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1. Incidence of cervical, breast and colorectal cancers between 2010 and 2015 in people living with HIV in France.

Author

Teresa Rojas Rojas, Isabelle Poizot-Martin, David Rey, Claudine Duvivier, Firouzé Bani-Sadr, André Cabie, Pierre Delobel, Christine Jacomet, Clotilde Allavena, Tristan Ferry, Pascal Pugliese, Marc-Antoine Valantin, Isabelle Lamaury, Laurent Hustache-Matthieu, Anne Fresard, Tamazighth Houyou, Thomas Huleux, Antoine Cheret, Alain Makinson, Véronique Obry-Roguet, Caroline Lions, Maria Patrizia Carrieri, Camelia Protopopescu, and Dat’AIDS Study Group

Subjects
Medicine, Science
Abstract

BackgroundWe aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program.SettingThis is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort.MethodsStandardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection.ResultsThe 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73).ConclusionThe present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.

Published
2022
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3. Potential for Drug-Drug Interactions between Antiretrovirals and HCV Direct Acting Antivirals in a Large Cohort of HIV/HCV Coinfected Patients.

Author

Isabelle Poizot-Martin, Alissa Naqvi, Véronique Obry-Roguet, Marc-Antoine Valantin, Lise Cuzin, Eric Billaud, Antoine Cheret, David Rey, Christine Jacomet, Claudine Duvivier, Pascal Pugliese, Pierre Pradat, Laurent Cotte, and Hepadat'AIDS Study Group

Subjects
Medicine, Science
Abstract

Development of direct acting antivirals (DAA) offers new benefits for patients with chronic hepatitis C. The combination of these drugs with antiretroviral treatment (cART) is a real challenge in HIV/HCV coinfected patients. The aim of this study was to describe potential drug-drug interactions between DAAs and antiretroviral drugs in a cohort of HIV/HCV coinfected patients.Cross-sectional study of all HIV/HCV coinfected patients attending at least one visit in 2012 in the multicenter French Dat'AIDS cohort. A simulation of drug-drug interactions between antiretroviral treatment and DAAs available in 2015 was performed.Of 16,634 HIV-infected patients, 2,511 had detectable anti-HCV antibodies, of whom 1,196 had a detectable HCV-RNA and were not receiving HCV treatment at the time of analysis. 97.1% of these patients were receiving cART and 81.2% had a plasma HIV RNA

Published
2015
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4. 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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5. Spectrum and incidence trends of AIDS and non-AIDS defining cancers between 2010-2015 in the French Dat'AIDS cohort

Author

Isabelle Lamaury, Anne Frésard, Christine Jacomet, Alain Makinson, Tristan Ferry, Clotilde Allavena, Isabelle Poizot-Martin, Olivia Zaegel-Faucher, Pascal Pugliese, Catherine Chirouze, T. Huleux, David Rey, Véronique Obry-Roguet, Claudine Duvivier, Firouzé Bani-Sadr, Pierre Delobel, Antoine Cheret, Caroline Lions, Sylvie Bregigeon, Teresa Rojas Rojas, André Cabié, Assistance Publique - Hôpitaux de Marseille (APHM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service Universitaire des Maladies Infectieuses et du Voyageur [Tourcoing], Centre Hospitalier Tourcoing, Centre Hospitalier Universitaire de Reims (CHU Reims), School of Civil and Environmental Engineering [Sydney], University of New South Wales [Sydney] (UNSW), Les Hôpitaux Universitaires de Strasbourg (HUS), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), CHU de la Martinique [Fort de France], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (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 Universitaire Marseille, CHU Marseille, 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 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), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Chrono-environnement (UMR 6249) (LCE), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Cholley, Pascal, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Aix Marseille Université (AMU), Hôtel-Dieu de Nantes, Centre Hospitalier Gustave Dron [Tourcoing], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), 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), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, 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), 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 Côte d'Azur (UCA), Centre de Physiopathologie Toulouse Purpan (CPTP), 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)-Centre National de la Recherche Scientifique (CNRS), Hôpital JeanMinjoz, Infectious and Tropical Diseases Department [Montpellier], Institut de Recherche pour le Développement (IRD)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), GReCSS - IRD UMI233, Maison méditerranéenne des sciences de l'Homme (MMSH), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre Médical de l'Institut Pasteur, Institut Pasteur [Paris], 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 National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), and BONIZEC, Sandrine

Subjects
0301 basic medicine, Oncology, Adult, Male, medicine.medical_specialty, Adolescent, Epidemiology, [SDV]Life Sciences [q-bio], Population, education, History, 21st Century, Cohort Studies, 03 medical and health sciences, Prostate cancer, Young Adult, 0302 clinical medicine, Breast cancer, Prostate, Internal medicine, Neoplasms, medicine, Humans, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, Cervical cancer, Aged, 80 and over, education.field_of_study, Acquired Immunodeficiency Syndrome, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Incidence (epidemiology), Incidence, Cancer, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], 030104 developmental biology, medicine.anatomical_structure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, 030220 oncology & carcinogenesis, Cohort, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: Cancer risk is higher in people living with HIV (PLWH) compared with the general population, and cancers related to age are expected to be most prevalent. Methods: We determined the spectrum and incidence rates of AIDS-defining cancers (ADC) and non–AIDS-defining cancers (NADC) and of lung, Hodgkin lymphoma (HL), head and neck (HNC), colon–rectum, anal, liver, breast, prostate, and urinary bladder cancers between January 2010 and December 2015 in the French Dat'AIDS cohort. Incidence rates were calculated by year and compared using the χ2 test for linear trend. Standardized incidence ratios [SIR (95% confidence interval)] were calculated relative to the French general population. Results: Among 44,642 patients, corresponding to 180,216.4 person-years (PY), 1,440 cancer cases occurred in 1,314 patients. ADC incidence was 191.4 (172.3–212.7)/105 PY and declined over time overall and in men, whereas NADC incidence was higher [548.8 (515.6–584.1)/105 PY] and did not change. In men, non-Hodgkin lymphoma was the most common cancer, but prostate cancer had the highest incidence among NADCs. Breast cancer was the most common cancer in women. SIRs were higher for cervical cancer [1.93 (1.18–3.14)], HNC in women [2.4 (1.4–4.2)], liver [overall: 3.8 (3.1–4.6); men: 3.2 (2.5–4.0); women: 12.9 (8.3–20.0)], and HL [overall: 13.8 (11.1–17.1); men: 16.2 (12.9–20.4); women: 6.2 (3.22–11.9)] but lower for lung [overall: 0.7 (0.6–0.9); men: 0.7 (0.5–0.8)], prostate [0.6 (0.5–0.7)], and breast cancers [0.6 (0.4–0.7)]. Conclusions: Spectrum of NADCs has changed, with prostate and breast cancers becoming the most common despite their lower SIR. Impact: These results confirm the need to maintain regular epidemiologic cancer monitoring in order to update screening guidelines.

Published
2020
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6. 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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7. Is the use of the QPC cognitive complaints questionnaire relevant for the screening strategy of HIV-Associated neurocognitive disorders?

Author

Maelys Tixier, Victoire Morisseau, Véronique Obry-Roguet, Hélène Laroche, Olivia Zaegel-Faucher, Isabelle Poizot-Martin, Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM), 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), and Dupuis, Christine

Subjects
“Neurocognitive impairment”, Male, Health (social science), AIDS Dementia Complex, “QPC”, Social Psychology, Anti-HIV Agents, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), Neurocognitive Disorders, HIV Infections, Neuropsychological Tests, medicine.disease_cause, “Cognitive complaints”, 03 medical and health sciences, 0302 clinical medicine, Cognition, Antiretroviral Therapy, Highly Active, medicine, Humans, Mass Screening, “HIV-associated neurocognitive disorders”, 030212 general & internal medicine, Retrospective Studies, 030505 public health, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], “HIV”, Cross-Sectional Studies, Female, Expert report, 0305 other medical science, business, Neurocognitive, Clinical psychology
Abstract

International audience; Background: The screening strategy for HIV-Associated Neurocognitive Disorders (HAND) is challenging. The French Expert Report recommend the use of the Cognitive Complaints Questionnaire (QPC) and the Montreal Cognitive assessment. However, the QPC has never been studied in People Living with HIV (PLWH). This study aims to determine the degree of agreement between QPC and the presence of HAND according to Frascati criteria, established by a battery of neuropsychological tests.Methods: Data from patients who performed both a QPC and a battery of neuropsychological tests over a six-month follow-up period were evaluated retrospectively.Results: A total of 121 patients were selected, with a median age of 53.1 years old. Among participants, 92.6% had an undetectable plasma viral load, 49.6% had a nadir CD4 less than 200/mm3 and 23.1% had a CDC stage C. Median CD4 cell count was 686/mm3. Prevalence of HAND was 57%, including 28.9% of Asymptomatic Neurocognitive Impairment, 24.8% of Mild Neurocognitive Disorder and 3.3% of HIV-associated Dementia. This analyze shows no agreement between QPC and HIV-associated neurocognitive disorders (kappa = -0.007).Conclusions: The QPC is not relevant in the screening for HAND. Thus, it urges to develop a specific tool to assess cognitive complaints among PLWH.

Published
2020
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8. Ledipasvir and tenofovir drug interaction in human immunodeficiency virus-hepatitis C virus coinfected patients: Impact on tenofovir trough concentrations and renal safety

Author

Bruno Lacarelle, Véronique Obry-Roguet, Catherine Tamalet, Caroline Solas, Olivia Faucher-Zaegel, Sylvie Quaranta, Sylvie Bregigeon, and Isabelle Poizot-Martin

Subjects
0301 basic medicine, Ledipasvir, medicine.medical_specialty, Sofosbuvir, Hepatitis C virus, 030106 microbiology, Population, Renal function, medicine.disease_cause, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, Interquartile range, Internal medicine, medicine, Pharmacology (medical), Trough Concentration, education, Pharmacology, education.field_of_study, business.industry, medicine.disease, 030112 virology, 3. Good health, chemistry, business, Kidney disease, medicine.drug
Abstract

We evaluate the impact of ledipasvir on both tenofovir plasma trough concentration and estimated glomerular renal function in human immunodeficiency virus-hepatitis C virus coinfected patients receiving a tenofovir-based antiretroviral regimen and treated with ledipasvir/sofosbuvir. Twenty-six patients [81% male, median age: 51 years; hepatitis C virus genotype 1(75%)/4(15%)] were included. Tenofovir trough concentration (interquartile range) increased from 78 ng ml-1 (53-110) at baseline to 141 ng ml-1 (72-176) at 1 month (P = 0.003). No significant difference on estimated glomerular renal function using both Cockroft-Gault and Modification of Diet in Renal Disease formulae, respectively, [median (interquartile range)] was observed between baseline [101.3 ml min-1 (91.1-114.1); 95.6 ml min-1 (86.5-111.2)], 1 month [102.4 ml min-1 (89.8-112.9), P = 0.26; 92.5 ml min-1 (88.1-114.3), P = 0.27], end-of-treatment [96.5 ml min-1 (82.4-115.4), P = 0.39; 95.4 ml min-1 (84.2-105.4), P = 0.16] and 12 weeks after the end of treatment [100.5 ml min-1 (83.3-111.9), P = 0.24; 93.4 ml min-1 (82.2-103.5), P = 0.16]. Three patients progressed from chronic kidney disease stage 1 to stage 2 at 12 weeks post-treatment. A significant increase in tenofovir exposure through P-glycoprotein inhibition by ledipasvir was confirmed without significant impact on glomerular renal function in our population with normal renal function or mild renal impairment.

Published
2017
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9. Hepatitis C virus-microelimination program and patient trajectories after hepatitis C virus cure in an outpatient HIV clinical unit

Author

Caroline Lions, Emmanuelle Ressiot, Olivia Zaegel-Faucher, Alena Ivanova, Marie-Ange Pieve, Véronique Obry-Roguet, Perrine Geneau de Lamarliere, Catherine Tamalet, Patrizia Carrieri, Anne-Suzel Ritleng, Caroline Debreux, Sylvie Bregigeon, Isabelle Poizot-Martin, Caroline Solas, Hélène Laroche, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Bidaut, Ghislain, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), and Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)

Subjects
medicine.medical_specialty, Hepatitis C virus, [SDV]Life Sciences [q-bio], MEDLINE, HIV Infections, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Hepacivirus, medicine.disease_cause, Antiviral Agents, Serology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Outpatients, medicine, Humans, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Hepatology, business.industry, Coinfection, Gastroenterology, virus diseases, Guideline, Hepatitis C, Hepatitis C, Chronic, medicine.disease, Mental health, digestive system diseases, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Cohort study
Abstract

Objective Treatment recommendations for hepatitis C now make no distinction between HIV/HCV-coinfected and HCV-monoinfected patients. The largest challenge remained lack of effective models to eliminate HCV in people living with HIV. We report the results of a microelimination program evaluating the possibility of eradicating HCV in an HIV-outpatient clinical unit within 12 months. Methods This HCV-microelimination program began in February 2016 in an unit following approximately 1000 HIV-infected patients and combined screening and therapeutic components according to the French guideline. A nested cohort study evaluating the impact of HCV cure on different health outcomes was conducted through self-administered questionnaires and using generalized mixed models. Results Among 601 patients eligible for HCV serological testing, 445 were evaluated, and two HCV acute infections were diagnosed. Among the 151 patients eligible for HCV RNA quantification, 119 were evaluated, and one reinfection with HCV was diagnosed. Among the 110 patients eligible for direct-acting antiviral treatment, 51 (46.4%) initiated treatment within the 12 months program, and 35 (31.8%) after. Sustained virologic response (SVR) rate was 96.1%, and two treatments failed. At least one self-reported symptom was declared by 72.5% (n = 29) of patients. Positive impact of HCV cure was observed on various markers of physical and mental health as well as on health habits. Conclusion Our program should be considered as a proof of concept, which confirmed the feasibility of a HCV-microelimination program at the scale of an HIV clinical unit. However, 12 months were not sufficient to achieve our objective despite the specific organization.

Published
2019
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10. 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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11. Infection par le VIH et parcours de soin : des recommandations à la pratique clinique

Author

Caroline Debreux, Caroline Lions, Isabelle Poizot-Martin, Alena Ivanova, Sylvie Bregigeon, Anne-Suzel Ritleng, Carla E. Cano, Olivia Zaegel-Faucher, Véronique Obry-Roguet, 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, Male, medicine.medical_specialty, Human immunodeficiency virus (HIV), Aftercare, HIV Infections, medicine.disease_cause, Algorithme, Comorbidities, 03 medical and health sciences, Risk groups, Multidisciplinary approach, Care pathway, Medicine, Humans, Practice Patterns, Physicians', Aged, Retrospective Studies, Patient Care Team, 0303 health sciences, 030306 microbiology, business.industry, Comorbidités, HIV, VIH, Retrospective cohort study, Middle Aged, 3. Good health, Clinical Practice, Algorithm, Infectious Diseases, Emergency medicine, Cohort, Practice Guidelines as Topic, Critical Pathways, Parcours de soins, Female, Interdisciplinary Communication, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Guideline Adherence, business, Viral load, Follow-Up Studies
Abstract

International audience; OBJECTIVES:To quantify within a cohort of HIV-infected individuals the number of medical visits and procedures to be carried out according to comorbidities and risk factors to implement a personalized care pathway.PATIENTS AND METHODS:Retrospective study of 915 patients consulting from January 1 to December 31, 2016 at an outpatient unit of multidisciplinary consultations, using an electronic patient record. We built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. The frequency of comorbidities was measured according to gender, transmission risk group, and nadir CD4 (200/mm3).RESULTS:Patients were mostly men (median age: 52 years), of whom 16% were aged≥60 years. Viral load was

Published
2019
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12. Dépistage de la stéatose hépatique chez les patients mono infectés VIH : un nouvel enjeu ?

Author

Isabelle Poizot-Martin, Sylvie Bregigeon, Emmanuelle Ressiot, Olivia Zaegel-Faucher, M. Soavi, S. Galie, A. Saout, D. Chamouilli, C. Leger, and Véronique Obry-Roguet

Subjects
Infectious Diseases
Abstract

Introduction Les comorbidites telles que le diabete, l’insulinoresistance ou le surpoids sont frequentes chez les patients vivants avec le VIH (PVVIH), qui sont donc a haut risque de developper une steatose hepatique, et ce meme en dehors de toute co-infection VHB/VHC. La recherche d’une steatose hepatique chez les PVVIH presentant des troubles metaboliques ou une elevation inexpliquee des transaminases figure desormais dans les recommandations nationales pour la prise en charge des PVVIH. Materiels et methodes Etude retrospective observationnelle visant a evaluer la prevalence de la steatose hepatique et des facteurs associes chez les PVVIH non coinfectes par le VHC qui ont beneficie d’un depistage de la steatose entre le 01/03/2017 et le 31/12/2018. Ce depistage est propose aux PVVIH presentant une insulinoresistance (score Homa ≥ 3), un syndrome metabolique, un surpoids/obesite, un diabete, une lipodystrophie ou un taux de transaminases > 1,5 N et comprend une echographie hepatique ainsi que la mesure des parametres permettant le calcul du Fatty Liver Index (FLI) (triglycerides, gammaGT, indice de masse corporelle (IMC) et tour de taille). Un score FLI ≥ 60 definit la presence d’une steatose hepatique. Resultats Les donnees de 314 patients, âges en mediane de 54,5 ans, ont ete analysees. La majorite sont des hommes (n = 209, 66,6 %) avec un sex-ratio de 2/1. Cent cinquante-deux patients (48,4 %) ont un nadir de CD4 Conclusion La prevalence elevee de la steatose hepatique chez des PVVIH non coinfectes par le VHC et majoritairement a risque metabolique souligne la necessite de ce depistage et de pouvoir disposer des nouveaux outils diagnostiques actuellement utilises en population generale.

Published
2019
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13. Risk factors associated with overweight and obesity in HIV-infected people Aging, behavioral factors but not cART in a cross-sectional study

Author

Hélène Laroche, Caroline Lions, Olivia Zaegel-Faucher, Sylvie Bregigeon, M. Soavi, Sébastien Galie, Perrine Geneau de Lamarliere, Carla E. Cano, Isabelle Poizot-Martin, Véronique Obry-Roguet, A. Saout, Matthieu Orticoni, 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), and DUFOUR, Jean-Charles

Subjects
0301 basic medicine, Cart, Adult, Male, Alcohol Drinking, Cross-sectional study, Anti-HIV Agents, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), MEDLINE, HIV Infections, Overweight, medicine.disease_cause, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Hiv infected, medicine, Humans, 030212 general & internal medicine, Obesity, 2. Zero hunger, business.industry, Smoking, Age Factors, nutritional and metabolic diseases, virus diseases, General Medicine, Middle Aged, medicine.disease, 030112 virology, 3. Good health, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Logistic Models, Female, medicine.symptom, business, Body mass index
Abstract

Identifying risk factors associated with overweight and obesity in HIV-infected patients. A cross-sectional study analyzing data from patients attending an HIV outpatient unit. Overweight was defined as body mass index (BMI) >= 25 kg/m(2); = 30kg/m(2). Patients' characteristics contemporary to BMI assessment were collected. Multivariate logistic regression identified risk factors associated with overweight/obesity. Eight hundred sixty-two patients, median age 51 years, 21.5 years of HIV infection follow-up, 585 (68%) male, 829 (96%) receiving combined antiretroviral therapy (cART) for median 16.7 years, 768 (91%) HIV load = 500 cells/mm(3); 266 (31%) HCV+ serology, 110 (13%) had detectable HCV-RNA. Overweight affected 191 (22%) patients and obesity 46 (5%). Overweight and obesity were associated with age, HIV follow-up duration, and HIV transmission risk group. Overweight was also associated with gender and HCV status. In patients with substance use data, overweight was associated with alcohol and nonsmoking status. Obesity was associated with nonsmoking and ex-smoker status. Overweight/obesity were not found associated with cART or immune cell counts. In HIV-infected people, aging, alcohol consumption, nonsmoking, and ex-smoker status, the absence of HCV coinfection and to have cleared HCV infection are associated with overweight and/or obesity. Clinicians should be aware of these trends and consider introducing weight management programs as part of routine HIV care.

Published
2018
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14. Dépistage des IST en pratique courante : à chaque âge son IST !

Author

Antonio Martín, P. Martinet, J. Robert, A. Delfosse, Caroline Lions, Isabelle Poizot-Martin, Sylvie Bregigeon, Véronique Obry-Roguet, and Hélène Laroche

Subjects
Infectious Diseases
Abstract

Introduction Compte tenu de la forte prevalence des infections sexuellement transmissibles (IST) en France, un depistage annuel est recommande selon les situations a risque chez les personnes vivant avec le VIH (PVVIH) ainsi que dans le cadre d’un traitement preexposition (PrEP) en prevention d’une infection par le VIH. L’objectif de cette etude est d’evaluer l’activite de depistage en pratique courante et d’analyser la prevalence des IST de facon globale, par type d’IST et selon les groupes a risque. Materiels et methodes Etude mono-centrique retrospective realisee sur 1021 patients ayant beneficie d’un depistage des IST entre le 1/01/2017 et le 31/12/2018. Les donnees demographiques, epidemiologiques, virologiques, et bacteriologiques ont ete analysees (logiciel SPSS). Resultats Sur les 1021 patients (âge median 51 ans, 725 (71 %) hommes), 929 (91 %) sont des PVVIH (330 (35,5 %) contamination homosexuelle (HSH)), 67 (6,6 %) ont ete depistes apres accident d’exposition virale (AEV), 15 pour une PrEP (1,5 %) et 10 (1 %) apres decouverte d’une hepatite C. Un antecedent d’IST est renseigne chez 470 patients (46 %) : 150 syphilis (31 %), 76 gonococcies (16 %), 69 chlamydiae (15 %) et 2 mycoplasmes. Sur les 2197 bilans d’IST, 2011 serologies syphilis ont ete realisees dont 192 (9,5 %) positives et 652 PCR dont 41 (6,2 %) sont positives a gonocoque (41 % a l’anus, 29 % a la gorge, 24 % dans les urines, 4,9 % a l’uretre), et 12 (1,8 %) a chlamydia (66 % a l’anus, 16 % a la gorge et 16 % dans les urines). Une IST active est presente chez 97 (9,5 %) patients (dont 89 (8,7 %) PVVIH) avec 59 (5,8 %) syphilis (29 (49 %) chez les plus de 45 ans), 32 (3,1 %) gonococcies et 11 (1 %) chlamydioses (tous ont moins de 45 ans). A noter, pour 15 (1,5 %) patients, tous âges de moins de 55 ans, la presence simultanee de plusieurs IST. Conclusion Avec 9,7 % d’IST dont 3 % de gonococcie, cette etude confirme la prevalence elevee des IST dans une population ciblee a risque. Elle souligne par ailleurs l’existence d’une disparite en fonction de l’âge avec des infections a chlamydiae et gonocoques plus frequentes chez les hommes jeunes, alors que la syphilis concerne egalement des tranches d’âge plus elevees. Par ailleurs, compare a la population generale, le profil bacteriologique des IST differe avec plus de syphilis et de gonococcies, cette derniere etant majoritairement retrouvee au niveau de l’anus.

Published
2019
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15. Renal Impairment in Patients Receiving a Tenofovir-cART Regimen

Author

Bruno Lacarelle, Vincent Pradel, Julie Allemand, Olivia Faucher, Isabelle Poizot-Martin, Caroline Solas, Véronique Obry-Roguet, and Sylvie Bregigeon

Subjects
Adult, Male, medicine.medical_specialty, Organophosphonates, Urology, Renal function, Kidney, urologic and male genital diseases, Epidemiology, Humans, Medicine, Pharmacology (medical), Trough Concentration, Tenofovir, medicine.diagnostic_test, business.industry, Adenine, Rwanda, Retrospective cohort study, Middle Aged, medicine.disease, Regimen, Infectious Diseases, Therapeutic drug monitoring, Cohort, Reverse Transcriptase Inhibitors, Female, business, Glomerular Filtration Rate, Kidney disease
Abstract

Tenofovir disoproxil fumarate (TDF) is known to induce renal dysfunction in HIV-infected patients. The aim of this retrospective study was to evaluate the correlation between TDF trough concentration (Ctrough-TDF) and glomerular filtration rate (GFR) in a cohort of patients on antiretroviral therapy.A total of 163 patients with at least one determination of Ctrough-TDF between 17-24 hours were retrospectively selected from a computerized database and distributed into 3 groups defined by TDF concentrations40 (11.7%), between 40 and 90 (36.8%), and90 (high-level group, 51.5%) ng/mL. GFR was measured by Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration formulae at the times of TDF initiation and Ctrough-TDF determination and after 12 months.At the time of Ctrough-TDF measurement, median duration of TDF-based therapy was 21.1 months. GFR was significantly decreased in high-level group (-8.5 mL/min; P0.001) whatever the method used. GFR decline was significantly associated with an older age. Gender-stratified analysis showed that the early impact of Ctrough-TDF90 ng/mL was significant in women only. After 12 months, the decrease in GFR in patients with high Ctrough-TDF was observed in both men and women (-8.27; P = 0.003).The high prevalence of elevated Ctrough-TDF and its correlation with an increased risk of renal impairment support the usefulness of therapeutic drug monitoring for TDF, particularly in women and older patients.

Published
2013
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16. Impact of tenofovir dose adjustment on both estimated glomerular filtration rate and tenofovir trough concentration

Author

Isabelle Poizot-Martin, Sylvie Bregigeon, Olivia Faucher, Catherine Tamalet, Véronique Obry-Roguet, Caroline Solas, Service de Pharmacocinétique et de Toxicologie, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Virology, Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'immuno-hématologie clinique (CISIH), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and COMBE, Isabelle

Subjects
Male, medicine.medical_specialty, Tenofovir, Anti-HIV Agents, Urology, Renal function, HIV Infections, Kidney, Kidney Function Tests, 030226 pharmacology & pharmacy, Severity of Illness Index, 03 medical and health sciences, Impaired renal function, 0302 clinical medicine, Dose adjustment, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antiretroviral Therapy, Highly Active, Medicine, Humans, Pharmacology (medical), In patient, Trough Concentration, Renal Insufficiency, Retrospective Studies, Pharmacology, business.industry, Treatment options, Middle Aged, 3. Good health, Regimen, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, business, medicine.drug, Glomerular Filtration Rate
Abstract

Background Tenofovir disoproxil fumarate (TDF)-based regimen is a treatment option for HIV-infected patients. TDF dose adjustment is recommended in patients with impaired renal function. We assessed the impact of TDF dose adjustment on renal function and tenofovir trough concentration. Methods Fourteen HIV patients for whom TDF dose was adjusted (1 tablet/48 h) because of estimated glomerular filtration rate (eGFR) 2, and/or due to a tenofovir trough concentration >90 ng/ml between 2006 and 2013 were selected. The eGFR was measured at baseline and 3, 6 and 12 months after TDF dose adjustment. Results A 50% TDF dose reduction resulted in a significant increase of the eGFR 3 months after dose adjustment (61.1 versus 72.8 ml/min/1.73 m2; P=0.003). Concomitantly, tenofovir trough concentration decreased from 175 to 66 ng/ml ( P=0.009). Antiviral efficacy was maintained in all patients. Conclusions TDF dose adjustment combined with therapeutic drug monitoring may be useful especially in patients at risk of kidney dysfunction.

Published
2017
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17. First-line cART regimen impacts the course of CD8+ T-cell counts in HIV-infected patients that achieve sustained undetectable viral load

Author

André Cabié, Bruno Hoen, Francine Guillouet de Salvador, Claudine Duvivier, Cyrille Delpierre, Clotilde Allavena, Isabelle Poizot-Martin, Véronique Obry-Roguet, Christine Katlama, Lise Cuzin, Antoine Cheret, David Rey, Pierre Dellamonica, Carla E. Cano, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'infectiologie Necker-Pasteur [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service des maladies infectieuses, CHU Nice-University Hospital, Les Hôpitaux Universitaires de Strasbourg (HUS), Université Paris Descartes - Paris 5 ( UPD5 ), service des maladies infectieuses [Tourcoing], Centre Hospitalier de Tourcoing, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH [Paris], Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses [CHU Pitié-Salêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], 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 des Maladies Infectieuses et Tropicales[Point-à-Pitre], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre hospitalier universitaire de Nantes (CHU Nantes), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), 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), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Nice (CHU Nice)-University Hospital, 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), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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], Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], 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), 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), ADENIS, ANTOINE, and Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]

Subjects
0301 basic medicine, Cart, Adult, Male, medicine.medical_specialty, Anti-HIV Agents, CD4:CD8 ratio, Observational Study, HIV Infections, CD8-Positive T-Lymphocytes, Gastroenterology, 03 medical and health sciences, Interquartile range, Internal medicine, medicine, Cytotoxic T cell, Humans, Protease inhibitor (pharmacology), non nucleotide reverse transcriptase inhibitors, Retrospective Studies, Reverse-transcriptase inhibitor, business.industry, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, CD8, Middle Aged, Viral Load, Prognosis, 030112 virology, 3. Good health, first-line cart, Regimen, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, HIV-1, Reverse Transcriptase Inhibitors, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Viral load, medicine.drug, Research Article, Follow-Up Studies
Abstract

Supplemental Digital Content is available in the text, The aim of the study was to investigate the impact of first-line combined antiretroviral therapy (cART) regimen on the course of CD8+ T-cell counts in human immunodeficiency virus (HIV)-infected patients. A retrospective observational study conducted on the French DAT’AIDS Cohort of HIV-infected patients. We selected 605 patients initiating a first-line cART between 2002 and 2009, and which achieved a sustained undetectable HIV plasma viral load (pVL) for at least 12 months without cART modification. The evolution of CD8+ T-cell counts according to cART regimen was assessed. CD8+ T-cell counts were assessed in 572 patients treated with 2NRTIs+1PI/r (n= 297), 2NRTIs+1NNRTI (n= 207) and 3NRTIs (n= 68). In multivariate analysis, after 12 months of follow-up, the 3NRTIs regimen was associated with a significantly smaller decrease of CD8+ T-cell count compared with NNRTI-containing regimens (–10.2 cells/μL in 3NRTIs vs –105.1 cells/μL; P=0.02) but not compared with PI-containing regimens (10.2 vs –60.9 cells/μL; P=0.21). After 24 months, the 3NRTIs regimen was associated with a smaller decrease of CD8+ T-cell count and % compared with PI/r- and NNRTI-containing regimens (0.2 in 3NRTIs vs –9.9 with PI/r-regimens, P=0.001, and vs –11.1 with NNRTI-regimens, p

Published
2016
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18. Phénotype fragile et infection VIH : un nouveau critère de surveillance de la densité minérale osseuse ?

Author

Hélène Laroche, O. Zaegel, Sylvie Bregigeon, A. Galinier, A. Saout, Isabelle Poizot-Martin, Véronique Obry-Roguet, and Carla E. Cano

Subjects
Infectious Diseases
Abstract

Introduction La fragilite est liee a l’âge et apparait plus precocement chez les personnes vivant avec le VIH (PVVIH). La perte de la densite minerale osseuse (DMO) est acceleree par l’infection par le VIH et le traitement antiretroviral (ARV). L’objectif de cette etude est d’evaluer si les PVVIH avec un phenotype de fragilite sont plus a risque d’une baisse de la DMO. Materiels et methodes Les donnees de PVVIH disposant d’une evaluation de la fragilite et d’une mesure de la DMO (Lunar®) realisee dans les deux ans precedant l’evaluation de la fragilite ont ete analysees. Un phenotype fragile est defini selon le Study of Osteoporotic Fractures (SOF) par la presence d’au moins 2 marqueurs parmi la perte de poids (PP) non-intentionnelle, epuisement (E), et faiblesse musculaire (FM ; lever de chaise). L’osteopenie est definie par un T-score entre −1,5 et −2,5 et l’osteoporose par un T-score Resultats Cent soixante-quinze patients (âge median hommes (121 ; 69 %) : 56 ans ; femmes : 53 ans ; p = 0,002) repondaient aux criteres de selection. Des marqueurs de fragilite (E : 67 [38,3 %] ; PP : 28 [16 %] et FM : 8 [4,6 %]) sont presents chez 93 (46,9 %) patients (H : 55 [45,5 %] ; F : 27 [50 %] ; pNS), avec un marqueur chez 65 patients (37,1 %), deux marqueurs chez 13 (7,4 %), trois marqueurs chez 4 (2,3 %). Un phenotype de fragilite est present chez 17 (9,6 %) patients (H : 11 [8,9 %] ; F : 6 [11 %] ; pNS). La DMO est significativement plus basse (p = 0,01) chez les femmes au niveau du rachis (H : 1,08 g/m2 ; F : 1,02 g/m2) et du col femoral (H : 0,87 g/m2 et F : 0,82 g/m2). Une osteoporose est presente chez 18 (10,3 %) patients (H : 11 [9,1 %] ; F : 7 [13 %] ; pNS) au niveau du rachis et chez 11 (6,3 %) au niveau du col femoral (H : 9 [7,4 %] ; F : 2 [3,7 %] ; pNS). Les femmes fragiles ont une DMO et un T-score au niveau rachidien significativement plus bas (fragiles : 0,89 g/m2 et −2,3 ; non fragiles : 1,03 g/m2 et −1,1 ; p ≤ 0,005), avec une association negative significative entre fragilite et DMO/T-score du rachis en analyse multivariee (β = −0,377 ; p Conclusion Ces donnees sont en faveur de la necessite d’une surveillance de la densite minerale osseuse chez les PVVIH qui presentent un phenotype fragile.

Published
2017
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19. High level of HPV 16 and 18 DNA load in anal swabs from male and female HIV-1 infected patients

Author

Isabelle Poizot-Martin, Catherine Tamalet, Mireille Henry, Véronique Obry-Roguet, Serge Benhaim, and Dominique Figarella

Subjects
Adult, Male, Oncology, medicine.medical_specialty, Anal Canal, HIV Infections, Acquired immunodeficiency syndrome (AIDS), Virology, Internal medicine, Immunopathology, Prevalence, medicine, Humans, Anal cancer, Sida, Human papillomavirus 16, Human papillomavirus 18, biology, Incidence (epidemiology), Papillomavirus Infections, virus diseases, Middle Aged, medicine.disease, Anus, biology.organism_classification, Cross-Sectional Studies, Infectious Diseases, medicine.anatomical_structure, DNA, Viral, Immunology, HIV-1, Female, Viral disease, Viral load
Abstract

Background Despite HAART, the prevalence and incidence of anal cancer in HIV-infected individuals have increased. Recently, the relationship between the severity of cervical lesions and oncogenic HPV load was demonstrated; however, few studies have assessed the level and the significance of oncogenic HPV load in patients at risk for anal neoplasia. Objectives To assess HPV genotypes and HPV 16/18 DNA load in HIV-1 infected patients at risk for anal neoplasia. Study design Cross-sectional pilot study from male and female HIV-1 infected individuals at risk for anal neoplasia in an outpatient HIV Clinical Unit of Marseilles university Hospitals. Results Anal HPV was found in 79% of the patients whereas high-risk (HR) HPV types and infection with multiple HPV types were found in 83% and 61% of the patients, respectively. Using a sensitive real-time PCR, median HPV 16 and 18 DNA load were 5 × 106 copies/106 cells and 3.2 × 105 copies/106 cells, respectively. Notably, there were no significant differences in the HPV 16/18 viral loads with respect to the anoscopic results. Conclusions Longitudinal studies are needed to evaluate the link between high anal HPV DNA load and progression to anal squamous intraepithelial lesions and anal cancer.

Published
2009
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20. A Case of Undiagnosed HIV Infection in a 57-Year-Old Woman with Multiple Myeloma: Consequences on Chemotherapy Efficiency and Safety

Author

Alena Ivanova, Isabelle Poizot-Martin, Sylvie Bregigeon, Carla E. Cano, Catherine Tamalet, Véronique Obry-Roguet, R Bouabdallah, Caroline Solas, Olivia Zaegel-Faucher, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Département d'Hematologie, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Assistance Publique - Hôpitaux de Marseille (APHM), Cytosquelette et Intégration des Signaux du Micro-Environnement Tumoral - UMR 6032 (CISMET), Centre National de la Recherche Scientifique (CNRS)-Université de Provence - Aix-Marseille 1-Université de la Méditerranée - Aix-Marseille 2, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Université de la Méditerranée - Aix-Marseille 2-Université de Provence - Aix-Marseille 1-Centre National de la Recherche Scientifique (CNRS), and COMBE, Isabelle

Subjects
medicine.medical_specialty, Efavirenz, Article Subject, medicine.medical_treatment, Case Report, chemotherapy, lcsh:RC254-282, 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, medicine, 030212 general & internal medicine, HIV-infected, Multiple myeloma, Cancer staging, Lenalidomide, Chemotherapy, Bortezomib, business.industry, virus diseases, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 3. Good health, Surgery, Transplantation, myeloma, Oncology, chemistry, 030220 oncology & carcinogenesis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, business, Viral load, medicine.drug
Abstract

Background. Non-AIDS-defining cancers represent a rising health issue among HIV-infected patients. Nevertheless, HIV testing is not systematic during the initial cancer staging. Here, we report a case of HIV infection diagnosed three years after chemotherapy initiation for multiple myeloma.Results. A 57-year-old woman diagnosed with multiple myeloma underwent a first round of chemotherapy by bortezomib/lenalidomide and then with bortezomib/liposomal-doxorubicine/dexamethasone, with partial remission, poor hematological tolerance, and multiple episodes of pneumococcal infection. Allogenic stem cell transplantation was proposed leading to HIV testing, which revealed seropositivity, with an HIV viral load of5.5 Log10/mLand severe CD4 T cell depletion (24 cells/mm3). Chemotherapy by bendamustin was initiated. Multidisciplinary staff decided the initiation of antiretroviral therapy with tenofovir/emtricitabin/efavirenz and prophylaxis against opportunistic infections. After 34 months, patient achieved complete remission, sustained HIV suppression, and significant CD4 recovery (450 cells/mm3), allowing effective pneumococcal immunization without relapse.Conclusion. Our case illustrates the drawback that ignored HIV infection is still causing to cancer patients receiving chemotherapy and highlights the importance of early HIV testing in oncology. A multidisciplinary approach including oncologists/hematologists, virologists, and pharmacists is recommended in order to avoid drug interactions between chemotherapy and antiretroviral drugs. Moreover, prophylactic medication is recommended in these patients regardless of CD4+ cell count at the initiation of chemotherapy.

Published
2016
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21. Impact of hepatitis C virus coinfection on T-cell dynamics in long-term HIV-suppressors under combined antiretroviral therapy

Author

Olivia Zaegel-Faucher, Carla E. Cano, Catherine Tamalet, Véronique Obry-Roguet, Corinne Nicolino-Brunet, Françoise Dignat-George, Sylvie Bregigeon, Isabelle Poizot-Martin, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital de la Timone [CHU - APHM] (TIMONE), Unité de Recherche en Biologie et Epidémiologie Parasitaires, Institut de Médecine Tropicale du Service de Santé des Armées-Centre National de la Recherche Scientifique (CNRS), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Malbec, Odile

Subjects
CD4-Positive T-Lymphocytes, Male, [SDV]Life Sciences [q-bio], HIV Infections, CD8-Positive T-Lymphocytes, medicine.disease_cause, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Immunology and Allergy, Medicine, Longitudinal Studies, 030212 general & internal medicine, hepatitis C virus genotype, 0303 health sciences, Coinfection, virus diseases, Middle Aged, Viral Load, 3. Good health, [SDV] Life Sciences [q-bio], immune restoration, Infectious Diseases, Anti-Retroviral Agents, Female, Viral load, Adult, Cart, medicine.medical_specialty, Hepatitis C virus, Immunology, CD4-CD8 Ratio, HIV Long-Term Survivors, 03 medical and health sciences, Internal medicine, Humans, Retrospective Studies, 030304 developmental biology, Hepatitis, business.industry, HIV, Retrospective cohort study, Hepatitis C, Chronic, medicine.disease, CD4 Lymphocyte Count, hepatitis C, business, Serostatus
Abstract

International audience; Objective: The objective of this study is to evaluate the impact of hepatitis C virus (HCV) serostatus on the evolution of CD8 þ cells and CD4 þ : CD8 þ ratio in HIV-infected patients on combined antiretroviral therapy (cART) who achieve sustained undetectable viral load (HIV-pVL). Design and methods: A longitudinal study performed in an outpatient HIV-unit following 1495 HIV-infected patients. Data of patients on cART achieving undetectable HIV-pVL for at least 3 years were collected retrospectively from our medical e-database NADIS from January 1997 to April 2005, a period defined in order to select patients who were naive of hepatitis treatment. T-cell counts were assessed every 6 months from HIVsuppression over the study period. Results: Two hundred and twenty-six HIV mono-infected (group 1) and 130 HCVcoinfected patients (group 2; genotype prevalence: 42% HCV-G1, 26% HCV-G3, 11% HCV-G4 and 21% HCV-G2) fulfilled the selection criteria. cART regimens were comparable between the groups, as were CD4 þ and CD8 þ cell counts at the first undetectable HIV-pVL. After 3 years, both groups displayed similar CD4 þ cell reconstitution, although CD4 þ percentage was higher in group 1 (30.3 AE 1.1 vs. 27 AE 1.1%; P < 0.001). HIV suppression led to a significant drop of median CD8 þ cell counts in group 1 (P ¼ 0.027), but not in group 2, which displayed higher CD8 þ cell counts all through the follow-up (mean diff. ¼ 135.71 AE 26.89 cells/ml, P < 0.001). Moreover, the fraction of patients reaching CD4 þ : CD8 þ ratio ! 1 was lower in group 2 (14 vs. 27.7%; P < 0.05). Conclusion: Despite sustained HIV suppression under cART, HCV coinfection was found to hamper CD8 þ downregulation. Further studies will determine the impact of treatment with direct-acting antiviral agents on the CD8 þ pool, and the advantage of systematic HCV-targeted therapy for HIV/HCV-coinfected patients.

Published
2015
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22. 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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23. CD4 decline prior diagnosis of hepatocarcinoma in HIV-infected patients: a new predictor?

Author

Sylvie Bregigeon, Isabelle Poizot-Martin, Catherine Tamalet, Olivia Zaegel-Faucher, Carla E. Cano, Françoise Dignat-George, Véronique Obry-Roguet, and Corinne Nicolino-Brunet

Subjects
medicine.medical_specialty, Epidemiology, business.industry, Immunology, Prior diagnosis, Public Health, Environmental and Occupational Health, Microbiology, QR1-502, Infectious Diseases, Virology, Internal medicine, medicine, Hiv infected patients, Public aspects of medicine, RA1-1270, business
Published
2016

24. Surpoids, obésité et infection VIH : prévalence et analyse des facteurs associés

Author

Caroline Lions, Isabelle Poizot-Martin, A. Saout, M. Soavi, Hélène Laroche, Sylvie Bregigeon, Olivia Zaegel-Faucher, M. Orticoni, Véronique Obry-Roguet, and S. Galie

Subjects
Infectious Diseases
Abstract

Introduction Decrire la prevalence et les facteurs associes a la presence d’un surpoids et d’une obesite au sein d’une file active de personnes vivant avec le VIH (PVVIH). Materiels et methodes Il s’agit d’une etude transversale realisee sur 862 PVVIH pris en charge entre le 01/01/2015 et le 31/12/2015. Le surpoids est defini par un indice de masse corporelle (IMC) compris entre 25 et 30 kg/m 2 et l’obesite par un IMC ≥ 30 kg/m 2 . Les caracteristiques epidemiologiques, immuno-virologiques, therapeutiques ainsi que la consommation de toxiques (tabac, alcool) ont ete analysees a la date de la mesure de l’IMC. L’analyse des facteurs associes a ete realisee par regression multivariee logistique multinomiale (SPSS ® Statistics 20). Resultats L’âge median de la population etudiee est de 51 ans [46 ; 56], avec une mediane de suivi de 21,5 ans, 68 % ( n = 585) sont des hommes, 96 % ( n = 829) sont sous ARV (inhibiteur de protease : 31 % n = 256 ; analogue non nucleosidique : 47 % n = 393 ; inhibiteur d’integrase : 27 % n = 222) avec une duree d’exposition de 16,7 ans, 91 % ( n = 768) ont une charge virale VIH n = 618) un taux de CD4 > 500/mm 3 et 41 % ( n = 343) un ratio CD4/CD8 > 1. La serologie VHC est positive chez 31 % ( n = 266) dont 13 % ( n = 110) avec un ARN VHC+. Parmi les 335 patients avec la consommation d’alcool et de tabac renseignees, 65 % ( n = 219) boivent de l’alcool, 55 % ( n = 183) sont fumeurs et 23 % ( n = 77) ex-fumeurs. La presence d’un surpoids est identifiee chez 191 patients (22 % ; H : 23,9 % [ n = 140] ; F : 18,4 % [ n = 51] p = 0,068) et d’une obesite chez 46 (5 % ; H : 4,8 % [ n = 28] ; F : 6,5 % [ n = 18] p = 0,296). Les facteurs associes a un surpoids sont l’âge (OR : 1,06 [1,04 ; 1,08]), la duree de suivi VIH (OR : 0,97 [0,95 ; 0,99]), une serologie VHC negative (OR : 2,25 [1,11 ; 4,58]) ou une hepatite VHC guerie (OR : 2,94 [1,36 ; 6,32]). Les facteurs associes a une obesite sont l’âge (OR : 1,07 [1,03 ; 1,10]) et la duree de suivi VIH (OR : 0,95 [0,91 ; 0,99]). Chez les patients avec la consommation d’alcool et de tabac renseignees ( n = 335), l’âge (OR : 1,06 [1,02 ; 1,09]) et la consommation d’alcool (OR : 2,69 [1,42 ; 5,08]) sont associes a un surpoids, et l’âge (OR : 1,07 [1,01 ; 1,13]), etre non-fumeur (OR : 6,03 [1,34 ; 27,06]) ou ex-fumeur (OR : 8,23 [2,18 ; 31,10]) sont associes a une obesite. Le sexe, la duree d’exposition ou la composition du traitement antiretroviral, le statut immuno-virologique lie au VIH, ne sont pas associes a un surpoids ou une obesite. Conclusion Le vieillissement de la population VIH expose, comme en population generale, a un risque de surpoids/obesite qui apparait ici independant du traitement antiretroviral. Ces donnees preliminaires soulignent la necessite de mettre en place des actions de prevention notamment vis-a-vis de la consommation d’alcool et d’un accompagnement dietetique renforce lors de l’arret du tabac.

Published
2017
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25. Impact of maraviroc on immune restoration in an advanced stage HIV-infected patient

Author

Amélie Menard, Catherine Tamalet, Sylvie Bregigeon, Caroline Solas, Isabelle Poizot-Martin, Olivia Faucher, and Véronique Obry-Roguet

Subjects
lcsh:Immunologic diseases. Allergy, Oncology, medicine.medical_specialty, biology, business.industry, CCR5 receptor antagonist, Virus, Clinical trial, chemistry.chemical_compound, Infectious Diseases, Refractory, chemistry, Immune Restoration, Virology, Internal medicine, Poster Presentation, Immunology, medicine, biology.protein, Antibody, lcsh:RC581-607, business, Viral load, Maraviroc
Abstract

Background Maraviroc is a CCR5 antagonist with clearly demonstrated virological efficacy in patients refractory to prior treatment and infected with an R5-tropic virus. This antiretroviral drug would appear to have a special immunomodulatory property, given the significantly higher increase in CD4 count in patients treated with maraviroc in clinical trials. We report the case of a severely immunocompromised patient in which the introduction of maraviroc reduced viral load to below the threshold of 40 copies/ml, with an increase in CD4 of over 100 in the space of 17 months. Methods

Published
2010
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26. Educational intervention and HIV infection: preliminary results

Author

Brigitte Canet, Véronique Obry-Roguet, Isabelle Poizot-Martin, Amélie Menard, and Sylvie Bregigeon

Subjects
lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, business.industry, Alternative medicine, Human immunodeficiency virus (HIV), Bioinformatics, medicine.disease_cause, Infectious Diseases, Quality of life, Virology, Family medicine, Intervention (counseling), Poster Presentation, medicine, Hiv infected patients, Self administered questionnaire, lcsh:RC581-607, business, Inclusion (education)
Abstract

Methods We initiated in March 2009 an EIP in an HIV outdoor Clinical Unit witch follow about 1000 HIV infected patients with 40% HCV coinfected. This program included at last 3 educational consultations for each patient (at least 2 initial educational consultations permitted to do a personal educational diagnosis and to fix objectives with patients and at least 1 follow up educational consultation to validate experiences) and was performed by a specifically training nurse. This analysis focused on quality of life with a self administered questionnaire at inclusion in the program.

Published
2010
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27. M-04 Dosage de l’alpha-fœtoprotéine (AFP) combinée à une échographie abdominale tous les 6 mois dans le dépistage des hépatocarcinomes (HCC) chez les patients coinfectés VIH-VHC

Author

M.P. Drogoul-Vey, Véronique Obry-Roguet, F. Vion-Dury, Isabelle Poizot-Martin, Jean-Louis Gastaut, S. Benhaim, and M.E. Mars-Kallee

Subjects
Infectious Diseases
Abstract

Objectif Evaluer la distribution des taux d’AFP (Tx.AFP) et l’interet de son dosage systematique en association avec une echographie abdominale (EchoG) tous les 6 mois dans le depistage des HCC chez les patients VIH-VHC+. Methodes Etude prospective initiee en avril 2004. Le dosage de l’AFP (Anormal (Anl) : > 12,1 ng/ml) et l’EchoG ont ete realises tous les 6 mois pendant 36 mois. La TxAFP a ete analysee selon les valeurs ≤ 5, > 5-20, > 20-50, > 50-100, > 100-200, > 200-400 et > 400 ng/ml. Resultats Les donnees de 133 patients VIH-VHC+ (76 % d’hommes ; âge median : 42,1 ans, 3,7 % VIH-VHB-VHC+ ; VHC-G1 : 59,5 %, VHC-G3 : 29,4 %, VHC-G4 : 13,5 %, VHC-G2 : 1,5 %) avec au moins deux evaluations completes sur 12 mois entre 04/2004 et 03/2006 ont ete analysees. La duree mediane de suivi de l’infection VIH et VHC etait respectivement de 16,9 et 9,4 ans. Le score METAVIR (PBH : n = 87 patients) etait F0 : n = 6, F1 : n = 31 ; F2 : n = 18 ;F3 : n = 19, F4 : n = 13. A M6, 33 % des patients avaient les deux marqueurs d’evaluation renseignes et 40 % a M12. Le taux median d’AFP etait de 3,94 (IQ : 2,29- 9,32) a la premiere mesure (Anl : 18 %), 5,7 (IQ : 3,5-9,4) a M6 ( n = 75) (Anl : 10,5 %), et 5,1 ng/ml (IQ : 3,12-9) a M12 ( n = 62) (Anl : 7,5 %). La TxAFP etait respectivement de 60,2 %, 31,6 %, 3,8 %, 2,3 %, 1,5 %, 0 % et 0,8 %. Le taux d’AFP n’etait pas correle au score METAVIR ni au genotype VHC ni au sexe. Trois cas d’HCC ont ete depistes sur la premiere EchoG (AFP : 115 663, 9,9 et 3,02 ng/ml) dont un patient en reponse virologique soutenue a 5 ans (A1F3). Conclusion Rythme et modalites du depistage des HCC dans la co-infection VIH-VHC restent a definir mais doit concerner les patients VHC-gueris et non cirrhotiques. Une EchoG tous les 6 mois reste cependant difficile a obtenir.

Published
2008
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28. H-14 Évaluation et suivi des charges virales oncogènes HPV 16 et 18 et des infections multiples à HPV anaux chez des patients infectés par le VIH-1

Author

Isabelle Poizot-Martin, M. Henry, Véronique Obry-Roguet, S. Benhaim, C. Tamalet, and F. Figarella

Subjects
Infectious Diseases
Abstract

Introduction et objectifs Depister des lesions anales chez des patients VIH+ a risque de developper un cancer du canal anal par cytologie, anuscopie, rechercher les differents types d’HPV, et mesurer la charge virale oncogene HPV 16 et 18. Materiels et methodes 119 patients (66 % d’hommes) recrutes au CISIH Sud (Mai 2007-Janvier 2009). Âge median : 44 ans [IQR 39-49] ; 90 % sous HAART; CD4 medians : 434 [IQR 273-565] ; CV plasmatique (CV) mediane : 687 copies/ml [IQR 136-31.397]. Sur prelevement anal (ecouvillon dacron) : HPV16/18 quantifies par PCR en temps reel et tous types d’HPV detectes et types par PCR, sequencage, clonage et analyse phylogenetique. Resultats Sur les frottis anaux, sont observes : cytologies normales (33 %), koilocytoses (33 %), troubles maturatifs cellulaires (28 %), dysplasies de bas grade (6 %). 76,5 % (91/119) des patients sont porteurs d’HPV. 69 % sont infectes par de multiples types (≥ 2), 87 % par des HPV a haut-risque (HR), 64 % par des HPV a bas risque. La mediane des CV HPV 16 et 18 est elevee (6,4 et 5,5 log10 copies/10 6 cellules). Parmi les 79 patients (66 %) ayant une anuscopie normale, 73 % (58/79) sont porteurs d’HPV dont 84 % (49/58) sont des HPV-HR. Le suivi de 15 patients (suivi median : 10 mois, IQR 6-12,7) dont 6/15 traites par Aldara ( n = 4), Condyline ( n = 1) ou par resection de la lesion ( n = 1) montre des CV HPV 16/18 stables, une detection fluctuante des multiples types d’HPV, une anuscopie qui redevient normale dans 3 cas traites. Conclusion Les CV HPV 16/18 oncogenes anales elevees ont pour le moment une signification incertaine et necessitent, en association avec des examens anuscopiques et cytologiques une surveillance reguliere des populations VIH+ a risque.

Published
2009
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29. H-02 Immunité fonctionnelle et charge virale intracellulaire après 10 ans de charge virale plasmatique indétectable (CVp)

Author

C. Nicolino-Brunet, M.P. Drogoul-Vey, Olivia Faucher, C. Tamalet, Véronique Obry-Roguet, Isabelle Poizot-Martin, and F. Dignat-George

Subjects
Infectious Diseases
Abstract

Introduction et objectifs Analyser la restauration immunitaire fonctionnelle chez des patients avec une negativation prolongee de la CVp. Quantifier la CV intracellulaire (ADN proviral, ADNp). Comparer la restauration de la fonctionnalite selon l’ADNp. Materiels et methodes Selection des patients avec une CV indetectable depuis au moins 7 ans. Mesure transversale des marqueurs de fonctionnalite sur les CD4 (CD45RA/CD62L, CD4CD28) et les CD8 (HLADR+, CD38+), comparee a une population temoin (T) n = 20). Mesure de l’ADNp (PCR temps reel, valeur seuil : 20 copies/106 de cellules). Analyse statistique sous SPSS. Resultats Les donnees de 62 patients (P) avec une duree mediane d’indetectabilite de 10,33 ans (IQ : 9,5-10,9) (40 hommes, âge median : 46,2 ans, Stade C : 27,4 %, VIH-VHC : 33,9 %, 56,4 % avec au moins 1 blip de CVp 1 : 45 %). 44 P (71 %) ont un ADNp ≥ 20 (mediane : 66,5/106 de cellules). La proportion de CD45RA62L et de CD4CD28 est identique chez les P et les T (pNS). La proportion de CD8CD38+ est plus faible chez les P (19,1vs 31,8) (p = 0,005) et celle de CD8DR+ plus elevee (17,6 vs 9,4) (p = 0,002). L’ADNp n’influe pas sur les marqueurs de fonctionnalite. Chez les BCVp, le taux median d’ADNp est de 40 copies (20-125)/106 de cellules vs 29 (19-84) chez les non BCV (p = 0,164). Seuls les CD8DR+ sont plus eleves chez les BCVp (21,1 vs 15,2 ; p = 0,036). Conclusion Apres 10 ans de controle virologique soutenu, on observe une recuperation de la fonctionnalite des CD4 mais une activation immunitaire persistante sans lien retrouve avec l’ADNp.

Published
2009
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