Search

International audience; ObjectivesWe aimed to investigate the first Omicron cases detected in France in order to assess case characteristics and provide supporting information on the possible impact of this variant on the healthcare system.MethodsA standardized questionnaire was used to collect information from confirmed and probable Omicron cases.ResultsMedian age of 468 investigated cases was 35 years, 376 were symptomatic (89%); 64% were vaccinated with two doses and 7% had received three doses. Loss of smell and taste were reported by 8.3% and 9% of cases, respectively. Seven cases were hospitalized, three of those were unvaccinated (including two with reported precondition). No admissions to intensive care and no deaths were reported.ConclusionsOur results confirm a mild clinical presentation among the first Omicron cases detected in France and highlight the importance for the national COVID-19 surveillance system to quickly detect and adapt to the emergence of a new variant.

BACKGROUND: Potent direct-acting antivirals (DAAs) for treatment of chronic hepatitis C virus (HCV) infection have reduced the need for on-treatment monitoring. Currently, on-treatment response and outcome are determined by HCV RNA testing. A less expensive alternative to verify viral replication is HCV core antigen (HCV Ag). AIMS: The aim of this study was to determine if HCV Ag can be used for initial confirmation of viremia, on-treatment monitoring and determination of SVR in patients with chronic HCV infection receiving DAA treatment. METHODS: To evaluate the role of HCV Ag in confirming SVR, patients treated with DAAs ±Peg-interferon (IFN)/RBV were included, for the purpose of assessing HCV Ag to determine relapse, patients treated with any regimen (including Peg-IFN/RBV) were included. Serum HCV RNA and HCV Ag levels were assessed at baseline (BL), on-treatment (OT), end of treatment (EOT) and week 12 and/or 24 of follow up (FU). HCV RNA was considered the gold standard. RESULTS: In total, 181 patients were included, 112 (62%) of whom achieved SVR. Mean age was 54 years (19–79), 115 (64%) patients were male. The majority of patients was infected with genotype 1 (68%) and treated with a sofosbuvir-based regimen (58%). Median HCV RNA level at BL was 6.1 Log10 IU/mL (2.7–7.4) and HCV Ag level was 2409 fmol/L (0.85-20000). At BL, 165 out of 167 (98.8%) viremic patients tested positive for HCV Ag. Of the two patients who tested HCV Ag negative, one patient had a low RNA level (2.67 log10 IU/mL), whereas in the second patient HCV RNA level was high (6.38 log10 IU/mL). Baseline HCV Ag and HCV RNA levels were significantly correlated (R=0.87, p

This article discusses the use of virologic assays in the diagnosis and management of hepatitis C virus (HCV) and hepatitis B (HBV) infection. The use of virologic tests has become essential in the management of HCV and HBV infection to diagnose viral infection, guide treatment decisions, and assess the virologic response to antiviral therapy. The continuing development of test systems accompanied by new antiviral drugs and novel therapeutic approaches should lead to an optimization of the treatment of HCV infection. Molecular methods for viral testing have become an integral part of the diagnostic and therapeutic management of infections with hepatitis C virus (HCV) and hepatitis B virus (HBV).

To evaluate the effects of minimal to moderate alcohol consumption on the severity of histological lesions in patients with chronic hepatitis C.Daily alcohol intake (none, 1-20, 21-30, 31-50 g/day) and histological activity and fibrosis were recorded in 260 patients with chronic hepatitis C.The proportion of patients with moderate (A2) or marked (A3) activity increased gradually from 53.8% in abstinent patients to 86.5% for an intake between 31 and 50 g/day (P = 0.003). In multivariate analysis, age40 years, alcohol intake between 31 and 50 g/day and moderate or severe steatosis were independently related to histological activity. The proportion of patients with moderate (F2) or marked (F3) fibrosis or cirrhosis (F4) gradually increased from 29.0% in abstinent patients to 67.6% for an intake between 31 and 50 g/day (P0.001). Multivariate analysis also showed that alcohol intake between 31 and 50 g/day, moderate or severe steatosis and histological activity were independently related to fibrosis. The deleterious effect of alcohol intake on histological lesions differed according to gender.This study demonstrates that both activity and fibrosis gradually increase according to the amount of alcohol ingested, and that even moderate alcohol consumption, as low as 31-50 g/day in men and 21-50 g/day in women, may aggravate histological lesions in patients with chronic hepatitis C.

Hepatitis C virus (HCV) is a member of the Flaviviridae family. Its genome is a positive single-stranded RNA molecule which comprises three distinct regions: a 5' non coding region, a long open reading frame encoding both the structural and non structural viral proteins, and a 3' non coding region. HCV circulates in infected individuals as complex mixtures of genetically distinct but closely related variants referred to as "quasispecies". The quasispecies nature of HCV genomes appears to play a major role in viral persistence, cell tropism of viral variants, pathogenicity and resistance to antiviral therapy.

The study of the molecular biology of infectious agents involves the examination of their genomes and the products of those genomes. Molecular biology methods may therefore allow us to study either DNAs or RNAs. The study of genomic RNAs (viruses) or messenger RNAs (all infectious agents) is used increasingly in infectious disease pathology. The hepatitis C virus was identified in 1989 and was shown to be responsible for a large number of chronic hepatitis cases in France and worldwide. This virus is a good model for the development of technologies to study RNAs, which will later be applied to the study of other viruses. The molecular biology methods used to study hepatitis C virus RNA may be classified into 3 categories. a) Detection methods evidence nucleic acids in fluid or tissue samples, mainly using the polymerase chain reaction (PCR), but also newly developed techniques, such as the NASBA (nucleic-acid-sequence-based amplification), the Q-beta reaction, and the LCR (ligase chain reaction), and techniques that localize viral RNAs in tissue (in situ hybridization, in situ PCR). b) Quantitative methods determine the amount of RNA present in a sample. These include quantitative PCR and new technologies based on signal amplification, such as the 'branched DNA' assays which have recently been developed. c) Qualitative analysis of the genome uses genotyping methods to classify viral strains into different genotypes and subtypes.

Background After the collapse of the Soviet Union at the beginning of the 1990s, people who inject drugs spiked in Eastern Europe. Facing local repression and an array of factors encouraging emigration, some users have migrated to France. This population now make up to a third of the patient list of some harm reduction services in Paris. This article aims to present original data on the sociodemographic profiles of these users, on their migration trajectory, their life conditions, and on the evolution of their drug use practices since arriving in Paris. Methods Data were collected as part of the ANRS-Coquelicot Survey, an HIV and HCV seroprevalence study among French-speaking people who use drugs. A sub-sample of Russian-speaking drug users who had relocated from Eastern Europe to live in Paris completed a quantitative questionnaire (N = 150) and a qualitative semi-structured interview (N = 20). The survey aimed to describe participants’ backgrounds, and a thematic analysis of interviews was conducted to explore participants’ migration histories, their life conditions in Paris, and their drug use practices before and after arriving in France. Results This study highlights the great vulnerability of the participating population, often following a loss of social status after migrating to France. Another important finding is that participants had better access to harm reduction tools and reduced their risk of exposure to HIV and HCV infections linked to needle sharing. Although 60% said they had already shared a syringe in their lifetime (49.9% of them in their home country), the proportions shrank to 13.9% after they arrived in France and to 9.3% in the month before the study, a proportion that is lower than among French-speaking people who use drugs. Conclusions Our main findings on the profiles and behaviors of the study population lead us to make two recommendations: to offer stronger global care to these users in Paris and to reform drug policy in their home countries by integrating it into a public health approach.