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4. Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Author

Lodi, Sara, Del Amo, Julia, Moreno, Santiago, Bucher, H. C., Furrer, Hansjakob, Logan, Roger, Sterne, Jonathan, Pérez-Hoyos, Santiago, Jarrín, Inma, Phillips, Andrew, Olson, Ashley, Van Sighem, Ard, Reiss, Peter, Sabin, C., Jose, Sophie, Justice, Amy, Goulet, Joseph, Miró, José M., Ferrer, Elena, Meyer, Laurence, Seng, Rémonie, Vourli, Georgia, Antoniadou, Anastasia, Dabis, Francois, Vandenhede, Mari Anne, Costagliola, Dominique, Abgrall, S., Hernán, Miguel A., Hernan, Miguel, Bansi, L., Hill, T., Dunn, D., Porter, K., Glabay, A., Orkin, C., Thomas, R., Jones, K., Fisher, M., Perry, N., Pullin, A., Churchill, D., Gazzard, B., Nelson, M., Asboe, D., Bulbeck, S., Mandalia, S., Clarke, J., Delpech, V., Anderson, J., Munshi, S., Post, F., Easterbrook, P., Khan, Y., Patel, P., Karim, F., Duffell, S., Gilson, R., Man, S. L., Williams, I., Gompels, M., Dooley, D., Schwenk, A., Ainsworth, J., Johnson, M., Youle, M., Lampe, F., Smith, C., Grabowska, H., Chaloner, C., Ismajani Puradiredja, D., Phillips, A., Walsh, J., Weber, J., Kemble, C., Mackie, N., Winston, A., Leen, C., Wilson, A., Bezemer, D. O., Gras, L. A.J., Kesselring, A. M., Van Sighem, A. I., Zaheri, S., Van Twillert, G., Kortmann, W., Branger, J., Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., Van Der Meer, J. T.M., Wit, F. W.M.N., Godfried, M. H., Reiss, P., Van Der Poll, T., Nellen, F. J.B., Lange, J. M.A., Geerlings, S. E., Van Vugt, M., Pajkrt, D., Bos, J. C., Van Der Valk, M., Grijsen, M. L., Wiersinga, W. J., Brinkman, K., Blok, W. L., Frissen, P. H.J., Schouten, W. E.M., Van Den Berk, G. E.L., Veenstra, J., Lettinga, K. D., Mulder, J. W., Vrouenraets, S. M.E., Lauw, F. N., Van Eeden, A., Verhagen, D. W.M., Van Agtmael, M. A., Perenboom, R. M., Claessen, F. A.P., Bomers, M., Peters, E. J.G., Richter, C., Van Der Berg, J. P., Gisolf, E. H., Schippers, E. F., Van Nieuwkoop, C., Van Elzakker, E. P., Leyten, E. M.S., Gelinck, L. B.S., Pronk, M. J.H., Bravenboer, B., Kootstra, G. J., Delsing, C. E., Sprenger, H. G., Doedens, R., Scholvinck, E. H., Van Assen, S., Bierman, W. F.W., Soetekouw, R., Ten Kate, R. W., Van Vonderen, M. G.A., Van Houte, D. P.F., Kroon, F. P., Van Dissel, J. T., Arend, S. M., De Boer, M. G.J., Jolink, H., Ter Vollaard, H. J.M., Bauer, M. P., Weijer, S., El Moussaoui, R., Lowe, S., Schreij, G., Oude Lashof, A., Posthouwer, D., Koopmans, P. P., Keuter, M., Van Der Ven, A. J.A.M., Ter Hofstede, H. J.M., Dofferhoff, A. S.M., Warris, A., Van Crevel, R., Van Der Ende, M. E., De Vries-Sluijs, T. E.M.S., Schurink, C. A.M., Nouwen, J. L., Nispen Tot Pannerden, M. H., Verbon, A., Rijnders, B. J.A., Van Gorp, E. C.M., Hassing, R. J., Smeulders, A. W.M., Hartwig, N. G., Driessen, G. J.A., Den Hollander, J. G., Pogany, K., Juttmann, J. R., Van Kasteren, M. E.E., Hoepelman, A. I.M., Mudrikova, T., Schneider, M. M.E., Jaspers, C. A.J.J., Ellerbroek, P. M., Oosterheert, J. J., Arends, J. E., Wassenberg, M. W.M., Barth, R. E., Geelen, S. P.M., Wolfs, T. F.W., Bont, L. J., Van Den Berge, M., Stegeman, A., Groeneveld, P. H.P., Alleman, M. A., Bouwhuis, J. W., Barin, F., Burty, C., Duvivier, C., Enel, P., Fredouille-Heripret, L., Gasnault, J., Khuong, M. A., Mahamat, A., Pilorgé, F., Tattevin, P., Salomon, Valérie, Jacquemet, N., Costagliola, D., Grabar, S., Guiguet, M., Lanoy, E., Lièvre, L., Mary-Krause, M., Selinger-Leneman, H., Lacombe, J. M., Potard, V., Bricaire, F., Herson, S., Katlama, C., Simon, A., Desplanque, N., Girard, P. M., Meynard, J. L., Meyohas, M. C., Picard, O., Cadranel, J., Mayaud, C., Pialoux, G., Clauvel, J. P., Decazes, J. M., Gérard, L., Molina, J. M., Diemer, M., Sellier, P., Bentata, M., Honoré, P., Jeantils, V., Tassi, S., Mechali, D., Taverne, B., Bouvet, E., Crickx, B., Ecobichon, J. L., Matheron, S., Picard-Dahan, C., Yeni, P., Berthé, H., Dupont, C., Chandemerle, C., Mortier, E., De Truchis, P., Tisne-Dessus, D., Weiss, L., Salmon, D., Auperin, I., Gilquin, J., Roudière, L., Viard, J. P., Boue, F., Fior, R., Delfraissy, J. F., Goujard, C., Jung, C., Lesprit, Ph, Vittecoq, D., Fraisse, P., Lang, J. M., Rey, D., Beck-Wirth, G., Stahl, J. P., Lecercq, P., Gourdon, F., Laurichesse, H., Fresard, A., Lucht, F., Bazin, C., Verdon, R., Chavanet, P., Arvieux, C., Michelet, C., Choutet, P., Goudeau, A., Maître, M. F., Hoen, B., Eglinger, P., Faller, J. P., Borsa-Lebas, F., Caron, F., Reynes, J., Daures, J. P., May, T., Rabaud, C., Berger, J. L., Rémy, G., Arlet-Suau, E., Cuzin, L., Massip, P., Thiercelin Legrand, M. F., Pontonnier, G., Viget, N., Yasdanpanah, Y., Dellamonica, P., Pradier, C., Pugliese, P., Aleksandrowicz, K., Quinsat, D., Ravaux, I., Tissot-Dupont, H., Delmont, J. P., Moreau, J., Gastaut, J. A., Poizot Martin, I., Retornaz, F., Soubeyrand, J., Galinier, A., Ruiz, J. M., Allegre, T., Blanc, P. A., Bonnet-Montchardon, D., Lepeu, G., Granet-Brunello, P., Esterni, J. P., Pelissier, L., Cohen-Valensi, R., Nezri, M., Chadapaud, S., Laffeuillade, A., Billaud, E., Raffi, F., Boibieux, A., Peyramond, D., Livrozet, J. M., Touraine, J. L., Cotte, L., Trepo, C., Strobel, M., Bissuel, F., Pradinaud, R., Sobesky, M., Cabié, A., Gaud, C., Contant, M., Aubert, V., Barth, J., Battegay, M., Bernasconi, E., Böni, J., Burton-Jeangros, C., Calmy, A., Cavassini, M., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Haerry, D., Fux, C. A., Gorgievski, M., Günthard, H., Hasse, B., Hirsch, H. H., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kovari, H., Ledergerber, B., Martinetti, G., Martinez De Tejada, B., Metzner, K., Müller, N., Nadal, D., Pantaleo, G., Rauch, A., Regenass, S., Rickenbach, M., Rudin, C., Schmid, P., Schultze, D., Schöni-Affolter, F., Schüpbach, J., Speck, R., Taffé, P., Tarr, P., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Casabona, J., Gallois, A., Esteve, A., Podzamczer, D., Murillas, J., Gatell, J. M., Manzardo, C., Tural, C., Clotet, B., Ferrer, E., Riera, M., Segura, F., Navarro, G., Force, L., Vilaró, J., Masabeu, A., García, I., Guadarrama, M., Cifuentes, C., Dalmau, D., Jaen, Agustí, C., Montoliu, A., Pérez, I., Gargoulas, Freyra, Blanco, J. L., Garcia-Alcaide, F., Martínez, E., Mallolas, J., López-Dieguez, M., García-Goez, J. F., Sirera, G., Romeu, J., Jou, A., Negredo, E., Miranda, C., Capitan, M. C., Saumoy, M., Imaz, A., Tiraboschi, J. M., Murillo, O., Bolao, F., Peña, C., Cabellos, C., Masó, M., Vila, A., Sala, M., Cervantes, M., Jose Amengual, Ma, Navarro, M., Penelo, E., Barrufet, P., Bejarano, G., Molina, J., Alvaro, M., Mercadal, J., Fernandez, Juanse, Ospina, Jesus E., Muñoz, M. A., Caro-Murillo, A. M., Sobrino, P., Jarrín, I., Gomez Sirvent, J. L., Rodríguez, P., Aleman, M. R., Alonso, M. M., Lopez, A. M., Hernandez, M. I., Soriano, V., Labarga, P., Barreiro, P., Medrano, J., Rivas, P., Herrero, D., Blanco, F., Vispo, M. E., Martín, L., Ramírez, G., De Diego, M., Rubio, R., Pulido, F., Moreno, V., Cepeda, C., Hervás, Rl, Iribarren, J. A., Arrizabalaga, J., Aramburu, M. J., Camino, X., Rodrí-guez-Arrondo, F., Von Wichmann, M. A., Pascual, L., Goenaga, M. A., Gutierrez, F., Masia, M., Ramos, J. M., Padilla, S., Sanchez-Hellín, V., Bernal, E., Escolano, C., Montolio, F., Peral, Y., Berenguer, J., Lopez, J. C., Miralles, P., Cosín, J., Sanchez, M., Gutierrez, I., Ramírez, M., Padilla, B., Vidal, F., Sanjuan, M., Peraire, J., Veloso, S., Vilades, C., Lopez-Dupla, M., Olona, M., Vargas, M., Aldeguer, J. L., Blanes, M., Lacruz, J., Salavert, M., Montero, M., Cuéllar, S., De Los Santos, I., Sanz, J., Oteo, J. A., Blanco, J. R., Ibarra, V., Metola, L., Sanz, M., Pérez-Martínez, L., Sola, J., Uriz, J., Castiello, J., Reparaz, J., Arriaza, M. J., Irigoyen, C., Moreno, S., Antela, A., Casado, J. L., Dronda, F., Moreno, A., Pérez, M. J., López, D., Gutiérrez, C., Hernández, B., Pumares, M., Martí, P., García, L., Page, C., García, F., Hernández, J., Peña, A., Muñoz, L., Parra, J., Viciana, P., Leal, M., López-Cortés, L. F., Trastoy, M., Mata, R., Justice, A. C., Fiellin, D. A., Rimland, D., Jones-Taylor, C., Oursler, K. A., Titanji, R., Brown, S., Garrison, S., Rodriguez-Barradas, M., Masozera, N., Goetz, M., Leaf, D., Simberkoff, M., Blumenthal, D., Leung, J., Butt, A., Hoffman, E., Gibert, C., Peck, R., Mattocks, K., Braithwaite, S., Brandt, C., Bryant, K., Cook, R., Conigliaro, J., Crothers, K., Chang, J., Crystal, S., Day, N., Erdos, J., Freiberg, M., Kozal, M., Gandhi, N., Gaziano, M., Gerschenson, M., Good, B., Gordon, A., Goulet, J. L., Hernán, M. A., Kraemer, K., Lim, J., Maisto, S., Miller, P., Mole, L., O'Connor, P., Papas, R., Robins, J. M., Rinaldo, C., Roberts, M., Samet, J., Tierney, B., Whittle, J., Babiker, A., Brettle, R., Darbyshire, J., Goldberg, D., Hawkins, D., Jaffe, H., Johnson, A., McLean, K., Pillay, D., Cursley, Adam, Ewings, Fiona, Fairbrother, Keith, Louisa Gnatiuc, S. L., Murphy, Brendan, Douglas, G., Kennedy, N., Pritchard, J., Andrady, U., Rajda, N., Maw, R., McKernan, S., Drake, S., Gilleran, G., White, D., Ross, J., Toomer, S., Hewart, R., Wilding, H., Woodward, R., Dean, G., Heald, L., Horner, P., Glover, S., Bansaal, D., Eduards, S., Carne, C., Browing, M., Das, R., Stanley, B., Estreich, S., Magdy, A., O'Mahony, C., Fraser, P., Hayman, B., Jebakumar, S. P.R., Joshi, U., Ralph, S., Wade, A., Mette, R., Lalik, J., Summerfield, H., El-Dalil, A., France, J. A., White, C., Robertson, R., Gordon, S., McMillan, S., Morris, S., Lean, C., Vithayathil, K., McLean, L., Winter, A., Gale, D., Jacobs, S., Tayal, S., Short, L., Green, S., Williams, G., Sivakumar, K., Bhattacharyya, N. D., Monteiro, E., Minton, J., Dhar, J., Nye, F., De Souza, C. B., Isaksen, A., McDonald, L., Franca, A., William, L., Jendrulek, I., Peters, B., Shaunak, S., El-Gadi, S., Easterbrook, P. J., Mazhude, C., Johnstone, R., Fakoya, A., McHale, J., Waters, A., Kegg, S., Mitchell, S., Byrne, P., Rice, P., Fidler, S., Mullaney, S. A., McCormack, S., David, D., Melville, R., Phillip, K., Balachandran, T., Mabey-Puttock, S., Sukthankar, A., Murphy, C., Wilkins, E., Ahmad, S., Haynes, J., Evans, E., Ong, E., Grey, R., Meaden, J., Bignell, C., Loay, D., Peacock, K., Girgis, M. R., Morgan, B., Palfreeman, A., Wilcox, J., Tobin, J., Tucker, L., Saeed, A. M., Chen, F., Deheragada, A., Williams, O., Lacey, H., Herman, S., Kinghorn, D., Devendra, V. S., Wither, J., Dawson, S., Rowen, D., Harvey, J., Bridgwood, A., Singh, G., Chauhan, M., Kellock, D., Young, S., Dannino, S., Kathir, Y., Rooney, G., Currie, J., FitzGerald, M., Devendra, S., Keane, F., Booth, G., Green, T., Arumainayyagam, J., Chandramani, S., Rajamanoharan, S., Robinson, T., Curless, E., Gokhale, R., Tariq, A., Luzzi, G., Fairley, I., Wallis, F., Smit, E., Ward, F., Loze, B., Morlat, P., Bonarek, M., Bonnet, F., Nouts, C., Louis, I., Reliquet, V., Sauser, F., Biron, C., Mounoury, O., Hue, H., Brosseau, D., Ghosn, J., Rannou, M. T., Bergmann, J. F., Badsi, E., Rami, A., Parrinello, M., Samanon-Bollens, D., Campa, P., Tourneur, M., Desplanques, N., Jeanblanc, F., Chiarello, P., Makhloufi, D., Blanc, A. P., Allègre, T., Baillat, V., Lemoing, V., Merle De Boever, C., Tramoni, C., Sobesky, G., Abel, S., Beaujolais, V., Slama, L., Chakvetadze, C., Berrebi, V., Fournier, I., Gerbe, J., Koffi, K., Augustin-Normand, C., Miailhes, P., Thoirain, V., Brochier, C., Souala, F., Ratajczak, M., Beytoux, J., Jacomet, C., Rouveix, E., Morelon, S., Olivier, C., Lortholary, O., Dupont, B., Maignan, A., Ragnaud, J. M., Raymond, I., Leport, C., Jadand, C., Jestin, C., Longuet, P., Boucherit, S., Sereni, D., Lascoux, C., Prevoteau, F., Sobel, A., Levy, Y., Lelievre, J. D., Lascaux, A. S., Dominguez, S., Dumont, C., Aumâitre, H., Delmas, B., Saada, M., Medus, M., Guillevin, L., Tahi, T., Yazdanpanah, Y., Pavel, S., Marien, M. C., Drenou, B., Beck, C., Benomar, M., Tubiana, R., Ait Mohand, H., Chermak, A., Ben Abdallah, S., Touam, F., Drobacheff, C., Folzer, A., Obadia, M., Prudhomme, L., Bonnet, E., Balzarin, F., Pichard, E., Chennebault, J. M., Fialaire, P., Loison, J., Galanaud, P., Boué, F., Bornarel, D., Six, M., Ferret, P., Batisse, D., Gonzales-Canali, G., Devidas, A., Chevojon, P., Turpault, I., Lafeuillade, A., Cheret, A., Philip, G., Morel, P., Timsit, J., Amirat, N., Brancion, C., Cabane, J., Tredup, J., Stein, A., Ravault, I., Chavanet, C., Buisson, M., Treuvetot, S., Nau, P., Bastides, F., Boyer, L., Wassoumbou, S., Oksenhendeler, E., Bernard, L., Domart, Y., Merrien, D., Greder Belan, A., Gayraud, M., Bodard, L., Meudec, A., Beuscart, C., Daniel, C., Pape, E., Vinceneux, P., Simonpoli, A. M., Zeng, A., Fournier, L., Fuzibet, J. G., Sohn, C., Rosenthal, E., Quaranta, M., Chaillou, S., Sabah, M., Audhuy, B., Schieber, A., Moreau, P., Niault, M., Vaillant, O., Huchon, G., Compagnucci, A., De Lacroix Szmania, I., Richier, L., Lamaury, I., Saint-Dizier, F., Garipuy, D., Drogoul, M. P., Fabre, G., Lambert De Cursay, G., Abraham, B., Perino, C., Lagarde, P., David, F., Roche-Sicot, J., Saraux, J. L., Leprêtre, A., Fampin, B., Uludag, A., Morin, A. S., Bletry, O., Zucman, D., Regnier, A., Girard, J. J., Quinsat, D. T., Heripret, L., Grihon, F., Houlbert, D., Ruel, M., Chemlal, K., Debab, Y., Tremollieres, F., Perronne, V., Slama, B., Perré, P., Miodovski, C., Guermonprez, G., Dulioust, A., Boudon, P., Malbec, D., Patey, O., Semaille, C., Deville, J., Remy, G., Béguinot, I., Chambrin, V., Pignon, C., Estocq, G. A., Levy, A., Duracinsky, M., Le Bras, P., Ngussan, M. S., Peretti, D., Medintzeff, N., Lambert, T., Segeral, O., Lezeau, P., Laurian, Y., Piketty, C., Karmochkine, M., Eliaszewitch, M., Jayle, D., Kazatchkine, M., Colasante, U., Duval, X., Nouaouia, W., Vilde, J. L., Bollens, D., Binet, D., Diallo, B., Fonquernie, L., Lagneau, J. L., Launay, O., Pietrie, M. P., Sicard, D., Stieltjes, N., Michot, J., Bourdillon, F., Obenga, G., Escaut, L., Bolliot, C., Schneider, L., Iguertsira, M., Tomei, C., Dhiver, C., Tissot Dupont, H., Vallon, A., Gallais, J., Gallais, H., Durant, J., Mondain, V., Perbost, I., Cassuto, J. P., Karsenti, J. M., Venti, H., Ceppi, C., Krivitsky, J. A., Bouchaud, O., Honore, P., Delgado, J., Rouzioux, C., Burgard, M., Boufassa, L., Peynet, J., Pérez-Hoyos, S., Del Amo, J., Alvarez, D., Monge, S., Muga, R., Sanvisens, A., Tor, J., Rivas, I., Vallecillo, G., Del Romero, J., Raposo, P., Rodríguez, C., Vera, M., Hurtado, I., Belda, J., Fernandez, E., Alastrue, I., Santos, C., Tasa, T., Juan, A., Trullen, J., Garcia De Olalla, P., Cayla, J., Masdeu, E., Knobel, H., Mirò, J. M., Sambeat, M. A., Guerrero, R., Rivera, E., Marco, A., Quintana, M., Gonzalez, C., Castilla, J., Guevara, M., De Mendoza, C., Zahonero, N., Ortíz, M., Paraskevis, D., Touloumi, G., Pantazis, N., Bakoyannis, G., Gioukari, V., Antoniadou, A., Papadopoulos, A., Petrikkos, G., Daikos, G., Psichogiou, M., Gargalianos-Kakolyris, P., Xylomenos, G., Katsarou, O., Kouramba, A., Ioannidou, P., Kordossis, T., Kontos, A., Lazanas, M., Chini, M., Tsogas, N., Panos, G., Paparizos, V., Leuow, K., Kourkounti, S., Sambatakou, H., Mariolis, I., Skoutelis, A., Papastamopoulos, V., Baraboutis, I., Internal medicine, APH - Aging & Later Life, Pediatric surgery, CCA - Innovative therapy, ICaR - Circulation and metabolism, ICaR - Ischemia and repair, Graduate School, Paediatric Infectious Diseases / Rheumatology / Immunology, Landsteiner Laboratory, AII - Amsterdam institute for Infection and Immunity, Infectious diseases, Global Health, Center of Experimental and Molecular Medicine, APH - Amsterdam Public Health, AII - Inflammatory diseases, and ARD - Amsterdam Reproduction and Development

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Opportunistic infection, AIDS-Related Opportunistic Infections, Immunology, Population, Retinitis, HIV Infections, Article, 17 Psychology And Cognitive Sciences, Young Adult, Immune reconstitution inflammatory syndrome, Antiretroviral Therapy, Highly Active, Neoplasms, Virology, Internal medicine, medicine, Humans, Immunology and Allergy, education, Inverse probability weighting, Aged, education.field_of_study, business.industry, Developed Countries, Incidence, Progressive multifocal leukoencephalopathy, Hazard ratio, HIV, virus diseases, 11 Medical And Health Sciences, Middle Aged, 06 Biological Sciences, medicine.disease, United States, Europe, Infectious Diseases, Anti-Retroviral Agents, Unmasking, Female, Cytomegalovirus retinitis, business
Abstract

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis.Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting.Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis.Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries.

Published
2014

5. Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Author

Lodi, S. Del Amo, J. Moreno, S. Bucher, H.C. Furrer, H. Logan, R. Sterne, J. Pérez-Hoyos, S. Jarrín, I. Phillips, A. Olson, A. Van Sighem, A. Reiss, P. Sabin, C. Jose, S. Justice, A. Goulet, J. Miró, J.M. Ferrer, E. Meyer, L. Seng, R. Vourli, G. Antoniadou, A. Dabis, F. Vandenhede, M.-A. Costagliola, D. Abgrall, S. Hernán, M.A. Hernan, M. Bansi, L. Hill, T. Sabin, C. Dunn, D. Porter, K. Glabay, A. Orkin, C. Thomas, R. Jones, K. Fisher, M. Perry, N. Pullin, A. Churchill, D. Gazzard, B. Nelson, M. Asboe, D. Bulbeck, S. Mandalia, S. Clarke, J. Delpech, V. Anderson, J. Munshi, S. Post, F. Easterbrook, P. Khan, Y. Patel, P. Karim, F. Duffell, S. Gilson, R. Man, S.-L. Williams, I. Gompels, M. Dooley, D. Schwenk, A. Ainsworth, J. Johnson, M. Youle, M. Lampe, F. Smith, C. Grabowska, H. Chaloner, C. Ismajani Puradiredja, D. Bansi, L. Hill, T. Phillips, A. Sabin, C. Walsh, J. Weber, J. Kemble, C. Mackie, N. Winston, A. Leen, C. Wilson, A. Bezemer, D.O. Gras, L.A.J. Kesselring, A.M. Van Sighem, A.I. Zaheri, S. Van Twillert, G. Kortmann, W. Branger, J. Prins, J.M. Kuijpers, T.W. Scherpbier, H.J. Van Der Meer, J.T.M. Wit, F.W.M.N. Godfried, M.H. Reiss, P. Van Der Poll, T. Nellen, F.J.B. Lange, J.M.A. Geerlings, S.E. Van Vugt, M. Pajkrt, D. Bos, J.C. Van Der Valk, M. Grijsen, M.L. Wiersinga, W.J. Brinkman, K. Blok, W.L. Frissen, P.H.J. Schouten, W.E.M. Van Den Berk, G.E.L. Veenstra, J. Lettinga, K.D. Mulder, J.W. Vrouenraets, S.M.E. Lauw, F.N. Van Eeden, A. Verhagen, D.W.M. Van Agtmael, M.A. Perenboom, R.M. Claessen, F.A.P. Bomers, M. Peters, E.J.G. Richter, C. Van Der Berg, J.P. Gisolf, E.H. Schippers, E.F. Van Nieuwkoop, C. Van Elzakker, E.P. Leyten, E.M.S. Gelinck, L.B.S. Pronk, M.J.H. Bravenboer, B. Kootstra, G.J. Delsing, C.E. Sprenger, H.G. Doedens, R. Scholvinck, E.H. Van Assen, S. Bierman, W.F.W. Soetekouw, R. Ten Kate, R.W. Van Vonderen, M.G.A. Van Houte, D.P.F. Kroon, F.P. Van Dissel, J.T. Arend, S.M. De Boer, M.G.J. Jolink, H. Ter Vollaard, H.J.M. Bauer, M.P. Weijer, S. El Moussaoui, R. Lowe, S. Schreij, G. Oude Lashof, A. Posthouwer, D. Koopmans, P.P. Keuter, M. Van Der Ven, A.J.A.M. Ter Hofstede, H.J.M. Dofferhoff, A.S.M. Warris, A. Van Crevel, R. Van Der Ende, M.E. De Vries-Sluijs, T.E.M.S. Schurink, C.A.M. Nouwen, J.L. Nispen Tot Pannerden, M.H. Verbon, A. Rijnders, B.J.A. Van Gorp, E.C.M. Hassing, R.J. Smeulders, A.W.M. Hartwig, N.G. Driessen, G.J.A. Den Hollander, J.G. Pogany, K. Juttmann, J.R. Van Kasteren, M.E.E. Hoepelman, A.I.M. Mudrikova, T. Schneider, M.M.E. Jaspers, C.A.J.J. Ellerbroek, P.M. Oosterheert, J.J. Arends, J.E. Wassenberg, M.W.M. Barth, R.E. Geelen, S.P.M. Wolfs, T.F.W. Bont, L.J. Van Den Berge, M. Stegeman, A. Groeneveld, P.H.P. Alleman, M.A. Bouwhuis, J.W. Barin, F. Burty, C. Duvivier, C. Enel, P. Fredouille-Heripret, L. Gasnault, J. Khuong, M.A. Mahamat, A. Pilorgé, F. Tattevin, P. Salomon, V. Jacquemet, N. Abgrall, S. Costagliola, D. Grabar, S. Guiguet, M. Lanoy, E. Lièvre, L. Mary-Krause, M. Selinger-Leneman, H. Lacombe, J.M. Potard, V. Bricaire, F. Herson, S. Katlama, C. Simon, A. Desplanque, N. Girard, P.M. Meynard, J.L. Meyohas, M.C. Picard, O. Cadranel, J. Mayaud, C. Pialoux, G. Clauvel, J.P. Decazes, J.M. Gerard, L. Molina, J.M. Diemer, M. Sellier, P. Bentata, M. Honoré, P. Jeantils, V. Tassi, S. Mechali, D. Taverne, B. Bouvet, E. Crickx, B. Ecobichon, J.L. Matheron, S. Picard-Dahan, C. Yeni, P. Berthé, H. Dupont, C. Chandemerle, C. Mortier, E. De Truchis, P. Tisne-Dessus, D. Weiss, L. Salmon, D. Auperin, I. Gilquin, J. Roudière, L. Viard, J.P. Boué, F. Fior, R. Delfraissy, J.F. Goujard, C. Jung, C. Lesprit, Ph. Vittecoq, D. Fraisse, P. Lang, J.M. Rey, D. Beck-Wirth, G. Stahl, J.P. Lecercq, P. Gourdon, F. Laurichesse, H. Fresard, A. Lucht, F. Bazin, C. Verdon, R. Chavanet, P. Arvieux, C. Michelet, C. Choutet, P. Goudeau, A. Maître, M.F. Hoen, B. Eglinger, P. Faller, J.P. Borsa-Lebas, F. Caron, F. Reynes, J. Daures, J.P. May, T. Rabaud, C. Berger, J.L. Rémy, G. Arlet-Suau, E. Cuzin, L. Massip, P. Thiercelin Legrand, M.F. Pontonnier, G. Viget, N. Yasdanpanah, Y. Dellamonica, P. Pradier, C. Pugliese, P. Aleksandrowicz, K. Quinsat, D. Ravaux, I. Tissot-Dupont, H. Delmont, J.P. Moreau, J. Gastaut, J.A. Poizot-Martin, I. Retornaz, F. Soubeyrand, J. Galinier, A. Ruiz, J.M. Allegre, T. Blanc, P.A. Bonnet-Montchardon, D. Lepeu, G. Granet-Brunello, P. Esterni, J.P. Pelissier, L. Cohen-Valensi, R. Nezri, M. Chadapaud, S. Laffeuillade, A. Billaud, E. Raffi, F. Boibieux, A. Peyramond, D. Livrozet, J.M. Touraine, J.L. Cotte, L. Trepo, C. Strobel, M. Bissuel, F. Pradinaud, R. Sobesky, M. Cabié, A. Gaud, C. Contant, M. Aubert, V. Barth, J. Battegay, M. Bernasconi, E. Böni, J. Bucher, H.C. Burton-Jeangros, C. Calmy, A. Cavassini, M. Egger, M. Elzi, L. Fehr, J. Fellay, J. Furrer, H. Haerry, D. Fux, C.A. Gorgievski, M. Günthard, H. Hasse, B. Hirsch, H.H. Hösli, I. Kahlert, C. Kaiser, L. Keiser, O. Klimkait, T. Kovari, H. Ledergerber, B. Martinetti, G. Martinez De Tejada, B. Metzner, K. Müller, N. Nadal, D. Pantaleo, G. Rauch, A. Regenass, S. Rickenbach, M. Rudin, C. Schmid, P. Schultze, D. Schöni-Affolter, F. Schüpbach, J. Speck, R. Taffé, P. Tarr, P. Telenti, A. Trkola, A. Vernazza, P. Weber, R. Yerly, S. Casabona, J. Gallois, A. Esteve, A. Podzamczer, D. Murillas, J. Gatell, J.M. Manzardo, C. Tural, C. Clotet, B. Ferrer, E. Riera, M. Segura, F. Navarro, G. Force, L. Vilaró, J. Masabeu, A. García, I. Guadarrama, M. Cifuentes, C. Dalmau, D. Jaen, À. Agustí, C. Montoliu, A. Pérez, I. Gargoulas, F. Blanco, J.L. Garcia-Alcaide, F. Martínez, E. Mallolas, J. López-Dieguez, M. García-Goez, J.F. Sirera, G. Romeu, J. Jou, A. Negredo, E. Miranda, C. Capitan, M.C. Saumoy, M. Imaz, A. Tiraboschi, J.M. Murillo, O. Bolao, F. Peña, C. Cabellos, C. Masó, M. Vila, A. Sala, M. Cervantes, M. Jose Amengual, Ma. Navarro, M. Penelo, E. Barrufet, P. Bejarano, G. Molina, J. Guadarrama, M. Alvaro, M. Mercadal, J. Fernandez, J. Ospina, J.E. Muñoz, M.A. Caro-Murillo, A.M. Sobrino, P. Jarrín, I. Gomez Sirvent, J.L. Rodríguez, P. Aleman, M.R. Alonso, M.M. Lopez, A.M. Hernandez, M.I. Soriano, V. Labarga, P. Barreiro, P. Medrano, J. Rivas, P. Herrero, D. Blanco, F. Vispo, M.E. Martín, L. Ramírez, G. De Diego, M. Rubio, R. Pulido, F. Moreno, V. Cepeda, C. Hervás, Rl. Iribarren, J.A. Arrizabalaga, J. Aramburu, M.J. Camino, X. Rodrí-guez-Arrondo, F. Von Wichmann, M.A. Pascual, L. Goenaga, M.A. Gutierrez, F. Masia, M. Ramos, J.M. Padilla, S. Sanchez-Hellín, V. Bernal, E. Escolano, C. Montolio, F. Peral, Y. Berenguer, J. Lopez, J.C. Miralles, P. Cosín, J. Sanchez, M. Gutierrez, I. Ramírez, M. Padilla, B. Vidal, F. Sanjuan, M. Peraire, J. Veloso, S. Vilades, C. Lopez-Dupla, M. Olona, M. Vargas, M. Aldeguer, J.L. Blanes, M. Lacruz, J. Salavert, M. Montero, M. Cuéllar, S. De Los Santos, I. Sanz, J. Oteo, J.A. Blanco, J.R. Ibarra, V. Metola, L. Sanz, M. Pérez-Martínez, L. Sola, J. Uriz, J. Castiello, J. Reparaz, J. Arriaza, M.J. Irigoyen, C. Moreno, S. Antela, A. Casado, J.L. Dronda, F. Moreno, A. Pérez, M.J. López, D. Gutiérrez, C. Hernández, B. Pumares, M. Martí, P. García, L. Page, C. García, F. Hernández, J. Peña, A. Muñoz, L. Parra, J. Viciana, P. Leal, M. López-Cortés, L.F. Trastoy, M. Mata, R. Justice, A.C. Fiellin, D.A. Rimland, D. Jones-Taylor, C. Oursler, K.A. Titanji, R. Brown, S. Garrison, S. Rodriguez-Barradas, M. Masozera, N. Goetz, M. Leaf, D. Simberkoff, M. Blumenthal, D. Leung, J. Butt, A. Hoffman, E. Gibert, C. Peck, R. Mattocks, K. Braithwaite, S. Brandt, C. Bryant, K. Cook, R. Conigliaro, J. Crothers, K. Chang, J. Crystal, S. Day, N. Erdos, J. Freiberg, M. Kozal, M. Gandhi, N. Gaziano, M. Gerschenson, M. Good, B. Gordon, A. Goulet, J.L. Kraemer, K. Lim, J. Maisto, S. Miller, P. Mole, L. O'Connor, P. Papas, R. Robins, J.M. Rinaldo, C. Roberts, M. Samet, J. Tierney, B. Whittle, J. Babiker, A. Brettle, R. Darbyshire, J. Gilson, R. Goldberg, D. Hawkins, D. Jaffe, H. Johnson, A. McLean, K. Pillay, D. Cursley, A. Ewings, F. Fairbrother, K. Louisa Gnatiuc, S.L. Murphy, B. Douglas, G. Kennedy, N. Pritchard, J. Andrady, U. Rajda, N. Maw, R. McKernan, S. Drake, S. Gilleran, G. White, D. Ross, J. Toomer, S. Hewart, R. Wilding, H. Woodward, R. Dean, G. Heald, L. Horner, P. Glover, S. Bansaal, D. Eduards, S. Carne, C. Browing, M. Das, R. Stanley, B. Estreich, S. Magdy, A. O'Mahony, C. Fraser, P. Hayman, B. Jebakumar, S.P.R. Joshi, U. Ralph, S. Wade, A. Mette, R. Lalik, J. Summerfield, H. El-Dalil, A. France, J.A. White, C. Robertson, R. Gordon, S. McMillan, S. Morris, S. Lean, C. Vithayathil, K. McLean, L. Winter, A. Gale, D. Jacobs, S. Tayal, S. Short, L. Roberts, M. Green, S. Williams, G. Sivakumar, K. Bhattacharyya, N.D. Monteiro, E. Minton, J. Dhar, J. Nye, F. De Souza, C.B. Isaksen, A. McDonald, L. McLean, K. Franca, A. Hawkins, D. William, L. Jendrulek, I. Peters, B. Shaunak, S. El-Gadi, S. Easterbrook, P.J. Mazhude, C. Gilson, R. Johnstone, R. Fakoya, A. McHale, J. Waters, A. Kegg, S. Mitchell, S. Byrne, P. Johnson, M. Rice, P. Fidler, S. Mullaney, S.A. McCormack, S. David, D. Melville, R. Phillip, K. Balachandran, T. Mabey-Puttock, S. Sukthankar, A. Murphy, C. Wilkins, E. Ahmad, S. Tayal, S. Haynes, J. Evans, E. Ong, E. Das, R. Grey, R. Meaden, J. Bignell, C. Loay, D. Peacock, K. Girgis, M.R. Morgan, B. Palfreeman, A. Wilcox, J. Tobin, J. Tucker, L. Saeed, A.M. Chen, F. Deheragada, A. Williams, O. Lacey, H. Herman, S. Kinghorn, D. Devendra, V.S. Wither, J. Dawson, S. Rowen, D. Harvey, J. Wilkins, E. Bridgwood, A. Singh, G. Chauhan, M. Kellock, D. Young, S. Dannino, S. Kathir, Y. Rooney, G. Currie, J. Fitzgerald, M. Devendra, S. Keane, F. Booth, G. Green, T. Arumainayyagam, J. Chandramani, S. Rajamanoharan, S. Robinson, T. Curless, E. Gokhale, R. Tariq, A. Roberts, M. Williams, O. Luzzi, G. FitzGerald, M. Fairley, I. Wallis, F. Smit, E. Ward, F. Molina, J.M. Loze, B. Morlat, P. Bonarek, M. Bonnet, F. Nouts, C. Louis, I. Raffi, F. Reliquet, V. Sauser, F. Biron, C. Mounoury, O. Hue, H. Brosseau, D. Delfraissy, J.F. Goujard, C. Ghosn, J. Rannou, M.T. Bergmann, J.F. Badsi, E. Rami, A. Diemer, M. Parrinello, M. Girard, P.M. Samanon-Bollens, D. Campa, P. Tourneur, M. Desplanques, N. Livrozet, J.M. Jeanblanc, F. Chiarello, P. Makhloufi, D. Blanc, A.P. Allègre, T. Reynes, J. Baillat, V. Lemoing, V. Merle De Boever, C. Tramoni, C. Cabié, A. Sobesky, G. Abel, S. Beaujolais, V. Pialoux, G. Slama, L. Chakvetadze, C. Berrebi, V. Yeni, P. Bouvet, E. Fournier, I. Gerbe, J. Trepo, C. Koffi, K. Augustin-Normand, C. Miailhes, P. Thoirain, V. Brochier, C. Thomas, R. Souala, F. Ratajczak, M. Beytoux, J. Jacomet, C. Gourdon, F. Rouveix, E. Morelon, S. Dupont, C. Olivier, C. Lortholary, O. Dupont, B. Viard, J.P. Maignan, A. Ragnaud, J.M. Raymond, I. Leport, C. Jadand, C. Jestin, C. Longuet, P. Boucherit, S. Sereni, D. Lascoux, C. Prevoteau, F. Sobel, A. Levy, Y. Lelièvre, J.D. Lascaux, A.S. Dominguez, S. Dumont, C. Aumâitre, H. Delmas, B. Saada, M. Medus, M. Guillevin, L. Salmon, D. Tahi, T. Yazdanpanah, Y. Pavel, S. Marien, M.C. Drenou, B. Beck-Wirth, G. Beck, C. Benomar, M. Katlama, C. Tubiana, R. Ait Mohand, H. Chermak, A. Ben Abdallah, S. Bentata, M. Touam, F. Hoen, B. Drobacheff, C. Folzer, A. Massip, P. Obadia, M. Prudhomme, L. Bonnet, E. Balzarin, F. Pichard, E. Chennebault, J.M. Fialaire, P. Loison, J. Galanaud, P. Boué, F. Bornarel, D. Verdon, R. Bazin, C. Six, M. Ferret, P. Weiss, L. Batisse, D. Gonzales-Canali, G. Tisne-Dessus, D. Devidas, A. Chevojon, P. Turpault, I. Lafeuillade, A. Cheret, A. Philip, G. Morel, P. Timsit, J. Herson, S. Amirat, N. Simon, A. Brancion, C. Cabane, J. Picard, O. Tredup, J. Stein, A. Ravault, I. Chavanet, C. Buisson, M. Treuvetot, S. Choutet, P. Nau, P. Bastides, F. May, T. Boyer, L. Wassoumbou, S. Oksenhendeler, E. Gérard, L. Bernard, L. De Truchis, P. Berthé, H. Domart, Y. Merrien, D. Greder Belan, A. Gayraud, M. Bodard, L. Meudec, A. Beuscart, C. Daniel, C. Pape, E. Vinceneux, P. Simonpoli, A.M. Zeng, A. Fournier, L. Fuzibet, J.G. Sohn, C. Rosenthal, E. Quaranta, M. Dellamonica, P. Chaillou, S. Sabah, M. Audhuy, B. Schieber, A. Moreau, P. Niault, M. Vaillant, O. Huchon, G. Compagnucci, A. De Lacroix Szmania, I. Richier, L. Lamaury, I. Saint-Dizier, F. Garipuy, D. Gastaut, J.A. Drogoul, M.P. Poizot Martin, I. Fabre, G. Lambert De Cursay, G. Abraham, B. Perino, C. Lagarde, P. David, F. Roche-Sicot, J. Saraux, J.L. Leprêtre, A. Fampin, B. Uludag, A. Morin, A.S. Bletry, O. Zucman, D. Regnier, A. Girard, J.J. Quinsat, D.T. Heripret, L. Grihon, F. Houlbert, D. Ruel, M. Chemlal, K. Caron, F. Debab, Y. Tremollieres, F. Perronne, V. Lepeu, G. Slama, B. Perré, P. Miodovski, C. Guermonprez, G. Dulioust, A. Boudon, P. Malbec, D. Patey, O. Semaille, C. Deville, J. Remy, G. Béguinot, I. Galanaud, P. Boue, F. Chambrin, V. Pignon, C. Estocq, G.A. Levy, A. Delfraissy, J.F. Goujard, C. Duracinsky, M. Le Bras, P. Ngussan, M.S. Peretti, D. Medintzeff, N. Lambert, T. Segeral, O. Lezeau, P. Laurian, Y. Weiss, L. Buisson, M. Piketty, C. Karmochkine, M. Batisse, D. Eliaszewitch, M. Jayle, D. Tisne-Dessus, D. Kazatchkine, M. Leport, C. Colasante, U. Jadand, C. Jestin, C. Duval, X. Nouaouia, W. Boucherit, S. Vilde, J.L. Girard, P.M. Bollens, D. Binet, D. Diallo, B. Meyohas, M.C. Fonquernie, L. Lagneau, J.L. Salmon, D. Guillevin, L. Tahi, T. Launay, O. Pietrie, M.P. Sicard, D. Stieltjes, N. Michot, J. Sobel, A. Levy, Y. Bourdillon, F. Lascaux, A.S. Lelievre, J.D. Dumont, C. Dupont, B. Obenga, G. Viard, J.P. Maignan, A. Vittecoq, D. Escaut, L. Bolliot, C. Bricaire, F. Katlama, C. Schneider, L. Herson, S. Simon, A. Iguertsira, M. Stein, A. Tomei, C. Ravaux, I. Dhiver, C. Tissot Dupont, H. Vallon, A. Gallais, J. Gallais, H. Gastaut, J.A. Drogoul, M.P. Fabre, G. Dellamonica, P. Durant, J. Mondain, V. Perbost, I. Cassuto, J.P. Karsenti, J.M. Venti, H. Fuzibet, J.G. Rosenthal, E. Ceppi, C. Quaranta, M. Krivitsky, J.A. Bentata, M. Bouchaud, O. Honore, P. Sereni, D. Lascoux, C. Delgado, J. Rouzioux, C. Burgard, M. Boufassa, L. Peynet, J. Pérez-Hoyos, S. Del Amo, J. Alvarez, D. Monge, S. Muga, R. Sanvisens, A. Clotet, B. Tor, J. Bolao, F. Rivas, I. Vallecillo, G. Del Romero, J. Raposo, P. Rodríguez, C. Vera, M. Hurtado, I. Belda, J. Fernandez, E. Alastrue, I. Santos, C. Tasa, T. Juan, A. Trullen, J. Garcia De Olalla, P. Cayla, J. Masdeu, E. Knobel, H. Mirò, J.M. Sambeat, M.A. Guerrero, R. Rivera, E. Guerrero, R. Marco, A. Quintana, M. Gonzalez, C. Castilla, J. Guevara, M. De Mendoza, C. Zahonero, N. Ortíz, M. Paraskevis, D. Touloumi, G. Pantazis, N. Bakoyannis, G. Gioukari, V. Antoniadou, A. Papadopoulos, A. Petrikkos, G. Daikos, G. Psichogiou, M. Gargalianos-Kakolyris, P. Xylomenos, G. Katsarou, O. Kouramba, A. Ioannidou, P. Kordossis, T. Kontos, A. Lazanas, M. Chini, M. Tsogas, N. Panos, G. Paparizos, V. Leuow, K. Kourkounti, S. Sambatakou, H. Mariolis, I. Skoutelis, A. Papastamopoulos, V. Baraboutis, I. The HIV-CAUSAL Collaboration

Subjects
virus diseases
Abstract

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Published
2014

25. Therapeutic principles of staphylococcal infections – Role and limitations of standard compounds.

Author

Domart, Y.

Subjects
*GLYCOPEPTIDES, *STAPHYLOCOCCAL diseases
Abstract

Antibiotic therapy plays an important (but not exclusive) role in the treatment of staphylococcal infections. Measures aimed at reducing the bacterial inoculum through local procedures must be envisaged as often as possible. The removal of any foreign, infected materials is essential to success. In this article, we review the different, active antibiotics available, their advantages and disadvantages and their indications. In the light of these data, we propose a therapeutic approach to severe bacterial infection caused by a cluster of Gram-positive cocci. Staphylococcal infections pose daily therapeutic problems, whether in open-care practice or intensive care units. The specificity of staphylococcal infections encountered in an intensive care setting require a therapeutic approach which takes account of the context, and particularly of the incidence of resistant staphylococcal infections. [Copyright &y& Elsevier]

Published
2002
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26. Pharmacokinetics of teicoplanin in critically ill patients with various degrees of renal impairment

Author

Domart, Y, Pierre, C, Clair, B, Garaud, J J, Regnier, B, and Gibert, C

Abstract

The pharmacokinetics of teicoplanin were studied in 15 adult patients in the acute phase of severe infections caused by gram-positive cocci. All the subjects were given a daily intravenous bolus dose of 6 mg of teicoplanin kg-1 (body weight). The pharmacokinetic study was performed over a 48-h period after injection 4. The subjects were categorized according to their mean creatinine clearances (ml.min-1.kg-1) during the study period: group 1 (n = 3), greater than 1.6; group 2 (n = 6), 0.8 to 1.6; and group 3 (n = 6), 0.15 to 0.8. Mean concentrations of teicoplanin in serum at 1, 24, and 48 h were 33 +/- 8, 9 +/- 3, and 6 +/- 2.5 micrograms.ml-1, respectively. The mean half-lives of the concentration-time curve from 12 to 48 h were 28 +/- 4, 44 +/- 24, and 48 +/- 14 h in groups 1, 2, and 3, respectively (group 3 versus group 1: P less than 0.05). The mean area under the serum concentration-time curve from time zero to 24 h was 344 +/- 92 mg.h.liter-1, and the mean hybrid volume of distribution was 1.09 +/- 0.46 liter.kg-1. These values were similar for the three groups, with a trend for larger areas under the curve in group 3. Creatinine clearance correlated directly with the total body clearance of teicoplanin (r = 0.70) and with the renal clearance of teicoplanin (r = 0.82). However, in critically ill patients, the wide interindividual variations in pharmacokinetic parameters are more relevant than those related to the variations in renal function when creatinine clearance is above 0.30 ml.min-1.kg-1. We concluded that, in such conditions, monitoring of concentrations of teicoplanin in serum is mandatory.

Published
1987
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28. Study of the effects of liposomal amphotericin B on Candida albicans, Cryptococcus neoformans, and erythrocytes by using small unilamellar vesicles prepared from saturated phospholipids

Author

Jullien, S, Contrepois, A, Sligh, J E, Domart, Y, Yeni, P, Brajtburg, J, Medoff, G, and Bolard, J

Abstract

We compared the anticellular effects of liposomal amphotericin B (AmB) formed from AmB and small unilamellar vesicles. The small unilamellar vesicles with or without cholesterol were prepared from three L-alpha-phosphatidylcholines with saturated acyl chains of different lengths: distearoyl (C18), dipalmitoyl (C16), and dimyristoyl (C14). We found that the anticellular potency of liposomal AmB, compared with that of free AmB, decreased with decreasing length of the acyl chain of the phospholipid and increased with the addition of cholesterol. In a parallel study (S. Jullien, A. Vertut-Croquin, J. Brajtburg, and J. Bolard, Anal. Biochem. 172:197-202, 1988), we found that binding of AmB to vesicles decreased with increasing length of the acyl chain of the phospholipid and decreased with the addition of cholesterol. We conclude that the anticellular effects of liposomal AmB preparations are due to the levels of AmB remaining free (unbound to the lipids) in these preparations.

Published
1989
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29. [Urinary tract obstruction by Candida bezoars, or fungus balls]

Author

Domart Y, Delmas V, Cornud F, abderrezak BOUCHAMA, Chastre J, and Gibert C

Subjects
Bezoars, Male, Radiography, Candidiasis, Humans, Female, Kidney Diseases, Middle Aged, Urinary Tract, Aged
Abstract

Two patients admitted to an intensive care unit for severe bacterial infection develops Candida albicans superinfection with obstruction of the urinary canals by "fungus balls". The development of medico-surgical techniques using antibiotics and immunosuppressive drugs accounts for the increasing incidence of disseminated candidiasis. The kidneys are particularly sensitive to Candida infections. Fungus balls are conglomerates of mycelium which may result in obstruction of the urinary tract. Their clinical, radiological and ultrasonic features, as well as the microbiological and serological diagnostic problems they raise are described. Ultrasonically guided percutaneous nephrostomy is a very interesting technique for the diagnosis of the condition and its local treatment by drainage and lavage with amphotericin B. This antifungal, combined with flucytosine is still used for the systemic treatment of candidiasis.

Published
1986

30. [Reversibility of severe digitoxin poisoning with antidigoxin antibodies]

Author

Domart, Y., Bismuth, C., Pontal, Pg, Scherrmann, Jm, Baud, F., Muszynski, J., Elkhouly, M., and Pierre-Edouard Fournier

Subjects
Male, Digoxin, Electrocardiography, Immunoglobulin Fab Fragments, Digitoxin, Humans, Aged
Abstract

We report a case of severe digitoxin poisoning treated at the stage of ventricular fibrillation by infusion of FAB antidigoxin fragments with low in vitro covering properties. There were no side effects. The possibility of rapidly reversing the prognosis will permit the use of specific FAB fragments before the onset of potentially lethal cardiac arrhythmias, when these antibodies become more generally available.

31. [Digitoxin poisoning: reversing ventricular fibrillation with Fab fragments of anti-digoxin antibody]

Author

Domart Y, Bismuth C, Jm, Schermann, Nisen Abuaf, Pg, Pontal, Baud F, Bolo A, Gailliot M, and Pe, Fournier

Subjects
Male, Digoxin, Sheep, Suicide, Attempted, Cross Reactions, Antibodies, Immunoglobulin Fab Fragments, Digitoxin, Inactivation, Metabolic, Ventricular Fibrillation, Potassium, Animals, Humans, Aged
Abstract

Purified Fab fragments of ovine anti-digoxin antibodies (Wellcome Foundation) were used to treat a patient who attempted suicide by absorbing 10 mg of digitoxin (serum concentration 265 micrograms/l). The poor prognosis, as assessed clinically and from serum potassium levels (7.5 mEq/l), seemed to warrant such a treatment. The weak (6.85%) cross-reactivity elicited in vitro between the anti-digoxin antibodies and digitoxin was compensated by increasing the doses, but improvement was observed with 3.6 g, i.e. about half the effective dosage initially considered. The criteria of effectiveness were clinical, electrocardiographic (reversal of the ventricular fibrillation), biochemical (simultaneous and opposite changes in extra- and intracellular potassium levels, suggesting that ATPase inhibition by digitalis is a reversible process) and toxicological: there was an increase in digitoxin serum levels suggesting displacement of the drug from tissue sites to plasma and other extracellular compartments where the Fab fragments are distributed, and Fab-bound digitoxin appeared fairly rapidly in the urine, which suggested shunting of the normal hepatic metabolic pathway.

32. Prophylaxis of infective endocarditis. Revision of the march 1992 French consensus conference: French recommendations 2002 | Prophylaxie de l'endocardite infectieuse. Révision de la conférence de consensus de mars 1992: Recommandations 2002

Author

Vildé, J. L., Chidiac, C., Byl, B., Choutet, P., Leport, C., Luciani, J., Perronne, C., Pothier, P., Quinet, B., Soussy, C. J., Stahl, J. P., Weinbreck, P., Dosquet, P., Etienne, J., Feki, A., Gibert, C., Michel, P. L., Danchin, N., Duval, X., Brochet, E., Andremont, A., Carlier, G., Christmann, D., Courillon-Mallet, A., Delahaye, F., Ducimetière, P., Mathieu, P., Pichelin, D., Ravery, V., Schabel, C., Sixou, M., Bouvet, A., Briançon, S., Chairay, J. P., Crémieux, A. C., Domart, Y., Habib, G., Hoen, B., Leroy, O., Moreillon, P., Ragot, J. P., Philippe Ravaud, Roche, Y., Strom, B. L., Thomas, D., Meer, J. T. M., Voiriot, P., Acar, C., Aliot, E., Artigou, J. Y., Auboyer, C., Aumaître, O., Aupetit, J. F., Avierinos, C., Bacq, Y., Bassand, J. P., Bastien, P., Becq-Giraudon, B., Bensaïd, J., Bertrand, M., Besnier, J. M., Beytout, J., Blanc, J. J., Bonnet, N., Bonhoure, J. P., Boy-Lefevre, M. L., Brochier, M., Broustet, J. P., Carlet, J., Caron, F., Chanoit, P., Chaptal, P. A., Chapuis, J., Charlemagne, D., Chauvel, C., Coste, P., Couetil, J. P., Daubert, J. C., Davy, C., Mello, G., Decazes, J. M., Delaye, J., Dersot, J. M., Derumeaux, G., Diebold, B., Djiane, P., Doco-Lecompte, T., Drahi, É, Ducardonnet, A., Dupont, B., Duran, D., Durand Gevigney, G., Dureuil, B., Fauchier, J. P., Gaillat, J., Gendrel, D., Grynberg, A., Guillemot, D., and Guize, L.

36. [Necrotic skin lesions caused by pet rats in two teenagers].

Author

Mancaux J, Vervel C, Bachour N, Domart Y, and Emond JP

Subjects
Adolescent, Animals, Female, Humans, Necrosis virology, Rats, Cowpox transmission, Pets virology, Skin pathology
Abstract

We report 2 observations in young girls who, after exposure to domestic rats from the same pet shop, presented with inflammatory and necrotic skin wounds in the neck and face. Since lesions did not improve with antibiotic therapy, surgical excision of necrosis healed the wounds, with a 2nd intervention necessary in 1 patient. All bacteriological investigations appeared to be negative; finally, electron microscopy of excised subepidermal tissue and PCR characterization provided the diagnosis of cowpox virus (CPXV) infection. CPXV is part of the Orthopox virus genus, like variola virus, and is generally transmitted to humans by infected cats or rodents. CPXV infection should be kept in mind when macular, vesicular, or necrotic cutaneous wounds do not improve with antibiotics., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Published
2011
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37. Cowpox virus transmission from pet rats to humans, France.

Author

Ninove L, Domart Y, Vervel C, Voinot C, Salez N, Raoult D, Meyer H, Capek I, Zandotti C, and Charrel RN

Subjects
Adolescent, Adult, Animals, Cowpox epidemiology, Cowpox veterinary, Cowpox virology, Cowpox virus genetics, Cowpox virus pathogenicity, Female, France epidemiology, Humans, Molecular Sequence Data, Phylogeny, Polymerase Chain Reaction, Rodent Diseases epidemiology, Rodent Diseases virology, Sequence Analysis, DNA, Zoonoses, Animals, Domestic virology, Cowpox transmission, Cowpox virus isolation & purification, Disease Outbreaks, Rats virology
Abstract

In early 2009, four human cases of cowpox virus cutaneous infection in northern France, resulting from direct contact with infected pet rats (Rattus norvegicus), were studied. Pet rats, originating from the same pet store, were shown to be infected by a unique virus strain. Infection was then transmitted to humans who purchased or had contact with pet rats.

Published
2009
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38. Discitis due to Clostridium perfringens.

Author

Caudron A, Grados F, Boubrit Y, Coullet JM, Merrien D, and Domart Y

Subjects
Aged, Amoxicillin therapeutic use, Anti-Bacterial Agents therapeutic use, Biopsy, Fine-Needle, Clostridium Infections drug therapy, Female, Humans, Lumbar Vertebrae pathology, Magnetic Resonance Imaging, Clostridium Infections complications, Clostridium Infections diagnosis, Clostridium perfringens pathogenicity, Discitis diagnosis, Discitis microbiology, Lumbar Vertebrae microbiology
Abstract

Introduction: A combination of disk space narrowing and vacuum phenomenon on radiographs of the spine is usually considered a reliable indicator of degenerative disk disease. We report a case in which vacuum phenomenon was related to Clostridium perfringens discitis., Methods: A 79-year-old woman was admitted for inflammatory low back pain that had worsened steadily over the last 2 months. Her body temperature was normal, laboratory tests showed inflammation (erythrocyte sedimentation rate, 61 mm/h; and C-reactive protein, 13 mg/L), and blood cultures were negative. Imaging studies (radiographs, computed tomography [CT], and magnetic resonance imaging) indicated L4-L5 discitis. Vacuum phenomenon within the L4-L5 disk was seen on radiographs and CT scans. C. perfringens was recovered by fine-needle biopsy of the disk. Diverticular disease of the colon was the only identifiable portal of entry. Amoxicillin therapy ensured a full recovery., Discussion: C. perfringens discitis is rare, with only 7 published cases in humans. A gastrointestinal portal of entry was identified in 70% of cases. Radiographs or CT scans visualized vacuum phenomenon in 80% of cases. Positive blood cultures were noted in 75% of cases. The outcome was favorable with antibiotic therapy, even when a single-drug was used. The other characteristics of C. perfringens discitis were indistinguishable from those of discitis caused by the usual organisms., Conclusion: Presence of gas within the disk does not rule out infectious discitis and may indicate C. perfringens discitis.

Published
2008
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39. First reported case of imported hantavirus pulmonary syndrome in europe.

Author

Murgue B, Domart Y, Coudrier D, Rollin PE, Darchis JP, Merrien D, and Zeller HG

Subjects
Argentina, Chile, Enzyme-Linked Immunosorbent Assay, France, Hantavirus Pulmonary Syndrome immunology, Humans, Immunoglobulin G blood, Immunoglobulin M blood, Male, Middle Aged, Travel, Antibodies, Viral blood, Orthohantavirus immunology, Hantavirus Pulmonary Syndrome diagnosis
Published
2002

41. Iatrogenic diseases as a reason for admission to the intensive care unit: incidence, causes, and consequences.

Author

Darchy B, Le Mière E, Figuérédo B, Bavoux E, and Domart Y

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, France epidemiology, Humans, Incidence, Intensive Care Units economics, Length of Stay economics, Male, Middle Aged, Patient Admission economics, Retrospective Studies, Severity of Illness Index, Iatrogenic Disease epidemiology, Intensive Care Units statistics & numerical data, Length of Stay statistics & numerical data, Patient Admission statistics & numerical data
Abstract

Background: Data on iatrogenic diseases (IDs) have been recorded for the past 25 years. We determined whether aging of the general population and medical advances, including more powerful drugs and complex procedures, have altered the incidence, causes, and consequences of severe IDs during this period., Methods: One-year retrospective study was conducted in an adult medical-surgical intensive care unit (ICU) affiliated with a French general hospital in an area of 200 000 inhabitants. All the patients admitted to the ICU during 1994 were screened for IDs. Patients with community or hospital-acquired IDs on admission were included. Follow-up assessed morbidity, mortality, workload, and costs of care for IDs, and the rate of preventable IDs. were included; the cause of the ID was drugs in 41, medical acts in 12, and surgical acts in 15. These 68 patients were in the ICU for 472 days, with a 13% fatality rate (9 patients) and a financial cost of US $688 470. They were not different from the 555 other ICU patients in terms of severity, mortality, workload, and length of stay in the ICU. Risk factors for ID were old age and the number of prescribed drugs. The rate of preventable ID was 51%., Conclusions: Iatrogenic diseases are a persistent and important reason for admission to the ICU, and the risk factors, causes, and consequences remain unchanged since 1980. Despite 25 years of experience with high-technology medicine, ID still has a negative impact on the health and resources of society.

Published
1999
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42. [Patients admitted to the intensive care unit for iatrogenic disease. Risk factors and consequences].

Author

Darchy B, Le Mière E, Figueredo B, Bavoux E, Cadoux G, and Domart Y

Subjects
Adult, Aged, Female, France epidemiology, Humans, Male, Middle Aged, Patient Admission statistics & numerical data, Retrospective Studies, Risk Factors, Iatrogenic Disease epidemiology, Intensive Care Units statistics & numerical data
Abstract

Purpose: Data pertaining to iatrogenic diseases have been recorded over the last 25 years. Regarding the evolution of medical practice (general ageing, more and more powerful drugs and complex procedures), it is not known whether the incidence and the consequences of iatrogenic diseases have changed since their first evaluation., Methods: To determine the admission rate to intensive care units for iatrogenic diseases, with the purpose of analyzing risk factors and consequences, and to compare our results with previous data recorded in 1979 (admission rate: 12.6%, mortality: 20%, preventable events: 47%), a 1-year retrospective study was conducted in an intensive care unit (ICU)., Results: During 1994, 68 (10.9%) out of 623 patients were admitted to the ICU for iatrogenic diseases (drugs: 41, medical acts: 12, surgical acts: 15). They were not different--in terms of severity, mortality, workload and length of stay in the ICU--from the other 555 patients hospitalized for other reasons. They were hospitalized on average for 472 days in the ICU, with a 13% fatality rate and a financial cost of US $688,470. Risk factors for iatrogenic diseases were the age and the number of prescribed drugs. The rate of preventable events was 51%., Conclusions: In this study, the occurrence of life-threatening iatrogenic diseases was a persistent and important purpose for admission to the ICU. Risk factors and consequences are still identical to those reported in 1979. Our results emphasize the persistence of the noxious impact of iatrogenic diseases on the quality and cost of medical care.

Published
1998
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43. Acute ammonia inhalation.

Author

Darchy B, Le Mière E, Lacour S, Bavoux E, and Domart Y

Subjects
Fatal Outcome, Humans, Male, Middle Aged, Ammonia poisoning, Burns, Chemical physiopathology, Burns, Inhalation physiopathology, Occupational Exposure adverse effects
Published
1997

44. [Coronary gas embolism after laparoscopic surgery].

Author

Popesco D, Le Mière E, Maître B, Darchy B, and Domart Y

Subjects
Aged, Combined Modality Therapy, Dopamine therapeutic use, Electrocardiography, Embolism, Air diagnosis, Embolism, Air physiopathology, Embolism, Air therapy, Emergency Medical Services, Epinephrine therapeutic use, Fatal Outcome, Female, Heart Arrest therapy, Heart Massage, Humans, Middle Aged, Myocardial Ischemia therapy, Ovarian Cysts surgery, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Postoperative Complications therapy, Carbon Dioxide, Cholecystectomy, Laparoscopic, Coronary Vessels, Embolism, Air etiology, Heart Arrest etiology, Laparoscopy, Myocardial Ischemia etiology, Pneumoperitoneum, Artificial adverse effects, Postoperative Complications etiology
Abstract

Gas embolism is a severe complication of laparoscopic surgery. We report two cases: one with lethal peroperative cardiac arrest from massive coronary artery gas embolism recognized during open-chest cardiac massage; the second case, also associated with coronary artery gas embolism, resulted in severe but transient abnormal left ventricular anterior wall motion, subepicardial ischaemia and injury in ECG leads V1 to V5, but unremarkable coronary arteriography and full recovery. The pathophysiology of gas embolism occurring during a laparoscopic procedure, the mechanisms of gas entry into the systemic vascular bed, the clinical, ECG, pulse oximetry, end-tidal CO2 concentration changes and alarm signs are discussed. The diagnostic value of Doppler transoesophageal echocardiography when possible is underlined, and emergency management of gas embolism is considered.

Published
1997
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45. Clinical and bacteriologic survey of epidural analgesia in patients in the intensive care unit.

Author

Darchy B, Forceville X, Bavoux E, Soriot F, and Domart Y

Subjects
Adult, Aged, Anti-Bacterial Agents therapeutic use, Catheterization adverse effects, Female, Humans, Male, Middle Aged, Spinal Cord Diseases etiology, Anesthesia, Epidural adverse effects, Bacterial Infections etiology, Critical Care methods
Abstract

Background: The risk of bacterial contamination related to epidural analgesia in patients cared for in the intensive care unit has not been assessed. Thus the authors studied patients who received care in the intensive care unit who were given epidural analgesia for more than 48 h to determine the rates of local, epidural catheter, and spinal space infection and to identify risk factors., Methods: Each patient receiving epidural analgesia for longer than 48 h was examined daily for local and general signs of infection. A swab sample for culture was taken if there was local discharge; all epidural catheters were cultured on withdrawal. All patients underwent weekly neurologic monitoring for 1 month; those with positive epidural catheter cultures had one spinal magnetic resonance image scan., Results: The 75 patients cared for in the intensive care unit who were studied had been receiving epidural analgesia for a median of 4 days (interquartile range, 3.5 to 5 days). Twenty-seven patients had signs of local inflammation (erythema or local discharge), and nine of these had infections. All the patients who had both local signs also had infection. All nine infections were local (12%), but four patients also had epidural catheter infections (5.3%). No patient with erythema alone or without local signs had a positive epidural catheter culture. No spinal space infection was diagnosed. Staphylococcus epidermidis was the most frequently cultured microorganism. Local infection was treated by removing the epidural catheter without any antibiotics. Concomitant infection at other sites (21 of 75 patients, or 28%), antibiotic therapy (64 of 75 patients, or 85%), the duration of epidural analgesia, and the insertion site level of the epidural catheter were not identified as risk factors for epidural analgesia-related infections., Conclusions: The risk of epidural analgesia-related infection in patients in the intensive care unit seems to be low. The presence of two local signs of inflammation is a strong predictor of local and epidural catheter infection.

Published
1996
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47. [Treatment of infections developing on catheters].

Author

Domart Y

Subjects
Anti-Bacterial Agents therapeutic use, Bacterial Infections drug therapy, Bacterial Infections prevention & control, Catheterization, Central Venous adverse effects, Catheterization, Peripheral adverse effects, Cross Infection drug therapy, Cross Infection etiology, Cross Infection prevention & control, Humans, Bacterial Infections etiology, Catheterization adverse effects
Published
1993

48. Evaluation of clinical judgment in the identification and treatment of nosocomial pneumonia in ventilated patients.

Author

Fagon JY, Chastre J, Hance AJ, Domart Y, Trouillet JL, and Gibert C

Subjects
Bacterial Infections diagnosis, Bacterial Infections drug therapy, Bacterial Infections etiology, Cross Infection drug therapy, Female, Humans, Male, Middle Aged, Pneumonia drug therapy, Pneumonia etiology, Prospective Studies, Cross Infection diagnosis, Pneumonia diagnosis, Respiration, Artificial adverse effects
Abstract

To evaluate the accuracy of clinical judgment in the diagnosis and treatment of nosocomial pneumonia in ventilated patients, we studied 84 patients suspected of having nosocomial pneumonia because of the presence of a new pulmonary infiltrate and purulent tracheal secretions. We prospectively evaluated the accuracy of diagnostic predictions and therapeutic plans independently formulated by a team of physicians aware of all clinical, radiologic and laboratory data, including the results of Gram-stained bronchial aspirates. Definite (n = 51) or probable (n = 33) diagnoses could be established in all patients by strict histopathologic and/or bacteriologic criteria. Only 27/84 patients were diagnosed as having pneumonia. Organisms responsible for pneumonias were identified by quantitative cultures of samples obtained using a protected specimen brush or pleural fluid cultures. Four hundred eight predictions were made for the 84 studied patients. Clinical diagnoses for patients subsequently diagnosed as having pneumonia were accurate in 81/131 cases (62 percent). Furthermore, only 43/131 (33 percent) therapeutic plans proposed for these patients represented effective therapy. Common causes of inappropriate treatment included failure to diagnose pneumonia (50 plans), failure to effectively treat highly resistant organisms (21 plans), and failure to treat all organisms in cases of polymicrobial pneumonia (14 plans). Therapeutic plans formulated for patients without pneumonia included the unnecessary use of antibiotics in 45/277 cases (16 percent). These findings indicate that the use of clinical criteria alone does not permit the accurate diagnosis of nosocomial pneumonia in ventilated patients, and commonly results in inappropriate or inadequate antibiotic therapy for these patients.

Published
1993
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