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1. COVID-19 and Pasteurella multocida Pulmonary Coinfection: A Case Series

Author: Ornella Cabras, Jean-Marie Turmel, Claude Olive, Bastien Bigeard, Mélanie Lehoux, Sandrine Pierre-Francois, Karine Guitteaud, Sylvie Abel, Lise Cuzin, and André Cabié
Subjects: COVID-19 coinfection, Pasteurella multocida pulmonary infection, ventilator-acquired pneumonia, Medicine
Abstract: Objectives: In COVID-19 patients, bacterial and fungal pulmonary coinfections, such as Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, or Aspergillus, have been reported, but to our knowledge, no case has been reported due to Pasteurella multocida. Patients and methods: We describe three cases of Pasteurella multocida coinfections occurring during the 4th wave of COVID-19 in Martinique (French West Indies). Results: All three cases were fatal; thus, Pasteurella multocida has to be considered as a potentially severe coinfection agent. Conclusions: Alteration of the epithelial–endothelial barrier due to a SARS-CoV-2 infection probably promotes the expression of a Pasteurella infection. In addition, the SARS-CoV-2 infection induced immunosuppression, and an inflammatory cascade could explain the infection’s severity. The use of corticosteroids, which are part of the first-line therapeutic arsenal against COVID-19, may also promote the pathogenicity of this agent.
Published: 2022
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2. Seroprevalence of chikungunya virus infection among HIV-infected adults in French Caribbean Islands of Martinique and Guadeloupe in 2015: A cross-sectional study.

Author: Elodie Curlier, Laurence Fagour, Cécile Herrmann-Storck, Adrien Staelen, Ingrid Vingadassalom, Sébastien Breurec, Sylvie Abel, Sandrine Pierre-François, Janick Jean-Marie, Cédric Laouénan, Raymond Césaire, Bruno Hoen, and André Cabié
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract: BackgroundIn 2014, a first outbreak of chikungunya hit the Caribbean area where chikungunya virus (CHIKV) had never circulated before.Methodology/principal findingsWe 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/significanceThis study showed that the seroprevalence of CHIKV infection was 61% after the 2014 outbreak, with one third of asymptomatic infections.Trial registrationClinicalTrials.gov NCT02553369.
Published: 2021
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3. 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, and DEPIPAPUFR study group
Subjects: Medicine, Science
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
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4. Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique): A prospective cohort study.

Author: Antoine Bertolotti, Marême Thioune, Sylvie Abel, Gilda Belrose, Isabelle Calmont, Raymond Césaire, Minerva Cervantes, Laurence Fagour, Émilie Javelle, Catherine Lebris, Fatiha Najioullah, Sandrine Pierre-François, Benoît Rozé, Marie Vigan, Cédric Laouénan, André Cabié, and Chronic Chikungunya working group of University Medical Center of Martinique
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract: BACKGROUND:The chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic and potentially incapacitating rheumatic musculoskeletal disorders known as chronic chikungunya arthritis (CCA). We conducted a prospective cohort study of CHIKV-infected subjects during the 2013 chikungunya outbreak in Martinique. The aim of this study was to assess the prevalence of CCA at 12 months and to search for acute phase factors significantly associated with chronicity. METHODOLOGY/PRINCIPAL FINDINGS:A total of 193 patients who tested positive for CHIKV RNA via qRT-PCR underwent clinical investigations in the acute phase (
Published: 2020
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5. The effects of chikungunya virus infection on people living with HIV during the 2014 Martinique outbreak.

Author: Mathilde Pircher, Edwin Pitono, Sandrine Pierre-François, Sabine Molcard, Lauren Brunier-Agot, Laurence Fagour, Fatiha Najioullah, Raymond Cesaire, Sylvie Abel, Lise Cuzin, and André Cabié
Subjects: Medicine, Science
Abstract: 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
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6. High prevalence of human papillomavirus infection in HIV-infected women living in French Antilles and French Guiana.

Author: Sylvie Abel, Fatiha Najioullah, Jean-Luc Voluménie, Laetitia Accrombessi, Gabriel Carles, Dominique Catherine, Déborah Chiappetta, Cyril Clavel, Akua Codjo-Sodokine, Myriam El Guedj, Janick Jean-Marie, Vincent Molinié, Sandrine Pierre-François, Sofia Stegmann-Planchard, Vincent Vantilcke, Tania Vaz, Mathieu Nacher, André Cabié, Raymond Césaire, and for HP2V study group
Subjects: Medicine, Science
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
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7. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources.

Author: Sylvie Abel, Lise Cuzin, Séverine Da Cunha, Jean-Marie Bolivard, Laurence Fagour, Charline Miossec, Mathilde Pircher, Marême Thioune, Raymond Césaire, and André Cabié
Subjects: Medicine, Science
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
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8. Reemergence of Syphilis in Martinique, 2001–2008

Author: André Cabié, Bruno Rollin, Sandrine Pierre-François, Sylvie Abel, Nicole Desbois, Pascale Richard, Patrick Hochedez, Raphaëlle Théodose, Danielle Quist, Raymond Hélénon, Christian Derancourt, Annick Cavelier, and Bernard Liautaud
Subjects: Syphilis, Caribbean, outbreak, reemergence, Martinique, homosexuality, Medicine, Infectious and parasitic diseases, RC109-216
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
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9. Sexually-transmitted/founder HIV-1 cannot be directly predicted from plasma or PBMC-derived viral quasispecies in the transmitting partner.

Author: Pierre Frange, Laurence Meyer, Matthieu Jung, Cecile Goujard, David Zucman, Sylvie Abel, Patrick Hochedez, Marine Gousset, Olivier Gascuel, Christine Rouzioux, Marie-Laure Chaix, and ANRS PRIMO Cohort Study Group
Subjects: Medicine, Science
Abstract: OBJECTIVE: Characterization of HIV-1 sequences in newly infected individuals is important for elucidating the mechanisms of viral sexual transmission. We report the identification of transmitted/founder viruses in eight pairs of HIV-1 sexually-infected patients enrolled at the time of primary infection ("recipients") and their transmitting partners ("donors"). METHODS: Using a single genome-amplification approach, we compared quasispecies in donors and recipients on the basis of 316 and 376 C2V5 env sequences amplified from plasma viral RNA and PBMC-associated DNA, respectively. RESULTS: Both DNA and RNA sequences indicated very homogeneous viral populations in all recipients, suggesting transmission of a single variant, even in cases of recent sexually transmitted infections (STIs) in donors (n = 2) or recipients (n = 3). In all pairs, the transmitted/founder virus was derived from an infrequent variant population within the blood of the donor. The donor variant sequences most closely related to the recipient sequences were found in plasma samples in 3/8 cases and/or in PBMC samples in 6/8 cases. Although donors were exclusively (n = 4) or predominantly (n = 4) infected by CCR5-tropic (R5) strains, two recipients were infected with highly homogeneous CXCR4/dual-mixed-tropic (X4/DM) viral populations, identified in both DNA and RNA. The proportion of X4/DM quasispecies in donors was higher in cases of X4/DM than R5 HIV transmission (16.7-22.0% versus 0-2.6%), suggesting that X4/DM transmission may be associated with a threshold population of X4/DM circulating quasispecies in donors. CONCLUSIONS: These suggest that a severe genetic bottleneck occurs during subtype B HIV-1 heterosexual and homosexual transmission. Sexually-transmitted/founder virus cannot be directly predicted by analysis of the donor's quasispecies in plasma and/or PBMC. Additional studies are required to fully understand the traits that confer the capacity to transmit and establish infection, and determine the role of concomitant STIs in mitigating the genetic bottleneck in mucosal HIV transmission.
Published: 2013
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10. Health informatics support for outbreak management: How to respond without an electronic health record?

Author: Emmanuelle Sylvestre, René-Michel Thuny, Elsa Cecilia-Joseph, Papa Gueye, Cyrille Chabartier, Yannick Brouste, Hossein Mehdaoui, Fatiha Najioullah, Sandrine Pierre-François, Sylvie Abel, André Cabié, and Moustapha Drame
Published: 2020
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11. In-Depth Characterization of Full-Length Archived Viral Genomes after Nine Years of Posttreatment HIV Control

Author: Pauline Trémeaux, Frédéric Lemoine, Adeline Mélard, Marine Gousset, Faroudy Boufassa, Sylvie Orr, Valérie Monceaux, Olivier Gascuel, Olivier Lambotte, Laurent Hocqueloux, Asier Saez-Cirion, Christine Rouzioux, Véronique Avettand-Fenoel, Firouzé Bani-Sadr, Maxime Hentzien, Jean-Luc Berger, Isabelle Kmiec, Gilles Pichancourt, Safa Nasri, Gilles Hittinger, Véronique Lambry, Anne-Cécile Beaudrey, Gilles Pialoux, Julie Chas, Christia Palacios, Anne Adda, Jean Paul Viard, Marie-Josée Dulucq, Laurence Weiss, Marina Karmochkine, Mohamed Meghadecha, Dominique Salmon-Ceron, Marie-Pierre Piétri, Philippe Blanche, Jean-Michel Molina, Olivier Taulera, Diane Ponscarme, Jeannine Delgado Bertaut, Djamila Makhloufi, Matthieu Godinot, Valérie Artizzu, Patrick Miailhes, Laurent Cotte, Sophie Pailhes, Anne Conrad, Ludovic Karkowski, Stanislas Ogoudjobi, Yazdan Yazdanpanah, Sophie Matheron, Cindy Godard, Louis Bernard, Frédéric Bastides, Olivier Bourgault, Christine Jacomet, Emilie Goncalves, Pascal Chavanet, Lionel Piroth, Sandrine Gohier, Agnès Meybeck, Thomas Huleux, Pauline Cornavin, Yasmine Debab, David Théron, Thierry Prazuck, Barbara De Dieuleveult, Jean-Pierre Faller, Patricia Eglinger, Pascal Roblot, David Plainchamp, Hugues Aumaître, Martine Malet, Christine Rouger, Gérard Rémy, Melle Kmiec Isabelle, Jean-Luc Delassus, Alain Devidas, Eric Froguel, Sylvie Tassi, Philippe Genet, Juliette Gerbe, Olivier Patey, Richier Laurent, Marie-Christine Drobacheff, Aurélie Proust, Helder Gil, Laurence Gérard, Eric Oksenhendler, Caroline Lascoux, Sylvie Parlier, Frédéric Lucht, Véronique Ronat, Michel Dupon, Hervé Dutronc, Séverine Le Puil, Didier Neau, Patrick Mercié, Philippe Morlat, Sabrina Caldato, Jean-Luc Schmit, Nathalie Decaux, Jean-Pierre Bru, Gaëlle Clavere, Jean-François Delfraissy, Cécile Goujard, Katia Bourdic, Daniel Vittecoq, Claudine Bolliot, Thierry Lambert, Jean-François Bergmann, Maguy Parrinello, Yves Welker, Alain Lafeuillade, Gisèle Philip, Christophe Rapp, Melle Lerondel, Pierre de Truchis, Berthe Huguette, Vincent Jeantils, Fatouma Mchangama, Paul Henri Consigny, Fatima Touam, Sophie le Nagat, Olivier Bouchaud, Patricia Honoré, François Boué, Mariem Raho-Moussa, Jean-Paul Viard, Agnès Cros, Dominique Salmon-Céron, Marie-Pierre Pietri, Lio Collias, David Zucman, Olivier Blétry, Dominique Bornarel, Emmanuel Mortier, Zeng Feng, Jean-Daniel Lelièvre, Christine Katlama, Yasmine Dudoit, Anne Simon, Catherine Lupin, Pierre-Marie Girard, Michèle Pauchard, Sylvie Abel, André Cabié, Pascale Fialaire, Jean-Marie Chennebault, Sami Rehaiem, Luc de Saint Martin, •••• Perfezou, Jean-Charles Duthe, Pierre Weinbreck, Claire Genet, Florence Garnier, Isabelle Poizot-Martin, Olivia Fauche, Alena Ivanova, Patrick Philibert, Mame Penda Sow, Patrick Yeni, Cyndi Godard, François Raffi, Hervé Hüe, Philippe Perré, Pierre Marie Roger, Aline Joulie, Éric Rosenthal, Christian Michelet, Faouzi Souala, Maja Ratajczak, Marialuisa Partisani, Patricia Fischer, Pascale Nau, Pierre Delobel, Florence Balsarin, Marc De Lavaissiere, Renaud Verdon, Philippe Feret, Pascale Leclercq, •••• Gerberon, Agnés Meybeck, Raphaël Biekre, Thierry May, •••• Bouillon, François Caron, David Theron, Marc Gatfosse, Martin Martinot, Anne Pachart, Patrice Poubeau, Catherine Gaud, Agnès Uludag, Philippe Arsac, Lydia Bouaraba, Barbara de Dieulevault, Isabelle De Lacroix Szmania, Laurent Richier, Vincent Daneluzzi, Elisabeth Rouveix, Geneviève Beck-Wirth, Philippe Romand, Laurent Blum, Martine Deschaud, Christophe Michau, Christian Bernard, Florence Salaun, Philippe Muller, Yves Poinsignon, Annie Lepretre, Albert Sotto, •••• Doncesco, Pascale Perfezou, Jean Charles Duthe, Mathilde Aurore Niault, Virginie Mouton-Rioux, Jean-Philippe Talarmin, Jean Charles Duthé, Mathilde Dupont, Stéphane Natur, Hikombo Hitoto, and Ali Mahamadou Ibrahim
Subjects: Microbiology (medical), Infectious Diseases, General Immunology and Microbiology, Ecology, Physiology, Genetics, Cell Biology
Abstract: Most people living with HIV need antiretroviral therapy to control their infection and experience viral relapse in case of treatment interruption, because of viral reservoir (proviruses) persistence. Knowing that proviruses are very diverse and most of them are defective in treated individuals, we aimed to characterize the HIV blood reservoirs of posttreatment controllers (PTCs), rare models of drug-free remission, in comparison with spontaneous controllers and treated individuals.
Published: 2023
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12. Les représentations des prisonniers à l’égard des mesures de réduction des risques

Author: Estelle Filipe, Philippe Trouiller-Gerfaux, Sylvie Abel, Guillaume Bayet, and Marie Jauffret-Roustide
Subjects: General Medicine
Published: 2023
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13. Case Report: Pulmonary Leptospirosis Misdiagnosed as COVID-19

Author: Jean-Marie Turmel, Claude Olive, Bastien Bigeard, Sylvie Abel, Rishika Banydeen, Laura Daoud, Pierre-Marie Fayolle, and André Cabié
Subjects: Infectious Diseases, Virology, Parasitology
Abstract: We report the case of an 83-year-old woman with acute, febrile respiratory failure resulting from interstitial pneumonia that required high-flow oxygen therapy. This clinical picture, associated with the ongoing epidemiological situation, initially guided us toward a diagnosis of COVID-19. Based on SARS-CoV-2 reverse transcription–polymerase chain reaction negativity and the absence of anti-SARS-CoV-2 antibodies, a search for a differential diagnosis was conducted that led us to conclude a diagnosis of severe pulmonary leptospirosis This case highlights the need to engage in early discussions about differential diagnoses, including neglected tropical and subtropical diseases, during the COVID-19 era.
Published: 2022
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14. Once-daily dolutegravir versus darunavir plus cobicistat in adults at the time of primary HIV-1 infection: the OPTIPRIM2-ANRS 169 randomized, open-label, Phase 3 trial

Author: Antoine Chéret, Rebecca Bauer, Vincent Meiffrédy, Pauline Lopez, Faïza Ajana, Karine Lacombe, Philippe Morlat, Caroline Lascoux, Jacques Reynes, Ruxandra Calin, Sylvie Abel, Cécile Goujard, Christine Rouzioux, Véronique Avettand-Fenoel, and Laurence Meyer
Subjects: Pharmacology, Microbiology (medical), Adult, Male, Anti-HIV Agents, Pyridones, HIV Infections, Viral Load, Piperazines, Infectious Diseases, Oxazines, HIV-1, Emtricitabine, Humans, RNA, Pharmacology (medical), Cobicistat, Female, Tenofovir, Heterocyclic Compounds, 3-Ring, Darunavir
Abstract: Background Whether integrase strand transfer inhibitors (INSTIs) can decrease HIV-1 DNA levels more rapidly than boosted PIs during primary HIV-1 infection (PHI) is unknown. We hypothesized that once-daily dolutegravir/tenofovir/emtricitabine could reduce the viral reservoir through rapid viral replication control further than once-daily darunavir/cobicistat/tenofovir/emtricitabine. Methods The OPTIPRIM2-ANRS 169 study was a randomized (1:1), open-label, multicentre trial in adults with ≤5 or ≤3 HIV antibodies detected, respectively, by western blot or immunoblot in the last 10 days. The primary endpoint was total HIV-1 DNA levels in PBMCs at Week 48 (W48) adjusted for baseline levels. The main secondary endpoint was HIV-1 RNA level decrease. Results Between April 2017 and August 2018, 101 patients were included from 31 hospitals. Most patients were men (93%), the median age was 36 years and 17% were Fiebig stage ≤3. The median (IQR) plasma HIV-1 RNA and DNA levels were, respectively, 5.8 (5.0–6.6) and 3.87 (3.52–4.15) log10 copies/million PBMCs. The median (IQR) decreases in HIV-1 DNA levels at W48 were −1.48 (−1.74 to −1.06) and −1.39 (−1.55 to −0.98) log10 copies/million PBMCs in the dolutegravir and darunavir/cobicistat groups, respectively (P = 0.52). Plasma HIV-1 RNA levels were Conclusions Dolutegravir-based and darunavir-based regimens initiated during PHI strongly and similarly decreased the blood reservoir size. Considering the rapid viral suppression during a period of high HIV-1 transmission risk, dolutegravir-based regimens are a major first-line option.
Published: 2022

15. 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
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16. Contribution of Research in the West Indies and Northeast Amazonia to Knowledge of the 2014–2015 Chikungunya Epidemic in the Americas

Author: Margarete do Socorro Mendonça Gomes, Raymond Cézaire, C Clavel, Dominique Rousset, Yanouk Epelboin, Sylvie Abel, Félix Djossou, Hélène Hilderal, Timothée Bonifay, Moustapha Dramé, Lidvine Godaert, Narcisse Elenga, Maylis Douine, André Cabié, Bruno Hoen, Fatiha Najioullah, Laurence Fagour, Loïc Epelboin, Marcus V. G. Lacerda, 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], Centre hospitalier [Valenciennes, Nord], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Louis Constant Fleming, CHU de la Martinique [Fort de France], Laboratório Central de Saúde Pública do Amapa, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU Pointe-à-Pitre/Abymes [Guadeloupe], and BONIZEC, Sandrine
Subjects: medicine.medical_specialty, Aedes albopictus, viruses, West Indies, [SDV]Life Sciences [q-bio], 030231 tropical medicine, America, Disease, medicine.disease_cause, Arbovirus, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Immunology and Allergy, 030212 general & internal medicine, Chikungunya, Socioeconomics, Amazonian Diseases in isolate populations (M Nacher, Section Editor), biology, Outbreak, virus diseases, biology.organism_classification, medicine.disease, [SDV] Life Sciences [q-bio], Infectious Diseases, Geography, Guiana Shield, Vector (epidemiology), Encephalitis
Abstract: Purpose of Review Although the chikungunya virus was discovered more than 60 years ago, it has only really been studied since the outbreak in La Reunion in 2005–2006. Ten years later, between 2014 and 2015, the chikungunya virus spread throughout the Americas, affecting millions of people. The objective of this review is to describe the contributions of research on chikungunya virus infection gained from epidemic in the West Indies and the Guiana Shield. Recent Findings Prevalence data were similar to those found in the Indian Ocean or Asia during epidemics. Clinically, there is now a better understanding of the typical, atypical, and severe forms. Several studies have insisted on the presence of neurological forms of chikungunya infection, such as encephalitis or Guillain–Barré syndrome. Cases of septic shock due to chikungunya virus as well as thrombotic thrombocytopenic purpura were described for the first time. Given the magnitude of the epidemic and the large number of people affected, this has led to a better description and new classifications of chikungunya virus infections in specific populations such as pregnant women, the elderly, and children. Several studies also described the behavior of populations faced with an emerging disease. Summary Current epidemiological data from tropical regions highlights the risk of spreading emerging diseases at higher latitudes, especially concerning arboviruses, since the vector Aedes albopictus is already established in many parts of northern countries. A better understanding of the disease and its epidemic dynamics will foster better management, the crucial importance of which was demonstrated during the COVID-19 epidemic.
Published: 2021
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17. 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
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18. 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
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19. 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
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20. 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
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21. 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
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22. 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

23. 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
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24. 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

25. Nodular regenerative hyperplasia: a new serious antiretroviral drugs side effect?

Author: Sandrine, Pierre-Francois, Sylvie, Abel, André, Edouard, Abdoulaye, Diedhiou, Bernard, Liautaud, and André, Cabie
Published: 2007
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26. Impact de la zone géographique de résidence dans la prévalence du surpoids et de l’obésité au sein de la cohorte Dat’AIDS

Author: Sylvie Bregigeon, Cyrille Delpierre, Véronique Obry-Roguet, Pascal Pugliese, Isabelle Poizot-Martin, Laurent Cotte, T. Huleux, Claudine Duvivier, and Sylvie Abel
Subjects: Infectious Diseases
Abstract: Introduction En France, l’enquete nationale OBEPI 2012 a rapporte une prevalence de surpoids et d’obesite respectivement de 32 % et 15 %, avec un gradient decroissant Nord/Sud. L’objectif de l’etude est de comparer la prevalence du surpoids et de l’obesite au sein de la cohorte Dat’AIDS par rapport a la population generale, de facon globale, selon l’âge, le sexe et la zone geographique de residence. Materiels et methodes Etude retrospective observationnelle realisee a partir des donnees recueillies en 2018 dans la cohorte Dat’AIDS ( NCT02898987 ), regroupant 23 centres de prise en charge des personnes vivant avec le VIH (PVVIH) repartis sur tout le territoire francais. Les caracteristiques demographiques, epidemiologiques, immuno-virologiques et therapeutiques des PVVIH avec au moins une valeur disponible d’Indice de Masse Corporelle (IMC) ont ete collectees au dernier suivi et reparties en trois groupes : IMC Resultats Sur les 32153 patients analyses, 68 % sont des hommes, d’âge median 51,5 ans [42,9 ; 58,5], suivis en mediane depuis 15 ans [7,6 ; 24], 97 % sous ARTdepuis 12 ans en mediane [6,1 ; 20,2], avec une charge virale Conclusion La prevalence du surpoids et de l’obesite est elevee chez les PVVIH mais cependant plus faible qu’en population generale et se repartit differemment selon l’âge, le sexe et le lieu de residence, facteurs qui devront etre pris en compte dans l’analyse des facteurs associes
Published: 2020
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27. 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
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28. 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
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29. 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
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30. 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
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31. 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
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32. IST-06 - Réémergence de la syphilis chez les personnes infectées par le VIH en Martinique en 2015

Author: R. Vilain, Benoît Rozé, André Cabié, Sandrine Pierre-François, Patrick Hochedez, Mathilde Pircher, Alain Putot, Charline Miossec, Sylvie Abel, N. Desbois, 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], and ADENIS, ANTOINE
Subjects: 0303 health sciences, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030306 microbiology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine
Abstract: National audience; En 2004 a débuté une épidémie de syphilis en Martinique chez les hommes ayant des rapports sexuels avec des hommes (HSH) et vivant avec le VIH, pour se généraliser secondairement à l’ensemble des groupes à risque. L’objectif de cette étude était d’estimer l’évolution, depuis 2005, de l’incidence et des caractéristiques des cas de syphilis récente dans la cohortede patients vivant avec le VIH (PVVIH) suivis en Martinique.
Published: 2016

33. Zika virus detection in cerebrospinal fluid from two patients with encephalopathy, Martinique, February 2016

Author: Benoît Rozé, Sarah Gourgoudou, André Cabié, Kossivi Apetse, Yannick Brouste, Patrick Hochedez, Aissatou Signate, Fatiha Najioullah, Sylvie Abel, Raymond Césaire, and Laurence Fagour
Subjects: Male, 0301 basic medicine, Epidemiology, viruses, Encephalopathy, Zika virus, Young Adult, 03 medical and health sciences, Cerebrospinal fluid, Virology, medicine, Humans, Martinique, In patient, Encephalitis, Viral, Aged, Cerebrospinal Fluid, biology, Zika Virus Infection, Arthropod-borne Virus, Public Health, Environmental and Occupational Health, Outbreak, Zika Virus, medicine.disease, biology.organism_classification, Flavivirus, 030104 developmental biology, Population Surveillance, Immunology, Female
Abstract: We report two cases of encephalopathy (one with seizures, one with electroencephalogram changes) in patients with Zika virus infection. The cases occurred on Martinique in February 2016, during the Zika virus outbreak. Awareness of the various neurological complications of Zika virus infection is needed for patients living in areas affected by Zika virus infections or for travellers to these areas.
Published: 2016
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34. 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
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35. Le taux d’attaque de l’épidémie de Chikungunya dans les Antilles en 2014 a été de 60 %

Author: Laurence Fagour, A. Staelen, André Cabié, Bruno Hoen, Raymond Césaire, Sandrine Pierre-François, Cécile Herrmann-Storck, Sylvie Abel, E. Curlier, and S. Breurec
Subjects: 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030204 cardiovascular system & hematology, 030217 neurology & neurosurgery
Abstract: Introduction En 2014, une epidemie de Chikungunya a touche les Antilles francaises. Cette arbovirose, jamais detectee sur ces territoires, s’est ensuite propagee a la plupart des iles de la Caraibe et en Amerique Latine. La connaissance de la proportion de la population touchee par cette epidemie est indispensable pour les travaux de modelisation des epidemies et pour etablir les recommandations d’utilisation d’un vaccin. L’objectif principal de l’etude etait d’estimer le taux d’attaque de l’epidemie de Chikungunya en Martinique et en Guadeloupe par une mesure de la seroprevalence a la fin de l’epidemie au sein d’un echantillon de personnes vivant avec le VIH (PVVIH) representatif de la population generale de Martinique et de Guadeloupe. Materiels et methodes La population de l’etude est un echantillon de PVVIH suivis dans les services de maladies infectieuses des CHU de Martinique et de Guadeloupe constitue de facon aleatoire pour etre representatif de la structure populationnelle des 2 territoires sur la base du recensement INSEE de 2011. Apres consentement individuel, chaque patient selectionne a fait l’objet d’un questionnaire standardise et d’une serologie Chikungunya IgG a l’occasion d’une consultation medicale de suivi du VIH dans les 6 mois qui ont suivi la fin de l’epidemie. Resultats Sur les 388 patients inclus, 377 ont pu etre analyses (198 en Martinique et 179 en Guadeloupe, 178 hommes et 199 femmes). Deux cent vingt de ces 377 patients (58,4 %) avaient une serologie Chikungunya positive, permettant de calculer le taux d’attaque de l’epidemie de Chikungunya a 58,4 % [IC 95 % 53,3–63,3]. Parmi les 182 patients qui declaraient avoir presente des manifestations evocatrices de Chikungunya aigu, 149 avaient une serologie positive. Les principaux symptomes rapportes etaient des arthralgies (94,0 %), une sensation febrile (74,7 %), des myalgies (55,1 %), une cephalee (48,3 %), une eruption cutanee (27,4 %) et des troubles gastro-intestinaux (10,1 %). Soixante et onze patients avec serologie positive pour le Chikungunya n’ont pas presente de manifestations cliniques, ce qui permet d’estimer la proportion de formes asymptomatiques a 32,3 % [IC 95 % 26,4–38,8]. Vingt-huit des 149 patients seropositifs pour le Chikungunya (18,8 %) ont presente une evolution chronique du Chikungunya. Conclusion Cette etude montre que le taux d’attaque de l’epidemie de Chikungunya a ete autour de 60 %, avec un tiers de formes asymptomatiques. L’evolution vers une forme chronique a ete peu frequente dans cette population de PVVIH.
Published: 2017
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36. 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
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37. 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
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38. 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

39. 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
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40. 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
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41. 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
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42. 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
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43. 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
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44. Quantification of HTLV Type I and HIV Type 1 DNA Load in Coinfected Patients: HIV Type 1 Infection Does Not Alter HTLV Type I Proviral Amount in the Peripheral Blood Compartment

Author: Guy Sobesky, Nathalie Désiré, Axelle Dehee, Odile Béra, Sylvie Abel, André Cabié, Raymond Césaire, Didier Smadja, Agnès Lézin, Olivier Bourdonné, Fabienne Dantin, and Jean-Claude Nicolas
Subjects: biology, viruses, Immunology, virus diseases, biology.organism_classification, medicine.disease, Asymptomatic, Peripheral blood mononuclear cell, Virology, Infectious Diseases, Real-time polymerase chain reaction, immune system diseases, hemic and lymphatic diseases, Lentivirus, Tropical spastic paraparesis, medicine, Coinfection, Viral disease, medicine.symptom, Viral load
Abstract: Several reports suggest that HTLV-I/HIV coinfection may be associated with an increased risk of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In HTLV-I-monoinfected patients, the occurrence of HAM/TSP is associated with high peripheral blood HTLV-I proviral load. Using a real-time quantitative PCR assay, we assessed the proviral DNA load in peripheral blood mononuclear cells (PBMCs) from 15 asymptomatic HTLV-I-monoinfected patients, 15 HTLV-I-monoinfected patients with HAM/TSP, and 25 HTLV-I/HIV-1 coinfected patients, including 4 with HAM/TSP. We also measured HIV-1 proviral DNA load in PBMCs from the coinfected patients. The median HTLV-I proviral loads were 6,800 and 4,100 copies per 10(6) PBMCs in the asymptomatic monoinfected and coinfected groups, and 58,800 and 43,300 copies per 10(6) PBMCs in the monoinfected and coinfected patients with HAM/TSP, respectively. The difference between HTLV-I proviral loads in HAM/TSP and asymptomatic monoinfected patients was statistically significant (p < 0.0001), but there was no difference between the HTLV-I-monoinfected and HTLV-I/HIV-1-coinfected groups. There was no correlation between HTLV-I and HIV-1 proviral load. HTLV-I proviral load did not correlate with the CD4+ T lymphocyte count. Among patients with no HTLV-I disease, the median copy number of HTLV-I per 10(6) circulating CD4+ T cells was 114,000 in the coinfected group and 16,700 in the monoinfected group, but the difference was not significant (p = 0.089). These data do not confirm the hypothesis in which HIV-1 coinfection would increase HTLV-I proviral burden in the PBMCs. However, depletion of the CD4+ T cell subset, the main target of HTLV-I, could be counterbalanced by an up-regulation of HTLV-I replication or by greater resistance of HTLV-I-infected cells to HIV-1-induced destruction.
Published: 2001
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45. 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
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46. Role and evolution of viral tropism in patients with advanced HIV disease receiving intensified initial regimen in the ANRS 130 APOLLO trial

Author: S. Couffin-Cadiergues, Delphine Bonnet, C Merle de Boever, J. M. Livrozet, S. Ben Abdallah, Patrick Yeni, D. Makhloufi, N. El Alami Talbi, M. P. Drogoul, R. Dhote, Daniel Vittecoq, B. C. Phung, N. Benmakhlouf, S Ferrando, S Breaud, F Touam, G. Melica, Pierre Tattevin, Faouzi Souala, C. Augustin-Normand, S. Wassoumbou, F. Sanderson, I. Suaud, P. De Truchis, Jean-Claude Melchior, P. Guadagnin, D. Neau, S. Pavel, B. Warde, O. Taulera, J. Durant, B. Liauthaud, V. Gueripel, P. Sellier, C. Leport, J. L. Touraine, Sophie Leautez-Nainville, N. de Castro, M. A. Arthus, A. Rachline, S. Neuville, Charlotte Charpentier, Sophie Abgrall, M. Bonmarchand, E Aïssi, J. M. Ragnaud, J. F. Faucher, Pascal Pugliese, G. Le Facher, C. Bechara, François Raffi, L. Iordache, O. Derradji, Sophie Tabuteau, A. Frosch, François Bricaire, M. C. Pertusa, J. G. Fuzibet, Y. Mouton, S. Dominguez, P. Dion, I Perbost, Lorraine Letranchant, Jean-François Delfraissy, F. De Salvador, T. Kandel, V. Joly, C. Lascoux-Combe, Cécile Goujard, David Rey, Sylvie Radenne, Michel Dupon, Marc-Antoine Valantin, S. Stegman, F. Bastides, A Brunet, H. Aumaître, M. Lafaurie, V. Reliquet, Christine Katlama, H. Gros, R. Mansouri, J. Delgado, E. Rosenthal, J. Rivalain, G. Pialloux, Cédric Arvieux, David Boutoille, S. Gallien, G. Lepeu, S. Ferret, T. May, M. Parrinello, M. Bentata, Jean-François Bergmann, O. Aubry, J. M. Besnier, Christian Trepo, M. Vassalo, H. Kouadio, Olivier Lortholary, Jean-Albert Gastaut, H. Cordel, H. Dutronc, V. Rahelinirina, P. Lack, Jade Ghosn, Catherine Fagard, J. F. Dailloux, S. Boucherit, P. Honoré-Berlureau, J. M. Chennebault, T. Tahi, Yazdan Yazdanpanah, I. Louis, P. Le Bret, J. M. Estavoyer, J. J. Laurichesse, V. Rabier, I. Schlienger, O. Danne, Jean-Michel Molina, Bruno Hoen, B. Lebouché, Louis Bernard, D. Le, E. Peyrouse, I. Raymond, A. Gervais, Benoit Visseaux, L. Blum, C. Fontaine, Christine Burty, Y Quertainmont, M. Poupard, S Bouchez, J. J. Jourdain, C Cheneau, H. Castillo, Eric Billaud, J. M. Lang, André Cabié, A. Soufflet, J. M. Chapplain, O. Mounoury, B. Bonnet, D. Salmon-Ceron, P. Jouve, V. Mondain, P. Nau, I. Fournier, F. Bailly, J. M. Jacquet, N. Colin de Verdière, C Biron, P. Chiarello, D. Sereni, S. Pierre François, G. Fabre, Juliette Pavie, Lucile Larrouy, F. Rouges, Nathalie Colin de Verdiere, A. Rami, T. Lukiana, M. Maynard, P. Miailhes, J. Delaune, P. Abgueguen, A. Sobel, M. Revest, Clotilde Allavena, S. Herson, Olivier Bouchaud, M. Malet, H. Hüe, M. Iguertsira, A. Leplatois, Jean-Paul Viard, A. Simon, Pierre Dellamonica, Isabelle Poizot-Martin, J. Loison, E. Teicher, M. Lagrange, K. Koffi, E. Pichard, Diane Descamps, M. Ratajczak, Christian Michelet, Loïc Guillevin, A. Krivitzky, W. Kamouh, C. Chesnel, Laurence Slama, J. Cailhol, M. Partisani, N. Agher, Luminita Schneider, S. Boucly, Y. Levy, Laurent Boyer, Jacques Reynes, A. Diallo, M. Môle, N. Bennamar, Laurent Cotte, F. Brunel-Delmas, Philippe Morlat, V. Thoirain, A Foltzer, Laurent Hustache-Mathieu, H. Berthé, Jean-Daniel Lelièvre, C. Tramoni, P. Yeni, Philippe Van de Perre, M. Gory, C. Brunet-François, W. Rozenbaum, M. Saada, Christian Perronne, M. Medus, C. Chakvetadze, T. Huynh, C. Pintado, G. Pahlavan, J. L. Esnault, J. Clarissou, D. Radia, V. Frixon-Marin, E. Boulanger, F. Jeanblanc, P. Choutet, C Ceppi, V. Prendki, Sylvie Abel, Véronique Joly, A. Certain, G. Pichancourt, V. Beaujolais, O. Faucher, C Brochier, Diane Ponscarme, P. Fischer, Aurélie Beuscart, Hugues Melliez, Laboratoire de Virologie, 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), Service de maladies infectieuses et tropicales, 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 Paris Diderot - Paris 7 (UPD7), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Maladies infectieuses et tropicales, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), ANRS 130 APOLLO Trial Study Group, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Enfuvirtide, enfuvirtide, MESH: HIV Envelope Protein gp41, viruses, HIV Infections, Drug resistance, MESH: Antiretroviral Therapy, Highly Active, law.invention, MESH: HIV-1, Randomized controlled trial, law, Antiretroviral Therapy, Highly Active, Genotype, Pharmacology (medical), MESH: Anti-HIV Agents, MESH: Peptide Fragments, MESH: Evolution, Molecular, MESH: Aged, 0303 health sciences, MESH: Middle Aged, MESH: Drug Resistance, Viral, tropism, MESH: HIV Infections, Middle Aged, HIV Envelope Protein gp41, switch, 3. Good health, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Young Adult, medicine.drug, Adult, Microbiology (medical), Adolescent, Anti-HIV Agents, Mutation, Missense, Biology, Evolution, Molecular, resistance, Young Adult, 03 medical and health sciences, HIV DNA, Drug Resistance, Viral, medicine, Humans, In patient, Tropism, Aged, 030304 developmental biology, Pharmacology, MESH: Adolescent, MESH: Mutation, Missense, MESH: Humans, 030306 microbiology, MESH: Adult, Virology, Peptide Fragments, Viral Tropism, Regimen, HIV-1, Tissue tropism, MESH: Viral Tropism
Abstract: International audience; OBJECTIVES: The aims of the study were to assess in patients with advanced HIV disease receiving antiretroviral therapy (ART) intensification with enfuvirtide (i) resistance at virological failure (VF), (ii) impact of baseline tropism on immunovirological response, and (iii) HIV-1 DNA tropism evolution during ART. METHODS: The ANRS 130 APOLLO randomized trial evaluated in naive patients the immunovirological impact of standard ART without (control arm) or with enfuvirtide. Tropism was determined on RNA and DNA by V3-loop sequencing interpreted using the Geno2Pheno algorithm. RESULTS: At baseline the median CD4 cell count was 30 cells/mm(3). Among the 170 patients assessable in this virological substudy, HIV-1 RNA tropism was as follows: 60% of viruses were R5 and 40% were R5X4/X4. HIV-1 DNA tropism was as follows: 54% were R5 and 46% were R5X4/X4. At week 24, 39% and 49% of patients experienced VF in the enfuvirtide and control arms, respectively. In the enfuvirtide arm, only resistance-associated mutations to enfuvirtide were detected. In the control arm, two patients displayed drug-resistant viruses at the time of VF. No impact of baseline tropism was observed on immunovirological response, regardless of the study arm. Among the 25 patients experiencing DNA tropism switch between baseline and week 24, 16 (64%) switched from R5 to R5X4/X4. These latter were mostly successfully suppressed patients receiving enfuvirtide and exhibiting poorer immunological response. CONCLUSIONS: Baseline RNA tropism had no impact on the immunovirological response. Drug resistance mutations were only detected for the fusion inhibitor. Finally, the mechanism of replenishment of the viral cellular reservoir with X4 viruses observed needs to be further analysed.
Published: 2013
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47. 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
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48. 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
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49. COL 7-01 - Prévalence et facteurs de risques associés de la forme chronique du Chikungunya ; une étude de cohorte

Author: Antoine Bertolotti, Mathieu Nacher, Raymond Césaire, Janick Jean-Marie, Isabelle Calmont, André Cabié, Marême Thioune, Sylvie Abel, Bernard Carme, Service de Maladies Infectieuses et Tropicales [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], Université de Bordeaux (UB), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), 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), and ADENIS, ANTOINE
Subjects: Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 3. Good health
Abstract: National audience; Introduction Le chikungunya (CHIKV) est un alphavirus ré-émergent depuis 10 ans responsable de nombreuses épidémies. Chez certains patients, il est à l'origine de troubles musculo-squelettiques et de polyarthropathies inva-lidants et persistants plus de 3 mois, définissant la forme chronique du chikun-gunya (CHIKC). Afin de déterminer la prévalence du CHIKC, nous avons mené une cohorte prospective de patients ambulatoires lors de la dernière épi-démie en outre-mer. Secondairement, nous avons recherché les facteurs de risques associés.
Published: 2016
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50. 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
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