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1. Frailty phenotype is associated with antiretroviral exposure among older persons living with HIV

Author: Frédérique Retornaz, Nathalie Petit, Isabelle Ravaux, Albert Darque, Gwendoline Felker, and Patricia Enel
Subjects: Male, medicine.medical_specialty, Frail Elderly, Immunology, Human immunodeficiency virus (HIV), MEDLINE, HIV Infections, medicine.disease_cause, Logistic regression, Virology, Internal medicine, medicine, Humans, Multicenter Studies as Topic, Depression (differential diagnoses), Aged, Aged, 80 and over, Univariate analysis, Frailty, Oncology (nursing), business.industry, Medical record, Cancer, Hematology, medicine.disease, Frailty phenotype, Infectious Diseases, Cross-Sectional Studies, Phenotype, Oncology, Female, business
Abstract: Purpose of review This multicentre, cross-sectional study was carried out in the South of France to assess the association between frailty phenotype and antiretroviral therapy (ART) in older persons living with HIV (PLWHIV). Sociodemographic and HIV data, geriatric assessment, comorbidities, behavioral and age-related variables and the five frailty markers of Fried were recorded. Exposure to any pharmacological class of ART and all regimens were retrieved from medical records. Recent findings The 509 PLWHIV analysed (72.7% male) received a mean of 6.01 ART regimens and 12.5 years exposure to ART. The prevalence of at least one frailty marker [frail and prefrail phenotype (FPFP)] was 66.4%. Duration of exposure to protease inhibitors and reverse transcriptase inhibitors, number of ART regimens and comorbidities, dyslipidaemia, cancer, depression, falls, disability and pain were significantly associated with FPFP by univariate analysis. In logistic regression multivariable analysis, independent predictors for FPFP were a large number of ART regimens, presence of cancer and pain. No significant association was found with HIV-related parameters neither with ART class and duration. Summary A significant association was found between FPFP and a large number of different ART regimens among older PLWHIV. The burden of cancer and pain in these patients shows the importance of comprehensive care.
Published: 2021

2. Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients

Author: Matthieu MILLION, Jean-Christophe LAGIER, Hervé TISSOT-DUPONT, Isabelle RAVAUX, Catherine DHIVER, Christelle TOMEI, Nadim CASSIR, Léa DELORME, Sébastien CORTAREDONA, Sophie AMRANE, Camille AUBRY, Karim BENDAMARDJI, Cyril BERENGER, Barbara DOUDIER, Sophie EDOUARD, Marie HOCQUART, Morgane MAILHE, Coralie PORCHETO, Piseth SENG, Catherine TRIQUET, Stéphanie GENTILE, Elisabeth JOUVE, Audrey GIRAUD-GATINEAU, Herve CHAUDET, Laurence CAMOIN-JAU, Philippe COLSON, Philippe GAUTRET, Pierre-Edouard FOURNIER, Baptiste MAILLE, Jean-Claude DEHARO, Paul HABERT, Jean-Yves GAUBERT, Alexis JACQUIER, Stéphane HONORE, Katell GUILLON-LORVELLEC, Yolande OBADIA, Philippe PAROLA, Philippe BROUQUI, Didier RAOULT, Microbes évolution phylogénie et infections (MEPHI), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Européen de Recherche en Imagerie médicale (CERIMED), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Pharmacie Clinique, CHU Timone, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), COMBE, Isabelle, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Service Pharmacie [Hôpital de la Timone - APHM], and Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
Subjects: Adult, Male, Time Factors, Adolescent, ambulatory, Azithromycin, Antiviral Agents, Risk Assessment, Young Adult, Sex Factors, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Early Medical Intervention, Outpatients, Ambulatory Care, Diseases of the circulatory (Cardiovascular) system, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Aged, 80 and over, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, treatment, Age Factors, COVID-19, Middle Aged, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, COVID-19 Drug Treatment, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hospitalization, sars-cov-2, Treatment Outcome, RC666-701, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Female, France, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Hydroxychloroquine
Abstract: We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID-19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as outpatients with a standardized protocol. The primary endpoint was 6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients (median age, 45 [IQR 32–57] years; 5597 [53.7%] women), 16 died (0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated with a higher risk of death, ICU transfer, and hospitalization. Treatment with HCQ+AZ (0.17 [0.06–0.48]) was associated with a lower risk of death, independently of age, sex and epidemic period. Meta-analysis evidenced consistency with 4 previous outpatient studies (32,124 patients—Odds ratio 0.31 [0.20–0.47], I2 = 0%). Early ambulatory treatment of COVID-19 with HCQ+AZ as a standard of care is associated with very low mortality, and HCQ+AZ improve COVID-19 survival compared to other regimens.
Published: 2021
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3. Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France

Author: Audrey Giraud-Gatineau, Stéphane Honoré, Philippe Parola, Hervé Tissot-Dupont, Yanis Roussel, Jean-Christophe Lagier, Eric Chabrière, Yolande Obadia, Carole Eldin, Didier Raoult, Morgane Mailhe, Florence Fenollar, Philippe Brouqui, Anthony Levasseur, Bernard La Scola, Michel Drancourt, Andreas Stein, Nadim Cassir, Jean-Marc Rolain, Jean Claude Deharo, Christine Zandotti, Vera Esteves-Vieira, Sophie Amrane, Camille Aubry, Catherine Dhiver, Alexis Jacquier, Piseth Seng, Pierre-Edouard Fournier, Christelle Tomei, Philippe Colson, Isabelle Ravaux, Marie Hocquart, Barbara Doudier, Cyril Berenger, Florian Correard, Matthieu Million, Philippe Gautret, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Département de Radiologie [Hôpital de la Timone - APHM], and Hôpital de la Timone [CHU - APHM] (TIMONE)
Subjects: Male, Time Factors, [SDV]Life Sciences [q-bio], Azithromycin, Polymerase Chain Reaction, 0302 clinical medicine, Belgium, Case fatality rate, 030212 general & internal medicine, Young adult, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Middle Aged, Viral Load, Treatment Outcome, Infectious Diseases, Drug Therapy, Combination, Female, France, Coronavirus Infections, Viral load, medicine.drug, Hydroxychloroquine, Adult, medicine.medical_specialty, Adolescent, 030231 tropical medicine, Pneumonia, Viral, Antiviral Agents, Article, 03 medical and health sciences, Betacoronavirus, Young Adult, Internal medicine, medicine, Humans, Viral shedding, Pandemics, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, Retrospective cohort study, COVID-19 Drug Treatment, Regimen, business, Follow-Up Studies
Abstract: Background In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19. Methods We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated with HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by 250 mg daily for the next four days) for at least three days. Outcomes were death, clinical worsening (transfer to ICU, and >10 day hospitalization) and viral shedding persistence (>10 days). Results A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p
Published: 2020
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4. Post-exposure prophylaxis completion and condom use in the context of potential sexual exposure to HIV

Author: Claudine Duvivier, André Cabié, Sylvie Bregigeon, Alain Makinson, David Rey, C Allavena, Jacques Reynes, Laurent Cotte, Isabelle Ravaux, Pierre Gantner, Les Hôptaux universitaires de Strasbourg (HUS), CHU Strasbourg, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôtel-Dieu de Nantes, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP), Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Dat'AIDS Study Group: Besançon: C. Drobacheff-Thiébaut, A. Foltzer, K. Bouiller, L. Hustache-Mathieu, C. Chirouze, F. Bozon, O. Babre, P. Muret, Clermont-Ferrand: H. Laurichesse, O. Lesens, M. Vidal, N. Mrozek, C. Aumeran, O. Baud, V. Corbin, P. Letertre, S. Casanova, C. Jacomet, Guadeloupe: B. Hoen, I. Lamaury, I. Fabre, E. Curlier, R. Ouissa, K. Schepers, C. Herrmann-Storck, N. Dournon, La Roche sur Yon: D. Merrien, P. Perré, T. Guimard, O. Bollangier, S. Leautez, M. Morrier, Lyon: F. Ader, F. Biron, A. Boibieux, L. Cotte, T. Ferry, P. Miailhes, T. Perpoint, S. Roux, S. Degroodt, C. Brochier, F. Valour, C. Chidiac, Marseille (IHU): C. Dhiver, M. Saadia Mokhtari, A. Ménard, H. Tissot Dupont, C. Toméi, L. Meddeb, A.Y. Belkhir, I. Ravaux, Marseille (Ste Marguerite): S. Brégigeon, O. Zaegel-Faucher, V. Obry-Roguet, H. Laroche, M. Orticoni, M.J. Soavi, P. Geneau de Lamarlière, E. Ressiot, M.J. Ducassou, I. Jaquet, S. Galie, A. Galinier, P. Martinet, M. Landon, A.S. Ritleng, A. Ivanova, C. Debreux, C. Lions, I. Poizot-Martin, Martinique: S. Abel, R. Césaire, L. Cuzin, G. Dos Santos, L. Fagour, M. Illiaquer, F. Najioullah, D. Nguyen, M. Ouka, S. Pierre-François, J. Pasquier, M. Pircher, B. Rozé, A. Cabié, Montpellier: N. Atoui, V. Le Moing, A. Makinson, N. Meftah, C. Merle de Boever, B. Montes, A. Montoya Ferrer, J. Reynes, Nancy: M. André, L. Boyer, M.P. Bouillon, M. Delestan, T. May, Nantes: C. Allavena, C. Bernaud, E. Billaud, C. Biron, B. Bonnet, S. Bouchez, D. Boutoille, C. Brunet-Cartier, C. Deschanvres, N. Hall, T. Jovelin, P. Morineau, V. Reliquet, H. Hue, S. Sécher, M. Cavellec, A. Soria, V. Ferré, E. André-Garnier, A. Rodallec, M. Lefebvre, O. Grossi, O. Aubry, F. Raffi, Nice: P. Pugliese, S. Breaud, C. Ceppi, J. Courjon, E. Cua, J. Cottalorda, P. Dellamonica, E. Demonchy, A. De Monte, J. Durant, C. Etienne, S. Ferrando, J.G. Fuzibet, R. Garraffo, A. Joulie, K. Risso, V. Mondain, A. Naqvi, N. Oran, I. Perbost, S. Pillet, B. Prouvost-Keller, C. Pradier, S. Wehrlen-Pugliese, V. Rio, E. Rosenthal, S. Sausse, G. Zouzou, Orléans: L. Hocqueloux, T. Prazuck, C. Gubavu, A. Sève, M. Niang, C. Boulard, Paris (Bicêtre): A. Cheret, C. Goujard, Y. Quertainmont, E. Teicher, N. Lerolle, D. Vittecoq, O. Deradji, F. Fourreau, C. Pallier, A. Barrail-Tran, Paris (Bichat): R. Landman, V. Joly, C. Rioux, S. Lariven, A. Gervais, F.X. Lescure, S. Matheron, F. Louni, C. Godard, Z. Julia, M. Chansombat, D. Rahli, C. Mackoumbou-Nkouka, C. Charpentier, D. Descamps, G. Peytavin, Y. Yazdanpanah, Paris (Pasteur-Necker): P.H. Consigny, G. Cessot, P. Bossi, J. Goesch, J. Benabdelmoumen, F. Lanternier, C. Charlier, K. Amazzough, B. Henry, B. Pilmis, C. Rouzaud, M. Morgand, F. Touam, C. Louisin, C. Duvivier, O. Lortholary, R. Guery, F. Danion, J. Lourenco, P. Parize, M. Launay, V. Avettand-Fenoel, Paris (Pitié): M.A. Valantin, F. Caby, R. Tubiana, R. Agher, S. Seang, L. Schneider, R. Palich, C. Blanc, C. Katlama, Reims: J.L. Berger, Y. N'Guyen, D. Lambert, D. Lebrun, I. Kmiec, M. Hentzien, V. Brodard, F. Bani-Sadr, Saint-Etienne: E. Botelho-Nevers, A. Gagneux-Brunon, A. Frésard, F. Lucht, Strasbourg: P. Fischer, M. Partisani, C. Cheneau, M. Priester, M.L. Batard, C. Bernard-Henry, E. de Mautort, P. Gantner, D. Rey, Toulouse: M. Alvarez, N. Biezunski, A. Debard, C. Delpierre, P. Lansalot, L. Lelièvre, G. Martin-Blondel, M. Piffaut, L. Porte, K. Saune, P. Delobel, and Tourcoing: F. Ajana, I. Alcaraz, V. Baclet, A. Boucher, P. Choisy, T. Huleux, B. Lafon-Desmurs, H. Melliez, A. Meybeck, A. Pasquet, M. Pradier, O. Robineau, N. Viget, M. Valette.
Subjects: 0301 basic medicine, Male, HIV Infections, law.invention, Men who have sex with men, Condoms, 0302 clinical medicine, MESH: Tenofovir, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Emtricitabine, MESH: Sexual Partners, Emtricitabine, Pharmacology (medical), 030212 general & internal medicine, Condom use, Health Policy, MESH: HIV Infections, Infectious Diseases, Sexual Partners, Cohort, cardiovascular system, Female, France, Post-Exposure Prophylaxis, circulatory and respiratory physiology, medicine.drug, Adult, medicine.medical_specialty, Unprotected Sexual Intercourse, MESH: Unsafe Sex, Treatment discontinuation, education, Context (language use), MESH: Multivariate Analysis, Medication Adherence, MESH: Homosexuality, Male, 03 medical and health sciences, MESH: Condoms, Condom, Internal medicine, medicine, Humans, Homosexuality, Male, Tenofovir, Retrospective Studies, MESH: Humans, Unsafe Sex, business.industry, HIV, MESH: Adult, MESH: Retrospective Studies, Odds ratio, MESH: Medication Adherence, 030112 virology, MESH: Male, Discontinuation, Sexual exposure, MESH: France, Multivariate Analysis, business, MESH: Female, MESH: Post-Exposure Prophylaxis
Abstract: International audience; ObjectivesPost-exposure prophylaxis (PEP) care remains a challenge for individuals with potential sexual exposure to HIV in terms of PEP completion and ongoing risk behaviours.MethodsA retrospective analysis was carried out on data from the French Dat’AIDS prevention cohort (NCT03795376) for individuals evaluated for PEP between 2004 and 2017. A multivariable analysis was performed of predictors of both PEP completion and condom use [odds ratios (ORs)] and their associated probabilities (P, with P > 95% being clinically relevant).ResultsOverall, 29 060 sexual exposures to HIV were evaluated for PEP [36% in men who have sex with men (MSM) and 64% in heterosexuals]. Overall, 12 different PEP regimens were offered in 19 240 cases (46%). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) was the preferred backbone (n = 14 304; 74%). We observed a shift from boosted protease inhibitor-based regimens to nonnucleoside reverse transcriptase inhibitor- or integrase inhibitor-based regimens in recent years. Overall, 20% of PEP prescriptions were prematurely discontinued. Older age, MSM, intercourse with a sex worker, rape and intercourse with a known HIV-infected source patient were factors associated with increased rates of PEP completion (OR > 1; P > 98%). None of the 12 PEP regimens was associated with premature discontinuation. We also found 12 774 cases of unprotected sexual intercourse (48%). Condom use decreased (OR < 1; P > 99%) with the year of exposure, and was lower in MSM and rape victims. Condom use increased (OR > 1, P > 99%) with age, and was higher in those who had intercourse with a sex worker or with a female partner and in those with knowledge of the partner’s HIV status.ConclusionsWe provide new insights into how rates of condom use and PEP completion might be improved in those receiving PEP by targeting certain groups of individuals for interventions. In particular, youth and MSM at risk should be linked in a prevention-to-care continuum.
Published: 2020
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5. Factors associated with psoriasis in a French Nationwide HIV cohort: the independent role of HLA-B*57:01

Author: David Rey, M. Viguier, Maxime Hentzien, Isabelle Ravaux, Antoine Cheret, Firouzé Bani-Sadr, Lise Cuzin, Jacques Reynes, Christine Jacomet, François Raffi, Centre Hospitalier Universitaire de Reims (CHU Reims), Service des Maladies Infectieuses et Tropicales [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Department of Infectious Diseases [Nantes], Hôtel-Dieu de Nantes, CHU Clermont-Ferrand, Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), School of Civil and Environmental Engineering [Sydney], University of New South Wales [Sydney] (UNSW), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Centre Hospitalier Tourcoing, Hôpital Saint-Louis, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), and Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)
Subjects: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, Immunology, HIV Infections, Disease, Lower risk, Logistic regression, Serology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Psoriasis, Internal medicine, medicine, Prevalence, Immunology and Allergy, Humans, 030212 general & internal medicine, Prospective Studies, ComputingMilieux_MISCELLANEOUS, business.industry, Middle Aged, medicine.disease, HLA-B, 3. Good health, 030104 developmental biology, Infectious Diseases, HLA-B Antigens, Cohort, France, business
Abstract: OBJECTIVE Psoriasis is a T-cell-mediated inflammatory disease with genetic factors involved in its etiopathogenesis. In non-HIV populations, HLA-B57:01 has been associated with a higher risk of psoriasis. The aim of this study was to investigate demographic and immunovirological characteristics associated with psoriasis, and to assess whether HLA-B57:01 is associated with psoriasis among people living with HIV (PLHIV) followed in a large French multicenter Dat'AIDS cohort. METHODS All PLHIV followed up from January 2000 to December 2018 with an available result for HLA-B57:01 were included. Logistic regression models were used to identify associations between psoriasis (outcome variable) and explanatory variables. RESULTS Among 31 076 PLHIV, the overall prevalence of psoriasis and HLA-B57:01 were 2.25 and 4.73%, respectively and varied according to ethnicity. By multivariate analysis, male gender [OR 1.81 (95% CI 1.46-2.24), P
Published: 2020
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6. Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France : a retrospective analysis

Author: Laurence Camoin-Jau, Didier Raoult, Audrey Giraud-Gatineau, Sébastien Cortaredona, Jean-Claude Deharo, Yolande Obadia, Christine Zandotti, Magali Richez, Yanis Roussel, Hervé Tissot-Dupont, Bernard La Scola, Michel Drancourt, Jean-Christophe Lagier, Philippe Parola, Stéphanie Gentile, Matthieu Bardou, Stéphane Honoré, Eric Chabrière, Philippe Gautret, Andreas Stein, Marie Hocquart, Nadim Cassir, Morgane Mailhe, Pierre-Edouard Fournier, Sophie Edouard, Philippe Brouqui, Anthony Levasseur, Katell Guillon-Lorvellec, Sophie Amrane, Matthieu Million, Camille Aubry, Florence Fenollar, Piseth Seng, Barbara Doudier, Claire Decoster, Philippe Colson, Jean-Marc Rolain, Christelle Tomei, Alexis Jacquier, Catherine Dhiver, Jean-Yves Gaubert, Cyril Berenger, Isabelle Ravaux, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Assistance Publique - Hôpitaux de Marseille (APHM), Service de cardiologie [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANR-10-IAHU-0003,Méditerranée Infection,I.H.U. Méditerranée Infection(2010), COMBE, Isabelle, Instituts Hospitalo-Universitaires - I.H.U. Méditerranée Infection - - Méditerranée Infection2010 - ANR-10-IAHU-0003 - IAHU - VALID, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Aix Marseille Université (AMU)-Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Azithromycin, law.invention, 0302 clinical medicine, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Case fatality rate, 030212 general & internal medicine, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Hazard ratio, Middle Aged, Intensive care unit, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Infectious Diseases, Treatment Outcome, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, Coronavirus Infections, Viral load, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, medicine.drug, Hydroxychloroquine, Adult, medicine.medical_specialty, 030231 tropical medicine, Pneumonia, Viral, Sudden death, Antiviral Agents, Article, 03 medical and health sciences, Betacoronavirus, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Pandemics, Retrospective Studies, business.industry, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, Retrospective cohort study, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, COVID-19 Drug Treatment, Regimen, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business
Abstract: Background In our institute in Marseille, France, we initiated early and massive screening for coronavirus disease 2019 (COVID-19). Hospitalization and early treatment with hydroxychloroquine and azithromycin (HCQ-AZ) was proposed for the positive cases. Methods We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200 mg of oral HCQ, three times daily for ten days and 500 mg of oral AZ on day 1 followed by 250 mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen (“others”). Outcomes were death, transfer to the intensive care unit (ICU), ≥10 days of hospitalization and viral shedding. Results The patients’ mean age was 45 (sd 17) years, 45% were male, and the case fatality rate was 0.9%. We performed 2,065 low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms (NEWS score = 0). A discrepancy between spontaneous dyspnoea, hypoxemia and lung lesions was observed. Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, troponin and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27), decreased risk of hospitalization ≥10 days (odds ratios 95% CI 0.38 0.27–0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17–1.42). QTc prolongation (>60 ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500 ms. No cases of torsade de pointe or sudden death were observed. Conclusion Although this is a retrospective analysis, results suggest that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome and a faster viral load reduction than other treatments.
Published: 2020
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7. Factors associated with social deprivation among older persons living with HIV

Author: Frank Tollinchi, Patricia Granet-Brunello, Thierry Allegre, Nathalie Petit, Laurence Pelissier, Gilles Pichancourt, Albert Darque, Patricia Enel, Sylvie Bregigeon, Jean-Pierre de Jaureguiberry, Isabelle Ravaux, Stephane Chadapaud, Patrick Philibert, Frédérique Retornaz, and Rolande Cohen-Valensi
Subjects: Adult, Male, Aging, medicine.medical_specialty, Health (social science), Social Psychology, Anti-HIV Agents, Human immunodeficiency virus (HIV), Psychosocial Deprivation, HIV Infections, medicine.disease_cause, 03 medical and health sciences, Health problems, 0302 clinical medicine, Prevalence, medicine, Health Status Indicators, Humans, 030212 general & internal medicine, Psychiatry, Depression (differential diagnoses), Aged, Aged, 80 and over, 030505 public health, Depression, business.industry, Public Health, Environmental and Occupational Health, Health Status Disparities, Middle Aged, Health Surveys, Mental health, Cross-Sectional Studies, Mental Health, Social deprivation, Female, France, 0305 other medical science, business
Abstract: Aging persons living with HIV may develop multiple health problems, including comorbidities, and altered physical and mental health, earlier than non-infected people. They may also experience social deprivation. We assessed the prevalence of social deprivation and its relationship with health indicators in older persons living with HIV. An 18-month, multicenter, cross-sectional study was carried out between 2013 and 2014 focusing on patients ≥50-years of age followed-up in 12 dedicated HIV medical hospital units located in the South of France and involved the VISAGE study group. Social deprivation was measured with the EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centers) score (ES) and defined as ES ≥30.17. The following data were recorded: health indicators (gender, age, body mass index), comorbidities, frailty markers, socioeconomic, behavioral and age-related variables. Among 509 patients recruited, 494 completed the ES social deprivation evaluation. Mean age was 58.5 ± 7.0 years and 72.9% were male. The prevalence of social deprivation was 49.0%. Multivariable logistic regression analysis showed that higher social deprivation was significantly linked to alcohol consumption (OR = 4.07 [95%CI: 1.23-13.48]), risk of depression (OR = 3.59 [95%CI: 2.26-5.70]), chronic obstructive pulmonary disease (OR = 3.10 [95%CI: 1.36-7.09]), hepatitis C (OR = 1.96 [95%CI: 1.10-3.52]), and chronic pain (OR = 1.11 [95%CI: 1.01-1.21]). Social deprivation was not related to HIV status. Our study showed that not only did older patients with HIV suffer from social deprivation, but they also received little support from social workers. Physicians should be aware of this situation and should systematically evaluate social deprivation in order to provide comprehensive targeted care involving global, social, and psychological support to reduce the burden of social deprivation.
Published: 2018
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8. Frail and pre-frail phenotype is associated with pain in older HIV-infected patients

Author: Sylvie Bregigeon, Patricia Enel, Albert Darque, Frédérique Retornaz, Isabelle Ravaux, Nathalie Petit, and Karine Baumstarck
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, Weakness, Activities of daily living, geriatric assessment, Frail Elderly, Observational Study, Pain, HIV Infections, Comorbidity, Logistic regression, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, precariousness, Internal medicine, Antiretroviral treatment, Prevalence, Medicine, Hiv infected patients, Humans, 030212 general & internal medicine, Mobility Limitation, frailty phenotype, Depression (differential diagnoses), Aged, Frailty, business.industry, General Medicine, HIV-aging, Middle Aged, 030112 virology, Phenotype, Hospitalization, Anti-Retroviral Agents, Cohort, Female, France, medicine.symptom, business, Research Article
Abstract: As HIV-infected patients grow older, some accumulate multiple health problems earlier than the noninfected ones in particular frailty phenotypes. Patients with frailty phenotype are at higher risk of adverse outcomes (worsening mobility, disability, hospitalization, and death within three years). Our study aimed to evaluate prevalence of frailty in elderly HIV-infected patients and to assess whether frailty is associated with HIV and geriatric factors, comorbidities, and precariousness in a French cohort of older HIV infected. This 18-month cross-sectional multicenter study carried in 2013 to 2014 had involved 502 HIV-infected patients aged 50 years and older, cared in 18 HIV-dedicated hospital medical units, located in South of France. Prevalence of frailty was 6.3% and of pre-frailty 57.2%. Low physical activity and weakness were the main frailty markers, respectively 49.4% and 19.9%. In univariate models, precariousness, duration of HIV antiretroviral treatment >15 years, 2 comorbidities or more, risk of depression, activities of daily living disability, and presence of pain were significantly associated with frail and pre-frail phenotype. Multivariate logistic regression analyses showed that only pain was significantly different between frail and pre frail phenotype versus non frail phenotype (odds ratio = 1.2; P = .002). Our study is the first showing a significant association between pain and frailty phenotype in older patients infected by HIV. As frailty phenotype could be potentially reversible, a better understanding of the underlying determinant is warranted. Further studies are needed to confirm these first findings.
Published: 2018

9. Impact of baseline plasma HIV-1 RNA and time to virological suppression on virological rebound according to first-line antiretroviral regimen

Author: Clotilde Allavena, Jacques Reynes, Pierre Delobel, Isabelle Poizot-Martin, Tristan Ferry, Pascal Pugliese, Bruno Hoen, Isabelle Ravaux, Marine Morrier, L. Khatchatourian, Firouzé Bani-Sadr, Amandine Gagneux-Brunon, Olivier Robineau, Matthieu Hanf, Véronique Joly, Christine Katlama, Catherine Chirouze, André Cabié, Thierry May, Christine Jacomet, François Raffi, David Rey, Claudine Duvivier, Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Maladies Infectieuses [Nice], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Services des maladies infectieuses [Tourcoing], Centre Hospitalier de Tourcoing, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses [Clermont-Ferrand], CHU Clermont-Ferrand, Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'immuno-hématologie clinique (CISIH), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Service des maladies infectieuses [Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Reims (CHU Reims), Service des Maladies Infectieuses et Tropicales [Point-à-Pitre], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service des maladies infectieuses [La Roche sur Yon], Centre hospitalier universitaire de Tlemcen (Algérie) (CHU de Tlemcen), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre d’Investigation Clinique de Nantes ( CIC Nantes ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses ( B2PHI ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales[Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de physiopathologie de Toulouse Purpan ( CPTP ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] ( SMIT ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre d'infectiologie Necker-Pasteur, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) ( EA 7327 ), Université Paris Descartes - Paris 5 ( UPD5 ), CHU Saint-Etienne, Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre Hospitalier Universitaire de Reims ( CHU Reims ), Centre d'Investigation Clinique Antilles-Guyane ( CIC - Antilles Guyane ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre hospitalier universitaire de Tlemcen (Algérie) ( CHU de Tlemcen ), CHU de la Martinique-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Service des maladies infectieuses et tropicales [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], 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 Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), and CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA)
Subjects: Male, 0301 basic medicine, Time Factors, Sustained Virologic Response, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Integrase inhibitor, HIV Infections, Plasma, chemistry.chemical_compound, 0302 clinical medicine, Recurrence, immune system diseases, Antiretroviral Therapy, Highly Active, Medicine, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, 80 and over, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Viral Load, 3. Good health, Infectious Diseases, RNA, Viral, Female, Viral load, Adult, Microbiology (medical), Efavirenz, Adolescent, Anti-HIV Agents, 030106 microbiology, Young Adult, 03 medical and health sciences, Humans, Protease inhibitor (pharmacology), Aged, Pharmacology, Protease, business.industry, Virology, Reverse transcriptase, Regimen, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Follow-Up Studies
Abstract: Objectives: We investigated the risk of virological rebound in HIV-1-infected patients achieving virological suppression on first-line combined ART (cART) according to baseline HIV-1 RNA, time to virological suppression and type of regimen. Patients and methods: Subjects were 10836 adults who initiated first-line cART (two nucleoside or nucleotide reverse transcriptase inhibitors!efavirenz, a ritonavir-boosted protease inhibitor or an integrase inhibitor) from 1 January 2007 to 31 December 2014. Cox proportional hazards models with multiple adjustment and propensity score matching were used to investigate the effect of baseline HIV-1 RNA and time to virological suppression on the occurrence of virological rebound. Results: During 411436 patient-months of follow-up, risk of virological rebound was higher in patients with baseline HIV-1 RNA 100000 copies/mL versus ,100000 copies/mL, in those achieving virological suppression in.6months versus ,6months, and lower with efavirenz or integrase inhibitors than with ritonavir-boosted protease inhibitors. Baseline HIV-1 RNA .100000 copies/mL was associated with virological rebound for ritonavir-boosted protease inhibitors but not for efavirenz or integrase inhibitors. Time to virological suppression .6months was strongly associated with virological rebound for all regimens. Conclusions: In HIV-1-infected patients starting cART, risk of virological rebound was lower with efavirenz or integrase inhibitors than with ritonavir-boosted protease inhibitors. These data, from a very large observational cohort, in addition to the more rapid initial virological suppression obtained with integrase inhibitors, reinforce the positioning of this class as the preferred one for first-line therapy.
Published: 2017
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10. Emergence of uncommon HIV-1 non-B subtypes and circulating recombinant forms and trends in transmission of antiretroviral drug resistance in patients with primary infection during the 2013-2015 period in Marseille, Southeastern France

Author: Anne Motte, Philippe Colson, Saadia Mokhtari, Isabelle Ravaux, Christian Tourres, Catherine Tamalet, Hélène Laroche, Catherine Dhiver, Sarah Aherfi, Hervé Tissot-Dupont, Isabelle Poizot-Martin, Hervé Chaudet, Sylvie Bregigeon, Andreas Stein, Olivia Zaegel-Faucher, Philippe Brouqui, Thérèse Dieng, Amélie Menard, Christelle Tomei, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was supported by a grant from the French State managed by the National Research Agency under the 'Investissements d’’avenir (Investments for the Future)' program with the referenceANR‐10‐IAHU‐03 (Méditerranée Infection)., ANR-10-IAHU-0003,Méditerranée Infection,I.H.U. Méditerranée Infection(2010), COMBE, Isabelle, Instituts Hospitalo-Universitaires - I.H.U. Méditerranée Infection - - Méditerranée Infection2010 - ANR-10-IAHU-0003 - IAHU - VALID, and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )
Subjects: 0301 basic medicine, Adult, Male, resistance-associated mutations, recombinant subtypes, Genotype, Anti-HIV Agents, Period (gene), men having sex with men, Etravirine, HIV Infections, non-B subtypes, law.invention, Men who have sex with men, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, law, Virology, Drug Resistance, Viral, medicine, Prevalence, Humans, In patient, Recombination, Genetic, Transmission (medicine), business.industry, Sequence Analysis, DNA, primary HIV Infection, Middle Aged, medicine.disease, Reverse transcriptase, 3. Good health, 030104 developmental biology, Infectious Diseases, Mutation, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Recombinant DNA, HIV-1, Female, France, primary antiretroviral resistance, business, medicine.drug
Abstract: International audience; Primary HIV-1 infections (PHI) with non-B subtypes are increasing in developed countries while transmission of HIV-1 harboring antiretroviral resistance-associated mutations (RAMs) remains a concern. This study assessed non-B HIV-1 subtypes and RAMs prevalence among patients with PHI in university hospitals of Marseille, Southeastern France, in 2005-2015 (11 years). HIV-1 sequences were obtained by inhouse protocols from 115 patients with PHI, including 38 for the 2013-2015 period. On the basis of the phylogenetic analysis of the reverse transcriptase region, non-B subtypes were identified in 31% of these patients. They included 3 different subtypes (3A, 1C, 4F), 23 circulating recombinant forms (CRFs) (CRF02_AG, best BLAST hits being CRF 36\ₓpx and CRF30 in 7 and 1 cases, respectively), and 5 unclassified sequences (U). Non-B subtypes proportion increased significantly, particularly in 2011-2013 vs in 2005-2010 (P = .03). CRF02_AG viruses largely predominated in 2005-2013 whereas atypical strains more difficult to classify and undetermined recombinants emerged recently (2014-2015). The prevalence of protease, nucleos(t) ide reverse transcriptase, and first-generation nonnucleoside reverse transcriptase inhibitors-associated RAMs were 1.7% (World Health Organization [WHO] list, 2009/2.6% International AIDS Society [IAS] list, 2017), 5.2%/4.3%, and 5.2%/5.2%, respectively. Etravirine/rilpivirine-associated RAM (IAS) prevalence was 4.3%. Men who have sex with men (MSM) were more frequently infected with drug-resistant viruses than other patients (26% vs 7%; P = .011). The recent increase of these rare HIV-1 strains and the spread of drug-resistant HIV-1 among MSM in Southeastern France might be considered when implementing prevention strategies and starting therapies.
Published: 2017
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11. Dolutegravir and weight gain: an unexpected bothering side effect?

Author: Catherine Dhiver, Amélie Menard, Philippe Brouqui, Philippe Colson, Hervé Tissot-Dupont, Christelle Tomei, Saadia Mokhtari, Andreas Stein, Isabelle Ravaux, Line Meddeb, Service de Maladies Infectieuses, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre de Référence des Infections Ostéo-articulaires Sud-Méditerranée (CRIOA), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Aix-Marseille Université - Faculté de pharmacie (AMU PHARM), Aix Marseille Université (AMU), Service des Maladies Infectieuses, Service des Maladies Infectieuses et Tropicales [CHU Hôpital Nord - Marseille] (M.I.T), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Hôpital Nord [CHU - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, and INSB-INSB-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, 0301 basic medicine, Cart, medicine.medical_specialty, Side effect, Pyridones, 030106 microbiology, Immunology, Weight Gain, Piperazines, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Oxazines, medicine, Humans, Immunology and Allergy, HIV Integrase Inhibitors, 030212 general & internal medicine, Adverse effect, ComputingMilieux_MISCELLANEOUS, business.industry, virus diseases, Middle Aged, 3. Good health, Discontinuation, Infectious Diseases, chemistry, Cohort, Dolutegravir, Female, medicine.symptom, business, Heterocyclic Compounds, 3-Ring, Weight gain, Cohort study
Abstract: We recently analyzed, in our real-life cohort of 2260 HIV-infected patients, the reasons for discontinuation of dolutegravir-based combined antiretroviral therapies (cARTs) [1]. Of 517 patients, 55 (10.6%) discontinued this cART due to adverse effects. Unexpectedly, four (7%) of these adverse effect
Published: 2017
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12. Intradermal injection of a Tat Oyi-based therapeutic HIV vaccine reduces of 1.5 log copies/mL the HIV RNA rebound median and no HIV DNA rebound following cART interruption in a phase I/II randomized controlled clinical trial

Author: Jihen Boussetta, Julie Coussirou, Corinne Nicolino-Brunet, Elisabeth Castanier, Vincent Couallier, Elvenn A. Loret, Sophie Morange, Christine Caloustian, Charleric Bornet, Olivier Blin, Albert Darque, Josiane Casanova, Elisabeth Jouve, Bertrand Dussol, Erwann Loret, Isabelle Ravaux, 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), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital de la Timone [CHU - APHM] (TIMONE), Aix-Marseille Université - Faculté de pharmacie (AMU PHARM), Aix Marseille Université (AMU), Centre d'Investigation Clinique [Hôpital de la Conception - APHM] (CIC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Biologie du Développement de Marseille (IBDM), Aix Marseille Université (AMU)-Collège de France (CdF (institution))-Centre National de la Recherche Scientifique (CNRS), Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Clinical Investigation Centre (CIC-UPCET) and Department of Clinical Pharmacology, Centre investigation clinique - Unité de pharmacologie clinique et d'évaluations thérapeutiques (CIC-UPCET), Assistance Publique - Hôpitaux de Marseille (APHM)-Assistance Publique - Hôpitaux de Marseille (APHM), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), and Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 0301 basic medicine, Cart, Adult, Male, ART interruption, Injections, Intradermal, medicine.medical_treatment, [SDV]Life Sciences [q-bio], HIV Infections, 03 medical and health sciences, 0302 clinical medicine, Immune system, Double-Blind Method, Virology, Medicine, Humans, 030212 general & internal medicine, Intradermal injection, HIV vaccine, AIDS Vaccines, business.industry, Research, virus diseases, HIV, Drug holiday, Middle Aged, Viral Load, 3. Good health, Vaccination, Clinical trial, 030104 developmental biology, Treatment Outcome, Infectious Diseases, Anti-Retroviral Agents, Immunology, DNA, Viral, HIV-1, RNA, Viral, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, tat Gene Products, Human Immunodeficiency Virus, Tat, Erratum, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, Viral load, Adjuvant, Vaccine
Abstract: International audience; Background: A Tat Oyi vaccine preparation was administered with informed consent to 48 long-term HIV-1 infected volunteers whose viral loads had been suppressed by antiretroviral therapy (cART). These volunteers were rand-omized in double-blind method into four groups (n = 12) that were injected intradermally with 0, 11, 33, or 99 µg of synthetic Tat Oyi proteins in buffer without adjuvant at times designated by month 0 (M0), M1 and M2, respectively. The volunteers then underwent a structured treatment interruption between M5 and M7. Results: The primary outcomes of this phase I/IIa clinical trial were the safety and lowering the extent of HIV RNA rebound after cART interruption. Only one undesirable event possibly due to vaccination was observed. The 33 µg dose was most effective at lowering the extent of HIV RNA and DNA rebound (Mann and Whitney test, p = 0.07 and p = 0.001). Immune responses against Tat were increased at M5 and this correlated with a low HIV RNA rebound at M6 (p = 0.01). Conclusion: This study suggests in vivo that extracellular Tat activates and protects HIV infected cells. The Tat Oyi vaccine in association with cART may provide an efficient means of controlling the HIV-infected cell reservoir.
Published: 2016
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13. Mycoplasma genitalium, an agent of reemerging sexually transmitted infections

Author: Annick Bernard, Isabelle Ravaux, Grégory Dubourg, Didier Raoult, Sophie Edouard, Andreas Stein, Pierre-Edouard Fournier, Hervé Tissot-Dupont, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, Sexually Transmitted Diseases, Bacterial, medicine.medical_specialty, Adolescent, 030106 microbiology, Population, Genital infections, Mycoplasma genitalium, Urine, urologic and male genital diseases, Real-Time Polymerase Chain Reaction, Communicable Diseases, Emerging, Pathology and Forensic Medicine, Hospitals, University, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Antibiotic resistance, Internal medicine, Prevalence, Immunology and Allergy, Medicine, Humans, In patient, Mycoplasma Infections, 030212 general & internal medicine, education, Child, Pathogen, Aged, Aged, 80 and over, education.field_of_study, biology, business.industry, General Medicine, Middle Aged, University hospital, biology.organism_classification, bacterial infections and mycoses, female genital diseases and pregnancy complications, 3. Good health, Female, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; M. genitalium is a reemerging microorganism, responsible for sexually transmissible infections (STIs), with prevalence which varies depending on the country and population group studied. We report here M. genitalium prevalence among the specimens received for STI diagnosis in our routine microbiological laboratory in the university hospital in Marseille, France. We tested 4 624 samples from 3 793 patients using qPCR for M. genitalium, C. trachomatis, N. gonorrheae, T. pallidum. Of these samples, 528 (13.6%) patients were tested positive for at least one pathogen and 126 (3.3%) were positive for M. genitalium. M. genitalium is the second most prevalent micro-organism detected in women after C. trachomatis (10.4%) and the third most prevalent in men after C. trachomatis (5.1%) and N. gonorrhoeae (4.4%). We observed no significant differences between the prevalence of M. genitalium in vaginal, urethral and urine specimens (p = 0.9). Prevalence of M. genitalium is significantly higher in patients aged between 10-30 years (4.1%) compared to those aged between 30 and 50 years (2.7%) (p = 0.02, RR = 1.54 [1.06-2.24]) and patients over 50 years of age (1.1%) (p = 0.003, RR= 3.98 [1.47-10.8]). M. genitalium is a common agent of STI, therefore we suggest that this micro-organism should be systematically tested during chronic, recurrent, or antibiotic resistant genital infections and in populations at high-risk of STIs.
Published: 2016
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14. Feasibility and Acceptability of Anal Self-Sampling for Human Papillomavirus Screening in HIV-Infected Patients

Author: Amélie Menard, Catherine Dhiver, Philippe Colson, Catherine Tamalet, Isabelle Ravaux, Andreas Stein, Virology, Hôpital de la Timone [CHU - APHM] (TIMONE), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service des Maladies Infectieuses, Service de Maladies Infectieuses, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre de Référence des Infections Ostéo-articulaires Sud-Méditerranée (CRIOA), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, medicine.medical_specialty, Outpatient Clinics, Hospital, Genotype, HIV Infections, Specimen Handling, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Internal medicine, Prevalence, medicine, Humans, Mass Screening, Anal cancer, Outpatient clinic, Hiv infected patients, 030212 general & internal medicine, Mass screening, Aged, Gynecology, Anus Diseases, Human papillomavirus 16, business.industry, Incidence (epidemiology), Papillomavirus Infections, Human papillomavirus screening, virus diseases, Anal dysplasia, Middle Aged, Anus Neoplasms, medicine.disease, 3. Good health, Infectious Diseases, 030220 oncology & carcinogenesis, DNA, Viral, Feasibility Studies, Female, France, business, Self sampling
Abstract: Objectives: Anal cancer incidence is increasing among HIV-positive patients. No consensus currently exists for the screening of anal dysplasia. This study aimed at evaluating the feasibility and acceptability of anal self-sampling and assessing the prevalence of human papillomavirus (HPV) types among HIV-positive patients from Marseille University Hospitals. Methods: Between October 2013 and March 2014, during their regular visits for the monitoring of their HIV infection in an HIV outpatient clinical unit of Marseille University Hospitals, patients were asked to self-sample anal swabs for HPV detection. A specimen self-collection kit was provided. HPV detection and genotyping were performed using in-house protocols. The quality of self-sampling was assessed by concurrent cellular quantification in collected samples. Results: The acceptability rate of anal self-sampling was 91%, and 91% of the self-sampled specimens were appropriate for HPV screening. In addition, 76% of the samples were positive for HPV, including 54% of HPV types with oncogenic potential. Conclusions: This study indicates that HPV detection and typing through anal self-sampling is a valuable strategy to screen patients at high risk for anal cancer development. This could allow earlier management of anal lesions and related cancer in patients at high risk for HPV.
Published: 2016
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15. Hepatitis E virus infection in patients infected with the human immunodeficiency virus

Author: Françoise Dignat-George, Jacques Moreau, Anne Motte, Hervé Richet, Philippe Brouqui, Corinne Nicolino-Brunet, Amélie Menard, Isabelle Ravaux, Catherine Dhiver, Isabelle Poizot-Martin, Mamadou Kaba, and Philippe Colson
Subjects: Adult, CD4-Positive T-Lymphocytes, Liver Cirrhosis, Male, Cirrhosis, Adolescent, viruses, HIV Infections, medicine.disease_cause, Virus, Serology, Immunocompromised Host, Hepatitis E virus, Virology, Genotype, medicine, Humans, Hepatitis Antibodies, Longitudinal Studies, Phylogeny, Aged, Base Sequence, biology, Sequence Analysis, RNA, business.industry, Incidence (epidemiology), virus diseases, Middle Aged, Hepatitis B, medicine.disease, digestive system diseases, CD4 Lymphocyte Count, Hepatitis E, Infectious Diseases, Immunoglobulin M, Immunoglobulin G, Immunology, biology.protein, RNA, Viral, Female, France, Antibody, business
Abstract: Hepatitis E virus (HEV) is a newly-identified causative agent of acute and chronic hepatitis in severely immunocompromized patients. The present study sought to assess the prevalences of past, recent, on-going, and chronic HEV infections in patients infected with human immunodeficiency virus (HIV) in Marseille, South-eastern France, and to determine if they were correlated with the patients' immunological status or with cirrhosis. Anti-HEV IgG and IgM and HEV RNA testing were concurrently performed on the plasma from 184 patients infected with HIV, including 81 with a CD4+ T-lymphocyte count (CD4 count)
Published: 2011
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16. Population Pharmacokinetics of Atazanavir in Human Immunodeficiency Virus-Infected Patients

Author: Nicolas Simon, Caroline Solas, Alain Lafeuillade, Bruno Lacarelle, Marie-Claude Gagnieu, Saadia Mokhtari, Isabelle Ravaux, and Marie-Pierre Drogoul
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, Pyridines, Atazanavir Sulfate, Population, HIV Infections, Context (language use), Pharmacology, Gastroenterology, Pharmacokinetics, Internal medicine, medicine, Humans, Pharmacology (medical), education, Aged, Retrospective Studies, Volume of distribution, education.field_of_study, business.industry, virus diseases, Middle Aged, Confidence interval, Atazanavir, NONMEM, Female, business, Oligopeptides, medicine.drug
Abstract: The aim of this study was to determine the population pharmacokinetic (PK) parameters of atazanavir in adult human immunodeficiency virus-infected patients to build up a Bayesian strategy for dosage regimen individualization. This was an observational study of patients treated with the once-daily regimen atazanavir associated with 100 mg of ritonavir. Blood samples were drawn at steady state at various times ranging from 1 to 26 hours postdose. Atazanavir plasma concentrations were determined by a validated reverse-phase high-performance liquid chromatography method. PK analysis of the atazanavir population was performed using a nonlinear mixed-effects model (NONMEM version 6). One hundred eighty-seven patients were included in the study. The atazanavir doses prescribed were 300 mg (n = 169), 400 mg (n = 12), 200 mg (n = 1), and 150 mg (n = 5). The atazanavir population PK was described using a 1-compartment model with first-order absorption. Mean PK parameter estimations (95% confidence interval, coefficients of variation %) were as follows: oral clearance (CL) = 7.6 L/h (6.9-8.3; 34%), volume of distribution (V) = 80.8 L (67.4-94; 37%), and absorption constant rate (Ka) = 1.05 hours (0.01-2.09; 156%). The mean estimated half-life (T-half) was 7.5 hours (95% confidence interval: 7.2 -7.8 hours). The estimated T-half of atazanavir was in agreement with that previously reported of 8.6 and 8.8 hours. We observed a wide interpatient variability for the PK parameters, especially for Ka. This population approach allowed us to determine atazanavir PK parameters in human immunodeficiency virus-infected patients in a real-life context and to perform Bayesian analysis to predict Ctrough from samples collected at any moment during the dosing interval. This could therefore improve therapeutic drug monitoring interpretations and provide an interesting tool for correlation with virologic data.
Published: 2008
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17. The impact of methadone or buprenorphine treatment and ongoing injection on highly active antiretroviral therapy (HAART) adherence: evidence from the MANIF2000 cohort study

Author: M. Patrizia Carrieri, Bruno Spire, Virgine Villes, Isabelle Ravaux, Perrine Roux, Pierre Dellamonica, and Isabelle Poizot-Martin
Subjects: Adult, Male, Narcotics, medicine.medical_specialty, media_common.quotation_subject, Medicine (miscellaneous), Nice, HIV Infections, Gee, Pharmacotherapy, Antiretroviral Therapy, Highly Active, Internal medicine, medicine, Humans, Medical prescription, Psychiatry, media_common, computer.programming_language, business.industry, Addiction, fungi, virus diseases, Opioid-Related Disorders, Buprenorphine, Epidemiologic Studies, Psychiatry and Mental health, Patient Compliance, Female, business, computer, Methadone, medicine.drug, Cohort study
Abstract: Aims Todate,nodataexistassessingtheimpactof eithermethadoneorbuprenorphineonadherencetohighlyactive antiretroviral therapy (HAART) in the long term. This study was conducted in order to evaluate whether receiving take-homemethadoneandbuprenorphinemayensurebetteradherencetoHAARTinindividualsinfectedwithhuman immunodeficiency virus (HIV) through injection drug use (IDU). Design Longitudinal data on adherence, opioid substitution treatment (OST) and patient behaviours starting from their first HAART prescription were collected for 276 individuals HIV-infected through drug use (n = 1558 visits).Setting Out-patient hospital services delivering HIV care in Marseilles, Avignon, Nice and Ile de France. Measurements At any given visit, patients were classified both according to the type of OST received and ongoing injection. Patients who reported no injection and no OST over the whole study period were considered as 'abstinent' and used as a reference category. A logit model based on generalized estimation equations (GEE) was used to identify predictors of non-adherence. Findings After adjustment for alcohol consumption, depression and self-reported side effects, patients ceasing injection during OST and abstinent patients exhibited comparable adherence. Patients reporting injection, on OST or not, had a twofold and threefold risk, respec- tively, of non-adherence compared with abstinent patients (P < 0.01 linear trend). Duration on OST without injecting was associated significantly with virological success. Conclusions Both access to and effectiveness of OST contribute to sustaining adherence to HAART in HIV-infected IDUs.These results advocate strongly the need of wider use of OST in countries scaling-up HAART where HIV is driven by IDUs.
Published: 2008
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18. Adding HCV Treatment to HIV Treatment in HIV-HCV Coinfected Patients: The Impact on the Different Dimensions of Fatigue and Self-Reported Side Effects

Author: Patrick Kurkdji, Marie Préau, Maria Patrizia Carrieri, Pierre Dellamonica, Fabienne Marcellin, Isabelle Ravaux, Bruno Spire, and Camelia Protopopescu
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, HIV Infections, Comorbidity, Antiviral Agents, Risk Assessment, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Weight loss, Surveys and Questionnaires, Internal medicine, Prevalence, medicine, Humans, Sida, Fatigue, General Nursing, Depression (differential diagnoses), biology, Depression, business.industry, virus diseases, Hepatitis C, Middle Aged, medicine.disease, biology.organism_classification, Causality, Anesthesiology and Pain Medicine, Relative risk, Immunology, Coinfection, Self-Examination, Drug Therapy, Combination, Female, France, Neurology (clinical), medicine.symptom, business, Psychosocial
Abstract: Hepatitis C virus (HCV) infection is frequent among human immunodeficiency virus (HIV)-infected patients, and is often associated with disabling symptoms such as fatigue. The purpose of this study was to assess the effect of HCV treatments on the perceived physical, cognitive, and psychosocial impact of fatigue (Fatigue Impact Scale) among HIV-HCV coinfected patients. A cross-sectional survey was conducted among 223 adult coinfected patients being followed-up in two clinical centers located in the south of France. Analysis was focused on patients who answered a self-administered questionnaire and who were being treated for their HIV infection (n=139). The cognitive, physical, and psychosocial impact of fatigue was significantly worse in patients also receiving HCV treatment (n=24) than in those receiving HIV treatment only (n=115). Along with depression, the number of self-reported treatment-related side effects was independently associated with fatigue scores after adjustment for all other characteristics. This number was significantly higher among patients on HCV treatment than among those who were not (relative risk [95% confidence interval]=1.4 [1.1; 1.7], P=0.002). In particular, skin or hair problems and general symptoms such as loss of appetite, loss of weight, fever, and headache were more prevalent among these patients. In conclusion, the combination of HIV and HCV treatments results in more self-reported side effects that exacerbate the perceived impact of fatigue among HIV-HCV coinfected patients. Effective follow-up of HCV-treated HIV-coinfected patients should, therefore, include close consideration and management of patients' subjective experience with treatments to reduce the burden of HCV-associated fatigue.
Published: 2007
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19. Epidemiological, clinical, virological features of hepatitis B newly diagnosed in 2011 in Marseille University hospitals, southeastern France

Author: Sahada, Moussa, Souleymane, Brah, Philippe, Parola, René, Gerolami, Marc, Gamerre, Léon, Boubli, Jean-Marie, Ruiz, Isabelle, Ravaux, Saada, Mokhtari, Julien, Mancini, Marie-Hélène, Romera, Anne, Motte, Catherine, Tamalet, and Philippe, Colson
Subjects: Adult, Male, Hepatitis B virus, Adolescent, Genotype, HIV Infections, Hospitals, University, Young Adult, Age Distribution, Hepatitis B, Chronic, Ethnicity, Humans, Hepatitis B Antibodies, Child, Aged, Retrospective Studies, Aged, 80 and over, Hepatitis B Surface Antigens, Coinfection, Infant, Alanine Transaminase, gamma-Glutamyltransferase, Middle Aged, Hepatitis C, Child, Preschool, Female, France
Abstract: Hepatitis B virus (HBV) infection is a public health problem. In France, 0.68% of adults are chronically infected. We aimed to describe the epidemiological, virological and clinical characteristics of HBV infections newly diagnosed in 2011 in University hospitals of Marseille, the second largest French city. HBV serology was performed for 18,130 sera from 15,744 patients. A total of 167 patients were newly-diagnosed with HBV based upon the detection of hepatitis B surface antigen and anti-hepatitis B core antibodies. Clinico-epidemiological features were analyzed for 78 patients. Patients included a majority of men (59%), women being significantly younger with a mean age of 36 ± 17 versus 43.5 ± 16.2 years (P = 0.009). Country of birth was available for 52 patients and 35% of them originated from sub-Saharan Africa. Levels of the liver biological parameters were significantly lower in women compared to men, in whom mean alanine aminotransferase and gammaglutamyl transferase levels were 24 ± 39 versus 37 ± 36 IU/l (P = 0.0001) and 20 ± 20 versus 51 ± 53 IU/l (P = 0.0001), respectively. Co-infections with hepatitis C and human immunodeficiency viruses were found in 5% and 6% of the patients, respectively. HBV DNA was detectable in 90% of the HBeAg-negative patients. In addition, there was a positive correlation between the HBsAg titer and the HBV DNA level (P = 0.001). Genotype D was the most common HBV genotype and was found in 53% of the patients tested, followed by genotype E (21%). HBV remains a major concern with a slightly greater number of new diagnoses than in 2004. HBV genetic diversity was substantial in the present cohort.
Published: 2015

20. Diversity of 1,213 hepatitis C virus NS3 protease sequences from a clinical virology laboratory database in Marseille university hospitals, southeastern France

Author: Hind, Hajji, Sarah, Aherfi, Anne, Motte, Isabelle, Ravaux, Saadia, Mokhtari, Jean-Marie, Ruiz, Isabelle, Poizot-Martin, Christian, Tourres, Natacha, Tivoli, René, Gérolami, Catherine, Tamalet, and Philippe, Colson
Subjects: Male, Genotype, Genotyping Techniques, Molecular Sequence Data, Mutation, Missense, Genetic Variation, Sequence Homology, Hepacivirus, Sequence Analysis, DNA, Middle Aged, Viral Nonstructural Proteins, Hepatitis C, Hospitals, University, Drug Resistance, Viral, Cluster Analysis, Humans, Female, France, Phylogeny
Abstract: Infection with hepatitis C virus (HCV) represents a major public health concern worldwide. Recent therapeutic advances have been considerable, HCV genotype continuing to guide therapeutic management. Since 2008, HCV genotyping in our clinical microbiology laboratory at university hospitals of Marseille, Southeastern France, has been based on NS3 protease gene population sequencing, to allow concurrent HCV genotype and protease inhibitor (PI) genotypic resistance determinations. We aimed, first, to analyze the genetic diversity of HCV NS3 protease obtained from blood samples collected between 2003 and 2013 from patients monitored at university hospitals of Marseille and detect possible atypical sequences; and, second, to identify NS3 protease amino acid patterns associated with decreased susceptibility to HCV PIs. A total of 1,213 HCV NS3 protease sequences were available in our laboratory sequence database. We implemented a strategy based on bioinformatic tools to determine whether HCV sequences are representative of our local HCV genetic diversity, or divergent. In our 2003-2012 HCV NS3 protease sequence database, we delineated 32 clusters representative of the majority HCV genetic diversity, and 61 divergent sequences. Five of these divergent sequences showed less than 85% nucleotide identity with their top GenBank hit. In addition, among the 294 sequences obtained in 2013, three were divergent relative to these 32 previously delineated clusters. Finally, we detected both natural and on-treatment genotypic resistance to HCV NS3 PIs, including a substantial prevalence of Q80K substitutions associated with decreased susceptibility to simeprevir, a second generation PI.
Published: 2015

21. A multifaceted intervention designed to improve medical management of moderate to advanced chronic kidney disease in HIV-infected patients: a cluster randomised trial

Author: P Brazille, Johan Chanal, N. de Castro, B. Lefebvre, Sophie Abgrall, N Petit, M Marcou, Pascal Pugliese, A Parrot, F Meier, Yazdan Yazdanpanah, A Signori-Schmuck, Hana Selinger-Leneman, Pierre Delobel, F Touam, A Cros, Claire Rouzaud, Philippe Bossi, J. P. Faller, Jean-Marc Mauboussin, Faiza Ajana, V Perronne, V Chambrin, Olivier Lortholary, Laurent Alric, V. Gendrin, C Sautron, K Benhadj, H Gil, C Lascoux, F Raffi, JE Kahn, Michel Vidal, J. J. Laurichesse, O Ruyer, F Brunel, Pascal Chavanet, J. Durant, J. M. Chapplain, T. Perpoint, D Blanc, S Casanova, Frédéric Méchaï, P Poubeau, M Benomar, David Zucman, P Fischer, H Fischer, V Ronat, D Coban, Elisabeth Rouveix, H. Berthé, E Roveix, Corinne Isnard-Bagnis, Aurélie Fillion, P Loulergue, Jennifer M. Rohan, Isabelle Ravaux, Catherine Michel, C Faudon, Jacques Gilquin, J. M. Livrozet, Christian Chidiac, G Wartel, Patricia Enel, G. Beck-Wirth, I Prade, O. Derradji, Jean-Paul Viard, Cécile Goujard, R Cohen Valensi, M Batard, Jean-Luc Meynard, G Camuset, Jacques Cadranel, Christian Pradier, S Gohier, Jean-François Bergmann, Francis Barin, D. Makhloufi, Philippe Gerhardt, A Canestri, Lionel Piroth, S Greffe, N Biezunski, C Bolliot, L Toko, G Mboungou, Jérôme Moreau, Valérie Potard, H Masson, Eric Rosenthal, Jacques Reynes, André Cabié, Gilles Pialoux, P Granet Brunello, F Durand, Véronique Obry-Roguet, Jade Ghosn, V Walter, P Gazalet, O Boulat, P M Girard, A Ménard, M. Môle, G Martin Blondel, M Hamidi, C Lupin, P Druart, Sophie Matheron, Catherine Chirouze, P. De Truchis, Laurent Cotte, P. Del Giudice, Caroline Dupont, Anne Frésard, C Jung, V Payssan, M Saidani, C. Chesnel, Véronique Joly, S Abgrall, B Wifaq, Bruno Hoen, I Fabre, E Pannier Metzger, M Beyrne, Christian Rabaud, C. Gaud, Pierre Durieux, S Makhloufi, Eric Billaud, Jean-Marc Lacombe, T Akpan, PY Dides, Dominique Mathez, V Delcey, P. Sellier, A Naqvi, Amanda Lopes, Laurent Hustache-Mathieu, C Bartoli, V Marcou, Murielle Mary-Krause, Elisabeth Botelho-Nevers, K Samar, Hervé Tissot-Dupont, M Ruquet, Laurence Weiss, Boue F, Philippe Morand, I Lamaury, L Meddeb, Nadia Valin, M Delestan, N. Jacquemet, N Méaux-Ruault, A Gergely, M. Blanc, M Sordage, L Sutton, Dominique Costagliola, V Thomas, PH Consigny, G Cessot, C Le Jeunne, A Freire Maresca, A Greder Belan, Jean-Pierre Morini, G Astier, D. Martin, Pierre-Marie Roger, E Bourzam, G Melica-Gregoire, Nicolas Vignier, B. Taverne, P. Leclercq, M. Sebire, A Adda, A Meybeck, MG Lebrette, André Boibieux, T. Allegre, Nicolas Dupin, M. Parrinello, S Roussin-Bretagne, Christine Jacomet, Laurence Gérard, Jean Deleuze, A S Ritleng, M Raho-Moussa, Marialuisa Partisani, Daniel Vittecoq, M André, Albert Sotto, Pierre Tattevin, S Marque Juillet, Antolini-Bouvenot, Sylvie Abel, M Guivarch, S Lang, P. Honoré, A Lavolé, C. Majerholc, Gilles Hittinger, Marguerite Guiguet, N Magy-Bertrand, Alain Lafeuillade, Elina Teicher, JM Riou, B Slama, Sophie Grabar, N. Viget, P Genet, Faouzi Souala, X. Duval, Lise Cuzin, B. Marchou, D Bonnabel, O. Faucher, S Stegmann, C Veyssier-Belot, I Perbost, K Bourdic, Cédric Arvieux, V Masse, L Pellissier, Giovanna Melica, S Lariven, S Chebrek, H Zerazhi, G Philip, Hugues Melliez, D Marigot-Outtandy, Mark Bloch, E Fourn, E. Billaud, J. Gerbe, C Dhiver, Benveniste O, Delphine Bonnet, D. Quinsat, V Daneluzzi, E Haustraete, P Guet, Dominique Salmon, Christophe Rioux, E Duvallon, E. Mortier, G Borgherini, P Goubin, D. Costagliola, Renaud Verdon, M J Soavi, A. Simon, F Zeng, Aba Mahamat, Mathieu Nacher, P Colardelle, F Granier, E Hope-Rapp, M. Poupard, V Vanticlke, M P Bouillon, C Clavel, Ml Lucas, P. Chiarello, Fabienne Caby, G Jacques, Juliette Pavie, MP Pietri, Blandine Denis, P. Miailhes, Sylvie Bregigeon, B Mouchet, Marie-Aude Khuong-Josses, P Thibaut, Antoine Rachas, H Laurichesse, Sylvie Dargere, C Godin Collet, Odile Launay, Jacques Gasnault, Clotilde Allavena, C. Dumont, Isabelle Poizot-Martin, M. Ratajczak, A. Maignan, A Brunon-Gagneux, Olivier Epaulard, A Therby, Tristan Ferry, E Reimann, Laurent Boyer, Régine Doncesco, Eric Cua, K Risso, Claudine Duvivier, Leila Adriouch, W. Rozenbaum, Christian Perronne, R Sambuc, I Kansau, J. F. Faucher, Florence Huber, J. M. Ruiz, Ma Khuong, Sandrine Pierre-François, Laurence Lievre, G Breton, J.-M. Molina, C. Tomei, M Guiguet, A Proust, L Fonquernie, D. Bornarel, David Rey, Isabelle Rouanet, C Guglielminotti, Jérôme Tourret, V. Reliquet, A Palacin, C Cheneau, Eric Oksenhendler, P Féret, B Montoya, V Lambry, N Hall, Jean-Daniel Lelièvre, Delphine Croisier, C Ricaud, M Ptak, Pierre Couppié, S Mokhtari, Y Welker, R Rodet, T May, Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Ecologie et Evolution des Microorganismes (EEM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS, 2009, the French Ministry of Health, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Ecologie et Evolution des Microorganismes ( EEM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, and Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]
Subjects: Male, Microbiology (medical), Nephrology, medicine.medical_specialty, HIV Infections, urologic and male genital diseases, law.invention, Randomized controlled trial, law, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Internal medicine, Humans, Medicine, Cluster randomised controlled trial, Aged, business.industry, Guideline, Middle Aged, medicine.disease, HIV infection, Confidence interval, 3. Good health, clinical practice, Clinical trial, Treatment Outcome, Infectious Diseases, Blood pressure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Practice Guidelines as Topic, Physical therapy, cluster randomized trial, Kidney Failure, Chronic, Female, business, chronic kidney disease, Glomerular Filtration Rate, Kidney disease
Abstract: International audience; Background - Chronic kidney disease (CKD) is frequent in individuals infected with human immunodeficiency virus (HIV). Progression to end-stage renal disease can be slowed by appropriate medical management. Methods - To assess whether active promotion of guidelines improves CKD management, we conducted a cluster randomized controlled trial within the French Hospital Database on HIV (FHDH-ANRS CO4). We randomized 46 centers participating in the FHDH to either simple information on guideline availability or active promotion with a multifaceted and repeated intervention comprising reminders and audit feedback and targeting of local opinion leaders carried out between April 2009 and April 2010. Outcome measure was CKD management adequacy assessed before and 2 years after the beginning of the intervention in HIV-infected patients with moderate to severe CKD. CKD management was considered adequate in case of referral to a nephrologist or if proteinuria, blood pressure, low-density lipoprotein cholesterol level, and glycemia had been measured during the previous year and medications had been prescribed when necessary. Results - Three hundred six patients were enrolled, of whom 238 (78%) completed the 2 years of follow-up. During the study period, the percentage of patients receiving adequate CKD management improved from 64.1% to 70.4% (+6.3%) in the active arm and from 68.3% to 75.6% (+7.3%) in the control arm (adjusted mean difference, -0.7 percentage points [95% confidence interval: -9.2 to 7.9]; P = .95). The biggest impact of active promotion was on the management of proteinuria and blood pressure. Conclusions - Adequate compliance with CKD management guidelines improved slightly between 2009 and 2011, with no difference between the simple information and active promotion arms. Clinical trials registration - CCTIRS 10.150 and CNIL DR-2010-379.
Published: 2015
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22. Genomic and phylogenetic analysis of hepatitis C virus isolates: A survey of 535 strains circulating in southern France

Author: Christian Tourres, Nouara Yahi, Isabelle Ravaux, Isabelle Poizot-Martin, Hervé Tissot-Dupont, Catherine Tamalet, Mireille Henry, Philippe Colson, Danielle Botta, and Natacha Tivoli
Subjects: Adult, Male, Adolescent, Genotype, Sequence analysis, Hepatitis C virus, Hepacivirus, Genome, Viral, Viral Nonstructural Proteins, medicine.disease_cause, Polymerase Chain Reaction, chemistry.chemical_compound, Flaviviridae, Virology, medicine, Humans, NS5B, Phylogeny, Aged, Aged, 80 and over, biology, Phylogenetic tree, Reverse Transcriptase Polymerase Chain Reaction, Sequence Analysis, DNA, Hepatitis C, Chronic, Middle Aged, biology.organism_classification, Subtyping, Infectious Diseases, chemistry, Female, France, 5' Untranslated Regions
Abstract: The present study examines the distribution of Hepatitis C virus (HCV) genotypes in Marseille, France in 2001-2002 and evaluates the efficiency of two in house direct sequence PCR protocols based on 5'NC analysis or NS5B analysis. By 5'NC sequencing, the distribution of 535 HCV strains derived from patients attending gastroenterology and AIDS referral centers, or dialysis units was as follows: 33% were infected by genotype 1a; 26% by 1b; 7% by 2; 22% by 3a; 10.7% by 4. In univariate analysis, HCV distribution was associated with age and source of infection, whereas in multivariate analysis only injecting drug use was an independent determinant for genotype distribution. Among the 535 specimens submitted to 5'NC direct sequencing, 18% could not be classified accurately into subtypes. A subset of 187 samples was amplified efficiently and sequenced by targeting the NS5B region of the viral genome. The two methods yielded concordant results in 70% of cases. Specimens unsubtypeable or misclassified most frequently by 5'NC analysis were type 1b and subtypes 2a/2c and 4a/4c. The data show that 5'NC direct sequence analysis is a sensitive method to identify genotypes in all cases, but that it can lead to subtyping misclassification (in particular, subtype 1b and 1a) or doubtful results (in particular subtypes 2a/2c and 4a/4c). Conversely, NS5B direct sequence assay, based on phylogenetic analysis, allowed better discrimination between subtypes. These two approaches are complementary and should be made available in clinical laboratories to ensure a reliable survey of HCV strains.
Published: 2003
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23. High Indinavir Cmin Is Associated With Higher Toxicity in Patients on Indinavir-Ritonavir 800/100 mg Twice-Daily Regimen

Author: A Durand, Bruno Lacarelle, Hervé Gallais, Caroline Solas, Isabelle Ravaux, Jean-Albert Gastaut, Isabelle Poizot-Martin, and Stéphanie Basso
Subjects: Adult, Male, medicine.medical_specialty, viruses, HIV Infections, Indinavir, Pharmacology, Gastroenterology, Cmin, immune system diseases, Internal medicine, medicine, Humans, Protease Inhibitors, heterocyclic compounds, Pharmacology (medical), Trough Concentration, In patient, Retrospective Studies, Ritonavir, business.industry, virus diseases, biochemical phenomena, metabolism, and nutrition, Regimen, Infectious Diseases, Toxicity, HIV-1, Drug Therapy, Combination, Female, Indinavir+Ritonavir, business, medicine.drug
Abstract: We retrospectively evaluated the incidence of side effects and treatment intervention according to indinavir trough concentration in 63 patients taking indinavir-ritonavir 800/100 mg twice daily. Median indinavir trough concentration was 1446 ng/mL at 800/100 mg twice daily associated with 60% of measured toxicity. Among patients with indinavir trough concentration500 ng/mL, 46 of 49 had a dosage adjustment and 17 have had more than two dosage adjustments. The primary reason for dosage adjustment was toxicity in 69% (43 cases). Renal and cutaneous toxicity were predominant.After dosage adjustment, median indinavir trough concentration was 459 ng/mL, which was associated with 8% of toxicity. Trough concentrations500 ng/mL were correlated with increased toxicity (p.05) and more treatment intervention (p =.02). In conclusion, achievement of indinavir trough concentrations500 ng/mL appears to be safe, and an optimal concentration range for indinavir trough concentration could be 150 to 500 ng/mL for an indinavir-ritonavir twice daily regimen.
Published: 2002
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24. Hepatitis C virus NS3 protease genotyping and drug concentration determination during triple therapy with telaprevir or boceprevir for chronic infection with genotype 1 viruses, southeastern France

Author: Sarah, Aherfi, Caroline, Solas, Anne, Motte, Jacques, Moreau, Patrick, Borentain, Saadia, Mokhtari, Danielle, Botta-Fridlund, Catherine, Dhiver, Isabelle, Portal, Jean-Marie, Ruiz, Isabelle, Ravaux, Sylvie, Bregigeon, Isabelle, Poizot-Martin, Andreas, Stein, René, Gérolami, Philippe, Brouqui, Catherine, Tamalet, and Philippe, Colson
Subjects: Adult, Male, Genotype, Proline, Mutation, Missense, Interferon-alpha, Hepacivirus, Hepatitis C, Chronic, Middle Aged, Viral Load, Viral Nonstructural Proteins, Antiviral Agents, Hospitals, University, Plasma, Young Adult, Amino Acid Substitution, Drug Resistance, Viral, Ribavirin, Humans, Drug Therapy, Combination, Female, France, Treatment Failure, Oligopeptides
Abstract: Telaprevir and boceprevir, the two first hepatitis C virus (HCV) NS3 protease inhibitors (PIs), considerably increase rates of sustained virologic response in association with pegylated interferon and ribavirin in chronic HCV genotype 1 infections. The 30 first patients treated by telaprevir or boceprevir including anti-HCV therapies since 2011 in Marseille University hospitals, France, were monitored. HCV loads and plasmatic concentrations of telaprevir and boceprevir were determined on sequential blood samples. HCV NS3 protease gene population sequencing was performed at baseline of treatment and in case of treatment failure. Fifteen patients (including 7 co-infected with HIV) received telaprevir and the other 15 patients (including 4 co-infected with HIV) received boceprevir. At baseline, HCV NS3 protease from six patients harbored amino acid substitutions associated with PI-resistance. Treatment failure occurred at week 12 for 7 patients. Amino acid substitutions associated with PI-resistance were observed in six of these cases. HCV NS3 R155K and T54A/S mutants, all of genotype 1a, were found from four patients. Median (interquartile range) plasma concentrations were 3,092 ng/ml (2,320-3,525) for telaprevir and 486 ng/ml (265-619) for boceprevir. For HIV-HCV co-infected patients, median concentrations were 3,162 ng/ml (2,270-4,232) for telaprevir and 374 ng/ml (229-519) for boceprevir. Plasma drug concentration monitoring revealed undetectable concentrations for two patients at week 4, and probable non-adherence to therapy for another patient. These findings indicate that routine HCV NS3 protease sequencing and plasma PI concentration monitoring might be helpful to characterize cases of therapy failure, at a cost dramatically low compared to that of anti-HCV therapy.
Published: 2014

25. TT virus infection: prevalence of elevated viraemia and arguments for the immune control of viral load

Author: Philippe de Micco, Xavier de Lamballerie, Philippe Biagini, Mhammed Touinssi, Catherine Tamalet, Catherine Dhiver, Yvon Berland, Houssam Attoui, Isabelle Ravaux, Bernard Vialettes, and Pierre Gallian
Subjects: Adult, Male, Blood Donors, HIV Infections, Biology, Polymerase Chain Reaction, Sensitivity and Specificity, Virus, law.invention, Diabetes Complications, Immunocompromised Host, Renal Dialysis, law, Virology, Immunopathology, Prevalence, medicine, Humans, Viremia, Immunodeficiency, Polymerase chain reaction, Torque teno virus, Middle Aged, Viral Load, medicine.disease, DNA Virus Infections, CD4 Lymphocyte Count, Infectious Diseases, DNA, Viral, Immunology, HIV-1, Female, Viral disease, Immunocompetence, Viral load, Nested polymerase chain reaction
Abstract: The most recent polymerase chain reaction (PCR) detection protocols for the TT virus (TTV) permit one to identify the presence of viral DNA in the serum of a majority of healthy individuals, in the absence of any particular risk factor. This is in contrast with previous epidemiological studies that reported a higher prevalence of TTV infection in populations such as haemodialysis patients (HD), haemophiliacs, intravenous drug users or diabetics.To show that these discrepant results were due to the different sensitivity (number of viral copies detected) of the detection protocols used in initial and more recent epidemiological studies.We designed a standardised primary PCR assay that detects only viraemia5x10(3) to 5x10(4) copies/ml for genotypes 1, 2 and 3, and compared the results of this test with those of a nested PCR assay which is 100-fold more sensitive. Viraemia5x10(3) to 5x10(4) copies/ml were statistically more frequent in HD patients (54.3%), diabetics (54.7%), and HIV-infected patients with CD4 cells200/mm(3) (69%) than in blood donors (37%) or HIV-infected patients with CD4 cells500/mm(3) (33%).These data suggest a possible relationship between the prevalence of elevated viral loads and the level of immunocompetence of the populations studied, and therefore that of an immune control of TTV viraemia. This corroborates previous findings showing that the stimulation of the immune system by an interferon treatment was able to clear TTV viraemia.
Published: 2001
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26. Drug interactions in elderly individuals with the human immunodeficiency virus

Author: Albert Darque, Nathalie Petit, Frédérique Retornaz, Isabelle Ravaux, and Patricia Enel
Subjects: Drug, Male, business.industry, media_common.quotation_subject, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Virology, Anti-Retroviral Agents, medicine, Polypharmacy, Humans, Drug Interactions, Female, Prospective Studies, Geriatrics and Gerontology, business, media_common, Aged
Published: 2012

27. Pharmacokinetic Interaction Between Lopinavir/r and Amprenavir in Salvage Therapy

Author: Isabelle Poizot-Martin, Stéphanie Basso, Isabelle Ravaux, Caroline Solas, Bruno Lacarelle, Anne-Marie Quinson, J. Bacconier, and Alain Durand
Subjects: Adult, Male, Anti-HIV Agents, Salvage therapy, Pyrimidinones, Pharmacology, Lopinavir, Amprenavir, Humans, Medicine, Drug Interactions, Pharmacology (medical), Furans, Retrospective Studies, Salvage Therapy, Acquired Immunodeficiency Syndrome, Sulfonamides, business.industry, Middle Aged, Infectious Diseases, HIV-1, Female, Carbamates, business, Pharmacokinetic interaction, medicine.drug
Published: 2002
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28. Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir

Author: M. Strobel, S. Herson, J. M. Lang, C. Picard-Dahan, Bruno Hoen, Dominique Salmon, Eric Billaud, P. Elinger, A. Laffeuillade, J. L. Touraine, M. Bentata, Renaud Verdon, Christine Katlama, P. Honoré, Claudine Duvivier, Sophie Abgrall, E. Arlet-Suau, K. Aleksandrowicz, Christian Trepo, Pascal Pugliese, T. Allegre, Jacques Gasnault, Jean-Pierre Daurès, C. Gaud, Xavier Duval, Emilie Lanoy, Anne Frésard, D. Quinsat, Valérie Potard, Jean-Pierre Clauvel, Jean-Michel Molina, J. M. Livrozet, P. Lecercq, B. Crickx, Elisabeth Bouvet, Hervé Tissot-Dupont, Y. Yasdanpanah, H. Laurichesse, M. Nezri, Christian Pradier, M. Brosseau, M. F. Maître, N. Desplanque, J. P. Delmont, Sophie Matheron, F. Lucht, D. Tisne-Dessus, Dominique Costagliola, François Raffi, P. De Truchis, Pierre Dellamonica, M. F. Thiercelin Legrand, Jean-Marc Lacombe, J. Soubeyrand, A. Simon, Cécile Goujard, E. Mortier, Isabelle Poizot-Martin, Hana Selinger-Leneman, Isabelle Ravaux, C. Jung, P. Sellier, Jean-Paul Viard, Christian Michelet, T. May, I. Auperin, J. L. Ecobichon, Valérie Martinez, J. P. Faller, P. Granet-Brunello, François Caron, M. Contant, Jean-Luc Berger, Laurence Lievre, Jacques Cadranel, Marie-Caroline Meyohas, C. Mayaud, Jacques Moreau, P. Choutet, André Boibieux, Patricia Enel, G. Beck-Wirth, Laurence Gérard, R. Pradinaud, Elisabeth Rouveix, M. Sobesky, H. Berthé, Francis Barin, J. M. Decazes, A. Galinier, Jacques Reynes, R. Cohen-Valensi, Patrick Yeni, T. Bommenel, Jean-Paul Stahl, C. Bazin, Vincent Jeantils, Pierluigi Blanc, Laurence Weiss, Daniel Vittecoq, Laurent Cotte, Pierre Tattevin, G. Pontonnier, David Rey, Sophie Grabar, Christian Rabaud, M. Diemer, D. Peyramond, Marguerite Guiguet, Pierre-Marie Girard, F. Pilorgé, S. Chapadaud, Jacques Gilquin, N. Jacquemet, Odile Launay, C. Chandemerle, P. Lesprit, Aba Mahamat, B. Taverne, F. Borsa-Lebas, G. Lepeu, Pascal Chavanet, Juliette Pavie, F. Gourdon, Jean-Albert Gastaut, Jean-François Delfraissy, Odile Picard, R. Fior, Alain Goudeau, P. Fraisse, M. A. Khuong, Lise Cuzin, Murielle Mary-Krause, L. Roudière, Boue F, V. Salomon, J. P. Esterni, N. Viget, D. Bonnet-Montchardon, Cédric Arvieux, André Cabié, Gilles Pialoux, François Bricaire, Jean-Luc Meynard, S. Tassi, Patrice Massip, Caroline Dupont, Christine Burty, F. Retornaz, D. Mechali, G. Rémy, Anne-Sophie Lascaux, L. Pelissier, J. M. Ruiz, F. Bissuel, Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Biotherapie - AP-HP (cochin - Pasteur), Institut National de la Santé et de la Recherche Médicale (INSERM), Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôtel-Dieu, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu, Service d'immunologie clinique [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service des maladies infectieuses, Hopital Andree Rosemond, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cytokines, chimiokines et immunopathologie, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Public Health Department, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), FHDH-ANRS CO4, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA)
Subjects: Cyclopropanes, Male, HIV Infections, boosted protease inhibitor, MESH: Antiretroviral Therapy, Highly Active, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Abacavir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, MESH: Anti-HIV Agents, MESH: Nevirapine, MESH: Cohort Studies, MESH: Treatment Outcome, 0303 health sciences, MESH: HIV, Hazard ratio, virus diseases, MESH: HIV Infections, Viral Load, switch, 3. Good health, Infectious Diseases, Treatment Outcome, MESH: Dideoxynucleosides, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Alkynes, MESH: Benzoxazines, HIV/AIDS, Female, MESH: Viral Load, Viral load, medicine.drug, Microbiology (medical), Cart, Adult, medicine.medical_specialty, Efavirenz, Nevirapine, Anti-HIV Agents, 03 medical and health sciences, Internal medicine, parasitic diseases, medicine, cohort study, Humans, MESH: HIV Protease Inhibitors, Pharmacology, MESH: Humans, 030306 microbiology, business.industry, HIV, MESH: Adult, HIV Protease Inhibitors, Virology, Confidence interval, Dideoxynucleosides, MESH: Male, MESH: Prospective Studies, Benzoxazines, Regimen, chemistry, business, MESH: Female, virological effectiveness
Abstract: International audience; OBJECTIVES: To compare virological effectiveness in patients who continued on a virologically successful first-line boosted protease inhibitor (PI)-containing combination antiretroviral therapy (cART) regimen or who switched to a PI-free cART including efavirenz, nevirapine or abacavir. METHODS: From the French Hospital Database on HIV, we selected 439 patients with undetectable viral load (VL) on a first-line boosted PI-containing cART regimen who switched to a PI-free combination including efavirenz, nevirapine or abacavir. Each of these patients was matched with three patients who continued to take their first-line cART regimen, on the basis of gender, age, CD4 cell count, VL, date of cART initiation and the duration of VL undetectability. Time to virological failure (VF) was analysed with Kaplan-Meier curves and Cox models. RESULTS: The 12 month probabilities of VF were 3.7% and 5.7% in non-switch and switch patients, respectively, and 3.9%, 7.2% and 9.0% in patients switching to efavirenz-, nevirapine- and abacavir-containing cART, respectively. After adjustment, only patients switching to abacavir-containing cART had a higher risk of VF than non-switch patients (adjusted hazard ratio, 1.99; 95% confidence interval, 1.05-3.79). CONCLUSIONS: Switching from a virologically successful first-line boosted PI-containing cART regimen to a non-nucleoside reverse transcriptase inhibitor-containing cART regimen containing either efavirenz or nevirapine is virologically safe, while switching to abacavir-containing cART should be avoided.
Published: 2011
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29. Antiretroviral therapy does not block the secretion of the human immunodeficiency virus tat protein

Author: Hervé Tissot-Dupont, Malika Mokhtari, Catherine Tamalet, Stephen A. Spector, Gilbert Baillat, Pascale Paul, Albert Darque, Philippe Brouqui, Corinne Brunet, Françoise Dignat-George, Andreas Stein, Herve Moreau, Catherine Dhiver, Grant R. Campbell, Isabelle Ravaux, Erwann Loret, and Sonia Mediouni
Subjects: Microbiology (medical), Adult, Male, Cellular immunity, Viral protein, Anti-HIV Agents, T cell, Enzyme-Linked Immunosorbent Assay, HIV Infections, Biology, medicine.disease_cause, medicine, Humans, Secretion, Longitudinal Studies, B cell, Pharmacology, General Medicine, Middle Aged, Virology, medicine.anatomical_structure, Immunoglobulin G, Immunology, Gene Products, tat, HIV-1, Molecular Medicine, Female, Viral load, CD8, Blood sampling
Abstract: Tat is a viral protein secreted from HIV infected cells and extra cellular Tat is suspected to prevent destruction of HIV infected cells from cells of the cellular immunity. The effect of anti retroviral therapy (ART) on Tat secretion has never been investigated. In this study, we tested for antibody reactivity against Tat variants representative of the main HIV subtypes in HIV positive patients receiving ART with undetectable viral loads ( < 40 copies/mL) over the course of one year with a blood sampling every three months. For each of theses five blood sampling, an average of 50 % of patients had Anti-Tat IgG, it turned out that 86% of patients could recognize Tat at least in one blood sampling during the course of the study. Amazingly, anti-Tat IgG appeared and/or disappeared in 66 % of patients. Only 20% had anti-Tat IgG remaining persistently while 14% were consistently without anti Tat IgG in the five blood sampling. No significant correlation was found between anti-Tat IgG and CD4+ T cell, CD8+ T cell and B cell counts revealing the incapacity of these anti Tat IgG to neutralize extra cellular Tat. Interestingly the absence and then the appearance of anti-Tat IgG in patients suggest the presence of HIV infected cells in the blood that may constitute a significant reservoir of HIV infected cells. As a conclusion antiretroviral therapy does not block the secretion of Tat and may explain why HIV infected cells can survive in spite of an effective ART treatment.
Published: 2011

30. Self-reported side effects in buprenorphine and methadone patients receiving antiretroviral therapy: results from the MANIF 2000 cohort study

Author: M Patrizia, Carrieri, Perrine, Roux, Julien, Cohen, Isabelle, Ravaux, Pierre, Dellamonica, Camelia, Protopopescu, Bruno, Spire, and Andrew, Rosenblum
Subjects: Male, Depression, Pain, HIV Infections, Opioid-Related Disorders, Health Services Accessibility, Buprenorphine, Medication Adherence, Substance Withdrawal Syndrome, Cohort Studies, Treatment Outcome, Anti-Retroviral Agents, Opiate Substitution Treatment, Humans, Female, France, Longitudinal Studies, Self Report, Substance Abuse, Intravenous, Attitude to Health, Methadone
Abstract: The aim of the study was to investigate the relationship between methadone and buprenorphine treatment and self-reported symptoms in HIV-infected opioid dependent individuals receiving antiretroviral therapy (ART).Longitudinal study.The French MANIF2000 cohort was used to compare self-reported symptoms in buprenorphine and methadone patients also receiving ART.We selected individuals receiving ART and OAT (342 visits among 106 patients).Symptoms were self-reported using a list of 14 symptoms (e.g. nausea, fatigue, fever) perceived during the previous 4 weeks, including three painful symptoms (abdominal or muscular pain, headaches). A two-step Heckman approach enabled us to account for the non-random assignment of OAT: a probit model identified predictors of starting either buprenorphine or methadone. A Poisson regression based on generalized estimating equations (GEE) was then used to identify predictors of the number of symptoms while adjusting for the non-random assignment of OAT.The median (interquartile range) number of symptoms was 4 (1-6) and 2 (1-6) among buprenorphine and methadone patients, respectively. After adjustment for non-random assignment of OAT type, depressive and opioid withdrawal symptoms, anxiolytics consumption and daily cannabis use, methadone patients were more likely to report a lower number of symptoms than those receiving buprenorphine.Methadone patients on ART report fewer symptoms than buprenorphine patients on ART under current treatment conditions in France. Further experimental research is still needed to identify an OAT-ART strategy which would minimize the burden of self-reported symptoms and potential interactions, while assuring sustainability and response to both treatments.
Published: 2010

31. Influence of the HCV subtype on the virological response to pegylated interferon and ribavirin therapy

Author: Florence, Legrand-Abravanel, Philippe, Colson, Hélène, Leguillou-Guillemette, Laurent, Alric, Isabelle, Ravaux, Françoise, Lunel-Fabiani, Magali, Bouviers-Alias, Pascale, Trimoulet, Marie Laure, Chaix, Christophe, Hézode, Juliette, Foucher, Hélène, Fontaine, Anne-Marie, Roque-Afonso, Michèle, Gassin, Evelyne, Schvoerer, Catherine, Gaudy, Bruno, Roche, Michel, Doffoël, Louis, D'Alteroche, Sophie, Vallet, Yazid, Baazia, Bruno, Pozzetto, Vincent, Thibault, Jean-Baptiste, Nousbaum, Dominique, Roulot, Henry, Coppere, Thierry, Poynard, Thierry, Poinard, Christopher, Payan, Jacques, Izopet, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire de virologie, Assistance Publique - Hôpitaux de Marseille (APHM), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service Médecine Interne et immunologie clinique [CHU Toulouse], Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service des maladies infectieuses, Service de bactériologie, virologie, hygiène [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de virologie et d'immunologie biologique, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire de Virologie, CHU Strasbourg, Service de bactériologie-virologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépato-gastroentérologie, CHU Strasbourg-Hopital Civil, Service de gastro-entérologie, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Laboratoire de Parasitologie et Mycologiede [CHRU Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de bactériologie-Virologie-Hygiène [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de gastroenterologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Peer, Hal, 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), CHU Saint Etienne, Service de virologie [CHU Pitié-Salpêtrière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Virologie [Toulouse], CHU Toulouse [Toulouse], Service de médecine interne, CHU Necker - Enfants Malades [AP-HP], Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Physiopathologie Toulouse Purpan (ex IFR 30 et IFR 150), Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR30-IFR150-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance Publique - Hôpitaux de Marseille ( APHM ), CHU Angers, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse, Centre hospitalier universitaire de Nantes ( CHU Nantes ), Hôpital Bretonneau-CHRU Tours, Centre hépato-biliaire ( CHB ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHRU Tours, Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne-Université Paris 13 ( UP13 ), Service de virologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Jean Verdier, Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière], and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP]
Subjects: Adult, Male, Hepacivirus, Hepatitis C virus, Genome, Viral, Interferon alpha-2, medicine.disease_cause, Antiviral Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Interferon, Pegylated interferon, Virology, Ribavirin, Humans, Medicine, 030212 general & internal medicine, Univariate analysis, biology, business.industry, Genetic Variation, Interferon-alpha, Hepatitis C, Hepatitis C, Chronic, Middle Aged, biology.organism_classification, medicine.disease, Recombinant Proteins, 3. Good health, Treatment Outcome, Infectious Diseases, chemistry, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, business, Viral load, medicine.drug
Abstract: International audience; The hepatitis C virus genotype is considered to be the most important baseline predictor of a sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin. The influence of the subtype on the sustained virological response was investigated in patients infected with genotypes 1, 4, 5 or 6. This study was done on 597 patients with chronic hepatitis C who were given pegylated interferon and ribavirin for 48 weeks. The overall rate of sustained virological response in the 597 patients was 37.8%. Univariate analysis indicated that the sustained virological response of patients infected with subtype 1b (39%) tended to be higher than that of patients infected with subtype 1a (30.6%; p=0.06) and it was similar to those patients infected with subtypes 4a (51.3%, p=0.12) or 4d (51.7%, p=0.16). Multivariate analysis indicated that five factors were independently associated with sustained virological response: the age (OR 0.97; 95% CI = 0.95-0.99), absence of cirrhosis (OR: 2.92; 95% CI = 1.7-5.0; p
Published: 2009
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32. Retention in opioid substitution treatment: a major predictor of long-term virological success for HIV-infected injection drug users receiving antiretroviral treatment

Author: M. Patrizia Carrieri, Pierre Dellamonica, Isabelle Poizot-Martin, Perrine Roux, Bruno Spire, Julien Cohen, and Isabelle Ravaux
Subjects: Microbiology (medical), Adult, Male, Narcotics, medicine.medical_specialty, HIV Infections, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Antiretroviral Therapy, Highly Active, medicine, Humans, Sida, biology, business.industry, fungi, Odds ratio, biology.organism_classification, medicine.disease, Confidence interval, Surgery, Buprenorphine, Infectious Diseases, Treatment Outcome, Cohort, Patient Compliance, Female, business, Viral load, Methadone, medicine.drug
Abstract: Background The positive impact of opioid substitution treatment (OST) on opioid-dependent individuals with human immunodeficiency virus (HIV) infection is well documented, especially with regard to adherence to highly active antiretroviral therapy (HAART). We used the data from a 5-year longitudinal study of the MANIF 2000 cohort of individuals infected with HIV (as a result of injection drug use) and receiving HAART to investigate the predictors of long-term virological success. Design. Data were collected every 6 months from outpatient hospital services delivering HIV care in France. We selected all patients who were receiving HAART for at least 6 months (baseline visit) and who had indications for OST (ie, still dependent on opioids). We selected a total of 113 patients, accounting for a total of 562 visits for all the analyses. Methods Long-term virological success was defined as an undetectable viral load after at least 6 months on HAART. Retention in OST was defined as the time interval between the last initiation or reinitiation of OST during HAART follow-up and any given visit on OST. A mixed logistic model was used to identify predictors of long-term virological success. Results At baseline, 53 patients were receiving buprenorphine, 28 patients were receiving methadone, and 32 patients were not on OST. The median duration of OST was 25 months (range, 3-42 months). In the multivariate analysis, after adjustment for significant predictors of long-term virological success such as adherence to HAART and early virological response, retention in OST was associated with long-term virological success (odds ratio, 1.20 per 6-month increase; 95% confidence interval, 1.09-1.32). Conclusions Our study presents important evidence of the positive impact of retention in OST on HIV outcomes. Increasing access to OST based on a comprehensive model of care for HIV-infected patients who have indications for OST may foster adherence and ensure long-term response to HAART.
Published: 2009

33. The genotypic inhibitory quotient: a predictive factor of atazanavir response in HIV-1-infected treatment-experienced patients

Author: Bruno Lacarelle, Isabelle Ravaux, Philippe Colson, Jacques Moreau, Caroline Solas, Catherine Tamalet, and Isabelle Poizot-Martin
Subjects: Adult, Male, medicine.medical_specialty, Genotype, Pyridines, Atazanavir Sulfate, Drug resistance, Gastroenterology, Internal medicine, Drug Resistance, Viral, medicine, Humans, Pharmacology (medical), Trough Concentration, Sida, Acquired Immunodeficiency Syndrome, Receiver operating characteristic, biology, virus diseases, HIV Protease Inhibitors, biology.organism_classification, Atazanavir, CD4 Lymphocyte Count, Regimen, Infectious Diseases, Immunology, Mutation, HIV-1, Female, Viral load, Oligopeptides, medicine.drug
Abstract: OBJECTIVE To evaluate the predictive value of the genotypic inhibitory quotient (GIQ) on the atazanavir response in treatment-experienced HIV-1-infected patients. PATIENTS AND METHODS Thirty-six patients receiving an atazanavir-containing regimen were enrolled in the study. Atazanavir plasma concentrations were measured at month (M) 1, and genotype was performed at baseline. Virologic response was defined as a viral load or =1 log10. RESULTS The median numbers (range) of previous regimens, baseline protease inhibitors, and atazanavir resistance mutations were 8 (0 to 20), 3 (0 to 15), and 1 (0 to 10), respectively. The atazanavir-GIQ was associated with virologic response at M6, with a median value (range) of 365 (50 to 1172) in responder patients compared with 126 (23 to 1126) in nonresponders (P = 0.05). The cutoff value estimated for the atazanavir-GIQ was 183 (receiver operating characteristic curve test: 60% specificity, 74% sensitivity). Virologic response was achieved in 74% of patients with an atazanavir-GIQ >183 compared with only 26% of patients with an atazanavir-GIQ
Published: 2008

34. Impaired Anger Control as an Underappreciated Side Effect of Treatments for Chronic HCV Infection in HIV-HCV Coinfected Patients

Author: Marie Préau, Dominique S. Blanc, Maria Patrizia Carrieri, Bruno Spire, Fabienne Marcellin, Pierre Dellamonica, Isabelle Ravaux, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), ORS PACA, Aix-Marseille Université - Faculté de pharmacie (AMU PHARM), Aix Marseille Université (AMU), Service des maladies infectieuses, Centre Hospitalier Universitaire de Nice (CHU Nice)-University Hospital, Centre de Recherche Juridique (CRJ), Université de La Réunion (UR), Greps, Laboratoire, and Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)
Subjects: Male, Cross-sectional study, [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, Anger, Medical Records, Polyethylene Glycols, chemistry.chemical_compound, 0302 clinical medicine, Quality of life, Pegylated interferon, Surveys and Questionnaires, 030212 general & internal medicine, media_common, Gastroenterology, Hepatitis C, Anxiety Disorders, Recombinant Proteins, 3. Good health, Treatment Outcome, Anti-Retroviral Agents, Interferon, Female, France, medicine.symptom, medicine.drug, Adult, medicine.medical_specialty, media_common.quotation_subject, Interferon alpha-2, Irritability, Antiviral Agents, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Ribavirin, medicine, Humans, business.industry, HIV, Interferon-alpha, Hepatitis C, Chronic, medicine.disease, HIV/HCV coinfection, Cross-Sectional Studies, chemistry, Immunology, business, 030217 neurology & neurosurgery
Abstract: OBJECTIVE: To study the specific impact of treatments for chronic hepatitis C virus (HCV) infection on anger expression and control in adult patients coinfected with HIV and HCV receiving antiretroviral therapy. DESIGN: In 2005, a cross-sectional survey, collecting both clinical and sociobehavioral data, was conducted in two French clinical centers among adult patients coinfected with HIV and HCV. METHODS: Participants were asked to answer anonymously a self-administered questionnaire aimed at obtaining sociodemographic, clinical and behavioral characteristics including self-reported treatments’ side effects, quality of life (WHOQOL-HIV BREF), and irritability and anger (STAXI-2). Clinical characteristics were obtained from medical records. RESULTS: Among the 139 patients who were receiving antiretroviral therapy at the time of survey and who had complete self-reported data, 24 were being treated for their HCV infection, using either pegylated interferon (pegIFN) and ribavirin (RBV) or pegIFN alone. Control of anger was significantly lower among treated patients than among untreated ones (STAXI-2 anger control-out dimension median scores of 18.5 versus 23 respectively, P = 0.02). Sociodemographic and clinical characteristics did not differ significantly between these 2 groups. Control of angry feelings was significantly correlated with psychological and social relationship dimensions of quality of life. CONCLUSION: Treatment of HCV-HIV co-infected patients may require closer monitoring for anger control issues and adjustment of treatment as appropriate.
Published: 2008
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35. Self-reported fatigue and depressive symptoms as main indicators of the quality of life (QOL) of patients living with HIV and Hepatitis C: implications for clinical management and future research

Author: Marie Préau, Fabienne Marcellin, Maria Patrizia Carrieri, Isabelle Ravaux, Bruno Spire, and Pierre Dellamonica
Subjects: Adult, Male, medicine.medical_specialty, Multivariate analysis, Hepatitis C virus, Statistics as Topic, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Quality of life, Internal medicine, Epidemiology, medicine, History of depression, Humans, Pharmacology (medical), Psychiatry, Depression (differential diagnoses), Fatigue, business.industry, Depression, Hepatitis C, Middle Aged, medicine.disease, humanities, Infectious Diseases, Quality of Life, Female, business
Abstract: To analyze the impact of self-reported fatigue and depressive symptoms on the quality of life (QOL) of patients co-infected with HIV and hepatitis C virus (HCV) not receiving anti-HCV therapy.We used data from a cross-sectional survey conducted among 115 co-infected adults including an assessment of QOL (WHOQOL-HIV bref questionnaire), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D]), and fatigue (Fatigue Impact Scale [FIS]).Eighty-four percent of patients had been infected through injecting drug use (IDU). Half reported a history of depression or other psychiatric co-morbidities, 57% presented depressive symptoms, and 69% reported fatigue. FIS and CES-D scores accounted for 54% and 66% of total variance in psychological QOL and level of independence-related QOL, respectively, in a multivariate analysis adjusted for sociodemographic and clinical characteristics and alcohol or drug use. High FIS scores were independently associated with impaired physical QOL and social relationships, whereas high CES-D scores were independently associated with lower environmental QOL.Self-reported fatigue and depressive symptoms are the best indicators of co-infected patients' QOL. These two indicators could be more easily used for a better clinical management of co-infected patients and also introduced as patient outcome measures in clinical research.
Published: 2007

36. Medically assisted procreation and transmission of hepatitis C virus: absence of HCV RNA in purified sperm fraction in HIV co-infected patients

Author: Philippe Halfon, Jean-Albert Gastaud, Hacène Khiri, Véronique Chabert-Orsoni, Hervé Gallais, Jacques Moreau, Isabelle Ravaux, Guillaume Penaranda, Roger Roulier, Claude Giorgetti, Jean-Marc Chincholle, and Marc Bourlière
Subjects: Adult, Male, Reproductive Techniques, Assisted, Hepatitis C virus, Immunology, Semen, HIV Infections, Hepacivirus, medicine.disease_cause, Virus, Cohort Studies, Flaviviridae, fluids and secretions, medicine, Immunology and Allergy, Humans, Infertility, Male, biology, urogenital system, Reverse Transcriptase Polymerase Chain Reaction, virus diseases, RNA, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Viral Load, medicine.disease, biology.organism_classification, Sperm, Virology, Spermatozoa, digestive system diseases, Infectious Diseases, HIV-1, Sperm Motility, RNA, Viral, Viral load
Abstract: Objective: The risk of hepatitis C virus (HCV) transmission in medically assisted procreation (MAP) is debated and some researchers have proposed to exclude MAP for HCV-positive infertile patients. The objectives of this study were to assess the presence of viral RNA in the final preparation of density gradient semen fractions collected from men with chronic HCV and HIV co-infection participating in a MAP program, and to assess whether HIV co-infection influences the rate of the presence of HCV RNA in the semen. Design and methods: The study was based on a cohort of 170 HCV-infected male patients (93 HIV co-infected) participating in a MAP program in a French center. Semen samples were subjected to standard MAP sperm preparation, using density-gradient centrifugation with 40 and 90% layers. All aliquots were tested with a commercially available HCV RNA assay (Roche Monitor), adapted for use with semen after a nucleic HCV RNA extraction modification (Organon Technika). Results: Seminal plasma samples from 19 (11%) patients were HCV RNA positive. The positive HCV viral load in semen was less than 600 IU/ml. None of the 90% fractions from HCV-infected patients were HCV RNA positive. Among the 93 co-infected patients, 10 were positive for HCV RNA in semen and three were HIV/HCV RNA positive in semen. Conclusions: Although HCV RNA was found in the semen of 11% of patients, no purified sperm fraction, or spermatozoa used in MAP were HCV RNA positive. The 90% purified sperm fraction discards the virus and must be used with care in MAP.
Published: 2006

37. Prevalence of skin infections in sheltered homeless

Author: Sékéné, Badiaga, Amélie, Menard, Hervé, Tissot Dupont, Isabelle, Ravaux, Didier, Chouquet, Céline, Graveriau, Didier, Raoult, and Philippe, Brouqui
Subjects: Adult, Male, Pruritus, Tinea Pedis, Lice Infestations, Impetigo, Scabies, Case-Control Studies, Ill-Housed Persons, Prevalence, Humans, Female, France, Skin Diseases, Infectious
Abstract: In an attempt to determine the prevalence of various skin infections in the homeless population in Marseilles, France, we undertook a case control study. Cases were recruited among institutionalized homeless subjects during two snapshot investigations conducted in January 2002 and 2003 respectively. The control subjects were recruited from among those who presented at a clinic for pre-travel advice. We recruited 498 cases and 200 control subjects. Compared to control subjects, a significantly higher proportion of cases had skin diseases (38% versus 0.5%; p0.0001). Pruritus, body-lice infestation, scratching lesions, folliculitis, tinea pedis, scabies and impetigo (ecthyma) were strongly significantly associated with homelessness. The higher prevalence of skin infections in the homeless people mainly results from the body-louse infestation, scabies, bacterial super-infection of skin surfaces that have been breached by frequent scratching and tinea pedis due to poor foot hygiene.
Published: 2005

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