Search

Your search keyword '"Epidémiologie Clinique et Traitement de l'Infection à VIH"' showing total 27 results
Start Over Author "Epidémiologie Clinique et Traitement de l'Infection à VIH"
27 results on '"Epidémiologie Clinique et Traitement de l'Infection à VIH"'

1. Outcomes for bipolar patients assessed in the French expert center network: A 2-year follow-up observational study (FondaMental Advanced Centers of Expertise for Bipolar Disorder [FACE-BD])

Author

Marion Leboyer, Frank Bellivier, Chantal Henry, Ophélia Godin, Philippe Courtet, Bruno Etain, Jean-Michel Azorin, Sébastien Gard, Valerie Aubin, Paul Roux, Jean-Pierre Kahn, Dominique Costagliola, Mircea Polosan, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Université Pierre et Marie Curie - Paris 6 (UPMC), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Service de psychiatrie adulte, Université Bordeaux Segalen - Bordeaux 2-Hôpital Charles Perrens, Neurobiologie et Psychiatrie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Psychiatrie, CHU Grenoble, Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratoire de Psychologie et NeuroCognition (LPNC ), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Psychiatrie et Psychologie Clinique, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Hôpital Jeanne-d'Arc, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental [Créteil], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Psychiatrie Translationnelle (Equipe 15), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Réseau de coopération scientifique en santé mentale, Université Bordeaux Segalen - Bordeaux 2-Centre hospitalier Charles Perrens [Bordeaux], École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and Cannard, Christine

Subjects
Adult, Male, medicine.medical_specialty, Bipolar Disorder, [SDV]Life Sciences [q-bio], Gee, 03 medical and health sciences, Cognition, 0302 clinical medicine, Health care, Humans, Medicine, Cognitive skill, Bipolar disorder, Social Behavior, Generalized estimating equation, Biological Psychiatry, ComputingMilieux_MISCELLANEOUS, Psychiatric Status Rating Scales, business.industry, Confounding, Middle Aged, Prognosis, medicine.disease, 3. Good health, 030227 psychiatry, Hospitalization, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Outcome and Process Assessment, Health Care, Mood, Physical therapy, Female, Observational study, France, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Objective A new health care system for patients with bipolar disorders was established in France under the auspices of Fondation FondaMental, based on thorough clinical assessment of patients and on close collaborations between expert centers and referring practitioners. We report the results of outcomes after 2 years of observational follow-up of adult patients assessed within the network. Method A total of 984 patients were included in the study. We compared several parameters (e.g., mood episodes and hospitalization) 1 year before inclusion and after 2 years of observational follow-up using the patient as his or her own control. Other outcomes were compared at baseline and during follow-up. We estimated the evolution of these parameters over a period of 2 years using mixed models for continuous parameters and a generalized estimating equation (GEE) model for categorical variables, adjusting for potential confounding factors. Results Mean age was 42.7 (±12.5) years and 58.8% were women. The number of hospitalization days decreased by 55% when comparing 1 year before inclusion vs the follow-up period. In addition, patients showed a clear functional improvement associated with a reduction of residual mood symptoms, diminished psychiatric comorbidities, improvement of sleep and a better adherence to treatment. Conclusions This study demonstrates an overall improvement of patients followed for 2 years after an assessment in expert centers for bipolar disorders. This new organization based on a thorough clinical assessment and on personalized recommendations (drug treatments, psycho-social strategies and lifestyle measures) sent to health care professionals, and actively involving patients and families, improves the prognosis of BD patients.

Published
2017

2. Outcomes for HIV-associated diffuse large B-cell lymphoma in the modern combined antiretroviral therapy era

Author

Rémi Lancar, Lucie Oberic, Richard Delarue, Michele Algarte-Genin, Gabriella Dos Santos, Yassine Taoufik, Sophie Prevot, Régis Costello, Nawel Mekerri, Marialuisa Partisani, Marie-Caroline Meyohas, Rene-Olivier Casasnovas, Jean Gabarre, Pierre Delobel, Fabrice Bonnet, François Boué, Cécile Goujard, Nicolas Mounier, Christian Recher, Dominique Costagliola, Caroline Besson, Paul Coppo, Houria Hendel-Chavez, Unité d'hématologie et d'oncologie [Centre Hospitalier de Versailles], Centre Hospitalier de Versailles André Mignot (CHV), Université Paris-Saclay, Service d'Anatomie et de Cytologie Pathologiques [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Antoine-Béclère, Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Léon Brillouin (LLB - UMR 12), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Service d'hématologie clinique et de thérapie cellulaire [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), Technologies avancées pour le génôme et la clinique (TAGC), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Hématologie [IUCT Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Archet 2 [Nice] (CHU), Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Antoine-Béclère-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, 0301 basic medicine, Oncology, medicine.medical_treatment, HIV Infections, chemotherapy, 0302 clinical medicine, immune system diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, hemic and lymphatic diseases, Epidemiology, Immunology and Allergy, Prospective Studies, Young adult, Prospective cohort study, Aged, 80 and over, Middle Aged, 3. Good health, Treatment Outcome, Infectious Diseases, Anti-Retroviral Agents, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, epidemiology, France, Lymphoma, Large B-Cell, Diffuse, Adult, non-Hodgkin's lymphoma, medicine.medical_specialty, Adolescent, Immunology, diffuse large B-cell lymphoma, Antineoplastic Agents, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, neoplasms, Survival analysis, Aged, Chemotherapy, business.industry, HIV, medicine.disease, Survival Analysis, Non-Hodgkin's lymphoma, Lymphoma, 030104 developmental biology, business, Diffuse large B-cell lymphoma
Abstract

International audience; Objective: Non-Hodgkin's lymphoma (NHL) remains among the most frequent malignancies in persons living with HIV (PLWHIV). Survival among patients with HIV-associated diffuse large B-cell lymphoma (DLBCL), the most frequent NHL subtype, has improved markedly in recent years. We aimed to analyze characteristics and outcomes of DLBCL in HIV-infected patients in the era of modern combined antiretroviral therapy (cART).Design: PLWHIV with lymphoma were prospectively enrolled in the French ANRS-CO16 Lymphovir cohort between 2008 and 2015. We compared the patients treated with R-CHOP) (rituximab, cyclophosphamide, daunorubicin, vin-cristine, prednisolone) with HIV-negative DLBCL patients enrolled simultaneously in the R-CHOP arms of Lymphoma Study Association trials.Results: Among 110 PLWHIV with NHL, 52 (47%) had systemic DLBCL. These 52 cases had frequent extranodal disease (81%), poor performance status (35%) and advanced age-adjusted international prognostic index (aaIPI) (58%), and were mainly treated with R-CHOP (n = 44, 85%). Their median CD4(+) T-cell count was 233 cells/mu l, and 79% of patients were on cART. The 2-year overall and progression-free survival rates were both 75% (95% confidence interval: 64%, 88%). Factors associated with progression or death in univariate analysis were poor performance status [hazard ratio: 3.3 (1.2, 8.9)], more than one extranodal site [hazard ratio: 3.4 (1.1, 10.5)] and an advanced aaIPI [hazard ratio: 3.7 (1.0, 13.1)]. Progression-free survival after R-CHOP therapy did not differ from that of the HIV-negative counterparts (P = 0.11).Conclusion: In the recent cART era, despite frequent high-risk features, the 2-year overall survival of HIV-DLBCL patients reaches 75%. Outcomes after R-CHOP therapy are similar to those of HIV-negative patients with similar aaIPI. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

Published
2017

3. Non-AIDS-defining deaths and immunodeficiency in the era of combination antiretroviral therapy

Author

A. Sarah Walker, Osamah Hamouda, Virginie Rondeau, Maria Dorrucci, Heiner C. Bucher, Maria Prins, Geneviève Chêne, Kholoud Porter, Caroline A. Sabin, Rodolphe Thiébaut, Benoît Marin, Dominique Costagliola, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Basel Institute for Clinical Epidemiology, University Hospital Basel [Basel], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Dipartimento di Malattie Infettive, Reparto di Epidemiologia, Istituto Superiore di Sanita [Rome], Department of Infectious Disease Epidemiology, Robert Koch Institute [Berlin] (RKI), Cluster Infectious Diseases, Amsterdam BioMed Cluster, Medical Research Council Clinical Trials Unit (MRC CTU), University College of London [London] (UCL), Research Department of Infection and Population Health [London], CASCADE has been funded through grants from the European Union BMH4-CT97-2550, QLK2-2000-01431, QLRT-2001-01708 and LSHP-CT-2006-018949., Istituto Superiore di Sanità (ISS), AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, and Infectious diseases

Subjects
Male, MESH: CD4 Lymphocyte Count, medicine.medical_treatment, CD4 cell count, Disease, MESH: Epidemiologic Methods, MESH: Antiretroviral Therapy, Highly Active, Hepatitis, Liver disease, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Neoplasms, Immunology and Allergy, MESH: Neoplasms, 030212 general & internal medicine, Causes of death, Immunodeficiency, MESH: Aged, 0303 health sciences, MESH: Middle Aged, MESH: AIDS-Related Opportunistic Infections, Liver Diseases, Immunosuppression, Middle Aged, Human Immunodeficiency Virus/AIDS, Antiretroviral therapy, 3. Good health, Infectious Diseases, Cardiovascular Diseases, MESH: Young Adult, Female, Viral disease, Adult, medicine.medical_specialty, MESH: Immune Tolerance, MESH: Liver Diseases, Adolescent, Immunology, Article, Young Adult, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Immune Tolerance, medicine, Humans, Seroconversion, highly active, Aged, MESH: Acquired Immunodeficiency Syndrome, MESH: Adolescent, Acquired Immunodeficiency Syndrome, MESH: Humans, AIDS-Related Opportunistic Infections, 030306 microbiology, business.industry, MESH: Cardiovascular Diseases, MESH: Adult, medicine.disease, MESH: Male, CD4 Lymphocyte Count, Neoplasm, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Bacterial infection, Epidemiologic Methods, business, MESH: Female
Abstract

International audience; OBJECTIVE: To assess whether immunodeficiency is associated with the most frequent non-AIDS-defining causes of death in the era of combination antiretroviral therapy (cART). DESIGN: Observational multicentre cohorts. METHODS: Twenty-three cohorts of adults with estimated dates of human immunodeficiency virus (HIV) seroconversion were considered. Patients were seroconverters followed within the cART era. Measurements were latest CD4, nadir CD4 and time spent with CD4 cell count less than 350 cells/microl. Outcomes were specific causes of death using a standardized classification. RESULTS: Among 9858 patients (71 230 person-years follow-up), 597 died, 333 (55.7%) from non-AIDS-defining causes. Non-AIDS-defining infection, liver disease, non-AIDS-defining malignancy and cardiovascular disease accounted for 53% of non-AIDS deaths. For each 100 cells/microl increment in the latest CD4 cell count, we found a 64% (95% confidence interval 58-69%) reduction in risk of death from AIDS-defining causes and significant reductions in death from non-AIDS infections (32, 18-44%), end-stage liver disease (33, 18-46%) and non-AIDS malignancies (34, 21-45%). Non-AIDS-defining causes of death were also associated with nadir CD4 while being cART-naive or duration of exposure to immunosuppression. No relationship between risk of death from cardiovascular disease and CD4 cell count was found though there was a raised risk associated with elevated HIV RNA. CONCLUSION: In the cART era, the most frequent non-AIDS-defining causes of death are associated with immunodeficiency, only cardiovascular disease was associated with high viral replication. Avoiding profound and mild immunodeficiency, through earlier initiation of cART, may impact on morbidity and mortality of HIV-infected patients.

Published
2009

4. Changes in Causes of Death Among Adults Infected by HIV Between 2000 and 2005: The 'Mortalité 2000 and 2005' Surveys (ANRS EN19 and Mortavic)

Author

Charlotte, Lewden, Thierry, May, Eric, Rosenthal, Christine, Burty, Fabrice, Bonnet, Dominique, Costagliola, Eric, Jougla, Caroline, Semaille, Philippe, Morlat, Dominique, Salmon, Patrice, Cacoub, Geneviève, Chêne, I, Chossat, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital L'Archet, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'épidémiologie sur les causes médicales de décès (CépiDc), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Mouillet, Evelyne, Institut National de la Santé et de la Recherche Médicale (INSERM) - Université Bordeaux Segalen - Bordeaux 2 - IFR99 - ISPED, Hôpital de Brabois, Hôpital de Brabois - CHU Nancy - Université Henri Poincaré - Nancy 1 (UHP), CHU Nice - Hôpital l'Archet, Université Pierre et Marie Curie - Paris 6 (UPMC) - IFR113 - Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UP7) - Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Cochin [APHP], CHU Pitié-Salpêtrière [APHP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Male, Disease, MESH: Cause of Death, 0302 clinical medicine, Cause of Death, Neoplasms, Surveys and Questionnaires, [SDV.SPEE] Life Sciences [q-bio]/Public Health and Epidemiology, MESH: Neoplasms, Pharmacology (medical), 030212 general & internal medicine, Sida, Cause of death, 0303 health sciences, MESH: Middle Aged, biology, Liver Diseases, Hepatitis C, Middle Aged, Hepatitis B, 3. Good health, Infectious Diseases, Cardiovascular Diseases, Female, Viral disease, Adult, medicine.medical_specialty, MESH: Liver Diseases, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Humans, MESH: Acquired Immunodeficiency Syndrome, Hepatitis, Acquired Immunodeficiency Syndrome, MESH: Humans, 030306 microbiology, business.industry, MESH: Questionnaires, MESH: Cardiovascular Diseases, MESH: Adult, medicine.disease, biology.organism_classification, MESH: Male, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; BACKGROUND: The multicenter national Mortalité 2005 survey aimed at describing the distribution of causes of death among HIV-infected adults in France in 2005 and its changes as compared with 2000. METHODS: Physicians involved in the management of HIV infection notified deaths and documented the causes using a standardized questionnaire similar to the previous survey performed in 2000. RESULTS: Overall, 1042 deaths were notified in 2005 (vs 964 in 2000): with median age, 46 years (vs 41 years); men, 76%; and median last CD4 cell count, 161/mm (vs 94). The proportion of underlying causes of death due to AIDS decreased (36% in 2005 vs 47% in 2000), and the proportion of cancer not related to AIDS or hepatitis (17% vs 11%), liver related disease (15% vs 13%: hepatitis C, 11%, and hepatitis B, 2%), cardiovascular disease (8% vs 7%), or suicide (5% vs 4%) increased. Among the 375 AIDS-related deaths, the most frequent event was non-Hodgkin lymphoma (28%). Among cancers not related to AIDS or hepatitis, the most frequent localizations were lung (31%) and digestive tract (14%). Among the 154 liver-related deaths, 24% were due to hepatocarcinoma. CONCLUSIONS: The heterogeneity of causes of death among HIV-infected adults was confirmed and intensified in 2005, with 3 causes following AIDS: cancers and liver-related and cardiovascular diseases.

Published
2008

5. Metabolic Syndrome in a French Cohort of Patients With Bipolar Disorder

Author

Godin, Ophelia, Etain, Bruno, Henry, Chantal, Bougerol, Thierry, Courtet, Philippe, Mayliss, Leroux, Passerieux, Christine, Azorin, Jean-Michel, Kahn, Jean-Pierre, Gard, Sébastien, Costagliola, Dominique, Leboyer, Marion, Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Centre Hospitalier Universitaire [Grenoble] (CHU), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fondation FondaMental [Créteil], Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Service de Psychiatrie et Psychologie Clinique, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Hôpital Jeanne-d'Arc, Service de psychiatrie adulte, Université Bordeaux Segalen - Bordeaux 2-Hôpital Charles Perrens, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Psychiatrie Translationnelle (Equipe 15), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Réseau de coopération scientifique en santé mentale, Université Bordeaux Segalen - Bordeaux 2-Centre hospitalier Charles Perrens [Bordeaux], Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)

Subjects
[SCCO]Cognitive science, ComputingMilieux_MISCELLANEOUS, [SHS]Humanities and Social Sciences
Abstract

International audience

Published
2014

6. Prevalence of HIV-1 drug resistance in treated patients with viral load >50 copies/mL in 2009: a French nationwide study

Author

Assoumou, Lambert, Descamps, Diane, Yerly, Sabine, dos Santos, Georges, Marcelin, Anne-Geneviève, Delaugerre, Constance, Morand-Joubert, Laurence, Ruffault, Annick, Izopet, Jacques, Plantier, Jean-Christophe, Pakianather, Sophie, Montes, Brigitte, Chaix, Marie-Laure, Wirden, Marc, Costagliola, Dominique, Masquelier, Bernard, Michelet, Christian, Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Etudes Lasers Intenses et Applications ( CELIA ), Université de Bordeaux ( UB ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ), Núcleo de Bioinformática Estrutural ( NBI ), Embrapa Informática Agropecuária, Service de virologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de microbiologie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Service de bactériologie-virologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Unité de Rétrovirologie, Hôpital Pontchaillou, Laboratoire de virologie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Département de microbiologie : Bactério, Virologie, Parasito, Hygiène, Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Microbiologie cellulaire et moléculaire et pathogénicité ( MCMP ), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique ( CNRS ), Service de virologie et d'immunologie biologique, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Geneva University Hospital (HUG), Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Faculté de Médecine Purpan, Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 (UPD5), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), ANRS AC11 Resistance Group, 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), Laboratoire de Virologie [Purpan], CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Département de microbiologie : Bactério, Virologie, Parasito, Hygiène-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Etudes Lasers Intenses et Applications (CELIA), Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Bordeaux (UB), Núcleo de Bioinformática Estrutural (NBI), Service de virologie [CHU Pitié-Salpêtrière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Département de microbiologie : Bactério, Virologie, Parasito, Hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Microbiologie Fondamentale et Pathogénicité (MFP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Département de microbiologie : Bactério, Virologie, Parasito, Hygiène-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Université Paris Descartes - Paris 5 ( UPD5 ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)

Subjects
Male, Prevalence, Integrase inhibitor, HIV Infections, Drug resistance, France/epidemiology, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Treatment Failure, ComputingMilieux_MISCELLANEOUS, ddc:616, 0303 health sciences, virological failure, Data Collection, Proteolytic enzymes, HIV Infections/epidemiology/virology, HIV-1/drug effects/genetics, Middle Aged, Viral Load, 3. Good health, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, RNA, Viral, Female, epidemiology, France, Viral load, Microbiology (medical), Genotype, Anti-HIV Agents, antiretroviral therapy, Biology, 03 medical and health sciences, multidrug resistance, Drug Resistance, Viral, Humans, Amino Acid Sequence, RNA, Viral/blood, Genotyping, Aged, Pharmacology, 030306 microbiology, plasma HIV RNA, Virology, Health Surveys, Reverse transcriptase, Multiple drug resistance, Anti-HIV Agents/therapeutic use, HIV-1, HIV-1 drug resistance
Abstract

International audience; BACKGROUND: Surveillance of HIV-1 drug resistance in treated patients with plasma viral load (VL) >50 copies/mL. METHODS: The protease and reverse transcriptase (RT) genes were systematically sequenced in samples from 756 patients with VL >50 copies/mL in 2009. The genotyping results were interpreted for each antiretroviral drug (ARV) by using the ANRS algorithm v21. Weighted analyses were used to derive representative estimates of percentages of patients. Prevalence rates were compared with those obtained in 2004 among patients with VL >1000 copies/mL. RESULTS: Sequences were obtained for 506 patients. Sequencing was successful in 45%, 80% and 96% of samples with VL of 51-500, 501-1000 and >1000 copies/mL, respectively. Resistance or possible resistance to at least one ARV was observed in 59% of samples. Overall, 0.9% of samples contained viruses resistant to all drugs belonging to at least three drug classes. All resistance prevalence rates were significantly lower in 2009 than in 2004. CONCLUSION: In France, where 86% of patients were receiving combination antiretroviral therapy in 2009, only 15.0% of patients had a VL >50 copies/mL, suggesting that only 8.9% of treated patients could potentially transmit resistant viruses. Only 0.08% of patients harboured viruses fully resistant to at least three antiretroviral drug classes. Further studies are needed to determine whether resistance continues to decline over time.

Published
2013

7. Preferential amplification of CD8 effector-T cells after transcutaneous application of an inactivated influenza vaccine: a randomized phase I trial

Author

Sabrina Hadam, Christine Katlama, Hans Schaefer, Dominique Costagliola, Béhazine Combadière, Olivia Bonduelle, Shlomo Staszewski, Brigitte Autran, Annika Vogt, Sylvie van der Werf, Brice Mahé, Wolfram Sterry, Ulrike Blume-Peytavi, Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Research Center for Hair and Skin Science, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Epidémiologie Clinique et Traitement de l'Infection à VIH, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Génétique Moléculaire des Virus Respiratoires, Institut Pasteur [Paris] (IP)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), HIV Treatment & Research Unit, Hospital of the Johann Wolfgang Goethe-University Frankfurt am Main, Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pasteur [Paris]-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], and Gau, Mireille

Subjects
CD4-Positive T-Lymphocytes, Immunology/Innate Immunity, lcsh:Medicine, HIV Infections, CD8-Positive T-Lymphocytes, medicine.disease_cause, Antibodies, Viral, 0302 clinical medicine, Antibody Specificity, Tetanus Toxoid, Cytotoxic T cell, Medicine, lcsh:Science, 0303 health sciences, Multidisciplinary, Tetanus, Viral Vaccine, Immunogenicity, Vaccination, Flow Cytometry, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Health, Influenza Vaccines, Research Article, Adult, Influenza vaccine, Immunology, Administration, Cutaneous, Injections, Intramuscular, 03 medical and health sciences, Young Adult, Immune system, ddc:570, Immunology/Immunity to Infections, Influenza, Human, Humans, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, 030304 developmental biology, Cell Proliferation, Demography, business.industry, lcsh:R, medicine.disease, Virology, Antibodies, Neutralizing, Influenza A virus subtype H5N1, Vaccines, Inactivated, Immunology/Immune Response, Antibody Formation, lcsh:Q, business, 030215 immunology
Abstract

International audience; BACKGROUND: Current conventional vaccination approaches do not induce potent CD8 T-cell responses for fighting mostly variable viral diseases such as influenza, avian influenza viruses or HIV. Following our recent study on vaccine penetration by targeting of vaccine to human hair follicular ducts surrounded by Langerhans cells, we tested in the first randomized Phase-Ia trial based on hair follicle penetration (namely transcutaneous route) the induction of virus-specific CD8 T cell responses. METHODS AND FINDINGS: We chose the inactivated influenza vaccine - a conventional licensed tetanus/influenza (TETAGRIP) vaccine - to compare the safety and immunogenicity of transcutaneous (TC) versus IM immunization in two randomized controlled, multi-center Phase I trials including 24 healthy-volunteers and 12 HIV-infected patients. Vaccination was performed by application of inactivated influenza vaccine according to a standard protocol allowing the opening of the hair duct for the TC route or needle-injection for the IM route. We demonstrated that the safety of the two routes was similar. We showed the superiority of TC application, but not the IM route, to induce a significant increase in influenza-specific CD8 cytokine-producing cells in healthy-volunteers and in HIV-infected patients. However, these routes did not differ significantly for the induction of influenza-specific CD4 responses, and neutralizing antibodies were induced only by the IM route. The CD8 cell response is thus the major immune response observed after TC vaccination. CONCLUSIONS: This Phase Ia clinical trial (Manon05) testing an anti-influenza vaccine demonstrated that vaccines designed for antibody induction by the IM route, generate vaccine-specific CD8 T cells when administered transcutaneously. These results underline the necessity of adapting vaccination strategies to control complex infectious diseases when CD8 cellular responses are crucial. Our work opens up a key area for the development of preventive and therapeutic vaccines for diseases in which CD8 cells play a crucial role. TRIAL REGISTRATION: Clinicaltrials.gov NCT00261001.

Published
2010

8. Low prevalence of HIV type 1 drug resistance mutations in untreated, recently infected patients from Burkina Faso, Côte d'Ivoire, Senegal, Thailand, and Vietnam: the ANRS 12134 study

Author

Dominique Costagliola, Coumba Toure Kane, Nicole Ngo-Giang-Huong, Eric Delaporte, Diane Valéa, Halimatou Diop, Eitel Mpoudi Ngole, Truong Xuan Lien, Avelin F. Aghokeng, Dominique Joulia-Ekaza, Eric Nerrienet, Laurence Vergne, Marie-Laure Chaix, Janin Nouhin, Ahidjo Ayouba, François Rouet, Thomas d. 'Aquin Toni, Martine Peeters, VIH/SIDA et maladies associées, Université Montpellier 1 (UM1), Institut Pasteur d'Ho Chi Minh Ville, Réseau International des Instituts Pasteur (RIIP), Institut Pasteur du Cambodge, CRESAR/IMPM/IRD - Virology, CRESAR/IMPM/IRD, Épidémiologie clinique, santé mère-enfant et VIH en Asie du Sud-Est (IRD_PHPT), Harvard University [Cambridge]-Chiang Mai university (Thaïlande), Laboratoire Bactériologie-Virologie, Hôpital Aristide-Le-Dantec, Institut de Recherche en Sciences de la Santé (IRSS) / Centre Muraz, Centre de recherche et de Diagnostic sur le Sida (CeDreS), CHU Treichville, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Université Montpellier 1 ( UM1 ), Réseau International des Instituts Pasteur ( RIIP ) -Institut Pasteur d'Ho Chi Minh Ville, Institut Pasteur du Cambodge-Réseau International des Instituts Pasteur ( RIIP ), Épidémiologie clinique, santé mère-enfant et VIH en Asie du Sud-Est ( IRD_PHPT ), Centre de recherche et de Diagnostic sur le Sida ( CeDreS ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Harvard University [Cambridge]-Chiang Mai University (CMU), Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Harvard University-Chiang Mai University (CMU)

Subjects
MESH: Sequence Analysis, DNA, MESH : Molecular Sequence Data, MESH : Prevalence, MESH : Genotype, HIV Infections, Drug resistance, 030312 virology, MESH: HIV-1, MESH: Genotype, 0302 clinical medicine, MESH: Pregnancy, HIV Protease, Pregnancy, Genotype, Epidemiology, Prevalence, Medicine, MESH : HIV Reverse Transcriptase, MESH : Female, 030212 general & internal medicine, MESH: Anti-HIV Agents, Pregnancy Complications, Infectious, MESH: Phylogeny, Phylogeny, 0303 health sciences, MESH: Drug Resistance, Viral, biology, virus diseases, MESH: HIV Infections, MESH : Adult, Thailand, MESH : Senegal, HIV Reverse Transcriptase, Senegal, 3. Good health, MESH : Drug Resistance, Viral, Infectious Diseases, Vietnam, MESH: Young Adult, Lentivirus, Female, Sample collection, MESH : Mutation, HIV drug resistance, MESH : HIV-1, Adult, medicine.medical_specialty, MESH: Mutation, MESH: Cote d'Ivoire, MESH: HIV Reverse Transcriptase, Anti-HIV Agents, Immunology, Molecular Sequence Data, MESH : Young Adult, Cote d ivoire, Context (language use), 03 medical and health sciences, MESH: HIV Protease, Young Adult, MESH: Senegal, Virology, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, parasitic diseases, Burkina Faso, Drug Resistance, Viral, MESH : HIV Infections, Humans, MESH: Pregnancy Complications, Infectious, MESH: Burkina Faso, MESH : Burkina Faso, MESH: Thailand, MESH: Prevalence, MESH: Humans, MESH: Molecular Sequence Data, business.industry, MESH : Anti-HIV Agents, MESH : Humans, MESH : Phylogeny, MESH: Adult, MESH : Vietnam, MESH : Cote d'Ivoire, Sequence Analysis, DNA, biology.organism_classification, MESH : Thailand, MESH : HIV Protease, MESH : Pregnancy, Cote d'Ivoire, MESH : Pregnancy Complications, Infectious, Mutation, HIV-1, MESH: Vietnam, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH : Sequence Analysis, DNA
Abstract

International audience; The frequency of transmitted HIV drug resistance (HIVDR) was evaluated in the context of rapid scale-up of antiretroviral treatment in Thailand, Vietnam, Burkina Faso, Côte d'Ivoire, and Senegal by using an adaptation of the WHO generic protocol of the HIV Drug Resistance Threshold Survey (HIVDR-TS) for sample collection and classification. Resistance-associated mutations were interpreted using the 2009 WHO list for epidemiological surveys. We included 266 subjects from the five study sites. Of the 266 RT and PR sequences analyzed, two from Vietnam harbored virus with major drug resistance mutations (G190A in RT for one individual and M46I in PR for the second individual). Phylogenetic analysis revealed that CRF01_AE predominates (>90%) in Thailand and Vietnam. CRF02 (>65%) cocirculates with other HIV-1 variants in Senegal and Côte d'Ivoire. The prevalence of HIVDRM is scored as low (< or = 5%) in all the five sites for the three drug classes analyzed. A continuous population survey for HIVDRM will provide a rational basis for maintaining or changing the current first line regimen in these countries.

Published
2009

9. Non-AIDS-defining deaths and immunodeficiency in the era of combination antiretroviral therapy

Author

Marin, Benoît, Thiébaut, Rodolphe, Bucher, Heiner, Rondeau, Virginie, Costagliola, Dominique, Dorrucci, Maria, Hamouda, Osamah, Prins, Maria, Walker, A. Sarah, Porter, Kholoud, Sabin, Caroline, Chêne, Geneviève, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Basel Institute for Clinical Epidemiology, University Hospital Basel [Basel], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Dipartimento di Malattie Infettive, Reparto di Epidemiologia, Istituto Superiore di Sanita [Rome], Department of Infectious Disease Epidemiology, Robert Koch Institute [Berlin] (RKI), Cluster Infectious Diseases, Amsterdam BioMed Cluster, Medical Research Council Clinical Trials Unit (MRC CTU), University College of London [London] (UCL), Research Department of Infection and Population Health [London], and CASCADE has been funded through grants from the European Union BMH4-CT97-2550, QLK2-2000-01431, QLRT-2001-01708 and LSHP-CT-2006-018949.

Subjects
MESH: Immune Tolerance, MESH: Liver Diseases, MESH: CD4 Lymphocyte Count, CD4 cell count, MESH: Epidemiologic Methods, MESH: Antiretroviral Therapy, Highly Active, Hepatitis, MESH: Neoplasms, Causes of death, highly active, MESH: Acquired Immunodeficiency Syndrome, MESH: Adolescent, MESH: Aged, MESH: Humans, MESH: Middle Aged, MESH: AIDS-Related Opportunistic Infections, MESH: Cardiovascular Diseases, MESH: Adult, Human Immunodeficiency Virus/AIDS, MESH: Male, Antiretroviral therapy, MESH: Young Adult, Neoplasm, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Bacterial infection, MESH: Female
Abstract

International audience; OBJECTIVE: To assess whether immunodeficiency is associated with the most frequent non-AIDS-defining causes of death in the era of combination antiretroviral therapy (cART). DESIGN: Observational multicentre cohorts. METHODS: Twenty-three cohorts of adults with estimated dates of human immunodeficiency virus (HIV) seroconversion were considered. Patients were seroconverters followed within the cART era. Measurements were latest CD4, nadir CD4 and time spent with CD4 cell count less than 350 cells/microl. Outcomes were specific causes of death using a standardized classification. RESULTS: Among 9858 patients (71 230 person-years follow-up), 597 died, 333 (55.7%) from non-AIDS-defining causes. Non-AIDS-defining infection, liver disease, non-AIDS-defining malignancy and cardiovascular disease accounted for 53% of non-AIDS deaths. For each 100 cells/microl increment in the latest CD4 cell count, we found a 64% (95% confidence interval 58-69%) reduction in risk of death from AIDS-defining causes and significant reductions in death from non-AIDS infections (32, 18-44%), end-stage liver disease (33, 18-46%) and non-AIDS malignancies (34, 21-45%). Non-AIDS-defining causes of death were also associated with nadir CD4 while being cART-naive or duration of exposure to immunosuppression. No relationship between risk of death from cardiovascular disease and CD4 cell count was found though there was a raised risk associated with elevated HIV RNA. CONCLUSION: In the cART era, the most frequent non-AIDS-defining causes of death are associated with immunodeficiency, only cardiovascular disease was associated with high viral replication. Avoiding profound and mild immunodeficiency, through earlier initiation of cART, may impact on morbidity and mortality of HIV-infected patients.

Published
2009

10. Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies

Author

Ronald B. Geskus, José M. Miró, Matthias Egger, Frank de Wolf, Andrew N. Phillips, Schlomo Staszewski, Stephen R. Cole, John Gill, François Dabis, Ross Harris, Gerd Fätkenheuer, Michele Jonsson Funk, Jonathan A C Sterne, Robert S. Hogg, Dominique Costagliola, Michael S. Saag, Colette Smith, Amy C. Justice, Margaret T May, Antonella d'Arminio Monforte, Bruno Ledergerber, Department of Social Medicine, University of Bristol [Bristol], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, National Institute on Alcohol Abuse and Alcoholism (2U10 AA 13566), National Institute on Aging (K23 G00826), Robert Wood Johnson Generalist Faculty Scholar Award, an Inter- Agency Agreement between National Institute on Aging, National Institute of Mental Health, and the Veterans Health Administration, the VHA Office of Research and Development, and, VHA Public Health Strategic Health Care Group., Mouillet, Evelyne, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Zurich, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Epidemiology and Data Science, and Infectious diseases

Subjects
HPTN 052, medicine.medical_specialty, Combination therapy, MESH: CD4 Lymphocyte Count, 610 Medicine & health, 2700 General Medicine, MESH: Drug Administration Schedule, MESH: Antiretroviral Therapy, Highly Active, 10234 Clinic for Infectious Diseases, MESH: Proportional Hazards Models, MESH: HIV-1, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), MESH: Practice Guidelines as Topic, Internal medicine, Fast track — Articles, Medicine, MESH: Patient Selection, 030212 general & internal medicine, MESH: Kaplan-Meiers Estimate, Prospective cohort study, Adverse effect, MESH: Cohort Studies, MESH: Treatment Outcome, 0303 health sciences, MESH: Humans, MESH: Middle Aged, 030306 microbiology, business.industry, Mortality rate, Hazard ratio, MESH: Time Factors, MESH: Adult, General Medicine, MESH: HIV Infections, medicine.disease, MESH: Male, MESH: Sensitivity and Specificity, 3. Good health, Surgery, MESH: North America, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Disease Progression, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business, MESH: Female, Cohort study
Abstract

International audience; BACKGROUND: The CD4 cell count at which combination antiretroviral therapy should be started is a central, unresolved issue in the care of HIV-1-infected patients. In the absence of randomised trials, we examined this question in prospective cohort studies. METHODS: We analysed data from 18 cohort studies of patients with HIV. Antiretroviral-naive patients from 15 of these studies were eligible for inclusion if they had started combination antiretroviral therapy (while AIDS-free, with a CD4 cell count less than 550 cells per microL, and with no history of injecting drug use) on or after Jan 1, 1998. We used data from patients followed up in seven of the cohorts in the era before the introduction of combination therapy (1989-95) to estimate distributions of lead times (from the first CD4 cell count measurement in an upper range to the upper threshold of a lower range) and unseen AIDS and death events (occurring before the upper threshold of a lower CD4 cell count range is reached) in the absence of treatment. These estimations were used to impute completed datasets in which lead times and unseen AIDS and death events were added to data for treated patients in deferred therapy groups. We compared the effect of deferred initiation of combination therapy with immediate initiation on rates of AIDS and death, and on death alone, in adjacent CD4 cell count ranges of width 100 cells per microL. FINDINGS: Data were obtained for 21 247 patients who were followed up during the era before the introduction of combination therapy and 24 444 patients who were followed up from the start of treatment. Deferring combination therapy until a CD4 cell count of 251-350 cells per microL was associated with higher rates of AIDS and death than starting therapy in the range 351-450 cells per microL (hazard ratio [HR] 1.28, 95% CI 1.04-1.57). The adverse effect of deferring treatment increased with decreasing CD4 cell count threshold. Deferred initiation of combination therapy was also associated with higher mortality rates, although effects on mortality were less marked than effects on AIDS and death (HR 1.13, 0.80-1.60, for deferred initiation of treatment at CD4 cell count 251-350 cells per microL compared with initiation at 351-450 cells per microL). INTERPRETATION: Our results suggest that 350 cells per microL should be the minimum threshold for initiation of antiretroviral therapy, and should help to guide physicians and patients in deciding when to start treatment.

Published
2009

11. Ethics and observational studies in medical research: various rules in a common framework

Author

Frédérique Claudot, Jeanne Fresson, François Alla, Henry Coudane, Thierry Calvez, Catherine Bonaïti-Pellié, Service Médecine légale et Droit de la Santé, Nancy Université, Pôle stratégie et ressources médicales, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Comité de protection des personnes Est III, Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R ), Ecole de santé publique, Université Paris Descartes - Paris 5 ( UPD5 ) -Nancy Université, Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé, CCTIRS, Service d'Epidémiologie, Maternité Régionale Universitaire, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Génétique épidémiologique et structures des populations humaines ( Inserm U535 ), Epidémiologie, sciences sociales, santé publique ( IFR 69 ), Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Université Paris Descartes - Paris 5 (UPD5)-Nancy Université, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique épidémiologique et structures des populations humaines (Inserm U535), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Bonaïti-Pellié, Catherine

Subjects
Biomedical Research, Standardization, Epidemiology, MESH : International Cooperation, International Cooperation, [SDV.GEN] Life Sciences [q-bio]/Genetics, 030204 cardiovascular system & hematology, MESH : Ethics Committees, Research, MESH : Multicenter Studies as Topic, Helsinki declaration, MESH : Ethics, Research, 0302 clinical medicine, MESH : Helsinki Declaration, Medicine, MESH : Legislation, Drug, Multicenter Studies as Topic, 030212 general & internal medicine, Helsinki Declaration, MESH: Helsinki Declaration, General Medicine, 16. Peace & justice, Institutional review board, Practice Guidelines as Topic, [ SDV.ETH ] Life Sciences [q-bio]/Ethics, Engineering ethics, France, MESH : Biomedical Research, International studies, Legislation, Article, Ethics, Research, 03 medical and health sciences, Humans, MESH: Ethics, Research, MESH : France, [SDV.GEN]Life Sciences [q-bio]/Genetics, Research ethics, MESH: Humans, Modalities, business.industry, MESH: Biomedical Research, MESH : Humans, MESH: Legislation, Drug, [SDV.ETH] Life Sciences [q-bio]/Ethics, Legislation, Drug, [SDV.ETH]Life Sciences [q-bio]/Ethics, MESH: France, MESH: International Cooperation, MESH: Multicenter Studies as Topic, Observational study, business, [ SDV.GEN ] Life Sciences [q-bio]/Genetics, MESH: Ethics Committees, Research, Ethics Committees, Research
Abstract

International audience; BACKGROUND: Research ethics have become universal in their principles through international agreements. The standardization of regulations facilitates the internationalization of research concerning drugs. However, in so-called observational studies (i.e. from data collected retrospectively or prospectively, obtained without any additional therapy or monitoring procedure) the modalities used for applying the main principles vary from one country to another. This situation may entail problems for the conduct of multi-centric international studies, as well as for the publication of results if the authors and editors come from countries governed by different regulations. In particular, several French observational studies were rejected or retracted by US peer-reviewed journals, because their protocols have not been submitted to an Institutional Review Board/Independent Ethics Committee (IRB/IEC). METHODS: National legislation case analysis. RESULTS: In accordance with European regulation, French observational studies from data obtained without any additional therapy or monitoring procedure, do not need the approval of an IRB/IEC. Nevertheless, these studies are neither exempt from scientific opinion nor from ethical and legal authorization. CONCLUSION: We wish to demonstrate through the study of this example that different bodies of law can provide equivalent levels of protection that respect the same ethical principles. Our purpose in writing this article was to encourage public bodies, scientific journals and researchers to gain a better understanding of the various sets of specific national regulations and to speak a common language.

Published
2009

12. Emerging role of hepatocellular carcinoma among liver-related causes of deaths in HIV-infected patients: The French national Mortalité 2005 study

Author

Eric Rosenthal, Fabrice Bonnet, Vincent Bouteloup, Patrice Cacoub, Charlotte Lewden, Dominique Salmon-Ceron, Eric Jougla, Christine Burty, Thierry May, Geneviève Chêne, Dominique Costagliola, Caroline Semaille, Philippe Morlat, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital L'Archet, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Bordeaux [Bordeaux], Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'épidémiologie sur les causes médicales de décès (CépiDc), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANRS EN19 Mortalité Study Group and Mortavic, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Cochin [APHP], CHU Nice - Hôpital l'Archet, Institut National de la Santé et de la Recherche Médicale (INSERM) - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Université Bordeaux Segalen - Bordeaux 2, Hôpital de Brabois, Hôpital de Brabois - CHU Nancy - Université Henri Poincaré - Nancy 1 (UHP), Université Pierre et Marie Curie - Paris 6 (UPMC) - IFR113 - Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UP7) - Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [APHP], and Mouillet, Evelyne

Subjects
Male, Cirrhosis, HIV Infections, 0302 clinical medicine, Liver Cirrhosis, Alcoholic, MESH: Liver Neoplasms, Epidemiology, [SDV.SPEE] Life Sciences [q-bio]/Public Health and Epidemiology, Medicine, 030212 general & internal medicine, Substance Abuse, Intravenous, MESH: Carcinoma, Hepatocellular, MESH: Middle Aged, MESH: Liver Cirrhosis, Alcoholic, Liver Neoplasms, virus diseases, Hepatitis C, Homosexuality, MESH: HIV Infections, Hepatitis B, Middle Aged, MESH: Homosexuality, 3. Good health, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Female, France, MESH: Heterosexuality, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Humans, Fulminant hepatitis, Heterosexuality, Hepatitis, MESH: Hepatitis C, MESH: Humans, Hepatology, MESH: Hepatitis B, business.industry, MESH: Adult, medicine.disease, digestive system diseases, MESH: Male, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, MESH: Substance Abuse, Intravenous, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; BACKGROUND/AIMS: Longer exposure to hepatitis C (HCV) or B virus (HBV) and the increased use of hepatitis treatment might have an impact on liver-related deaths in patients co-infected with the Human Immunodeficiency Virus (HIV). We describe the proportion of liver-related deaths among HIV-infected patients in 2005 compared with 2000. METHODS: In a nationwide survey (341 hospital departments involved in HIV management), all deaths of HIV-infected patients were prospectively reported. Deaths from either cirrhosis, hepatocellular carcinoma or fulminant hepatitis were defined as liver-related deaths. RESULTS: Of the 898 deaths reported in 2005, liver-related causes accounted for 15.4%; this is compared to 13.4% in 2000. Among liver-related deaths, hepatocellular carcinoma increased from 15% to 25% (p=0.04). Among hepatocellular carcinoma-related deaths: in 2000, 10% were HCV-infected; in 2005, 25% were HCV-infected (p=0.03). Half of the HCV-related deaths had been treated for HCV but 98% remained HCV-RNA positive at time of death. The proportion of HBV-related deaths remained stable between 2000 and 2005. CONCLUSIONS: Liver-related deaths, mainly liver cancers, have increased in HIV-infected patients in France despite wide access to HCV treatment. The stability of HBV-related deaths might be explained by the use of dually active antiretroviral drugs in co-infected patients.

Published
2009

13. Incidence and risk factors of HIV-related non-Hodgkin's lymphoma in the era of combination antiretroviral therapy: a European multicohort study

Author

Bohlius, Julia, Schmidlin, Kurt, Costagliola, Dominique, Fã¤tkenheuer, Gerd, May, Margaret, Caro murillo, Ana Maria, Mocroft, Amanda, Bonnet, Fabrice, Clifford, Gary, Karafoulidou, Anastasia, Miro, Jose M., Lundgren, Jens, Chene, Genevieve, Egger, Matthias, Cohere, Coorth, CASTAGNA, ANTONELLA, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases, Other departments, Landsteiner Laboratory, Bohlius, Julia, Schmidlin, Kurt, Costagliola, Dominique, Fã¤tkenheuer, Gerd, May, Margaret, Caro murillo, Ana Maria, Mocroft, Amanda, Bonnet, Fabrice, Clifford, Gary, Karafoulidou, Anastasia, Miro, Jose M., Lundgren, Jen, Chene, Genevieve, Egger, Matthia, Cohere, Coorth, Castagna, Antonella, Institute of Social and Preventive Medicine (ISPM), University of Bern, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine, University of Cologne, Department of Social Medicine, University of Bristol [Bristol], Centro Nacional de Epidemiología, Instituto de Salud Carlos III [Madrid] (ISC), Department of primary care and population sciences, University College of London [London] (UCL), Centre d'Information et de Soins de l'Immunodéficience Humaine (CISIH), CHU Bordeaux [Bordeaux], International Agency for Cancer Research (IACR), 2nd Blood Transfusion and Hemophilia Center, Laikon General Hospital, Infectious Diseases Service, Universitat de Barcelona (UB)-Hospital Clinic-IDIBAPS, Copenhagen HIV Programme, Rigshospitalet [Copenhagen], Copenhagen University Hospital-Copenhagen University Hospital-University of Copenhagen = Københavns Universitet (KU), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Copenhagen University Hospital-Copenhagen University Hospital-University of Copenhagen = Københavns Universitet (UCPH), and Mouillet, Evelyne

Subjects
Male, HIV Infections, Rate ratio, 0302 clinical medicine, cohort studies, Risk Factors, immune system diseases, hemic and lymphatic diseases, HIV Infection, Pharmacology (medical), 030212 general & internal medicine, Prospective cohort study, Lymphoma, AIDS-Related, Brain Neoplasms, non-Hodgkin lymphoma, Incidence, Lymphoma, Non-Hodgkin, Medicine (all), Incidence (epidemiology), Hazard ratio, Non-Hodgkin's Lymphoma, virus diseases, viral load, 3. Good health, Europe, Infectious Diseases, 030220 oncology & carcinogenesis, multicohort study, Drug Therapy, Combination, Female, Viral load, Human, Adult, Cart, HIV patients, medicine.medical_specialty, Anti-HIV Agents, antiretroviral therapy, Article, AIDS-related lymphoma, Brain Neoplasm, 03 medical and health sciences, Internal medicine, mental disorders, medicine, Humans, Pharmacology, business.industry, Risk Factor, Kaposi sarcoma, Anti-HIV Agent, medicine.disease, Non-Hodgkin's lymphoma, nervous system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort Studie, business, immunodeficiency
Abstract

Background Incidence and risk factors of HIV-associated non-Hodgkin's lymphoma (NHL) are not well defined in the era of combination antiretroviral therapy (cART). Methods A total of 56,305 adult HIV type-1 (HIV-1)-infected patients who started cART in 1 of 22 prospective studies in Europe were included. Weibull random effects models were used to estimate hazard ratios (HRs) for developing systemic NHL and included CD4+ T-cell counts and viral load as time-updated variables. Results During the 212,042 person-years of follow-up, 521 patients were diagnosed with systemic NHL and 62 with primary brain lymphoma (PBL). The incidence rate of systemic NHL was 463 per 100,000 person-years not on cART and 205 per 100,000 person-years in treated patients for a rate ratio of 0.44 (95% confidence interval [CI] 0.37–0.53). The corresponding incidence rates of PBL were 57 and 24 per 100,000 person-years (rate ratio 0.43, 95% CI 0.25-0.73). Suppression of HIV-1 replication on cART (HR 0.60, 95% CI 0.44-0.81, comparing ≤500 with 10,000-99,999 copies/ml) and increases in CD4+ T-cell counts (HR 0.30, 0.22-0.42, comparing ≥350 with 100-199 cells/pl) were protective; a history of Kaposi's sarcoma (HR 1.70, 1.08-2.68, compared to no history of AIDS), transmission through sex between men (HR 1.57, 1.19-2.08, compared with heterosexual transmission) and older age (HR 3.71, 2.37-5.80, comparing ≥50 with 16-29 years) were risk factors for systemic NHL. Conclusions The incidence rates of both systemic NHL and PBL were substantially reduced in patients on cART. Timely initiation of therapy is key to the prevention of NHL in the era of cART.

Published
2009

14. Does short-term virologic failure translate to clinical events in antiretroviral-naïve patients initiating antiretroviral therapy in clinical practice?: VF & Clinical Events by ART Regimen

Author

Mugavero, Michael, May, Margaret, Harris, Ross, Saag, Michael, Costagliola, Dominique, Egger, Matthias, Phillips, Andrew, Günthard, Huldrych, Dabis, Francois, Hogg, Robert, De Wolf, Frank, Fatkenheuer, Gerd, John Gill, M., Justice, Amy, D'Arminio Monforte, Antonella, Lampe, Fiona, Miró, Jose, Staszewski, Schlomo, Sterne, Jonathan, Division of Infectious Disease, University of Alabama at Birmingham [ Birmingham] (UAB), Department of Social Medicine, University of Bristol [Bristol], Desmond Tutu HIV Centre, University of Cape Town-Institute of Infectious Disease and Molecular Medicine, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute of Social and Preventive Medicine, University of Berne, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Divison of Infectious Diseases and Hospital Epidemiology, University hospital of Zurich [Zurich], Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Academisch Medisch Centrum bij, Universiteit van Amsterdam (UvA), Department of Internal Medicine, University of Cologne, Division of Infectious Diseases, University of Calgary, Yale University School of Medicine, Clinic of Infectious Diseases & Tropical Medicine, 'San Paolo' Hospital-University of Milan, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Zentrum der Inneren Medizin, Goethe-Universität Frankfurt am Main, Universität Bern [Bern] (UNIBE), Yale School of Medicine [New Haven, Connecticut] (YSM), and Università degli Studi di Milano = University of Milan (UNIMI)-'San Paolo' Hospital

Subjects
AIDS, virus diseases, HIV, Antiretroviral Therapy, Highly Active, Viral load, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort analysis, AIDS-related Opportunistic Infections, Mortality
Abstract

International audience; OBJECTIVE: To determine whether differences in short-term virologic failure among commonly used antiretroviral therapy (ART) regimens translate to differences in clinical events in antiretroviral-na? patients initiating ART. DESIGN: Observational cohort study of patients initiating ART between January 2000 and December 2005. SETTING: The Antiretroviral Therapy Cohort Collaboration (ART-CC) is a collaboration of 15 HIV cohort studies from Canada, Europe, and the United States. STUDY PARTICIPANTS: A total of 13 546 antiretroviral-na? HIV-positive patients initiating ART with efavirenz, nevirapine, lopinavir/ritonavir, nelfinavir, or abacavir as third drugs in combination with a zidovudine and lamivudine nucleoside reverse transcriptase inhibitor backbone. MAIN OUTCOME MEASURES: Short-term (24-week) virologic failure (>500 copies/ml) and clinical events within 2 years of ART initiation (incident AIDS-defining event, death, and a composite measure of these two outcomes). RESULTS: Compared with efavirenz as initial third drug, short-term virologic failure was more common with all other third drugs evaluated; nevirapine (adjusted odds ratio = 1.87, 95% confidence interval (CI) = 1.58-2.22), lopinavir/ritonavir (1.32, 95% CI = 1.12-1.57), nelfinavir (3.20, 95% CI = 2.74-3.74), and abacavir (2.13, 95% CI = 1.82-2.50). However, the rate of clinical events within 2 years of ART initiation appeared higher only with nevirapine (adjusted hazard ratio for composite outcome measure 1.27, 95% CI = 1.04-1.56) and abacavir (1.22, 95% CI = 1.00-1.48). CONCLUSION: Among antiretroviral-na? patients initiating therapy, between-ART regimen, differences in short-term virologic failure do not necessarily translate to differences in clinical outcomes. Our results should be interpreted with caution because of the possibility of residual confounding by indication.

Published
2008

15. [Cervical cancer: new testing strategies?]

Author

Heard, Isabelle, Costagliola, Dominique, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance médicale à la procréation, Biologie de reproduction - Stérilité [Pitié-Salpétrière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract

National audience; Le cancer du col de l'utérus reste le deuxième cancer le plus fréquent chez les femmes dans le monde, alors que son dépistage, par le frottis, existe depuis plus de 50 ans. En France, le cancer du col de l'utérus est le huitième cancer féminin avec 3 387 nouveaux cas estimés en 2000

Published
2008

16. Le cancer du col de l'utérus, nouvelles stratégies de dépistage ?

Author

Isabelle, Heard, Dominique, Costagliola, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance médicale à la procréation, Biologie de reproduction - Stérilité [Pitié-Salpétrière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Vaginal Smears, Papillomavirus Infections, Humans, Uterine Cervical Neoplasms, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Papillomaviridae
Abstract

National audience; Le cancer du col de l'utérus reste le deuxième cancer le plus fréquent chez les femmes dans le monde, alors que son dépistage, par le frottis, existe depuis plus de 50 ans. En France, le cancer du col de l'utérus est le huitième cancer féminin avec 3 387 nouveaux cas estimés en 2000

Published
2008

17. One or two enzyme-linked immunosorbent assay tests on the first serum sample for initial diagnosis of HIV-1 infection?

Author

Pierre Palmer, Florence Damond, Christine Rouzioux, Françoise Brun-Vézinet, Dominique Costagliola, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Laboratoire de Virologie, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Recherche Antivirale, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 ( UPD5 ), Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], and Costagliola, Dominique

Subjects
diagnosis, Immunology, Human immunodeficiency virus (HIV), Enzyme-Linked Immunosorbent Assay, HIV Infections, medicine.disease_cause, Sensitivity and Specificity, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, chemistry.chemical_classification, 0303 health sciences, biology, 030306 microbiology, AIDS Serodiagnosis, HIV, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Elisa assay, Virology, 3. Good health, Infectious Diseases, Enzyme, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, biology.protein, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ELISA, Antibody
Abstract

International audience; In France, the first sample for the initial diagnosis of HIV-1 infection must be tested with two antibody assays: one being an enzyme-linked immunosorbent assay. If one is positive, confirmation tests are performed. We evaluated the performance of initial diagnostic strategies based on the use of one versus two enzyme-linked immunosorbent assay tests, either an antigen-antibody test or a simple antibody assay. We found that a single antigen-antibody test was more efficient than a combination of the two tests.

Published
2008

18. Prothrombotic markers and early spontaneous recanalization in ST-segment elevation myocardial infarction

Author

Huisse, Marie-Geneviève, Lanoy, Emilie, Tcheche, Didier, Feldman, Laurent, Bezeaud, Annie, Anglès-Cano, Eduardo, Mary-Krause, Murielle, De Prost, Dominique, Guillin, Marie-Claude, Steg, Ph.Gabriel, Service d'hématologie et immunologie, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hématologie et Immunologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de cardiologie, Sérine protéases et physiopathologie de l'unité neurovasculaire, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Financial support: This work was supported by funds from Fondation de France. Additional support was provided by Diagnostica Stago., and Angles-Cano, Eduardo

Subjects
myocardial infarction, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, plasmin-antiplasmin, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, endothelial injury, thrombin, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, soluble Glycoprotein V, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract

28 pages; International audience; We tested the hypothesis that selected prothrombotic biomarkers might be associated with early spontaneous coronary recanalization in patients with ST-segment elevation acute myocardial infarction (STEMI). We prospectively enrolled 123 patients with STEMI including 53 patients with spontaneous coronary recanalization (cases) and 70 patients with persistent occlusion (controls) at the time of emergent coronary angiography and before angioplasty. All had received aspirin and heparin. Blood samples were collected immediately before angioplasty to measure soluble P-selectin, circulating microparticles originating from platelets (PMPs), granulocytes (GMPs), endothelial cells (EMPs); tissue factor-associated MP (TF-MP); soluble platelet glycoprotein V (sGPV) and prothrombin F1 + 2; tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) and plasmin-antiplasmin (PAP). A sub-group of 70 patients (35 cases, 35 controls) was available for flow cytometry analysis of platelet P-selectin and activated GPIIb-IIIa. Baseline clinical characteristics did not differ between groups except for more frequent hypertension and dyslipidemia in controls. Platelet activation markers and PMP did not differ between the two groups. Controls had higher numbers of EMPs and GMPs compared to cases, but the difference was no longer significant when corrected for risk factors. Controls differed from cases by higher plasma levels of sGPV [64 (47-84) ng/ml vs. 53 (44-63) ng/ml] and PAP [114(65-225) ng/ml vs. 88 (51-147) ng/ml]. The difference persisted after adjustment for risks factors (p = 0.031 and 0.037, respectively). Persistent occlusion of the infarct related artery is associated with some markers related to higher thrombin (sGPV) and plasmin (PAP) production but is not associated with markers of platelet activation.

Published
2007

19. Prothrombotic markers and early spontaneous recanalization in ST-segment elevation myocardial infarction

Author

Ph. Gabriel Steg, Laurent J. Feldman, Murielle Mary-Krause, Didier Tcheche, Marie-Geneviève Huisse, Annie Bezeaud, Eduardo Anglés-Cano, Marie-Claude Guillin, Emilie Lanoy, Dominique de Prost, Service d'hématologie et immunologie, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hématologie et Immunologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de cardiologie, Sérine protéases et physiopathologie de l'unité neurovasculaire, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Financial support: This work was supported by funds from Fondation de France. Additional support was provided by Diagnostica Stago., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), and Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Remission, Spontaneous, Coronary Disease, 030204 cardiovascular system & hematology, Tissue plasminogen activator, Electrocardiography, 0302 clinical medicine, Thrombophilia, Platelet, Fibrinolysin, Prospective Studies, Myocardial infarction, Aged, 80 and over, 0303 health sciences, ST elevation, Hematology, Middle Aged, endothelial injury, Thrombosis, thrombin, 3. Good health, soluble Glycoprotein V, surgical procedures, operative, myocardial infarction, Cardiology, Female, medicine.drug, Adult, medicine.medical_specialty, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Article, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, cardiovascular diseases, Platelet activation, plasmin-antiplasmin, Aged, 030304 developmental biology, business.industry, Platelet Activation, medicine.disease, Case-Control Studies, Immunology, business, Plasminogen activator, Biomarkers
Abstract

SummaryWe tested the hypothesis that selected prothrombotic biomarkers might be associated with early spontaneous coronary recanalization in patients with ST-segment elevation acute myocardial infarction (STEMI). We prospectively enrolled 123 patients with STEMI including 53 patients with spontaneous coronary recanalization (cases) and 70 patients with persistent occlusion (controls) at the time of emergent coronary angiography and before angioplasty. All had received aspirin and heparin. Blood samples were collected immediately before angioplasty to measure soluble P-selectin, circulating microparticles originating from platelets (PMPs), granulocytes (GMPs), endothelial cells (EMPs); tissue factor-associated MP (TF-MP); soluble platelet glycoprotein V (sGPV) and prothrombin F1+2; tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) and plasmin-antiplasmin (PAP). A sub-group of 70 patients (35 cases, 35 controls) was available for flow cytometry analysis of platelet P-selectin and activated GPIIb-IIIa. Baseline clinical characteristics did not differ between groups except for more frequent hypertension and dyslipidemia in controls. Platelet activation markers and PMP did not differ between the two groups. Controls had higher numbers of EMPs and GMPs compared to cases, but the difference was no longer significant when corrected for risk factors. Controls differed from cases by higher plasma levels of sGPV [64 (47–84) ng/ml vs. 53 (44–63) ng/ml] and PAP [114(65–225) ng/ml vs. 88 (51–147) ng/ml].The difference persisted after adjustment for risks factors (p=0.031 and 0.037, respectively). Persistent occlusion of the infarct related artery is associated with some markers related to higher thrombin (sGPV) and plasmin (PAP) production but is not associated with markers of platelet activation.

Published
2007

20. Do tests devised to detect recent HIV-1 infection provide reliable estimates of incidence in Africa?

Author

Gary Murphy, François Dabis, François Rouet, Dominique Costagliola, Ahmadou Alioum, John Parry, Roger Salamon, Charlotte Sakarovitch, Francis Barin, Albert Minga, Equipe de Biostatistique, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Epidémiologie, santé publique et développement, Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), Virus Reference Department, Health Protection Agency Centre for Infections [London], PRIMO-CI, Programme PAC-CI (ANRS 1220), ANRS France Recherche Nord & sud Sida-hiv hépatites, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Virus, pseudo-virus: Morphogénèse et Antigénicité, Université de Tours (UT)-EA3856, Mouillet, Evelyne, and Université de Tours-EA3856

Subjects
Time Factors, HIV Infections, MESH: Africa, Cohort Studies, Immunoenzyme Techniques, MESH: HIV Seroprevalence, MESH: HIV-1, 0302 clinical medicine, HIV Seropositivity, Epidemiology, Prevalence, Medicine, Pharmacology (medical), 030212 general & internal medicine, MESH: Incidence, Sida, MESH: Cohort Studies, 0303 health sciences, biology, Incidence, Incidence (epidemiology), AIDS Serodiagnosis, MESH: HIV Infections, 3. Good health, MESH: Reproducibility of Results, Infectious Diseases, Population Surveillance, Biological Assay, Viral disease, medicine.medical_specialty, Context (language use), MESH: Biological Assay, Sensitivity and Specificity, MESH: Population Surveillance, 03 medical and health sciences, MESH: HIV Seropositivity, Acquired immunodeficiency syndrome (AIDS), HIV Seroprevalence, Internal medicine, Humans, Avidity, Seroconversion, MESH: Immunoenzyme Techniques, MESH: Prevalence, MESH: Humans, 030306 microbiology, business.industry, MESH: Time Factors, Reproducibility of Results, MESH: ROC Curve, medicine.disease, biology.organism_classification, MESH: Sensitivity and Specificity, ROC Curve, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: AIDS Serodiagnosis, Africa, Immunology, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

International audience; The objective of this study was to assess the performance of 4 biologic tests designed to detect recent HIV-1 infections in estimating incidence in West Africa (BED, Vironostika, Avidity, and IDE-V3). These tests were assessed on a panel of 135 samples from 79 HIV-1-positive regular blood donors from Abidjan, C?d'Ivoire, whose date of seroconversion was known (Agence Nationale de Recherches sur le SIDA et les H?tites Virales 1220 cohort). The 135 samples included 26 from recently infected patients (< or =180 days), 94 from AIDS-free subjects with long-standing infection (>180 days), and 15 from patients with clinical AIDS. The performance of each assay in estimating HIV incidence was assessed through simulations. The modified commercial assays gave the best results for sensitivity (100% for both), and the IDE-V3 technique gave the best result for specificity (96.3%). In a context like Abidjan, with a 10% HIV-1 prevalence associated with a 1% annual incidence, the estimated test-specific annual incidence rates would be 1.2% (IDE-V3), 5.5% (Vironostika), 6.2% (BED), and 11.2% (Avidity). Most of the specimens falsely classified as incident cases were from patients infected for >180 days but

Published
2007

21. Faut-il craindre une épidémie de grande taille pour le nouveau variant de la maladie de Creutzfeldt-Jacob ?

Author

Costagliola, Dominique, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), and Costagliola, Dominique

Subjects
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract

non disponible

Published
2007

22. Serious psychiatric outcome of subjects prenatally exposed to diethylstilboestrol in the E3N cohort study

Author

Françoise Clavel-Chapelon, Hélène Verdoux, Jacques Ropers, Dominique Costagliola, Xavier Paoletti, Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations, Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSAPS), AFSSAPS, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), The E3N study is supporting financially by the French League against Cancer, the European Community, the 3M Company, the Mutuelle Générale de l'Education Nationale, and the French Drugs Regulatory Agency (Agence Française de Sécurité Sanitaire des Produits de Santé )., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), and Clavel-Chapelon, F.

Subjects
Adult, Male, Risk, Pediatrics, medicine.medical_specialty, Adolescent, Offspring, Poison control, Suicide prevention, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Injury prevention, medicine, Humans, Estrogens, Non-Steroidal, Prospective Studies, Prospective cohort study, Psychiatry, Diethylstilbestrol, Referral and Consultation, Applied Psychology, business.industry, Mental Disorders, Odds ratio, Middle Aged, medicine.disease, 3. Good health, 030227 psychiatry, Hospitalization, Psychiatry and Mental health, Suicide, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Prenatal Exposure Delayed Effects, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, business, 030217 neurology & neurosurgery, Cohort study, Follow-Up Studies
Abstract

BackgroundPrenatal exposure to diethylstilboestrol (DES) may induce neurodevelopmental disturbances potentially mediating an increased risk of psychiatric disorders in exposed subjects. Most findings of an increased prevalence of psychiatric disorders in men and women prenatally exposed to DES are not easy to interpret because of selection biases.MethodInformation on hormonal treatment during pregnancy and on offspring's medical outcome was collected from women participating in the Etude Epidemiologique de femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort who completed consecutive postal questionnaires on a range of medical events since 1990. Information on hormonal treatment during pregnancy was collected in 1992 and on offspring's medical outcome in 2004. The psychiatric outcome of subjects prenatally exposed to DES was compared to that of their unexposed siblings.ResultsA total of 1352 mothers with DES treatment for at least one pregnancy provided information on 1680 exposed children and 1447 unexposed siblings. After adjustment for duration of follow-up, educational level, history of obstetric complication, prenatal exposure to progestagen drugs or other hormones and parental history of psychiatric hospitalization, no association was found between prenatal exposure to DES and occurrence of strictly defined serious psychiatric outcome (suicide or psychiatric hospitalization) [adjusted odds ratio (OR) 0·8, 95% confidence interval (CI) 0·5–1·2], or of broadly defined serious psychiatric outcome (same events plus psychiatric or psychological consultation) (adjusted OR 1·0, 95% CI 0·8–1·2).ConclusionsThese findings suggest that the impact of prenatal DES exposure on foetal brain development, if any, is unlikely to increase the risk of serious psychiatric disorders.

Published
2007

23. Complementary approach of data analysis and modeling to estimate the pattern of the BSE epidemic: the example of France

Author

Calavas, Didier, Supervie, Virginie, Morignat, Eric, Costagliola, Dominique, Ducrot, Christian, ProdInra, Migration, Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), Unité de Recherche d'Épidémiologie Animale (UR EpiA), and Institut National de la Recherche Agronomique (INRA)

Subjects
Meat, Models, Statistical, [SDV]Life Sciences [q-bio], animal diseases, Age Factors, BOVINE SPONGIFORM ENCEPHALOPATHY, FRANCE, Food Contamination, Animal Feed, Risk Assessment, Disease Outbreaks, Encephalopathy, Bovine Spongiform, [SDV] Life Sciences [q-bio], Logistic Models, MODELING, Data Interpretation, Statistical, Animals, Humans, EPIDEMIOLOGY, Cattle, Longitudinal Studies, Retrospective Studies
Abstract

Special Issue: The Future of BSE Assessments; International audience; Clinical surveillance was the only way to detect bovine spongiform encephalopathy (BSE) until July 2000 in France. From the 103 cases identified as such between 1991 and June 2000, we used a back-calculation method to reconstruct the longitudinal trend of BSE infections. Between July 1987 and June 1997, an estimated 51,300 (CI =[24,300-84,700]) cattle were infected in France. The comprehensive surveillance of BSE with rapid tests, set up in France since 2001 at the abattoir and fallen plant, allowed study of the relative exposure of the successive birth cohorts with nonconditional logistic regression models adjusted for possible confounding variables. The results were in agreement with those of the back-calculation model, estimating a decrease of the BSE exposure from the birth cohort July 1995-June 1996 that matched with the decrease of the infection after June 1996. In view of the long incubation period of BSE, it is not possible to precisely assess the impact of any control measure before several years. Modeling was therefore used to estimate prospectively the efficiency of the ban of meat and bone meal extended to all farm species in November 2000. Using parameters about age at infection and incubation time estimated earlier, we assessed the minimum time to first detection if infections still occurred. We have waited up to June 2007 to know if less than 100 infections occurred among French cattle during the 6 months following January 2001.

Published
2007

24. First-line highly active antiretroviral regimens in 2001-2002 in the French Hospital Database on HIV: combination prescribed and biological outcomes.: First-line haart : combination prescribed and biological outcomes

Author

Potard, Valérie, Rey, David, Mokhtari, Saadia, Frixon-Marin, Véronique, Pradier, Christian, Rozenbaum, Willy, Brun-Vézinet, Francoise, Costagliola, Dominique, Database On Hiv, French Hospital, Potard, Valérie, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Information et de Soin de l'Immuno-déficience Humaine Alsace, CISIH Alsace, Hôpital Nord [CHU - APHM], Hôpital Sainte Marguerite, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte Marguerite, Centre d'Information et de Soin de l'Immuno-déficience Humaine Nice, CISIH Nice, Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Bichat - Claude Bernard, and ANRS C04

Subjects
immune system diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, virus diseases
Abstract

INTRODUCTION: We compared biological outcomes in antiretroviral-naive patients with viral load (VL) > 5,000 copies/ml starting combivir-based, three-drug highly active antiretroviral therapy regimens in 2001-2002 according to the third component, namely abacavir (ABC), nelfinavir (NFV), indinavir/ritonavir (IDV/r), lopinavir/ritonavir (LPV/r), nevirapine (NVP) or efavirenz (EFV). METHODS: We evaluated virological response (HIV RNA < 500 copies/ml) and immunological response (increase of > or = 50 CD4+ T-cells/microl) separately in patients with baseline VL < 100,000 copies/ml (n = 992) and a100,000 copies/ml (n = 1,048). Hazard ratios (HR) were calculated with Cox models stratified for quintiles of propensity scores, estimated by multinomial regression from baseline characteristics. RESULTS: Median follow up was 19 months. EFV had better virological efficacy than NFV and IDV/r among patients with baseline VL < 100,000 copies/ml, with respective HRs of 0.71 and 0.72, compared with 0.81 for NVP, 0.89 for ABC and 0.99 for LPV/r. The immunological efficacy of EFV was lower than that of LPV/r (1.37) and similar to that of NFV (0.96), IDV/r (0.81), NVP (1.08) and ABC (1.04). Among patients with baseline VL > or = 100,000 copies/ml, the virological efficacy of EFV was similar to that of NVP (0.90) and LPV/r (0.97) and better than that of NFV (0.62), ABC (0.75) and IDV/r (0.78). The immunological results found in these patients were similar to those observed in patients with baseline VL < 100,000 copies/ml. CONCLUSIONS: For first-line therapy, in this observational setting, EFV, LPV/r and NVP, when added to the combivir backbone, were more likely to drive viral load < 500 copies/ml. LPV/r showed the best immunological effectiveness.

Published
2007

25. SIDA, maladies associées : pistes pour de nouveaux médicaments

Author

Auclair , Christian, Bousseau , Anne, Costagliola , Dominique, Dei-Cas , Eduardo, Dormont , Dominique, Junien , Jean-Louis, Katlama , Christine, Melchior , Jean-Claude, Marsac , Jean, Moatti , Jean-Paul, Perronne , Christian, Rouzioux , Christine, Sonigo , Pierre, Souteyrand , Yves, Tardieu , Marc, de la Tullaye , Jean, Yeni , Patrick, Institut Gustave Roussy (IGR), Rhone Poulenc Rorer, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Inserm U42, Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Immuno-Pathologie Expérimentale, Service de Neurovirologie, Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CRSSA, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sanofi synthelabo, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Infectieuses et Tropicales [CHU Raymond Poincaré], Hôpital Raymond Poincaré [AP-HP], Laboratoire de Virologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ANRS France Recherche Nord & sud Sida-hiv hépatites, Hôpital Bicêtre, Sanofi-Synthelabo, Sanofi-Synthélabo, Service de médecine interne [Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut national de la santé et de la recherche médicale(INSERM), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, ORANGE, Colette, Université Paris-Sud - Paris 11 (UP11)-École Pratique des Hautes Études (EPHE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Gustave Roussy ( IGR ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -École pratique des hautes études ( EPHE ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -CRSSA, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut National de la Santé et de la Recherche Médicale ( INSERM ) -UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Raymond Poincaré, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), ANRS, and Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]

Subjects
Infections parasitaires, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Molécules anti-VIH, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Syndrome de dénutrition spécifique, Infections à mycobactéries, VIH, Herpesvirus, Antirétroviral, Infections fongiques, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

En France, l'infection par le VIH atteindrait actuellement 70 000 à 160 000personnes. Même si l'incidence des cas de sida diminue dans tous les groupes detransmission, le nombre de cas continue à augmenter, sauf dans le groupe deshémophiles et des transfusés. Le nombre de nouveaux cas dans le groupe deshomo-bisexuels a tendance à se stabiliser. L'analyse des données de la base DMI 2montre que, chaque année, 20 à 25 % des sujets inclus développent un sida. Cetaux est cependant surestimé du fait de l'avancement des sujets dans la maladie;effectivement, le passage réel à la pathologie parmi les sujets contaminés toutescatégories confondues est de l'ordre de 5 %. Le suivi des patients de la base DMI 2permet également de tracer l'incidence des principales pathologies opportunistesrencontrées au cours de la maladie on peut ainsi noter le recul de lapneumocystose, de la toxoplasmose et de la tuberculose, et l'augmentation relativedes infections à cytomegalovirus, des mycobactérioses atypiques et descryptosporidioses.En termes de coûts, la lutte contre le VIH a représenté pour l'année 1993 5,348milliards de francs, soit 0,7 % du budget de la dépense nationale de santé.Soixante-dix pour cent de cette dépense sont consacrés à la prise en chargemédicale des patients. En 1993, le coût annuel total de 1'hospitalisation d'un patientinfecté par le VIH variait de 30 000 francs pour les sujets asymptomatiques à 140000 francs pour les patients en phase de sida déclaré. La prise en charge extrahospitalière(hospitalisation à domicile, hôpital de jour, consultations externes) atendance à se développer aux dépens de l'hospitalisation classique. Cela démontrela contribution à l'activité de soins de l'entourage du patient, du patient lui-même etdu secteur associatif. Enfin, les modes de prise en charge, et par conséquent lescoûts, varient significativement d'un hôpital à l'autre.Depuis plus d'une décennie, les programmes de recherche se sont diversifiés nonseulement dans le domaine de la rétrovirologie, mais aussi dans le champ despathologies associées du sida. L'amélioration de la qualité de vie estprogressivement devenue un objectif de recherche important, car les patients souffrent non seulement de l'infection elle-même, mais également deseffets délétères, pénibles et invalidants de certains traitements.Une infection virale persistante et progressiveL'Expertise collective s'est dès le départ appuyée sur des travaux éclairant d'unelumière nouvelle la physiopathologie de l'infection par le VIH. Parmi ceux-ci, lesplus récents ont confirmé le caractère dynamique du processus infectieux, qui semanifeste par une réplication massive et ininterrompue du virus dès son entrée dansl'organisme. Cette réplication constante, longtemps mal évaluée, entraîne uneréponse immunitaire intense, dont l'efficacité et la durée se mesurent à l'absence demanifestations cliniques, durant ce qui a été appelé, à tort, la phase latente del'infection.Pendant cette phase dite Symptomatique, les ganglions lymphatiques et la rateconstituent les principaux réservoirs du VIH, la virémie ne reflétant quepartiellement l'intensité de l'infection. La multiplication virale dans les organeslymphoïdes active de façon constante le système immunitaire. L'état inflammatoirechronique qui en découle conduit à la déstructuration des organes lymphoïdespériphériques et à l'installation subséquente d'une immunodéficience. Par analogieavec le modèle de l'hépatite B. l'infection à VIH peut donc être assimilée à uneadénite rétrovirale chronique active. La destruction progressive du poollymphocytaire, notamment des lymphocytes T mémoire, va permettre l'apparitiondes pathologies opportunistes.Une telle conception de la dynamique virale nécessite que soit élucidé lephénomène de persistance de l'infection. Quels sont les rôles respectifs de lalatence virale (arrêt de synthèse des protéines virales), de la variabilité antigéniqueconsidérable du VIH (permettant une évolution rapide par sélection naturelle), etde l'aptitude du VIH à se rendre invisible pour le système immunitaire ?Il est également primordial de mieux apprécier la nature exacte des différentescellules cibles de la réplication virale ainsi que les mécanismes et les conséquencesfonctionnelles de la destruction des cellules et des tissus. Cet objectif ne se limitepas aux cellules du système immunitaire. Ainsi, l'infection des macrophagescérébraux par le VIH est presque constante et particulièrement précoce.Cependant, ni l'existence de souches virales à tropisme cérébral préférentiel, ni lamanière dont le virus pénètre dans le système nerveux central n'ont pu être établies.Pendant la phase aiguë de l'infection (primo-infection), la réponse immune estessentiellement dominée par les lymphocytes T cytotoxiques (CTLs) qui détruisent,massivement et très tôt, les cellules infectées. L'effet des anticorps neutralisantssusceptibles de bloquer l'entrée du virus dans les cellules reste, aujourd'hui encore,incertain...

Published
1996

26. Predictors identified for losses to follow-up among HIV-seropositive patients

Author

Lanoy, Emilie, Mary-Krause, Murielle, Tattevin, Pierre, Dray-Spira, Rosemary, Duvivier, Claudine, Fischer, Patricia, Obadia, Yolande, Lert, France, Costagliola, Dominique, The Clinical Epidemiology Group Of The French Hospital Database On Hiv Infection, Epidémiologie Clinique et Traitement de l'Infection à VIH, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Antenne d'immuno-onco-hématologie, CHU Strasbourg, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Kaniewski, Nadine, Service des maladies infectieuses et réanimation médicale [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou

Subjects
Adult, Male, medicine.medical_specialty, Patient Dropouts, Time Factors, Anti-HIV Agents, Epidemiology, HIV Infections, Logistic regression, Men who have sex with men, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Internal medicine, Ethnicity, medicine, Humans, 030212 general & internal medicine, Substance Abuse, Intravenous, Sida, 0303 health sciences, biology, 030306 microbiology, business.industry, Homosexuality, Emigration and Immigration, Middle Aged, medicine.disease, biology.organism_classification, Confidence interval, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Viral load, Demography, Cohort study
Abstract

BACKGROUND AND OBJECTIVE: This study aims to describe predictors of loss to follow-up (LFU) in the French Hospital Database on HIV infection (FHDH). METHODS: We studied the prevalence and predictors of LFU among 34,835 patients enrolled in FHDH in 1999. Impacts of demographic and clinical factors were studied by using multivariate logistic regression analysis. RESULTS: Among included patients, 1,478 (4.2%) died and 2,950 (8.5%) were lost to follow-up. LFU was more frequent among recently diagnosed patients ( 1 year, 7.1). Among recently diagnosed patients, LFU was less frequent among men who have sex with men (MSM) [odds radio (OR) = 0.6, 95% confidence interval (CI) = (0.5;0.7)], and among patients with AIDS [OR = 0.5, 95%CI = (0.4;0.6)], and more frequent among immigrants [OR = 1.3, 95%CI = (1.0;1.5)]. Among less recently diagnosed patients, LFU was more frequent in French Departments of America than in the Paris area. The proportion of LFU fell with age, and LFU was more frequent among intravenous drug users (IVDU) than among MSM [OR = 1.2, 95%CI = (1.1;1.4)]. Patients with viral load >5,000 copies/mL or CD4 cell counts

Published
2006

Catalog

Books, media, physical & digital resources
See catalog results