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1. Acceptability and efficacy of vaginal self-sampling for genital infection and bacterial vaginosis: A cross-sectional study

Author

Melissa Lebsir, Anne Plauzolles, Edwin Quarello, Philippe Halfon, Hacène Khiri, Lucie Molet, Bernard Blanc, Claire Camus, Guillaume Penaranda, Sabine Camiade, and Laurent Chiche

Subjects
Cross-sectional study, Polymers, Vaginal Diseases, Pathology and Laboratory Medicine, Group B, Medical Conditions, Medicine and Health Sciences, Mass Screening, Polyvinyl Chloride, Materials, media_common, Multidisciplinary, medicine.diagnostic_test, Obstetrics, Fungal Diseases, Vaginosis, Bacterial, Chemistry, Infectious Diseases, Macromolecules, Medical Microbiology, Viral Pathogens, Urinary Tract Infections, Physical Sciences, Viruses, Medicine, Female, France, Group B streptococcal infection, Bacterial vaginosis, medicine.symptom, Pathogens, Research Article, Adult, medicine.medical_specialty, Herpesviruses, Patients, media_common.quotation_subject, Urology, Science, Bacterial diseases, Materials Science, Sexually Transmitted Diseases, Group B Streptococcal Infection, Fertility, Asymptomatic, Microbiology, Specimen Handling, Bacterial Vaginosis, medicine, Humans, Sex organ, Genitalia, Pelvic examination, Microbial Pathogens, Biology and life sciences, business.industry, Genitourinary Infections, Organisms, Patient Acceptance of Health Care, medicine.disease, Polymer Chemistry, Herpes Simplex Virus, Health Care, Cross-Sectional Studies, Self-Testing, Yeast Infections, business, DNA viruses
Abstract

Background & aim Screening for genital infection (GI) such as bacterial vaginosis (BV) and yeast infection, for sexually transmitted infection (STI), and for asymptomatic carriage of group B streptococcus (GBS) in pregnant women are common reason for medical appointments. The diagnosis and control of GIs, STIs, and GBS are major issues, for fertility and overall well-being of affected women. Conventional testing is performed using vaginal/cervical classical sampling (VCS); this procedure requires pelvic examination performed by health care professionals which raises concerns among women. Vaginal-self-sampling (VSS), as an alternative to VCS, might capture more women. The aim was first to show non-inferiority of VSS compared with VCS to screen for GIs, STIs, and GBS; second to determine the feasibility of VSS. Methods VSS and VCS from 1027 women were collected by health care professionals and simultaneously carried out on each patient. GIs, STIs, and GBS were systematically screened in both paired VSS and VCS samples. Non-inferiority of VSS compared with VCS was assessed using z statistic for binomial proportions. Results Prevalence of GIs were 39.7% using VSS and 38.1% using VCS (p = 0.0016). Prevalence of STIs was 8.5% (VSS) vs 8.1% (VCS) (p = 0.0087). Prevalence of GBS was 13.4% (VSS) and 11.5% (VCS) (p = 0.0001). Most participants (84%) recommended the use of VSS. Conclusions This study shows that VSS was not inferior to VCS for the detection of GIs, STIs, and GBS. This study provides evidence that VSS can be used as a universal specimen for detection of lower genital tract infections in women. Study identification number ID-RCB 2014-A01250-4.

Published
2021

2. Baseline and Post-Treatment Hepatitis C NS5A Resistance in Relapsed Patients from a Multicentric Real-Life Cohort

Author

Philippe Halfon, Jacques Izopet, Pascale Trimoulet, Caroline Scholtes, Sofiane Mohamed, Denis Ouzan, Laurent Chiche, Victor de Ledinghen, Hacène Khiri, Marc Bourlière, M.A. Thelu, Sophie Metivier, Guillaume Penaranda, Anne Plauzolles, Laurent Alric, Vincent Leroy, Fabien Zoulim, Sylvie Larrat, Florence Abravanel, ALPHABIO - Laboratoire de biologie médicale, Centre de Recherche en Cancérologie de Lyon (CRCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Institut de biologie structurale (IBS - UMR 5075), Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS), Service de virologie et d'immunologie biologique, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'Hépatologie et de Gastroentérologie [Lyon], Hospices Civils de Lyon (HCL), Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gastro-entérologie - Hépatologie [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Hôpital Michallon, Institut Arnault Tzanck, Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine interne [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille], Aix Marseille Université (AMU)-Hôpital Saint-Joseph [Marseille], Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen [Fondation Ambroise Paré - Marseille], Centre Hospitalier Universitaire de Lyon (CHU Lyon), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Bordeaux [Bordeaux], Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Hôpital Haut-Lévêque [CHU Bordeaux], Hôpital Saint-Joseph [Marseille], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Institut de Recherche pour le Développement (IRD), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon], 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), Institut de biologie structurale (IBS - UMR 5075 ), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Physiopathologie du cancer du foie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Laboratoire de Virologie [CHU Purpan, Toulouse], Institut Fédératif de Biologie (IFB) - Hôpital Purpan, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Léon Bérard [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), Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT)

Subjects
Male, 0301 basic medicine, DNA Mutational Analysis, Viral Nonstructural Proteins / genetics, Drug Resistance, Hepacivirus, Drug resistance, Viral Nonstructural Proteins, Virological response, Viral Nonstructural Proteins / antagonists & inhibitors, 0302 clinical medicine, Medicine, Pharmacology (medical), Viral, Treatment Failure, Hepatitis C, Viral Load, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, 3. Good health, [SDV.BBM.BS]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biomolecules [q-bio.BM], Treatment Outcome, Infectious Diseases, Antiviral Agents / pharmacology, Cohort, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, Viral load, Hepacivirus / genetics, medicine.medical_specialty, Genotype, Antiviral Agents / therapeutic use, Antiviral Agents, 03 medical and health sciences, Pharmacotherapy, Drug Therapy, Internal medicine, Drug Resistance, Viral, Humans, NS5A, Pharmacology, business.industry, medicine.disease, 030104 developmental biology, Hepatitis C / virology, Hepacivirus / drug effects, Post treatment, Hepatitis C / drug therapy, business
Abstract

Background Recent data have suggested that failure to achieve sustained virological response with direct-acting antiviral therapy is usually due to relapse and is primarily associated with the emergence of resistance-associated substitutions. The aim of this study was to investigate the prevalence and characterization of non-structural-5A resistance-associated substitutions in patients infected with HCV genotypes 1, 3 and 4 treated by direct-acting antiviral therapy, including anti-non-structural-5A, and to characterize the pre-existing resistance-associated substitutions in subjects treated with anti-non-structural-5A inhibitors. Methods From January 2014 to March 2016, 2,995 patients infected with HCV genotypes 1, 3 and 4 were exposed to non-structural-5A inhibitors. Sequencing results at the time of virological failure were available for 61 patients; sequencing at baseline was available for 35 of these patients. Results Among the 35 patients with sequencing results available at baseline, 15 had no resistance-associated substitution, 16 had only one resistance-associated substitution, and 4 had more than one resistance-associated substitution. Resistance-associated substitutions were harbored in 57% of the sequences in the non-structural-5A region. Among the 61 patients sequenced at virological failure, 50 (82%) patients presented at least one resistance-associated substitutions inducing a high level of resistance to non-structural-5A inhibitors (>10-fold resistance). Conclusions This pooled analysis suggests that non-structural-5A resistance-associated substitutions screening should be recommended when considering retreatment with a non-structural-5A inhibitor regimen in patients who have previously experienced failed non-structural-5A treatment.

Published
2017
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3. Prospective screening of liver fibrosis in a primary care cohort using systematic calculation of fib-4 in routine results

Author

Philippe Halfon, Patrick Dukan, Frédérique Retornaz, Marc Bourlière, Laurent Chiche, Guillaume Penaranda, Anne Plauzolles, C. Stavris, and Christelle Ansaldi

Subjects
Liver Cirrhosis, Male, 0301 basic medicine, Epidemiology, Physiology, Liver fibrosis, Severity of Illness Index, Liver disease, 0302 clinical medicine, Animal Cells, Fibrosis, Medicine and Health Sciences, Mass Screening, Medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, education.field_of_study, Multidisciplinary, Liver Diseases, Fatty liver, Middle Aged, Body Fluids, Blood, Cohort, Liver Fibrosis, Female, 030211 gastroenterology & hepatology, Anatomy, Cellular Types, Research Article, Platelets, Adult, medicine.medical_specialty, Science, Population, Gastroenterology and Hepatology, Primary care, 03 medical and health sciences, Internal medicine, Severity of illness, Humans, education, Primary Care, Mass screening, Aged, Blood Cells, Primary Health Care, business.industry, Public health, Biology and Life Sciences, Cell Biology, medicine.disease, Health Care, Fatty Liver, 030104 developmental biology, Medical Risk Factors, business, Developmental Biology, Significant fibrosis
Abstract

Background & AimLiver fibrosis screening in primary care population is a major public health issue. The FIB-4 index is a simple non-invasive fibrosis test combining age, transaminases, platelets count, developed for the diagnosis of advanced fibrosis. The aim of our study was to evaluate the interest of liver fibrosis screening using systematic calculation of FIB-4 in routine blood analysis.MethodsBetween December 2018 and May 2019, we conducted a prospective screening of liver fibrosis in 134 158 patients during a medical check-up including routine blood analysis. Among these patients, 29 707 had transaminases and platelets counts available and benefited from an automatic calculation of FIB-4. Results were obtained from 21 French clinical laboratories in the Bouches du Rhône region.ResultsAmong the 29 707 patients, 2160 (7.3%) had significant fibrosis (FIB-4>2.67). Individual investigation of patients with FIB-4>2.67 allowed to screen 1267 (1267/2160: 59%) patients who were not managed for any liver disease.ConclusionsThis work demonstrates the interest of FIB-4 for the screening of liver fibrosis in primary care population. Our study strongly supports this easy-to-implement strategy using a simple Fib-4 measure resulting from the use of available routine test results.FundingThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Clinical Registering NumberMR-0314071019 (INDS: French National Institute for Medical Data)

Published
2021
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4. Quantification of HPV16 E6/E7 mRNA Spliced Isoforms Viral Load as a Novel Diagnostic Tool for Improving Cervical Cancer Screening

Author

Céline Loubatier, Philippe Halfon, Valérie Giordanengo, Anne Plauzolles, Xavier Carcopino, Sébastien Vitale, Guillaume Penaranda, Hacène Khiri, Claire Camus, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Service de Gynécologie-Obstétrique, CHU Marseille, Hôpital Nord, AP-HM, 13015 Marseille, France., CHU Marseille, Microbes évolution phylogénie et infections (MEPHI), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), ALPHABIO - Laboratoire de biologie médicale, Bases, Corpus, Langage (UMR 7320 - UCA / CNRS) (BCL), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Gene isoform, high risk human papillomaviruses (HPVs) infection, cervical cancer, lcsh:Medicine, [SDV.CAN]Life Sciences [q-bio]/Cancer, Cervical intraepithelial neoplasia, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, Pap test, Cervical cancer, Messenger RNA, medicine.diagnostic_test, business.industry, lcsh:R, qRT-PCR, General Medicine, medicine.disease, Molecular biology, 3. Good health, Reverse transcription polymerase chain reaction, 030104 developmental biology, Real-time polymerase chain reaction, 030220 oncology & carcinogenesis, grade 2 or higher cervical intraepithelial neoplasia, HPV16 E6/E7 mRNA viral loads, business, Viral load, diagnostic tool
Abstract

High-risk human papillomaviruses (HPVs) have been identified as the main contributors to cervical cancer. Despite various diagnostic tools available, including the predominant Papanicolaou test (Pap test), technical limitations affect the efficiency of cervical cancer screening. The aim of this study was to evaluate the diagnostic performance of spliced HPV16 E6/E7 mRNA viral loads (VL) for grade 2 or higher cervical intraepithelial neoplasia diagnosis. A new dedicated (quantitative reverse transcription polymerase chain reaction) qRT-PCR assay was developed, allowing selective quantification of several HPV16 E6/E7 mRNA: Full length (FL) with or without all or selected spliced forms (total E6/E7 mRNA corresponding to SP + E6^E7 mRNA (T), + spliced E6/E7 mRNA containing intact E7 ORF (SP), and E6/E7 mRNA containing disrupted E6 and E7 ORFs calculated by the following subtraction T-SP (E6^E7)). Twenty HPV16 DNA and mRNA positive uterine cervical smears representative of all cytological and histological stages of severity were tested. We have shown that all E6/E7 mRNA isoforms expression levels were significantly increased in high grade cervical lesions. Statistical analysis demonstrated that the SP-E6/E7 VL assay exhibited: (i) The best diagnostic performance for identification of both cervical intraepithelial neoplasia (CIN)2+ (90% (56&ndash, 100) sensitivity and specificity) and CIN3+ (100% (72&ndash, 100) sensitivity and 79% (49&ndash, 95) specificity) lesions, (ii) a greater sensitivity compared to the Pap test for CIN2+ lesions detection (80% (44&ndash, 97)), (iii) a predictive value of the histological grade of cervical lesions in 67% of atypical squamous cells of unknown significance (ASC-US) and 100% of low-grade (LSIL) patients. Overall, these results highlight the value of SP-E6/E7 mRNA VL as an innovative tool for improving cervical cancer screening.

Published
2018
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5. 453 SIGNATURE RESISTANCE MUTATIONS TO DIRECTLY ACTING ANTIVIRAL AGENTS OCCUR AT LOW PREVALENCE IN TREATMENT NAIVE SUBJECTS WITH RECENTLY ACQUIRED HEPATITIS C INFECTION

Author

Anne Plauzolles, Tanya L. Applegate, Silvana Gaudieri, Simon Mallal, Michaela Lucas, Andrew R. Lloyd, M. Tshochner, Helmut M. Diepolder, Jason Grebely, M. Hellard, Gail V. Matthews, G. Pore, John M. Kaldor, Katja Pfafferott, and Axel Ulsenheimer

Subjects
Therapy naive, Hepatology, business.industry, Immunology, medicine, Hepatitis C, medicine.disease, business, Virology
Published
2011
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