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1. Risk of severe clinical events after sustained virological response following direct‐acting antiviral therapy in HIV and hepatitis C virus coinfected participants

Author: Chalouni, Mathieu, Wittkop, Linda, Bani-Sadr, Firouze, Lacombe, Karine, Esterle, Laure, Gilbert, Camille, Miailhes, Patrick, Zucman, David, Valantin, Marc Antoine, Bregigeon-Ronot, Sylvie, Morlat, Philippe, Billaud, Eric, Piroth, Lionel, Naqvi, Alissa, Sogni, Philippe, Salmon, Dominique, Group, Anrs Co Hepavih Cohort Study, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Liver Cirrhosis, medicine.medical_specialty, SVR, Cirrhosis, [SDV]Life Sciences [q-bio], Hepatitis C virus, Human immunodeficiency virus (HIV), HIV Infections, Hepacivirus, medicine.disease_cause, Antiviral Agents, Virological response, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Internal medicine, Humans, Medicine, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Mortality, HCV coinfection, ComputingMilieux_MISCELLANEOUS, Coinfection, business.industry, Clinical events, Health Policy, Antiviral therapy, HIV, Hepatitis C, Chronic, medicine.disease, Hepatitis C, Confidence interval, 3. Good health, Treatment Outcome, Infectious Diseases, DAA treatment, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030211 gastroenterology & hepatology, Morbidity, business
Abstract: OBJECTIVES: Sustained virological response (SVR) decreases the risk of hepatitis C virus (HCV)-related events. Nevertheless, a substantial risk of events persists. We estimated incidences and identified factors associated with severe clinical events after SVR following treatment with a direct-acting antiviral (DAA) in HIV/HCV-coinfected patients. METHODS: Participants from the ANRS CO13 HEPAVIH were included if they reached SVR. Incidence rates of overall mortality, liver-related events, AIDS-defining events, ischaemic events and non-liver non-AIDS-defining cancers (NLNA) were estimated. Factors associated with the risk of those events were identified using Poisson models adjusted on age at SVR and sex. RESULTS: In all, 775 participants were included. Incidence rates (95% confidence interval) of liver-related events, overall mortality, AIDS-defining events, ischaemic events and NLNA cancers per 1000 person-years were 5.9 (3.3-10.3), 22.2 (16.8-29.5), 0.6 (0.1-4.5), 7.3 (4.4-12.2) and 13.7 (9.4-20.0), respectively. For all events, incidence rates were higher in cirrhotic than in non-cirrhotic participants. Cirrhosis, liver stiffness and CD4 count were associated with liver-related events. Factors associated with overall mortality were age, cirrhosis, liver stiffness and gamma-glutamyl transferase (GGT). For ischaemic events and NLNA cancers, associated factors were total cholesterol and CD4 count, respectively. CONCLUSIONS: After SVR following a DAA treatment, liver-related and AIDS-defining events were observed less frequently than NLNA cancers. Severity of liver disease was associated with the risk of liver-related events and of overall mortality but not with ischaemic events and NLNA cancers. Factors reflecting HIV infection were associated with NLNA cancers and liver-related events.
Published: 2021
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2. Direct, indirect and total effect of HIV coinfection on the risk of non-liver-related cancer in hepatitis C virus-infected patients treated by direct-acting antivirals: a mediation analysis

Author: Chalouni, Mathieu, Pol, Stanislas, Sogni, Philippe, Fontaine, Helene, Lacombe, Karine, Lacombe, Jean-Marc, Esterle, Laure, Dorival, Celine, Bourliere, Marc, Bani-Sadr, Firouze, De Ledinghen, Victor, Zucman, David, Larrey, Dominique, Salmon, Dominique, Carrat, Fabrice, Wittkop, Linda, ANRS CO13 HEPAVIH, Anrs C. O. Hepather Cohorts Study Groups, Martinez, V., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Research In Translational Oncology [Bordeaux] (BaRITOn), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Team MORPH3EUS (INSERM U1219 - UB - ISPED), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), INSERM-TRANSFERT [Paris] (IT), Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Saint-Joseph [Marseille], Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Bordeaux [Bordeaux], Hôpital Foch [Suresnes], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), MC was supported by a doctoral award from the French national Agency for Research on Aids and Viral Hepatitis (ANRS: France Recherche Nord & Sud Sida-HIV Hépatites), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris Cité (UPC)
Subjects: Sustained Virologic Response, medicine.medical_treatment, MESH: Sustained Virologic Response, HIV Infections, Hepacivirus, medicine.disease_cause, 0302 clinical medicine, Neoplasms, Pharmacology (medical), MESH: Hepacivirus, MESH: Neoplasms, 030212 general & internal medicine, Coinfection, Health Policy, Hazard ratio, virus diseases, Immunosuppression, MESH: HIV Infections, Hepatitis C, 3. Good health, MESH: Hepatitis C, Chronic, Infectious Diseases, Cohort, HCV, 030211 gastroenterology & hepatology, Non-liver-related cancers, MESH: Antiviral Agents, medicine.medical_specialty, Hepatitis C virus, MESH: Mediation Analysis, Antiviral Agents, 03 medical and health sciences, Internal medicine, medicine, Humans, Direct-acting antiviral (DAA) treatment, MESH: Hepatitis C, MESH: Humans, Mediation Analysis, business.industry, HIV coinfection, Cancer, Hepatitis C, Chronic, medicine.disease, Confidence interval, Indirect effect, MESH: Coinfection, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Metabolic syndrome, business
Abstract: International audience; OBJECTIVES: HIV-coinfected patients experience higher incidences of non-liver-related cancers than HCV-monoinfected patients. Chronic inflammation, immunosuppression, but also higher tobacco or alcohol consumption and metabolic dysregulation could explain this higher risk. We aimed to estimate the direct, indirect and total effects of HIV coinfection on the risk of non-liver-related cancers in HCV participants treated with direct-acting antivirals (DAAs). METHODS: Up to four HCV-monoinfected participants from the ANRS CO22 HEPATHER cohort were matched by age and sex to HIV/HCV-coinfected participants from the ANRS CO13 HEPAVIH cohort. Participants were followed from DAA initiation until the occurrence of a non-liver-related cancer. Counterfactual mediation analysis was carried out to estimate the direct (chronic inflammation and immunosuppression), indirect (tobacco and alcohol consumption and metabolic syndrome) and total effect of HIV coinfection on the risk of non-liver-related cancers. RESULTS: 548 HIV/HCV-coinfected and 2016 monoinfected participants were included. Overall, HIV coinfection was associated with a 3.7-fold [95% confidence interval (CI): 1.7-7.0] higher risk of non-liver-related cancers in HCV participants. This increased risk was explained by significant direct effect [hazard ratio (HR) = 3.4, 95% CI: 1.7-6.6] but not indirect effect (HR = 1.1, 95% CI: 0.8-1.5) of HIV coinfection. CONCLUSIONS: In HCV participants treated with DAAs, the direct effect of HIV coinfection, reflecting chronic inflammation and immunosuppression, was associated with a 3.7-fold higher risk of non-liver-related cancer. By contrast, the indirect effect of HIV coinfection, reflecting higher tobacco and alcohol consumption and metabolic dysregulation, was not significantly associated with the risk of non-liver-related cancers.
Published: 2021
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3. HCV Eradication in Primary or Secondary Prevention Optimizes Hepatocellular Carcinoma Curative Management

Author: Nahon, Pierre, Layese, Richard, Cagnot, Carole, Asselah, Tarik, Guyader, Dominique, Pol, Stanislas, Pageaux, Georges-Philippe, de Lédinghen, Victor, Ouzan, Denis, Zoulim, Fabien, Audureau, Etienne, Cirvir Group, Anrs Co12, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13), Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC] (FunGeST), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), Hôpital Beaujon [AP-HP], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes], Hôpital Cochin [AP-HP], Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut Arnault Tzanck, Université de Lyon, Hospices Civils de Lyon (HCL), This study was sponsored by the ANRS (France REcherche Nord & sud Sida-hiv Hépatites: FRENSH). This work was also supported, in part, by a grant from AbbVie., ANRS CO12 CirVir group: Pierre Nahon, Tarik Asselah, Dominique Guyader, Stanislas Pol, Hélène Fontaine, Dominique Larrey, Victor De Lédinghen, Denis Ouzan, Fabien Zoulim, Dominique Roulot, Albert Tran, Jean-Pierre Bronowicki, Jean-Pierre Zarski, Vincent Leroy, Ghassan Riachi, Paul Calès, Jean-Marie Péron, Laurent Alric, Marc Bourlière, Philippe Mathurin, Sebastien Dharancy, Jean-Frédéric Blanc, Armand Abergel, Lawrence Serfaty, Ariane Mallat, Jean-Didier Grangé, Pierre Attali, Yannick Bacq, Claire Wartelle, Thông Dao, Dominique Thabut, Christophe Pilette, Christine Silvain, Christos Christidis, Eric Nguyen-Khac, Brigitte Bernard-Chabert, Sophie Hillaire, Vincent Di Martino., École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Liver Cirrhosis, Male, 0301 basic medicine, Cancer Research, Multivariate analysis, Cirrhosis, Sustained Virologic Response, [SDV]Life Sciences [q-bio], MESH: Sustained Virologic Response, Hepacivirus, Gastroenterology, 0302 clinical medicine, MESH: Liver Neoplasms, Secondary Prevention, MESH: Hepacivirus, Prospective Studies, MESH: Incidence, MESH: Carcinoma, Hepatocellular, Secondary prevention, MESH: Aged, MESH: Middle Aged, MESH: Secondary Prevention, Incidence, Liver Neoplasms, MESH: Follow-Up Studies, Middle Aged, MESH: Hepatitis C, Chronic, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cohort, Female, MESH: Liver Cirrhosis, MESH: Neoplasm Recurrence, Local, MESH: Antiviral Agents, medicine.medical_specialty, Carcinoma, Hepatocellular, Antiviral Agents, Disease-Free Survival, 03 medical and health sciences, Internal medicine, medicine, Humans, Aged, MESH: Humans, business.industry, Hepatitis C, Chronic, medicine.disease, BCLC Stage, digestive system diseases, MESH: Male, MESH: Prospective Studies, Regimen, 030104 developmental biology, MESH: Disease-Free Survival, Liver function, Neoplasm Recurrence, Local, business, MESH: Female, Follow-Up Studies
Abstract: To assess the impact of HCV eradication on the outcomes of cirrhotic patients treated curatively for incidental hepatocellular carcinoma (HCC) detected during surveillance program. Data were collected on 1,323 French patients with compensated biopsy-proven HCV cirrhosis recruited in 35 centers (ANRS CO12 CirVir cohort). Sustained virologic responses (SVR) and the occurrence of HCC were recorded prospectively. During a median follow-up of 68.3 months, 218 patients developed HCC, 126 of whom underwent a curative procedure as first-line therapy (ablation = 95, resection = 31). The HCC BCLC stage was 0/A in 97.5% of patients; 74 (58.7%) never achieved SVR. During a median follow-up of 26.0 months after HCC treatment, 59 (46.8%) experienced HCC recurrence. SVR was not associated with a recurrence, whether considering final SVR status [HR = 0.77; 95% confidence interval (95% CI), 0.43–1.39; P = 0.39] or its time to achievement (prior to/after HCC occurrence; global P = 0.28). During the same timeframe, 46 patients with HCC (36.5%) died (liver failure: 41.9%, HCC progression: 37.2%, extrahepatic causes: 20.9%). Under multivariate analysis, SVR was associated with improved survival [HR = 0.21; 95% CI, 0.08–0.52; P = 0.001]. Survival benefit was explained by a lower incidence of liver decompensation and higher rates of sequential HCC re-treatment. Direct antiviral intake was not associated with a higher risk of HCC recurrence, but with improved survival (HR = 0.23; 95% CI, 0.06–0.83; P = 0.024). HCV eradication in primary or secondary prevention optimizes HCC management through preservation of liver function and improves survival, whatever the regimen. Prevention Relevance: Liver failure is a competing risk of death in patients with HCC eligible for curative procedures. HCV eradication does not decrease risk of HCC recurrence in the first two years, but enables sequential curative HCC treatments through preservation of liver function. Direct-acting antiviral agent intake is not associated with HCC recurrence and improves survival.
Published: 2021
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4. HCV Cure and Cannabis Abstinence Facilitate Tobacco Smoking Quit Attempts in HIV-HCV Co-Infected Patients (ANRS CO13 HEPAVIH Cohort Study)

Author: BARRE, Tangui, MERCIE, Patrick, MARCELLIN, Fabienne, ESTERLE, Laure, DUVIVIER, Claudine, TEICHER, Elina, BUREAU, Morgane, CHAS, Julie, SALMON-CERON, Dominique, SOGNI, Philippe, CARRIERI, Maria Patrizia, WITTKOP, Linda, PROTOPOPESCU, Camelia, GROUP, Anrs Co Hepavih Study, Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Team MORPH3EUS (INSERM U1219 - UB - ISPED), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris], Hôpital Paul Brousse, DHU Hepatinov [Villejuif], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle de Santé publique [CHU Bordeaux], CHU de bordeaux, Agence Nationale de Recherches sur le Sida et les Hépatites Virales, ANRS CO13 HEPAVIH Study Group, Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Institut Pasteur [Paris] (IP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Admin, Oskar, Centre Médical de l'Institut Pasteur, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris]
Subjects: medicine.medical_specialty, Social Psychology, medicine.medical_treatment, media_common.quotation_subject, [SDV]Life Sciences [q-bio], HIV Infections, Hepacivirus, Smoking cessation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Tobacco, Tobacco Smoking, Medicine, Humans, 030212 general & internal medicine, Chronic, ComputingMilieux_MISCELLANEOUS, media_common, Cannabis, biology, business.industry, Proportional hazards model, Coinfection, Human immunodeficiency virus, Hazard ratio, Public Health, Environmental and Occupational Health, virus diseases, Hepatitis C, Abstinence, medicine.disease, biology.organism_classification, 3. Good health, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, 030211 gastroenterology & hepatology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cohort study
Abstract: International audience; In Western countries, tobacco smoking is highly prevalent among patients co-infected with HIV and hepatitis C virus (HCV). In the era of antiretrovirals and HCV cure, smoking-related health damages contribute greatly to morbidity and mortality in HIV-HCV co-infected patients. We used longitudinal data from the ANRS CO13 HEPAVIH cohort to identify the correlates of tobacco smoking quit attempts (TSQA) in HIV-HCV co-infected patients. TSQA were modelled using a multivariable discrete-time Cox proportional hazards model in 695 HIV-HCV co-infected tobacco smokers. HCV cure was associated with a 76% higher chance of TSQA (adjusted hazard ratio [95% confidence interval]: 1.76 [1.06-2.93], p = 0.029), and cannabis use with a 37% lower chance (0.63 [0.40-1.00], p = 0.049), independently of the mode of HIV transmission, other psychoactive substance use, and body mass index. Patients should be screened for tobacco and cannabis use at HCV treatment initiation and during follow-up. They should also be provided with comprehensive counselling and referral to addiction services. Non-smoking routes of cannabis administration should be promoted for cannabis users who wish to quit smoking tobacco.
Published: 2021
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5. Deep sequencing analysis of M184V/I mutation at the switch and at the time of virological failure of boosted protease inhibitor plus lamivudine or boosted protease inhibitor maintenance strategy (substudy of the ANRS-MOBIDIP trial)

Author: Marie-Laure Nere, Sinata Koulla-Shiro, Adrien Sawadogo, Jacques Reynes, Sabrina Eymard-Duvernay, Mireille Mpoudi Ngolle, Cheik Tidiane Ndour, Alix Armero, Constance Delaugerre, Marie-Laure Chaix, Anrs, Laura Ciaffi, Ali Amara, and Ndaye Fatou Ngom Gueye
Subjects: 0301 basic medicine, Microbiology (medical), Oncology, medicine.medical_specialty, Anti-HIV Agents, 030106 microbiology, HIV Infections, Deep sequencing, Defective virus, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Drug Resistance, Viral, medicine, Humans, Protease Inhibitors, Pharmacology (medical), Protease inhibitor (pharmacology), 030212 general & internal medicine, Pharmacology, business.industry, High-Throughput Nucleotide Sequencing, Lamivudine, Viral Load, Resistance mutation, Virological failure, Stop codon, Infectious Diseases, Mutation, Mutation (genetic algorithm), HIV-1, business, medicine.drug
Abstract: BackgroundThe ANRS12286/MOBIDIP trial showed that boosted protease inhibitor (bPI) plus lamivudine dual therapy was superior to bPI monotherapy as maintenance treatment in subjects with a history of M184V mutation.ObjectivesWe aimed to deep analyse the detection of M184V/I variants at time of switch and at the time of virological failure (VF).MethodsUltra-deep sequencing (UDS) was performed on proviral HIV-DNA at inclusion among 265 patients enrolled in the ANRS 12026/MOBIDIP trial, and on plasma from 31 patients experiencing VF. The proportion of M184V/I variants was described and the association between the M184V/I mutation at 1% of threshold and VF was explored with logistic regression models.ResultsM184V and I mutations were detected in HIV-DNA for 173/252 (69%) and 31/252 (12%) of participants, respectively. Longer duration of first-line treatment, higher plasma viral load at first-line treatment failure and higher baseline HIV-DNA load were associated with the archived M184V. M184I mutation was always associated with a STOP codon, suggesting defective virus. The 48 week estimated probability of remaining free from VF was comparable with or without the M184V/I mutation for dual therapy. At failure, M184V and major PI mutations were detected in 1/17 and 5/15 patients in the bPI arm and in 2/2 and 0/3 in the bPI+lamivudine arm, respectively.ConclusionsUsing UDS evidenced that archiving of M184V in HIV-DNA is heterogeneous despite past historical M184V in 96% of cases. The antiviral efficacy of lamivudine-based dual therapy regimens is mainly due to the residual lamivudine activity.
Published: 2021
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6. Initiating Antiretroviral Treatment Early in Infancy Has Long-term Benefits on the Human Immunodeficiency Virus Reservoir in Late Childhood and Adolescence

Author: Mariama Sadjo Diallo, Albert Faye, Jérome Lechenadec, Véronique Avettand-Fenoel, Stéphane Blanche, Florence Buseyne, Pierre Frange, Anrs-Ep Cleac Study, Josiane Warszawski, Adeline Melard, Brigitte Autran, Catherine Dollfus, Marine Fillion, Assia Samri, and Kahina Amokrane
Subjects: 0301 basic medicine, Microbiology (medical), Cart, medicine.medical_specialty, Adolescent, T cell, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, Viremia, Human leukocyte antigen, medicine.disease_cause, Peripheral blood mononuclear cell, 03 medical and health sciences, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Internal medicine, Antiretroviral treatment, Humans, Medicine, 030212 general & internal medicine, Child, business.industry, virus diseases, Viral Load, medicine.disease, 3. Good health, Infectious Diseases, medicine.anatomical_structure, DNA, Viral, HIV-1, Leukocytes, Mononuclear, business, Ex vivo
Abstract: BackgroundEarly combined antiretroviral therapy (cART) limits the total HIV-DNA load in children. However, data on its impact in older children and adolescents remain scarce. This study compares HIV reservoirs in children (5–12 years) and adolescents (13–17 years) who started cART 2 years (late [L-] group).MethodsThe ANRS-EP59-CLEAC study prospectively enrolled 76 patients perinatally infected with HIV-1 who reached HIV-RNA ResultsTotal HIV-DNA levels were lower in early- versus late-treated patients (children: 2.14 vs 2.87 log copies/million PBMCs; adolescents: 2.25 vs 2.74 log; P < .0001 for both). Low reservoir was independently associated with treatment precocity, protective HLA, and low cumulative viremia since cART initiation. The 60 participants with undetectable integrated HIV-DNA started cART earlier than other patients (4 vs 54 months; P = .03). In those with sustained virological control, transitional and effector memory CD4+ T cells were less infected in the E-group than in the L-group (P = .03 and .02, respectively). Viral inducibility of reservoir cells after normalization to HIV-DNA levels was similar between groups.ConclusionsEarly cART results in a smaller blood HIV reservoir until adolescence, but all tested participants had an inducible reservoir. This deserves cautious consideration for HIV remission strategies.
Published: 2021
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7. Non-virological factors are drivers of hepatocellular carcinoma in virosuppressed hepatitis B cirrhosis: Results of ANRS CO12 CirVir cohort

Author: Brichler, Ségolène, Nahon, Pierre, Zoulim, Fabien, Layese, Richard, Bourcier, Valérie, Audureau, Etienne, Sutton, Angela, Letouzé, Eric, Cagnot, Carole, Marcellin, Patrick, Guyader, Dominique, Roulot, Dominique, Pol, Stanislas, de Ledinghen, Victor, Zarski, Jean-Pierre, Calès, Paul, Tran, Albert, Peron, Jean-Marie, Mallat, Ariane, Riachi, Ghassan, Grangé, Jean-Didier, Blanc, Jean-Frederic, Bacq, Yannick, Ouzan, Denis, Bronowicki, Jean-Pierre, Mathurin, Philippe, Larrey, Dominique, Alric, Laurent, Attali, Pierre, Serfaty, Lawrence, Pilette, Christophe, Bourlière, Marc, Thabut, Dominique, Silvain, Christine, Wartelle, Claire, Zucman, David, Christidis, Christos, Roudot-Thoraval, Françoise, Ganne-Carrie, Nathalie, (anrs Co22 Hepather, Co12 Cirvir And Co23 Cupilt Cohorts), Anrs Collaborative Study Group On Hepatocellular Carcinoma, Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Microbiologie Clinique [Hôpital Avicenne - APHP], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hépato-gastroentérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche biomédicale Bichat-Beaujon (CRB3), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Hépatologie, Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Service de santé publique [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), ANRS France Recherche Nord & sud Sida-hiv hépatites, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes], Service de gastroenterologie, Physiopathologie du Système Immunitaire, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Hôpital Michallon, Département d'hépato-gastroentérologie, CHU Grenoble-Université Grenoble Alpes (UGA), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Centre méditérannéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Rouen, Normandie Université (NU), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Physiopathologie du cancer du foie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'hépato-gastro-entérologie [Hôpital Trousseau : CHRU Tours], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Arnault Tzanck, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Inflammation: mécanismes et régulation et interactions avec la nutrition et les candidoses, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Hôpital Paul Brousse, Hôpital de Hautepierre [Strasbourg], Centre Hospitalier Le Mans (CH Le Mans), Hôpital Saint-Joseph [Marseille], CHU Pitié-Salpêtrière [AP-HP], Department of Hepatology and Gastroenterology, CHU de Poitiers, Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Hôpital Foch [Suresnes], Institut Mutualiste de Montsouris (IMM), Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Paris – Seine Saint-Denis, Site Jean Verdier, Pôle d’Activité Cancérologique Spécialisée, Service d’Hépatologie, F-93143 Bondy, France, ANRS. Grant Number: 15275, Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service d'hépatologie [CHU Pontchaillou], Université Grenoble Alpes (UGA)-CHU Grenoble, Université Nice Sophia Antipolis (... - 2019) (UNS), Hôpital Purpan [Toulouse], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Médecine Interne [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], École Pratique des Hautes Études (EPHE), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)-CHU Trousseau [APHP]
Subjects: Liver Cirrhosis, Male, HBsAg, Sustained Virologic Response, [SDV]Life Sciences [q-bio], Kaplan-Meier Estimate, medicine.disease_cause, Gastroenterology, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, 2. Zero hunger, Liver Neoplasms, Hepatitis C, Middle Aged, Hepatitis B, 3. Good health, Infectious Diseases, Hepatocellular carcinoma, ANRS CO12 CirVir, Female, 030211 gastroenterology & hepatology, Viral hepatitis, carcinogenesis, Hepatitis B virus, medicine.medical_specialty, Carcinoma, Hepatocellular, Genotype, risk score, Antiviral Agents, 03 medical and health sciences, Virology, Internal medicine, medicine, Humans, Proportional Hazards Models, Hepatitis, Hepatitis B Surface Antigens, Hepatology, business.industry, medicine.disease, digestive system diseases, prognosis, viral cirrhosis, business
Abstract: International audience; Worldwide, hepatocellular carcinoma (HCC) occurs mainly in Asian patients with hepatitis B virus (HBV) infection. This study aimed to decipher the environmental and virological factors associated with HCC occurrence and validate risk scoring systems in a French multicentre prospective cohort of HBV cirrhotic patients. Patients with biopsy‐proven Child‐Pugh A viral cirrhosis included in the ANRS CO12 CirVir cohort who were HBsAg(+) without hepatitis C coinfection were selected for: (a) interview through a standardized questionnaire reporting coffee consumption and HCC familial history; (b) HBsAg quantification using baseline and sequential 2‐year frozen sera; (c) baseline HBV genotype determination; and (d) assessment of risk factors and applicability of HCC risk scores (Kaplan‐Meier analysis, Cox models). Among 317 patients studied (261 men, median age 53 years, past or ongoing antiviral treatment 93.3% and baseline detectable HBV DNA in 88 patients), the baseline and 2‐year median HBsAg levels were 810 and 463 IU/mL, respectively. After a median follow‐up of 65.2 months, 27 HCC cases were diagnosed (annual incidence: 1.6%). Three factors were independently associated with HCC occurrence: age > 50 years, platelets ≤ 150 × 103/mm3 and body mass index ≥ 30 kg/m2. Two out of five risk scores were validated, and the most accurate was PAGE‐B at 1 year. Moreover, HCC in patients without maintained virological suppression seems more aggressive and less accessible to curative treatment. In conclusion, in French patients with HBV cirrhosis mostly virally suppressed, independent HCC risk factors were host‐related (age, obesity) or linked to the severity of cirrhosis (thrombopenia), and the European PAGE‐B score was the most accurate risk score.
Published: 2019
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8. The dynamic effect of direct‐acting antiviral treatments on the risk of hepatocellular carcinoma in patients with cirrhosis and chronic hepatitis C

Author: Mélanie Simony, Fabrice Carrat, Céline Dorival, Hélène Fontaine, Clovis Lusivika-Nzinga, Anrs, Stanislas Pol, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), 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), ANRS France Recherche Nord & sud Sida-hiv hépatites, Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'hépatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
Subjects: Liver Cirrhosis, Male, Cirrhosis, Hepatocellular carcinoma, Biopsy, medicine.medical_treatment, Liver transplantation, medicine.disease_cause, Gastroenterology, 0302 clinical medicine, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Hepatitis C virus, Liver Neoplasms, time-varying effect, Middle Aged, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Treatment Outcome, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Coinfection, Female, 030211 gastroenterology & hepatology, Cohort study, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antiviral Agents, Risk Assessment, Virus, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Virology, Internal medicine, medicine, Humans, Aged, Weighted cumulative exposure model, Hepatology, Proportional hazards model, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatitis C, Chronic, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, digestive system diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Direct-acting antiviral agents, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Biomarkers, Follow-Up Studies
Abstract: International audience; There is still some controversy over a potentially increased short-term risk of developing hepatocellular carcinoma (HCC) after the initiation of direct-acting antiviral (DAA) therapy, even though a decreased long-term risk of HCC has been reported following a sustained virological response in patients with chronic hepatitis C virus (HCV) infection. We characterized the time-varying effect of DAAs on the risk of the occurrence of HCC in patients with cirrhosis and HCV infection. We analysed patients with cirrhosis and chronic HCV infection from the ANRS CO22 HEPATHER cohort study. We excluded patients with active HBV coinfection, liver transplantation or a past history of HCC. We used a flexible weighted effect cumulative exposure Cox model to characterize the time-varying effect of DAAs on the risk of HCC. A total of 3595 patients, mean age 59.3 years old, 65% men, were eligible for the study. Median follow-up was 36.8 months (IQR 24.6-47.1). DAAs were started during follow-up in 3292 patients. Three hundred and fifty-six HCCs were reported (275 treated, 81 untreated). Overall, a constant decrease in the risk of occurrence of HCC (vs untreated) was found from the start of treatment. Results were similar in patients without a history of decompensated cirrhosis (DC). Analysis of patients with a past history of DC showed a nonsignificant increase in the occurrence of HCC over the first 6 months, while the HR was significantly decreased at 14 months. These findings support the urgent initiation of DAAs in all patients.
Published: 2019
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9. High nevirapine levels in breast milk and consequences in HIV-infected child when initiated on antiretroviral therapy

Author: PRESSIAT, Claire, TONI, Thomas D'Aquin, TRELUYER, Jean Marc, YONABA, Caroline, DAHOUROU, Desire Lucien, MALATESTE, Karen, SEGUIN-DEVAUX, Carole, LEROY, Valeriane, HIRT, Deborah, and GROUP, Monod Anrs Study
Subjects: Pediatrics, medicine.medical_specialty, Nevirapine, Milk, Human, Anti-HIV Agents, business.industry, Immunology, HIV Infections, Breast milk, Antiretroviral therapy, Infectious Disease Transmission, Vertical, Infectious Diseases, Hiv infected, Humans, Immunology and Allergy, Medicine, Female, Child, business, medicine.drug
Published: 2021

10. Migration experiences, life conditions, and drug use practices of Russian-speaking drug users who live in Paris: a mixed-method analysis from the ANRS-Coquelicot study

Author: Yaël Tibi-Lévy, Daria Serebryakova, Marie Jauffret-Roustide, ANRS-Coquelicot Study Group, CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institut Convergences Migrations [Aubervilliers] (IC Migrations), University at Buffalo [SUNY] (SUNY Buffalo), State University of New York (SUNY), ANRS-Coquelicot Study Group: F Barin, S Brunet, S Chevaliez, M Jauffret-Roustide, L Léon, Y Le Strat, J-M Pawlotsky, J Pillonel, C Semaille, C Sommen, A Soulier, D Thierry, L Weill-Barillet., ORANGE, Colette, and École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)
Subjects: Male, Public policy, 030508 substance abuse, Medicine (miscellaneous), [SHS]Humanities and Social Sciences, Drug Users, 0302 clinical medicine, Surveys and Questionnaires, 030212 general & internal medicine, Sociology, Substance Abuse, Intravenous, Migration, Social policy, Harm reduction, education.field_of_study, lcsh:Public aspects of medicine, People who inject drugs (PWID), Emigration and Immigration, Middle Aged, 3. Good health, Needle-Exchange Programs, Psychiatry and Mental health, Health psychology, Female, France, [SHS] Humanities and Social Sciences, Thematic analysis, 0305 other medical science, Adult, Paris, medicine.medical_specialty, Population, Eastern Europe, Vulnerable Populations, Life Change Events, 03 medical and health sciences, medicine, Humans, education, Needle sharing, Research, Public health, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Emigration, Socioeconomic Factors, USSR, Demography
Abstract: Background After the collapse of the Soviet Union at the beginning of the 1990s, people who inject drugs spiked in Eastern Europe. Facing local repression and an array of factors encouraging emigration, some users have migrated to France. This population now make up to a third of the patient list of some harm reduction services in Paris. This article aims to present original data on the sociodemographic profiles of these users, on their migration trajectory, their life conditions, and on the evolution of their drug use practices since arriving in Paris. Methods Data were collected as part of the ANRS-Coquelicot Survey, an HIV and HCV seroprevalence study among French-speaking people who use drugs. A sub-sample of Russian-speaking drug users who had relocated from Eastern Europe to live in Paris completed a quantitative questionnaire (N = 150) and a qualitative semi-structured interview (N = 20). The survey aimed to describe participants’ backgrounds, and a thematic analysis of interviews was conducted to explore participants’ migration histories, their life conditions in Paris, and their drug use practices before and after arriving in France. Results This study highlights the great vulnerability of the participating population, often following a loss of social status after migrating to France. Another important finding is that participants had better access to harm reduction tools and reduced their risk of exposure to HIV and HCV infections linked to needle sharing. Although 60% said they had already shared a syringe in their lifetime (49.9% of them in their home country), the proportions shrank to 13.9% after they arrived in France and to 9.3% in the month before the study, a proportion that is lower than among French-speaking people who use drugs. Conclusions Our main findings on the profiles and behaviors of the study population lead us to make two recommendations: to offer stronger global care to these users in Paris and to reform drug policy in their home countries by integrating it into a public health approach.
Published: 2020
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11. Social vulnerability of patients co-infected with hepatitis B and hepatitis delta viruses: Data from the ANRS CO22 HEPATHER cohort

Author: Céline Dorival, Stanislas Pol, Patrizia Carrieri, Fabienne Marcellin, Marta Lotto, Clémence Ramier, Anrs, Camelia Protopopescu, Fabrice Carrat, Hélène Fontaine, 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), Institut des sciences de la santé publique [Marseille] (ISSPAM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris]
Subjects: Hepatitis B virus, medicine.medical_specialty, Epidemiology, [SDV]Life Sciences [q-bio], 030312 virology, Antiviral Agents, Migrants, Cohort Studies, 03 medical and health sciences, Virology, medicine, Humans, ComputingMilieux_MISCELLANEOUS, 0303 health sciences, business.industry, HEPATITIS DELTA, Hepatitis B, medicine.disease, 3. Good health, Infectious Diseases, Hepatitis delta, Cohort, Hepatitis D virus, Hepatitis Delta Virus, business, Social vulnerability
Abstract: International audience; No abstract available
Published: 2021
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12. Evolution of patients’ socio-behavioral characteristics in the context of DAA: Results from the French ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients

Author: Issifou Yaya, Perrine Roux, Fabienne Marcellin, Linda Wittkop, Laure Esterle, Bruno Spire, Stéphanie Dominguez, Boni Armand Elegbe, Lionel Piroth, Philippe Sogni, Dominique Salmon-Ceron, Maria Patrizia Carrieri, ANRS CO13 HEPAVIH Study Group, 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), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), DILTEC - Didactique des langues, des textes et des cultures - EA 2288 (DILTEC), Université Sorbonne Nouvelle - Paris 3, GHU A. Chenevier - Henri Mondor (Inserm U955, équipe 16), Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), 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), CIC - Biotherapie - AP-HP (cochin - Pasteur), Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS CO13-HEPAVIH Study Group ANRS CO13-HEPAVIH Study Group, Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'information médicale, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Physiopathologie du système immunitaire, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], ANRS CO13 HEPAVIH Study Group¶, and DUFOUR, Jean-Charles
Subjects: RNA viruses, Male, Health Behavior, Social Sciences, lcsh:Medicine, HIV Infections, Hepacivirus, Geographical locations, Chronic Liver Disease, 0302 clinical medicine, Risk Factors, Prevalence, Psychology, Alcohol consumption, Prospective Studies, 030212 general & internal medicine, Young adult, Prospective cohort study, lcsh:Science, Pathology and laboratory medicine, media_common, Chronic hepatitis, Drug injection, Clinical Trials as Topic, Multidisciplinary, biology, Pharmaceutics, Coinfection, Hepatitis C virus, Liver Diseases, virus diseases, Medical microbiology, Middle Aged, Prognosis, Hepatitis C, Addicts, 3. Good health, Europe, Behavioral Pharmacology, Drug users, Viruses, Cohort, Female, 030211 gastroenterology & hepatology, Drug therapy, France, Pathogens, Research Article, Adult, Drug, medicine.medical_specialty, Substance-Related Disorders, media_common.quotation_subject, Liver fibrosis, Addiction, Context (language use), Gastroenterology and Hepatology, Microbiology, Antiviral Agents, Young Adult, 03 medical and health sciences, Pharmacotherapy, Recreational Drug Use, Internal medicine, medicine, Humans, European Union, Nutrition, Aged, Cannabis, Medicine and health sciences, Pharmacology, Biology and life sciences, Flaviviruses, business.industry, lcsh:R, Organisms, Viral pathogens, HIV, biology.organism_classification, Hepatitis viruses, digestive system diseases, Microbial pathogens, Diet, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, People and places, business
Abstract: International audience; BACKGROUND:Direct-acting antivirals (DAA) have dramatically increased HCV cure rates with minimal toxicity in HIV-HCV co-infected patients. This study aimed to compare the socio-behavioral characteristics of patients initiating pegylated-interferon (PEG-IFN)-based HCV treatment with those of patients initiating DAA-based treatment.METHODS:ANRS CO13 HEPAVIH is a national multicenter prospective cohort started in 2005, which enrolled 1,859 HIV-HCV co-infected patients followed up in French hospital outpatient units. Both clinical/biological and socio-behavioral data were collected during follow-up. We selected patients with socio-behavioral data available before HCV treatment initiation.RESULTS:A total of 580 patients were included in this analysis. Of these, 347 initiated PEG-IFN-based treatment, and 233 DAA-based treatment. There were significant differences regarding patient mean age (45 years±6 for the PEG-IFN group vs. 52 years±8 for the DAA group, p
Published: 2018
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13. Long-term safety and vaccine-induced seropositivity in healthy volunteers from HIV vaccine trials

Author: Bénédicte Bonnet, Anrs, Jean-Daniel Lelièvre, Christelle Paul, Isabelle Poizot-Martin, Amel Bouakane, Corinne Desaint, Laurence Meyer, Odile Launay, Sophie Grabar, Lise Cuzin, Bruno Spire, Christine Durier, Gilles Pialoux, Benjamin Silbermann, Essais Therapeutiques et Infection Par Le Vih, Université Paris-Sud - Paris 11 (UP11)-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), 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 de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [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), 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), 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), ANRS France Recherche Nord & sud Sida-hiv hépatites, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes, Sorbonne Paris Cité, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Cochin [AP-HP], INSERM U64 [AP-HP Hôpital Tenon], Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Tenon [AP-HP], CHU Toulouse [Toulouse], Centre hospitalier universitaire de Nantes (CHU Nantes), Aix Marseille Université (AMU), Santé et droits sexuels et reproductifs (Unité Ined - Inserm - Université Paris Sud - UVSQ) (UR14), Institut national d'études démographiques (INED), Service de Maladies Infectieuses et Tropicales, Service des maladies infectieuses et tropicales [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe hospitalier Broca-Université Paris Descartes - Paris 5 (UPD5)-Hôtel-Dieu-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and GRABAR, SOPHIE
Subjects: 0301 basic medicine, Vaccine-induced seropositivity, Male, HIV Infections, long-term follow-up, HIV Antibodies, 0302 clinical medicine, vaccine-induced seropositivity, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Immunology and Allergy, 030212 general & internal medicine, Prospective Studies, HIV vaccine, Prospective cohort study, AIDS Vaccines, education.field_of_study, Clinical Trials as Topic, Clinical Trials, Phase I as Topic, risk of HIV exposure, Middle Aged, Healthy Volunteers, 3. Good health, Infectious Diseases, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, Adult, safety, medicine.medical_specialty, Sexual Behavior, Immunology, Population, Time, 03 medical and health sciences, Clinical Trials, Phase II as Topic, Internal medicine, medicine, Humans, Adverse effect, education, Social Behavior, Retrospective Studies, business.industry, preventive HIV vaccine trials, Retrospective cohort study, 030104 developmental biology, Standardized mortality ratio, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Background: The ANRS COV1-COHVAC cohort was a long-term safety cohort of healthy volunteers who received preventive HIV-vaccine candidates in 17 phase I/II clinical trials.Methods: Data collected from the first vaccine candidate administration and annually after inclusion in the cohort included grade 3/4 adverse events and all grade adverse events suggestive of neurological, ophthalmological and immune disorders, self-administered questionnaires on behaviors and HIV ELISA results. Age-and-sex-standardized mortality ratios (SMRs) were calculated with respect to the French population. The cohort was early terminated in 2016 due to the absence of safety signal.Results: Of 496 volunteers, 488 were included: 355 in the 7-year prospective follow-up and 133 in the retrospective data collection only. The total follow-up after the first vaccination was 4934 person-years (median: 10 years) and 270 (76%) volunteers completed their follow-up. No relevant adverse event possibly related to the vaccine was reported. Breast cancer incidence and woman mortality did not differ from those of the French general population (standardized incidence ratio = 1.47, P = 0.45 and SMR = 0.65, P = 0.28, respectively) while man mortality was significantly lower (SMR = 0.26, P = 0.0003). At the last visit, 21/29 (72%) volunteers who received the recombinant HIV gp160 protein still showed vaccine-induced seropositivity after a median follow-up of 23 years. Only a few volunteers reported risky sexual practices (men: 20/192, women: 2/162).Conclusion: Volunteers showed a sustained high commitment. No long-term safety alert was identified during the postvaccine follow-up. Participating in vaccine trials did not increase risky behaviors for HIV infection. Vaccine-induced seropositivity may persist for more than 23 years after receiving rgp160.
Published: 2019
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14. Coffee Intake and Neurocognitive Performance in HIV/HCV Coinfected Patients (ANRS CO13 HEPAVIH)

Author: Saskia, Antwerpes, Camelia, Protopopescu, Philippe, Morlat, Fabienne, Marcellin, Linda, Wittkop, Vincent, Di Beo, Dominique, Salmon-Céron, Philippe, Sogni, Laurent, Michel, Maria Patrizia, Carrieri, The Anrs Co Hepavih Study Group, 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), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle de Santé publique [CHU Bordeaux], CHU de bordeaux, Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), 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), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre Pierre Nicole [Paris], and Dupuis, Christine
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], coffee, neurocognitive disorders, lcsh:TX341-641, HIV Infections, Article, Cohort Studies, 03 medical and health sciences, Eating, Executive Function, 0302 clinical medicine, Cognition, Quality of life, Internal medicine, medicine, Verbal fluency test, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Psychomotor learning, Nutrition and Dietetics, business.industry, Coinfection, HIV, Hepatitis C, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Cohort, Major depressive disorder, 030211 gastroenterology & hepatology, Female, hepatitis C, business, lcsh:Nutrition. Foods and food supply, Neurocognitive, Viral load, Psychomotor Performance, Food Science
Abstract: International audience; Coffee is one of the most consumed beverages worldwide. Previous research has demonstrated its neuroprotective effects in the elderly. People coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) experience an accelerated aging process and cognitive impairment, which significantly impair quality of life and may affect disease-related dimensions such as treatment adherence. This study aimed to analyse the relationship between regular coffee intake and neurocognitive performance (NCP) in HIV-HCV coinfected people. We used data from 139 coinfected patients who participated in both the ANRS CO13 HEPAVIH cohort and the HEPAVIH-Psy cross-sectional survey. Linear regression models adjusting for potential sociodemographic (age, gender, educational level), clinical (liver disease status, ongoing HCV treatment, HIV viral load, major depressive disorder) and socio-behavioural (cannabis use) correlates of NCP were used. Our results showed significant, positive associations between elevated coffee intake (ECI) (three or more cups of coffee per day) and NCP in verbal fluency, psychomotor speed (coding) and executive functioning. ECI might therefore preserve neurocognitive functioning in people living with HIV and HCV.
Published: 2020
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15. Precore G1896A mutation is associated with reduced rates of HBsAg seroclearance in treated HIV hepatitis B virus co-infected patients from Western Africa

Author: Delphine Gabillard, Anders Boyd, Serge-Paul Eholié, Christine Danel, M Abdou Chekaraou, Sarah Maylin, Karine Lacombe, Xavier Anglaret, Anrs VarBVA study, Fabien Zoulim, Nadia Mahjoub, Constance Delaugerre, and Raoul Moh
Subjects: Adult, Male, 0301 basic medicine, Hepatitis B virus, medicine.medical_specialty, HBsAg, Genotype, medicine.disease_cause, Antiviral Agents, Gastroenterology, Serology, 03 medical and health sciences, 0302 clinical medicine, Antigen, Virology, Internal medicine, medicine, Humans, Hepatitis B e Antigens, Prospective Studies, Promoter Regions, Genetic, Tenofovir, Prospective cohort study, Hepatitis B Surface Antigens, AIDS-Related Opportunistic Infections, Hepatology, business.industry, virus diseases, Lamivudine, Hepatitis B, medicine.disease, Hepatitis B Core Antigens, digestive system diseases, 3. Good health, Africa, Western, 030104 developmental biology, Infectious Diseases, Anti-Retroviral Agents, HBeAg, DNA, Viral, Mutation, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: The nucleotide substitution G1896A on the precore (pc) region has been implicated in virological and serological responses during treatment in hepatitis B virus (HBV)-infected patients. Whether this mutation affects the therapeutic course of HIV-HBV co-infected patients, especially from Western Africa, is unknown. In this prospective cohort study, 86 antiretroviral (ARV)-naive HIV-HBV co-infected patients from Cote d'Ivoire, initiating ARV-treatment containing lamivudine (n = 53) or tenofovir (n = 33), had available baseline pc sequences. Association of the pcG1896A mutation with time to undetectable HBV-DNA, hepatitis B "e" antigen (HBeAg) seroclearance (in HBeAg-positive patients), and hepatitis B surface antigen (HBsAg) seroclearance was evaluated using Cox proportional hazards regression. At ARV-initiation, median HBV-DNA was 6.04 log10 copies/mL (IQR = 3.70-7.93) with 97.7% harbouring HBV genotype E. Baseline pcG1896A mutation was identified in 51 (59.3%) patients, who were more commonly HBeAg-negative (P < .001) and had basal core promotor A1762T/G1764A mutations (P < .001). Patients were followed for a median 36 months (IQR = 24-36). Cumulative proportion of undetectable HBV-DNA was significantly higher in patients with baseline mutation (pcG1896A = 86.6% vs no pcG1896A = 66.9%, P = .04), but not after adjusting for baseline HBV-DNA levels and anti-HBV agent (P = .2). No difference in cumulative proportion of HBeAg seroclearance was observed between mutation groups (pcG1896A = 57.1% vs no pcG1896A = 54.3%, P = .7). Significantly higher cumulative proportion of HBsAg seroclearance was observed in patients without this mutation (pcG1896A = 0% vs no pcG1896A = 36.9%, P < .001), even after adjusting for baseline HBsAg quantification and anti-HBV agent (P < .001). In conclusion, lacking the pcG1896A mutation before ARV initiation appeared to increase HBsAg seroclearance rates during treatment. The therapeutic implications of this mutation need further exploration in this setting.
Published: 2018
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16. Virologic Response to Early Antiretroviral Therapy in HIV-infected Infants

Author: Ndongo, Francis Ateba, Texier, Gaetan, Penda, Calixte Ida, Tejiokem, Mathurin Cyrille, Ndiang, Suzie Tetang, Ndongo, Jean-Audrey, Guemkam, Georgette, Sofeu, Casimir Ledoux, Kfutwah, Anfumbom, Faye, Albert, Msellati, Philippe, Warszawski, Josiane, Grp, ANRS-Pediacam Study, Centre d'épidémiologie et de santé publique des armées (CESPA), Service de Santé des Armées, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Laboratoire d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre Mère et Enfant de la Fondation Chantal Biya, Université Paris-Sud de Yaounde, Service de Virologie, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris]-Université Paris Diderot - Paris 7 (UPD7), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Université Paris-Sud - Paris 11 (UP11), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'épidémiologie et de santé publique des armées [Marseille] (CESPA), Service de Virologie [Yaounde], Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Microbiology (medical), Pediatrics, medicine.medical_specialty, Sustained Virologic Response, Anti-HIV Agents, HIV Infections, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk Factors, 030225 pediatrics, Humans, Medicine, Cumulative incidence, Cameroon, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, business.industry, Mortality rate, Infant, Newborn, Infant, Viral Load, Antiretroviral therapy, Confidence interval, Infant mortality, 3. Good health, Infectious Diseases, Virologic response, Pediatrics, Perinatology and Child Health, Female, business, Viral load
Abstract: International audience; Introduction: Little is known about virologic responses to early antiretroviral therapy (ART) in HIV-infected infants in resource-limited settings. We estimated the probability of achieving viral suppression within 2 years of ART initiation and investigated the factors associated with success. Methods: We analyzed all 190 infants from the Cameroon Pediacam who initiated ART by 12 months of age. The main outcome measure was viral suppression (
Published: 2018
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17. A new 3p25 locus is associated with liver fibrosis progression in human immunodeficiency virus/hepatitis C virus-coinfected patients

Author: Ulveling, Damien, Le Clerc, Sigrid, Cobat, Aurélie, Labib, Taoufik, Noirel, Josselin, Laville, Vincent, Coulonges, Cédric, Carpentier, Wassila, Nalpas, Bertrand, Heim, Markus H., Poynard, Thierry, Cerny, Andreas, Pol, Stanislas, Bochud, Pierre-Yves, Dabis, Francois, Theodorou, Ioannis, Lévy, Yves, Salmon, Dominique, Abel, Laurent, Dominguez, Stéphanie, Zagury, Jean-François, Grp, HEPAVIH ANRS CO13 Cohort Study, Grp, Swiss Hepatitis C Cohort Study, Genoscan, French ANRS HC EP 26, Laboratoire génomique, bioinformatique et applications (GBA), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Human genetics of infectious diseases: Complex predisposition (Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Plateforme Post-génomique de la Pitié-Salpêtrière (P3S), UMS omique (OMIQUE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'hépatologie [CHU Cochin], Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University Hospital Basel [Basel], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epatocentro Ticino, Université de Lausanne (UNIL), Epidemiologie-Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux Ségalen [Bordeaux 2], Centre d'Immunologie et de Maladies Infectieuses (CIMI), 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), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Rockefeller University [New York], French National Agency for Research on AIDS and Viral Hepatitis (ANRS), Merck Sharp and Dohme (France), National Agency for Research on AIDS and Viral Hepatitis (ANRS), Swiss National Science Foundation [33CS30\₁48417, 324730-144054], Leenaards Foundation, Santos-Suarez Foundation, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Lausanne = University of Lausanne (UNIL), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire génomique, bioinformatique et applications ( GBA ), Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Human genetics of infectious diseases: Complex predisposition ( Equipe Inserm U1163 ), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre National de la Recherche Scientifique ( CNRS ) -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 Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Plateforme Post-génomique de la Pitié-Salpêtrière ( P3S ), UMS omique ( OMIQUE ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Pasteur [Paris]-CHU Cochin [AP-HP]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Pitié-Salpêtrière [APHP], Université de Lausanne ( UNIL ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bordeaux Ségalen [Bordeaux 2], Centre d'Immunologie et de Maladies Infectieuses ( CIMI ), 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 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Sorbonne Université-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Sorbonne Université, Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), CHU Cochin [AP-HP], The Rockefeller University [New-York], Centre National de la Recherche Scientifique (CNRS)-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 Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CHU Cochin [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Liver Cirrhosis, medicine.medical_specialty, Linkage disequilibrium, MESH : Hepatitis C, Chronic, Hepatitis C virus, Genome-wide association study, HIV Infections, Biology, medicine.disease_cause, Polymorphism, Single Nucleotide, MESH: Genetic Loci, 03 medical and health sciences, Liver disease, Acquired immunodeficiency syndrome (AIDS), MESH : Genetic Loci, Internal medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], medicine, MESH : HIV Infections, Humans, MESH : Liver Cirrhosis, MESH: Humans, Hepatology, Coinfection, MESH: Polymorphism, Single Nucleotide, MESH : Humans, MESH : Polymorphism, Single Nucleotide, MESH : Disease Progression, MESH: HIV Infections, Hepatitis C, Chronic, medicine.disease, 3. Good health, MESH: Coinfection, MESH: Hepatitis C, Chronic, MESH : Coinfection, 030104 developmental biology, Genetic Loci, [ SDV.BBM.GTP ] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Immunology, MESH: Genome-Wide Association Study, Disease Progression, MESH: Disease Progression, MESH: Liver Cirrhosis, Viral hepatitis, MESH : Genome-Wide Association Study, Genome-Wide Association Study
Abstract: International audience; There is growing evidence that human genetic variants contribute to liver fibrosis in subjects with hepatitis C virus (HCV) monoinfection, but this aspect has been little investigated in patients coinfected with HCV and human immunodeficiency virus (HIV). We performed the first genome-wide association study of liver fibrosis progression in patients coinfected with HCV and HIV, using the well-characterized French National Agency for Research on AIDS and Viral Hepatitis CO13 HEPAVIH cohort. Liver fibrosis was assessed by elastography (FibroScan), providing a quantitative fibrosis score. After quality control, a genome-wide association study was conducted on 289 Caucasian patients, for a total of 8,426,597 genotyped (Illumina Omni2.5 BeadChip) or reliably imputed single-nucleotide polymorphisms. Single-nucleotide polymorphisms with P values
Published: 2016
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18. Impact of Alcohol and Coffee Intake on the Risk of Advanced Liver Fibrosis: A Longitudinal Analysis in HIV-HCV Coinfected Patients (ANRS CO-13 HEPAVIH Cohort)

Author: Yaya, Issifou, Marcellin, Fabienne, Costa, Marie, Morlat, Philippe, Protopopescu, Camelia, Pialoux, Gilles, Santos, Melina Erica, Wittkop, Linda, Esterle, Laure, Gervais, Anne, Sogni, Philippe, Salmon-Ceron, Dominique, Carrieri, Maria Patrizia, Group, the ANRS CO13-HEPAVIH Cohort Study, 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), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Departamento de Vigilância, Prevenção e Controle das IST, do HIV/Aids e das Hepatites Virais [Brasília, Brazil], Ministério da Saúde [Brasília, Brazil]-Secretaria de Vigilância em Saúde [Brasília, Brazil], Programa de Pós-Graduação em Saúde Coletiva [Brasília, Brazil], Universidade de Brasilia [Brasília] (UnB)-Faculdade de Ciências da Saúde [Brasília, Brazil], Service d'information médicale, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service des maladies infectieuses et tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), 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), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), This work was supported by the French National Agency for Research on Aids and Viral Hepatitis (ANRS), with the participation of Abbott France, Glaxo-Smith-Kline, Roche, Schering-Plough, and INSERM’s ‘Programme Cohortes TGIR’., Service des maladies infectieuses et tropicales [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Hépato-gastro-entérologie et cancérologie digestive [APHP Bichat Claude Bernard], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur [Paris], and YAYA, Issifou
Subjects: Liver Cirrhosis, Male, Alcoholic liver disease, Liver fibrosis, Alcohol, HIV Infections, Logistic regression, Severity of Illness Index, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Medicine, HIV-HCV co-infection, Longitudinal Studies, Prospective Studies, ComputingMilieux_MISCELLANEOUS, liver fibrosis, Nutrition and Dietetics, Middle Aged, 3. Good health, Liver, 030220 oncology & carcinogenesis, Cohort, Disease Progression, 030211 gastroenterology & hepatology, Female, France, lcsh:Nutrition. Foods and food supply, Adult, Risk, medicine.medical_specialty, Alcohol Drinking, alcohol consumption, coffee, lcsh:TX341-641, Lower risk, Article, 03 medical and health sciences, Internal medicine, Coffee intake, Humans, Ethanol, business.industry, Hepatitis C, Chronic, medicine.disease, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Self Report, business, Biomarkers, Food Science
Abstract: International audience; BACKGROUND:Coffee intake has been shown to modulate both the effect of ethanol on serum GGT activities in some alcohol consumers and the risk of alcoholic cirrhosis in some patients with chronic diseases. This study aimed to analyze the impact of coffee intake and alcohol consumption on advanced liver fibrosis (ALF) in HIV-HCV co-infected patients.METHODS:ANRS CO13-HEPAVIH is a French, nationwide, multicenter cohort of HIV-HCV-co-infected patients. Sociodemographic, behavioral, and clinical data including alcohol and coffee consumption were prospectively collected using annual self-administered questionnaires during five years of follow-up. Mixed logistic regression models were performed, relating coffee intake and alcohol consumption to ALF.RESULTS:1019 patients were included. At the last available visit, 5.8% reported high-risk alcohol consumption, 27.4% reported high coffee intake and 14.5% had ALF. Compared with patients with low coffee intake and high-risk alcohol consumption, patients with low coffee intake and low-risk alcohol consumption had a lower risk of ALF (aOR (95% CI) 0.24 (0.12⁻0.50)). In addition, patients with high coffee intake had a lower risk of ALF than the reference group (0.14 (0.03⁻0.64) in high-risk alcohol drinkers and 0.11 (0.05⁻0.25) in low-risk alcohol drinkers).CONCLUSIONS:High coffee intake was associated with a low risk of liver fibrosis even in HIV-HCV co-infected patients with high-risk alcohol consumption.
Published: 2018
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19. Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co-infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End-Stage Liver Disease as Compared to HCV Mono-infected Patients

Author: Valérie Bourcier, Firouzé Bani-Sadr, Laurence Merchadou, Anrs Co Hepavih study groups, Philippe Sogni, Pierre Nahon, Anrs Co CirVir, Richard Layese, Françoise Roudot-Thoraval, Etienne Audureau, François Dabis, Linda Wittkop, and Dominique Salmon-Ceron
Subjects: 0301 basic medicine, Liver Cirrhosis, Male, Cirrhosis, HIV Infections, Hepacivirus, Kaplan-Meier Estimate, medicine.disease_cause, Gastroenterology, Cohort Studies, Liver disease, 0302 clinical medicine, Prevalence, medicine.diagnostic_test, Coinfection, Liver Neoplasms, virus diseases, Hepatitis C, Middle Aged, Viral Load, Prognosis, 3. Good health, Anti-Retroviral Agents, Hepatocellular carcinoma, Liver biopsy, Disease Progression, 030211 gastroenterology & hepatology, Female, France, Viral load, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatitis C virus, Risk Assessment, End Stage Liver Disease, 03 medical and health sciences, Internal medicine, medicine, Humans, Decompensation, Proportional Hazards Models, Retrospective Studies, Hepatology, business.industry, Hepatitis C, Chronic, medicine.disease, Survival Analysis, digestive system diseases, 030104 developmental biology, Multivariate Analysis, business
Abstract: It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono-infected patients and 175 HIV/HCV co-infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child-Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine-Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow-up similar rates of HCV eradication than HCV mono-infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5-year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co-infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15-3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV-infected patients with cirrhosis, HIV co-infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.
Published: 2018

20. Higher Mortality Despite Early Antiretroviral Therapy in Human Immunodeficiency Virus and Hepatitis B Virus (HBV)–Coinfected Patients With High HBV Replication

Author: Anani Badje, Anders Boyd, Jean-Baptiste Ntakpe, Delphine Gabillard, Fabien Zoulim, Christine Danel, Eric Ouattara, Xavier Anglaret, Serge-Paul Eholié, Arlette Emieme, Raoul Moh, Mariama Abdou Chekaraou, Sarah Maylin, Gérard-Menan Kouamé, Anrs VarBVA Study Groups, and Karine Lacombe
Subjects: Adult, Male, Microbiology (medical), Hepatitis B virus, medicine.medical_specialty, Population, HIV Infections, Emtricitabine, medicine.disease_cause, Antiviral Agents, 03 medical and health sciences, Hepatitis B, Chronic, 0302 clinical medicine, Internal medicine, Correspondence, Secondary Prevention, medicine, Risk of mortality, Humans, 030212 general & internal medicine, education, Randomized Controlled Trials as Topic, Hepatitis, education.field_of_study, Coinfection, business.industry, virus diseases, Lamivudine, Viral Load, Hepatitis B, medicine.disease, Survival Analysis, 3. Good health, Africa, Western, Infectious Diseases, DNA, Viral, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Background In human immunodeficiency virus (HIV)-infected patients, hepatitis B virus (HBV) coinfection increases the risk of disease progression. Tenofovir plus emtricitabine/lamivudine (TDF/XTC)-based antiretroviral therapy (ART), which suppresses HIV and HBV replication, has the potential for decreasing this risk. Here, we analyze the association between HBV replication, early ART, and mortality in West African adults. Methods The Temprano randomized controlled trial assessed the benefits of immediately initiating vs deferring ART in HIV-infected adults with high CD4 counts. After trial completion, participants continued follow-up in a posttrial phase. We analyzed the association between HBV status, immediate ART, and mortality over the entire trial and posttrial follow-up using multivariable Cox proportional hazards regression. Results A total of 2052 HIV-infected adults (median baseline CD4 count, 464 cells/μL) were followed for 9394 person-years. At baseline, 1862 (91%) were HIV monoinfected and 190 (9%) HIV/HBV coinfected. Of the latter, 135 (71%) had plasma HBV DNA
Published: 2017
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21. Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?

Author: Jérôme Le Chenadec, Anrs Epf Co, Pierre Frange, Ana Canestri, Roland Tubiana, Laurent Mandelbrot, Josiane Warszawski, Cécile Brunet-Cartier, Laurent Cotte, Jeanne Sibiude, Jacques Reynes, Cédric Arvieux, and Centre for Reproductive Medicine - Gynaecology
Subjects: 0301 basic medicine, Microbiology (medical), safety, medicine.medical_specialty, RFC, Anti-HIV Agents, HIV Infections, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pregnancy, Obstetrics and Gynaecology, medicine, Emtricitabine, Humans, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, business.industry, Obstetrics, Rilpivirine, Infant, Newborn, Gestational age, Viral Load, medicine.disease, 030112 virology, 3. Good health, HIV-1-positive, Regimen, Infectious Diseases, chemistry, Cohort, HIV-1, Gestation, Ritonavir, Female, women, business, Viral load, medicine.drug
Abstract: BackgroundSafety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.ObjectivesTo describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.MethodsIn the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010–18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (ResultsAmong 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was ConclusionsIn virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.
Published: 2019

22. In situ BCL2 expression is an independent prognostic factor in HIV-associated DLBCL, a LYMPHOVIR cohort study

Author: François Boué, Claire Delattre, Bruno Petitjean, Catherine Chassagne-Clément, Frédérique Capron, Rémi Lancar, Thierry Lazure, Laure Philippe, Sophie Prevot, Isabelle Goubin-Versini, Marie Parrens, Anrs-Co Lymphovir Cohort, Michele Algarte-Genin, Laure Gibault, Camille Laurent, Frédéric Charlotte, Caroline Besson, Nicolas Mounier, Régis Costello, Marie Pierre Chenard, Bettina Fabiani, Dominique Costagliola, Centre Hospitalier de Versailles André Mignot (CHV), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris-Saclay, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Léon Bérard [Lyon], Service de Pathologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Hôpital de Hautepierre [Strasbourg], CHU Strasbourg, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service de pathologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier René Dubos [Pontoise], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital l'Archet, Assistance Publique-Hôpitaux de Marseille (AP-HM), Institut Gustave Roussy (IGR), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier de Versailles (CHV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Université Paris-Sud 11 - Faculté de médecine (UP11 UFR Médecine), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Anatomie et cytologie pathologiques = Service de Pathologie [CHU Pitié-Salpêtrière] (ACP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance Publique - Hôpitaux de Marseille (APHM), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Oncology, Adult, Male, medicine.medical_specialty, Cell of origin, [SDV]Life Sciences [q-bio], diffuse large B-cell lymphoma, HIV Infections, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Internal medicine, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, neoplasms, Cyclophosphamide, business.industry, HIV, Hematology, Middle Aged, medicine.disease, non-Hodgkin’s lymphoma, 3. Good health, Lymphoma, Non-Hodgkin's lymphoma, Gene Expression Regulation, Neoplastic, Survival Rate, Proto-Oncogene Proteins c-bcl-2, Doxorubicin, Vincristine, 030220 oncology & carcinogenesis, Cohort, HIV-1, Immunohistochemistry, Prednisone, Female, Lymphoma, Large B-Cell, Diffuse, Viral hepatitis, business, Rituximab, Diffuse large B-cell lymphoma, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030215 immunology, Cohort study, BCL2 expression
Abstract: International audience; The prognostic value of cell of origin (COO) classification and BCL2 expression is not well established in diffuse large B-cell lymphoma (DLBCL) patients with human immunodeficiency virus (HIV) infection in the recent era. Phenotypic patterns were determined by immunohistochemistry (IHC) of pathological samples from patients with HIV-associated DLBCL prospectively enrolled in the French AIDS and Viral Hepatitis CO16 Lymphovir cohort between 2008 and 2015. Molecular subgroup classification into germinal centre B-cell (GCB) and non-GCB subtypes was determined using the Hans algorithm. Among 52 samples of systemic DLBCL subjected to centralized pathological analysis, 25 of the 42 tested for BCL2 expression were positive. Samples were further classified into GCB (n = 19) and non-GCB (n = 16) subtypes and 17 remained unclassified. In multivariable analysis, BCL2 expression was an independent pejorative prognostic biomarker [4-year progression-free survival (PFS): 52% for BCL2+ vs. 88% for BCL2- , P = 0·02] and tended to reduce 4-year overall survival (OS) (63% for BCL2+ vs. 88% for BCL2- , P = 0·06). The difference between CGB and non-GCB subtypes on PFS and OS did not reach significance (4-year PFS: 79% for GCB vs. 53% for non-GCB, P = 0·24 and 4-year OS: 78% for GCB vs. 69% for non-GCB, P = 0·34). BCL2 expression determined by IHC is an independent pejorative prognostic biomarker in HIV-associated DLBCL in the recent era. This supports the investigation of new therapeutic strategies in patients with BCL2 expression.
Published: 2019
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23. Diagnostic accuracy of noninvasive markers of steatosis, NASH, and liver fibrosis in HIV-monoinfected individuals at risk of Nonalcoholic Fatty Liver Disease (NAFLD): Results from the ECHAM study

Author: Lemoine, M, Assoumou, L, De Wit, S, Girard, P-M, Valantin, MA, Katlama, C, Necsoi, C, Campa, P, Huefner, AD, Schulze Zur Wiesch, J, Rougier, H, Bastard, J-P, Stocker, H, Mauss, S, Serfaty, L, Ratziu, V, Menu, Y, Schlue, J, Behrens, G, Bedossa, P, Capeau, J, Ingiliz, P, Costagliola, D, and ANRS-ECHAM Group
Subjects: Liver Cirrhosis, Male, medicine.medical_specialty, Liver fibrosis, ANRS-ECHAM Group, Population, Diagnostic accuracy, HIV Infections, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Adipokines, Belgium, Fibrosis, Non-alcoholic Fatty Liver Disease, Internal medicine, Germany, Virology, Nonalcoholic fatty liver disease, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, Prospective cohort study, education, Aged, Ultrasonography, 2. Zero hunger, education.field_of_study, medicine.diagnostic_test, business.industry, 1103 Clinical Sciences, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Infectious Diseases, Anti-Retroviral Agents, Liver biopsy, Elasticity Imaging Techniques, 030211 gastroenterology & hepatology, Female, France, Steatosis, business
Abstract: BACKGROUND: HIV-monoinfected individuals are at high risk of nonalcoholic fatty liver disease. Noninvasive tests of steatosis, nonalcoholic steatohepatitis (NASH), and fibrosis have been poorly assessed in this population. Using liver biopsy (LB) as a reference, we assessed the accuracy of noninvasive methods for their respective diagnosis: magnetic resonance imaging proton-density-fat-fraction (MRI-PDFF), FibroScan/controlled attenuation parameter (CAP), and biochemical tests. METHODS: We enrolled antiretroviral therapy-controlled participants with persistently elevated transaminases and/or metabolic syndrome, and/or lipodystrophy. All had hepatic MRI-PDFF, FibroScan/CAP, FibroTest/NashTest/SteatoTest, APRI, FIB-4, and nonalcoholic fatty liver disease-fibrosis score. A LB was indicated if suspected significant fibrosis (FibroScan ≥7.1 kPa and/or FibroTest ≥0.49). Performance was considered as good if area under a receiver operating characteristic curves (AUROCs) was >0.80. RESULTS: Among the 140 patients with suspected significant fibrosis out of the 402 eligible patients, 49 had had a LB: median age of 54 years (53-65), body mass index: 26 kg/m (24-30), steatosis in 37 (76%), NASH in 23 (47%), and fibrosis in 31 (63%) patients [F2: 7 (14%); F3: 6 (12%); and F4: 2 (4%)]. Regarding steatosis, MRI-PDFF had excellent and CAP good performances with AUROCs at 0.98 (95% confidence interval: 0.96 to 1.00) and 0.88 (0.76 to 0.99), respectively, whereas the AUROCs of SteatoTest was 0.68 (0.51 to 0.85). Regarding fibrosis (≥F2), APRI and FIB-4 had good performance with AUROCs at 0.86 (0.74 to 0.98) and 0.81 (0.67 to 0.95). By contrast, FibroScan and FibroTest had poor AUROCs [0.61 (0.43 to 0.79) and 0.61 (0.44 to 0.78)], with very low specificity. Regarding NASH, alanine aminotransferase ≥36 IU/L had good performance with AUROCs of 0.83 (0.71 to 0.94), whereas the NashTest had an AUROC of 0.60 (0.44 to 0.76). CONCLUSIONS: In HIV-monoinfected patients, MRI-PDFF and FibroScan/CAP are highly accurate for the diagnosis of steatosis. The alanine aminotransferase level and APRI should be considered for the detection of NASH and fibrosis.
Published: 2019

24. Immunoblots may not be effective in confirming the recency of HIV-1 infection

Author: Véronique Avettand-Fenoel, Karl Stefic, Cécile Goujard, Anrs Primo cohort, Alice-Andrée Mariaggi, Laurence Meyer, Antoine Cheret, Asma Essat, Francis Barin, Elise Gardiennet, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Université de Paris (UP), Service de Virologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Morphogénèse et antigénicité du VIH et du virus des Hépatites (MAVIVH - U1259 Inserm - CHRU Tours ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Bicêtre, and CCSD, Accord Elsevier
Subjects: 0301 basic medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], HIV diagnosis, Blotting, Western, 030106 microbiology, Western blot, HIV Infections, HIV Antibodies, Immunoblot, Sensitivity and Specificity, Pathogenesis, 03 medical and health sciences, INNO-LIA, Antigen, Virology, Epidemiology, medicine, Humans, Seroconversion, Stage (cooking), ComputingMilieux_MISCELLANEOUS, Geenius, Immunoassay, biology, 3. Good health, [SDV] Life Sciences [q-bio], Chronic infection, 030104 developmental biology, HIV-2, Immunology, Cohort, HIV primary infection, HIV-1, biology.protein, Antibody
Abstract: International audience; Recently, immunoblots (IBs) have tended to substitute Western blots (WBs) for HIV infection diagnosis. Several studies have confirmed IBs' high sensitivity to confirm HIV infection for every stage. Since the nature and pattern of the antigens of IBs are different from those of WB, the abilities of IBs and WBs to distinguish the stages of recent seroconversion and open-ended chronic infection might differ. We aimed to evaluate the performance of two IBs (INNO-LIA™ HIVI/II, Fujirebio, and Geenius™ HIV1/2 Confirmatory assay, Bio-Rad) to define the stage of infection. We studied 53 patients from the French ANRS CO6 PRIMO cohort. IBs have higher positive rates than WB. However, Geenius was less sensitive than WB and INNO-LIA to detect antibodies to p31 (0% vs 22.6 % and 15.1 %, respectively), so it could wrongly label late Fiebig stage and open-ended chronic infections as recent infections (n = 5/53). For the first time, we provide evidence that centralized WBs associated with an enzyme immunoassay for the identification of recent HIV-1 infection support the establishment of a more accurate diagnosis of primary HIV infection to improve the accuracy of enrollments in cohorts of recent HIV infections useful for epidemiological studies, pathogenesis studies or therapeutic trials.
Published: 2021
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25. Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study

Author: Rodolphe Thiébaut, François Raffi, Camelia Protopopescu, Tristan Ferry, Lise Cuzin, Mariam Noelie Hema, Vincent Le Moing, Michel Dupon, Renaud Verdon, Catherine Leport, Anrs Co, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de référence des infections ostéo-articulaires complexes Rhône Alpes Auvergne, Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Service des maladies infectieuses, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Maladies Infectieuses et Tropicales [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), ORS PACA, 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 des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), ANRS CO8 APROCO-COPILOTE,APROCO-COPILOTE,Cohorte de patients infectés par le VIH ayant débuté un traitement avec inhibiteur de protéase en 1997-1999, 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), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), 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), Cohorte de patients infectés par le VIH ayant débuté un traitement avec inhibiteur de protéase en 1997-1999 APROCO-COPILOTE ANRS CO8 APROCO-COPILOTE, DARMIGNY, Sandrine, 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), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: RNA viruses, CD4-Positive T-Lymphocytes, Male, 0301 basic medicine, Physiology, Myocardial Infarction, CD4-CD8 Ratio, lcsh:Medicine, HIV Infections, CD8-Positive T-Lymphocytes, Blood plasma, Pathology and Laboratory Medicine, 0302 clinical medicine, Immunodeficiency Viruses, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antiretroviral Therapy, Highly Active, Neoplasms, Cellular types, Medicine and Health Sciences, Public and Occupational Health, Prospective Studies, 030212 general & internal medicine, Soft tissue infections, lcsh:Science, Prospective cohort study, Multidisciplinary, Incidence (epidemiology), Immune cells, Hematology, Bacterial Infections, Viral Load, Prognosis, Vaccination and Immunization, Body Fluids, 3. Good health, Antiretroviral therapy, Infectious Diseases, Blood, Medical Microbiology, Viral Pathogens, Viruses, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, White blood cells, Female, Pathogens, Anatomy, Viral load, Research Article, Adult, Cell biology, Blood cells, medicine.medical_specialty, Immunology, Bacterial diseases, T cells, Cytotoxic T cells, Microbiology, 03 medical and health sciences, Antiviral Therapy, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Retroviruses, medicine, Humans, Microbial Pathogens, Immune activation, Proportional hazards model, business.industry, Lentivirus, lcsh:R, Organisms, Immunity, Biology and Life Sciences, HIV, HIV Protease Inhibitors, medicine.disease, Health Care, 030104 developmental biology, Animal cells, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Preventive Medicine, Myocardial infarction diagnosis, Health Statistics, Morbidity, business, Biomarkers
Abstract: International audience; Objectives To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART). Methods The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997-1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm 3 , CD4 > 500/mm 3 and CD4/CD8 ratio < 1, CD4 > 500/mm 3 and CD4/CD8 ratio > 1). Models adjusted on base-line characteristics and time-dependent viral load were compared using Akaike Information Criterion.Methods: The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm3, CD4 > 500/mm3 and CD4/CD8 ratio < 1, CD4 > 500/mm3 and CD4/CD8 ratio > 1). Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion.Results: We included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2–11.4). Median CD4 was 530/mm3 at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2–0.5) at baseline and 0.6 (IQR: 0.4–0.9) after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%), cardiovascular events (14%) and cancers (10%). For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32–3.44).Conclusions: CD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening.
Published: 2016
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26. The negative impact of HBV/HCV coinfection on cirrhosis and its consequences

Author: Stanislas Pol, Pierre Nahon, Fabrice Carrat, Christine Larsen, Fabien Zoulim, Hélène Fontaine, M. Bourlière, Georges Haour, French Anrs Co Hepather cohort, Dominique Larrey, Céline Dorival, Linda Wittkop, J-M Pawlostky, Jacqueline Capeau, Francesco Negro, J-P Zarski, V. de Ledinghen, Philippe Mathurin, Patrice Cacoub, G-P Pageaux, Yazdan Yazdanpanah, Ventzislava Petrov-Sanchez, Patrizia Carrieri, Patrick Marcellin, 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), Physiopathologie du système immunitaire (Inserm U1223), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), 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), ANRS France Recherche Nord & sud Sida-hiv hépatites, Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille], Aix Marseille Université (AMU)-Hôpital Saint-Joseph [Marseille], Université Pierre et Marie Curie - Paris 6 (UPMC), Sorbonne Universités (COMUE), Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [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), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Service d’Hépatologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépatologie et de Gastroentérologie [Lyon], Hospices Civils de Lyon (HCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Bordeaux Research In Translational Oncology [Bordeaux] (BaRITOn), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille], Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Geneva University Hospital (HUG), Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Departement Hospitalo- Universitaire - Inflammation, Immunopathologie, Biothérapie [Paris] (DHU - I2B), and Université Pierre et Marie Curie - Paris 6 (UPMC)-CHU Pitié-Salpêtrière [AP-HP]
Subjects: 0301 basic medicine, Male, Liver Cirrhosis, Cirrhosis, viruses, Coinfection/virology, [SDV]Life Sciences [q-bio], medicine.disease_cause, Gastroenterology, Cohort Studies, 0302 clinical medicine, Fibrosis, Medicine, Pharmacology (medical), ddc:616, biology, Coinfection, virus diseases, Middle Aged, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Hepatitis B, Hepatitis C, 3. Good health, 030211 gastroenterology & hepatology, Female, Antibody, Cohort study, Adult, medicine.medical_specialty, Hepatitis B/epidemiology/pathology, Hepatitis C virus, Hepatitis b surface antigen, 03 medical and health sciences, Internal medicine, Humans, Aged, Hepatitis B virus, Hepatology, business.industry, Liver Cirrhosis/epidemiology/pathology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatitis C/epidemiology/pathology, Hepatitis C Antibodies, medicine.disease, Virology, digestive system diseases, ddc:616.8, 030104 developmental biology, biology.protein, business
Abstract: International audience; BACKGROUND: Hepatitis B virus (HBV)/hepatitis C virus (HCV) confection has been rarely studied in nonasian series. AIM: To compare the characteristics of HBV/HCV coinfected patients to those of HBV- or HCV-monoinfected patients in the ANRS CO22 HEPATHER cohort study. PATIENTS AND METHODS: Of the 20 936 included patients, 95 had HBV/HCV coinfection (hepatitis B surface antigen, anti-HCV antibody and HCV RNA positive) and were matched with 375 HBV- and 380 HCV-monoinfected patients on age, gender and time since HBV or HCV diagnosis. RESULTS: F3-F4 fibrosis was more frequent in coinfected patients (58%) than in HBV- (32%, P \textless .0001), but similar in HCV-monoinfected patients (52%, P = .3142). Decompensated cirrhosis was more frequent in coinfected patients (11%) than in HBV- (2%, P = .0002) or HCV- (4%, P = .0275) monoinfected patients. Past excessive alcohol use was more frequent in coinfected patients (26%) than in HBV (12%, P = .0011), but similar in HCV monoinfected patients (32%, P = .2868). Coinfected patients had a higher proportion with arterial hypertension (42%) than HBV- (26%) or HCV-monoinfected patients (25%) (P \textless .003). Multivariable analysis confirmed the association between F3-F4 fibrosis and HCV infection in HBV-infected patients (OR = 3.84, 95% CI 1.99-7.43) and the association between decompensated cirrhosis and coinfection in HBV infected (OR = 5.58, 95% CI 1.42-22.0) or HCV infected patients (OR = 3.02, 95% CI 1.22-7.44). CONCLUSIONS: HCV coinfection harmfully affects liver fibrosis in HBV patients, while decompensated cirrhosis is increased in coinfected patients compared with HBV- or HCV-monoinfected patients. HCV treatment is as safe and effective in coinfected as monoinfected patients and should be considered following the same rules as HCV monoinfected patients.
Published: 2017
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27. Bacterial infection in compensated viral cirrhosis impairs 5-year survival (ANRS CO12 CirVir prospective cohort)

Author: Nahon, Pierre, Lescat, Mathilde, Layese, Richard, Bourcier, Valérie, Talmat, Nabila, Allam, Setty, Marcellin, Patrick, Guyader, Dominique, Pol, Stanislas, Larrey, Dominique, de Lédinghen, Victor, Ouzan, Denis, Zoulim, Fabien, Roulot, Dominique, Tran, Albert, Bronowicki, Jean-Pierre, Zarski, Jean-Pierre, Goria, Odile, Calès, Paul, Peron, Jean-Marie, Alric, Laurent, Bourlière, Marc, Mathurin, Philippe, Blanc, Jean-Frederic, Abergel, Armand, Serfaty, Lawrence, Mallat, Ariane, Grangé, Jean-Didier, Attali, Pierre, Bacq, Yannick, Wartelle, Claire, Dao, Thong, Benhamou, Yves, Pilette, Christophe, Silvain, Christine, Christidis, Christos, Capron, Dominique, Bernard-Chabert, Brigitte, Hillaire, Sophie, Di Martino, Vincent, Trinchet, Jean-Claude, Moreau, Richard, Roudot-Thoraval, Françoise, Cirvir Group, Anrs Co12, Service d'hépato-gastroentérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche biomédicale Bichat-Beaujon (CRB3), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et Pharmacotoxicologie Placentaire Humaine (U1139), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Service d'Hépato-gastroentérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Foie, métabolismes et cancer, 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 ), CHU Pontchaillou [Rennes], Department of hepatology, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Cellules souches normales et cancéreuses, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Service de Gastro-entérologie [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Pôle Digestif, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Département d'hépato-gastroentérologie, CHU Grenoble-Université Grenoble Alpes (UGA), CHU Rouen, Normandie Université (NU), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Hepato-gastro-enterology, Toulouse University hospital, Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Service d'hépato-gastro-entérologie, Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Huriez-Université de Lille, Inserm, UMR-1053, Université de Bordeaux, Bordeaux, F-33076, France, Centre hospitalier universitaire de Bordeaux, Department of Hepatology, Hôpital Saint-André, Bordeaux, F-33076, France, Centre Hospitalier Universitaire Estaing, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Service d'hépato-gastro-entérologie [APHP Henri Mondor], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Service de gastro-entérologie [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Service d'Hépato-Gastro-Enterologie et Nutrition [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Mobilités : Vieillissement, Pathologie, Santé (COMETE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service d'Hépatogastroentérologie, CHU Amiens-Picardie, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Service de santé publique [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), Service d’Hépatologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], 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 ), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut Arnault Tzanck, Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Hôpital Saint-Joseph [Marseille], Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Saint-André, Hôpital Hôtel-Dieu de Clermont-Ferrand, CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Tenon [AP-HP], CHU Trousseau [APHP], Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Le Mans (CH Le Mans), Institut mutualiste Monsouris (IMM), Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Foch [Suresnes], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut National de la Santé et de la Recherche Médicale (INSERM)-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 de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes (UGA)-CHU Grenoble, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (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], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-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)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP), Centre de recherche biomédicale Bichat-Beaujon ( CRB3 ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Physiopathologie et Pharmacotoxicologie Placentaire Humaine ( U1139 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Jean Verdier, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Jean Verdier, Centre de recherche sur l'Inflammation ( CRI ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), 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 ), CHU Cochin [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -CHU Saint-Eloi, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hospices Civils de Lyon ( HCL ), Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Centre méditérannéen de médecine moléculaire ( C3M ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Nice-Hôpital l'Archet, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques ( HIFIH ), Université d'Angers ( UA ), Pharmacochimie et Pharmacologie Pour le Développement ( PHARMA-DEV ), Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ), CHU Saint-Antoine [APHP], Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse, Service de gastro-entérologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Service d'Hépato-Gastro-Enterologie et Nutrition [Caen], Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Caen, Mobilités : Vieillissement, Pathologie, Santé ( COMETE ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Beaujon, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Avicenne [AP-HP], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Institut de Recherche pour le Développement (IRD), Hôpital Paul Brousse-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Liver Cirrhosis, Male, Cirrhosis, Gastroenterology, Severity of Illness Index, 0302 clinical medicine, Risk Factors, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Cause of Death, Medicine, Cumulative incidence, Prospective Studies, Prospective cohort study, Coinfection, Incidence, Liver Neoplasms, Hepatitis C, Bacterial Infections, Hepatitis B, Middle Aged, Prognosis, 3. Good health, Survival Rate, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, 030220 oncology & carcinogenesis, Urinary Tract Infections, HEPATITIS C, 030211 gastroenterology & hepatology, Female, France, Liver cancer, Viral hepatitis, Adult, medicine.medical_specialty, Peritonitis, 03 medical and health sciences, Hepatitis B, Chronic, Internal medicine, Humans, Survival rate, business.industry, cirrhosis, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Pneumonia, Hepatitis C, Chronic, medicine.disease, BACTERIAL INFECTION, Immunology, business, Liver Failure
Abstract: International audience; OBJECTIVE: To assess incidence and prognostic significance of bacterial infections (BIs) occurring in compensated viral cirrhosis. DESIGN: This prospective study involved 35 French centres. Inclusion criteria were biopsy-proven HCV or HBV cirrhosis, Child-Pugh A and no previous hepatic complications. Cumulative incidence (CumI) of events was estimated in a competing risks framework. RESULTS: 1672 patients were enrolled (HCV 1323, HBV 318, HCV-HBV 31). During a median follow-up of 43 months, 234 BIs occurred in 171 patients (5 year CumI: 12.9%), among whom 14.6% had septic shock. Main localisations included the urinary tract (27.4%), lung (25.2%) and peritoneum (10.7%) (other, 86 (36.7%)). Most BIs occurred as a first event prior to liver decompensation (n=140, 81.8%) and were community-acquired (CA, 84.2%). The risk of BI was higher in patients with HCV than in patients with HBV (5 year CumI: 15.2% vs 5.5%, p=0.0008). Digestive localisation, concomitant interferon-based treatment, isolation of resistant bacteria and non-CA BIs were associated with lowest probability of resolution. The occurrence of a first BI impaired survival in patients infected with HCV (5 year survival: 60.2% vs 90.4%, p\textless0.001) and patients infected with HBV (5 year survival: 69.2% vs 97.6%, p\textless0.001). BIs represented the third cause of death (14.1%) after liver failure and liver cancer. BI risk factors comprised older age, lower albumin, proton pump inhibitor intake and absence of virological eradication/control. CONCLUSION: BI mostly occurs as a first complication and represents a turning point in the course of compensated viral cirrhosis. Its occurrence impacts long-term prognosis and may define a subgroup of patients in whom adaptation of management is warranted
Published: 2017
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28. Intensive five-drug antiretroviral therapy regimen versus standard triple-drug therapy during primary HIV-1 infection (OPTIPRIM-ANRS 147): a randomised, open-label, phase 3 trial

Author: Chéret, A, Nembot, G, Mélard, A, Lascoux, C, Slama, L, Miailhes, P, Yeni, P, Abel, S, Avettand-Fenoel, V, Venet, A, Chaix, Ml, Molina, Jm, Katlama, C, Goujard, C, Tamalet, C, Raffi, F, Lafeuillade, A, Reynes, J, Ravaux, I, Hoën, B, Delfraissy, Jf, Meyer, L, Rouzioux, C, Group, Optiprim Anrs Study, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Médecine interne [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier de Tourcoing, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Service de maladies infectieuses et tropicales, 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)-Université Paris Diderot - Paris 7 (UPD7), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Laboratoire de virologie, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Virology, Hôpital de la Timone [CHU - APHM] (TIMONE), Maladies infectieuses et tropicales, Department of Infectious Diseases, General Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er 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 [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU Pointe-à-Pitre/Abymes [Guadeloupe], France REcherche Nord & sud Sida-hiv Hépatites (FRENSH), Inserm–ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck, and ViiV Laboratories, Asier Saez-Cirion collabore dans le groupe OPTIPRIM ANRS Study Group, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) ( EA 7327 ), Université Paris Descartes - Paris 5 ( UPD5 ), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Centre de Recherche en Cancérologie de Lyon ( CRCL ), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), CHU Fort de France-CHU de la Martinique-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique, Université Paris-Sud - Paris 11 ( UP11 ) -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], Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Hôpital de la Timone [CHU - APHM] ( TIMONE ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -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 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 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 Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Diallo, Ousseynatou
Subjects: Cart, Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, Mononuclear, Antiretroviral Therapy, HIV Infections, Emtricitabine, 03 medical and health sciences, chemistry.chemical_compound, immune system diseases, Internal medicine, Antiretroviral Therapy, Highly Active, medicine, Leukocytes, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Humans, Highly Active, education, Darunavir, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, Maraviroc, 0303 health sciences, education.field_of_study, 030306 microbiology, business.industry, virus diseases, Middle Aged, Viral Load, Raltegravir, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], Regimen, Infectious Diseases, Treatment Outcome, chemistry, Anti-Retroviral Agents, HIV-1, Leukocytes, Mononuclear, [SDV.IMM]Life Sciences [q-bio]/Immunology, Ritonavir, Female, France, business, medicine.drug
Abstract: International audience; BACKGROUND: Early combination antiretroviral therapy (cART) initiation at the time of primary HIV-1 infection could restrict the establishment of HIV reservoirs. We aimed to assess the effect of a cART regimen intensified with raltegravir and maraviroc, compared with standard triple-drug cART, on HIV-DNA load. METHODS: In this randomised, open-label, phase 3 trial, we recruited patients from hospitals across France. Inclusion criteria were primary HIV-1 infection (an incomplete HIV-1 western blot and detectable plasma HIV-RNA), with either symptoms or a CD4+ cell count below 500 cells per μL. Patients were randomly assigned (1:1) to an intensive, five-drug cART regimen (raltegravir 400 mg and maraviroc 150 mg twice daily, and a fixed-dose combination of tenofovir disoproxil fumarate 300 g plus emtricitabine 200 g, darunavir 800 g, and ritonavir 100 g once daily) or a standard triple-drug cART regimen (tenofovir disoproxil fumarate 300 g plus emtricitabine 200 g, darunavir 800 g, and ritonavir 100 g once daily) using a predefined randomised list generated by randomly selected variable block sizes. The primary endpoint was the median number of HIV-DNA copies per 10(6) peripheral blood mononuclear cells (PBMC) at month 24, analysed in the modified intention-to-treat population, defined as all patients who started their assigned treatment. This study is registered with ClinicalTrials.gov, number NCT01033760. FINDINGS: Between April 26, 2010, and July 13, 2011, 110 patients were enrolled, of whom 92 were randomly assigned and 90 started treatment (45 in each treatment group). Six (13%) patients in the intensive cART group and two (4%) in the standard cART group discontinued before month 24. At month 24, HIV-DNA loads were similar between groups (2·35 [IQR 2·05-2·50] log₁₀ per 10(6) PBMC in the intensive cART group vs 2·25 [1·71-2·55] in the standard cART group; p=0·21). Eight grade 3-4 clinical adverse events were reported in seven patients in the intensive cART group and seven grade 3-4 clinical adverse events were reported in seven patients in the standard cART group. Three serious clinical adverse events occurred: two (pancreatitis and lipodystrophy) in the standard cART group, which were regarded as treatment related, and one event (suicide attempt) in the intensive cART group that was unrelated to treatment. INTERPRETATION: After 24 months, cART intensified with raltegravir and maraviroc did not have a greater effect on HIV blood reservoirs than did standard cART. These results should help to design future trials of treatments aiming to decrease the HIV reservoir in patients with primary HIV-1 infection. FUNDING: Inserm-ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck, and ViiV Laboratories.
Published: 2015
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29. Value of chest X-ray in TB diagnosis in HIV-infected children living in resource-limited countries: the ANRS 12229-PAANTHER 01 study

Author: L. Berteloot, O. Marcy, B. Nguyen, V. Ung, M. Tejiokem, B. Nacro, S. Goyet, B. Dim, S. Blanche, L. Borand, P. Msellati, C. Delacourt, null for the ANRS PAANTHER Study Group, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Tuberculosis, diagnosis, Radiography, HIV Infections, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, IDLIC, 03 medical and health sciences, 0302 clinical medicine, Cohen's kappa, children, Interquartile range, 030225 pediatrics, Burkina Faso, Humans, Medicine, Cameroon, Prospective Studies, Child, Prospective cohort study, Tuberculosis, Pulmonary, business.industry, HIV, Pulmonologist, medicine.disease, chest X-ray, 3. Good health, Infectious Diseases, tuberculosis, Vietnam, Child, Preschool, Radiological weapon, Health Resources, Female, Radiography, Thoracic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cambodia, business, Kappa
Abstract: OBJECTIVE: To evaluate inter-reader agreement and diagnostic accuracy of chest radiography (CXR) in the diagnosis of tuberculosis (TB) in children with human immunodeficiency virus (HIV) infection. DESIGN: HIV-infected children with clinically suspected TB were enrolled in a prospective study conducted in Burkina Faso, Cambodia, Cameroon and Viet Nam from April 2010 to December 2014. Three readers-a local radiologist, a paediatric pulmonologist and a paediatric radiologist-independently reviewed the CXRs. Inter-reader agreement was then assessed using the kappa coefficient. Diagnostic accuracy of CXR was assessed in culture-confirmed cases and controls. RESULTS: A total of 403 children (median age 7.3 years, interquartile range 3.5-9.7; 49.6% males) were enrolled. Inter-reader agreement was as follows: between local radiologist and paediatric pulmonologist, kappa = 0.36 (95%CI 0.27-0.45); local radiologist and paediatric radiologist, kappa = 0.16 (95%CI 0.08-0.24); and paediatric pulmonologist and paediatric radiologist, kappa = 0.30 (95%CI 0.21-0.40). Among 51 cases and 151 controls, after a consensus, CXR had a sensitivity of 71.4% (95%CI 58.8-84.1) and a specificity of 50.0% (95%CI 41.9-58.1). Alveolar opacities and enlarged lymph nodes on CXR had limited specificity for TB (64.7% and 70.2%, respectively). Miliary and/or nodular opacities patterns on CXR were more specific to TB (specificity 94.3%). CONCLUSION: CXR showed poor-to-fair inter-reader agreement and limited diagnostic accuracy for TB in HIV-infected children, likely due to comorbidities. Radiological criteria for this specific population require further investigation.
Published: 2018
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30. Daily cannabis and reduced risk of steatosis in human immunodeficiency virus and hepatitis C virus-co-infected patients (ANRS CO13-HEPAVIH)

Author: Dabis, F., Chas, J., Rey, D., Wittkop, L., Sogni, P., Carrieri, P., Grp, ANRS CO13 HEPAVIH Study, Nordmann, S., Vilotitch, A., Roux, P., Esterle, L., Spire, B., Marcellin, F., Salmon-Ceron, D., DUFOUR, Jean-Charles, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, [SDV]Life Sciences [q-bio], HIV Infections, Hepacivirus, medicine.disease_cause, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Prospective Studies, 030212 general & internal medicine, Ultrasonography, education.field_of_study, biology, Coinfection, Lamivudine, Middle Aged, Hepatitis C, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Liver, Cohort, Female, 030211 gastroenterology & hepatology, France, medicine.drug, Adult, medicine.medical_specialty, Hepatitis C virus, Population, Marijuana Smoking, 03 medical and health sciences, Virology, Internal medicine, medicine, Humans, education, Hepatology, business.industry, Odds ratio, medicine.disease, biology.organism_classification, Fatty Liver, Cross-Sectional Studies, Logistic Models, Cannabis, Insulin Resistance, Steatosis, business, Body mass index
Abstract: Summary Liver steatosis is common in human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-co-infected patients. Some recent studies have found that cannabis use is negatively associated with insulin resistance in the general population and in HIV-HCV-co-infected patients. Given the causal link between insulin resistance and steatosis, we hypothesized that cannabis use has a positive impact on steatosis. Therefore, we aimed to study whether cannabis use in this population was associated with a reduced risk of steatosis, measured by ultrasound examination. ANRS CO13-HEPAVIH is a French nationwide multicentre cohort of HIV-HCV-co-infected patients. Medical and socio-behavioural data from clinical follow-up visits and annual self-administered questionnaires were prospectively collected. A cross-sectional analysis was conducted using data from the first visit where both ultrasound examination data for steatosis (positive or negative diagnosis) and data on cannabis use were available. A logistic regression model was used to evaluate the association between cannabis use and steatosis. Among study sample patients (n = 838), 40.1% had steatosis. Fourteen per cent reported daily cannabis use, 11.7% regular use and 74.7% no use or occasional use (“never or sometimes”). Daily cannabis use was independently associated with a reduced prevalence of steatosis (adjusted odds ratio [95% CI] = 0.64 [0.42;0.99]; P = .046), after adjusting for body mass index, hazardous alcohol consumption and current or lifetime use of lamivudine/zidovudine. Daily cannabis use may be a protective factor against steatosis in HIV-HCV-co-infected patients. These findings confirm the need for a clinical evaluation of cannabis-based pharmacotherapies in this population. Eudract.ema.europa.eu number, DGS050367.
Published: 2018
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31. CD4+ cell count recovery after combined antiretroviral therapy in the modern combined antiretroviral therapy era

Author: Hélène Roul, Jade Ghosn, Fhdh-Anrs Co, Odile Launay, Pierre de Truchis, Laurence Weiss, Dominique Costagliola, Constance Delaugerre, Jean-Marc Lacombe, Amélie Menard, Gilles Pialoux, Jean-François Delfraissy, Murielle Mary-Krause, Lise Cuzin, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université (SU), 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)), 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), Université Sorbonne Paris Cité (USPC), Laboratoire de Virologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Service des maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de la Martinique [Fort de France], Hôpital Cochin [AP-HP], Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Hôpital Raymond Poincaré [AP-HP], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Nord, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP]-Sorbonne Université (SU), CHU Cochin [AP-HP], Institut Hospitalier Universitaire Méditerranée Infection (IHU AMU), AP-HP Hôpital Raymond Poincaré [Garches], and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: 0301 basic medicine, Cart, Adult, Male, medicine.medical_specialty, Adolescent, Sustained Virologic Response, [SDV]Life Sciences [q-bio], Immunology, Population, HIV Infections, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Immune Reconstitution, Internal medicine, Antiretroviral Therapy, Highly Active, Immunology and Allergy, Medicine, Humans, Cumulative incidence, 030212 general & internal medicine, Young adult, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, Middle Aged, 030112 virology, Confidence interval, 3. Good health, CD4 Lymphocyte Count, Infectious Diseases, Treatment Outcome, Anti-Retroviral Agents, HIV-1, Female, France, business, Viral load, CD8, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study
Abstract: International audience; Objective: To assess CD4 recovery after combined antiretroviral therapy (cART) initiation with sustained virologic control.Design: Cohort study based on the French Hospital Database on HIV (FHDH-ANRS CO4).Methods: We selected naive HIV-1-infected individuals initiating cART between 2006 and 2014 with CD4 cell counts less than 500 cells/μl who achieved virologic control, defined as two consecutive viral loads less than 50 copies/ml. We estimated the cumulative incidence of CD4 recovery at least 500 cells/μl and identified associated factors, considering 'virologic failure,' 'loss to follow-up' and 'death' as competing events.Results: We analyzed 6050 individuals with a median follow-up of 14.2 months since virologic control. The cumulative incidence for CD4 recovery after 6 years of virologic control reached 69.7%. The main factor associated with CD4 recovery was the CD4 count at treatment initiation [subdistribution hazard ratio (sHR) 9.64, 95% confidence interval (95% CI) 8.12-11.43 for CD4 cell counts between 350 and 500 cells/μl compared with CD4 cell counts
Published: 2018
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32. Reply to 'A strong message is needed to address the issue of HCC recurrence after DAA therapy'

Author: Carrat, F., Nahon, P., Duclos-Vallée, J.C., Pageaux, G.P., Fontaine, H., Pol, S., (ANRS CO22 HEPATHER, CO12 CirVir and CO23 CUPILT cohorts), ANRS collaborative study group on hepatocellular carcinoma, 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), Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Physiopathologie et traitement des maladies du foie, Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hepatinov (DHU), Université Paris-Sud - Paris 11 (UP11)-Centre Hépato-Biliaire Paul Brousse, Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Université de Montpellier (UM)-CHU Saint-Eloi, 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), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital Paul Brousse, CHU Saint-Eloi-Université de Montpellier (UM), and CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatology, business.industry, Liver Neoplasms, Alternative medicine, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Antiviral Agents, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Humans, Medicine, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business, Intensive care medicine, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2016
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33. Long-term Immune Response to Hepatitis B Virus Vaccination Regimens in Adults With Human Immunodeficiency Virus 1: Secondary Analysis of a Randomized Clinical Trial

Author: Launay, Odile, Rosenberg, Arielle, Rey, David, Pouget, Noelle, Michel, Marie-Louise, Reynes, Jacques, Neau, Didier, Raffi, François, Piroth, Lionel, Carrat, Fabrice, Group, ANRS HB03 VIHVAC-B (Trial Comparing 3 Strategies of Vaccination Against the Virus of Hepatitis B in HIV-Infected Patients), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIC Cochin Pasteur (CIC 1417), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe hospitalier Broca-Université Paris Descartes - Paris 5 (UPD5)-Hôtel-Dieu-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), REseau national d'Investigation clinique en VACcinologie (REIVAC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de Gestion des Essais de Produits de Santé (CeNGEPS), CHU Strasbourg, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie des virus entériques (BVE), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Service des Maladies Infectieuses et Tropicales A [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Collège des Universitaires des Maladies Infectieuses et Tropicales (CMIT), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Agroécologie [Dijon], Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), This study was supported by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS). Sanofi Pasteur-MSD contributed the vaccines., CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de Gestion des Essais de Produits de Santé (CeNGEPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Microbiologie Fondamentale et Pathogénicité (MFP), Herrada, Anthony, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Male, HIV Infections, medicine.disease_cause, law.invention, MESH: HIV-1, 0302 clinical medicine, Randomized controlled trial, law, Single-Blind Method, 030212 general & internal medicine, MESH: Hepatitis B Antibodies, MESH: Treatment Outcome, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Vaccination, MESH: Follow-Up Studies, MESH: HIV Infections, Hepatitis B, Middle Aged, 16. Peace & justice, MESH: Injections, Intramuscular, 3. Good health, Treatment Outcome, Female, France, Intramuscular injection, Adult, medicine.medical_specialty, Hepatitis B vaccine, Injections, Intradermal, 030106 microbiology, Population, Injections, Intramuscular, 03 medical and health sciences, Internal medicine, Internal Medicine, medicine, Humans, Hepatitis B Vaccines, Hepatitis B Antibodies, education, Hepatitis B virus, MESH: Injections, Intradermal, MESH: Hepatitis B Vaccines, MESH: Humans, MESH: Hepatitis B, business.industry, MESH: Adult, MESH: Vaccination, medicine.disease, MESH: Single-Blind Method, MESH: Male, Surgery, MESH: France, Regimen, HIV-1, MESH: Biomarkers, business, MESH: Female, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; IMPORTANCE:Data on long-term immune responses to hepatitis B virus (HBV) vaccination in adults with human immunodeficiency virus 1 (HIV-1) infection are scarce.OBJECTIVE:To compare long-term (up to month 42) immune responses to the standard HBV vaccination regimen with a 4-injection intramuscular double-dose regimen and a 4-injection intradermal low-dose regimen.DESIGN, SETTING, AND PARTICIPANTS:The phase 3, open-label, multicenter parallel-group (1:1:1 allocation ratio) randomized clinical trial was conducted from June 28, 2007, to October 23, 2008, at 33 centers in France. Participants included 437 HBV-seronegative adults with HIV-1 and CD4 cell counts of more than 200/μL. Follow-up was extended to September 12, 2012, and data were assessed from February 13, 2015, to January 22, 2016. The analysis was imputed for an intention-to-treat population.INTERVENTIONS:Patients were randomly assigned to receive 3 intramuscular standard-dose (20-μg) injections of recombinant HBV vaccine at weeks 0, 4, and 24 (IM20 × 3 group) (145 participants), 4 intramuscular double-dose (40-μg) injections at weeks 0, 4, 8, and 24 (IM40 × 4 group) (148 participants), or 4 intradermal low-dose (4-μg) injections at weeks 0, 4, 8, and 24 (ID4 × 4 group) (144 participants).MAIN OUTCOMES AND MEASURES:The previously published primary trial end point was the percentage of responders at week 28, defined as patients with hepatitis B surface antibody (HBsAb) levels of at least 10 mIU/mL among patients who received at least 1 vaccine dose. The secondary trial end points included the percentage of responders at months 18, 30, and 42 and the duration of response from week 28. Multiple imputation was used to address missing measurements during the follow-up.RESULTS:Among the 437 patients randomized, 426 received at least 1 dose of vaccine. Of these, 287 were men (67.4%) and they had a mean (SD) age of 42.9 (9.7) years. The percentage of responders at month 42 was 41% (95% CI, 33%-49%) in the IM20 × 3 group, 71% (95% CI, 64%-79%) in the IM40 × 4 group (P
Published: 2016
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34. Missed Opportunities for Early Access to Care of HIV-Infected Infants in Burkina Faso

Author: Malik Coulibaly, Nicolas Meda, Caroline Yonaba, Sylvie Ouedraogo, Malika Congo, Mamoudou Barry, Elisabeth Thio, Issa Siribié, Fla Koueta, Diarra Ye, Ludovic Kam, Stéphane Blanche, Phillipe Van De Perre, Valériane Leroy, MONOD Study Group ANRS 12206, Boutin, Marion, Projet MONOD [Ouagadougou, Burkina Faso], Université Joseph Ki-Zerbo [Ouagadougou] (UJZK)-ANRS Agence Nationale de Recherche sur le Sida [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Service de Pédiatrie [Ouagadougou, Burkina Faso], Centre Hospitalier Universitaire Yalgado Ouédraogo (CHUYO), Service de Pédiatrie médicale [Ouagadougou, Burkina Faso], CHU Pédiatrique Charles De Gaulle [Ouagadougou, Burkina Faso] (CHUP-CDG), Laboratoire de Bactériologie et Virologie du CHU-Yalgado Ouédraogo, Projet MONOD, Service d'immuno-hématologie pédiatrique [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), Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, and ANRS Agence Nationale de Recherche sur le Sida [Ouagadougou, Burkina Faso]-Université Joseph Ki-Zerbo [Ouagadougou] (UJZK)
Subjects: Program evaluation, Male, Pediatrics, Viral Diseases, Cross-sectional study, Epidemiology, lcsh:Medicine, HIV Infections, Health Services Accessibility, Immunodeficiency Viruses, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Health care, Pregnancy Complications, Infectious, Child, Health Systems Strengthening, lcsh:Science, education.field_of_study, Multidisciplinary, Transmission (medicine), Child and Adolescent Health Policy, Child Health, Obstetrics and Gynecology, virus diseases, HIV diagnosis and management, Socioeconomic Aspects of Health, 3. Good health, Infectious Diseases, Medical Microbiology, HIV epidemiology, Child, Preschool, Viral Pathogens, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Research Article, medicine.medical_specialty, Adolescent, Anti-HIV Agents, Urology, Population, HIV prevention, Staffing, Developing country, Microbiology, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Burkina Faso, medicine, Humans, education, Microbial Pathogens, Medicine and health sciences, Preventive medicine, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Health Care Policy, business.industry, Genitourinary Infections, lcsh:R, Infant, Biology and Life Sciences, HIV, medicine.disease, Infectious Disease Transmission, Vertical, Diagnostic medicine, Health Care, Public and occupational health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Pediatric epidemiology, Women's Health, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health Statistics, business
Abstract: International audience; Objective: The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIV-infected children before the age of two since 2010, but this implies an early identification of these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.Methods: We conducted a cross-sectional survey in 2011 in all health care facilities involved in PMTCT and pediatric HIV care in Ouagadougou. We assessed them according to their coverage in pediatric HIV care and WHO standards, through a desk review of medical registers and a semi-structured questionnaire administered to health-care workers (HCW).Results: In 2011, there was no offer of care in primary health care facilities for HIV-infected children in Ouagadougou. Six district hospitals and two university hospitals provided pediatric HIV care. Among the 67 592 pregnant women attending antenatal clinics in 2011, 85.9% were tested for HIV. The prevalence of HIV was 1.8% (95% Confidence Interval: 1.7%-1.9%). Among the 1 064 HIV-infected pregnant women attending antenatal clinics, 41.4% received a mother-to-child HIV transmission prevention intervention. Among the HIV-exposed infants, 313 (29.4%) had an early infant HIV test, and 306 (97.8%) of these infants tested received their result within a four-month period. Among the 40 children initially tested HIV-infected, 33 (82.5%) were referred to a health care facility, 3 (9.0%) were false positive, and 27 (90.0%) were initiated on ART. Although health care facilities were adequately supplied with HIV drugs, they were hindered by operational challenges such as shortage of infrastructures, laboratory reagents, and trained HCW.Conclusions: The PMTCT cascade revealed bottle necks in PMTCT intervention and HIV early infant diagnosis. The staffing in HIV care and quality of health care infrastructures were also insufficient in 2011 in Ouagadougou.
Published: 2014
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35. HBV or HCV Coinfection in HIV-1-Infected Pregnant Women in France: Prevalence and Pregnancy Outcomes

Author: Josiane Warszawski, Valérie Benhammou, Sophie Matheron, Roland Tubiana, P. Sellier, Anrs Epf Co, Emmanuelle Marel, Jérôme Le Chenadec, Babak Khoshnood, and Laurent Mandelbrot
Subjects: Adult, medicine.medical_specialty, Adolescent, Emigrants and Immigrants, HIV Infections, Emtricitabine, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Hepatitis B, Chronic, Pregnancy, Internal medicine, Surveys and Questionnaires, Prevalence, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Cholestasis, Hepatitis B Surface Antigens, business.industry, Coinfection, Infant, Newborn, Pregnancy Outcome, virus diseases, Lamivudine, Hepatitis C, Odds ratio, Hepatitis B, Hepatitis C, Chronic, Viral Load, medicine.disease, digestive system diseases, CD4 Lymphocyte Count, Infectious Diseases, Anti-Retroviral Agents, Premature Birth, RNA, Viral, 030211 gastroenterology & hepatology, Female, France, business, Viral load, medicine.drug
Abstract: BACKGROUND Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infected persons but their impact on pregnant HIV-infected women is understudied. We explored whether these coinfections are associated with adverse pregnancy outcomes and lower response to antiretroviral therapy (ART). METHODS Pregnancies in HIV-1-infected women included in the ANRS French Perinatal Cohort between 2005 and 2013 were analyzed if HBV and HCV infection statuses were available. RESULTS Among 4236 women, the prevalence of HBV (HBs Ag+) and HCV (RNA+) were 6.2% (95% confidence interval: 5.4 to 6.8) and 1.7% (1.3 to 2.1), respectively. HCV coinfection was strongly associated with a history of drug use; HBV coinfection was 6 times more frequent in women born in Sub-Saharan Africa than in European France. Baseline HIV viral load, CD4 count, and HIV care during pregnancy were similar in coinfected and monoinfected HIV mothers, except that 90% of HBV/HIV women were receiving tenofovir and/or lamivudine or emtricitabine. HCV coinfection was significantly associated with cholestasis [adjusted odds ratio: 4.1 (1.5-10.8), P = 0.005], preterm delivery [3.0 (1.6-5.7), P < 0.001], lower CD4 [2.6 (1.0-6.4), P < 0.001], and detectable viral load [2.3 (1.0-5.5), P = 0.06] at the end of pregnancy. HBV coinfection was not associated with any of these outcomes. CONCLUSIONS In HIV-infected women, chronic HBV infection, mostly treated using targeted ART, had no major impact on the course of pregnancy. By contrast, chronic HCV infection was associated with a higher risk of obstetrical complications and a poorer immune-virological response to ART. It is yet unknown whether cure of HCV infection before conception can limit these adverse outcomes.
Published: 2017

36. Cytochrome 2B6 polymorphism and efavirenz-induced central nervous system symptoms : a substudy of the ANRS ALIZE trial

Author: Gallien, Sébastien, Journot, V, Loriot, M. A., Sauvageon, H., Morlat, P, Reynes, J., Reliquet, V., Chêne, G., Molina, J-M, trial study group, ANRS 099 ALIZE, Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Hôpital Saint-Louis, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)
Subjects: Cyclopropanes, Male, HIV Infections, Pharmacology, 030226 pharmacology & pharmacy, Gastroenterology, chemistry.chemical_compound, Plasma, 0302 clinical medicine, Interquartile range, Central Nervous System Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Didanosine, cytochrome P450 2B6 (CYP2B6), pharmacogenetics, Health Policy, efavirenz, Middle Aged, 3. Good health, Infectious Diseases, Alkynes, Female, medicine.drug, Adult, medicine.medical_specialty, Efavirenz, Drug-Related Side Effects and Adverse Reactions, Anti-HIV Agents, Single-nucleotide polymorphism, Emtricitabine, Polymorphism, Single Nucleotide, 03 medical and health sciences, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, CYP3A5, business.industry, toxicity, central nervous system, Benzoxazines, Cytochrome P-450 CYP2B6, chemistry, Relative risk, business, Pharmacogenetics, Follow-Up Studies
Abstract: International audience; OBJECTIVES:Single nucleotide polymorphisms in the cytochrome P450 (CYP) 2B6 gene have been associated with high interindividual variation in efavirenz pharmacokinetics. However, clinical data on the relationship of CYP2B6 polymorphisms with the occurrence of efavirenz-induced central nervous system (CNS) symptoms are limited.METHODS:We analysed four polymorphisms in the CYP2B6 (516 G>T), CYP3A5 (6986 A>G) and ATP-binding cassette, sub-family B, member 1 (ABCB1) (2677 G>T/A and 3435 C>T) genes in HIV-infected adults virologically suppressed on a protease inhibitor-based regimen who switched to a regimen containing emtricitabine, didanosine and efavirenz in the setting of the ANRS ALIZE trial. Kaplan-Meier methods and Cox regression analysis were used to investigate their association with efavirenz plasma levels and CNS events up to 48 months after switching.RESULTS:In total, 191 patients with a median age of 41 years, who were 87% male and 85% Caucasian, were enrolled in the study. Variant allelic frequencies were 0.49, 0.93, 0.59 and 0.63 for CYP2B6 516, CYP3A5 392, ABCB1 2677 and ABCB1 3435, respectively. The median efavirenz plasma concentration (MEPC) was 2.2 mg/L [interquartile range (IQR) 1.7-2.8 mg/L] and was significantly higher in patients with the deficient CYP2B6 516T. Overall, 242 CNS events were reported in 104 individuals (54%). No correlation was found between MEPC and CNS events. The occurrence of a first CNS event was lower in patients with the CYP2B6 516 G/G genotype vs. CYP2B6 516 T genotypes [50% (IQR: 40-60%) vs. 66% (IQR: 56-75%), respectively; P = 0.02]. In an adjusted Cox regression model, there was a tendency towards a higher risk of a first CNS event among carriers of the variant CYP2B6 516 T allele (relative risk 1.4 [95% CI, 0.99-2.1]; P?=?.06), compared with noncarriers.CONCLUSIONS:The deficient CYP2B6 516 T allele is associated with higher efavirenz plasma drug levels and more frequent CNS-related symptoms.
Published: 2017
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37. Hepatic, Renal, Hematologic, and Inflammatory Markers in HIV-Infected Children on Long-term Suppressive Antiretroviral Therapy

Author: Anna Turkova, Pactg, Anrs Study Team, Alexandra Compagnucci, Gareth Tudor-Williams, Yacine Saidi, Linda Harrison, Penpact (Penta ), Meredith G. Warshaw, and Ann J. Melvin
Subjects: 0301 basic medicine, Cyclopropanes, Male, Time Factors, Lipopolysaccharide Receptors, HIV Infections, Kidney, Gastroenterology, Lopinavir, chemistry.chemical_compound, 0302 clinical medicine, Interquartile range, Antiretroviral Therapy, Highly Active, 030212 general & internal medicine, Child, biology, virus diseases, General Medicine, Europe, Infectious Diseases, C-Reactive Protein, Cholesterol, Treatment Outcome, Liver, Alkynes, Child, Preschool, Creatinine, Toxicity, Reverse Transcriptase Inhibitors, Female, Drug Monitoring, medicine.drug, medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, 030106 microbiology, Electronic Articles, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Internal medicine, medicine, Humans, Cystatin C, Inflammation, Ritonavir, business.industry, Interleukin-6, C-reactive protein, Benzoxazines, chemistry, Pediatrics, Perinatology and Child Health, North America, biology.protein, business, Biomarkers
Abstract: Background Data on long-term toxicity of antiretroviral therapy (ART) in HIV-infected children are sparse. PENPACT-1 was an open-label trial in which HIV-infected children were assigned randomly to receive protease inhibitor (PI)- or nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based ART. Methods We examined changes in clinical, immunologic, and inflammatory markers from baseline to year 4 in the subset of children in the PENPACT-1 study who experienced viral suppression between week 24 and year 4 of ART. Liver enzyme, creatinine, and cholesterol levels and hematologic parameters were assessed during the trial. Cystatin C, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), d-dimer, and soluble CD14 (sCD14) were assayed from cryopreserved specimens. Results Ninety-nine children (52 on PI-based and 47 on NNRTI-based ART) met inclusion criteria. The median age at initiation of ART was 6.5 years (interquartile range [IQR], 3.7-13.4 years), and 22% were aged
Published: 2017

38. Failure to achieve immunological recovery in HIV-infected patients with clinical and virological success after 10 years of combined ART: role of treatment course

Author: Raffi, François, Le Moing, Vincent, Assuied, Alex, Habak, Sofiane, Spire, Bruno, Cazanave, Charles, Billaud, Eric, Dellamonica, Pierre, Ferry, Tristan, Fagard, Catherine, Leport, Catherine, Group, ANRS CO8 APROCO-COPILOTE Study, Université de Nantes (UN), 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), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), 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), 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), Université de Bordeaux (UB), Service des maladies infectieuses, Centre Hospitalier Universitaire de Nice (CHU Nice)-University Hospital, Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), 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), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cholley, Pascal, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, 0301 basic medicine, Microbiology (medical), Cart, medicine.medical_specialty, CD4-CD8 Ratio, HIV Infections, Logistic regression, Disease course, 03 medical and health sciences, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Internal medicine, medicine, Humans, Pharmacology (medical), Prospective Studies, Treatment Failure, 030212 general & internal medicine, Prospective cohort study, Pharmacology, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Drug holiday, Middle Aged, 030112 virology, CD4 Lymphocyte Count, 3. Good health, Regimen, Infectious Diseases, Anti-Retroviral Agents, Immunology, Cohort, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: We assessed factors, including treatment course, associated with failure to obtain a 10 year immunological response after starting first-generation PI-containing combined ART (cART)., In the prospective COPILOTE cohort of HIV-infected patients started on a first-generation PI-containing regimen in 1997-99, the impact of cART history on the failure to achieve immunological response measured at 10 years was assessed by multivariate logistic regression models in the 399 patients with clinical and virological success of cART., Failure of CD4 response (CD4 >500/mm(3)) was associated with age ≥40 years at baseline (P 500/mm(3) and CD4:CD8 ratio >1) were CD4:CD8 ratio ≤0.8 at month 8 (P, In this therapeutic cohort of patients starting first-generation PI-containing cART in 1997-99, poor initial immunological response had a negative impact on 10 year CD4 and CD4 plus CD4:CD8 ratio response, despite prolonged virological success. Lack of treatment interruption may improve long-term immunological outcome in HIV infection.
Published: 2017
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39. Impact socio-économique d’une décennie de prise en charge thérapeutique pour les personnes vivant avec le VIH traitées par ARV au Sénégal

Author: J. Coutherut and groupe d’étude de la Cohorte Anrs
Subjects: medicine.medical_specialty, Political science, Tropical medicine, medicine, Humanities, Pathology and Forensic Medicine
Abstract: Une enquete biographique retrospective a ete conduite aupres d’un echantillon de patients dont la duree mediane de traitement par ARV etait de 9 ans (dans le cadre de la cohorte ANRS 1215 a Dakar) afin de documenter le devenir socio-economique a long terme des PVVIH. L’etude montre que globalement les indicateurs socio-economiques n’ont pas connu de degradation majeure depuis le debut de la prise en charge therapeutique. Le profil socio-economique des patients, defini par le type d’emploi et le salaire selon le sexe, est identique a celui de la population generale. La prise en charge therapeutique par les ARVa contribue a limiter l’impact social negatif de la maladie. Cependant, la precarite economique de ces personnes, comparable a celle de la population generale, constitue une menace sur leur prise en charge medicale a long terme.
Published: 2014
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40. Prévalence des complications métaboliques à 10 ans de traitements antirétroviraux au Sénégal

Author: A. Diouf, groupe d’étude de la Cohorte Anrs, and Amandine Cournil
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Stavudine, medicine.disease, Pathology and Forensic Medicine, Diabetes mellitus, Cohort, Epidemiology, Tropical medicine, medicine, Hiv patients, Lipodystrophy, business, Lipoatrophy, medicine.drug
Abstract: Among the patients of the cohort still followed after a median of 9 years of antiretroviral treatment (ART), 37% had lipodystrophy, 28% had hypertension and 14% presented with diabetes. This study confirms the association between stavudine and lipodystrophy particulary lipoatrophy and shows that a longer duration of ART was associated with the presence of diabetes. These results highlight the need to implement programs for prevention of cardiovascular risk factors in HIV patients from resource-constrained settings.
Published: 2014
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41. Efficacité clinique et biologique des traitements antirétroviraux : exemple de la cohorte ANRS 1215

Author: groupe d’étude de la Cohorte Anrs, A. Diouf, De Beaudrap P, and Bousso Niang K
Subjects: VIROLOGIC FAILURE, medicine.medical_specialty, Disease severity, business.industry, Internal medicine, Cohort, Antiretroviral treatment, Medicine, Drug resistance, business, Antiretroviral therapy, Pathology and Forensic Medicine
Abstract: In 1998, the cohort ANRS 1215 was launched in Senegal with one of the first African antiretroviral treatment programs. Four hundred forty four HIV-infected adults started on ART were included between 1998 and 2004, and followed up to 2010. Mortality before 6 months was 15.6/100 person-year (PY) and associated to the initial disease severity. It decreased to 3.36/100 PY thereafter. The cumulative risks of virologic failure at 60 months and of drug resistance at 48 months were 25% and 16%, respectively.
Published: 2014
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42. Le partage du statut sérologique des personnes vivant avec le VIH à 10 ans de traitement antirétroviral au Sénégal

Author: A. Desclaux, J. Coutherut, and groupe d’étude de la Cohorte Anrs
Subjects: medicine.medical_specialty, Truth Disclosure, business.industry, Carrier state, Human immunodeficiency virus (HIV), medicine.disease_cause, Pathology and Forensic Medicine, Epidemiology, Tropical medicine, medicine, Antiretroviral treatment, Hiv status, business, Demography
Abstract: Rates of HIV status disclosure observed in Africa, especially to partners, are too low for an optimal implementation of preventive strategies. Access to antiretroviral drugs appears to have facilitated disclosure in the short term, but knowledge is insufficient about long-term practices. A study held with 185 people living with HIV (PLHIV) examined factors associated with disclosure in general and with partners over 10 years of antiretroviral treatment in Dakar. Two third of PLHIV disclosed their status to at least one person, and 56% with their partners. The main results concern factors associated with disclosure to partners (having a child, knowing one's partner status) which are different from factors associated to disclosure in general (duration of ART treatment, secondary or higher education level, being a member of an association). After ten years, 44% of people still living in couple has not disclosed (no significant differences by sex and marital regime). These results invite to regularly offer counselling to PLHIV during follow-up.
Published: 2014
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43. Patterns of adherence to antiretroviral therapy and HIV drug resistance over time in the Stratall ANRS 12110/ESTHER trial in Cameroon

Author: Marie Suzan-Monti, Avelin F. Aghokeng, Maria Patrizia Carrieri, Meresse M, Bruno Spire, Christian Laurent, Stratall Anrs, Sylvie Boyer, Renée-Cécile Bonono, Gabrièle Laborde-Balen, Laura March, Charles Kouanfack, and Eric Delaporte
Subjects: medicine.medical_specialty, Reverse-transcriptase inhibitor, business.industry, Proportional hazards model, Health Policy, Hazard ratio, Odds ratio, Confidence interval, Surgery, Infectious Diseases, Internal medicine, medicine, Pharmacology (medical), business, Viral load, HIV drug resistance, Cohort study, medicine.drug
Abstract: Objectives The emergence of HIV drug resistance is a crucial issue in Africa, where second-line antiretroviral therapy (ART) is limited, expensive and complex. We assessed the association between adherence patterns and resistance emergence over time, using an adherence measure that distinguishes low adherence from treatment interruptions, in rural Cameroon. Methods We performed a cohort study among patients receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART in nine district hospitals, using data from the Stratall trial (2006−2010). Genotypic mutations associated with antiretroviral drug resistance were assessed when 6-monthly HIV viral loads were > 5000 HIV-1 RNA copies/mL. ART adherence data were collected using face-to-face questionnaires. Combined indicators of early (1−3 months) and late (6 months to t − 1; t is the time point when the resistance had been detected) adherence were constructed. Multivariate logistic regression and Cox models were used to assess the association between adherence patterns and early (at 6 months) and late (after 6 months) resistance emergence, respectively. Results Among 456 participants (71% women; median age 37 years), 45 developed HIV drug resistance (18 early and 27 late). Early low adherence ( 2 days) were associated with early resistance [adjusted odds ratio (95% confidence interval) 8.51 (1.30–55.61) and 5.25 (1.45–18.95), respectively]. Early treatment interruptions were also associated with late resistance [adjusted hazard ratio (95% confidence interval) 3.72 (1.27–10.92)]. Conclusions The emergence of HIV drug resistance on first-line NNRTI-based regimens was associated with different patterns of adherence over time. Ensuring optimal early adherence through specific interventions, adequate management of drug stocks, and viral load monitoring is a clinical and public health priority in Africa.
Published: 2014
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44. Progression to WHO criteria for starting antiretroviral therapy in a 7-year cohort of adult HIV-1 seroconverters in Abidjan, Cote d'Ivoire

Author: Minga, Albert, Danel, Christine, Abo, Yao, Dohoun, Lambert, Bonard, Dominique, Coulibaly, Ali, Duvignac, Julien, Dabis, François, Salamon, Roger, Anglaret, Xavier, Study Group, Anrs 1220, Programme PAC-CI, ANRS France Recherche Nord & sud Sida-hiv hépatites, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, and Anglaret, Xavier
Subjects: Male, Pediatrics, Time Factors, MESH: CD4 Lymphocyte Count, MESH: Practice Guidelines, HIV Infections, MESH: World Health Organization, MESH: Antiretroviral Therapy, Highly Active, MESH: HIV-1, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antiretroviral Therapy, Highly Active, HIV Seropositivity, Medicine, Prospective Studies, Prospective cohort study, Sida, MESH: Middle Aged, biology, Incidence (epidemiology), MESH: HIV Infections, Middle Aged, Anti-Retroviral Agents, Practice Guidelines as Topic, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Disease Progression, MESH: Disease Progression, Female, Cohort study, Adult, medicine.medical_specialty, MESH: Cote d'Ivoire, World Health Organization, MESH: Anti-Retroviral Agents, MESH: HIV Seropositivity, Acquired immunodeficiency syndrome (AIDS), Humans, Seroconversion, MESH: Humans, business.industry, Research, MESH: Time Factors, Public Health, Environmental and Occupational Health, MESH: Adult, medicine.disease, biology.organism_classification, MESH: Male, MESH: Prospective Studies, CD4 Lymphocyte Count, Cote d'Ivoire, Immunology, HIV-1, business, MESH: Female, Malaria
Abstract: OBJECTIVE: To estimate the probability of reaching the criteria for starting highly active antiretroviral therapy (HAART) in a prospective cohort of adult HIV-1 seroconverters in Abidjan, Cote d'Ivoire. METHODS: We recruited participants from HIV-positive donors at the blood bank of Abidjan for whom the delay since the estimated date of seroconversion (midpoint between last negative and first positive HIV-1 test) was < 36 months. Participants were offered early trimethoprim-sulfamethoxazole (cotrimoxazole) prophylaxis, twice-yearly measurement of CD4 count and we made standardized records of morbidity. We used the Kaplan-Meier method to estimate the probability of reaching the criteria for starting HAART according to WHO 2006 guidelines. FINDINGS: 217 adults (77 women (35%)) were followed up during 668 person-years (PY). The most frequent diseases recorded were mild bacterial diseases (6.0 per 100 PY), malaria (3.6/100 PY), herpes zoster (3.4/100 PY), severe bacterial diseases (3.1/100 PY) and tuberculosis (2.1/100 PY). The probability of reaching the WHO 2006 criteria for HAART initiation was estimated at 0.09, 0.16, 0.24, 0.36 and 0.44 at 1, 2, 3, 4 and 5 years, respectively. CONCLUSION: Our data underline the incidence of the early HIV morbidity in an Ivorian adult population and provide support for HIV testing to be made more readily available and for early follow-up of HIV-infected adults in West Africa.
Published: 2007
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45. Impact of IL28B, APOH and ITPA Polymorphisms on Efficacy and Safety of TVR- or BOC-Based Triple Therapy in Treatment-Experienced HCV-1 Patients with Compensated Cirrhosis from the ANRS CO20-CUPIC Study

Author: About, Frédégonde, Oudot-Mellakh, Tiphaine, Niay, Jonathan, Rabiéga, Pascaline, Pedergnana, Vincent, Duffy, Darragh, Sultanik, Philippe, Cagnot, Carole, Carrat, Fabrice, Marcellin, Patrick, Zoulim, Fabien, Larrey, Dominique, Hézode, Christophe, Fontaine, Hélène, Bronowicki, Jean-Pierre, Pol, Stanislas, Albert, Matthew L, Theodorou, Ioannis, Cobat, Aurélie, Abel, Laurent, ANRS CO20-CUPIC study group, Human genetics of infectious diseases : Mendelian predisposition (Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Immunologie et de Maladies Infectieuses (CIMI), 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), 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), Immunobiologie des Cellules Dendritiques, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Immunologie Humaine (CIH), Département d'hépatologie [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unit for Basic and Clinical research on Viral Hepatitis, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hospices Civils de Lyon (HCL), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), AP-HP, Hôpital Henri-Mondor Albert-Chenevier, Service d'Immunologie Clinique et Maladies Infectieuses 94000 Créteil, France, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was supported by INSERM-ANRS (France REcherche Nord & sud Sida-HIVHépatites-FRENSH, Grant n° 2010-A01273-36,http://www.anrs.fr), Institut National de la Santé et dela Recherche Médicale (INSERM,http://www.inserm.fr), University Paris Descartes (http://www.parisdescartes.fr), the French National ResearchAgency (ANR,http://www.agence-nationale-recherche.fr) under the ‟Investments for the future' program (grant n°ANR-10-IAHU-01), and in part bythe Association Française pour l'Etude du Foie(AFEF,http://www.afef.asso.fr). FA is the recipient of a fellowship from Fondation pour la RechercheMédicale (FRM, Grant n° FDM20140630671,http://www.frm.org)., ANR-10-IAHU-0001,Imagine,Institut Hospitalo-Universitaire Imagine(2010), HAL-UPMC, Gestionnaire, Instituts Hospitalo-Universitaires - Institut Hospitalo-Universitaire Imagine - - Imagine2010 - ANR-10-IAHU-0001 - IAHU - VALID, Laboratory of Human Genetics of Infectious Diseases, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of hepatology, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Saint-Eloi, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP HP, Departement Gastroenterologie, Centre Hospitalier Universitaire Henri Mondor, Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Centre d'Immunologie et de Maladies Infectieuses ( CIMI ), 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 ), 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 ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Immunologie Humaine ( CIH ), CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Beaujon, Hospices Civils de Lyon ( HCL ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), ANR-10-IAHU-0001/10-IAHU-0001,Imagine,Imagine ( 2010 ), and Negro, Francesco
Subjects: Oncology, Liver Cirrhosis, Plus ribavirin, Pyrophosphatases/genetics, lcsh:Medicine, Proline/adverse effects/analogs & derivatives/therapeutic use, Dose reduction, Hepacivirus, Telaprevir, chemistry.chemical_compound, Hemoglobins, Hepacivirus/physiology, Interleukins/genetics, Pegylated interferon, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Liver Cirrhosis/complications/drug therapy/genetics/virology, Protect, Pyrophosphatases, lcsh:Science, ddc:616, Boceprevir, Multidisciplinary, Hepatitis C virus, Variants, virus diseases, Anemia, Hepatitis C, Chronic/complications/drug therapy/genetics/virology, Induced hemolytic anemia, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Treatment Outcome, beta 2-Glycoprotein I, Combination, Anemia/complications, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, ITPA, Beta 2-Glycoprotein I/genetics, Single Nucleotide/genetics, Oligopeptides, medicine.drug, Research Article, medicine.medical_specialty, Proline, Genotype 1 infection, Polymorphism, Single Nucleotide, Drug Therapy, Internal medicine, Genetic model, medicine, Beta 2-Glycoprotein I, Humans, Genetic variation, Polymorphism, business.industry, Hemoglobins/metabolism, Ribavirin, Interleukins, lcsh:R, Hepatitis C, Chronic, medicine.disease, Virology, digestive system diseases, chemistry, Oligopeptides/adverse effects/therapeutic use, lcsh:Q, Interferons, business
Abstract: International audience; BackgroundHuman genetic factors influence the outcome of pegylated interferon and ribavirin hepatitis C therapy. We explored the role of IL28B, APOH and ITPA SNPs on the outcomes of triple therapy including telaprevir or boceprevir in patients with compensated cirrhosis chronically infected with HCV-1.Patients and MethodsA total of 256 HCV-1 Caucasian treatment-experienced patients with compensated cirrhosis from the ANRS CO20-CUPIC cohort were genotyped for a total of 10 candidate SNPs in IL28B (rs12979860 and rs368234815), APOH (rs8178822, rs12944940, rs10048158, rs52797880, rs1801689 and rs1801690) and ITPA (rs1127354 and rs7270101). We tested the association of IL28B and APOH SNPs with sustained virological response and of ITPA SNPs with anemia related phenotypes by means of logistic regression assuming an additive genetic model.ResultsNone of the six APOH SNPs were associated with sustained virological response. The favorable alleles of the IL28B SNPs rs12979860 and rs368234815 were associated with sustained virological response (rs12979860: OR = 2.35[1.50–3.70], P = 2x10-4). Refined analysis showed that the effect of IL28B SNPs on sustained virological response was restricted to prior PegIFN/RBV relapse (OR = 3.80[1.82–8.92], P = 8x10-4). We also confirmed the association between ITPA low activity alleles and protection against early hemoglobin decline in triple therapy (P = 2x10-5).ConclusionOur results suggest that the screening of rs12979860 may remain interesting for decision making in prior relapse HCV-1 Caucasian patients with compensated cirrhosis eligible for a telaprevir- or boceprevir-based therapy.
Published: 2015
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46. The CUPIC algorithm: an accurate model for the prediction of sustained viral response under telaprevir or boceprevir triple therapy in cirrhotic patients

Author: Boursier, J, Ducancelle, A, Vergniol, J, Veillon, P, Moal, V, Dufour, C, Bronowicki, J-P, Larrey, D, Hézode, C, Zoulim, F, Fontaine, H, Canva, V, Poynard, T, Allam, S, De Lédinghen, V, ANRS CO20-CUPIC study group, Negro, Francesco, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Bordeaux [Bordeaux], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Saint-Eloi, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hospices Civils de Lyon (HCL), Service d'hépatologie médicale [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], ANRS France Recherche Nord & sud Sida-hiv hépatites, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Liver Cirrhosis, hepatitis C virus, Male, Hepacivirus, Gastroenterology, Polyethylene Glycols, Telaprevir, chemistry.chemical_compound, Random Allocation, Theoretical, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Models, boceprevir, Sustained viral response, Antiviral Agents/therapeutic use, education.field_of_study, Interferon-alpha/therapeutic use, Viral Load, Middle Aged, Hepatitis C, 3. Good health, Infectious Diseases, Treatment Outcome, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Combination, Drug Therapy, Combination, Female, Early phase, Oligopeptides, Viral load, Algorithm, Algorithms, medicine.drug, medicine.medical_specialty, Proline, Population, Ribavirin/therapeutic use, Polyethylene Glycols/therapeutic use, Antiviral Agents, Chronic/drug therapy, Proline/analogs & derivatives/therapeutic use, Drug Therapy, Virology, Internal medicine, Boceprevir, Ribavirin, medicine, Humans, telaprevir, Derivation, ddc:610, education, Liver Cirrhosis/drug therapy/virology, Hepatology, business.industry, cirrhosis, Hepacivirus/drug effects, Interferon-alpha, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatitis C, Chronic, Models, Theoretical, Viral Load/drug effects, sustained viral response, chemistry, Oligopeptides/therapeutic use, business
Abstract: International audience; Triple therapy using boceprevir or telaprevir remains the reference treatment for genotype 1 chronic hepatitis C in countries where new interferon-free regimens have not yet become available. Antiviral treatment is highly required in cirrhotic patients, but they represent a difficult-to-treat population. We aimed to develop a simple algorithm for the prediction of sustained viral response (SVR) in cirrhotic patients treated with triple therapy. A total of 484 cirrhotic patients from the ANRS CO20 CUPIC cohort treated with triple therapy were randomly distributed into derivation and validation sets. A total of 52.1% of patients achieved SVR. In the derivation set, a D0 score for the prediction of SVR before treatment initiation included the following independent predictors collected at day 0: prior treatment response, gamma-GT, platelets, telaprevir treatment, viral load. To refine the prediction at the early phase of the treatment, a W4 score included as additional parameter the viral load collected at week 4. The D0 and W4 scores were combined in the CUPIC algorithm defining three subgroups: 'no treatment initiation or early stop at week 4', 'undetermined' and 'SVR highly probable'. In the validation set, the rates of SVR in these three subgroups were, respectively, 11.1%, 50.0% and 82.2% (P
Published: 2015
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47. 18-month occurrence of severe events among early diagnosed HIV-infected children before antiretroviral therapy in Abidjan, Côte d'Ivoire: A cohort study

Author: Pety Touré, Patricia Fassinou, Roger Salamon, Jérôme Harambat, François Rouet, Anrs, Stéphane Blanche, Marguerite Timite-Konan, Philippe Msellati, François Dabis, Renaud Becquet, Valériane Leroy, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Service de pédiatrie, CHU Yopougon, Programme PAC-CI, ANRS France Recherche Nord & sud Sida-hiv hépatites, Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), VIH/SIDA et maladies associées, Université Montpellier 1 (UM1), Service d'immuno-hématologie pédiatrique [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), Mouillet, Evelyne, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Santé Publique, d'Epidémiologie et de Développement ( ISPED ), ANRS, Centre de recherche et de Diagnostic sur le Sida ( CeDreS ), CHU Treichville, Université Montpellier 1 ( UM1 ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Population, HIV Infections, Kaplan-Meier Estimate, Severity of Illness Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Anti-Infective Agents, Pregnancy, Trimethoprim, Sulfamethoxazole Drug Combination, Severity of illness, Epidemiology, medicine, Humans, 030212 general & internal medicine, Pregnancy Complications, Infectious, education, education.field_of_study, business.industry, Public health, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:RA1-1270, medicine.disease, Verbal autopsy, Infectious Disease Transmission, Vertical, 3. Good health, Cote d'Ivoire, Early Diagnosis, Anti-Retroviral Agents, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Maternal death, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, 030217 neurology & neurosurgery, Research Article, Cohort study
Abstract: Objective To assess the 18-month field effectiveness on severe events of a pediatric package combining early HIV-diagnosis and targeted cotrimoxazole prophylaxis in HIV-infected children from age six-week before the antiretroviral era, in Abidjan, Côte d'Ivoire. Methods Data from two consecutive prevention of HIV mother-to-child transmission programs were compared: the ANRS 1201/1202 Ditrame-Plus cohort (2001–2005) and the pooled data of the ANRS 049a Ditrame randomized trial and its following open-labeled cohort (1995–2000), used as a reference group. HIV-infected pregnant women ≥ 32–36 weeks of gestation were offered a short-course peri-partum antiretroviral prophylaxis (ZDV in Ditrame, and ZDV ± 3TC+single-dose (sd) NVP in Ditrame-Plus). Neonatal prophylaxis was provided in Ditrame-Plus only: 7-day ZDV and sdNVP 48–72 h after birth. A 6-week pediatric HIV-RNA diagnosis was provided on-line in the Ditrame-Plus while it was only oriented on clinical symptoms in Ditrame. Six-week HIV-infected children received a daily cotrimoxazole prophylaxis in Ditrame-Plus while no prophylaxis was provided in Ditrame. The determinants of severe events (death or hospitalization > 1 day) were assessed in a Cox regression model. Results Between 1995 and 2003, 98 out of the 1121 live-births were diagnosed as HIV-infected in peri-partum: 45 from Ditrame-Plus and 53 from Ditrame. The 18-month Kaplan-Meier cumulative probability of presenting a severe event was 66% in Ditrame-Plus (95% confidence interval [95%CI]: 50%–81%) and 77% in Ditrame (95%CI: 65%–89%), Log Rank test: p = 0.47. After adjustment on maternal WHO clinical stage, maternal death, 6-week pediatric viral load, birth-weight, and breastfeeding exposure, the 18-month risk of severe event was lower in Ditrame-Plus than in Ditrame (adjusted Hazard Ratio (aHR): 0.55, 95%CI: 0.3–1.1), although the difference was not statistically significant; p = 0.07). Maternal death was the only variable determinant of the occurrence of severe events in children (aHR: 3.73; CI: 2.2–11.2; p = 0.01). Conclusion Early cotrimoxazole from 6 weeks of age in HIV-infected infants seemed to reduce probability of severe events but the study lacked statistical power to prove this. Even with systematic cotrimoxazole prophylaxis, infant morbidity and mortality remained high pointing towards a need for early pediatric HIV-diagnosis and antiretroviral treatment in Africa.
Published: 2008
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48. Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa

Author: H. Brou, G. Djohan, R. Becquet, G. Allou, D.K. Ekouevi, B. Zanou, V. Leroy, A. Desgrees-du-Loû, null ANRS 1201/1202/1253 Ditrame Plus St, Laboratoire Population-Environnement-Développement (LPED), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Ditrame Plus, Programme PAC-CI (ANRS 1201/1202), ANRS France Recherche Nord & sud Sida-hiv hépatites-CHU Treichville, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, ANRS, Sidaction, and Becquet, Renaud
Subjects: Postnatal Care, Male, medicine.medical_specialty, Health (social science), Social Psychology, Voluntary counseling and testing, Prenatal hiv-testing, HIV Infections, Truth Disclosure, Article, law.invention, Condoms, 03 medical and health sciences, 0302 clinical medicine, 5. Gender equality, Acquired immunodeficiency syndrome (AIDS), Condom, law, Pregnancy, Prenatal Diagnosis, Couple, medicine, Humans, 030212 general & internal medicine, Condom use, Gynecology, 030505 public health, biology, Obstetrics, business.industry, Public health, Public Health, Environmental and Occupational Health, virus diseases, biology.organism_classification, medicine.disease, 3. Good health, Sexual intercourse, Cote d'Ivoire, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Lentivirus, Africa, Cote d'ivoire, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Follow-Up Studies
Abstract: International audience; The resumption of sexual activity after delivery is a key moment in the management of the risk of sexual HIV transmission within the couple for women who have been prenatally tested for HIV. In this study, we have investigated consistent condom use during the resumption of sexual activity and its evolution over time among women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV-infected and 393 HIV-negative women within the Ditrame Plus ANRS project in Abidjan; these women were followed-up for two years after delivery. Most HIV-negative women (96.7%) disclosed their HIV-test result to their partners, whereas only 45.6% of HIV-infected women did so (p
Published: 2008
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49. 18-Month Effectiveness of Short-Course Antiretroviral Regimens Combined with Alternatives to Breastfeeding to Prevent HIV Mother-to-Child Transmission

Author: Leroy, Valériane, Ekouevi, Didier, Becquet, Renaud, Viho, Ida, Dequae-Merchadou, Laurence, Tonwe-Gold, Besigin, Rouet, François, Sakarovitch, Charlotte, Horo, Apollinaire, Timite-Konan, Marguerite, Rouzioux, Chrisitine, Dabis, François, Ditrame Plus Study Group, Anrs 1201/1202, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2 - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Institut National de la Santé et de la Recherche Médicale (INSERM), Ditrame Plus, Programme PAC-CI (ANRS 1201/1202), ANRS - CHU Treichville, Centre de recherche et de Diagnostic sur le Sida (CeDreS), CHU Treichville, Service de gynécologie - obstétrique, CHU de Yopougon, Service de pédiatrie, CHU Yopougon, Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Necker - Enfants Malades [AP-HP], ANRS, Sidaction, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS France Recherche Nord & sud Sida-hiv hépatites-CHU Treichville, Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), CHU Necker - Enfants Malades [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)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Becquet, Renaud
Subjects: Pediatrics, Breastfeeding, Pediatrics and Child Health, lcsh:Medicine, Public Health and Epidemiology/Infectious Diseases, HIV Infections, 0302 clinical medicine, 030212 general & internal medicine, Prospective cohort study, lcsh:Science, 2. Zero hunger, 0303 health sciences, education.field_of_study, Multidisciplinary, Lamivudine, virus diseases, Infectious Diseases/HIV Infection and AIDS, 3. Good health, Survival Rate, Breast Feeding, Treatment Outcome, Cohort, Drug Therapy, Combination, Female, Zidovudine, medicine.drug, Research Article, medicine.medical_specialty, Nevirapine, Anti-HIV Agents, Population, 03 medical and health sciences, medicine, Humans, education, Proportional Hazards Models, 030306 microbiology, business.industry, lcsh:R, Infant, Newborn, Infant, Infectious Disease Transmission, Vertical, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Africa, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, business, Breast feeding, Public Health and Epidemiology/Social and Behavioral Determinants of Health
Abstract: International audience; OBJECTIVE: We assessed the 18-month effectiveness of short-course (sc) antiretroviral peripartum regimens combined with alternatives to prolonged breastfeeding to prevent mother-to-child transmission (MTCT) of HIV-1 in Abidjan, C?d'Ivoire. METHODOLOGY: HIV-1 infected pregnant women received from >/=32-36 weeks of gestation scZidovudine (ZDV)+/-Lamivudine (3TC)+single-dose Nevirapine (sdNVP) at delivery within the ANRS 1201/1202 DITRAME-Plus cohort (2001-2003). Neonates received a sdNVP+7-day ZDV prophylaxis. Two infant-feeding interventions were systematically offered free of charge: formula-feeding or exclusive shortened breastfeeding with early cessation from four months. The reference group was the ANRS 049a DITRAME cohort (1994-2000) exposed to scZDV from 36 weeks, then to prolonged breastfeeding. Pediatric HIV infection was defined by a positive plasma HIV-1 RNA at any age, or if aged >/=18 months, a positive HIV-1 serology. Turnbull estimates of cumulative transmission risks (CTR) and effectiveness (HIV-free survival) were compared by exposure group using a Cox model. FINDINGS: Among 926 live-born children enrolled, 107 (11.6%) were HIV-infected at 18 months. CTRs were 22.3% (95% confidence interval[CI]:16-30%) in the 238 ZDV long-term breastfed reference group, 15.9% (CI:10-27%) in the 169 ZDV+sdNVP shortened breastfed group; 9.4% (CI:6-14%) in the 195 ZDV+sdNVP formula-fed group; 6.8% (CI:4-11%) in the 198 ZDV+3TC+sdNVP shortened breastfed group, and 5.6% (CI:2-10%) in the 126 ZDV+3TC+sdNVP formula-fed group. Each combination had a significantly higher effectiveness than the ZDV long-term breastfed group except for ZDV+sdNVP shortened breastfed children, ranging from 51% (CI:20-70%) for ZDV+sdNVP formula fed children to 63% (CI:40-80%) for ZDV+3TC+NVPsd shortened breastfed children, after adjustment for maternal eligibility for antiretroviral therapy (ART), home delivery and low birth-weight. Substantial MTCT risk reductions are reachable in Africa, even in short-term breastfed children. The two sc antiretroviral combinations associated to any of the two infant feeding interventions, formula-feeding and shortened breastfeeding, reduce significantly MTCT with long-term benefit until age 18 months and without increasing mortality.
Published: 2008
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50. Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire

Author: Didier K. Ekouevi, Anrs, Clarisse Amani-Bosse, Valériane Leroy, Marguerite Timite-Konan, Hervé Menan, Ida Viho, François Dabis, Laurence Bequet, Renaud Becquet, Becquet, Renaud, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Ditrame Plus, Programme PAC-CI (ANRS 1201/1202), ANRS France Recherche Nord & sud Sida-hiv hépatites-CHU Treichville, Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), Service de pédiatrie, CHU Yopougon, and ANRS, SIDACTION
Subjects: Pediatrics, Epidemiology, breastfeeding, Breastfeeding, HIV Infections, MESH: Pregnancy, Pregnancy, Risk Factors, MESH: Risk Factors, Pregnancy Complications, Infectious, Hiv transmission, education.field_of_study, Transmission (medicine), MESH: Infant, Newborn, MESH: HIV Infections, Mixed feeding, MESH: Infant, MESH: Infectious Disease Transmission, Vertical, Breast Feeding, MESH: Breast Feeding, Female, Infant Food, medicine.medical_specialty, MESH: Cote d'Ivoire, Population, Weaning, MESH: Weaning, medicine, Humans, MESH: Pregnancy Complications, Infectious, education, MESH: Infant Food, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, mother-to-child transmission, Infant, HIV, medicine.disease, Infectious Disease Transmission, Vertical, Clinical research, Cote d'Ivoire, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Africa, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; OBJECTIVE: To evaluate the risk of postnatal HIV transmission among women in Abidjan, Côte d'Ivoire offered alternatives to prolonged breastfeeding, and to assess the impact of the breastfeeding pattern and duration on this risk. METHODS: In 2001-2003, HIV-infected pregnant women received peri-partum antiretroviral prophylaxis and were counselled antenatally regarding infant feeding options: formula feeding or exclusive breastfeeding with early cessation from 4 months of age. The primary outcome was HIV postnatal transmission by 18 months of age, defined by a positive HIV test after a negative test > or =30 days. The effect of the pattern (mixed feeding, defined as breastmilk plus food-based fluid, solid food or non-human milk) and duration (less vs. more than 6 months) of breastfeeding on postnatal transmission was assessed. RESULTS: Of 622 live-born infants who were HIV uninfected at or after 30 days, 15 were infected postnatally, 13/324 among breastfed, and 2/298 among formula-fed infants. The 18-month probability of remaining free from HIV infection was 0.95 [95% CI, 0.92-0.97] and 0.99 [95% CI, 0.97-1.00] in the breastfeeding and formula-feeding groups respectively (p
Published: 2008
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