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2. Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020.

Author

Viriot D, Lucas E, de Barbeyrac B, Bébéar C, Fouéré S, Dupin N, Bertolotti A, Berçot B, Cazanave C, Delmas G, Pillonel J, Lot F, and Ngangro NN

Subjects
Adolescent, Adult, Aged, Anti-Bacterial Agents, Communicable Disease Control, Delivery of Health Care, Humans, Pandemics, COVID-19, Chlamydia Infections diagnosis, Chlamydia Infections epidemiology, Chlamydia Infections prevention & control, Gonorrhea diagnosis, Gonorrhea epidemiology, HIV Infections epidemiology, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control, Syphilis epidemiology
Abstract

BackgroundDiagnoses of bacterial sexually transmitted infections (STIs) have increased in France since the 2000s. The main strategy to control STI transmission is recommending/facilitating access to condom use, testing, and antibiotic treatments.AimThis study analyses the evolution of STI testing in the private sector in France from 2006 to 2020.MethodsNational health insurance reimbursement data were used to determine numbers and rates of individuals aged ≥ 15 years tested for diagnoses of chlamydia, gonorrhoea and syphilis in the private sector in France and to describe their evolution from 2006 to 2020.ResultsUpward tendencies in testing were observed from 2006 to 2019 for all three STIs. The highest testing rates were identified in people aged 25‒29-years old. The observed testing-increase from 2017 to 2019 was twice as high in young people (< 25 years old) as in older people. In 2019, chlamydia, gonorrhoea and syphilis testing rates were respectively 45.4 (+ 21% since 2017), 41.3 (+ 60%), and 47.2 (+ 22%) per 1,000 inhabitants. For all STIs combined, the number of tested individuals decreased by 37% between March and April 2020 during the first COVID-19 epidemic wave and lockdown in France.ConclusionImprovements found in STI testing rates may have resulted from better awareness, especially among young people and health professionals, of the importance of testing, following prevention campaigns. Nevertheless, testing levels remain insufficient considering increasing diagnoses. In 2020, the COVID-19 pandemic had a considerable impact on STI testing. Partner notification and offering diverse testing opportunities including self-sampling are essential to control STI epidemics particularly in exposed populations.

Published
2022
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3. High prevalence of syphilis in women, minors and precarious patients: a cross-sectional study in a Reunion Island sexually transmitted infection clinic, 2017-2020.

Author

Delfosse A, Bouscaren N, Dupin N, Jaubert J, Tran PL, Saint Pastou C, Manaquin R, Poubeau P, Gerardin P, and Bertolotti A

Subjects
Adolescent, Aged, Cross-Sectional Studies, Female, Homosexuality, Male, Humans, Male, Minors, Pregnancy, Prevalence, Reunion epidemiology, Risk Factors, HIV Infections, Sexual and Gender Minorities, Sexually Transmitted Diseases epidemiology, Syphilis epidemiology
Abstract

Background: Syphilis is a sexually transmitted infection (STI) with a global prevalence estimated at 0.5% in 2012. Syphilis has been on the rise among men who have sex with men (MSM) in high-income countries and remains at endemic levels in low- and middle-income countries. This trend, however, has not been observed in Reunion Island., Objectives: To determine the prevalence, clinical characteristics and risk factors of syphilis in at-risk patients visiting the South Reunion STI clinic in Reunion Island., Methods: This monocentric cross-sectional study included all patients who visited our STI clinic between 2017 and 2020. Syphilis serology was performed on all included patients, and data were collected using a standardized self-administered questionnaire., Results: Over the 3-year study period, 2593 patients were enrolled. The prevalence of syphilis was 7.52% (n = 195, 95% CI, 6.50-8.65%) in the overall study population, 11.76% (n = 18, 95% CI, 6.97-18.59%) in minors (aged under 18 years) and 36.36% (n = 16, 95% CI, 21-59%) in pregnant women. The risk factors identified in multivariate analysis were being female [adjusted Prevalence Ratio (aPR) 1.85, 95% CI, 1.10-3.11], being MSM (aPR 2.87, 95% CI, 1.71-4.80), being aged under 18 years (aPR 3.54, 95% CI, 1.90-6.57), living in precarious conditions [aPR 3.12, 95% CI, 2.11-4.62] and being born in Reunion Island (aPR 2.43, 95% CI, 1.42-4.13). The clinical presentation was heterogeneous (plaques and papules, chancre, atypical ulcerations, multiple ulcerations, condyloma lata, etc.)., Conclusions: These findings suggest a high prevalence of syphilis in at-risk patients visiting our STI clinic. Unlike the situation in other high-income countries, the people most at risk of syphilis in Reunion Island are local-born residents, minors, women and precarious patients. This is a source of concern, especially given the risk of resurgence of congenital syphilis on the island., (© 2021 European Academy of Dermatology and Venereology.)

Published
2021
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4. Trends and determinants of condomless sex in gonorrhoea patients diagnosed in France through the sentinel surveillance network ResIST, 2005-2014.

Author

Itodo OA, Viriot D, Velter A, Leon L, Dupin N, Bercot B, Goubard A, Lassau F, Fouere S, Martinet P, Tosini W, Florence S, Lot F, and Ndeikoundam Ngangro N

Subjects
Condoms, Female, France epidemiology, Homosexuality, Male, Humans, Male, Paris epidemiology, Sentinel Surveillance, Sexual Behavior, Sexual Partners, Unsafe Sex, Gonorrhea diagnosis, Gonorrhea epidemiology, HIV Infections, Sexual and Gender Minorities
Abstract

Background: Gonorrhoea is increasing in France since its resurgence in the late 1990's. Understanding trends of condomless sex is a requirement to tailor prevention toward most exposed individuals. This study aims to analyse trends and determinants of condomless penetrative sex (PS) in MSM and heterosexuals diagnosed with gonorrhoea in France., Methods: A standardized self-administered questionnaire filled by 3453 patients was used to monitor condomless sex through the sentinel surveillance network ResIST between 2005 and 2014. Trends were used to describe consistent condom use for penetrative sex (PS). A logistic regression model analysed patients' characteristics associated with condomless PS., Results: Between 2005 and 2014, condomless PS increased regardless of sexual orientation. Condomless PS was particularly common among HIV positive men who have sex with men (MSM (65%)). People living in metropolitan regions outside Paris area (adjusted odds-ratio (AOR) [95% CI] =1.33[1.12-1.58]) were more likely to engage in condomless PS. Conversely, MSM (AOR [95% CI] =0.21 [0.16-0.29]), HIV seronegative patients (AOR [95% CI] =0.68 [0.51-0.89]), patients diagnosed in hospital (AOR [95% CI] = 0.66 [0.45-0.97]) and multi-partners (≥ 10 partners, AOR [95% CI] = 0.54 [0.40-0.74]) were more likely to use condoms., Conclusions: These findings highlight a decreasing use of condom in MSM and heterosexuals diagnosed with gonorrhoea. Prevention strategies should take in account drivers of condomless sex in a context of uncontrolled STI epidemics.

Published
2020
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5. [Primary HIV infection].

Author

Timsit FJ, Janier M, Vernay-Vaïsse C, Bouscarat F, Fouéré S, and Dupin N

Subjects
Anti-Retroviral Agents therapeutic use, Biomarkers blood, Blotting, Western, CD4-CD8 Ratio, DNA, Viral genetics, Diagnosis, Differential, Enzyme-Linked Immunosorbent Assay, Genotype, HIV Infections drug therapy, HIV Infections epidemiology, Humans, Polymerase Chain Reaction, HIV Infections diagnosis
Published
2016
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6. Clinical Aspects of Syphilis Reinfection in HIV-Infected Patients.

Author

Courjon J, Hubiche T, Dupin N, Grange PA, and Del Giudice P

Subjects
Adult, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Coinfection, HIV Infections blood, HIV Infections drug therapy, Homosexuality, Male, Humans, Male, Middle Aged, Photography, Recurrence, Retrospective Studies, Severity of Illness Index, HIV Infections complications, Syphilis complications, Syphilis pathology
Abstract

Background: The incidence of HIV-syphilis co-infection has risen since 2000, especially among men having sex with men (MSM). Syphilis reinfection can occur, but the clinical features of such events remain poorly characterized., Objective: To compare the cutaneous lesions seen with syphilis reinfections with those of first episodes in HIV-infected patients., Methods: In a cohort of HIV-infected patients, syphilis reinfection was established both clinically and biologically by evaluating changes in Venereal Disease Research Laboratory titers. Photographs and medical records were studied in order to determine the type of skin lesions and their quantification., Results: Among 533 HIV-infected patients, 42 (8%) experienced a first syphilis infection. Thirteen episodes of reinfection occurred in 12/42 (28%) patients, all MSM. In 78% of cases, reinfections were less symptomatic than first episodes. All patients presented classical syphilis lesions., Conclusions: We observed a high rate of reinfection, but with less severe skin manifestations during reinfection episodes.

Published
2015
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7. Effect of early syphilis infection on plasma viral load and CD4 cell count in human immunodeficiency virus-infected men: results from the FHDH-ANRS CO4 cohort.

Author

Jarzebowski W, Caumes E, Dupin N, Farhi D, Lascaux AS, Piketty C, de Truchis P, Bouldouyre MA, Derradji O, Pacanowski J, Costagliola D, and Grabar S

Subjects
Adolescent, Adult, CD4 Lymphocyte Count, Cohort Studies, HIV Infections complications, Humans, Male, Middle Aged, Risk, Syphilis complications, Viral Load, HIV Infections immunology, HIV Infections virology, Syphilis immunology, Syphilis virology
Abstract

Background: Concomitant syphilis and human immunodeficiency virus (HIV) infection is increasingly frequent in industrialized countries., Methods: From a large hospital cohort of HIV-infected patients followed up in the Paris area between 1998 and 2006, we examined the effect of early syphilis on plasma HIV-1 RNA levels and CD4 cell counts. We compared 282 HIV-1-infected men diagnosed as having incident primary or secondary syphilis with 1233 syphilis-free men matched for age (±5 years), sexual orientation, participating center, length of follow-up (±6 months), and immunologic and virologic status before the date of syphilis diagnosis (index date). Increase in viral load (VL) (plasma HIV-1 RNA) of at least 0.5 log or a rise to greater than 500 copies/mL in patients with previously controlled VL during the 6 months after the index date was analyzed, as were CD4 cell count variations and CD4 slope after the index date., Results: During the 6 months after the index date, VL increase was observed in 77 men with syphilis (27.3%) and in 205 syphilis-free men (16.6%) (adjusted odds ratio [aOR], 1.87; 95% CI, 1.40-2.49). Even in men with a VL of less than 500 copies/mL undergoing antiretroviral therapy, syphilis was associated with a higher risk of VL increase (aOR, 1.52; 95% CI, 1.02-2.26). The CD4 cell count decreased significantly (mean, -28/μL) compared with the syphilis-free group during the syphilis episode (P = .001) but returned to previous levels thereafter., Conclusions: In HIV-infected men, syphilis was associated with a slight and transient decrease in the CD4 cell count and with an increase in VL, which implies that syphilis may increase the risk of HIV transmission, even in patients receiving antiretroviral therapy and with a VL of less than 500 copies/mL.

Published
2012
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8. A 26-year-old man presenting with loss of vision, skin lesions and wasting.

Author

Chakvetadze C, Monfort JB, Dupin N, Carlotti A, Tan BK, Grange P, Guillevin L, and Salmon-Ceron D

Subjects
Adult, Humans, Male, Penicillins therapeutic use, Syphilis complications, Syphilis drug therapy, Syphilis Serodiagnosis, Weight Loss, Alopecia etiology, Foot Dermatoses etiology, HIV Infections complications, HIV Wasting Syndrome etiology, Hand Dermatoses etiology, Syphilis diagnosis, Uveitis, Anterior etiology, Uveitis, Intermediate etiology
Published
2012
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9. Epidermodysplasia verruciformis in human immunodeficiency virus-infected patients: a marker of human papillomavirus-related disorders not affected by antiretroviral therapy.

Author

Jacobelli S, Laude H, Carlotti A, Rozenberg F, Deleuze J, Morini JP, Franck N, Gorin I, Avril MF, and Dupin N

Subjects
Adult, Epidermodysplasia Verruciformis pathology, Female, HIV Infections drug therapy, Humans, Male, Papillomaviridae genetics, Papillomavirus Infections pathology, Skin pathology, Young Adult, Antiretroviral Therapy, Highly Active, Epidermodysplasia Verruciformis complications, Epidermodysplasia Verruciformis virology, HIV Infections complications, Papillomavirus Infections complications
Abstract

Background: Skin eruptions resembling epidermodysplasia verruciformis (EV) are rarely observed in immunocompromised patients. We focused on the epidemiologic, clinical, virologic, and immunologic features of EV in human immunodeficiency virus (HIV)-positive patients., Observations: We studied 11 HIV-positive patients (6 men and 5 women) with clinical and histological features of EV observed at our department. The median age at HIV diagnosis was 27 years. At the onset of eruption, the median age was 40 years and the median CD4 T-cell count was 170/μL. Clinical presentation included flat warts (n = 11), pityriasis versicolor-like macules (n = 5), and lichenoid papules (n = 3) on sun-exposed skin. Detection and typing of cutaneous human papillomavirus (HPV) were carried out in 8 cases and always revealed β-HPV infection, including oncogenic HPV-5 or 8 (n = 6). Mucosal HPV-related diseases were present in 7 cases. Histories of skin cancer and lymphoproliferative disorder were recorded in 3 and 4 patients, respectively, including 2 fatal cases. Skin eruption was never improved by highly active antiretroviral therapy (HAART). In 2 cases, EV was associated with an immune reconstitution syndrome. The present series is the largest with a complete characterization. A review of similar cases was carried out., Conclusion: Despite effective HAART, HIV-infected patients with EV require a prolonged and careful follow-up to detect mucosal HPV-related diseases, lymphoproliferative disorders, and skin cancers.

Published
2011
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10. Remission of severe CD8(+) cytotoxic T cell skin infiltrative disease in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy.

Author

Sbidian E, Battistella M, Rivet J, Flageul B, Molina JM, Joly P, Caumes E, Gorochov G, Cayuela JM, Rabian C, Dupin N, Lebbé C, Janin A, Janier M, Oksenhendler E, and Bachelez H

Subjects
Adult, Dermatitis, Exfoliative immunology, Dermatitis, Exfoliative pathology, Histocytochemistry, Humans, Immunohistochemistry, Male, Microscopy, Middle Aged, Remission Induction, Skin pathology, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, CD8-Positive T-Lymphocytes immunology, Dermatitis, Exfoliative drug therapy, HIV Infections complications, HIV Infections drug therapy, T-Lymphocytes, Cytotoxic immunology
Abstract

Background: A CD8 cutaneous lymphoinfiltrative disease has been described in human immunodeficiency virus (HIV)-infected patients presenting with a severe erythroderma. The true nature of this severe skin infiltrative disorder is still elusive. Although some clinical features of this syndrome have raised the hypothesis of its malignant nature in initial observations, several studies have provided stronger support to the hypothesis that it is a reactive pseudotumoral process., Methods: From 1995 through 2008, 8 HIV type 1 (HIV-1)-infected patients presenting with a chronic skin eruption, diagnosed as CD8 T cell infiltration of the skin, were studied., Results: All patients showed diffuse infiltrated skin with superficial lymphadenopathy. A profound CD4(+) lymphocytopenia and eosinophilia were other major features. Histological and immunostaining analysis revealed a predominant dermal and epidermal infiltration by CD8(+) T cells belonging to the cytotoxic lineage, without evidence for a monoclonal status by polymerase chain reaction-based molecular analysis of lesional skin. A remission of skin symptoms occurred in all cases following highly active antiretroviral therapy, which paralleled the decrease of HIV-1 RNA load and the increase of CD4(+) peripheral blood absolute count., Conclusions: Altogether, these results emphasize the reactive, nonmalignant nature of this syndrome and strongly support the coupling between HIV-induced immune deficiency and uncontrolled CD8 activation.

Published
2010
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11. Management of syphilis in the HIV-infected patient: facts and controversies.

Author

Farhi D and Dupin N

Subjects
Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Cerebrospinal Fluid microbiology, Clinical Trials as Topic, Female, HIV Infections drug therapy, Humans, Lost to Follow-Up, Male, Randomized Controlled Trials as Topic, Spinal Puncture, Syphilis immunology, Unsafe Sex statistics & numerical data, HIV Infections complications, Syphilis diagnosis, Syphilis drug therapy
Abstract

After reaching an all time low at the turn of the millennium in several industrialized countries, the syphilis incidence is rising again, perhaps as a consequence of unsafe sexual behavior in response to improved antiretroviral therapeutic options for HIV. Since the beginning of the HIV pandemic, numerous reports on the various aspects of the interaction between syphilis and HIV have been published. Controversies persist on many issues of the management of coinfected patients. This contribution presents a critical appraisal of the available literature. Few large-scale, properly designed, controlled studies have compared syphilis baseline presentation and treatment response according to HIV status. Among the weakness are (1) high rates of patients lost to follow-up, (2) lack of long-term follow-up, (3) lack of gold standard criteria for treatment response, (4) small sample size, and (5) lack of stratification according to syphilis stage, ongoing antiretroviral treatment, CD4 cell count and HIV viral load. From the available data, and given the ever-possible publication bias, we conclude that if HIV has an effect on the course of syphilis, it is small and clinically manageable in most cases. The controversial issues discussed should furnish the rational for clinical research during the forthcoming decade., (Copyright 2010 Elsevier Inc. All rights reserved.)

Published
2010
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12. Clinical and serologic baseline and follow-up features of syphilis according to HIV status in the post-HAART era.

Author

Farhi D, Benhaddou N, Grange P, Zizi N, Deleuze J, Morini JP, Gerhardt P, Krivine A, Avril MF, and Dupin N

Subjects
Adolescent, Adult, Aged, Cohort Studies, Female, Homosexuality, Male, Humans, Male, Middle Aged, Retrospective Studies, Syphilis blood, Syphilis diagnosis, Syphilis Serodiagnosis, Young Adult, Antiretroviral Therapy, Highly Active, HIV Infections complications, Syphilis complications
Abstract

There is a lack of large studies appraising the effect of the human immunodeficiency virus (HIV) on the course of syphilis since the advent of highly active antiretroviral therapy (HAART). We aimed to appraise the effect of HIV on clinical and serologic features of syphilis at baseline and during follow-up in the post-HAART era.We designed a retrospective cohort study of consecutive syphilis cases, diagnosed between 2000 and 2007, in an academic venereal disease center. Data were collected using standardized medical forms. Patients were treated according to the European guidelines. Serologic failure was defined as either a 4-fold rise in Venereal Disease Research Laboratory (VDRL) titers 30-400 days posttreatment or a lack of 4-fold drop in VDRL titers at 270-400 days posttreatment.Among 279 syphilis cases with informative baseline clinical and serologic data, HIV infection was significantly associated with men having sex with men, French origin, multiple partners, lesser usage of condom, history of sexually transmitted disease, early syphilis, anal primary chancre, and cutaneous eruption. Median baseline titer from the Treponema pallidum hemagglutination assay (TPHA) was higher in HIV-infected patients (p = 0.02).Among 144 informative syphilis cases, there was a nonsignificant trend for a lower rate of serologic response among HIV-positive patients (91.8% vs. 98.3%, p = 0.14). Serologic failure was significantly associated with a history of previous syphilis (p < 0.05). The median delay to serologic response was similar in HIV-positive (117 d) and in HIV-negative (123 d) patients (p = 0.44).We conclude that for patients under HAART treatment, the effect of HIV on serologic response to syphilis treatment is likely minimal or absent.

Published
2009
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13. A population analysis of weight-related differences in lopinavir pharmacokinetics and possible consequences for protease inhibitor-naive and -experienced patients.

Author

Bouillon-Pichault M, Jullien V, Piketty C, Viard JP, Morini JP, Chhun S, Krivine A, Salmon D, Dupin N, Weiss L, Lortholary O, Pons G, Launay O, and Treluyer JM

Subjects
Adolescent, Adult, Aged, Female, Humans, Lopinavir, Male, Middle Aged, Models, Statistical, Population Surveillance, Tablets, Body Weight, HIV Infections drug therapy, HIV Protease Inhibitors pharmacokinetics, Pyrimidinones pharmacokinetics
Abstract

Background: Lopinavir is a potent protease inhibitor (PI) used for the treatment of HIV infection. Different lopinavir target trough concentrations (C(troughs)) were previously determined according to patient treatment histories: 1 mg/l for PI-naive patients, and 4 and 5.7 mg/l for PI-experienced patients. However, the probability to achieve these target C(troughs) with the current 400 mg twice-daily or 800 mg once-daily doses of the new tablet form, and the influence of body weight on this probability are unknown., Methods: A population pharmacokinetic model for lopinavir was developed using data from 424 HIV type-1-infected patients, and the final model was used to estimate the probability to achieve target C(troughs) via Monte Carlo simulations., Results: A one-compartment model adequately described the data. Mean population estimates (percentage interindividual variability) were 4.61 l/h (36%) for apparent clearance (CL/F) and 63.2 l (70%) for apparent distribution volume. Body weight was found to explain the interindividual variability of lopinavir CL/F. Probability to achieve the 1 mg/l target C(trough) was >96% for the twice-daily dose and comprised between 80% and 90% for the once-daily dose. The probability to achieve the 4 and 5.7 mg/l target C(troughs) with the twice-daily dose significantly decreased when body weight increased (from 76% to 61% and from 56% to 37% respectively, for body weights increasing from 50 to 90 kg)., Conclusions: These results support lopinavir therapeutic drug monitoring and the use of higher lopinavir doses for PI-pretreated patients.

Published
2009
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14. Editorial commentary: treatment of Kaposi sarcoma in the highly active antiretroviral therapy era.

Author

Dupin N and Del Giudice P

Subjects
Antibiotics, Antineoplastic therapeutic use, Doxorubicin analogs & derivatives, Doxorubicin therapeutic use, HIV Infections complications, Humans, Lymphoma, Non-Hodgkin complications, Lymphoma, Non-Hodgkin virology, Polyethylene Glycols therapeutic use, Sarcoma, Kaposi complications, Sarcoma, Kaposi drug therapy, Antiretroviral Therapy, Highly Active, HIV Infections drug therapy, Herpesvirus 8, Human, Sarcoma, Kaposi virology
Published
2008
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15. [Extensive oral condylomas treated by in situ cidofovir injection in an HIV patient].

Author

Beaulieu D, Burnouf M, Plantier F, Régnier S, Lacau Saint-Guily J, Avril MF, and Dupin N

Subjects
Adult, Cidofovir, Condylomata Acuminata pathology, Cytosine administration & dosage, Humans, Injections, Intralesional, Male, Mouth Diseases pathology, Antiviral Agents administration & dosage, Condylomata Acuminata drug therapy, Condylomata Acuminata etiology, Cytosine analogs & derivatives, HIV Infections complications, Mouth Diseases drug therapy, Mouth Diseases etiology, Organophosphonates administration & dosage
Abstract

Background: Human papillomavirus infections are difficult to treat and have a high rate of recurrence, especially in a setting of human immunodeficiency (HIV) infection. Moreover, there is no standard treatment for oral condylomas., Patients and Methods: We report the partial success of in situ injections of cidofovir in an HIV patient, presenting extensive oral condylomas. The injections were well tolerated and the response was still present at one year while the immune status of the patient was unchanged., Discussion: The efficacy of topical cidofovir against condyloma acuminata has been reported and the value of in situ cidofovir injections for the treatment of laryngeal papillomatosis is well established. This case report shows the need for further investigation of in situ cidofovir injections as an alternative treatment for human papillomavirus lesions that are difficult to treat because of both site and extension.

Published
2008
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16. Study of persistence and recurrence rates in 106 patients with condyloma and intraepithelial neoplasia after CO2 laser treatment.

Author

Aynaud O, Buffet M, Roman P, Plantier F, and Dupin N

Subjects
Adolescent, Adult, Aged, Anal Canal pathology, Condylomata Acuminata complications, Condylomata Acuminata epidemiology, Condylomata Acuminata pathology, Female, France epidemiology, Humans, Immunocompetence, Laser Therapy, Male, Middle Aged, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local pathology, Penis pathology, Perineum pathology, Retrospective Studies, Scrotum pathology, Skin Neoplasms complications, Skin Neoplasms epidemiology, Skin Neoplasms pathology, Treatment Outcome, Urethra pathology, Vulva pathology, Condylomata Acuminata surgery, HIV Infections complications, Neoplasm Recurrence, Local surgery, Papillomaviridae, Skin Neoplasms surgery
Abstract

Our aim was to evaluate remission and relapse rates and the number of laser sessions necessary for treatment. Among the relapses observed, we sought to differentiate between the persistence and recurrence of an HPV-induced lesion. This retrospective study was performed in patients, immunocompetent or not, treated with CO2 laser for condylomatous or neoplastic anogenital lesions by the same operator over a period of 12 months. 106 treated patients were followed for 6 months. Three groups of patients were analysed: HIV(+) patients, patients with therapeutic immunosuppression (ImST) and immunocompetent patients (ImC). Twenty-seven (25.5%) patients presented with high-grade intraepithelial neoplasms (IEN III). IEN III lesions were more common in the HIV(+) group than in immunocompetent patients (47.4% versus 20.2%, p = 0.015). The development of HPV-induced lesions at several sites on the body was also more common in HIV(+) patients. Post-laser controls at one month demonstrated a clinical absence of HPV-induced lesions in 81.2% of cases, recurrence in 12.6% of cases and persistence in 6.6% of cases. Remission rates at one month did not differ significantly between the three groups. 93% of patients in remission at one month were still in remission at three months. IEN III neoplasms in remission at one month remained so at six months. ImC and ImST patients presented more frequently with recurrence than persistence, when compared with HIV(+) patients. At six months, 83% of patients were in remission after 1.4 laser treatments. The excision of HPV-induced anogenital lesions using CO2 laser remains an efficient treatment, even if it needs to be repeated if lesions recur or persist. CO2 laser treatment under colposcopic guidance can achieve remission in both immunocompromised and non-compromised patients with longstanding lesions.

Published
2008
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17. Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy.

Author

Martinez V, Caumes E, Gambotti L, Ittah H, Morini JP, Deleuze J, Gorin I, Katlama C, Bricaire F, and Dupin N

Subjects
Adult, Aged, CD4 Lymphocyte Count, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Protease Inhibitors therapeutic use, Retrospective Studies, Survival Analysis, Treatment Outcome, Viral Load, Antiretroviral Therapy, Highly Active, HIV Infections complications, HIV Infections drug therapy, Protease Inhibitors pharmacology, Sarcoma, Kaposi drug therapy, Sarcoma, Kaposi virology, Virus Replication drug effects
Abstract

Highly active antiretroviral therapy (HAART) reduces the incidence and improves the prognosis of Kaposi's sarcoma (KS). This study was designed to identify factors associated with KS clinical responses in HIV-infected patients during HAART. We reviewed the files of 138 HIV-1-infected patients with KS. Epidemiologic and HIV-related clinical and biological parameters were recorded at KS diagnosis (baseline) and every 6 months thereafter. In a subset of 73 antiretroviral-naive patients, we compared the clinical outcome of KS according to the use or nonuse of protease inhibitors (PI). After 6 months of follow-up, KS remission was more frequent in patients who were naive of HAART and who were at ACTG stage S0 at baseline (P = 0.03 and 0.02). Undetectable HIV viral load was strongly associated with KS remission (P< or = 0.004 at all time points), while CD4 cell count was not. Among the 73 antiretroviral-naive patients at baseline, and who were studied for 24 months, KS outcome did not differ between patients who were prescribed PI-containing and PI-sparing regimens. Intercurrent multicentric Castleman's disease was associated with poor outcome after 60 months of follow-up (P< or = 0.0001). Fourteen deaths occurred after a median follow-up of 37.5 months, eight of which were KS related. Suppression of HIV replication appears to be crucial to control KS. Non-PI-based regimens were equivalent to PI-based regimens as regards the clinical and virological outcome of antiretroviral-naive HIV-infected patients with KS.

Published
2006
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18. Evaluation of Coleman lipostructure for treatment of facial lipoatrophy in patients with human immunodeficiency virus and parameters associated with the efficiency of this technique.

Author

Burnouf M, Buffet M, Schwarzinger M, Roman P, Bui P, Prévot M, Deleuze J, Morini JP, Franck N, Gorin I, and Dupin N

Subjects
Adult, Female, Humans, Injections, Subcutaneous, Lipodystrophy pathology, Male, Middle Aged, Patient Satisfaction, Transplantation, Autologous adverse effects, Treatment Outcome, Adipose Tissue transplantation, Antiretroviral Therapy, Highly Active adverse effects, HIV Infections drug therapy, Lipodystrophy chemically induced, Lipodystrophy surgery
Abstract

Objective: To evaluate the efficiency of Coleman lipostructure in patients infected with human immunodeficiency virus (HIV)., Design: Open-label study and survey., Setting: Ambulatory dermatosurgery department of a university hospital., Patients: Thirty-three consecutive HIV-infected patients undergoing Coleman lipostructure between 2000 and 2001., Interventions: Clinical examination, blood tests, and standardized photographs at baseline and 1 year after the lipostructure., Mean Outcome Measures: Efficiency was assessed by the agreement of 3 independent medical specialists on facial lipodystrophy improvement after surgery and by patient satisfaction., Results: Facial lipoatrophy was improved in 12 patients (36%; 95% confidence interval, 20%-52%) as judged by all 3 evaluators. Quantity of fat injected (P = .01) and a low serum triglyceride level before surgery (P = .03) were significantly associated with improvement of facial lipoatrophy. Of the 33 patients, 14 (43%) were very satisfied, 17 (50%) were partly satisfied, and 27 (81%) had a better quality of life. The most common comment was that the patient looked better and appeared less ill., Conclusion: Our 1-year evaluation of Coleman lipostructure for correction of facial lipoatrophy in HIV-infected patients proved the efficiency of this treatment when measured conservatively by agreement on improvement by 3 independent specialists and demonstrated a patient satisfaction rate of 93%.

Published
2005
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19. Population pharmacokinetics of tenofovir in human immunodeficiency virus-infected patients taking highly active antiretroviral therapy.

Author

Jullien V, Tréluyer JM, Rey E, Jaffray P, Krivine A, Moachon L, Lillo-Le Louet A, Lescoat A, Dupin N, Salmon D, Pons G, and Urien S

Subjects
Adenine administration & dosage, Adenine pharmacokinetics, Adolescent, Adult, Aged, Anti-HIV Agents administration & dosage, Area Under Curve, Bayes Theorem, Female, HIV Infections drug therapy, HIV Infections virology, Humans, Kidney Function Tests, Male, Metabolic Clearance Rate, Middle Aged, Models, Biological, Organophosphonates administration & dosage, Reverse Transcriptase Inhibitors administration & dosage, Tenofovir, Adenine analogs & derivatives, Anti-HIV Agents pharmacokinetics, Antiretroviral Therapy, Highly Active, HIV Infections metabolism, HIV-1 drug effects, Organophosphonates pharmacokinetics, Reverse Transcriptase Inhibitors pharmacokinetics
Abstract

The influence of renal function on tenofovir pharmacokinetics was investigated in 193 human immunodeficiency virus (HIV)-infected patients by the use of a population approach performed with the nonlinear mixed effects modeling program NONMEM. Tenofovir pharmacokinetics was well described by a two-compartment open model in which the absorption and the distribution rate constants are equal. Typical population estimates of apparent central distribution volume (V(c)/F), peripheral distribution volume (V(p)/F), intercompartmental clearance (Q/F), and plasma clearance (CL/F) were 297 +/- 28.5 [corrected] liters, 848 +/- 209 [corrected] liters, 80 +/- 15 [corrected] liters/h and 50.5 +/- 3.1 [corrected] liters/h, respectively. Apparent plasma clearance was related to body weight/serum creatinine ratio (BW/S(CR)) and to the existence of a tubular dysfunction. Concomitant treatment with lopinavir/ritonavir was found to decrease tenofovir clearance. Individual Bayesian estimates of CL/F were used to calculate the tenofovir area under the concentration-time curve from time zero to 24 h (AUC(0-24)). In patients without tubular dysfunction, AUC(0-24) values markedly decreased from 6.7 to 1.4 mg . h/liter for BW/S(CR) increasing from 0.44 to 1.73. The relevance of a dosage adjustment based on BW/S(CR) should be further evaluated.

Published
2005
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20. HIV-1 intermittent viraemia in patients treated by non-nucleoside reverse transcriptase inhibitor-based regimen.

Author

Martinez V, Marcelin AG, Morini JP, Deleuze J, Krivine A, Gorin I, Yerly S, Perrin L, Peytavin G, Calvez V, and Dupin N

Subjects
Adult, Aged, Alkynes, Benzoxazines, CD4 Lymphocyte Count, Cyclopropanes, Female, Humans, Male, Middle Aged, Nevirapine therapeutic use, Oxazines therapeutic use, Retrospective Studies, Viral Load, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Reverse Transcriptase antagonists & inhibitors, Reverse Transcriptase Inhibitors therapeutic use, Viremia etiology
Abstract

Background: It has been demonstrated that, in patients treated by protease-inhibitor-based regimen, intermittent viraemia occurred frequently and was associated with higher concentrations of residual replication but not with virological failure. Risk factors associated with intermittent viraemia and its impact in patients treated by non-nucleoside-reverse-transcriptase-inhibitor-based (NNRTI) regimen need to be evaluated., Methods: We analyzed the occurrence of blips (one HIV-1 RNA > 50 copies/ml with a subsequent value < 50 copies/ml), the level of these blips (between 3 and 50 copies/ml) and their effect on CD4 cell count and the occurrence of virological failure in 43 patients with stable suppression of HIV-1 plasma viraemia (< 50 copies/ml) under NNRTI-based therapy., Results: Eight out of 43 patients had one episode of blips during the follow-up (median = 350 copies/ml). Comparing patients with and without blips, the median level of HIV-1 RNA at baseline was 7.5 versus 3 copies/ml (P = 0.008), respectively. Patients with blips had a significantly lower CD4 cell count after 12 and 18 months than the others. Plasma concentrations of NNRTI before, during, and after the blips were adequate. In addition, the occurrence of blips was not associated with virological failure., Conclusion: These results suggest that blips may reflect ongoing viraemia of below 50 copies/ml and can impair the CD4 cell count recovery under an NNRTI regimen. The impairment of CD4 cell count recovery seems to be affected more by the occurrence of blips than by the level of viraemia (< 50 copies/ml) itself. Nevertheless, despite a tight genetic barrier for resistance with NNRTI drugs, no virologic failure occurred during the follow-up.

Published
2005
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21. Mitochondrial DNA depletion in adipose tissue of HIV-infected patients with peripheral lipoatrophy.

Author

Buffet M, Schwarzinger M, Amellal B, Gourlain K, Bui P, Prévot M, Deleuze J, Morini JP, Gorin I, Calvez V, and Dupin N

Subjects
Adipose Tissue drug effects, Adipose Tissue metabolism, Adolescent, Adult, Aged, DNA, Mitochondrial drug effects, Didanosine adverse effects, Female, HIV Infections virology, HIV-1, Humans, Male, Middle Aged, Stavudine adverse effects, Adipose Tissue pathology, Anti-HIV Agents adverse effects, DNA, Mitochondrial metabolism, HIV Infections drug therapy, HIV-Associated Lipodystrophy Syndrome chemically induced, Reverse Transcriptase Inhibitors adverse effects
Abstract

Background: NRTI-induced host toxicity is proposed to involve cellular mitochondrial DNA (mtDNA) depletion. Determinants of cellular mtDNA copy number from HIV-infected patients receiving HAART and HIV-seronegative controls were investigated from subcutaneous fat samples, and relation with antiretroviral regimen was studied., Study Design: HIV-infected patients receiving HAART (n = 50), HIV-infected patients not currently under HAART regimen (n = 2) and HIV-seronegative controls (n = 9) of similar age and BMI were enrolled prospectively when undergoing Coleman's lipostructure for correction of facial lipoatrophy or plastic surgery, respectively. After centrifugation, abdominal fat tissue was collected and stored at -80 degrees C. MtDNA analysis was blindly performed after a total DNA extraction from adipose tissue, followed by a real-time PCR quantification. The log of mtDNA copies/cell in adipose tissue [log(DNA)] was compared between groups by means of analysis of variance., Results: The log(DNA) in adipose tissue of HIV-infected patients was significantly lower than in the HIV-seronegative control group (P < 0.0001). In HIV-infected patients, log(DNA) was significantly reduced in the 50 NRTI-treated patients (P < 0.01), but not when considering mtDNA level according to the use of PI or NNRTI in current HAART regimen. In NRTI-treated patients, only stavudine (n = 20) and didanosine (n=14) were significantly and independently associated with reduced mtDNA level (P < 0.0001 and <0.05, respectively). Currently stavudine or didanosine-treated patients had a significant reduced mtDNA level compared to past users (P < 0.0001 and <0.05, respectively). Other clinical, biological, and immuno-virological variables than NRTI did not correlate significantly to adipocyte mtDNA level., Conclusion: This study supports that current treatment by NRTI is a main determinant of mtDNA depletion in adipose tissue of HIV-seropositive patients with peripheral fat wasting. Stavudine or didanosine current intake is significantly associated with mtDNA depletion in vivo, that could be reversible after the discontinuation of these molecules, when considering mtDNA level according to current use versus past use of these molecules.

Published
2005
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22. Weight related differences in the pharmacokinetics of abacavir in HIV-infected patients.

Author

Jullien V, Tréluyer JM, Chappuy H, Dimet J, Rey E, Dupin N, Salmon D, Pons G, and Urien S

Subjects
Administration, Oral, Adolescent, Adult, Anti-HIV Agents administration & dosage, Area Under Curve, Chromatography, High Pressure Liquid, Dideoxynucleosides administration & dosage, Female, Humans, Male, Tablets, Anti-HIV Agents pharmacokinetics, Body Weight, Dideoxynucleosides pharmacokinetics, HIV Infections drug therapy, HIV-1, Reverse Transcriptase Inhibitors pharmacokinetics
Abstract

Aim: To study the possible influence of patient characteristics on abacavir pharmacokinetics., Methods: A population pharmacokinetic model for abacavir was developed using data from 188 adult patients by the use of a nonlinear mixed effects modelling method performed with NONMEM., Results: Abacavir pharmacokinetics was well described by a two-compartment open model with linear absorption and elimination. Typical population estimates for the absorption rate constant (Ka), the apparent central distribution volume (Vc/F), the apparent peripheral distribution volume (Vp/F), the apparent intercompartmental clearance (Q/F) and the apparent plasma clearance (CL/F) were 1.8 h(-1), 75 l, 23.6 l, 10 l h(-1) and 47.5 l h(-1), respectively. Apparent plasma clearance was positively related to bodyweight. Individual Bayesian estimates of CL/F were used to calculate abacavir AUC. The latter decreased from 10.7 +/- 5.0 to 5.7 +/- 1.6 mgh l(-1) when bodyweight increased from 36 to 102 kg. This drop in abacavir exposure could lead to suboptimal treatment for the heaviest patients, as antiviral efficacy of abacavir is known to be related to its AUC. A 400 mg abacavir dose would be necessary to achieve adequate exposure to abacavir in patients weighing more than 60 kg., Conclusions: The apparent plasma clearance of abacavir was positively related to bodyweight. The efficacy of the current recommended abacavir dosage for patients with high bodyweight should be evaluated in further studies.

Published
2005
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23. Syphilis surveillance in France, 2000-2003.

Author

Couturier E, Michel A, Janier M, Dupin N, and Semaille C

Subjects
Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Comorbidity, Female, France epidemiology, HIV Infections diagnosis, Humans, Incidence, Male, Mandatory Reporting, Middle Aged, Risk Factors, Sex Distribution, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology, Syphilis diagnosis, HIV Infections epidemiology, Homosexuality, Male statistics & numerical data, Penicillin G Benzathine therapeutic use, Population Surveillance methods, Risk Assessment methods, Syphilis drug therapy, Syphilis epidemiology
Abstract

This article describes syphilis trends, characteristics of patients from 2000 to 2003 in France and trends of the benzylpenicillin benzathine 2.4 million UI sales from 2001 to 2003. The ongoing surveillance system for syphilis case reporting since 2001 has been set up in volunteer settings, mostly public settings where STI treatment is offered. Clinical case reporting is complemented by sexual behavioural data based on a self-administered questionnaire. From 2000 to 2003, 1089 syphilis cases were reported in France, increasing from 37 cases in 2000 to 428 in 2003. Overall, 96% of syphilis cases were in men with a mean age of 36.5 years and 70% of whom were born in France. The proportion of syphilis cases with HIV co-infection decreased over time from 60% in 2000 to 33% in 2003. The most affected area by the syphilis epidemic is the Ile-de-France region, mainly the city of Paris. The greatest proportion of syphilis cases diagnosed in men who have sex with men (MSM) were in the Ile-de-France region, where they made up 87% of cases, compared with 75% in other regions. Among the patients who completed the self-administered questionnaire on sexual behaviour, 83% reported having casual sex partners in the 3 months prior to their syphilis diagnosis. Trends in the sales of benzylpenicillin benzathine 2.4 million UI in private pharmacies are similar to those observed in the surveillance system, and increased between 2001 and 2003. In conclusion, syphilis transmission is still ongoing in France in 2003 and the role of unprotected oral sex in the transmission of syphilis should be emphasised.

Published
2004

24. [Syphilis, new epidemiologic features].

Author

Dupin N and Couturier E

Subjects
Adult, France epidemiology, HIV Infections transmission, Humans, Male, Risk Factors, Syphilis prevention & control, Disease Outbreaks, HIV Infections complications, Syphilis epidemiology
Abstract

The epidemiologic survey by the InVS from data from voluntary sites shows an increase of the cases of syphilis from 2000 to 2002 in France. Most of patients with early syphilis are men having sex with men and more than half of cases is HIV infected patients. Resurgence of syphilis reflects the relapse of high-risk sexual practices and the most sexual practice evocated is unprotected oral sex. The same situation has been reported in countries from the west of Europe. In east of Europe, the epidemiology is a little bit different with an increase of cases since the early 90's mostly in sex workers and in relation to the rapid increase in the number of injecting drug users. In United States, although increases in syphilis rates among men who have sex with men have been documented since 1997, the majority of cases have been reported in the South affecting disproportionately blacks, reflecting low access to medical care but also racial segregation in sexual activity. The resurgence of syphilis while it is limited highlights the need for more health promotion initiatives especially in the most affected population.

Published
2004

25. Rituximab therapy for HIV-associated Castleman disease.

Author

Marcelin AG, Aaron L, Mateus C, Gyan E, Gorin I, Viard JP, Calvez V, and Dupin N

Subjects
Adult, Antibodies, Monoclonal, Murine-Derived, Antigens, CD19 blood, C-Reactive Protein biosynthesis, CD4 Antigens blood, DNA, Viral blood, Female, Herpesvirus 8, Human metabolism, Humans, Leukocytes, Mononuclear metabolism, Male, Remission Induction, Rituximab, Time Factors, Treatment Outcome, Antibodies, Monoclonal therapeutic use, Antineoplastic Agents therapeutic use, Castleman Disease drug therapy, HIV Infections complications
Abstract

To assess the clinical benefit of rituximab for HIV-associated Castleman disease, 5 patients infected with HIV with histologic-proven Castleman disease were prospectively enrolled to receive 4 infusions of rituximab. Clinical and biologic parameters (C-reactive protein, CD19 cell count, Kaposi sarcoma-associated herpesvirus [KSHV] viral load in peripheral blood mononuclear cells) were assessed before and at different time points following rituximab infusions. Two patients died very quickly after the beginning of rituximab therapy with no effect on both KSHV viral load and CD19 cell count. Three of 5 patients were considered in complete remission with no more clinical symptoms related to Castleman disease with a follow-up of 4 to 14 months. In 2 cases, clinical remission correlated with a dramatic decrease of KSHV viral load and C-reactive protein levels and a transitory but sharp decrease of CD19 cell count. In 2 responders, we observed an aggravation of Kaposi sarcoma. Our preliminary results suggest that rituximab may be effective in controlling Castleman disease in a subset of patients, although it may exacerbate concomitant Kaposi sarcoma.

Published
2003
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26. Quantitative analysis of human mitochondrial DNA using a real-time PCR assay.

Author

Gourlain K, Amellal B, Ait Arkoub Z, Dupin N, Katlama C, and Calvez V

Subjects
Adipose Tissue drug effects, Adipose Tissue metabolism, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Cytochrome b Group analysis, DNA, Mitochondrial drug effects, Humans, Leukocytes, Mononuclear drug effects, Leukocytes, Mononuclear metabolism, Plasmids, Reverse Transcriptase Inhibitors pharmacology, Reverse Transcriptase Inhibitors therapeutic use, Sensitivity and Specificity, Anti-HIV Agents pharmacology, DNA, Mitochondrial analysis, HIV Infections drug therapy, Polymerase Chain Reaction methods
Abstract

Objectives: Known for their ability to inhibit the human DNA polymerase-gamma, nucleoside analogues induce toxic effects on mitochondria ranging from increased serum lactate levels to fatal lactic acidosis. DNA polymerase-gamma ensures the mitochondrial DNA (mtDNA) replication and, thus, its inhibition leads to the decrease of the mtDNA. We describe a real-time PCR assay for mtDNA quantification associating DNA extraction procedures applied on peripheral blood mononuclear cells (PBMCs) and subcutaneous adipose tissues and to study the antiretroviral effect on mitochondria., Methods: Total DNA was extracted from PBMCs and subcutaneous adipose tissues. Nuclear and mitochondrial genes were amplified to determine the number of copies of mtDNA per cell using a cyt-b recombinant plasmid as standard control. We analysed eight HIV-infected asymptomatic patients never treated, four patients who had been treated for 6 months with highly active antiretroviral therapy (HAART) and six non-infected donors., Results: The mtDNA quantification gave rise to reproducible results as the mean coefficients of variation were 1.09% for replicates of samples undertaken 10 times within the same run, and 5.78% and 3.7% for replicates tested in five different runs at 1:100 and 1:1000 dilutions, respectively. Median levels of mtDNA in PBMCs of healthy donors, naive and treated HIV-infected patients were 2.94, 2.78 and 1.93 log HIV-1 RNA copies/mL, respectively. Whereas DNA from PBMCs was shown to be devoid of inhibitors, subcutaneous adipose tissues needed an extra treatment as they were found to be highly inhibited., Conclusions: The method generated consistent and reproducible results and was successfully applied to DNAs extracted from PBMCs and subcutaneous adipose tissues with adapted extraction. The mtDNA changes in PBMCs were found to be fast as they fall off after 6 months' therapy, decreasing from 2.78 to 1.93 log copies/mL.

Published
2003
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27. HIV and antiretroviral drug distribution in plasma and fat tissue of HIV-infected patients with lipodystrophy.

Author

Dupin N, Buffet M, Marcelin AG, Lamotte C, Gorin I, Ait-Arkoub Z, Tréluyer JM, Bui P, Calvez V, and Peytavin G

Subjects
Adipocytes virology, Adipose Tissue chemistry, Anti-HIV Agents analysis, Anti-HIV Agents blood, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Female, HIV Infections blood, HIV-1 genetics, HIV-1 isolation & purification, Humans, Male, Middle Aged, Prospective Studies, Protease Inhibitors analysis, RNA, Viral analysis, Adipose Tissue virology, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV-Associated Lipodystrophy Syndrome blood
Abstract

Objective: To determine HIV and antiretroviral drug distribution in plasma and fat tissue of HIV-infected patients with lipodystrophy., Methods: Twenty-three consecutive HIV-infected patients (median age, 43 years; male:female ratio, 18:5; median CD4 cell count, 419 x 10(6)/l) undergoing Coleman's lipostructure were enrolled prospectively in this study. HIV-1 RNA and plasma concentration of antiretroviral drugs were determined blindly in plasma and adipocyte lysate samples. HIV-1 proviral DNA was detected by nested PCR in fresh frozen adipocytes., Results: Mean plasma HIV-1 RNA was significantly higher than that in adipocyte lysate samples (this was below the limit of detection in all patients tested). HIV-1 proviral DNA was positive in two out of 18 adipocyte samples with a level between 2 and 5 copies; the distribution seemed to be specific and comparable within each therapeutic class--protease inhibitors (PI) or non-nucleoside reverse transcriptase inhibitors (NNRTI). NNRTI concentrations in adipocyte lysates were approximately 100-fold higher than those of PI. Efavirenz may accumulate in fat tissue as a function of treatment duration., Conclusion: Our results suggest that HIV does not replicate and does not integrate its genome in fat tissue in patients with fat redistribution abnormalities. In patients with effective nadir plasma concentrations of PI and NNRTI, determination of concentration in adipocyte lysates suggests that PI may diffuse in fat tissue with the same pattern of distribution for all structurally related components tested. NNRTI present a high affinity for fat tissue and may accumulate in this compartment.

Published
2002
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28. High concentrations of nelfinavir as an independent risk factor for lipodystrophy in human immunodeficiency virus-infected patients.

Author

Tréluyer JM, Morini JP, Dimet J, Gorin I, Rey E, Deleuze J, Ceccaldi PF, Escande JP, Pons G, and Dupin N

Subjects
Body Composition, Female, Humans, Male, Middle Aged, Risk Factors, HIV Infections drug therapy, HIV Protease Inhibitors adverse effects, HIV-1, Lipodystrophy chemically induced, Nelfinavir adverse effects
Abstract

To assess the relationship between antiretroviral drug exposure and lipodystrophy, 69 human immunodeficiency virus type 1-infected patients receiving nelfinavir were investigated cross-sectionally. Lipodystrophy was defined by patients' self-report. Nelfinavir trough concentrations in plasma were significantly related to overall lipodystrophy and peripheral fat wasting scores and appeared to be an independent risk factor for lipodystrophy

Published
2002
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29. High incidence of Kaposi sarcoma-associated herpesvirus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease.

Author

Oksenhendler E, Boulanger E, Galicier L, Du MQ, Dupin N, Diss TC, Hamoudi R, Daniel MT, Agbalika F, Boshoff C, Clauvel JP, Isaacson PG, and Meignin V

Subjects
Antiviral Agents therapeutic use, Castleman Disease genetics, Castleman Disease pathology, Cohort Studies, Follow-Up Studies, HIV Infections drug therapy, HIV Infections genetics, Herpesvirus 8, Human genetics, Humans, Immunoglobulins genetics, Lymphoma, Non-Hodgkin genetics, Lymphoma, Non-Hodgkin pathology, Lymphoma, Non-Hodgkin virology, Neoplasm Staging, RNA, Viral isolation & purification, Sarcoma, Kaposi drug therapy, Sarcoma, Kaposi genetics, Sarcoma, Kaposi pathology, Time Factors, Castleman Disease complications, Gene Rearrangement, HIV isolation & purification, HIV Infections complications, Herpesvirus 8, Human isolation & purification, Lymphoma, Non-Hodgkin etiology, Sarcoma, Kaposi complications
Abstract

Multicentric Castleman disease (MCD) is a distinct type of lymphoproliferative disorder associated with inflammatory symptoms and interleukin 6 (IL-6) dysregulation. In the context of human immunodeficiency virus (HIV) infection, MCD is associated with Kaposi sarcoma-associated herpesvirus, also called human herpesvirus type 8 (KSHV/HHV8). Within a prospective cohort study on 60 HIV-infected patients with MCD, and a median follow-up period of 20 months, 14 patients developed KSHV/HHV8-associated non-Hodgkin lymphoma (NHL): 3 "classic" KSHV/HHV8(+) Epstein-Barr virus-positive (EBV(+)) primary effusion lymphoma (PEL), 5 KSHV/HHV8(+) EBV(-) visceral large cell NHL with a PEL-like phenotype, and 6 plasmablastic lymphoma/leukemia (3/3 KSHV/HHV8(+) EBV(-)). The NHL incidence observed in this cohort study (101/1000 patient-years) is about 15-fold what is expected in the general HIV(+) population. MCD-associated KSHV/HHV8(+) NHL fell into 2 groups, suggesting different pathogenesis. The plasmablastic NHL likely represents the expansion of plasmablastic microlymphoma from the MCD lesion and progression toward aggressive NHL. In contrast, the PEL and PEL-like NHL may implicate a different original infected cell whose growth is promoted by the cytokine-rich environment of the MCD lesions.

Published
2002
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30. Primary infection with human herpesvirus 8 in an HIV-1-infected patient.

Author

Marcelin AG, Dupin N, Simon F, Descamps D, Agut H, and Calvez V

Subjects
AIDS-Related Opportunistic Infections diagnosis, AIDS-Related Opportunistic Infections immunology, Adult, Antibodies, Viral blood, HIV-1, Herpesviridae Infections diagnosis, Herpesviridae Infections immunology, Homosexuality, Humans, Male, Time Factors, AIDS-Related Opportunistic Infections complications, HIV Infections complications, Herpesviridae Infections complications, Herpesvirus 8, Human immunology
Published
2000
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31. [Clinical importance of the quantification of HIV-1 RNA in cerebrospinal fluid for the diagnosis of HIV encephalitis].

Author

Bossi P, Dupré S, Dupin N, Coutellier A, Bricaire F, Lubetzki C, Katlama C, and Calvez V

Subjects
AIDS Dementia Complex cerebrospinal fluid, AIDS Dementia Complex diagnosis, AIDS Dementia Complex virology, Adult, Biomarkers, Encephalitis, Viral cerebrospinal fluid, Encephalitis, Viral virology, Evaluation Studies as Topic, Female, HIV Infections blood, HIV Infections cerebrospinal fluid, HIV Infections virology, Humans, Male, Prospective Studies, RNA, Viral blood, Viral Load, Encephalitis, Viral diagnosis, HIV Infections diagnosis, HIV-1 isolation & purification, RNA, Viral cerebrospinal fluid
Abstract

We evaluated prospectively the HIV-1 RNA level in CSF as a marker of HIV encephalitis diagnosis. 110 HIV-1 infected patients (mean age: 39 years; sex-ratio M/F: 94/16) were tested for HIV-1 RNA in plasma and CSF. Lumbar punctures were performed to explore cognitive deficit, seizure or fever. HIV encephalitis was diagnosed in 15 patients (14%), other CNS disease in 34 (31%), and fever without CNS disease in 61 (55%). HIV-1 RNA was detectable in 93% of the plasma and in 62% of the CSF. No significant difference was observed in CSF HIV-1 RNA between patients with or without HIV encephalitis. CSF HIV-1 RNA was correlated with plasma HIV-1 RNA (p < 0.01), CSF protein (p < 0.01) and CSF white cell counts (p < 0.01). The absence of any significant difference between patients with or without HIV encephalitis, suggests that the CSF HIV-1 RNA level is not a good marker for its diagnosis.

Published
1998

33. No effect of protease inhibitor on clinical and virological evolution of Castleman's disease in an HIV-1-infected patient.

Author

Dupin N, Krivine A, Calvez V, Gorin I, Franck N, and Escande JP

Subjects
Adult, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, Herpesvirus 8, Human drug effects, Herpesvirus 8, Human growth & development, Homosexuality, Male, Humans, Male, RNA, Viral analysis, Castleman Disease diagnosis, Castleman Disease drug therapy, HIV Infections complications, HIV Protease Inhibitors therapeutic use, HIV-1, Indinavir therapeutic use
Published
1997

34. [Kaposi disease].

Author

Dupin N

Subjects
Animals, Humans, AIDS-Related Opportunistic Infections virology, HIV Infections complications, Sarcoma, Kaposi virology, Skin Neoplasms virology
Published
1995
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35. Human Immunodeficiency Virus Continuum of Care in 11 European Union Countries at the End of 2016 Overall and by Key Population: Have We Made Progress?

Author

Vourli, G., Noori, T., Pharris, A., Porter, K., Axelsson, M., Begovac, J., Cazein, F., Costagliola, D., Cowan, S., Croxford, S., Monforte, A. D., Delpech, V., Diaz, A., Girardi, E., Gunsenheimer-Bartmeyer, B., Hernando, V., Leierer, G., Lot, F., Nunez, O., Obel, N., Op de Coul, E., Paraskeva, D., Patrinos, S., Reiss, P., Schmid, D., Sonnerborg, A., Suligoi, B., Supervie, V., van Sighem, A., Zangerle, R., Touloumi, G., Egle, A., Kanatschnig, M., Ollinger, A., Rieger, A., Schmied, B., Wallner, E., Dewasurendra, D., Gisinger, M., Kitchen, M., Plattner, A., Rieser, E., Sarcletti, M., Greil, R., Schachner, M., Skocic, M., Muller, M., Aichwalder, R., Chromy, D., Grabmeier-Pfstershammer, K., Skoll, M., Touzeau, V., Cichon, P., Wolf-Nussmuller, S., Laferl, H., Zoufaly, A., Genger-Hackl, C., Kapper, A., Schneeberger, T., Trattner, E., Schober, G., Atzl, M., Hartmann, B., Puchhammer-Stockl, E., Berg, J., Appoyer, H., Rappold, M., Strickner, S., Schindelwig, K., Ledergerber, B., Fatkenheuer, G., Gerstof, J., Kronborg, G., Pedersen, C., Larsen, C. S., Pedersen, G., Mohey, R., Nielsen, L., Weise, L., Kvinesdal, B., Jensen, J., Abgrall, S., Bernard, L., Billaud, E., Boue, F., Boyer, L., Cabie, A., Caby, F., Canestri, A., Cotte, L., de Truchis, P., Duval, X., Duvivier, C., Enel, P., Fischer, H., Gasnault, J., Gaud, C., Grabar, S., Khuong-Josses, M. A., Launay, O., Marchand, L., Mary-Krause, M., Matheron, S., Melica-Gregoire, G., Melliez, H., Meynard, J. L., Nacher, M., Pavie, J., Piroth, L., Poizot-Martin, I., Pradier, C., Reynes, J., Rouveix, E., Simon, A., Slama, L., Tattevin, P., Tissot-Dupont, H., Biga, J., Kurth, T., Jacquemet, N., Guiguet, M., Leclercq, S., Lievre, L., Marshall, E., Roul, H., Selinger-Leneman, H., Potard, V., Benveniste, O., Breton, G., Lupin, C., Bourzam, E., Girard, P. M., Fonquernie, L., Valin, N., Lefebvre, B., Sebire, M., Pialoux, G., Lebrette, M. G., Tibaut, P., Adda, A., Hamidi, M., Cadranel, J., Lavole, A., Parrot, A., Bouchaud, O., Vignier, N., Mechai, F., Makhlouf, S., Honore, P., Bergmann, J. F., Delcey, V., Lopes, A., Sellier, P., Parrinello, M., Oksenhendler, E., Gerard, L., Molina, J. M., Rozenbaum, W., Denis, B., De Castro, N., Lascoux, C., Yazdanpanah, Y., Lariven, S., Joly, V., Rioux, C., Poupard, M., Taverne, B., Sutton, L., Masse, V., Genet, P., Wifaq, B., Gerbe, J., Grefe, S., Dupont, C., Freire Maresca, A., Reimann, E., Bloch, M., Meier, F., Mortier, E., Zeng, F., Montoya, B., Perronne, C., Mathez, D., Marigot-Outtandy, D., Berthe, H., Greder Belan, A., Terby, A., Godin Collet, C., Marque Juillet, S., Ruquet, M., Roussin-Bretagne, S., Colardelle, P., Granier, F., Laurichesse, J. J., Perronne, V., Akpan, T., Marcou, M., Daneluzzi, V., Veyssier-Belot, C., Masson, H., Welker, Y., Brazille, P., Kahn, J. E., Zucman, D., Majerholc, C., Fourn, E., Bornarel, D., Chambrin, V., Kansau, I., Raho-Moussa, M., Lelievre, J. D., Saidani, M., Chesnel, C., Dumont, C., Vittecoq, D., Derradji, O., Bolliot, C., Goujard, C., Teicher, E., Mole, M., Bourdic, K., Salmon, D., Le Jeunne, C., Guet, P., Pietri, M. P., Pannier Metzger, E., Marcou, V., Loulergue, P., Dupin, N., Morini, J. P., Deleuze, J., Gerhardt, P., Chanal, J., Weiss, L., Lucas, M. L., Jung, C., Ptak, M., Viard, J. P., Ghosn, J., Gazalet, P., Cros, A., Maignan, A., Lortholary, O., Rouzaud, C., Touam, F., Benhadj, K., Consigny, P. H., Bossi, P., Gergely, A., Cessot, G., Durand, F., Beck-Wirth, G., Michel, C., Benomar, M., Rey, D., Partisani, M., Cheneau, C., Batard, M. 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M., Makhlouf, D., Brunel, F., Chiarello, P., Hoen, B., Lamaury, I., Fabre, I., Samar, K., Duvallon, E., Clavel, C., Stegmann, S., Walter, V., Adriouch, L., Huber, F., Vanticlke, V., Couppie, P., Abel, S., Pierre-Francois, S., Ricaud, C., Rodet, R., Wartel, G., Sautron, C., Poubeau, P., Borgherini, G., Camuset, G., Arasteh, K., Kowohl Vivantes, S., Schurmann, D., Warncke Charite, M., Rockstroh, J., Wasmuth, J., Hass, S., Jensen, B. O., Feind, C., Esser, S., Schenk-Westkamp, P., Haberl, A., Stephan, C., Plettenberg, A., Kuhlendahl, F., Adam, A., Weitner, L., Schewe, K., Goey, H., Fenske, S., Buhk, T., Stellbrink, H. J., Hofmann, C., Hansen, S., Degen, O., Heuer, M., Stoll, M., Gerschmann, S., Horst, H., Trautmann, S., Gillor, D., Bogner, J., Sonntag, B., Salzberger, B., Fritzsche, C., Adamis, G., Antoniadou, A., Chini, M., Chrysos, G., Gikas, A., Gogos, H. A., Katsarou, O., Lazanas, M., Metallidis, S., Panagopoulos, P., Paparizos, V., Papastamopoulos, V., Paraskevis, D., Psychogiou, M., Sambatakou, H., Sipsas, N. V., Pantazis, N., Papadopoulos, A., Nitsotolis, T., Xylomenos, G., Marangos, M. N., Kouramba, A., Kontos, A., Lioni, A., Tsachouridou, O., Kourkounti, S., Ganitis, A., Barbounakis, E., d'Arminio Monforte, A., Antinori, A., Andreoni, M., Castagna, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Cozzi-Lepri, A., Lo Caputo, S., Mussini, C., Puoti, M., Perno, C. F., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, A., Cinque, P., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Trufa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolf, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. 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V., Smit, E., Struik-Kalkman, D., Tearno, C., van Niekerk, T., Pontesilli, O., Lowe, S. H., Oude Lashof, A. M. L., Posthouwer, D., Ackens, R. P., Burgers, K., Schippers, J., Weijenberg-Maes, B., van Loo, I. H. M., Havenith, T. R. A., Weijer, S., van Vonderen, M. G. A., Kampschreur, L. M., Faber, S., Steeman-Bouma, R., Weel, J., Kootstra, G. J., Delsing, C. E., van der Burg-Van de Plas, M., Heins, H., Kortmann, W., van Twillert, G., Renckens, R., Ruiter-Pronk, D., van Truijen-Oud, F. A., Cohen Stuart, J. W. T., Jansen, E. R., Hoogewerf, M., Rozemeijer, W., van der Reijden, W. A., Sinnige, J. C., Brinkman, K., van den Berk, G. E. L., Blok, W. L., Frissen, P. H. J., Lettinga, K. D., Schouten, W. E. M., Veenstra, J., Vrouenraets, S. M. E., Brouwer, C. J., Geerders, G. F., Hoeksema, K., Kleene, M. J., Knapen, M., van der Meche, I. B., Mulder-Seeleman, E., Toonen, A. J. M., Wijnands, S., Kwa, D., van Crevel, R., van Aerde, K., Doferhof, A. S. M., Henriet, S. S. V., ter Hofstede, H. J. M., Hoogerwerf, J., Keuter, M., Richel, O., Albers, M., Grintjes-Huisman, K. J. T., de Haan, M., Marneef, M., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F. F., Burger, D., Gisolf, E. H., Hassing, R. J., Claassen, M., ter Beest, G., van Bentum, P. H. M., Langebeek, N., Tiemessen, R., Swanink, C. M. A., van Lelyveld, S. F. L., Soetekouw, R., van der Prijt, L. M. M., van der Swaluw, J., Bermon, N., Jansen, R., Herpers, B. L., Veenendaal, D., Verhagen, D. W. M., Lauw, F. N., van Broekhuizen, M. C., van Wijk, M., Bierman, W. F. W., Bakker, M., Kleinnijenhuis, J., Kloeze, E., Middel, A., Scholvinck, E. H., Stienstra, Y., Verhage, A. R., Wouthuyzen-Bakker, K. M., Boonstra, A., de Groot-De Jonge, H., van der Meulen, P. A., de Weerd, D. A., Niesters, H. G. M., van Leer-Buter, C. C., Knoester, M., Hoepelman, A. I. M., Arends, J. E., Barth, R. E., Bruns, A. H. W., Ellerbroek, P. M., Mudrikova, T., Oosterheert, J. J., de Regt, M. J. A., Schadd, E. M., van Zoelen, M. A. 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E., Gorgolas, M., Svedhem-Johansson, V., Flamholc, L., Gisslen, M., Hejdeman, B., Norgren, H., Wendahl, S., European Centre for Disease Prevention and Control (ECDC), Esser, Stefan (Beitragende*r), Schenk-Westkamp, Pia (Herausgeber*in), Vourli G., Noori T., Pharris A., Porter K., Axelsson M., Begovac J., Cazein F., Costagliola D., Cowan S., Croxford S., Monforte A.D., Delpech V., Diaz A., Girardi E., Gunsenheimer-Bartmeyer B., Hernando V., Leierer G., Lot F., Nunez O., Obel N., Op de Coul E., Paraskeva D., Patrinos S., Reiss P., Schmid D., Sonnerborg A., Suligoi B., Supervie V., van Sighem A., Zangerle R., Touloumi G., Egle A., Kanatschnig M., Ollinger A., Rieger A., Schmied B., Wallner E., Dewasurendra D., Gisinger M., Kitchen M., Plattner A., Rieser E., Sarcletti M., Greil R., Schachner M., Skocic M., Muller M., Aichwalder R., Chromy D., Grabmeier-Pfstershammer K., Skoll M., Touzeau V., Cichon P., Wolf-Nussmuller S., Laferl H., Zoufaly A., Genger-Hackl C., Kapper A., Schneeberger T., Trattner E., Schober G., Atzl M., Hartmann B., Puchhammer-Stockl E., Berg J., Appoyer H., Rappold M., Strickner S., Schindelwig K., Ledergerber B., Fatkenheuer G., Gerstof J., Kronborg G., Pedersen C., Larsen C.S., Pedersen G., Mohey R., Nielsen L., Weise L., Kvinesdal B., Jensen J., Abgrall S., Bernard L., Billaud E., Boue F., Boyer L., Cabie A., Caby F., Canestri A., Cotte L., de Truchis P., Duval X., Duvivier C., Enel P., Fischer H., Gasnault J., Gaud C., Grabar S., Khuong-Josses M.A., Launay O., Marchand L., Mary-Krause M., Matheron S., Melica-Gregoire G., Melliez H., Meynard J.L., Nacher M., Pavie J., Piroth L., Poizot-Martin I., Pradier C., Reynes J., Rouveix E., Simon A., Slama L., Tattevin P., Tissot-Dupont H., Biga J., Kurth T., Jacquemet N., Guiguet M., Leclercq S., Lievre L., Marshall E., Roul H., Selinger-Leneman H., Potard V., Benveniste O., Breton G., Lupin C., Bourzam E., Girard P.M., Fonquernie L., Valin N., Lefebvre B., Sebire M., Pialoux G., Lebrette M.G., Tibaut P., Adda A., Hamidi M., Cadranel J., Lavole A., Parrot A., Bouchaud O., Vignier N., Mechai F., Makhlouf S., Honore P., Bergmann J.F., Delcey V., Lopes A., Sellier P., Parrinello M., Oksenhendler E., Gerard L., Molina J.M., Rozenbaum W., Denis B., De Castro N., Lascoux C., Yazdanpanah Y., Lariven S., Joly V., Rioux C., Poupard M., Taverne B., Sutton L., Masse V., Genet P., Wifaq B., Gerbe J., Grefe S., Dupont C., Freire Maresca A., Reimann E., Bloch M., Meier F., Mortier E., Zeng F., Montoya B., Perronne C., Mathez D., Marigot-Outtandy D., Berthe H., Greder Belan A., Terby A., Godin Collet C., Marque Juillet S., Ruquet M., Roussin-Bretagne S., Colardelle P., Granier F., Laurichesse J.J., Perronne V., Akpan T., Marcou M., Daneluzzi V., Veyssier-Belot C., Masson H., Welker Y., Brazille P., Kahn J.E., Zucman D., Majerholc C., Fourn E., Bornarel D., Chambrin V., Kansau I., Raho-Moussa M., Lelievre J.D., Saidani M., Chesnel C., Dumont C., Vittecoq D., Derradji O., Bolliot C., Goujard C., Teicher E., Mole M., Bourdic K., Salmon D., Le Jeunne C., Guet P., Pietri M.P., Pannier Metzger E., Marcou V., Loulergue P., Dupin N., Morini J.P., Deleuze J., Gerhardt P., Chanal J., Weiss L., Lucas M.L., Jung C., Ptak M., Viard J.P., Ghosn J., Gazalet P., Cros A., Maignan A., Lortholary O., Rouzaud C., Touam F., Benhadj K., Consigny P.H., Bossi P., Gergely A., Cessot G., Durand F., Beck-Wirth G., Michel C., Benomar M., Rey D., Partisani M., Cheneau C., Batard M.L., Fischer P., Leclercq P., Blanc M., Morand P., Epaulard O., Signori-Schmuck A., Laurichesse H., Jacomet C., Vidal M., Coban D., Casanova S., Fresard A., Guglielminotti C., Botelho-Nevers E., Brunon-Gagneux A., Ronat V., Verdon R., Dargere S., Haustraete E., Feret P., Goubin P., Chavanet P., Fillion A., Croisier D., Gohier S., Arvieux C., Souala F., Chapplain J.M., Ratajczak M., Rohan J., Faller J.P., Ruyer O., Gendrin V., Toko L., Chirouze C., Hustache-Mathieu L., Faucher J.F., Proust A., Magy-Bertrand N., Gil H., Meaux-Ruault N., Sotto A., Rouanet I., Mauboussin J.M., Doncesco R., Jacques G., May T., Rabaud C., Andre M., Delestan M., Bouillon M.P., Bani-Sadr F., Rouger C., Berger J.L., Nguyen Y., Marchou B., Delobel P., Martin Blondel G., Cuzin L., Biezunski N., Alric L., Bonnet D., Guivarch M., Palacin A., Payssan V., Ajana F., Meybeck A., Viget N., Pugliese P., Roger P.M., Rosenthal E., Durant J., Cua E., Naqvi A., Perbost I., Risso K., Quinsat D., Raphael St., Del Giudice P., Dides P.Y., Sambuc R., Antolini-Bouvenot M.S., Druart P., Meddeb L., Ravaux I., Menard A., Tomei C., Dhiver C., Moreau J., Mokhtari S., Soavi M.J., Tomas V., Bregigeon S., Faucher O., Obry-Roguet V., Ritleng A.S., Petit N., Bartoli C., Ruiz J.M., Blanc D., Allegre T., Sordage M., Riou J.M., Faudon C., Slama B., Zerazhi H., Boulat O., Chebrek S., Beyrne M., Granet Brunello P., Pellissier L., Bonnabel D., Cohen Valensi R., Mouchet B., Mboungou G., Lafeuillade A., Hope-Rapp E., Hittinger G., Philip G., Lambry V., Raf F., Allavena C., Hall N., Reliquet V., Chidiac C., Ferry T., Perpoint T., Miailhes P., Boibieux A., Livrozet J.M., Makhlouf D., Brunel F., Chiarello P., Hoen B., Lamaury I., Fabre I., Samar K., Duvallon E., Clavel C., Stegmann S., Walter V., Adriouch L., Huber F., Vanticlke V., Couppie P., Abel S., Pierre-Francois S., Ricaud C., Rodet R., Wartel G., Sautron C., Poubeau P., Borgherini G., Camuset G., Arasteh K., Kowohl Vivantes S., Schurmann D., Warncke Charite M., Rockstroh J., Wasmuth J., Hass S., Jensen B.O., Feind C., Esser S., Schenk-Westkamp P., Haberl A., Stephan C., Plettenberg A., Kuhlendahl F., Adam A., Weitner L., Schewe K., Goey H., Fenske S., Buhk T., Stellbrink H.J., Hofmann C., Hansen S., Degen O., Heuer M., Stoll M., Gerschmann S., Horst H., Trautmann S., Gillor D., Bogner J., Sonntag B., Salzberger B., Fritzsche C., Adamis G., Antoniadou A., Chini M., Chrysos G., Gikas A., Gogos H.A., Katsarou O., Lazanas M., Metallidis S., Panagopoulos P., Paparizos V., Papastamopoulos V., Paraskevis D., Psychogiou M., Sambatakou H., Sipsas N.V., Pantazis N., Papadopoulos A., Nitsotolis T., Xylomenos G., Marangos M.N., Kouramba A., Kontos A., Lioni A., Tsachouridou O., Kourkounti S., Ganitis A., Barbounakis E., d'Arminio Monforte A., Antinori A., Andreoni M., Castagna A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G.C., Rezza G., von Schloesser F., Viale P., Ceccherini-Silberstein F., Cozzi-Lepri A., Lo Caputo S., Mussini C., Puoti M., Perno C.F., Bai F., Balotta C., Bandera A., Bonora S., Borderi M., Calcagno A., Capetti A., Capobianchi M.R., Cicalini S., Cingolani A., Cinque P., Di Biagio A., Gianotti N., Gori A., Guaraldi G., Lapadula G., Lichtner M., Madeddu G., Maggiolo F., Marchetti G., Monno L., Nozza S., Pinnetti C., Quiros Roldan E., Rossotti R., Rusconi S., Santoro M.M., Saracino A., Sarmati L., Fanti I., Galli L., Lorenzini P., Rodano A., Macchia M., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petroni F., Prota G., Trufa S., Giacometti A., Costantini A., Barocci V., Angarano G., Milano E., Suardi C., Donati V., Verucchi G., Castelnuovo F., Minardi C., Menzaghi B., Abeli C., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Pan A., Lorenzotti S., Sighinolf L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Fondaco L., Bonfanti P., Molteni C., Chiodera A., Milini P., Nunnari G., Pellicano G., Rizzardini G., Cannizzo E.S., Moioli M.C., Piolini R., Bernacchia D., Salpietro S., Tincati C., Puzzolante C., Migliorino C., Sangiovanni V., Borgia G., Esposito V., Di Flumeri G., Gentile I., Rizzo V., Cattelan A.M., Marinello S., Cascio A., Trizzino M., Francisci D., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M.A., Cristaudo A., Vullo V., Acinapura R., Moschese D., Capozzi M., Mondi A., Rivano Capparuccia M., Iaiani G., Latini A., Gagliardini R., Plazzi M.M., De Girolamo G., Vergori A., Cecchetto M., Viviani F., De Vito A., Rossetti 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Pedreira J.D., Galera C., Albendin H., Iborra A., Campillo M.A., Vidal A., Amador C., Pasquau F., Ena J., Benito C., Fenoll V., Mohamed-Balghata M.O., Gomez M.A., Alberto de Zarraga M., Rivas M.E., Gorgolas M., Svedhem-Johansson V., Flamholc L., Gisslen M., Hejdeman B., Norgren H., Wendahl S., Global Health, Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, ANS - Neuroinfection & -inflammation, Internal medicine, Medical Microbiology and Infection Prevention, AMS - Rehabilitation & Development, VU University medical center, Amsterdam Gastroenterology Endocrinology Metabolism, Pediatric surgery, Neurology, Amsterdam Neuroscience - Neurodegeneration, Pulmonary medicine, Psychiatry, APH - Mental Health, Amsterdam Neuroscience - Complex Trait Genetics, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, Ethics, Law & Medical humanities, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, Amsterdam Neuroscience - Neuroinfection & -inflammation, Amsterdam Reproduction & Development (AR&D), APH - Societal Participation & Health, Pediatrics, HAL-SU, Gestionnaire, National and Kapodistrian University of Athens (NKUA), University College of London [London] (UCL), Public Health Agency of Sweden, University of Zagreb, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Statens Serum Institut [Copenhagen], Public Health England [London], Università degli Studi di Milano = University of Milan (UNIMI), Instituto de Salud Carlos III [Madrid] (ISC), Istituto Nazionale di Malattie Infettive 'Lazzaro Spallanzani' (INMI), Robert Koch Institute [Berlin] (RKI), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), University of Copenhagen = Københavns Universitet (UCPH), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Hellenic Center for Disease Control and Prevention, Amsterdam UMC - Amsterdam University Medical Center, Austrian Agency for Health and Food Safety (AGES), Department of Infectious Diseases, Institution of Medicine, Karolinska University Hospital and Karolinska Institutet, Istituto Superiore di Sanita [Rome], Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), University of Athens Medical School [Athens], Vourli, G, Noori, T, Pharris, A, Porter, K, Axelsson, M, Begovac, J, Cazein, F, Costagliola, D, Cowan, S, Croxford, S, Monforte, A, Delpech, V, Diaz, A, Girardi, E, Gunsenheimer-Bartmeyer, B, Hernando, V, Leierer, G, Lot, F, Nunez, O, Obel, N, Op de Coul, E, Paraskeva, D, Patrinos, S, Reiss, P, Schmid, D, Sonnerborg, A, Suligoi, B, Supervie, V, van Sighem, A, Zangerle, R, Touloumi, G, Egle, A, Kanatschnig, M, Ollinger, A, Rieger, A, Schmied, B, Wallner, E, Dewasurendra, D, Gisinger, M, Kitchen, M, Plattner, A, Rieser, E, Sarcletti, 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Subjects
Male, 0301 basic medicine, Psychological intervention, Human immunodeficiency virus (HIV), Medizin, Continuum of care, Europe, HIV infection, Key population, Sex, Anti-Retroviral Agents, Continuity of Patient Care, European Union, HIV, Humans, HIV Infections, medicine.disease_cause, key population, 0302 clinical medicine, HIV Infection, 030212 general & internal medicine, Men having sex with men, media_common, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Transmission (medicine), Infectious Diseases, AcademicSubjects/MED00290, HIV infection, continuum of care, sex, key population, Europe, Microbiology (medical), Population, Socio-culturale, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, medicine, media_common.cataloged_instance, European union, education, Pandemics, continuum of care, sex, business.industry, SARS-CoV-2, COVID-19, medicine.disease, 030112 virology, Major Articles and Commentaries, Anti-Retroviral Agent, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract

Background High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control., Standardized definitions were used to estimate a 4-stage continuum of human immunodeficiency virus (HIV) care in 11 European Union (EU) countries in 2016. The EU is close to the 90-90-90 target, with the main challenge being the percentage of undiagnosed infections.

Published
2020

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