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8. No increased risk of Kaposi sarcoma relapse in patients with controlled HIV‐1 infection after switching protease inhibitor‐based antiretroviral therapy

Author

Lajaunie, Rébecca, Cuzin, Lise, Palich, Romain, Makinson, Alain, Bani-Sadr, Firouzé, Duvivier, Claudine, Arvieux, Cedric, Rey, David, Poizot-Martin, Isabelle, Delpierre, Cyril, Delobel, Pierre, Martin-Blondel, Guillaume, Chirouze, C., Drobacheff-Thiébaut, C., Foltzer, A., Bouiller, K., Hustache- Mathieu, L., Lepiller, Q., Bozon, F., Babre, O, Brunel, As., Muret, P., Chevalier, E., Jacomet, C., Laurichesse, H., Lesens, O., Vidal, M., Mrozek, N., Aumeran, C., Baud, O., Corbin, V., Goncalvez, E., Mirand, A, Brebion, A, Henquell, C, Lamaury, I., Fabre, I., Curlier, E., Ouissa, R., Herrmann-Storck, C., Tressieres, B., Receveur, Mc., Boulard, F., Daniel, C., Clavel, C., Roger, Pm., Markowicz, S., Chellum Rungen, N., Merrien, D., Perré, P., Guimard, T., Bollangier, O., Leautez, S., Morrier, M., Laine, L., Boucher, D., Point, P., Cotte, L., Ader, F., Becker, A., Boibieux, A., Brochier, C., Brunel-Dalmas, F., Cannesson, O., Chiarello, P., Chidiac, C., Degroodt, S., Ferry, T., Godinot, M., Livrozet, J.M., Makhloufi, D., Miailhes, P., Perpoint, T., Perry, M., Pouderoux, C., Roux, S., Triffault-Fillit, C., Valour, F., Charre, C., Icard, V., Tardy, J.C., Trabaud, M.A., Ravaux, I., Ménard, A., Belkhir, Ay., Colson, P., Dhiver, C., Madrid, A., Martin-Degioanni, M., Meddeb, L., Mokhtari, M., Motte, A., Raoux, A., Toméi, C., Tissot-Dupont, H., Poizot-Martin, I., Brégigeon, S., Zaegel-Faucher, O., Obry-Roguet, V., Laroche, H, Orticoni, M., Soavi, M.J., Ressiot, E., Ducassou, M.J., Jaquet, I., Galie, S., Colson, H., Ritleng, A.S., Ivanova, A., Debreux, C., Lions, C., Rojas-Rojas, T, Cabié, A., Abel, S., Bavay, J., Bigeard, B., Cabras, O., Cuzin, L., Dupin de Majoubert, R., Fagour, L., Guitteaud, K., Marquise, A., Najioullah, F., Pierre-François, S., Pasquier, J., Richard, P., Rome, K., Turmel, Jm, Varache, C., Atoui, N., Bistoquet, M., Delaporte, E, Le Moing, V., Makinson, A., Meftah, N., Merle de Boever, C., Montes, B., Montoya Ferrer, A., Tuaillon, E., Reynes, J., Lefèvre, B., Jeanmaire, E., Hénard, S., Frentiu, E., Charmillon, A., Legoff, A., Tissot, N., André, M., Boyer, L., Bouillon, Mp., Delestan, M., Goehringer, F., Bevilacqua, S., Rabaud, C., May, T., Raffi, F., Allavena, C., Aubry, O., Billaud, E., Biron, C., Bonnet, B., Bouchez, S., Boutoille, D., Brunet-Cartier, C., Deschanvres, C., Gaborit, B.J., Grégoire, A., Grégoire, M., Grossi, O., Guéry, R., Jovelin, T., Lefebvre, M., Le Turnier, P., Lecomte, R., Morineau, P., Reliquet, V., Sécher, S., Cavellec, M., Paredes, E., Soria, A., Ferré, V., André-Garnier, E., Rodallec, A., Pugliese, P., Breaud, S., Ceppi, C., Chirio, D., Cua, E., Dellamonica, P., Demonchy, E., de Monte, A., Durant, J., Etienne, C., Ferrando, S., Garraffo, R., Michelangeli, C., Mondain, V., Naqvi, A., Oran, N., Perbost, I., Carles, M., Klotz, C., Maka, A., Pradier, C., Prouvost-Keller, B., Risso, K., Rio, V., Rosenthal, E., Touitou, I., Wehrlen-Pugliese, S., Zouzou, G., Hocqueloux, L., Prazuck, T., Gubavu, C., Sève, A., Giaché, S., Rzepecki, V., Colin, M., Boulard, C., Thomas, G., Cheret, A., Goujard, C., Quertainmont, Y., Teicher, E., Lerolle, N., Jaureguiberry, S., Colarino, R., Deradji, O., Castro, A., Barrail-Tran, A., Yazdanpanah, Y., Landman, R., Joly, V., Ghosn, J., Rioux, C., Lariven, S., Gervais, A., Lescure, Fx., Matheron, S., Louni, F., Julia, Z., Le Gac, S., Charpentier, C., Descamps, D., Peytavin, G., Duvivier, C., Aguilar, C., Alby-Laurent, F., Amazzough, K., Benabdelmoumen, G., Bossi, P., Cessot, G., Charlier, C., Consigny, P.H., Jidar, K., Lafont, E., Lanternier, F., Leporrier, J., Lortholary, O., Louisin, C., Lourenco, J., Parize, P., Pilmis, B., Rouzaud, C., Touam, F., Valantin, Ma., Tubiana, R., Agher, R., Seang, Sophie, Schneider, L., Palich, R., Blanc, C., Katlama, C., Bani-Sadr, F., Berger, Jl., N’guyen, Y., Lambert, D., Kmiec, I., Hentzien, M., Brunet, A., Romaru, J., Marty, H., Brodard, V., Arvieux, C., Tattevin, P., Revest, M., Souala, F., Baldeyrou, M., Patrat-Delon, S., Chapplain, J.M., Benezit, F., Dupont, M., Poinot, M., Maillard, A., Pronier, C., Lemaitre, F., Morlat, C., Poisson-Vannier, M., Sinteff, Jp., Gagneux-Brunon, A., Botelho-Nevers, E., Frésard, A., Ronat, V., Lucht, F., Rey, D., Fischer, P., Partisani, M., Cheneau, C., Priester, M., Batard, Ml., Mélounou, C, Bernard-Henry, C., de Mautort, E., Fafi-Kremer, S., Delobel, P., Alvarez, M., Biezunski, N., Debard, A., Delpierre, C., Gaube, G., Lansalot, P., Lelièvre, L., Marcel, M., Martin-Blondel, G., Piffaut, M., Porte, L., Saune, K., Robineau, O., Ajana, F., Aïssi, E., Alcaraz, I., Alidjinou, E., Baclet, V., Bocket, L., Boucher, A., Digumber, M., Huleux, T., Lafon-Desmurs, B., Meybeck, A., Pradier, M., Tetart, M., Thill, P., Viget, N., Valette, M., Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU de la Martinique [Fort de France], 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), 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), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Reims (CHU Reims), Service des Maladies infectieuses et tropicales [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), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), CHU Pontchaillou [Rennes], CHU Strasbourg, 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), Université Toulouse III Paul Sabatier - Faculté de médecine Purpan (UTPS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), And The Dat’AIDS study group: C Chirouze, C Drobacheff-Thiébaut, A Foltzer, K Bouiller, L Hustache-Mathieu, Q Lepiller, F Bozon, O Babre, A S Brunel, P Muret, E Chevalier, C Jacomet, H Laurichesse, O Lesens, M Vidal, N Mrozek, C Aumeran, O Baud, V Corbin, E Goncalvez, A Mirand, A Brebion, C Henquell, I Lamaury, I Fabre, E Curlier, R Ouissa, C Herrmann-Storck, B Tressieres, M C Receveur, F Boulard, C Daniel, C Clavel, P M Roger, S Markowicz, N Chellum Rungen, D Merrien, P Perré, T Guimard, O Bollangier, S Leautez, M Morrier, L Laine, D Boucher, P Point, L Cotte, F Ader, A Becker, A Boibieux, C Brochier, F Brunel-Dalmas, O Cannesson, P Chiarello, C Chidiac, S Degroodt, T Ferry, M Godinot, J M Livrozet, D Makhloufi, P Miailhes, T Perpoint, M Perry, C Pouderoux, S Roux, C Triffault-Fillit, F Valour, C Charre, V Icard, J C Tardy, M A Trabaud, I Ravaux, A Ménard, A Y Belkhir, P Colson, C Dhiver, A Madrid, M Martin-Degioanni, L Meddeb, M Mokhtari, A Motte, A Raoux, C Toméi, H Tissot-Dupont, I Poizot-Martin, S Brégigeon, O Zaegel-Faucher, V Obry-Roguet, H Laroche, M Orticoni, M J Soavi, E Ressiot, M J Ducassou, I Jaquet, S Galie, H Colson, A S Ritleng, A Ivanova, C Debreux, C Lions, T Rojas-Rojas, A Cabié, S Abel, J Bavay, B Bigeard, O Cabras, L Cuzin, R Dupin de Majoubert, L Fagour, K Guitteaud, A Marquise, F Najioullah, S Pierre-François, J Pasquier, P Richard, K Rome, J M Turmel, C Varache, N Atoui, M Bistoquet, E Delaporte, V Le Moing, A Makinson, N Meftah, C Merle de Boever, B Montes, A Montoya Ferrer, E Tuaillon, J Reynes, B Lefèvre, E Jeanmaire, S Hénard, E Frentiu, A Charmillon, A Legoff, N Tissot, M André, L Boyer, M P Bouillon, M Delestan, F Goehringer, S Bevilacqua, C Rabaud, T May, F Raffi, C Allavena, O Aubry, E Billaud, C Biron, B Bonnet, S Bouchez, D Boutoille, C Brunet-Cartier, C Deschanvres, B J Gaborit, A Grégoire, M Grégoire, O Grossi, R Guéry, T Jovelin, M Lefebvre, P Le Turnier, R Lecomte, P Morineau, V Reliquet, S Sécher, M Cavellec, E Paredes, A Soria, V Ferré, E André-Garnier, A Rodallec, P Pugliese, S Breaud, C Ceppi, D Chirio, E Cua, P Dellamonica, E Demonchy, A De Monte, J Durant, C Etienne, S Ferrando, R Garraffo, C Michelangeli, V Mondain, A Naqvi, N Oran, I Perbost, M Carles, C Klotz, A Maka, C Pradier, B Prouvost-Keller, K Risso, V Rio, E Rosenthal, I Touitou, S Wehrlen-Pugliese, G Zouzou, L Hocqueloux, T Prazuck, C Gubavu, A Sève, S Giaché, V Rzepecki, M Colin, C Boulard, G Thomas, A Cheret, C Goujard, Y Quertainmont, E Teicher, N Lerolle, S Jaureguiberry, R Colarino, O Deradji, A Castro, A Barrail-Tran, Y Yazdanpanah, R Landman, V Joly, J Ghosn, C Rioux, S Lariven, A Gervais, F X Lescure, S Matheron, F Louni, Z Julia, S Le Gac, C Charpentier, D Descamps, G Peytavin, C Duvivier, C Aguilar, F Alby-Laurent, K Amazzough, G Benabdelmoumen, P Bossi, G Cessot, C Charlier, P H Consigny, K Jidar, E Lafont, F Lanternier, J Leporrier, O Lortholary, C Louisin, J Lourenco, P Parize, B Pilmis, C Rouzaud, F Touam, M A Valantin, R Tubiana, R Agher, S Seang, L Schneider, R Palich, C Blanc, C Katlama, F Bani-Sadr, J L Berger, Y N'Guyen, D Lambert, I Kmiec, M Hentzien, A Brunet, J Romaru, H Marty, V Brodard, C Arvieux, P Tattevin, M Revest, F Souala, M Baldeyrou, S Patrat-Delon, J M Chapplain, F Benezit, M Dupont, M Poinot, A Maillard, C Pronier, F Lemaitre, C Morlat, M Poisson-Vannier, T Jovelin, J P Sinteff, A Gagneux-Brunon, E Botelho-Nevers, A Frésard, V Ronat, F Lucht, D Rey, P Fischer, M Partisani, C Cheneau, M Priester, M L Batard, C Mélounou, C Bernard-Henry, E de Mautort, S Fafi-Kremer, P Delobel, M Alvarez, N Biezunski, A Debard, C Delpierre, G Gaube, P Lansalot, L Lelièvre, M Marcel, G Martin-Blondel, M Piffaut, L Porte, K Saune, O Robineau, F Ajana, E Aïssi, I Alcaraz, E Alidjinou, V Baclet, L Bocket, A Boucher, M Digumber, T Huleux, B Lafon-Desmurs, A Meybeck, M Pradier, M Tetart, P Thill, N Viget, M Valette, Malbec, Odile, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse (UT)-Université de Toulouse (UT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Rennes (CHU Rennes), Laboratoire de Physique des Lasers (LPL), Université Paris 13 (UP13)-Centre National de la Recherche Scientifique (CNRS)-Université Sorbonne Paris Nord, Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Institut des sciences de la santé publique [Marseille] (ISSPAM), European Infective Endocarditis Registry (Euro-Endo), EMERGEN consortium, Stratégies thérapeutiques contre l'infection VIH et les maladies virales associées [iPLesp] (THERAVIR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Laboratoire Microorganismes : Génome et Environnement (LMGE), and Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)

Subjects
medicine.medical_specialty, MESH: CD4 Lymphocyte Count, [SDV]Life Sciences [q-bio], antiretroviral therapy, Human immunodeficiency virus (HIV), protease inhibitors, HIV Infections, medicine.disease_cause, MESH: HIV-1, Acquired immunodeficiency syndrome (AIDS), MESH: Neoplasm Recurrence, Local / complications, Internal medicine, medicine, Humans, HHV8, MESH: HIV Infections* / complications, MESH: Protease Inhibitors / adverse effects, Pharmacology (medical), Protease inhibitor (pharmacology), Sarcoma, Kaposi, Retrospective Studies, MESH: Humans, business.industry, Health Policy, Kaposi sarcoma, MESH: Retrospective Studies, Viral Load, MESH: HIV Infections* / drug therapy, medicine.disease, Antiretroviral therapy, switch, CD4 Lymphocyte Count, AIDS, [SDV] Life Sciences [q-bio], Regimen, Infectious Diseases, Increased risk, MESH: Sarcoma, Kaposi* / drug therapy, HIV-1, Sarcoma, Neoplasm Recurrence, Local, business, MESH: Viral Load, Viral load
Abstract

International audience; Objectives: Our aim was to assess if switching from a protease inhibitors (PI)-based regimen to a PI-free one is associated with an increased risk of Kaposi Sarcoma (KS) relapse among patients living with HIV (PLHIV) with history of KS and controlled HIV replication.Methods: In a retrospective analysis of the prospectively collected Dat'AIDS database we selected patients who both had a past KS history and a HIV-1 viral load below 200 copies/mL while being PI-treated. We searched for KS relapses while persistent virological success was maintained for at least 6 months, whether patients kept taking the PI, or switched to PI-free regimen.Results: Among the 216 patients with past KS event and a history of HIV-1 infection efficiently treated by a PI-based regimen, 148 patients (68.5%) later switched to a PI-sparing regimen. Their baseline characteristics were not different from non-switching patients. We described 7 cases of relapse (3.2% of the 216 patients). Five cases of relapse occurred in switching patients (3.4%). The remaining two relapses occurred in PI-treated patients (2.9%). At KS relapse, CD4 cell count was 459 cells/μL (range 225-560) for switching patients, compared with 362 and 136 cells/μL for the other two patients.Conclusions: In this large cohort of PLHIV with a history of KS and ART-controlled HIV replication, KS relapses were described in 3.2% of the patients, and were not more frequent when a PI-containing ART regimen has been switched to a PI-free regimen. Our results do not support a specific effect of PI on KS.

Published
2022

9. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012-2018

Author

Pradat, Pierre, Chirouze, C, Drobacheff-Thiébaut, C, Foltzer, A, Bouiller, K, Hustache-Mathieu, L, Lepiller, Q, Bozon, F, Babre, O, Brunel, A, Muret, P, Chevalier, E, Jacomet, C, Laurichesse, H, LESENS, O, Vidal, M, Mrozek, N, Aumeran, C, Baud, O, Corbin, V, Goncalvez, E, Mirand, A, brebion, A, Henquell, C, Lamaury, I, Fabre, I, Curlier, E, Ouissa, R, Herrmann-Storck, C, Tressieres, B, Receveur, M, Boulard, F, Daniel, C, CLAVEL, C, Roger, P, Markowicz, S, Chellum Rungen, N, Merrien, D, Perré, P, Guimard, T, Bollangier, O, Leautez, S, Morrier, M, Laine, L, Boucher, D, Point, P, Cotte, Laurent, Ader, F, Becker, A, Boibieux, A, Brochier, C, Brunel-Dalmas, F, Cannesson, O, Chiarello, P, Chidiac, C, Degroodt, S, FERRY, T, Godinot, M, Livrozet, J, Makhloufi, D, Miailhes, P, Perpoint, T, Perry, M, Pouderoux, C, Roux, Stéphane, Triffault-Fillit, C, Valour, F, Charre, C, Icard, V, Tardy, J, Trabaud, M, Ravaux, I, Ménard, A, Belkhir, A, Colson, P, Dhiver, C, Madrid, A, Martin-Degioanni, M, Meddeb, L, Mokhtari, M, Motte, A, Raoux, A, Toméi, C, Tissot-Dupont, H, Poizot-Martin, Isabelle, Brégigeon, S, Zaegel-Faucher, O, Obry-Roguet, V, Laroche, H, Orticoni, M, Soavi, M, Ressiot, E, Ducassou, M, Jaquet, I, Galie, S, Colson, H, Ritleng, A, Ivanova, A, Debreux, C, Lions, C, Rojas-Rojas, T, Cabié, André, Abel, S, Bavay, J, Bigeard, B, Cabras, O, Cuzin, L, Dupin de Majoubert, R, Fagour, L, Guitteaud, K, Marquise, A, Najioullah, F, Pierre-François, S, Pasquier, J, Richard, P, Rome, K, Turmel, J, Varache, C, Atoui, N, Bistoquet, M, Delaporte, E, Le Moing, V, Makinson, A, Meftah, N, Merle de Boever, C, Montes, B, Montoya Ferrer, A, Tuaillon, E, Reynes, J, Lefèvre, B, Jeanmaire, E, Hénard, S, Frentiu, E, Charmillon, A, Legoff, A, Tissot, N, André, M, Boyer, L, Bouillon, M, Delestan, M, Goehringer, F, Bevilacqua, S, Rabaud, C, May, T, Raffi, F, Allavena, C, Aubry, O, Billaud, E, Biron, C, Bonnet, B, Bouchez, S, Boutoille, D, Brunet-Cartier, C, Deschanvres, C, Gaborit, B, Grégoire, A, Grégoire, M, Grossi, O, Guéry, R, Lefebvre, Maeva, Le Turnier, P, Lecomte, R, Morineau, P, Reliquet, V, Sécher, S, Cavellec, M, Paredes, E, Soria, A, Ferré, V, André-Garnier, E, Rodallec, A, Pugliese, Pascal, Breaud, S, Ceppi, C, Chirio, D, Cua, E, Dellamonica, P, Demonchy, E, De Monte, A, Durant, J, Etienne, C, Ferrando, S, Garraffo, R, Michelangeli, C, Mondain, V, Naqvi, A, Oran, N, Perbost, I, Carles, M, Klotz, C, Maka, A, Pradier, C, Prouvost-Keller, B, Risso, K, Rio, V, Rosenthal, E, Touitou, I, Wehrlen-Pugliese, S, Zouzou, G, Hocqueloux, Laurent, Prazuck, T, Gubavu, C, Sève, A, Giaché, S, Rzepecki, V, Colin, M, Boulard, C, Thomas, G, Cheret, A, Goujard, C, Quertainmont, Y, Teicher, E, Lerolle, N, Jaureguiberry, S, Colarino, R, Deradji, O, Castro, A, Barrail-Tran, A, Yazdanpanah, Y, Landman, R, Joly, V, Ghosn, J, Rioux, C, Lariven, S, gervais, a, Lescure, F, Matheron, S, Louni, F, Julia, Z, Le Gac, S, Charpentier, c, Descamps, D, Peytavin, G, Duvivier, C, Aguilar, C, Alby-Laurent, F, Amazzough, K, Benabdelmoumen, G, Bossi, P, Cessot, G, Charlier, C, Consigny, P, Jidar, K, Lafont, E, Lanternier, F, Leporrier, J, Lortholary, O, Louisin, C, Lourenco, J, Parize, P, Pilmis, B, Rouzaud, C, Touam, F, Valantin, M, Tubiana, R, Agher, R, Seang, S, Schneider, L, PaLich, R, Blanc, C, Katlama, C, Bani-Sadr, Firouze, Berger, J, N’Guyen, Y, Lambert, D, Kmiec, I, Hentzien, M, Brunet, A, Romaru, J, Marty, H, Brodard, V, Arvieux, C, Tattevin, P, Revest, M, Souala, F, Baldeyrou, M, Patrat-Delon, S, Chapplain, J, Benezit, F, Dupont, M, Poinot, M, MAILLARD, A, Pronier, C, Lemaitre, F, Morlat, C, Poisson-Vannier, M, Jovelin, T, Sinteff, J, Gagneux-Brunon, A, Botelho-Nevers, E, Frésard, A, Ronat, V, Lucht, F, Rey, David, Fischer, P, Partisani, M, Cheneau, C, Priester, M, Mélounou, C, Bernard-Henry, C, de Mautort, E, Fafi-Kremer, S, Delobel, P, Alvarez, M, Biezunski, N, Debard, A, Delpierre, C, Gaube, G, Lansalot, P, Lelièvre, L, Marcel, M, Martin-Blondel, G, Piffaut, M, Porte, L, Saune, K, Robineau, O, Ajana, F, Aïssi, E, Alcaraz, I, Alidjinou, E, Baclet, V, Bocket, L, Boucher, A, Digumber, M, Huleux, Thomas, Lafon-Desmurs, B, Meybeck, A, Pradier, M, Tetart, M, Thill, P, Viget, N, Valette, M, Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), Université des Antilles (UA)-Etablissement français du don du sang [Montpellier]-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional d'Orléans (CHRO), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital universitaire Robert Debré [Reims], Centre Hospitalier Gustave Dron [Tourcoing], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Aix Marseille Université (AMU), 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), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital l'Archet, Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Université des Antilles (UA), 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], Dat’AIDS Study Group Besançon: C. Chirouze, C. Drobacheff-Thiébaut, A. Foltzer, K. Bouiller, L. Hustache- Mathieu, Q. Lepiller, F. Bozon, O. Babre, AS. Brunel, P. Muret, E. Chevalier. Clermont-Ferrand: C. Jacomet, H. Laurichesse, O. Lesens, M. Vidal, N. Mrozek, C. Aumeran, O. Baud, V. Corbin, E. Goncalvez, A Mirand, A brebion, C Henquell. Guadeloupe: I. Lamaury, I. Fabre, E. Curlier, R. Ouissa, C. Herrmann-Storck, B. Tressieres, MC. Receveur, F. Boulard, C. Daniel, C. Clavel, PM. Roger, S. Markowicz, N. Chellum Rungen. La Roche sur Yon: D. Merrien, P. Perré, T. Guimard, O. Bollangier, S. Leautez, M. Morrier, L. Laine, D. Boucher, P. Point. Lyon: L. Cotte, F. Ader, A. Becker, A. Boibieux, C. Brochier F, Brunel-Dalmas, O. Cannesson, P. Chiarello, C. Chidiac, S. Degroodt, T. Ferry, M. Godinot, J.M. Livrozet, D. Makhloufi, P. Miailhes, T. Perpoint, M. Perry, C. Pouderoux, S. Roux, C. Triffault-Fillit, F. Valour, C. Charre, V. Icard, J.C. Tardy, M.A. Trabaud. Marseille IHU Méditerrannée: I. Ravaux, A. Ménard, AY. Belkhir, P. Colson, C. Dhiver, A. Madrid, M. Martin-Degioanni, L. Meddeb, M. Mokhtari, A. Motte, A. Raoux, C. Toméi, H. Tissot-Dupont. Marseille Ste Marguerite: I. Poizot-Martin, S. Brégigeon, O. Zaegel-Faucher, V. Obry-Roguet, H Laroche, M. Orticoni, M.J. Soavi, E. Ressiot, M.J. Ducassou, I. Jaquet, S. Galie, H. Colson, A.S. Ritleng, A. Ivanova, C. Debreux, C. Lions, T Rojas-Rojas. Martinique: A. Cabié, S. Abel, J. Bavay, B. Bigeard, O. Cabras, L. Cuzin, R. Dupin de Majoubert, L. Fagour, K. Guitteaud, A. Marquise, F. Najioullah, S. Pierre-François, J. Pasquier, P. Richard, K. Rome, JM Turmel, C. Varache. Montpellier: N. Atoui, M. Bistoquet, E Delaporte, V. Le Moing, A. Makinson, N. Meftah, C. Merle de Boever, B. Montes, A. Montoya Ferrer, E. Tuaillon, J. Reynes. Nancy: B. Lefèvre, E. Jeanmaire, S. Hénard, E. Frentiu, A. Charmillon, A. Legoff, N. Tissot, M. André, L. Boyer, MP. Bouillon, M. Delestan, F. Goehringer, S. Bevilacqua, C. Rabaud, T. May. Nantes: F. Raffi, C. Allavena, O. Aubry, E. Billaud, C. Biron, B. Bonnet, S. Bouchez, D. Boutoille, C. Brunet-Cartier, C. Deschanvres, B.J. Gaborit, A. Grégoire, M. Grégoire, O. Grossi, R. Guéry, T. Jovelin, M. Lefebvre, P. Le Turnier, R. Lecomte, P. Morineau, V. Reliquet, S. Sécher, M. Cavellec, E. Paredes, A. Soria, V. Ferré, E. André-Garnier, A. Rodallec. Nice: P. Pugliese, S. Breaud, C. Ceppi, D. Chirio, E. Cua, P. Dellamonica, E. Demonchy, A. De Monte, J. Durant, C. Etienne, S. Ferrando, R. Garraffo, C. Michelangeli, V. Mondain, A. Naqvi, N. Oran, I. Perbost, M. Carles, C. Klotz, A. Maka, C. Pradier, B. Prouvost- Keller, K. Risso, V. Rio, E. Rosenthal, I. Touitou, S. Wehrlen-Pugliese, G. Zouzou. Orléans: L. Hocqueloux, T. Prazuck, C. Gubavu, A. Sève, S. Giaché, V. Rzepecki, M. Colin, C. Boulard, G. Thomas. Paris APHP Bicètre: A. Cheret, C. Goujard, Y. Quertainmont, E. Teicher, N. Lerolle, S. Jaureguiberry, R. Colarino, O. Deradji, A. Castro, A. Barrail-Tran. Paris APHP Bichat: Y. Yazdanpanah, R. Landman, V. Joly, J. Ghosn, C. Rioux, S. Lariven, A. Gervais, FX. Lescure, S. Matheron, F. Louni, Z. Julia, S. Le GAC, C. Charpentier, D. Descamps, G. Peytavin. Paris APHP Necker Pasteur: C. Duvivier, C. Aguilar, F. Alby-Laurent, K. Amazzough, G. Benabdelmoumen, P. Bossi, G. Cessot, C. Charlier, P.H. Consigny, K. Jidar, E. Lafont, F. Lanternier, J. Leporrier, O. Lortholary, C. Louisin, J. Lourenco, P. Parize, B. Pilmis, C. Rouzaud, F. Touam. Paris APHP Pitié Salpetrière: MA. Valantin, R. Tubiana, R. Agher, S. Seang, L. Schneider, R. PaLich, C. Blanc, C. Katlama. Reims: F. Bani-Sadr, JL. Berger, Y. N’Guyen, D. Lambert, I. Kmiec, M. Hentzien, A. Brunet, J. Romaru, H. Marty, V. Brodard. Rennes: C. Arvieux, P. Tattevin, M. Revest, F. Souala, M. Baldeyrou, S. Patrat-Delon, J.M. Chapplain, F. Benezit, M. Dupont, M. Poinot, A. Maillard, C. Pronier, F. Lemaitre, C. Morlat, M. Poisson-Vannier, T. Jovelin, JP. Sinteff. St Etienne: A. Gagneux-Brunon, E. Botelho-Nevers, A. Frésard, V. Ronat, F. Lucht. Strasbourg: D. Rey, P. Fischer, M. Partisani, C. Cheneau, M. Priester, C. Mélounou, C. Bernard-Henry, E. de Mautort, S. Fafi-Kremer. Toulouse: P. Delobel, M. Alvarez, N. Biezunski, A. Debard, C. Delpierre, G. Gaube, P. Lansalot, L. Lelièvre, M. Marcel, G. Martin-Blondel, M. Piffaut, L. Porte, K. Saune. Tourcoing: O. Robineau, F. Ajana, E. Aïssi, I. Alcaraz, E. Alidjinou, V. Baclet, L. Bocket, A. Boucher, M. Digumber, T. Huleux, B. Lafon-Desmurs, A. Meybeck, M. Pradier, M. Tetart, P. Thill, N. Viget, M. Valette., 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 Malbec, Odile

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Hepatitis C virus, [SDV]Life Sciences [q-bio], Population, men having sex with men, HIV Infections, Hepacivirus, medicine.disease_cause, Antiviral Agents, Men who have sex with men, 03 medical and health sciences, Sexual and Gender Minorities, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Human Immunodeficiency virus, Homosexuality, Male, education, Retrospective Studies, Hepatitis, education.field_of_study, business.industry, Coinfection, Mortality rate, Incidence (epidemiology), microelimination, virus diseases, HIV, Hepatitis C, Chronic, medicine.disease, Hepatitis C, digestive system diseases, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Cohort, 030211 gastroenterology & hepatology, epidemiology, France, business
Abstract

Background The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort. Methods This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors. Results From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018. Conclusions A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM. Clinical Trials Registration. NCT02898987.

Published
2020

21. Enterococcus-related vascular graft infection: A case series.

Author

Bauer J, Robineau O, Sobocinski J, D'Elia P, Boucher A, Lafon-Desmurs B, Tetart M, Meybeck A, Patoz P, and Senneville E

Subjects
Humans, Male, Female, Aged, Middle Aged, Blood Vessel Prosthesis adverse effects, Prospective Studies, Aged, 80 and over, Recurrence, Enterococcus isolation & purification, Prosthesis-Related Infections microbiology, Prosthesis-Related Infections epidemiology, Prosthesis-Related Infections drug therapy, Gram-Positive Bacterial Infections epidemiology, Gram-Positive Bacterial Infections drug therapy, Gram-Positive Bacterial Infections microbiology, Anti-Bacterial Agents therapeutic use
Abstract

Objectives: We aimed to assess the frequency, management, and burden of enterococcal-related vascular graft infection., Patients and Methods: From 2008 to 2021, data regarding all episodes of vascular graft infections initially managed or secondarily referred to our referral center were prospectively collected. We described the history and management of the infection, depending on the type of prosthesis used., Results: The frequency of enterococcal-related vascular graft infections was 29/249 (12 %). Most of them were early infections (22/29, 76 %). Infections were polymicrobial (26/29, 90 %), mostly associated with Enterobacterales. Among patients with positive blood cultures, 7/8 (88 %) involved enterococci. Patients with enterococcal-related vascular graft infections were mainly (22/29, 76 %) treated with an association of antibiotics. Mortality and relapse occurred in 28 % and 7 % respectively of the cases., Conclusions: Enterococcal-related vascular graft infections occurred in patients with comorbidities, during the early period following surgery and were more frequent in cases of intra-cavitary prosthesis. Their potential virulence needs to be considered, especially in polymicrobial infections., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Published
2024
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22. Are unknown co-medications, over-the-counter and off-label drug use still problems among people living with HIV? Results from a transversal survey in 23 centres in France.

Author

Tetart M, Passecountrin P, Lesourd A, Sanderink D, Le Moal G, Surgers L, Beraud G, Katlama C, Robineau O, and Parienti JJ

Subjects
Adult, Humans, Middle Aged, Cross-Sectional Studies, Nonprescription Drugs therapeutic use, France epidemiology, Surveys and Questionnaires, Off-Label Use, HIV Infections drug therapy
Abstract

Introduction: Polypharmacy can lead to drug-drug interactions (DDIs), especially with ART. The burden of co-medications, including over-the-counter (OTC) drugs and self-medications, could be underestimated. We aimed to investigate the proportion of people living with HIV (PLHIV) with declared and undeclared co-medications, as well as their potential burden., Methods: We conducted a national, multicentre, 1 week cross-sectional study between 10 December and 16 December 2019 in 23 French hospitals amongst consecutive adult PLHIV presenting for a routine outpatient visit. A standardized questionnaire filled in by the physicians assessed all medications and other active chemical substances taken by the PLHIV., Results: Overall we enrolled 496 participants from 23 centres. Median age was 50.6 years; ART regimens included an integrase inhibitor in 61% (n = 302), an NNRTI in 34% (n = 169) and a PI in 14% (n = 70) of the cases. Co-medications involved 392 (79%) PLHIV, among which 85 (17%) received polypharmacy (≥5 medications). Previously unknown co-medications or other active substances were found for 32% (n = 159) of the participants. Corticosteroids (9%, n = 46) and proton pump inhibitors (10%, n = 50) were frequently administered. These co-medications did not differ according to age range. Illegal drug use was declared by 11% (n = 54) and OTC drugs by 23% (n = 113) of PLHIV. Potential DDIs were discovered for 11% (n = 53), leading to treatment modifications in 47% (25/53) of cases., Conclusions: Potential DDIs that lead to therapeutic modifications remain significant whatever the age of PLHIV. More devoted time to identify co-medications and OTC treatment is needed in all PLHIV., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2023
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23. HIV pre-exposure prophylaxis (PrEP) knowledge among general practitioners in 2020: A French survey.

Author

Gilles M, Tetart M, Huleux T, Thill P, Meybeck A, and Robineau O

Subjects
Humans, Male, Middle Aged, Female, Homosexuality, Male, Cross-Sectional Studies, Patient Acceptance of Health Care, Health Knowledge, Attitudes, Practice, Surveys and Questionnaires, HIV Infections prevention & control, General Practitioners, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
Abstract

Introduction: Since 2017, pre-exposure prophylaxis (PrEP) has been one of the tools in combination HIV prevention strategies. The objective of our questionnaire was to analyze the knowledge and the position of general practitioners in Hauts-de-France on PrEP., Method: This quantitative, observational, cross-sectional study was conducted in 2020 using an anonymous questionnaire sent by post to a sample of 3007 GPs., Results: Four hundred and forty-four questionnaires (14.8 %) were included. The GPs were predominantly male (n = 253, 57 %) with a median age of 47 years. The median interest shown by respondents was 7/10. One hundred and sixty participating GPs (36%) were aware of the principles of PrEP, one hundred and sixty were only aware of the title (36%) and 124 (28%) showed no awareness at all. Out of the 160 GPs who knew about PrEP, 72 % considered it effective, 30 % knew about it from a patient and 34 % declared having at least one patient using PrEP. GPs who knew about PrEP were more likely to: have graduated less than 10 years before, having seen in consultation men who have sex with men (MSMs) and, lastly; using screening practices for sexually transmitted infections that were better aligned with the recommendations than those who reported not knowing about PrEP., Conclusion: Although PrEP remains insufficiently known to GPs, many expressed eagerness to be involved. The training of health professionals and the highlighting of GPs' role in prevention could help to optimize the fight against HIV., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Published
2023
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24. Rifabutin versus rifampicin bactericidal and antibiofilm activities against clinical strains of Staphylococcus spp. isolated from bone and joint infections.

Author

Thill P, Robineau O, Roosen G, Patoz P, Gachet B, Lafon-Desmurs B, Tetart M, Nadji S, Senneville E, and Blondiaux N

Subjects
Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Biofilms, Humans, Microbial Sensitivity Tests, Rifabutin pharmacology, Rifabutin therapeutic use, Rifampin pharmacology, Rifampin therapeutic use, Staphylococcal Infections drug therapy, Staphylococcus
Abstract

Background: Staphylococci account for approximately 60% of periprosthetic joint infections (PJIs). Rifampicin (RMP) combination therapy is generally considered to be the treatment of choice for staphylococcal PJIs but carries an important risk of adverse events and drug-drug interactions. Rifabutin (RFB) shares many of the properties of rifampicin but causes fewer adverse events., Objectives: To compare the minimal inhibitory concentration (MIC), the minimum bactericidal concentrations (MBC), and the minimum biofilm eradication concentrations (MBEC) of rifabutin and rifampicin for staphylococcal clinical strains isolated from PJIs., Methods: 132 clinical strains of rifampicin-susceptible staphylococci [51 Staphylococcus aureus (SA), 48 Staphylococcus epidermidis (SE) and 33 other coagulase-negative staphylococci (CoNS)] were studied. The MBC and the MBEC were determined using the MBEC® Assay for rifabutin and rifampicin and were compared., Results: When compared with the rifampicin MIC median value, the rifabutin MIC median value was significantly higher for SA (P < 0.05), but there was no statistically significant difference for SE (P = 0.25) and CoNS (P = 0.29). The rifabutin MBC median value was significantly higher than that of rifampicin for SA (P = 0.003) and was lower for SE (P = 0.003) and CoNS (P = 0.03). Rifabutin MBEC median value was statistically lower than that of rifampicin for all strains tested., Conclusions: Using the determination of MBEC values, our study suggests that rifabutin is more effective than rifampicin against clinical strains of Staphylococcus spp. obtained from PJIs. Using MBECs instead of MICs seems to be of interest when considering biofilms. In vivo higher efficacy of rifabutin when compared with rifampicin needs to be confirmed., (© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2022
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25. A disseminated Mycobacterium marinum infection in a renal transplant HIV-infected patient successfully treated with a bedaquiline-containing antimycobacterial treatment: A case report.

Author

Meybeck A, Tetart M, Baclet V, Alcaraz I, Blondiaux N, Peytavin G, Veyziris N, Robineau O, and Senneville E

Subjects
Female, Humans, Immunocompromised Host, Middle Aged, Mycobacterium Infections, Nontuberculous etiology, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Diarylquinolines therapeutic use, Kidney Transplantation adverse effects, Mycobacterium Infections, Nontuberculous drug therapy
Abstract

Background: Disseminated Mycobacterium marinum infections occur rarely, in immunocompromised patients. Treatment with a prolonged multi-drug regimen exposes patients to drug-drug interactions and side effects., Case Report: We report a case of disseminated M. marinum infection in a 54-year-old renal transplant, HIV-infected woman. Manifestations of the infection were cutaneous and subcutaneous nodules, mediastinal lymph nodes and left pulmonary infiltrate. Empirical treatment for non-tuberculous mycobacteria was initiated with rifabutin, ethambutol and azithromycin. After identifying M. marinum in sputum, due to unfavourable clinical evolution and severe drug-related adverse events, treatment was changed to doxycycline and rifabutin. Digestive and haematologic side effects motivated a change in antimycobacterial treatment to a combination of moxifloxacin and bedaquiline. Tolerance was satisfactory, and the patient was cured after 12 months of treatment., Conclusion: We report (to the authors' knowledge) the first case of disseminated M. marinum infection successfully treated with a bedaquiline-containing regimen. Bedaquiline could be an alternative to recommended antimicrobial regimens in cases of non-tuberculous mycobacterial disease, including M. marinum infection., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2021
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26. Accuracy of endobronchial ultrasound-guided transbronchial needle aspiration in HIV-infected patients with thoracic lymphadenopathy in a tuberculosis low-burden area.

Author

Tetart M, Betraoui F, Huleux T, Wallyn F, Brichet A, Thill P, Robineau O, and Meybeck A

Subjects
Female, France epidemiology, HIV Infections pathology, Humans, Lymphadenopathy diagnosis, Male, Mediastinum pathology, Middle Aged, Reproducibility of Results, Retrospective Studies, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary pathology, Ultrasonography, Interventional, Viral Load, Biopsy, Needle methods, HIV Infections complications, Lymphadenopathy pathology, Tuberculosis, Pulmonary diagnosis
Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an innovative technique to explore hilar and mediastinal lymphadenopathy. We aimed to assess its diagnostic accuracy in HIV-infected patients in a tuberculosis low-burden area. A retrospective review was performed of all HIV-infected patients with thoracic lymphadenopathy referred for EBUS-TBNA between January 2012 and January 2019 in 3 Northern French Hospitals. A total of 15 patients was included during the study period. Our patients were predominantly male (80%), with a mean age of 50 ± 11 years. Six patients (43%) had a CD4 cells count of less than 200/mm 3 . Eleven patients (73%) were receiving antiretroviral therapy, and 7 (47%) reached undetectable viral load. Adequate lymphnode sampling was accomplished in all patients. No serious complications were reported. EBUS-TBNA led to a definitive diagnosis in 12 out of 15 patients (80%). It identified 4 neoplasia, 3 atypical mycobacterial diseases, 2 tuberculosis, 1 Castleman disease, 1 sarcoidosis, and 1 professional dustiness. In 3 cases, sampling revealed normal lymphoid tissue. Active surveillance confirmed the suspected diagnosis of HIV adenitis with regression of lymphadenopathy on antiretroviral therapy in 2 cases. In one case of negative sampling, thoracoscopy led to the diagnosis of tuberculosis. In our cohort, accuracy of EBUS-TBNA was 92%. EBUS-TBNA appeared to be a safe and accurate tool in the investigation of mediastinal lymphadenopathy in HIV-infected patients in settings of tuberculosis low-prevalence. It can avoid more invasive procedures such as mediastinoscopy.

Published
2020
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27. Virological Outcome After Choice of Antiretroviral Regimen Guided by Proviral HIV-1 DNA Genotyping in a Real-Life Cohort of HIV-Infected Patients.

Author

Meybeck A, Alidjinou EK, Huleux T, Boucher A, Tetart M, Choisy P, Bocket L, Ajana F, and Robineau O

Subjects
Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Cohort Studies, Female, Genotype, HIV Infections genetics, HIV Infections virology, HIV-1 genetics, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Viremia drug therapy, Viremia virology, Anti-HIV Agents therapeutic use, Anti-Retroviral Agents therapeutic use, Drug Resistance, Viral genetics, HIV Infections drug therapy, HIV-1 drug effects, Viral Load drug effects
Abstract

Issues have been raised concerning clinical relevance of HIV-1 proviral DNA genotypic resistance test (DNA GRT). To assess impact of DNA GRT on choice of antiretroviral therapy (ART) and subsequent virological outcome, we retrospectively reviewed decision-making and viral load (VL) evolution following DNA GRT performed in our center between January 2012 and December 2017, except those prescribed within the framework of a clinical trial. A total of 304 DNA GRTs were included, 185 (62%) performed in a context of virological success. Only 34% of tests were followed by ART change, more frequently in situation of virological success (39% vs. 26%, p  = 0.02). In this situation, ART change guided by DNA GRT led to VL >20 copies/mL after 6 months in 5% of cases. In multivariate analysis, higher HIV DNA quantification ( p  = 0.01) was associated with occurrence of viremia. A higher nadir of CD4 count ( p  = 0.04) and a longer time with VL <20 copies/mL ( p  = 0.04) were independently associated with a lower risk of viremia. In situation of low-level viremia, ART change guided by DNA GRT led to VL <20 copies/mL after 6 months in 52% of cases, while decision to maintain the same treatment led to VL <20 copies/mL in 74% of cases. In multivariate analysis, longer time with VL >20 copies/mL ( p  = 0.02) was associated with persistence of virological replication. In conclusion, in situation of virological success, use of DNA GRT in addition to analysis of historical RNA GRT to guide ART optimization appears safe. Its prescription framework in situation of low-level viremia deserves to be better defined.

Published
2020
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28. Impact of Achromobacter xylosoxidans isolation on the respiratory function of adult patients with cystic fibrosis.

Author

Tetart M, Wallet F, Kyheng M, Leroy S, Perez T, Le Rouzic O, Wallaert B, and Prevotat A

Abstract

Background: The prevalence of Achromobacter xylosoxidans lung isolation in cystic fibrosis (CF) patients has increased, but the impact on lung function is controversial. The aim of this study was to evaluate the long-term effects of A. xylosoxidans isolation on respiratory function of adult patients with CF in the first 3 years after identification of A. xylosoxidans isolation., Methods: This was a case-control retrospective study performed at a single CF centre in Lille, France. Data for 36 patients with CF who had at least one sputum culture positive for A. xylosoxidans ( Ax+ ) were evaluated and compared with control CF patients uninfected by A. xylosoxidans ( Ax- ). Respiratory function and exacerbation frequency were evaluated between 1 year prior to and 3 years after A. xylosoxidans isolation., Results: Compared with the Ax - group, the Ax+ group had a lower forced expiratory volume in 1 s (FEV 1 ) at baseline (median (interquartile range): 55.2% (50.6-59.8%) versus 73.8% (67.2-80.4%); p=0.005), a greater decline in FEV 1 (±se) in the first year after A. xylosoxidans identification (-153.6±16.1 mL·year -1 versus -63.8±18.5 mL·year -1 ; p=0.0003), and more exacerbations in the first 3 years after A. xylosoxidans identification (9 (7-12) versus 7 (5-10); p=0.03). Ax+ patients co-colonised with Pseudomonas aeruginosa (n=27, 75%) had a greater FEV 1 decline (p=0.003) and more exacerbations in the year after A. xylosoxidans identification (p=0.037) compared with patients colonised with A. xylosoxidans alone. Patients with chronic A. xylosoxidans isolation (n=23, 64%) had more exacerbations than intermittently colonised patients in the 3 years after A. xylosoxidans identification (p=0.012)., Conclusion: A. xylosoxidans isolation is associated with a decline in respiratory function in patients with CF. Chronic A. xylosoxidans isolation and P. aeruginosa co-isolation may be markers of more severe respiratory disease in Ax + patients., Competing Interests: Conflict of interest: M. Tetart has nothing to disclose. Conflict of interest: F. Wallet has nothing to disclose. Conflict of interest: M. Kyheng has nothing to disclose. Conflict of interest: S. Leroy has nothing to disclose. Conflict of interest: T. Perez reports being the principal investigator of a clinical study evaluating a device for chest clearance in cystic fibrosis (Simeox, PhysioAssist). Conflict of interest: O. Le Rouzic reports personal fees and nonfinancial support from AstraZeneca, Boehringer Ingelheim, Chiesi, Lilly and Novartis, and nonfinancial support from GlaxoSmithKline, MundiPharma, Pfizer, Teva, the Santelys Association, Vertex and Vitalaire, outside the submitted work. Conflict of interest: B. Wallaert reports personal fees from Roche and Boehringer Ingelheim, outside the submitted work. Conflict of interest: A. Prevotat reports personal fees from Vertex and GSK, and congress invitations from Teva and Novartis, outside the submitted work., (Copyright ©ERS 2019.)

Published
2019
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29. Decision algorithm for infectious diarrhea

Author

Tetart M and Alfandari S

Subjects
Algorithms, Humans, Decision Making, Diarrhea therapy
Abstract

Competing Interests: S. Alfandari déclare participer ou avoir participé à des interventions ponctuelles pour l’entreprise Gilead (action de formation), MSD (action de formation, conseil), Novartis (action de formation), Pfizer (action de formation) ; et avoir été pris en charge (transport, hôtel, repas), à l’occasion de déplacement pour congrès, par Astellas, Gilead, MSD, Novex et Pfizer. M. Tetart n'a pas fourni de déclaration de lien d'intérêts.

Published
2017

30. Infectious diarrhea of adults and children

Author

Tetart M and Alfandari S

Subjects
Adult, Child, Humans, Infant, Diarrhea
Abstract

Competing Interests: S. Alfandari déclare participer ou avoir participé à des interventions ponctuelles pour l’entreprise Gilead (action de formation), MSD (action de formation, conseil), Novartis (action de formation), Pfizer (action de formation) ; et avoir été pris en charge (transport, hôtel, repas), à l’occasion de déplacement pour congrès, par Astellas, Gilead, MSD, Novex et Pfizer. M. Tetart n'a pas fourni de déclaration de lien d'intérêts.

Published
2017

31. [A well-inked pneumonia… can you decrypt it?]

Author

Tetart M, Trosini-Désert V, Fekkar A, and Chenivesse C

Subjects
Cryptococcosis complications, Cryptococcosis pathology, Female, Humans, Immunocompetence, Lymphadenopathy complications, Lymphadenopathy microbiology, Mediastinum microbiology, Necrosis, Pneumonia complications, Pneumonia microbiology, Young Adult, Lymphadenopathy pathology, Mediastinum pathology, Pneumonia pathology
Abstract

Introduction: We report a case of pneumonia associated with necrotic mediastinal lymph nodes in an immunocompetent patient. The case report illustrates the difficulties in making a diagnosis in necrotic mediastinal lymph nodes and discusses strategies to optimize sampling., Observation: A 21-year-old immunocompetent woman was admitted to hospital with dyspnea and fever occurring ten days after delivery. Physical examination, biological results and chest X-ray led to the diagnosis of right upper lobe pneumonia. Treatment with three broad-spectrum antibiotics was ineffective. Thoracic CT-scan showed compressive mediastinal and hilar necrotic adenopathies and consolidation of the right upper lobe. Bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration was non-diagnostic. A second bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration performed in close collaboration with the mycology laboratory led to the diagnosis of cryptococcosis. Antifungal therapy with fluconazole resulted in a complete resolution of clinical and radiological signs., Conclusion: Although it is extremely rare, pulmonary cryptococcosis should be considered in immunocompetent patients presenting with necrotic pneumonia. Effectiveness of lymph node sampling can be improved by collaboration between clinicians and microbiologists., (Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Published
2017
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