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1. Cannabidiol use and perceptions in France: a national survey

Author

Clémence Casanova, Clémence Ramier, Davide Fortin, Patrizia Carrieri, Julien Mancini, and Tangui Barré

Subjects
Cannabidiol, Cannabis, France, Risk perception, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Cannabidiol (CBD), a safe, non-intoxicating cannabis component, is growing in popularity in Europe and worldwide. However, CBD EU regulation is blurry, and consequent labelling and product quality issues may have implications for public health. There is therefore a need to assess the prevalence and perceived harmfulness of CBD use in EU countries, as well as to characterise CBD users. We aimed to do so in the French population. Methods In December 2021, an online survey was conducted in a sample respecting the French adult population structure for key demographic variables. Sociodemographic, behavioural and CBD perception data were collected. Three separate regressions were performed to identify correlates of i) having heard of CBD, ii) using CBD, iii) perceived harmfulness of CBD. A hierarchical classification was also performed to identify profiles of CBD users. Results The study sample comprised 1969 adults, of whom 69.2% had heard of CBD and 10.1% used it. Less than half (46.8%) of the former considered it harmful. Having heard of CBD was associated with younger age, being born in France, tobacco use, and cannabis use. CBD use was associated with younger age, tobacco use, cannabis use, poor self-reported general health status, and positive perception of alternative medicines. Cluster analysis revealed four different CBD user profiles based on socio-demographics and behavioural characteristics. Conclusion Ten percent of the adults in this French study used CBD, and several user profiles emerged. Our results indirectly advocate clearer European CBD regulations to ensure safe and high-quality products.

Published
2022
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2. Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort

Author

Tangui Barré, Fabrice Carrat, Clémence Ramier, Hélène Fontaine, Vincent Di Beo, Morgane Bureau, Céline Dorival, Dominique Larrey, Elisabeth Delarocque-Astagneau, Philippe Mathurin, Fabienne Marcellin, Ventzislava Petrov-Sanchez, Carole Cagnot, Patrizia Carrieri, Stanislas Pol, Camelia Protopopescu, and the ANRS/AFEF Hepather study group

Subjects
Cannabis, Marijuana, Hepatitis C, Chronic, Obesity, Body weight, Fibrosis, Pharmacy and materia medica, RS1-441, Plant culture, SB1-1110
Abstract

Abstract Background Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection. Methods Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models. Results Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37–0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19–0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38–0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI. Conclusions We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure. Trial registration ClinicalTrials.gov identifier: NCT01953458 .

Published
2022
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3. Metabolic Disorders in Patients with Chronic Hepatitis B Virus Infection: Coffee as a Panacea? (ANRS CO22 Hepather Cohort)

Author

Tangui Barré, Hélène Fontaine, Stanislas Pol, Clémence Ramier, Vincent Di Beo, Camelia Protopopescu, Fabienne Marcellin, Morgane Bureau, Marc Bourlière, Céline Dorival, Ventzislava Petrov-Sanchez, Tarik Asselah, Elisabeth Delarocque-Astagneau, Dominique Larrey, Jean-Charles Duclos-Vallée, Fabrice Carrat, Patrizia Carrieri, and on behalf of the ANRS/AFEF Hepather Study Group

Subjects
coffee, tea, hepatitis B, metabolic syndrome, dyslipidemia, hypertension, Therapeutics. Pharmacology, RM1-950
Abstract

People living with chronic hepatitis B virus (HBV) infection are at high risk of liver disease progression, which is positively associated with metabolic disorders, but inversely associated with dyslipidemia. Diet, including dietary antioxidants, is a lever of metabolic disorder management. In particular, elevated coffee consumption is associated with different metabolic outcomes in the general population. We aimed to test whether such associations occur in HBV-infected people. Based on cross-sectional data from the ANRS CO22 Hepather cohort, we performed logistic regression models with (i) dyslipidemia, (ii) hypertension, and (iii) diabetes as outcomes, and with demographic, clinical, and socio-behavioral (including coffee consumption) data as explanatory variables. Among 4746 HBV-infected patients, drinking ≥3 cups of coffee per day was associated with a higher risk of dyslipidemia (adjusted odds ratio [95% confidence interval] 1.49 [1.10–2.00], p = 0.009) and a lower risk of hypertension (0.64 [0.50–0.82], p = 0.001). It was not associated with diabetes. Elevated coffee consumption was associated with a higher risk of dyslipidemia and a lower risk of hypertension in HBV-infected patients, two effects expected to be associated with favorable clinical outcomes. Further studies should test whether such metabolic benefits translate into reduced mortality risk in this population.

Published
2022
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4. A novel community‐based therapeutic education program for reducing alcohol‐related harms and stigma in people with alcohol use disorders: A quasi‐experimental study ( <scp>ETHER</scp> study)

Author

Tangui Barré, Clémence Ramier, Saskia Antwerpes, Marie Costa, Morgane Bureau, Gwenaelle Maradan, Vincent Di Beo, Christophe Cutarella, Jacques Leloutre, Olivier Riccobono‐Soulier, Sophie Hedoire, Elodie Frot, Fabienne Vernier, Stéphanie Vassas‐Goyard, Sabine Dufort, Camelia Protopopescu, Fabienne Marcellin, Danielle Casanova, Marion Coste, Patrizia Carrieri, 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 de Recherche pour le Développement (IRD), Clinique Saint Barnabé - Ramsay Santé [Marseille] (CSB-RS), Association Addictions France, Aix-Marseille Sciences Economiques (AMSE), École des hautes études en sciences sociales (EHESS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), ARS PACA (Agence Régionale de Santé de Provence-Alpes Côte d'Azur), ANR-17-EURE-0020,AMSE (EUR),Aix-Marseille School of Economics(2017), and ANR-11-IDEX-0001,Amidex,INITIATIVE D'EXCELLENCE AIX MARSEILLE UNIVERSITE(2011)

Subjects
Health (social science), psychosocial skills, [SDV]Life Sciences [q-bio], Medicine (miscellaneous), France, harm reduction, alcohol use disorder, therapeutic patient education, [SHS]Humanities and Social Sciences
Abstract

International audience; IntroductionAlcohol use disorder (AUD) is associated with a significant disease burden in France, where alcohol use is deeply rooted in culture. However, the treatment gap is large because of several barriers, including stigmatisation and drinkers' apprehension about total abstinence. However, standardised and evidence-based interventions based on controlled-drinking for people with AUD are lacking. We aimed to assess the effectiveness of a novel community-based French therapeutic patient education (TPE) program for people with AUD named Choizitaconso.MethodsA before-after non-randomised quasi-experimental study, named ETHER, was designed and implemented with people living with AUD, over a period of 6 months. The primary outcome was percentage change in the number of alcohol-related harms experienced. Secondary outcomes were percentage changes in psycho-social patient-reported and community-validated outcomes. Participants in the intervention group (n = 34) benefited from the 10-week TPE program Choizitaconso, while the comparison group (n = 58) received standard care. The Kruskall–Wallis and chi-squared or Fisher's exact tests were used to compare before-after changes in variables in both groups. Linear regression models were used to test for the effect of study group on each outcome and to test for the effect of alcohol consumption as a confounder.ResultsAt 6 months, all outcomes but one either remained stable or numerically improved in both groups. Internalised stigma significantly improved in the intervention group (p = 0.026) but not in the comparison group (p = 0.207), with a significant group effect (p = 0.014).Discussion and ConclusionsThis study demonstrates the effectiveness of the Choizitaconso TPE program on community-validated outcomes, especially internalised stigma.

Published
2023
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5. Symptom improvements following therapeutic use of cannabis-based products in French people with multiple sclerosis

Author

Tangui Barré, Clémence Ramier, Camelia Protopopescu, Patrizia Carrieri, Lise Radoszycki, 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), Carenity [Paris] (Else Care), and Barré, Tangui

Subjects
cannabis, neurologic manifestations, Neurology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Humans, pain, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), General Medicine, Medical Marijuana, Muscle spasticity, multiple sclerosis
Abstract

International audience; No abstract available

Published
2022
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6. A Community-Based Therapeutic Education Programme for People with Alcohol Use Disorder in France: A Qualitative Study (ETHER)

Author

Carrieri, Marie Costa, Tangui Barré, Saskia Antwerpes, Marion Coste, Morgane Bureau, Clémence Ramier, Gwenaelle Maradan, Olivier Riccobono-Soulier, Stéphanie Vassas-Goyard, Danielle Casanova, and Patrizia

Subjects
alcohol use disorder, harm reduction, therapeutic patient education, controlled drinking, qualitative method, thematic analysis
Abstract

Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to “normalize” participants’ relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants’ health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care.

Published
2022
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7. A Community-Based Therapeutic Education Programme for People with Alcohol Use Disorder in France: A Qualitative Study (ETHER)

Author

Marie, Costa, Tangui, Barré, Saskia, Antwerpes, Marion, Coste, Morgane, Bureau, Clémence, Ramier, Gwenaelle, Maradan, Olivier, Riccobono-Soulier, Stéphanie, Vassas-Goyard, Danielle, Casanova, and Patrizia, Carrieri

Subjects
Alcoholism, Humans, France, Health Promotion, Ether, Qualitative Research
Abstract

Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to "normalize" participants' relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants' health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care.

Published
2022

8. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH)

Author

Fabienne Marcellin, Sylvie Brégigeon-Ronot, Clémence Ramier, Camelia Protopopescu, Camille Gilbert, Vincent Di Beo, Claudine Duvivier, Morgane Bureau-Stoltmann, Eric Rosenthal, Linda Wittkop, Dominique Salmon-Céron, Patrizia Carrieri, Philippe Sogni, Tangui Barré, D. Salmon, R. Usubillaga, P. Sogni, B. Terris, P. Tremeaux, C. Katlama, M.A. Valantin, H. Stitou, A. Simon, P. Cacoub, S. Nafissa, Y. Benhamou, F. Charlotte, Virologie: S. Fourati, I. Poizot-Martin, O. Zaegel, H. Laroche, C. Tamalet, G. Pialoux, J. Chas, P. Callard, F. Bendjaballah, C. Amiel, C. Le Pendeven, B. Marchou, L. Alric, K. Barange, S. Metivier, J. Selves, F. Larroquette, E. Rosenthal, null Infectiologie, A. Naqvi, V. Rio, J. Haudebourg, M.C. Saint-Paul, A. De Monte, V. Giordanengo, C. Partouche, O. Bouchaud, A. Martin, M. Ziol, Y. Baazia, V. Iwaka-Bande, A. Gerber, M. Uzan, A. Bicart-See, D. Garipuy, M.J. Ferro-Collados, null Virologie, F. Nicot, A. Gervais, Y. Yazdanpanah, H. Adle-Biassette, G. Alexandre, G. Peytavin, C. Lascoux-Combe, J.M. Molina, P. Bertheau, M.L. Chaix, C. Delaugerre, S. Maylin, K. Lacombe, J. Bottero, J. Krause, P.M. Girard, D. Wendum, P. Cervera, J. Adam, C. Viala, D. Vittecocq, C. Goujard, Y. Quertainmont, E. Teicher, C. Pallier, O. Lortholary, C. Duvivier, C. Rouzaud, J. Lourenco, F. Touam, C. Louisin, V. Avettand-Fenoel, E. Gardiennet, A. Mélard, D. Neau, A. Ochoa, E. Blanchard, S. Castet-Lafarie, C. Cazanave, D. Malvy, M. Dupon, H. Dutronc, F. Dauchy, L. Lacaze-Buzy, A. Desclaux, P. Bioulac-Sage, P. Trimoulet, S. Reigadas, P. Morlat, D. Lacoste, F. Bonnet, N. Bernard, M. Hessamfar, null J, F. Paccalin, C. Martell, M.C. Pertusa, M. Vandenhende, P. Mercié, T. Pistone, M.C. Receveur, M. Méchain, P. Duffau, C. Rivoisy, I. Faure, S. Caldato, P. Bellecave, C. Tumiotto, J.L. Pellegrin, J.F. Viallard, E. Lazzaro, C. Greib, D. Zucman, C. Majerholc, M. Brollo, E. Farfour, F. Boué, J. Polo Devoto, I. Kansau, V. Chambrin, C. Pignon, L. Berroukeche, R. Fior, V. Martinez, S. Abgrall, M. Favier, C. Deback, Y. Lévy, S. Dominguez, J.D. Lelièvre, A.S. Lascaux, G. Melica, E. Billaud, F. Raffi, C. Allavena, V. Reliquet, D. Boutoille, C. Biron, M. Lefebvre, N. Hall, S. Bouchez, A. Rodallec, L. Le Guen, C. Hemon, P. Miailhes, D. Peyramond, C. Chidiac, F. Ader, F. Biron, A. Boibieux, L. Cotte, T. Ferry, T. Perpoint, J. Koffi, F. Zoulim, F. Bailly, P. Lack, M. Maynard, S. Radenne, M. Amiri, F. Valour, C. Augustin-Normand, C. Scholtes, T.T. Le-Thi, L. Piroth, P. Chavanet, M. Duong Van Huyen, M. Buisson, A. Waldner-Combernoux, S. Mahy, A. Salmon Rousseau, C. Martins, H. Aumaître, S. Galim, F. Bani-Sadr, D. Lambert, Y. Nguyen, J.L. Berger, M. Hentzien, V. Brodard, D. Rey, M. Partisani, M.L. Batard, C. Cheneau, M. Priester, C. Bernard-Henry, E. de Mautort, P. Fischer, P. Gantner, S. Fafi-Kremer, F. Roustant, P. Platterier, I. Kmiec, L. Traore, S. Lepuil, S. Parlier, V. Sicart-Payssan, E. Bedel, S. Anriamiandrisoa, C. Pomes, M. Mole, C. Bolliot, P. Catalan, M. Mebarki, A. Adda-Lievin, P. Thilbaut, Y. Ousidhoum, F.Z. Makhoukhi, O. Braik, R. Bayoud, C. Gatey, M.P. Pietri, V. Le Baut, R. Ben Rayana, D. Bornarel, C. Chesnel, D. Beniken, M. Pauchard, S. Akel, C. Lions, A. Ivanova, A.-S. Ritleg, C. Debreux, L. Chalal, J. Zelie, H. Hue, A. Soria, M. Cavellec, S. Breau, A. Joulie, P. Fisher, S. Gohier, D. Croisier-Bertin, S. Ogoudjobi, C. Brochier, V. Thoirain-Galvan, M. Le Cam, L. Wittkop, L. Esterle, J. Izopet, L. Serfaty, V. Paradis, B. Spire, P. Carrieri, O. Zaegel-Faucher, L. Meyer, F. Boufassa, B. Autran, A.M. Roque, C. Solas, H. Fontaine, D. Costagliola, V. Petrov-Sanchez, A. Levier, null P. Carrieri, M. Chalouni, V. Conte, L. Dequae-Merchadou, M. Desvallées, C. Gilbert, S. Gillet, Q. Guillochon, C. Khan, R. Knight, F. Marcellin, L. Michel, M. Mora, C. Protopopescu, P. Roux, T. Barré, C. Ramier, A. Sow, V. Di Beo, and M. Bureau

Subjects
Hepatology, Gastroenterology, Internal Medicine, Immunology and Allergy
Abstract

A growing literature shows an improvement of chronic hepatitis C virus (HCV)-related depression after successful treatment with direct-acting antivirals. However, depression after HCV cure remains insufficiently documented in people living with HIV (PLWH) and HCV, a population with specific mental health challenges. This study aimed to (i) document the prevalence of moderate-to-severe depression (PHQ-9 score ≥10) across different age classes in HCV-cured PLWH; (ii) identify associated socio-behavioral correlates.Descriptive analyses were performed on data collected during a cross-sectional survey (February 2018 - May 2019) nested in a prospective, multicenter cohort of individuals living with HIV and HCV (ANRS CO13 HEPAVIH). Socio-behavioral correlates of moderate-to-severe depression were identified using logistic regression.Among the 398 HCV-cured individuals in the study sample (median age [IQR]: 56 [53-59] years; 73.1% men), 23.9% presented with moderate-to-severe depression (PHQ-9 score ≥10). Depressive symptom prevalence rates were as follows: anhedonia: 52.3%; feeling 'down' or feelings of hopelessness: 48.3%; sleeping problems: 65.7%; lack of energy: 70.3%; eating disorders: 51.2%; lack of self-esteem: 34.3%; difficulty concentrating: 34.9%; sluggishness (in movement and voice) or restlessness: 24.6%; suicidal ideation: 17.1%. No significant difference was detected across age classes. Female sex, unhealthy alcohol use, sedentary lifestyle, and unhealthy eating behaviors were associated with increased odds of moderate-to-severe depression.Depressive symptoms were common in this sample of HCV-cured PLWH. Unlike findings for the French general population, the prevalence of depression did not decrease with age class. Mental health remains a key issue for HIV-HCV-coinfected individuals, even after HCV cure, especially in women and in individuals with unhealthy behaviors.Despite potential improvements in mental health after successful treatment with direct-acting antivirals, many people living with HIV (PLWH) and hepatitis C virus (HCV) - even in older age classes - still face depressive symptoms after HCV cure. In this population, women and people reporting unhealthy alcohol use, sedentary lifestyle, or unhealthy eating behaviors are more prone to report depressive symptoms after HCV cure. Mental health and lifestyle-related issues should be integrated in a global care model for PLWH living with or having a history of hepatitis C.

Published
2022

9. Metabolic Disorders in Patients with Chronic Hepatitis B Virus Infection: Coffee as a Panacea? (ANRS CO22 Hepather Cohort)

Author

Group, Tangui Barré, Hélène Fontaine, Stanislas Pol, Clémence Ramier, Vincent Di Beo, Camelia Protopopescu, Fabienne Marcellin, Morgane Bureau, Marc Bourlière, Céline Dorival, Ventzislava Petrov-Sanchez, Tarik Asselah, Elisabeth Delarocque-Astagneau, Dominique Larrey, Jean-Charles Duclos-Vallée, Fabrice Carrat, Patrizia Carrieri, and on behalf of the ANRS/AFEF Hepather Study Group on behalf of the ANRS/AFEF Hepather Study

Subjects
coffee, tea, hepatitis B, metabolic syndrome, dyslipidemia, hypertension, polyphenol
Abstract

People living with chronic hepatitis B virus (HBV) infection are at high risk of liver disease progression, which is positively associated with metabolic disorders, but inversely associated with dyslipidemia. Diet, including dietary antioxidants, is a lever of metabolic disorder management. In particular, elevated coffee consumption is associated with different metabolic outcomes in the general population. We aimed to test whether such associations occur in HBV-infected people. Based on cross-sectional data from the ANRS CO22 Hepather cohort, we performed logistic regression models with (i) dyslipidemia, (ii) hypertension, and (iii) diabetes as outcomes, and with demographic, clinical, and socio-behavioral (including coffee consumption) data as explanatory variables. Among 4746 HBV-infected patients, drinking ≥3 cups of coffee per day was associated with a higher risk of dyslipidemia (adjusted odds ratio [95% confidence interval] 1.49 [1.10–2.00], p = 0.009) and a lower risk of hypertension (0.64 [0.50–0.82], p = 0.001). It was not associated with diabetes. Elevated coffee consumption was associated with a higher risk of dyslipidemia and a lower risk of hypertension in HBV-infected patients, two effects expected to be associated with favorable clinical outcomes. Further studies should test whether such metabolic benefits translate into reduced mortality risk in this population.

Published
2022
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10. Elevated coffee consumption is associated with a lower risk of elevated liver fibrosis biomarkers in patients treated for chronic hepatitis B (ANRS CO22 Hepather cohort)

Author

Tangui Barré, Hélène Fontaine, Clémence Ramier, Vincent Di Beo, Stanislas Pol, Patrizia Carrieri, Fabienne Marcellin, Carole Cagnot, Céline Dorival, Jessica Zucman-Rossi, Fabien Zoulim, Fabrice Carrat, Camelia Protopopescu, Gestionnaire, HAL Sorbonne Université 5, 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), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 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), Cancer Research and Personalized Medicine - CARPEM [Paris], 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [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), Hospices Civils de Lyon (HCL), and École Pratique des Hautes Études (EPHE)

Subjects
Liver Cirrhosis, MESH: Hepatitis B, Chronic, Liver fibrosis, Critical Care and Intensive Care Medicine, Severity of Illness Index, Coffee, MESH: gamma-Glutamyltransferase, MESH: Aspartate Aminotransferases, Hepatitis B, Chronic, MESH: Cross-Sectional Studies, Caffeine, MESH: Severity of Illness Index, Humans, Aspartate Aminotransferases, MESH: Platelet Count, Retrospective Studies, Nutrition and Dietetics, MESH: Humans, Platelet Count, MESH: Coffee, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, gamma-Glutamyltransferase, Hepatitis B, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Biomarkers, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, MESH: Liver Cirrhosis, Biomarkers
Abstract

International audience; Background and aimsPatients chronically infected with hepatitis B virus (HBV) are at high risk of liver fibrosis, cirrhosis and liver cancer, despite recent therapeutic advances. It is therefore crucial to find non-pharmaceutical options for liver fibrosis prevention in this population. Using cross-sectional data from the ANRS CO22 Hepather cohort, we aimed to identify socio-demographic and modifiable risk factors for significant fibrosis in chronic HBV patients.MethodsLogistic regression or Firth's penalized maximum likelihood logistic regression (according to outcome prevalence) multivariable models were used to test for associations between explanatory variables and significant fibrosis, as assessed by three non-invasive markers: aspartate aminotransferase to platelet ratio index (APRI), FIB-4, and gamma glutamyltransferase to platelet ratio (GPR). Analyses were stratified by HBV treatment status.ResultsThe study population comprised 2065 untreated and 1727 treated chronic HBV patients. Elevated coffee consumption was consistently associated with a lower risk of elevated fibrosis biomarkers in all three treated-participant models, suggesting a dose-response relationship (adjusted odds ratios for ≥3 cups/day versus 0 cups/day: 0.16, 0.35 and 0.62, p ≤ 0.002, according to APRI, FIB-4 and GPR, respectively). Other modifiable risk factors included tobacco and alcohol use.ConclusionElevated coffee consumption was consistently associated with a lower risk of significant liver fibrosis, as assessed by three non-invasive markers in treated chronic HBV patients. This result can be immediately used in real-world situations, as increasing coffee consumption may be beneficial for patients at risk of advanced liver disease

Published
2022
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11. Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France

Author

Tangui Barré, Clémence Ramier, Izza Mounir, Renaud David, Loick Menvielle, Fabienne Marcellin, Patrizia Carrieri, Camelia Protopopescu, Faredj Cherikh, 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), Hôpital Archet 2 [Nice] (CHU), CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), EDHEC Business School (EDHEC), Université catholique de Lille (UCL), and Barré, Tangui

Subjects
Psychiatry and Mental health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Tobacco, Addictive behavior, COVID-19, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Psychological distress, Alcohol, Mindfulness
Abstract

International audience; COVID-19-related national lockdowns worldwide have had repercussions on people’s well-being and have led to increased substance use. Mindfulness has previously been associated with reduced psychological distress and benefits in terms of addictive behaviors. We aimed to assess whether dispositional mindfulness protected against increased tobacco and alcohol use in hospital workers after France’s first lockdown started. All workers in two French hospitals were contacted by email to participate in an online survey. Three hundred eighty-five workers answered. We ran two separate logistic regression models to test for associations between the level of dispositional mindfulness and both increased tobacco and alcohol use, after adjusting for affect deterioration. Dispositional mindfulness was associated with a lower likelihood of increased tobacco (adjusted odds ratio (AOR) [95% CI] 0.71 [0.51; 0.99], p = 0.046) and alcohol (0.66 [0.50; 0.87], p = 0.004) use. The effect of mindfulness on tobacco use was partially mediated by affect deterioration. Dispositional mindfulness appeared to be a protective factor against lockdown-related tobacco and alcohol use increases in French hospital workers.

Published
2022
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12. Tobacco use in people living with HIV: The need for complementary descriptive data to see beyond the smoke screen

Author

Fabienne Marcellin, David Zucman, Clémence Ramier, Marta Lotto, Patrick Miailhes, Lionel Piroth, Hugues Aumaitre, Patrick Mercié, Tangui Barré, Linda Wittkop, Philippe Sogni, Dominique Salmon-Ceron, Patrizia Carrieri, 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), Hôpital Foch [Suresnes], 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), 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), Centre Hospitalier Saint Jean de Perpignan, Service de Médecine Interne et Immunologie Clinique [CHU Bordeaux] (Pôle Médecine Interne), CHU Bordeaux [Bordeaux], Team MORPH3EUS (INSERM U1219 - UB - ISPED), 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), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), 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), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], The ANRS CO13 HEPAVIH cohort was supported by the ANRS Emerging Infectious Diseases, with the participation of SIDACTION, Abbott France, Glaxo-Smith-Kline, Roche, Schering-Plough, BMS, Merck-Serono., and ANRS CO13 HEPAVIH Study Group

Subjects
Tobacco Use, MESH: Humans, Health Policy, [SDV]Life Sciences [q-bio], MESH: Delivery of Health Care, MESH: Tobacco Smoke Pollution, Medicine (miscellaneous), Humans, HIV Infections, Tobacco Smoke Pollution, MESH: HIV Infections, MESH: Tobacco Use, Delivery of Health Care
Abstract

International audience; No abstract available

Published
2021
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13. 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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14. Cannabis Use Is Inversely Associated with Metabolic Disorders in Hepatitis C-Infected Patients (ANRS CO22 Hepather Cohort)

Author

Tangui, Barré, Marc, Bourlière, Clémence, Ramier, Fabrice, Carrat, Vincent, Di Beo, Camelia, Protopopescu, Fabienne, Marcellin, Morgane, Bureau, Carole, Cagnot, Céline, Dorival, Fabien, Zoulim, Jessica, Zucman-Rossi, Jean-Charles, Duclos-Vallée, Hélène, Fontaine, Patrizia, Carrieri, The Anrs/Afef Hepather 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), Institut des sciences de la santé publique [Marseille] (ISSPAM), Hôpital Saint-Joseph [Marseille], 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), Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), 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), 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), 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), Hôpital Paul Brousse, 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), Hepatinov (DHU), Université Paris-Sud - Paris 11 (UP11)-Centre Hépato-Biliaire Paul Brousse, 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), CARRAT, FABRICE, 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 École pratique des hautes études (EPHE)

Subjects
cannabis, hypertension, dyslipidemia, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, hepatitis C, chronic, metabolic syndrome, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract

International audience; Background and Aims. Hepatitis C virus (HCV) infection is associated with the onset of metabolic disorders which constitute risk factors for liver disease progression. Their impact may persist after the HCV infection has been cured. Cannabis use is associated with a lower risk of obesity and diabetes in both general and HCV populations. The associations between cannabis use and both dyslipidemia and hypertension have not yet been studied in persons with chronic HCV infection. Methods. Using cross-sectional data from the French ANRS CO22 Hepather cohort, we used regression models to test for an inverse relationship between cannabis use and (i) dyslipidemia, (ii) hypertension, and (iii) the total number of metabolic disorders. Results. Among the 6364 participants in the study population, both former and current cannabis use were associated with a lower risk of hypertension and fewer metabolic disorders. These results were independent of central obesity. Cannabis use was not associated with dyslipidemia. Conclusions. In people chronically infected with HCV, cannabis use was associated with a lower risk of hypertension and a lower number of metabolic disorders. Post-HCV cure studies are needed to confirm these findings using longitudinal data and to test whether they translate into reduced mortality in this population.

Published
2022
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16. Liver fibrosis and all‐cause mortality in chronic HCV‐infected diabetic patients: A paradoxical association? (ANRS CO22 HEPATHER)

Author

Tangui, Barré, Clémence, Ramier, Vincent, Di Beo, Fabrice, Carrat, Hélène, Fontaine, Fabienne, Marcellin, Patrizia, Carrieri, Stanislas, Pol, Camelia, Protopopescu, Marie-Josée, Lafrance, 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), Sorbonne Université (SU), 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), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunité Innée - Innate Immunity, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS/AFEF Hepather study group: Delphine Bonnet, Virginie Sicart, François Bailly, Marjolaine Beaudoin, Dominique Giboz, Kerstin Hartig-Lavie, Marianne Maynard, Morane Cavellec, Marjorie Cheraud-Carpentier, François Raffi, Florian Vivrel, Jaouad Benhida, Jérôme Boursier, Paul Calès, Françoise Lunel, Frédéric Oberti, Nathalie Boyer, Audrey Gilibert, Nathalie Giuily, Giovanna Scoazec, Sandrine Fernandes, Sylvie Keser, Philippe Sultanik, Anaïs Vallet-Pichard, Juliette Foucher, Jean-Baptiste Hiriart, Aurore Mathias, Julien Vergniol, Chrystelle Ansaldi, Laëtitia Chouquet, Emilie De Luca, Valérie Oules, Rodolphe Anty, Eve Gelsi, Régine Truchi, Elena Luckina, Nadia Messaoudi, Joseph Moussali, Barbara De Dieuleveult, Damien Labarriere, Pascal Poter, Si Nafa Si Ahmed, Nathalie Ganne-Carrié, Véronique Grando-Lemaire, Pierre Nahon, Alan Peltier, Judith Ung, Mariette Gougeon, Anne Guillygomarch, Caroline Jezequel, Romain Moirand, Thomas F Baumert, Michel Dofföel, Catherine Mutter, Pauline Simo-Noumbissie, Hélène Barraud, Mouni Bensenane, Abdelbasset Nani, Sarah Hassani-Nani, Marie-Albertine Bernard, Michael Bismuth, Ludovic Caillo, Stéphanie Faure, Georges-Philippe Pageaux, Marie P Ripault, Karl Barange, Christophe Bureau, Jean M Peron, Marie A Robic, Léa Tarallo, Marine Faure, Bruno Froissart, Marie-Noelle Hilleret, Vincent Leroy, Odile Goria, Victorien Grard, Hélène Montialoux, Muriel François, Christian Ouedraogo, Christelle Pauleau, Anne Varault, Tony Andreani, Bénédicte Angoulevant, Azeline Chevance, Lawrence Serfaty, Teresa Antonini, Audrey Coilly, Jean-Charles D Vallée, Mariagrazia Tateo, Armand Abergel, Corinne Bonny, Chanteranne Brigitte, Géraldine Lamblin, Léon Muti, Abdenour Babouri, Virginie Filipe, Camille Barrault, Laurent Costes, Hervé Hagège, Soraya Merbah, Paul Carrier, Maryline Debette-Gratien, Jérémie Jacques, Florent Artu, Valérie Canva, Sébastien Dharancy, Alexandre Louvet, Marc Bardou, Donya Da Costa Souhiel, Patrick Hillon, Marianne Latournerie, Yannick Bacq, Didier Barbereau, Charlotte Nicolas, Nisserine B Amara, Danièle Botta-Fridlund, Isabelle Portal, Moana Gelu-Simeon, Marie-Josée Lafrance, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), The cohort received financial support from the INSERM-ANRS (France Recherche Nord and Sud Sida-HIV Hépatites), the French ANR (Agence Nationale de la Recherche), the French DGS (Direction Générale de la Santé), Merck Sharp and Dohme, Janssen-Cilag, Gilead, Abbvie, Bristol-Myers Squibb and Roche. FC reports grants from INSERM-ANRS, during the conduct of the study, and personal fees from Imaxio, outside the submitted work. MB reports grants and personal fees from AbbVie and Gilead, outside the submitted work, and personal fees from MSD, Janssen, Boehringher Ingelheim, Intercept and Bristol-Myers Squibb, outside the submitted work. SP has received consulting and lecturing fees from Bristol-Myers Squibb, Janssen, Gilead, Roche, MSD, MYR-Pharma, Shionogi, Biotest and Abbvie, as well as grants from Bristol-Myers Squibb, Gilead, Roche and MSD. HF reports personal fees and invitations for medical meetings from Gilead, AbbVie, Bristol-Myers Squibb, MSD and Janssen, outside the submitted work. Other authors declare no financial support., and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Liver Cirrhosis, 0303 health sciences, medicine.medical_specialty, Hepatology, business.industry, Liver fibrosis, [SDV]Life Sciences [q-bio], Hepatitis C, Chronic, Antiviral Agents, Gastroenterology, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Text mining, Internal medicine, Diabetes Mellitus, medicine, Humans, 030211 gastroenterology & hepatology, business, All cause mortality, ComputingMilieux_MISCELLANEOUS, Follow-Up Studies, 030304 developmental biology
Abstract

International audience; No abstract available

Published
2021
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17. Facteurs socio-comportementaux associés à la mortalité de cause hépatique et non hépatique chez les patients atteints d’hépatite C chronique (cohorte ANRS CO22 HEPATHER)

Author

Carole Cagnot, V. Di Beo, Elisabeth Delarocque-Astagneau, Hélène Fontaine, Fabrice Carrat, Patrizia Carrieri, Fabienne Marcellin, Stanislas Pol, M. Bourlière, Melina Erica Santos, Clémence Ramier, Dominique Larrey, Céline Dorival, and Camelia Protopopescu

Subjects
Epidemiology, Public Health, Environmental and Occupational Health
Abstract

Introduction Depuis l’arrivee des antiviraux a action directe, la quasi-totalite des patients souffrant d’hepatite C chronique (VHC) peuvent etre gueris, mais leur risque de complications hepatiques et de maladies cardiovasculaires ou metaboliques reste plus eleve que dans la population generale. Dans ce contexte, il est important de pouvoir identifier les facteurs socio-comportementaux associes a la mortalite chez les patients VHC. Or, les etudes publiees a ce jour sont restreintes a des sous-populations specifiques (ex : patients co-infectes par le VIH) ou a l’analyse des facteurs de risque cliniques. Nous avons analyse l’effet des facteurs socio-comportementaux sur l’incidence de deces de cause hepatique et non hepatique, chez des patients VHC suivis sur une duree de cinq ans. Methodes La population d’etude etait composee des patients VHC participant a la cohorte prospective, multicentrique ANRS CO22 HEPATHER, ayant des donnees socio-comportementales et cliniques collectees lors d’une premiere visite d’inclusion et lors de visites de suivi annuelles pendant cinq ans. Les facteurs associes a la mortalite hepatique et non hepatique ont ete identifies a l’aide du modele de Fine et Gray en presence de risques competitifs. Les variables ont d’abord ete testees en analyse univariee et celles ayant une p-valeur inferieure a 0,20 (test de Wald) dans au moins l’une des deux analyses ont ete incluses dans l’analyse multivariee. Une selection descendante des variables a ete utilisee pour construire les modeles finaux avec un taux de significativite fixe a 5 % dans au moins l’une des deux analyses. Resultats La population d’etude (n = 10 420, 27 450 personnes-annees) etait composee de 55,9 % d’hommes et l’âge median etait de 56 ans (intervalle interquartile = [50-64] ans). A l’inclusion, 31,5 % des patients vivaient sous le seuil de pauvrete (niveau de vie du menage Conclusion A l’ere de la guerison de l’hepatite C, la precarite sociale, les antecedents de consommation excessive d’alcool et l’usage de tabac constituent des facteurs de risque socio-comportementaux de mortalite chez les patients avec hepatite C chronique.

Published
2021
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