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1. 4CPS-152 Chemotherapy pharmaceutical consultation: pharmaceutical interventions after 18 months of implementation

Author

T Berod, R Cohen-Valensi, S Martinez, E Gerardin, and E Protesti

Subjects
Medication review, medicine.medical_specialty, Modalities, Community pharmacist, business.industry, Phone, Family medicine, Conflict of interest, Psychological intervention, Medicine, Pharmacy, business, Consultation report
Abstract

Background In January 2017, our pharmacy department implemented an oral chemotherapy pharmaceutical consultation in which the order was checked, a medication review was done and drugs information provided (toxicity, taking drug, drug-drug interaction) and completed by an information sheet for patients. In order to promote therapy monitoring, side-effects’ management and treatment adherence, we contacted health professionals: nurse, physician, oncologist and community pharmacist. Purpose Eighteen months after the implementation of the pharmaceutical consultation the purpose was to assess pharmaceutical interventions on patients, oncologists, physicians and community pharmacists. Material and methods Revision of our consultation sheets from January 2017 to June 2018. Sixty-four pharmaceutical consultations occurred for 56 patients (33 males; 28 females; mean 69 years (33–93) with an average time of 33.4 min. Results Seventy-nine medication-related problems were reported: 31 side effects, 15 drug-drug interactions, 10 absences of adapted comedication and eight inobservances. One-hundred and two pharmaceutical interventions had been achieved: 51 on patients, 28 on oncologists, 18 on community pharmacists, four on nurses and one on a physician. During pharmaceutical consultation 51 patient information sheets on oral chemotherapy were given to patients, who mostly had medium or bad theoretical (n=31) and technical (n=22) knowledge about their oral chemotherapy, which could reduce its efficacy. Twenty-eight feedbacks were transmitted to oncologists by phone, face-to-face or secure mail. Eighty-two per cent of pharmaceutical interventions were accepted by oncologists. Eighteen community pharmacists had been contacted by phone. A consultation report condensed and patient information sheets were sent to them by fax (n=15) or secure e-mail (n=3). Four nurses had received information by phone on modalities of storage, administration, waste and side-effects’ management. One physician was contacted for a drug-drug interaction. Our first results showed the quantitative and qualitative importance of pharmacist interventions with patients and other health professionals. However, to improve the quality of our consultations we must develop a systemic and easy feedback to these professionals. A follow-up for the patients during the treatment will be useful. Conclusion Completed by patient information sheets and feedback, the pharmaceutical consultations appear essential to facilitate care by other health professionals and to give patients significant information concerning their health. References and/or acknowledgements No conflict of interest.

Published
2019
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2. A multifaceted intervention designed to improve medical management of moderate to advanced chronic kidney disease in HIV-infected patients: a cluster randomised trial

Author

P Brazille, Johan Chanal, N. de Castro, B. Lefebvre, Sophie Abgrall, N Petit, M Marcou, Pascal Pugliese, A Parrot, F Meier, Yazdan Yazdanpanah, A Signori-Schmuck, Hana Selinger-Leneman, Pierre Delobel, F Touam, A Cros, Claire Rouzaud, Philippe Bossi, J. P. Faller, Jean-Marc Mauboussin, Faiza Ajana, V Perronne, V Chambrin, Olivier Lortholary, Laurent Alric, V. Gendrin, C Sautron, K Benhadj, H Gil, C Lascoux, F Raffi, JE Kahn, Michel Vidal, J. J. Laurichesse, O Ruyer, F Brunel, Pascal Chavanet, J. Durant, J. M. Chapplain, T. Perpoint, D Blanc, S Casanova, Frédéric Méchaï, P Poubeau, M Benomar, David Zucman, P Fischer, H Fischer, V Ronat, D Coban, Elisabeth Rouveix, H. Berthé, E Roveix, Corinne Isnard-Bagnis, Aurélie Fillion, P Loulergue, Jennifer M. Rohan, Isabelle Ravaux, Catherine Michel, C Faudon, Jacques Gilquin, J. M. Livrozet, Christian Chidiac, G Wartel, Patricia Enel, G. Beck-Wirth, I Prade, O. Derradji, Jean-Paul Viard, Cécile Goujard, R Cohen Valensi, M Batard, Jean-Luc Meynard, G Camuset, Jacques Cadranel, Christian Pradier, S Gohier, Jean-François Bergmann, Francis Barin, D. Makhloufi, Philippe Gerhardt, A Canestri, Lionel Piroth, S Greffe, N Biezunski, C Bolliot, L Toko, G Mboungou, Jérôme Moreau, Valérie Potard, H Masson, Eric Rosenthal, Jacques Reynes, André Cabié, Gilles Pialoux, P Granet Brunello, F Durand, Véronique Obry-Roguet, Jade Ghosn, V Walter, P Gazalet, O Boulat, P M Girard, A Ménard, M. Môle, G Martin Blondel, M Hamidi, C Lupin, P Druart, Sophie Matheron, Catherine Chirouze, P. De Truchis, Laurent Cotte, P. Del Giudice, Caroline Dupont, Anne Frésard, C Jung, V Payssan, M Saidani, C. Chesnel, Véronique Joly, S Abgrall, B Wifaq, Bruno Hoen, I Fabre, E Pannier Metzger, M Beyrne, Christian Rabaud, C. Gaud, Pierre Durieux, S Makhloufi, Eric Billaud, Jean-Marc Lacombe, T Akpan, PY Dides, Dominique Mathez, V Delcey, P. Sellier, A Naqvi, Amanda Lopes, Laurent Hustache-Mathieu, C Bartoli, V Marcou, Murielle Mary-Krause, Elisabeth Botelho-Nevers, K Samar, Hervé Tissot-Dupont, M Ruquet, Laurence Weiss, Boue F, Philippe Morand, I Lamaury, L Meddeb, Nadia Valin, M Delestan, N. Jacquemet, N Méaux-Ruault, A Gergely, M. Blanc, M Sordage, L Sutton, Dominique Costagliola, V Thomas, PH Consigny, G Cessot, C Le Jeunne, A Freire Maresca, A Greder Belan, Jean-Pierre Morini, G Astier, D. Martin, Pierre-Marie Roger, E Bourzam, G Melica-Gregoire, Nicolas Vignier, B. Taverne, P. Leclercq, M. Sebire, A Adda, A Meybeck, MG Lebrette, André Boibieux, T. Allegre, Nicolas Dupin, M. Parrinello, S Roussin-Bretagne, Christine Jacomet, Laurence Gérard, Jean Deleuze, A S Ritleng, M Raho-Moussa, Marialuisa Partisani, Daniel Vittecoq, M André, Albert Sotto, Pierre Tattevin, S Marque Juillet, Antolini-Bouvenot, Sylvie Abel, M Guivarch, S Lang, P. Honoré, A Lavolé, C. Majerholc, Gilles Hittinger, Marguerite Guiguet, N Magy-Bertrand, Alain Lafeuillade, Elina Teicher, JM Riou, B Slama, Sophie Grabar, N. Viget, P Genet, Faouzi Souala, X. Duval, Lise Cuzin, B. Marchou, D Bonnabel, O. Faucher, S Stegmann, C Veyssier-Belot, I Perbost, K Bourdic, Cédric Arvieux, V Masse, L Pellissier, Giovanna Melica, S Lariven, S Chebrek, H Zerazhi, G Philip, Hugues Melliez, D Marigot-Outtandy, Mark Bloch, E Fourn, E. Billaud, J. Gerbe, C Dhiver, Benveniste O, Delphine Bonnet, D. Quinsat, V Daneluzzi, E Haustraete, P Guet, Dominique Salmon, Christophe Rioux, E Duvallon, E. Mortier, G Borgherini, P Goubin, D. Costagliola, Renaud Verdon, M J Soavi, A. Simon, F Zeng, Aba Mahamat, Mathieu Nacher, P Colardelle, F Granier, E Hope-Rapp, M. Poupard, V Vanticlke, M P Bouillon, C Clavel, Ml Lucas, P. Chiarello, Fabienne Caby, G Jacques, Juliette Pavie, MP Pietri, Blandine Denis, P. Miailhes, Sylvie Bregigeon, B Mouchet, Marie-Aude Khuong-Josses, P Thibaut, Antoine Rachas, H Laurichesse, Sylvie Dargere, C Godin Collet, Odile Launay, Jacques Gasnault, Clotilde Allavena, C. Dumont, Isabelle Poizot-Martin, M. Ratajczak, A. Maignan, A Brunon-Gagneux, Olivier Epaulard, A Therby, Tristan Ferry, E Reimann, Laurent Boyer, Régine Doncesco, Eric Cua, K Risso, Claudine Duvivier, Leila Adriouch, W. Rozenbaum, Christian Perronne, R Sambuc, I Kansau, J. F. Faucher, Florence Huber, J. M. Ruiz, Ma Khuong, Sandrine Pierre-François, Laurence Lievre, G Breton, J.-M. Molina, C. Tomei, M Guiguet, A Proust, L Fonquernie, D. Bornarel, David Rey, Isabelle Rouanet, C Guglielminotti, Jérôme Tourret, V. Reliquet, A Palacin, C Cheneau, Eric Oksenhendler, P Féret, B Montoya, V Lambry, N Hall, Jean-Daniel Lelièvre, Delphine Croisier, C Ricaud, M Ptak, Pierre Couppié, S Mokhtari, Y Welker, R Rodet, T May, 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), Ecologie et Evolution des Microorganismes (EEM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-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), ANRS, 2009, the French Ministry of Health, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Ecologie et Evolution des Microorganismes ( EEM ), 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 ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, and Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]

Subjects
Male, Microbiology (medical), Nephrology, medicine.medical_specialty, HIV Infections, urologic and male genital diseases, law.invention, Randomized controlled trial, law, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Internal medicine, Humans, Medicine, Cluster randomised controlled trial, Aged, business.industry, Guideline, Middle Aged, medicine.disease, HIV infection, Confidence interval, 3. Good health, clinical practice, Clinical trial, Treatment Outcome, Infectious Diseases, Blood pressure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Practice Guidelines as Topic, Physical therapy, cluster randomized trial, Kidney Failure, Chronic, Female, business, chronic kidney disease, Glomerular Filtration Rate, Kidney disease
Abstract

International audience; Background - Chronic kidney disease (CKD) is frequent in individuals infected with human immunodeficiency virus (HIV). Progression to end-stage renal disease can be slowed by appropriate medical management. Methods - To assess whether active promotion of guidelines improves CKD management, we conducted a cluster randomized controlled trial within the French Hospital Database on HIV (FHDH-ANRS CO4). We randomized 46 centers participating in the FHDH to either simple information on guideline availability or active promotion with a multifaceted and repeated intervention comprising reminders and audit feedback and targeting of local opinion leaders carried out between April 2009 and April 2010. Outcome measure was CKD management adequacy assessed before and 2 years after the beginning of the intervention in HIV-infected patients with moderate to severe CKD. CKD management was considered adequate in case of referral to a nephrologist or if proteinuria, blood pressure, low-density lipoprotein cholesterol level, and glycemia had been measured during the previous year and medications had been prescribed when necessary. Results - Three hundred six patients were enrolled, of whom 238 (78%) completed the 2 years of follow-up. During the study period, the percentage of patients receiving adequate CKD management improved from 64.1% to 70.4% (+6.3%) in the active arm and from 68.3% to 75.6% (+7.3%) in the control arm (adjusted mean difference, -0.7 percentage points [95% confidence interval: -9.2 to 7.9]; P = .95). The biggest impact of active promotion was on the management of proteinuria and blood pressure. Conclusions - Adequate compliance with CKD management guidelines improved slightly between 2009 and 2011, with no difference between the simple information and active promotion arms. Clinical trials registration - CCTIRS 10.150 and CNIL DR-2010-379.

Published
2015
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3. Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir

Author

M. Strobel, S. Herson, J. M. Lang, C. Picard-Dahan, Bruno Hoen, Dominique Salmon, Eric Billaud, P. Elinger, A. Laffeuillade, J. L. Touraine, M. Bentata, Renaud Verdon, Christine Katlama, P. Honoré, Claudine Duvivier, Sophie Abgrall, E. Arlet-Suau, K. Aleksandrowicz, Christian Trepo, Pascal Pugliese, T. Allegre, Jacques Gasnault, Jean-Pierre Daurès, C. Gaud, Xavier Duval, Emilie Lanoy, Anne Frésard, D. Quinsat, Valérie Potard, Jean-Pierre Clauvel, Jean-Michel Molina, J. M. Livrozet, P. Lecercq, B. Crickx, Elisabeth Bouvet, Hervé Tissot-Dupont, Y. Yasdanpanah, H. Laurichesse, M. Nezri, Christian Pradier, M. Brosseau, M. F. Maître, N. Desplanque, J. P. Delmont, Sophie Matheron, F. Lucht, D. Tisne-Dessus, Dominique Costagliola, François Raffi, P. De Truchis, Pierre Dellamonica, M. F. Thiercelin Legrand, Jean-Marc Lacombe, J. Soubeyrand, A. Simon, Cécile Goujard, E. Mortier, Isabelle Poizot-Martin, Hana Selinger-Leneman, Isabelle Ravaux, C. Jung, P. Sellier, Jean-Paul Viard, Christian Michelet, T. May, I. Auperin, J. L. Ecobichon, Valérie Martinez, J. P. Faller, P. Granet-Brunello, François Caron, M. Contant, Jean-Luc Berger, Laurence Lievre, Jacques Cadranel, Marie-Caroline Meyohas, C. Mayaud, Jacques Moreau, P. Choutet, André Boibieux, Patricia Enel, G. Beck-Wirth, Laurence Gérard, R. Pradinaud, Elisabeth Rouveix, M. Sobesky, H. Berthé, Francis Barin, J. M. Decazes, A. Galinier, Jacques Reynes, R. Cohen-Valensi, Patrick Yeni, T. Bommenel, Jean-Paul Stahl, C. Bazin, Vincent Jeantils, Pierluigi Blanc, Laurence Weiss, Daniel Vittecoq, Laurent Cotte, Pierre Tattevin, G. Pontonnier, David Rey, Sophie Grabar, Christian Rabaud, M. Diemer, D. Peyramond, Marguerite Guiguet, Pierre-Marie Girard, F. Pilorgé, S. Chapadaud, Jacques Gilquin, N. Jacquemet, Odile Launay, C. Chandemerle, P. Lesprit, Aba Mahamat, B. Taverne, F. Borsa-Lebas, G. Lepeu, Pascal Chavanet, Juliette Pavie, F. Gourdon, Jean-Albert Gastaut, Jean-François Delfraissy, Odile Picard, R. Fior, Alain Goudeau, P. Fraisse, M. A. Khuong, Lise Cuzin, Murielle Mary-Krause, L. Roudière, Boue F, V. Salomon, J. P. Esterni, N. Viget, D. Bonnet-Montchardon, Cédric Arvieux, André Cabié, Gilles Pialoux, François Bricaire, Jean-Luc Meynard, S. Tassi, Patrice Massip, Caroline Dupont, Christine Burty, F. Retornaz, D. Mechali, G. Rémy, Anne-Sophie Lascaux, L. Pelissier, J. M. Ruiz, F. Bissuel, 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), CIC - Biotherapie - AP-HP (cochin - Pasteur), Institut National de la Santé et de la Recherche Médicale (INSERM), Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [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), Hôtel-Dieu, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu, Service d'immunologie clinique [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service des maladies infectieuses, Hopital Andree Rosemond, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cytokines, chimiokines et immunopathologie, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Public Health Department, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Institut de recherche en 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 ), FHDH-ANRS CO4, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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 ), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA)

Subjects
Cyclopropanes, Male, HIV Infections, boosted protease inhibitor, MESH: Antiretroviral Therapy, Highly Active, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Abacavir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, MESH: Anti-HIV Agents, MESH: Nevirapine, MESH: Cohort Studies, MESH: Treatment Outcome, 0303 health sciences, MESH: HIV, Hazard ratio, virus diseases, MESH: HIV Infections, Viral Load, switch, 3. Good health, Infectious Diseases, Treatment Outcome, MESH: Dideoxynucleosides, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Alkynes, MESH: Benzoxazines, HIV/AIDS, Female, MESH: Viral Load, Viral load, medicine.drug, Microbiology (medical), Cart, Adult, medicine.medical_specialty, Efavirenz, Nevirapine, Anti-HIV Agents, 03 medical and health sciences, Internal medicine, parasitic diseases, medicine, cohort study, Humans, MESH: HIV Protease Inhibitors, Pharmacology, MESH: Humans, 030306 microbiology, business.industry, HIV, MESH: Adult, HIV Protease Inhibitors, Virology, Confidence interval, Dideoxynucleosides, MESH: Male, MESH: Prospective Studies, Benzoxazines, Regimen, chemistry, business, MESH: Female, virological effectiveness
Abstract

International audience; OBJECTIVES: To compare virological effectiveness in patients who continued on a virologically successful first-line boosted protease inhibitor (PI)-containing combination antiretroviral therapy (cART) regimen or who switched to a PI-free cART including efavirenz, nevirapine or abacavir. METHODS: From the French Hospital Database on HIV, we selected 439 patients with undetectable viral load (VL) on a first-line boosted PI-containing cART regimen who switched to a PI-free combination including efavirenz, nevirapine or abacavir. Each of these patients was matched with three patients who continued to take their first-line cART regimen, on the basis of gender, age, CD4 cell count, VL, date of cART initiation and the duration of VL undetectability. Time to virological failure (VF) was analysed with Kaplan-Meier curves and Cox models. RESULTS: The 12 month probabilities of VF were 3.7% and 5.7% in non-switch and switch patients, respectively, and 3.9%, 7.2% and 9.0% in patients switching to efavirenz-, nevirapine- and abacavir-containing cART, respectively. After adjustment, only patients switching to abacavir-containing cART had a higher risk of VF than non-switch patients (adjusted hazard ratio, 1.99; 95% confidence interval, 1.05-3.79). CONCLUSIONS: Switching from a virologically successful first-line boosted PI-containing cART regimen to a non-nucleoside reverse transcriptase inhibitor-containing cART regimen containing either efavirenz or nevirapine is virologically safe, while switching to abacavir-containing cART should be avoided.

Published
2011
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4. [First report of a human case of trichinellosis due to Trichinella britovi after jackal (Canis aureus) meat consumption in Algeria]

Author

M, Nezri, J, Ruer, A, De Bruyne, R, Cohen-Valensi, E, Pozio, and J, Dupouy-Camet

Subjects
Male, Meat, Algeria, Biopsy, Trichinella, Animals, Humans, Trichinellosis, Jackals, Muscle, Skeletal, Polymerase Chain Reaction, Aged
Abstract

We report a single case of trichinellosis contracted in Algeria (Batna region), in a practising Moslim. Shortly after returning to France in November 2004, the patient developed the typical clinical and biological signs of the disease. Although the patient claimed having only eaten mutton, an unusual host for Trichinella, a meticulous investigation revealed that he also had eaten a grilled leg of jackal (Canis aureus). One of the four Trichinella larvae detected in a muscular biopsy enabled us to identify the parasite as Trichinella britovi by a multiplex PCR analysis. This is the first identification of the etiological agent of sylvatic trichinellosis occurring in North Africa and the first case of symptomatic trichinellosis due to jackal meat consumption in Africa.

Published
2006

7. Acute myeloid leukemia and myelodysplasia in patients with chronic lymphocytic leukemia receiving fludarabine as initial therapy

Author

R. Costello, R. Bouabdallah, M. Nezri, D. Coso, D. Sainty, R. Cohen-Valensi, and J. A. Gastaut

Subjects
Oncology, medicine.medical_specialty, business.industry, Chronic lymphocytic leukemia, Myeloid leukemia, Hematology, medicine.disease, Fludarabine, Internal medicine, medicine, In patient, business, Initial therapy, medicine.drug
Published
1999
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8. Vasculitis associated with myelodysplastic syndrome and chronic myelomonocytic leukemia: French multicenter case-control study.

Author

Roupie AL, Guedon A, Terrier B, Lahuna C, Jachiet V, Regent A, de Boysson H, Carrat F, Seguier J, Terriou L, Versini M, Queyrel V, Groh M, Benhamou Y, Maurier F, Ledoult E, Clech LL, D'Aveni M, Rossignol J, Galland J, Willems L, Chiche NJ, Peterlin P, Roux-Sauvat M, Parcelier A, Wemeau M, Lambert M, Belizna C, Puechal X, Swiader L, Cohen-Valensi R, Noc V, Dao E, Thepot S, de Frémont GM, Tanguy-Schmidt A, Koka AM, Bussone G, Philipponnet C, Konate A, Cavaille G, Guilpain P, Allain JS, Broner J, Solary E, Ruivard M, de Renzis B, Corm S, Baati N, Schleinitz N, Ponsoye M, Stamatoullas-Bastard A, Ades L, Dellal A, Tchirkov A, Aouba A, Fenaux P, Fain O, and Mekinian A

Subjects
Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, Giant Cell Arteritis, Leukemia, Myelomonocytic, Chronic complications, Leukemia, Myelomonocytic, Chronic drug therapy, Leukemia, Myelomonocytic, Chronic epidemiology, Myelodysplastic Syndromes complications, Myelodysplastic Syndromes drug therapy, Myelodysplastic Syndromes epidemiology
Abstract

Introduction: Our objective was to evaluate characteristics, treatment and outcome of vasculitis associated with myelodysplastic syndrome (MDS) and chronic myelomonicytic leukemia (CMML) PATIENTS AND METHODS: Retrospective descriptive analysis of MDS/CMML-related vasculitis and comparison with MDS/CMML patients without dysimmune features., Results: Seventy patients with vasculitis and MDS/CMML were included, with median age of 71.5 [21-90] years and male/female ratio of 2.3. Vasculitis was diagnosed prior to MDS/CMML in 31 patients (44%), and after in 20 patients. In comparison with MDS/CMML without autoimmune/inflammatory features, vasculitis with MDS/MPN showed no difference in MDS/CMML subtypes distribution nor International Prognostic Scoring System and CMML-specific prognostic (IPSS/CPSS) scores. Vasculitis subtypes included Giant cell arteritis in 24 patients (34%), Behçet's-like syndrome in 11 patients (20%) and polyarteritis nodosa in 6 patients (9%). Glucocorticoids (GCs) were used as first-line therapy for MDS/CMML vasculitis in 64/70 patients (91%) and 41 (59%) received combined immunosuppressive therapies during the follow-up. After a median follow-up of 33.2 months [1-162], 31 patients (44%) achieved sustained remission. At least one relapse occurred in 43 patients (61%). Relapse rates were higher in patients treated with conventional Disease Modifying Anti-Rheumatic Drug (DMARDs) (odds ratio 4.86 [95% CI 1.38 - 17.10]), but did not differ for biologics (odds ratio 0.59 [95% CI 0.11-3.20]) and azacytidine (odds ratio 1.44 [95% CI 0.21-9.76]) than under glucocorticoids. Overall survival in MDS/CMML vasculitis was not significantly different from MDS/CMML patients without autoimmune/inflammatory features (p = 0.5), but acute leukemia progression rates were decreased (log rank <0.05)., Conclusion: This study shows no correlation of vasculitis diagnoses with subtypes and severity of MDS/CMML, and no significant impact of vasculitis on overall survival. Whereas conventional DMARDs seem to be less effective, biologics or azacytidine therapy could be considered for even low-risk MDS/CMML vasculitis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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9. Factors associated with social deprivation among older persons living with HIV.

Author

Enel P, Retornaz F, Ravaux I, Jaureguiberry JP, Philibert P, Allegre T, Chadapaud S, Cohen-Valensi R, Granet-Brunello P, Pelissier L, Pichancourt G, Bregigeon S, Tollinchi F, Darque A, and Petit N

Subjects
Adult, Aged, Aged, 80 and over, Anti-HIV Agents therapeutic use, Cross-Sectional Studies, Depression epidemiology, Female, France epidemiology, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections psychology, Health Status Indicators, Health Surveys, Humans, Male, Mental Health, Middle Aged, Prevalence, Aging, Depression psychology, HIV Infections complications, Health Status Disparities, Psychosocial Deprivation
Abstract

Aging persons living with HIV may develop multiple health problems, including comorbidities, and altered physical and mental health, earlier than non-infected people. They may also experience social deprivation. We assessed the prevalence of social deprivation and its relationship with health indicators in older persons living with HIV. An 18-month, multicenter, cross-sectional study was carried out between 2013 and 2014 focusing on patients ≥50-years of age followed-up in 12 dedicated HIV medical hospital units located in the South of France and involved the VISAGE study group. Social deprivation was measured with the EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centers) score (ES) and defined as ES ≥30.17. The following data were recorded: health indicators (gender, age, body mass index), comorbidities, frailty markers, socioeconomic, behavioral and age-related variables. Among 509 patients recruited, 494 completed the ES social deprivation evaluation. Mean age was 58.5 ± 7.0 years and 72.9% were male. The prevalence of social deprivation was 49.0%. Multivariable logistic regression analysis showed that higher social deprivation was significantly linked to alcohol consumption (OR = 4.07 [95%CI: 1.23-13.48]), risk of depression (OR = 3.59 [95%CI: 2.26-5.70]), chronic obstructive pulmonary disease (OR = 3.10 [95%CI: 1.36-7.09]), hepatitis C (OR = 1.96 [95%CI: 1.10-3.52]), and chronic pain (OR = 1.11 [95%CI: 1.01-1.21]). Social deprivation was not related to HIV status. Our study showed that not only did older patients with HIV suffer from social deprivation, but they also received little support from social workers. Physicians should be aware of this situation and should systematically evaluate social deprivation in order to provide comprehensive targeted care involving global, social, and psychological support to reduce the burden of social deprivation.

Published
2019
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10. Black lymph nodes--and a colourful skin.

Author

Kluger N, Cohen-Valensi R, and Nezri M

Subjects
Adult, Axilla, Biopsy, Diagnosis, Differential, Humans, Male, Melanoma diagnosis, Remission, Spontaneous, Lymph Nodes pathology, Lymphadenitis etiology, Lymphadenitis pathology, Pseudolymphoma etiology, Pseudolymphoma pathology, Tattooing
Published
2008
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11. [First report of a human case of trichinellosis due to Trichinella britovi after jackal (Canis aureus) meat consumption in Algeria].

Author

Nezri M, Ruer J, De Bruyne A, Cohen-Valensi R, Pozio E, and Dupouy-Camet J

Subjects
Aged, Algeria, Animals, Biopsy, Humans, Male, Muscle, Skeletal parasitology, Polymerase Chain Reaction, Trichinellosis etiology, Jackals, Meat parasitology, Trichinella genetics, Trichinella isolation & purification, Trichinellosis diagnosis
Abstract

We report a single case of trichinellosis contracted in Algeria (Batna region), in a practising Moslim. Shortly after returning to France in November 2004, the patient developed the typical clinical and biological signs of the disease. Although the patient claimed having only eaten mutton, an unusual host for Trichinella, a meticulous investigation revealed that he also had eaten a grilled leg of jackal (Canis aureus). One of the four Trichinella larvae detected in a muscular biopsy enabled us to identify the parasite as Trichinella britovi by a multiplex PCR analysis. This is the first identification of the etiological agent of sylvatic trichinellosis occurring in North Africa and the first case of symptomatic trichinellosis due to jackal meat consumption in Africa.

Published
2006

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