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2,116 results on '"Pol Stanislas"'

201. 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, Péron, Jean-Marie, Alric, Laurent, Bourlière, Marc, Mathurin, Philippe, Blanc, Jean-Frédéric, Abergel, Armand, Serfaty, Lawrence, Mallat, Ariane, Grangé, Jean-Didier, Attali, Pierre, Bacq, Yannick, Wartelle, Claire, Dao, Thông, 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, Kempf, Marie, Bert, Fréderic, Doloy, Alexandra, Poilane, Isabelle, Peuchant, Olivia, Carbonnelle, Etienne, Picard, Bertrand, Burucoa, Christophe, Cattoir, Vincent, Decré, Dominique, Degand, Nicolas, Dortet, Laurent, Kayal, Samer, Vernet-Garnier, Véronique, Lozniewski, Alain, Tuaillon, Edouard, Vimont, Sophie, Bessède, Emilie, Patry, Isabelle, Lemaitre, Nadine, and Pachetii, Christine

Published
2017
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207. Histological Characteristics and Management of Hepatitis on Immune Checkpoint Inhibitors: A Retrospective Descriptive Study.

Author

Parlati, Lucia, Marcin, Kennie, Terris, Benoit, Vallet-Pichard, Anaïs, Corouge, Marion, Hollande, Clémence, Sogni, Philippe, Mallet, Vincent, and Pol, Stanislas

Subjects
IMMUNE checkpoint inhibitors, LIVER biopsy, HEPATITIS, IPILIMUMAB, UNIVERSITY hospitals, LIVER injuries
Abstract

Background and aims: the side effects of immune checkpoint inhibitors (ICI) pose a problem for the clinical management of cancer patients. There is a lack of knowledge of the value of liver biopsy in patients with ICI-related drug-induced liver injury (ICI-DILI). The aim of this study was to explore the impact of liver biopsy on clinical management and response to corticosteroids, according to histological findings. Methods: We conducted a retrospective, single-center study to evaluate the biochemical, histological and clinical data of 35 patients with ICI-DILI between 2015 and 2021 in a university hospital in France. Results: Of the 35 patients with ICI-DILI (median [interquartile range] age 62 [48–73] years, 40% males) studied, 20 underwent a liver biopsy. There was no difference in the management of ICI-DILI according to liver biopsy in terms of ICI withdrawal, reduction or rechallenge. According to the histological profile, patients with toxic and granulomatous profiles had a better response to corticosteroids, while patients with cholangitic lesions had the worst response. Conclusion: In ICI-DILI, liver biopsy must not delay patient care but may be useful in identifying patients with a cholangitic profile who have a poorer response to corticosteroids. [ABSTRACT FROM AUTHOR]

Published
2023
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208. Impact of direct‐acting antiviral treatment for hepatitis C on cardiovascular diseases and extrahepatic cancers.

Author

Lam, Laurent, Fontaine, Hélène, Lapidus, Nathanael, Dorival, Céline, Bellet, Jonathan, Larrey, Dominique, Nahon, Pierre, Diallo, Alpha, Cagnot, Carole, Lusivika‐Nzinga, Clovis, Téoulé, François, Hejblum, Gilles, Bourlière, Marc, Pol, Stanislas, and Carrat, Fabrice

Abstract

Purpose: The impact of direct‐acting antivirals (DAAs) on extrahepatic complications in chronic hepatitis C (CHC) patients remains poorly described. We estimated the association of DAAs with cardiovascular events and extrahepatic cancers. Methods: The prospective ANRS CO22 HEPATHER cohort was enriched with individual data until December 2018 from the French Health Insurance Database (SNDS). CHC patients were enrolled between August 2012 and December 2015 in 32 French hepatology centers. A total of 8148 CHC adults were selected. Cardiovascular events (stroke, acute coronary syndrome, pulmonary embolism, heart failure, arrhythmias and conduction disorders [ACD], peripheral arterial disease [PAD]) and extrahepatic solid cancers were derived from the SNDS. Associations between DAAs and extrahepatic events were estimated using marginal structural models, with adjustments for clinical confounders. Results: Analyses of 12 905 person‐years of no DAA exposure and 22 326 person‐years following DAA exposure showed a decreased risk of PAD after DAA exposure (hazard ratio [HR], 0.54; 95% CI, 0.33–0.89), a beneficial effect of DAAs on overall cardiovascular outcomes in patients with advanced fibrosis (aHR, 0.58; 95% CI, 0.42–0.79), and an increased risk of ACD (hazard ratio [HR], 1.46; 95% CI, 1.04–2.04), predominant after the first year following DAA initiation. There was no association between DAAs and extrahepatic cancer risk (HR, 1.23; 95% CI, 0.50–3.03). Conclusions: DAAs were not associated with extrahepatic cancer development or reduction. They were associated with a decreased risk of PAD and an increased risk of ACD, supporting long‐term cardiac monitoring after DAA therapy. [ABSTRACT FROM AUTHOR]

Published
2023
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215. Tocilizumab: Therapy and safety management

Author

Pham, Thao, Claudepierre, Pascal, Constantin, Arnaud, de Bandt, Michel, Fautrel, Bruno, Gossec, Laure, Gottenberg, Jacques-Eric, Goupille, Philippe, Guillaume, Séverine, Hachulla, Eric, Masson, Charles, Morel, Jacques, Puéchal, Xavier, Saraux, Alain, Schaeverbeke, Thierry, Wendling, Daniel, Bruckert, Eric, Pol, Stanislas, Mariette, Xavier, and Sibilia, Jean

Published
2010
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219. Reply to: “Progressive cholangiopathy in COVID-19 patients: Other possible diagnoses than ketamine-induced cholangiopathy should be considered”

Author

Mallet, Vincent, Bock, Kilian, Dellagi, Mourad, Tano, Marion, Siorat, Virginie, Beeker, Nathanaël, Paubel, Pascal, Mandengue, Paul Doumbe, Dufour, Nicolas, Voigtländer, Torsten, Ricard, Jean-Damien, Isnard, Pierre, Frochot, Vincent, Letavernier, Emmanuel, Moga, Lucile, Landrieux, Amandine, Rautou, Pierre-Emmanuel, Pons-Kerjean, Nathalie, Vallet-Pichard, Anaïs, Hollande, Clémence, Fontaine, Hélène, Chouchana, Laurent, Gernez, Coralie, Burger, Carole, Scemla, Anne, de Tymowski, Christian, Depret, François, Dudoignon, Emmanuel, Lamhaut, Lionel, Flicoteau, Rémi, Rousseau, Géraldine, Duong Van Huyen, Jean-Paul, Correas, Jean-Michel, Wedemeyer, Heiner, and Pol, Stanislas

Published
2021
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221. Burden of liver disease progression in hospitalized patients with type 2 diabetes mellitus

Author

Mallet, Vincent, primary, Parlati, Lucia, additional, Martinino, Alessandro, additional, Scarano Pereira, Juan Pablo, additional, Jimenez, Carmen Navas, additional, Sakka, Mehdi, additional, Bouam, Samir, additional, Retbi, Aurelia, additional, Krasteva, Donika, additional, Meritet, Jean-François, additional, Schwarzinger, Michaël, additional, Thabut, Dominique, additional, Rufat, Pierre, additional, Bonnefont-Rousselot, Dominique, additional, Sogni, Philippe, additional, Pol, Stanislas, additional, Tsochatzis, Emmanuel, additional, Fontaine, Hélène, additional, Corouge, Marion, additional, Pichard, Anaïs Vallet, additional, Hollande, Clémence, additional, Terris, Benoit, additional, Larger, Etienne, additional, Bertherat, Jérome, additional, Ratziu, Vlad, additional, and Hartemann, Agnès, additional

Published
2022
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228. Complications and competing risks of death in compensated viral cirrhosis (ANRS CO12 CirVir prospective cohort)

Author

Trinchet, Jean-Claude, Bourcier, Valérie, Chaffaut, Cendrine, Ait Ahmed, Mohand, 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, Péron, Jean-Marie, Alric, Laurent, Bourlière, Marc, Mathurin, Philippe, Blanc, Jean-Frédéric, Abergel, Armand, Serfaty, Lawrence, Mallat, Ariane, Grangé, Jean-Didier, Buffet, Catherine, Bacq, Yannick, Wartelle, Claire, Dao, Thông, Benhamou, Yves, Pilette, Christophe, Silvain, Christine, Christidis, Christos, Capron, Dominique, Thiefin, Gérard, Hillaire, Sophie, Di Martino, Vincent, Nahon, Pierre, and Chevret, Sylvie

Published
2015
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231. Ledipasvir and sofosbuvir in patients with genotype 1 hepatitis C virus infection and compensated cirrhosis: An integrated safety and efficacy analysis

Author

Reddy, Rajender K., Bourlière, Marc, Sulkowski, Mark, Omata, Masao, Zeuzem, Stefan, Feld, Jordan J., Lawitz, Eric, Marcellin, Patrick, Welzel, Tania M., Hyland, Robert, Ding, Xiao, Yang, Jenny, Knox, Steven, Pang, Phillip, Dvory-Sobol, Hadas, Subramanian, Mani G., Symonds, William, McHutchison, John G., Mangia, Alessandra, Gane, Edward, Mizokami, Masashi, Pol, Stanislas, and Afdhal, Nezam

Published
2015
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232. Daclatasvir plus peginterferon alfa and ribavirin for treatment-naive chronic hepatitis C genotype 1 or 4 infection: a randomised study

Author

Hézode, Christophe, Hirschfield, Gideon M, Ghesquiere, Wayne, Sievert, William, Rodriguez-Torres, Maribel, Shafran, Stephen D, Thuluvath, Paul J, Tatum, Harvey A, Waked, Imam, Esmat, Gamal, Lawitz, Eric J, Rustgi, Vinod K, Pol, Stanislas, Weis, Nina, Pockros, Paul J, Bourlière, Marc, Serfaty, Lawrence, Vierling, John M, Fried, Michael W, Weiland, Ola, Brunetto, Maurizia R, Everson, Gregory T, Zeuzem, Stefan, Kwo, Paul Y, Sulkowski, Mark, Bräu, Norbert, Hernandez, Dennis, McPhee, Fiona, Wind-Rotolo, Megan, Liu, Zhaohui, Noviello, Stephanie, Hughes, Eric A, Yin, Philip D, and Schnittman, Steven

Published
2015
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233. Fixed-Dose Combination Therapy With Daclatasvir, Asunaprevir, and Beclabuvir for Noncirrhotic Patients With HCV Genotype 1 Infection

Author

Poordad, Fred, Sievert, William, Mollison, Lindsay, Bennett, Michael, Tse, Edmund, Bräu, Norbert, Levin, James, Sepe, Thomas, Lee, Samuel S., Angus, Peter, Conway, Brian, Pol, Stanislas, Boyer, Nathalie, Bronowicki, Jean-Pierre, Jacobson, Ira, Muir, Andrew J., Reddy, K. Rajender, Tam, Edward, Ortiz-Lasanta, Grisell, de Lédinghen, Victor, Sulkowski, Mark, Boparai, Navdeep, McPhee, Fiona, Hughes, Eric, Swenson, E. Scott, and Yin, Philip D.

Published
2015
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237. Performance of algorithms for identifying patients with chronic hepatitis B or C infection in the french health insurance claims databases using the ANRS CO22 HEPATHER cohort.

Author

Lam, Laurent, Fontaine, Hélène, Lapidus, Nathanael, Bellet, Jonathan, Lusivika‐Nzinga, Clovis, Nicol, Jérôme, Dorival, Céline, Cagnot, Carole, Hejblum, Gilles, Pol, Stanislas, Bourlière, Marc, and Carrat, Fabrice

Subjects
CHRONIC hepatitis B, HEALTH insurance claims, HEPATIC fibrosis, CLINICAL pathology, NATIONAL health insurance
Abstract

The validity of algorithms for identifying patients with chronic hepatitis B or C virus (HBV or HCV) infection in claims databases has been little explored. The performance of 15 algorithms was evaluated. Data from HBV‐ or HCV‐infected patients enrolled between August 2012 and December 2015 in French hepatology centres (ANRS CO22 HEPATHER cohort) were individually linked to the French national health insurance system (SNDS). The SNDS covers 99% of the French population and contains healthcare reimbursement data. Performance metrics were calculated by comparing the viral status established by clinicians with those obtained with the algorithms identifying chronic HBV‐ and HCV‐infected patients. A total of 14 751 patients (29% with chronic HBV and 63% with chronic HCV infection) followed‐up until December 2018 were selected. Despite good specificity, the algorithms relying on ICD‐10 codes performed poorly. By contrast, the multi‐criteria algorithms combining ICD‐10 codes, antiviral dispensing, laboratory diagnostic tests (HBV DNA or HCV RNA detection and quantification, HCV genotyping), examinations for the assessment of liver fibrosis and long‐term disease registrations were the most effective (sensitivity 0.92, 95% CI, 0.91–0.93 and specificity 0.96, 95% CI, 0.95–0.96 for identifying chronic HBV‐infected patients; sensitivity 0.94, 95% CI, 0.94–0.94 and specificity 0.85, 95% CI, 0.84–0.86 for identifying chronic HCV‐infected patients). In conclusion, the multi‐criteria algorithms perform well in identifying patients with chronic hepatitis B or C infection and can be used to estimate the magnitude of the public health burden associated with hepatitis B and C in France. [ABSTRACT FROM AUTHOR]

Published
2023
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238. Резюме клінічної практики KDIGO 2022 щодо профілактики, діагностики, оцінки й лікування гепатиту С при хронічній хворобі нирок.

Author

Martin, Paul, Awan, Ahmed A., Berenguer, Marina C., Bruchfeld, Annette, Fabrizi, Fabrizio, Goldberg, David S., Jia, Jidong, Kamar, Nassim, Mohamed, Rosmawati, Pessôa, Mário Guimarães, Pol, Stanislas, Sise, Meghan E., Balk, Ethan M., Gordon, Craig E., Adam, Gaelen, Cheung, Michael, Earley, Amy, and Jadoul, Michel

Subjects
HEPATITIS C treatment, CHRONIC kidney failure
Published
2023
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239. IL-17A in human liver: an important source of liver inflammation and an old new friend of retinoic acid

Author

Kartasheva-Ebertz, Daria, Gaston, Jesintha, Massault, Pierre-Philippe, Scatton, Olivier, Gaujoux, Sebastien, Vaillant, Jean-Christophe, Pol, Stanislas, Lagaye, Sylvie, Immunobiologie des Cellules dendritiques, 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), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Service d'hépatologie médicale [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (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 de Paris (UP), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], 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
Chronic inflammation and fibrosis, tissue damage and repair, immune communication, MAIT cells, inflammatory molecules, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, cytokines and mediators, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Il‐17A is considered to guide liver inflammation and fibrosis. Using human liver slice culture, we aim to study whether IL‐17A is capable of influencing the fibrogenesis, but also, to look into lymphatic immune cell composition, secreting IL‐17A. Using human liver samples (F0‐F4) and blood samples, collected after partial hepatectomy due to different pathologies, we analyzed IL‐17A secretion and immune cell profile. Liver tissue was used for primary culture of human liver slices, followed by subsequent cytokine stimulation and analysis by Elisa of fibrotic markers. The Huh7.5.1 cell line was used for SeaHorse and WB analysis. IL‐17A concentration in human liver tissue was significantly higher in the early fibrotic stage compared with the advanced stage. Th17 T cells and, to a lesser extent, MAIT cells are the main sources of IL‐17A in both compartments, liver and blood. Moreover, the presence of liver Th17IL‐ 17A+INFγ+ cells were detected. IL‐17A stimulation of human liver slices increases the expression of profibrotic markers. Stimulation by IL‐17A+TGF‐β1 removes the reserve respiratory capacity in Huh7.5.1 cells, while RA addition is capable to restore it and to reverse the expression of LC3II/LC3I ratio. IL‐17A, secreted by Th17 and MAIT cells, induce the expression of pro‐fibrotic markers. However, the level of hepatic IL‐17A secretion is probably more related to the underlying pathologies that cause fibrosis rather than to the mechanism of fibrosis itself. There is also a terrain of communication between IL‐17A and retinoic acid in the liver, that should be investigated.

Published
2021
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243. 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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244. 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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245. Letter: tenofovir may be superior to entecavir for treatment-naïve chronic hepatitis B patients-authors' reply

Author

Pol, Stanislas, Lusivika Nzinga, Clovis, Carrat, Fabrice, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 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), and HAL-SU, Gestionnaire

Subjects
MESH: Antiviral Agents, MESH: Guanine, MESH: Hepatitis B virus, MESH: Humans, MESH: Tenofovir, MESH: Hepatitis B, Chronic, MESH: Liver Neoplasms, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Carcinoma, Hepatocellular
Abstract

International audience

Published
2021
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