe, Dominique Salmon, Gilles Pialoux, Lionel Piroth, Didier Neau, François Dabis, Linda Wittkop, Claudine Duvivier, François Raffi, Philippe Morlat, Caroline Lascoux-Combe, Stéphanie Dominguez, Isabelle Poizot-Martin, Olivier Bouchaud, Victor de Ledinghen, Anne Gervais-Hasenknoff, Laurent Alric, Marc-Antoine Valantin, Philippe Sogni, David Zucman, Eric Rosenthal, Daniel Garipuy, Hugues Aumaitre, Sarah Shili-Masmoudi, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie du cancer du foie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Hôpital l'Archet, CHU Saint-Antoine [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Tenon [AP-HP], Service de maladies infectieuses et tropicales [CHU Avicenne], Hôpital Avicenne [AP-HP], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Laboratoire d'Immunologie [AP-HP Hôpital Kremlin-Bicêtre] (GHU Paris-Sud), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Bordeaux Segalen - Bordeaux 2, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales [CHU Tenon], Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Service de Maladies infectieuses et tropicales [CHU Tenon], and HAL AMU, Administrateur

Subjects
Male, RNA viruses, Sustained Virologic Response, Metabolic disorders, Social Sciences, HIV Infections, Hepacivirus, medicine.disease_cause, Gastroenterology, 0302 clinical medicine, Immunodeficiency Viruses, Risk Factors, Psychology, Alcohol consumption, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Pathology and laboratory medicine, Multidisciplinary, Death rates, Coinfection, Hepatitis C virus, Mortality rate, Hazard ratio, virus diseases, Hepatitis C, Middle Aged, Medical microbiology, Addicts, 3. Good health, Liver, Drug users, Viruses, Cohort, Elasticity Imaging Techniques, Medicine, Female, 030211 gastroenterology & hepatology, France, Pathogens, Research Article, Cohort study, Adult, medicine.medical_specialty, Science, Liver fibrosis, Addiction, Gastroenterology and Hepatology, Antiviral Agents, Microbiology, 03 medical and health sciences, Population Metrics, Internal medicine, Retroviruses, medicine, Humans, Mortality, Liver diseases, Proportional Hazards Models, Nutrition, Medicine and health sciences, Biology and life sciences, Flaviviruses, Population Biology, business.industry, Proportional hazards model, Lentivirus, Organisms, Viral pathogens, HIV, Hepatitis C, Chronic, medicine.disease, Hepatitis viruses, Microbial pathogens, Diet, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Background The association between liver stiffness measurements (LSM) and mortality has not been fully described. In particular the effect of LSM on all-cause mortality taking sustained virological response (SVR) into account needs further study. Methods HIV/HCV participants in the French nation-wide, prospective, multicenter ANRS CO13 HEPAVIH cohort, with ≥1 LSM by FibroScan (FS) and a detectable HCV RNA when the first valid FS was performed were included. Cox proportional hazards models with delayed entry were performed to determine factors associated with all-cause mortality. LSM and SVR were considered as time dependent covariates. Results 1,062 patients were included from 2005 to 2015 (69.8% men, median age 45.7 years (IQR 42.4–49.1)). 21.7% had baseline LSM >12.5 kPa. Median follow-up was 4.9 years (IQR 3.2–6.1). 727 (68.5%) were ever treated for HCV: 189 of them (26.0%) achieved SVR. 76 deaths were observed (26 liver-related, 10 HIV-related, 29 non-liver-non-HIV-related, 11 of unknown cause). At the age of 50, the mortality rate was 4.5% for patients with LSM ≤12.5 kPa and 10.8% for patients with LSM >12.5 kPa. LSM >12.5 kPa (adjusted Hazard Ratio [aHR] = 3.35 [2.06; 5.45], p12.5 kPa was strongly associated with all-cause mortality independently of SVR and other important covariates. Our results suggest that close follow-up of these patients should remain a priority even after achieving SVR.

Published
2019
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9. Analyse des effets indésirables des médicaments du VIH

Author

Patrice Massip, Daniel Garipuy, Jean-Louis Montastruc, Eric Bonnet, Agnès Sommet, Magalie Baudrant, Françoise Lucas, Christian Aquilina, Lise Cuzin, Valérie Bassoua, Emmanuelle Guitton, and Haleh Bagheri

Subjects
medicine.medical_specialty, biology, business.industry, MEDLINE, medicine.disease, University hospital, biology.organism_classification, Surgery, Acquired immunodeficiency syndrome (AIDS), Infectious disease (medical specialty), Emergency medicine, Pharmacovigilance, medicine, Pharmacology (medical), Viral disease, Adverse effect, Sida, business
Abstract

In 1999, The Regional Center of Pharmacogilance and the Department of Infectious Disease of the Toulouse University Hospital set up a system to improve the data collection about antiretroviral-induced adverse reactionss (ADRs). From November 1999 to April 2003, a resident of pharmacovigilance collected ADRs reported with antiretroviral drugs during 2 weekly medical consultations. A total of 613 ADRs corresponding to 428 patients were reported, classified as "non serious" in 88.6% of cases and required the withdrawal of suspected drugs in 57% of cases. Our data show an improvement of antiretroviral drug-induced ADRs reporting.

Published
2006
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10. INFLUENCE OF HCV GENOTYPE 1 SUBTYPES ON THE VIRUS RESPONSE TO PEG INTERFERON ALPHA-2a PLUS RIBAVIRIN THERAPY

Author

Sophie Thebault, Etienne Chatelut, Jean-Louis Payen, Christophe Renou, Laurent Alric, Jean-Jacques Meurisse, Jacques Izopet, Yves Imbert, Daniel Garipuy, Florence Nicot, Thierry Morin, B. Castan, Karine Sauné, Stéphane Sire, Jean-Marc Combis, Bruno Guérin, Karl Barange, Hervé Desmorat, Jean-Michel Dramard, S. Metivier, Jean-Marie Peron, Pierre Barel, Virology Laboratory, Hospital, Département d'hépatologie et de gastroentérologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Gastroenterology, Toulouse University hospital, Val d'Ariège Hospital, Ambroise Paré Cinic, General Medicine, Internal Medicine, Ducuing Hospital, Polyclinique du Parc, Hepato-gastro-enterology, Bigorre Hospital, Hepatology, Hopital, Laboratory of Virology, EA3035, Institut Claudius Regaud, VIROLOGIE, and CHU Toulouse [Toulouse]

Subjects
Adult, Male, Genotype, Hepacivirus, Hepatitis C virus, HIV Infections, medicine.disease_cause, Antiviral Agents, Polyethylene Glycols, 03 medical and health sciences, chemistry.chemical_compound, Flaviviridae, 0302 clinical medicine, Pegylated interferon, Virology, Ribavirin, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, 030304 developmental biology, Aged, 0303 health sciences, biology, business.industry, Interferon-alpha, virus diseases, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Viral Load, biology.organism_classification, medicine.disease, Recombinant Proteins, digestive system diseases, 3. Good health, Infectious Diseases, Treatment Outcome, chemistry, Drug Therapy, Combination, Female, Viral disease, business, medicine.drug
Abstract

International audience; New factors that influence the viral response in HCV non-genotype 2/3 patients must be identified in order to optimize anti-HCV treatment. This multicenter prospective study evaluates the influence of HCV variability and pharmacological parameters on the virological response of these patients to pegylated interferon α2a (peg-IFN-α2a: 180 µg/week) and ribavirin (800-1200 mg/day) for 48 weeks. HCV subtypes were identified by sequencing the NS5B region. Serum ribavirin and peg-IFN-α2a concentrations were measured at weeks 4 and 12. The 115 patients (67 men; median age=49, range [31-76]) included 64 who had never been treated and 27 co-infected with HIV. The mean baseline HCV RNA was 6.30 ± 0.06 log IU/mL and the HCV genotypes were: G1 (n=93) with 1a (n=37) and 1b (n=50), G4 (n=20) and G5 (n=2). Most patients (79/108; 73%) had an early virological response. Independent predictors of an early virological response were interferon naive patients (OR=2.98 [1.15; 7.72]) and ribavirin of > 2,200 ng/mL at week 12 (OR=3.41 [1.31; 8.90]). Forty of 104 patients (38%) had a sustained virological response. The only independent predictors of a sustained virological response were subtype 1b (OR=6.82 [1.7; 26.8]), and HCV RNA 2,200 ng/mL was associated with an early virological response and patients infected with HCV subtype 1b had a better chance of a sustained virological response than did those infected with subtype 1a.

Published
2011
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11. Buprenorphine versus methadone in pregnant opioid-dependent women: a prospective multicenter study

Author

Daniel Garipuy, Isabelle Lacroix, Jean-Louis Montastruc, Alain Berrebi, Catherine Chaumerliac, Maryse Lapeyre-Mestre, Christine Damase-Michel, Yamina Hammou, and Laurent Schmitt

Subjects
Adult, Narcotics, medicine.medical_specialty, Neonatal withdrawal, Birth weight, Abortion, Heroin, Pregnancy, medicine, Opiate Substitution Treatment, Birth Weight, Humans, Pharmacology (medical), Prospective Studies, Pharmacology, business.industry, Obstetrics, Heroin Dependence, Infant, Newborn, Pregnancy Outcome, General Medicine, medicine.disease, Opioid-Related Disorders, Buprenorphine, Analgesics, Opioid, Pregnancy Complications, Anesthesia, Female, Opiate, business, Neonatal Abstinence Syndrome, Methadone, medicine.drug
Abstract

In order to investigate the effects of exposure to buprenorphine compared with methadone during pregnancy, a prospective multicenter study was conducted in collaboration with maternity hospitals, maintenance therapy centers, and general practitioners involved in addiction care. Ninety pregnant women exposed to buprenorphine and 45 to metadone were selected for the study. During pregnancy, some women were exposed to illicit agents: cannabis (42% in the buprenorphine group vs. 58% in the methadone-treated group), heroin (17% vs. 44%), or cocaine (3% vs. 11%). Pregnancies ended in 85 vs. 40 live births, one vs. two stillbirths, two vs. one spontaneous abortion, two vs. one voluntary termination, and one vs. one medical termination in the buprenorphine and the methadone groups, respectively. Newborns had a birth weight of 2,892 ± 506 g (buprenorphine) vs. 2,731 ± 634 g (methadone) and a body length of 47.6 ± 2.5 cm vs. 47.1 ± 3 cm. 18.8% vs. 10% of newborns were delivered before 37 weeks of amenorrhea. Neonatal withdrawal syndrome occurred more frequently in the methadone group (62.5% vs. 41.2, p = 0.03). After adjustment for heroin exposure in late pregnancy, rates of neonatal withdrawal were no longer different between the methadone and buprenorphine groups. Twenty-one babies (84%) in the methadone group and 20 (57%) in the buprenorphine group (p = 0.03) required opiate treatment. We did not observe more frequent malformations or cases of withdrawal syndrome in the buprenorphine group than in the methadone-treated group. Buprenorphine appears to be as safe as the currently approved substitute methadone considered to date as the reference treatment for pregnant opioid-dependent women.

Published
2010

12. [Analysis of antiretroviral drugs-induced adverse effects]

Author

Magalie, Baudrant, Haleh, Bagheri, Lise, Cuzin, Agnès, Sommet, Valérie, Bassoua, Emmanuelle, Guitton, Eric, Bonnet, Daniel, Garipuy, Françoise, Lucas, Christian, Aquilina, Jean-Louis, Montastruc, and Patrice, Massip

Subjects
Hospitals, University, Risk Management, Humans, France, Antiviral Agents, Retroviridae Infections
Abstract

In 1999, The Regional Center of Pharmacogilance and the Department of Infectious Disease of the Toulouse University Hospital set up a system to improve the data collection about antiretroviral-induced adverse reactionss (ADRs). From November 1999 to April 2003, a resident of pharmacovigilance collected ADRs reported with antiretroviral drugs during 2 weekly medical consultations. A total of 613 ADRs corresponding to 428 patients were reported, classified as "non serious" in 88.6% of cases and required the withdrawal of suspected drugs in 57% of cases. Our data show an improvement of antiretroviral drug-induced ADRs reporting.

Published
2006

13. [Not Available]

Author

Magalie, Bandrant, Haleh, Bagheri, Lise, Cuzin, Agnès, Sommet, Valérie, Bassoua, Emmanuelle, Guitton, Eric, Bonnet, Daniel, Garipuy, Françoise, Lucas, Christian, Aquilina, Jean-Louis, Montastruc, and Patrice, Massip

Abstract

Analysis of Antiretroviral Drugs-Induced Adverse Elfects. In 1999, The Regional Center of Pharmacogilance and the Department of Infectious Disease of the Toulouse University Hospital set up a system to improve the data collection about antiretroviral-induced adverse reactionss (ADRs). From November 1999 to April 2003, a resident of pharmacovigilance collected ADRs reported with antiretroviral drugs during 2 weekly medical consultations. A total of 613 ADRs corresponding to 428 patients were reported, classified as "non serious" in 88.6% of cases and required the withdrawal of suspected drugs in 57% of cases. Our data show an improvement of antiretroviral drug-induced ADRs reporting.

Published
2004

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