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1. Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients.

Author

Clotilde Allavena, Matthieu Hanf, David Rey, Claudine Duvivier, Firouze BaniSadr, Isabelle Poizot-Martin, Christine Jacomet, Pascal Pugliese, Pierre Delobel, Christine Katlama, Véronique Joly, Christian Chidiac, Nathalie Dournon, Dominique Merrien, Thierry May, Jacques Reynes, Amandine Gagneux-Brunon, Catherine Chirouze, Thomas Huleux, André Cabié, François Raffi, and Dat’AIDS study group

Subjects
Medicine, Science
Abstract

As HIV-infected adults on successful antiretroviral therapy (ART) are expected to have close to normal lifespans, they will increasingly develop age-related comorbidities. The objective of this cross-sectional study was to compare in the French Dat'AIDS cohort, the HIV geriatric population, aged 75 years and over, to the elderly one, aged from 50 to 74 years. As of Dec 2015, 16,436 subjects (43.8% of the French Dat'AIDS cohort) were aged from 50 to 74 (elderly group) and 572 subjects (1.5%) were aged 75 and over (geriatric group). Durations of HIV infection and of ART were slightly but significantly different, median at 19 and 18 years, and 15 and 16 years in the elderly and geriatric group, respectively. The geriatric group was more frequently at CDC stage C and had a lower nadir CD4. This group had been more exposed to first generation protease inhibitors and thymidine analogues. Despite similar virologic suppression, type of ART at the last visit significantly differed between the 2 groups: triple ART in 74% versus 68.2%, ART ≥ 4 drugs in 4.7% versus 2.7%; dual therapy in 11.6% versus 16.4% in the elderly group and the geriatric group, respectively. In the geriatric group all co-morbidities were significantly more frequent, except dyslipidemia, 4.3% of the elderly group had ≥4 co-morbidities versus18.4% in the geriatric group. Despite more co-morbidities and more advanced HIV infection the geriatric population achieve similar high rate of virologic suppression than the elderly population. A multidisciplinary approach should be developed to face the incoming challenge of aging HIV population.

Published
2018
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2. Rural vs Urban Crossed Approaches: School and Territory Representations of Pupils at the End of Primary Education. Case Study of Drôme, France

Author

Cécile dos Santos, Thierry May-Carle, and Pierre Champollion

Subjects
Language apprenticeship, Learning territory, Social representation, Rural school, Urban school, Education, Special aspects of education, LC8-6691
Abstract

Learning, trajectories and social representations of pupils at the end of primary school (CM2) have often been the object of territorial analysis, both rural and urban. But, so far, few comparative studies have picked up on this subject. This is what began here: after twice characterizing the education of rural students in CM2 (in 2000 and 2012, in the context of longitudinal studies), in 2014 the Ardèche and Drôme researchers of the Observatory of Education and Territories (OET) proceeded to «survey» CM2 students from three schools-one in a «small town» (Privas), a downtown one in a «big city» (Valencia) and one in a «difficult neighbourhood» in a big city (Valencia once again)-in an attempt to explore and map out the future research that started in the spring of 2015. The very first «results» are presented in this article, which focuses on an ongoing experiment in the field of «educational planning» («didactique du territoire»).

Published
2015
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3. Cancer-Related Causes of Death among HIV-Infected Patients in France in 2010: Evolution since 2000.

Author

Marie-Anne Vandenhende, Caroline Roussillon, Sandrine Henard, Philippe Morlat, Eric Oksenhendler, Hugues Aumaitre, Aurore Georget, Thierry May, Eric Rosenthal, Dominique Salmon, Patrice Cacoub, Dominique Costagliola, Geneviève Chêne, Fabrice Bonnet, and ANRS EN20 Mortalité 2010 study group

Subjects
Medicine, Science
Abstract

ObjectivesThe current study aimed at describing the distribution and characteristics of malignancy related deaths in human immunodeficiency virus (HIV) infected patients in 2010 and at comparing them to those obtained in 2000 and 2005.MethodsData were obtained from three national surveys conducted in France in 2010, 2005 and 2000. The underlying cause of death was documented using a standardized questionnaire fulfilled in French hospital wards involved in the management of HIV infection.ResultsAmong the 728 deaths reported in 2010, 262 were cancer-related (36%). After a significant increase from 28% in 2000 to 33% in 2005 and 36% in 2010, cancers represent the leading cause of mortality in HIV infected patients. The proportion of deaths attributed to non-AIDS/non-hepatitis-related cancers significantly increased from 2000 to 2010 (11% of the deaths in 2000, 17% in 2005 and 22% in 2010, pConclusionsCancer prevention (especially smoking cessation), screening strategies and therapeutic management need to be optimized in HIV-infected patients in order to reduce mortality, particularly in the field of respiratory cancers.

Published
2015
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4. Late Antiretroviral Therapy (ART) Initiation Is Associated with Long-Term Persistence of Systemic Inflammation and Metabolic Abnormalities.

Author

Mathilde Ghislain, Jean-Philippe Bastard, Laurence Meyer, Jacqueline Capeau, Soraya Fellahi, Laurence Gérard, Thierry May, Anne Simon, Corinne Vigouroux, Cécile Goujard, and ANRS-COPANA Cohort Study Group

Subjects
Medicine, Science
Abstract

HIV-induced immunodeficiency is associated with metabolic abnormalities and systemic inflammation. We investigated the effect of antiretroviral therapy (ART) on restoration of insulin sensitivity, markers of immune activation and inflammation.Immunological, metabolic and inflammatory status was assessed at antiretroviral therapy initiation and three years later in 208 patients from the ANRS-COPANA cohort. Patients were compared according to their pre-ART CD4+ cell count (group 1: ≤ 200/mm3, n = 66 vs. group 2: > 200/mm3, n = 142).Median CD4+ cell count increased in both groups after 3 years of successful ART but remained significantly lower in group 1 than in group 2 (404 vs 572 cells/mm3). Triglyceride and insulin levels were higher or tended to be higher in group 1 than in group 2 at ART initiation (median: 1.32 vs 0.97 mmol/l, p = 0.04 and 7.6 vs 6.8 IU, p = 0.09, respectively) and remained higher after three years of ART (1.42 vs 1.16 mmol/L, p = 0.0009 and 8.9 vs 7.2 IU, p = 0.01). After adjustment for individual characteristics and antiretroviral therapy regimens (protease inhibitor (PI), zidovudine), insulin levels remained significantly higher in patients with low baseline CD4+ cell count. Baseline IL-6, sCD14 and sTNFR2 levels were higher in group 1 than in group 2. Most biomarkers of immune activation/inflammation declined during ART, but IL-6 and hsCRP levels remained higher in patients with low baseline CD4+ cell count than in the other patients (median are respectively 1.4 vs 1.1 pg/ml, p = 0.03 and 2.1 vs 1.3 mg/ml, p = 0.07).After three years of successful ART, low pretreatment CD4+ T cell count remained associated with elevated insulin, triglyceride, IL-6 and hsCRP levels. These persistent metabolic and inflammatory abnormalities could contribute to an increased risk of cardiovascular and metabolic disease.

Published
2015
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5. In-Depth Characterization of Full-Length Archived Viral Genomes after Nine Years of Posttreatment HIV Control

Author

Pauline Trémeaux, Frédéric Lemoine, Adeline Mélard, Marine Gousset, Faroudy Boufassa, Sylvie Orr, Valérie Monceaux, Olivier Gascuel, Olivier Lambotte, Laurent Hocqueloux, Asier Saez-Cirion, Christine Rouzioux, Véronique Avettand-Fenoel, Firouzé Bani-Sadr, Maxime Hentzien, Jean-Luc Berger, Isabelle Kmiec, Gilles Pichancourt, Safa Nasri, Gilles Hittinger, Véronique Lambry, Anne-Cécile Beaudrey, Gilles Pialoux, Julie Chas, Christia Palacios, Anne Adda, Jean Paul Viard, Marie-Josée Dulucq, Laurence Weiss, Marina Karmochkine, Mohamed Meghadecha, Dominique Salmon-Ceron, Marie-Pierre Piétri, Philippe Blanche, Jean-Michel Molina, Olivier Taulera, Diane Ponscarme, Jeannine Delgado Bertaut, Djamila Makhloufi, Matthieu Godinot, Valérie Artizzu, Patrick Miailhes, Laurent Cotte, Sophie Pailhes, Anne Conrad, Ludovic Karkowski, Stanislas Ogoudjobi, Yazdan Yazdanpanah, Sophie Matheron, Cindy Godard, Louis Bernard, Frédéric Bastides, Olivier Bourgault, Christine Jacomet, Emilie Goncalves, Pascal Chavanet, Lionel Piroth, Sandrine Gohier, Agnès Meybeck, Thomas Huleux, Pauline Cornavin, Yasmine Debab, David Théron, Thierry Prazuck, Barbara De Dieuleveult, Jean-Pierre Faller, Patricia Eglinger, Pascal Roblot, David Plainchamp, Hugues Aumaître, Martine Malet, Christine Rouger, Gérard Rémy, Melle Kmiec Isabelle, Jean-Luc Delassus, Alain Devidas, Eric Froguel, Sylvie Tassi, Philippe Genet, Juliette Gerbe, Olivier Patey, Richier Laurent, Marie-Christine Drobacheff, Aurélie Proust, Helder Gil, Laurence Gérard, Eric Oksenhendler, Caroline Lascoux, Sylvie Parlier, Frédéric Lucht, Véronique Ronat, Michel Dupon, Hervé Dutronc, Séverine Le Puil, Didier Neau, Patrick Mercié, Philippe Morlat, Sabrina Caldato, Jean-Luc Schmit, Nathalie Decaux, Jean-Pierre Bru, Gaëlle Clavere, Jean-François Delfraissy, Cécile Goujard, Katia Bourdic, Daniel Vittecoq, Claudine Bolliot, Thierry Lambert, Jean-François Bergmann, Maguy Parrinello, Yves Welker, Alain Lafeuillade, Gisèle Philip, Christophe Rapp, Melle Lerondel, Pierre de Truchis, Berthe Huguette, Vincent Jeantils, Fatouma Mchangama, Paul Henri Consigny, Fatima Touam, Sophie le Nagat, Olivier Bouchaud, Patricia Honoré, François Boué, Mariem Raho-Moussa, Jean-Paul Viard, Agnès Cros, Dominique Salmon-Céron, Marie-Pierre Pietri, Lio Collias, David Zucman, Olivier Blétry, Dominique Bornarel, Emmanuel Mortier, Zeng Feng, Jean-Daniel Lelièvre, Christine Katlama, Yasmine Dudoit, Anne Simon, Catherine Lupin, Pierre-Marie Girard, Michèle Pauchard, Sylvie Abel, André Cabié, Pascale Fialaire, Jean-Marie Chennebault, Sami Rehaiem, Luc de Saint Martin, •••• Perfezou, Jean-Charles Duthe, Pierre Weinbreck, Claire Genet, Florence Garnier, Isabelle Poizot-Martin, Olivia Fauche, Alena Ivanova, Patrick Philibert, Mame Penda Sow, Patrick Yeni, Cyndi Godard, François Raffi, Hervé Hüe, Philippe Perré, Pierre Marie Roger, Aline Joulie, Éric Rosenthal, Christian Michelet, Faouzi Souala, Maja Ratajczak, Marialuisa Partisani, Patricia Fischer, Pascale Nau, Pierre Delobel, Florence Balsarin, Marc De Lavaissiere, Renaud Verdon, Philippe Feret, Pascale Leclercq, •••• Gerberon, Agnés Meybeck, Raphaël Biekre, Thierry May, •••• Bouillon, François Caron, David Theron, Marc Gatfosse, Martin Martinot, Anne Pachart, Patrice Poubeau, Catherine Gaud, Agnès Uludag, Philippe Arsac, Lydia Bouaraba, Barbara de Dieulevault, Isabelle De Lacroix Szmania, Laurent Richier, Vincent Daneluzzi, Elisabeth Rouveix, Geneviève Beck-Wirth, Philippe Romand, Laurent Blum, Martine Deschaud, Christophe Michau, Christian Bernard, Florence Salaun, Philippe Muller, Yves Poinsignon, Annie Lepretre, Albert Sotto, •••• Doncesco, Pascale Perfezou, Jean Charles Duthe, Mathilde Aurore Niault, Virginie Mouton-Rioux, Jean-Philippe Talarmin, Jean Charles Duthé, Mathilde Dupont, Stéphane Natur, Hikombo Hitoto, and Ali Mahamadou Ibrahim

Subjects
Microbiology (medical), Infectious Diseases, General Immunology and Microbiology, Ecology, Physiology, Genetics, Cell Biology
Abstract

Most people living with HIV need antiretroviral therapy to control their infection and experience viral relapse in case of treatment interruption, because of viral reservoir (proviruses) persistence. Knowing that proviruses are very diverse and most of them are defective in treated individuals, we aimed to characterize the HIV blood reservoirs of posttreatment controllers (PTCs), rare models of drug-free remission, in comparison with spontaneous controllers and treated individuals.

Published
2023

6. Time to blood culture positivity: An independent predictor of infective endocarditis and mortality in patients with Staphylococcus aureus bacteraemia

Author

V. Le Moing, Sandrine Barbas, Elodie Curlier, Hélène Jean-Pierre, Willem Vanwamel, Damien Fournier, Isabelle Patry, Eric Bellissant, Jacques Reynes, Sandrine Gohier-Treuvelot, François Alla, Catherine Chirouze, Fabienne Le Gac, Catherine Neuwirth, Philippe Géraud, François Goehringer, Christine Selton-Suty, Bruno Hoen, Virginie Sussmuth, Christine Delonca, Nathalie Keil, Catherine Sportouch, Thanh Doco-Lecompte, S. Tubiana, F. Vandenesch, Laetitia Minary, S. Desage, Catherine Leport, Hepher Malela, Cécile Descottes-Genon, Lionel Piroth, Christian Michelet, Pascale Rausch, Matthieu Revest, Bernard Iung, Jerome Etienne, Albert Sotto, Vincent Le Moing, J.-P. Lavigne, Catherine Cornu, Fernando Rivadeneira, Elise Thebault, Nathalie Bedos, Pierre-Yves Donnio, Lucie Vettoretti, Michèle Bes, S. Siméon, Jean-Christophe Eicher, Catherine Lechiche, X. Duval, François Vandenesch, Marie Célard, Pascal Chavanet, Sarah Tubiana, Raymond Ruimy, M.-L. Erpelding, Thierry May, André Pechinot, Nejla Aissa, Emila Ilic Habensus, François Delahaye, C.-A. Gustave, Lorraine Letranchant, Taissia Lelekov-Boissard, C. Chirouze, Anne Tristan, Audrey Coma, Jean-Philippe Lavigne, Xavier Duval, Pierre Tattevin, Alex van Belkum, Pierre Braquet, Marie-Line Erpelding, Pascale Longuet, Malika Hadid, Marie-Christine Greusard, Florence Galtier, Anne Verchère, P. Tattevin, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Maladies Infectieuses [CHU de Montpellier], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), 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), CIC1425 Bichat [AP-HP Hôpital Bichat - Claude Bernard] (INSERM), 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)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Bactériologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Virulence bactérienne et maladies infectieuses (VBMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Microbiologie [CHU Caremeau, Nîmes], Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de référence des Staphylocoques [HCL, Lyon] (Institut des Agents Infectieux), Hospices Civils de Lyon (HCL), Laboratoire de Bactériologie [HCL, Lyon] (Institut des Agents Infectieux), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), ARN régulateurs bactériens et médecine (BRM), 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 ), VIRSTA/AEPEI Study Group. Chirouze C, Curlier E, Descottes-Genon C, Hoen B, Patry I, Vettoretti L, Chavanet P, Eicher JC, Gohier-Treuvelot S, Greusard MC, Neuwirth C, Péchinot A, Piroth L, Célard M, Cornu C, Delahaye F, Hadid M, Rausch P, Coma A, Galtier F, Géraud P, Jean-Pierre H, Le Moing V, Sportouch C, Reynes J, Aissa N, Doco-Lecompte T, Goehringer F, Keil N, Letranchant L, Malela H, May T, Selton-Suty C, Bedos N, Lavigne JP, Lechiche C, Sotto A, Duval X, Habensus EI, Iung B, Leport C, Longuet P, Ruimy R, Bellissant E, Donnio PY, Le Gac F, Michelet C, Revest M, Tattevin P, Thebault E, Alla F, Braquet P, Erpelding ML, Minary L, Tubiana S, Bès M, Etienne J, Lelekov-Boissard T, Tristan A, Vandenesch F, Van Belkum A, Rivadeneira F, Vanwamel W, Barbas S, Delonca C, Sussmuth V, Verchère A., Service des maladies infectieuses et réanimation médicale, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), CHU Caremeau, Nîmes, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Hôpital Jean Minjoz, Centre National de référence des Staphylocoques, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Service des Maladies Infectieuses et Tropicales [Point-à-Pitre, Guadeloupe], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Biologie Laboratoire de Bacteriologie, Laboratoire de Microbiologie Médicale et Moléculaire, Université de Bourgogne (UB), Département d'infectiologie (CHU de Dijon), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), REseau national d'Investigation clinique en VACcinologie (REIVAC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de Gestion des Essais de Produits de Santé (CeNGEPS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Service de Bactériologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Laboratoire universitaire d'antibiologie, Université Montpellier 1 (UM1), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Bichat - Claude Bernard, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie : Risques Infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service des maladies infectieuses, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), CHU Montpellier, Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre National de Reference des Staphylocoques, Université de Lyon, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Laboratoire Chrono-environnement (UMR 6249) (LCE), 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 ), and Jonchère, Laurent

Subjects
Male, Methicillin-Resistant Staphylococcus aureus, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, bacteraemia, medicine.medical_specialty, Time Factors, Multivariate analysis, 030106 microbiology, Bacteremia, Independent predictor, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Blood culture, Prospective Studies, 030212 general & internal medicine, time to blood culture positivity, Prospective cohort study, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, medicine.diagnostic_test, infective endocarditis, business.industry, Endocarditis, Bacterial, General Medicine, Middle Aged, Staphylococcal Infections, respiratory system, medicine.disease, mortality, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Quartile, Blood Culture, Infective endocarditis, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Objectives - Time to blood culture positivity (TTP), a routinely available parameter in automated blood culture systems, may be a proxy for infectious burden in patients with bloodstream infections. We aimed to study the association between TTP and infective endocarditis (IE), or death, in patients with Staphylococcus aureus bacteraemia. Methods - VIRSTA is a multicenter prospective cohort study that included all adult patients with S. aureus bacteraemia in eight university hospitals in France (2009-2011). We analyzed data from four centers which collected data on TTP. Regression models were used to study the association between TTP and definite IE (Duke-Li criteria), and 30 day-mortality. Results - We included 587 patients with S. aureus bacteraemia: mean age was 65.3±16.3 years, 420/587 patients (71.6%) were male, 121/587 (20.6%) died, and 42/587 (7.2%) had definite IE. Median TTP of first positive blood culture was 13.7 h (interquartile range, 9.9-18). On multivariate analysis, 30-day mortality was associated with TTP≤13.7 h (74/295 (25.1%) vs 47/292 (16.1%), P=0.02), as well as old age, McCabe score, methicillin resistance, stroke, pneumonia, and C-Reactive Protein. TTP was also independently associated with IE, but with a U-shape curve: IE was more common in the first (TTP18 h, 8/146, 5.5%) quartiles of TTP, P=0.002. Conclusions - TTP provides reliable information in patients with S. aureus bacteraemia, on the risk of IE, and prognosis, with short TTP being an independent predictor of death. This data readily available at no cost may be used to identify patients who require specific attention.

Published
2019

7. Dolutegravir Monotherapy Versus Dolutegravir/Abacavir/Lamivudine for Virologically Suppressed People Living With Chronic Human Immunodeficiency Virus Infection: The Randomized Noninferiority MONotherapy of TiviCAY Trial

Author

Simon Sunder, Louis Bernard, Mohamadou Niang, Romain Lemarie, Cendrine Boulard, Jean-Luc Esnault, Sabelline Bouchez, Philippe Van de Perre, Aurélie Despujols, Guillaume Gras, David Rey, Eric Billaud, Thomas Guimard, Marie André, Francis Barin, Olivier Bollengier-Stragier, Antoine Valery, Samira Fafi-Kremer, Florian Vivrel, Elisabeth André-Garnier, François Raffi, Gaëlle Thomas, Gwenael Le Moal, Clotilde Allavena, Catherine Mille, Camille Bernaud, Anabele Dos-Santos, Thierry Prazuck, Sandrine Lefeuvre, Marie-Laure Batard, Pascal Le Bret, Pascale Deleplanque, Thierry May, Montasser Ouezzani, Xavier Pouget-Abadie, Adrien Lemaignen, Véronique Reliquet, Mariam Roncato-Saberan, Jean-Jacques Parienti, Evelyne Schvoerer, G. Giraudeau, Sophie Leautez, Nolwenn Hall, Marie Charlotte Hallouin-Bernard, Jérôme Guinard, Laurent Hocqueloux, Véronique Avettand-Fenoel, Karl Stefic, and Frédéric Bastides

Subjects
Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Anti-HIV Agents, Pyridones, 030106 microbiology, Integrase inhibitor, HIV Infections, Piperazines, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Abacavir, Internal medicine, Drug Resistance, Viral, Oxazines, Confidence Intervals, medicine, Humans, Cumulative incidence, 030212 general & internal medicine, Adverse effect, business.industry, Lamivudine, Abacavir/Lamivudine, Middle Aged, Resistance mutation, Dideoxynucleosides, Infectious Diseases, chemistry, Mutation, Dolutegravir, Female, business, Heterocyclic Compounds, 3-Ring, medicine.drug
Abstract

Background We investigated whether dolutegravir (DTG) monotherapy could be used to maintain virological suppression in people living with human immunodeficiency virus (HIV) on a successful dolutegravir-based triple therapy. Methods MONCAY (MONotherapy of TiviCAY) was a 48-week, multicentric, randomized, open-label, 12% noninferiority margin trial. Patients with CD4 nadir >100/μL, plasma HIV-1 RNA 50 copies/mL within 2 weeks apart. Results Seventy-eight patients were assigned to DTG monotherapy and 80 to continue DTG/ABC/3TC. By week 24, 2 patients in the DTG group experienced VF without resistance to the integrase strand transfer inhibitor (INSTI) class; 1 patient discontinued DTG/ABC/3TC due to an adverse event. The success rate at week 24 was 73/78 (93.6%) in the DTG arm and 77/80 (96.3%) in the DTG/ABC/3TC arm (difference, 2.7%; 95% confidence interval [CI], –5.0 to 10.8). During subsequent follow-up, 5 additional VFs occurred in the DTG arm (2 of which harbored emerging resistance mutation to INSTI). The cumulative incidence of VF at week 48 was 9.7% (95% CI, 2.8 to 16.6) in the DTG arm compared with 0% in the DTG/ABC/3TC arm (P = .005 by the log-rank test). The Data Safety Monitoring Board recommended to reintensify the DTG arm with standardized triple therapy. Conclusions Because the risk of VF with resistance increases over time, we recommend avoiding DTG monotherapy as a maintenance strategy among people living with chronic HIV infection. Clinical Trials Registration NCT02596334 and EudraCT 2015-002853-36.

Published
2019

8. Vaccination for influenza and pneumococcus in patients with gastrointestinal cancer or inflammatory bowel disease: A prospective cohort study of methods for improving coverage

Author

Laurent Peyrin-Biroulet, Jean-Pierre Bronowicki, Emilia Frentiu, Julien Sitte, Thierry May, Cédric Baumann, Anthony Lopez, and Hélène Rousseau

Subjects
Adult, Male, medicine.medical_specialty, Influenza vaccine, Inflammatory bowel disease, Cohort Studies, Pneumococcal Vaccines, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Internal medicine, Influenza, Human, medicine, Humans, Outpatient clinic, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Gastrointestinal Neoplasms, Hepatology, business.industry, Vaccination, Gastroenterology, Middle Aged, Inflammatory Bowel Diseases, medicine.disease, Pneumococcal vaccine, Influenza Vaccines, Infectious disease (medical specialty), Female, 030211 gastroenterology & hepatology, business, Cohort study
Abstract

Background Although influenza and pneumococcal vaccinations for high-risk populations are recommended by current guidelines, vaccination coverage is low in patients with gastrointestinal cancer (GC) or inflammatory bowel disease (IBD). Aim To evaluate the impact of a specialised infectious disease consultation on vaccination coverage rates in these patients. Methods Between December 2016 and April 2017, all patients with GC or IBD followed in the outpatient clinic of the Gastroenterology department at the Nancy University Hospital enrolled in a 3-phase vaccination programme. Phase 1: Initial questionnaire (vaccination status, knowledge about vaccines and possible barriers to vaccination); Phase 2: Infectious disease consultation; Phase 3: Subsequent questionnaire (evolution of patients' knowledge about vaccination). Results A total of 366 patients were included (GC = 99, IBD = 267). Vaccination rate was 34.7% for influenza and 14.5% for pneumococcus. About 43% of the patients feared side effects of vaccines. After the initial questionnaire, 49.3% of the interested patients participated in a specialised vaccination consultation (n = 102). 87.3% (n = 89) received new vaccination, 41.2% changed their mind about vaccination, and 92.2% would recommend this programme to other patients. Among vaccinated patients, 97.8% (n = 87) received pneumococcal vaccine, 40.4% received tetanus-diphtheria-polio vaccine, and 7.9% received influenza vaccine. In GC patients, anti-pneumococcal vaccination rate was 87.5% after the specialised consultation compared with 10.1% before. In IBD patients, corresponding rates were 85.7% and 16.1%. Conclusions A specialised infectious disease consultation can improve GC and IBD patients' knowledge about vaccination and vaccination coverage. This approach could be applied to all high-risk populations.

Published
2018

9. Efficacy and safety of varenicline for smoking cessation in people living with HIV in France (ANRS 144 Inter-ACTIV): a randomised controlled phase 3 clinical trial

Author

Patrick Mercié, Julie Arsandaux, Christine Katlama, Samuel Ferret, Aurélie Beuscart, Christian Spadone, Claudine Duvivier, Jacques Reynes, Nathalie Wirth, Laetitia Moinot, Antoine Bénard, David Zucman, Xavier Duval, Jean-Michel Molina, Bruno Spire, Catherine Fagard, Geneviève Chêne, Hélène Allaguy-Salachy, Henri-Jean Aubin, Claudine Bernard-Henry, Claude Beuscart, Anne Borgne, Olivier Bouchaud, Charles Brahmy, Dominique Breilh, André Cabié, Claude Cateland, Antoine Cheret, Sandrine Couffin-Cadiergues, Marie-Dominique Dautzenberg, Pierre Dellamonica, Pascale Denis-Kandel, Christine Denis-Vatant, Michel Detilleux, Michel Dupon, Brigitte El Harrar, Marie Christine Fagnen Sylvaire, Simone Guillermet, Christine Jacomet, Vincent Jeantils, Marek Korzek, Estibaliz Lazaro, Béatrice Le Maitre, Frédéric Lucht, Marianne Maquet, Audrey Mathieu, Thierry May, Sonia Merigeaud, Philippe Morlat, Alissa Naqvi, Didier Neau, Jean Perriot, Sandrine Pierre-François, Isabelle Poizot-Martin, Elisabeth Quoix, Matthieu Rebillard, Caroline Roussillon, Eric Rosenthal, Thierry Sainte-Marie, Dominique Salmon-Céron, Luminita Schneider, Anne Simon, Malika Soussi, Albert Sotto, Anne-Marie Taburet, Elina Teicher, Monique Termote, Valery Trosini-Desert, Renaud Verdon, Jean-Paul Viard, Daniel Vittecoq, Muriel Vray, David Youssi, Service de Médecine Interne et Immunologie Clinique [CHU Bordeaux] (Pôle Médecine Interne), CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [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), Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d’information Médicale [CHU de Bordeaux] (Pôle de Santé Publique), Service de Médecine Interne [Hôpital Foch, Suresnes] (SMI), Hôpital Foch [Suresnes], CIC Bichat [AP-HP, Hôpital Bichat-Claude-Bernard] (CIC 1425 Inserm), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], 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), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANRS 144 Inter-ACTIV study group : Allaguy-Salachy H, Arsandaux J, Aubin HJ, Bénard A, Bernard-Henry C, Beuscart A, Beuscart C, Borgne A, Bouchaud O, Brahmy C, Breilh D, Cabié A, Cateland C, Chêne G, Cheret A, Couffin-Cadiergues S, Dautzenberg MD, Dellamonica P, Denis-Kandel P, Denis-Vatant C, Detilleux M, Dupon M, Duval X, Duvivier C, El Harrar B, Fagard C, Fagnen Sylvaire MC, Ferret S, Guillermet S, Jacomet C, Jeantils V, Katlama C, Korzek M, Lazaro E, Le Maitre B, Lucht F, Maquet M, Mathieu A, May T, Mercié P, Merigeaud S, Moinot L, Molina JM, Morlat P, Naqvi A, Neau D, Perriot J, Pierre-François S, Poizot-Martin I, Quoix E, Rebillard M, Reynes J, Roussillon C, Rosenthal E, Sainte-Marie T, Salmon-Céron D, Schneider L, Simon A, Soussi M, Sotto A, Spadone C, Spire B, Taburet AM, Teicher E, Termote M, Trosini-Desert V, Verdon R, Viard JP, Vittecoq D, Vray M, Wirth N, Youssi D, Zucman D., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), 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), Service de 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), and Dupuis, Christine

Subjects
Adult, Counseling, Male, medicine.medical_specialty, Epidemiology, medicine.medical_treatment, Immunology, Population, HIV Infections, Placebo, Drug Administration Schedule, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, law, Virology, Internal medicine, medicine, Humans, Nicotinic Agonists, 030212 general & internal medicine, education, Varenicline, education.field_of_study, 030505 public health, business.industry, Incidence (epidemiology), Smoking, Odds ratio, Middle Aged, 3. Good health, Clinical trial, Treatment Outcome, Infectious Diseases, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Smoking cessation, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, 0305 other medical science, business
Abstract

International audience; BACKGROUND:Tobacco smoking is common in people living with HIV, but high-quality evidence on interventions for smoking cessation is not available in this population. We aimed to assess the efficacy and safety of varenicline with counselling to aid smoking cessation in people living with HIV.METHODS:The ANRS 144 Inter-ACTIV randomised, parallel, double-blind, multicentre, placebo-controlled phase 3 trial was done at 30 clinical hospital sites in France. People living with HIV who had smoked at least ten cigarettes per day for 1 year or longer, were motivated to stop smoking, were not dependent on another psychoactive substance, and had no history of depression or suicide attempt were eligible. Using a computer-generated randomisation sequence, we allocated (1:1) the patients to receive either varenicline titrated to two 0·5 mg doses twice daily or placebo twice daily for 12 weeks, plus face-to-face counselling. Patients and investigators were masked to treatment group allocation. Patients who were not abstinent at week 24 were offered open-label varenicline for 12 additional weeks. The primary outcome was the proportion of smokers continuously abstinent from week 9 to week 48. Smoking status was confirmed by carbon monoxide in exhaled air. Primary analyses were done in both the intention-to-treat (ITT) population and modified ITT (mITT) population, which comprised all patients who took at least one tablet of their assigned study treatment. The safety analyses were done in the mITT population. The trial is registered at ClinicalTrials.gov, number NCT00918307. The trial status is complete.FINDINGS:From Oct 26, 2009, to Dec 20, 2012, of 303 patients assessed for eligibility, 248 patients were randomly assigned to the varenicline group (n=123) or the placebo group (n=125). After randomisation, one participant initially assigned to the placebo group was excluded from the ITT analysis for a regulatory reason (no French health-care coverage). 102 patients in the varenicline group and 111 patients in the placebo group received at least one dose of their assigned treatment and were included in the mITT analysis. In the ITT analysis, varenicline was associated with a higher proportion of patients achieving continuous abstinence over the study period (week 9-48): 18 (15%, 95% CI 8-21) of 123 in the varenicline group versus eight (6%, 2-11) of 124 in the placebo group, adjusted odds ratio (OR) 2·5 (95% CI 1·0-6·1; p=0·041). In the mITT analysis, varenicline was also associated with higher continuous abstinence: 18 (18%, 95% CI 10-25) of 102 versus eight (7%, 2-12) of 111 in the placebo group (adjusted OR 2·7, 95% CI 1·1-6·5; p=0·029). The incidence of depression was 2·4 per 100 person-years (95% CI 0·6-9·5; two [2%] of 102) in the varenicline group and 12·4 per 100 person-years (95% CI 6·9-22·5; 11 [10%] of 111) in the placebo group. 14 (7%) of 213 participants had 18 cardiovascular events: six (6%) of 102 people in the varenicline group and eight (7%) of 111 people in the placebo group.INTERPRETATION:Varenicline is safe and efficacious for smoking cessation in people living with HIV and should be recommended as the standard of care.FUNDING:The French National Institute for Health and Medical Research (INSERM)-French National Agency for Research on AIDS and Viral Hepatitis (ANRS) and Pfizer.

Published
2018

11. Treatment as prevention enrolling at least 75% of individuals on ART will be needed to significantly reduce HIV prevalence in a HIV cohort

Author

Jean-Philippe Lanoix, Marialuisa Partisani, John M. Murray, Eliette Jeanmaire, Hélène Jeulin, Evelyne Schvoerer, Brice Malve, Laurent Hustache-Mathieu, Hugues Melliez, Marie André, Thierry May, François Goehringer, Service de Virologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement (LCPME), Institut de Chimie du CNRS (INC)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], School of Mathematics and Statistics, University of New South Wales [Sydney] (UNSW), Cancer Council New South Wales (Cancer Council NSW), Service des Maladies Infectieuses et Tropicales [Hôpital Gustave Dron, Tourcoing], Centre Hospitalier Gustave Dron [Tourcoing], Pathologies infectieuses et tropicales [CHU Amiens], CHU Amiens-Picardie, service de maladies infectieuses CHU J Minjoz Besancon, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], and CHU Strasbourg

Subjects
0301 basic medicine, Adult, Male, Unprotected Sexual Intercourse, 030106 microbiology, Human immunodeficiency virus (HIV), Emigrants and Immigrants, HIV Infections, medicine.disease_cause, Cohort Studies, 03 medical and health sciences, Treatment status, Young Adult, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Prevalence, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, ComputingMilieux_MISCELLANEOUS, Sex Characteristics, Unsafe Sex, business.industry, Transmission (medicine), virus diseases, Middle Aged, Models, Theoretical, Treatment as prevention, Hiv prevalence, Antiretroviral therapy, 3. Good health, Infectious Diseases, Anti-Retroviral Agents, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, France, Patient Participation, business, Demography
Abstract

"Treatment as Prevention" (TasP) aims to reduce new HIV infections through higher enrolment on suppressive antiretroviral therapy (ART).We studied the current epidemic and possible impact of TasP in a French HIV cohort including MSM and migrant subjects.Socio-demographic, clinical and laboratory variables were collected during the follow-up of 6995 HIV-infected patients. The numbers of individuals living with HIV in each year were estimated from diagnoses up to that year minus recorded deaths. Patients were classified according to gender, transmission mode, country of birth and treatment status.The cohort includes 6995 individuals diagnosed from 1985 to 2015, of whom 72% were men. Unprotected sexual intercourse was the main mode of transmission. Women were more likely to be migrants (45% versus 13%), whereas men were more likely to have been born in France (52% versus 27%). Diagnoses were more correlated with untreated than treated prevalence in each group. MSM diagnoses was strongly correlated to untreated prevalence whatever the country of birth (p 0.0001). However, heterosexual diagnoses were better correlated with prevalence within individual country groups (b = 0.29 female diagnoses/year per untreated male born in France, compared to b = 0.73 for foreigners). Using these transmission rates, mathematical modelling estimated that enrolling 75% of untreated individuals per year would decrease diagnoses ten-fold by 2021.Enrolling at least 75% of individuals on ART is necessary to substantially impact numbers of new HIV infections in this cohort. Treatment as prevention will actually be effective to reduce HIV prevalence.

Published
2019

12. A case report of Guillain Barré syndrome revealing underlying infective endocarditis due to Cardiobacterium hominis

Author

Corentine Alauzet, François Goehringer, Kévin Diallo, Isabelle Beguinot, Christine Selton-Suty, Caroline Jacquet, Thierry May, Bruno Hoen, Stress, Immunité, Pathogènes (SIMPA), and Université de Lorraine (UL)

Subjects
Aortic valve, Male, medicine.medical_specialty, Cardiobacterium, Guillain-Barre Syndrome, blood culture, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, medicine, Endocarditis, Humans, 030212 general & internal medicine, Clinical Case Report, biology, Guillain-Barre syndrome, business.industry, infective endocarditis, Polyradiculoneuropathy, General Medicine, Endocarditis, Bacterial, Middle Aged, medicine.disease, biology.organism_classification, Guillain-Barré syndrome, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Infective endocarditis, Cardiobacterium hominis, business, Gram-Negative Bacterial Infections, Research Article
Abstract

International audience; Rationale: Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy presumed to result from an infection-triggered autoimmune reaction. Patient concerns: This paper describes a 53-year-old man admitted to hospital for deterioration of his general condition. Diagnosis: He developed GBS, confirmed by lumbar puncture and electromyogram, which recovered after intravenous immunoglobulins. A grade 2 aortic regurgitation was detected by transthoracic echocardiography upon diagnosis of GBS, but in the absence of fever, no further investigations were conducted. A few weeks later, the patient presented with fever and infective endocarditis (IE) was diagnosed after the identification of vegetation on the aortic valve with transesophageal echocardiography. The etiologic agent was identified as Cardiobacterium hominis based on 3 positive blood cultures and DNA detection in valvular material. Interventions: IE was cured with a 6-week course of antibiotics and aortic valve replacement. Outcomes: The patient completely recovered from Guillain-Baré syndrome and IE. Lessons: This case of GBS associated with C hominis endocarditis, emphasizes the importance of blood cultures and transesophageal echocardiography for the detection of IE and highlights the insidious nature of C hominis endocarditis which is often diagnosed late. Abbreviations: GBS = Guillain-Barré syndrome, IE = infective endocarditis.

Published
2019

13. Factors associated with influenza vaccination of general medicine interns in Nancy, France, in 2017

Author

Céline Pulcini, Nathalie Thilly, Clémence Cordonnier, Cossi Angelo Attinsounon, Thierry May, Paolo Di-Patrizio, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Parakou (UP), Département de médecine générale [Univ. Lorraine], Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), and Service des Maladies Infectieuses et Tropicales [CHRU Nancy]

Subjects
Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Vaccination Coverage, Multivariate analysis, Influenza vaccination status, Health Personnel, General Practice, 030106 microbiology, Health Services Accessibility, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Influenza, Human, medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Health professionals, business.industry, Vaccination, Internship and Residency, General Medicine, 3. Good health, Cross-Sectional Studies, Infectious Diseases, Vaccination Campaigns, Influenza Vaccines, Infectious disease (medical specialty), Health Care Surveys, Vaccination coverage, Family medicine, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Seasons, business
Abstract

Winter flu is an epidemic infectious disease which sometimes causes serious complications in vulnerable people treated in general practice. Currently, the most effective means of prevention is influenza vaccination, which is recommended for healthcare professionals, including general medicine interns. The target of 75% coverage set by WHO for healthcare professional is rarely reached. Our survey provides an assessment of reported influenza vaccination of general medicine interns (GMI) and evaluates factors influencing their vaccination status. A cross-sectional survey was conducted from 27 September to 2 November 2017 in the Faculty of Medicine at the University of Lorraine in France. An anonymous self-administered questionnaire was distributed electronically (SurveyMonkey software) to all GMI. It collected data on their vaccination status and on levers and barriers to influenza vaccination. The data were analysed using SAS 9.4 software. Multivariate analysis helped identify factors associated with their influenza vaccination status. Of the 595 GMI invited, 269 participated in the survey, with a response rate of 45.2%. During the 2015, 2016, and 2017 winters, overall self-declared vaccine coverage was 37.9, 49.4, and 56.5%, respectively. Being at the end of training (p = 0.008, OR = 3.2), the presence of a mobile vaccination team (p = 0.019, OR = 3.1), and recommending vaccination to one’s relatives and friends (p

Published
2019

14. Francisella tularensis endocarditis: two case reports and a literature review

Author

Céline Pulcini, François Goehringer, Christine Selton-Suty, Rostane Gaci, Alain Lozniewski, Thierry May, Corentine Alauzet, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), and Université de Lorraine (UL)

Subjects
Adult, Male, 0301 basic medicine, Microbiology (medical), 030106 microbiology, review, Microbiology, Tularemia, 03 medical and health sciences, 0302 clinical medicine, Possible diagnosis, medicine, Humans, Endocarditis, 030212 general & internal medicine, Francisella tularensis, ComputingMilieux_MISCELLANEOUS, Aged, General Immunology and Microbiology, biology, business.industry, General Medicine, Middle Aged, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Virology, 3. Good health, Europe, Infectious Diseases, Infective endocarditis, endocarditis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

We report the first two cases of infective endocarditis caused by Francisella tularensis in Europe (two cases have previously been reported outside Europe). We suggest clinicians should consider tularemia as a possible diagnosis in endemic regions in cases of culture-negative endocarditis.

Published
2016

15. Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

Author

Amandine Gagneux-Brunon, Firouzé Bani-Sadr, Claudine Duvivier, François Raffi, Dominique Merrien, Pierre Delobel, David Rey, André Cabié, Clotilde Allavena, Christine Katlama, Isabelle Poizot-Martin, Pascal Pugliese, Thierry May, Jacques Reynes, Christian Chidiac, Catherine Chirouze, Matthieu Hanf, Véronique Joly, T. Huleux, Nathalie Dournon, Christine Jacomet, Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes (Hôpital Hôtel-Dieu de Nantes - CHU de Nantes), CeGIDD [Strasbourg], Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [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 de Reims Champagne-Ardenne (URCA), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Clermont-Ferrand, Centre Hospitalier Universitaire de l’Archet, Hôpital Universitaire de Toulouse, CHU Pitié-Salpêtrière [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 Claude Bernard Lyon 1 (UCBL), Université de Lyon, Université des Antilles - UFR des sciences médicales Hyacinthe Bastaraud (UA UFR SM), Université des Antilles (UA), CHD Vendee (La Roche Sur Yon), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Université de Saint-Etienne, Université de Besançon, Hôpital de Tourcoing, Université des Antilles (Pôle Martinique), Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, Département de Pédiatrie et maladies infectieuses [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Centre Hospitalier Universitaire de Reims (CHU Reims), Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Service des Maladies Infectieuses et Tropicales [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Maladies Infectieuses [Nice], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université Jean Monnet - Saint-Étienne (UJM), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and DUFOUR, Jean-Charles

Subjects
0301 basic medicine, RNA viruses, Male, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), lcsh:Medicine, Comorbidity, medicine.disease_cause, Pathology and Laboratory Medicine, Cohort Studies, 0302 clinical medicine, Elderly, Immunodeficiency Viruses, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Geriatric psychiatry, Medicine and Health Sciences, Medicine, Public and Occupational Health, 030212 general & internal medicine, Stage (cooking), lcsh:Science, ComputingMilieux_MISCELLANEOUS, Geriatrics, Aged, 80 and over, education.field_of_study, Multidisciplinary, Depression, Age Factors, HIV diagnosis and management, Middle Aged, Vaccination and Immunization, 3. Good health, Antiretroviral therapy, [SDV] Life Sciences [q-bio], [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Medical Microbiology, Cardiovascular Diseases, Viral Pathogens, Cohort, Viruses, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Infectious diseases, Female, France, Pathogens, Research Article, HIV infections, medicine.medical_specialty, Anti-HIV Agents, 030106 microbiology, Population, Immunology, Viral diseases, Microbiology, Diabetes Complications, 03 medical and health sciences, Antiviral Therapy, Internal medicine, Mental Health and Psychiatry, Retroviruses, Humans, Geriatric depression, Renal Insufficiency, Chronic, education, Microbial Pathogens, Aged, business.industry, Mood Disorders, Lentivirus, lcsh:R, Organisms, Biology and Life Sciences, HIV, medicine.disease, Diagnostic medicine, CD4 Lymphocyte Count, Cross-Sectional Studies, Age Groups, People and Places, HIV-2, HIV-1, Population Groupings, lcsh:Q, Preventive Medicine, business, Dyslipidemia, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; As HIV-infected adults on successful antiretroviral therapy (ART) are expected to have close to normal lifespans, they will increasingly develop age-related comorbidities. The objective of this cross-sectional study was to compare in the French Dat’AIDS cohort, the HIV geriatric population, aged 75 years and over, to the elderly one, aged from 50 to 74 years. As of Dec 2015, 16,436 subjects (43.8% of the French Dat’AIDS cohort) were aged from 50 to 74 (elderly group) and 572 subjects (1.5%) were aged 75 and over (geriatric group). Durations of HIV infection and of ART were slightly but significantly different, median at 19 and 18 years, and 15 and 16 years in the elderly and geriatric group, respectively. The geriatric group was more frequently at CDC stage C and had a lower nadir CD4. This group had been more exposed to first generation protease inhibitors and thymidine analogues. Despite similar virologic suppression, type of ART at the last visit significantly differed between the 2 groups: triple ART in 74% versus 68.2%, ART ≥ 4 drugs in 4.7% versus 2.7%; dual therapy in 11.6% versus 16.4% in the elderly group and the geriatric group, respectively. In the geriatric group all co-morbidities were significantly more frequent, except dyslipidemia, 4.3% of the elderly group had ≥4 co-morbidities versus18.4% in the geriatric group. Despite more co-morbidities and more advanced HIV infection the geriatric population achieve similar high rate of virologic suppression than the elderly population. A multidisciplinary approach should be developed to face the incoming challenge of aging HIV population.

Published
2018

16. Impact of baseline plasma HIV-1 RNA and time to virological suppression on virological rebound according to first-line antiretroviral regimen

Author

Clotilde Allavena, Jacques Reynes, Pierre Delobel, Isabelle Poizot-Martin, Tristan Ferry, Pascal Pugliese, Bruno Hoen, Isabelle Ravaux, Marine Morrier, L. Khatchatourian, Firouzé Bani-Sadr, Amandine Gagneux-Brunon, Olivier Robineau, Matthieu Hanf, Véronique Joly, Christine Katlama, Catherine Chirouze, André Cabié, Thierry May, Christine Jacomet, François Raffi, David Rey, Claudine Duvivier, Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Services de Maladies Infectieuses et Tropicales [CHU Bichat], 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), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), 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), Service de Maladies Infectieuses [Nice], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Services des maladies infectieuses [Tourcoing], Centre Hospitalier de Tourcoing, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses [Clermont-Ferrand], CHU Clermont-Ferrand, Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'immuno-hématologie clinique (CISIH), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Service des maladies infectieuses [Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg], CHU Strasbourg, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Reims (CHU Reims), Service des Maladies Infectieuses et Tropicales [Point-à-Pitre], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service des maladies infectieuses [La Roche sur Yon], Centre hospitalier universitaire de Tlemcen (Algérie) (CHU de Tlemcen), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre d’Investigation Clinique de Nantes ( CIC Nantes ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses ( B2PHI ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), 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 ), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales[Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de physiopathologie de Toulouse Purpan ( CPTP ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] ( SMIT ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre d'infectiologie Necker-Pasteur, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) ( EA 7327 ), Université Paris Descartes - Paris 5 ( UPD5 ), CHU Saint-Etienne, Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre Hospitalier Universitaire de Reims ( CHU Reims ), Centre d'Investigation Clinique Antilles-Guyane ( CIC - Antilles Guyane ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre hospitalier universitaire de Tlemcen (Algérie) ( CHU de Tlemcen ), CHU de la Martinique-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Service des maladies infectieuses et tropicales [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), and CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA)

Subjects
Male, 0301 basic medicine, Time Factors, Sustained Virologic Response, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Integrase inhibitor, HIV Infections, Plasma, chemistry.chemical_compound, 0302 clinical medicine, Recurrence, immune system diseases, Antiretroviral Therapy, Highly Active, Medicine, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, 80 and over, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Viral Load, 3. Good health, Infectious Diseases, RNA, Viral, Female, Viral load, Adult, Microbiology (medical), Efavirenz, Adolescent, Anti-HIV Agents, 030106 microbiology, Young Adult, 03 medical and health sciences, Humans, Protease inhibitor (pharmacology), Aged, Pharmacology, Protease, business.industry, Virology, Reverse transcriptase, Regimen, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Follow-Up Studies
Abstract

Objectives: We investigated the risk of virological rebound in HIV-1-infected patients achieving virological suppression on first-line combined ART (cART) according to baseline HIV-1 RNA, time to virological suppression and type of regimen. Patients and methods: Subjects were 10836 adults who initiated first-line cART (two nucleoside or nucleotide reverse transcriptase inhibitors!efavirenz, a ritonavir-boosted protease inhibitor or an integrase inhibitor) from 1 January 2007 to 31 December 2014. Cox proportional hazards models with multiple adjustment and propensity score matching were used to investigate the effect of baseline HIV-1 RNA and time to virological suppression on the occurrence of virological rebound. Results: During 411436 patient-months of follow-up, risk of virological rebound was higher in patients with baseline HIV-1 RNA 100000 copies/mL versus ,100000 copies/mL, in those achieving virological suppression in.6months versus ,6months, and lower with efavirenz or integrase inhibitors than with ritonavir-boosted protease inhibitors. Baseline HIV-1 RNA .100000 copies/mL was associated with virological rebound for ritonavir-boosted protease inhibitors but not for efavirenz or integrase inhibitors. Time to virological suppression .6months was strongly associated with virological rebound for all regimens. Conclusions: In HIV-1-infected patients starting cART, risk of virological rebound was lower with efavirenz or integrase inhibitors than with ritonavir-boosted protease inhibitors. These data, from a very large observational cohort, in addition to the more rapid initial virological suppression obtained with integrase inhibitors, reinforce the positioning of this class as the preferred one for first-line therapy.

Published
2017

17. The variability of hepatitis B envelope is associated with HBs antigen persistence in either chronic or acute HBV genotype A infection

Author

M. Bensenane, Thierry May, Honorine Fenaux, Fabien Zoulim, Evelyne Schvoerer, Brice Malve, Jean-Pierre Bronowicki, François Goehringer, Sibel Berger, Aurélie Velay, Hélène Jeulin, Jean-Pol Frippiat, Marine Eschlimann, Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Virology Laboratory, General Hospital Papageorgiou, Virus des hépatites et pathologies associées, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Service de Virologie [CHRU Nancy]

Subjects
0301 basic medicine, Adult, Male, Antigenicity, HBsAg, Hepatitis B virus, Genotype, HIV Infections, medicine.disease_cause, Persistence (computer science), Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Viral Envelope Proteins, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, medicine, Humans, ComputingMilieux_MISCELLANEOUS, Aged, Sequence Deletion, Mutation, Hepatitis B Surface Antigens, business.industry, Coinfection, Haplotype, virus diseases, Hepatitis B, Middle Aged, Viral Load, medicine.disease, digestive system diseases, 3. Good health, Chronic infection, 030104 developmental biology, Infectious Diseases, Immunology, DNA, Viral, 030211 gastroenterology & hepatology, business
Abstract

Background More than 240 million people are chronically infected by hepatitis B virus (HBV) worldwide. Envelope proteins play a crucial role in viral cellular entry and immune recognition. The loss of HBs antigen (HBsAg) correlated with a good clinical prognosis is rarely achieved with or without treatment (3–16%). Objectives HBV envelope variability was investigated according to HBsAg persistence. Study design The cohort consisted of 15 HBV genotype A-infected patients divided into “resolvers”, with HBsAg clearance, and “non-resolvers”, with HBsAg persistence and in subgroups: acute (n = 5, AHBV) or chronic infection (n = 4, CHBV) and HBV/HIV coinfection (n = 6, CHBV/HIV). HBV S and preS sequences were studied by direct and ultra-deep sequencing. Amino acid sequences were analyzed with bioinformatics for predicted antigenicity. Results In S gene, the complexity was lower in AHBV than in chronic-infected patients (p = 0.046). Major mutations, detected using direct sequencing, were more frequent in AHBV developing chronicity (p = 0.01) than in AHBV resolvers. In the Major Hydrophilic Region, more frequent mutations were observed in non-resolvers versus resolvers (p = 0.047) and non-resolvers tended to have more haplotypes with a reduced predicted antigenicity (p = 0.07). Most of the mutations in preS/S region were found rather in epitopic than in non-epitopic areas (p = 0.025). Interestingly, the mutation sY161F found in 3/8 non-resolvers was associated with a decrease in predicted antigenicity (28%; AnTheProt). Conclusions HBsAg persistence was correlated with mutations and deletions in areas playing a key role in immune recognition. These data suggest that variability in HBV envelope could favor immune escape in various clinical settings of HBV genotype A-infected patients.

Published
2017

18. Impact of deletions and mutations in Hepatitis B virus envelope proteins on serological profile and clinical evolution

Author

Marine Eschlimann, Hélène Jeulin, Shaunagh Galgey, Honorine Fenaux, Thierry May, Evelyne Schvoerer, Christian Rabaud, Fabien Zoulim, Brice Malve, François Goehringer, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], and Service de Virologie [CHRU Nancy]

Subjects
0301 basic medicine, Adult, Male, Cancer Research, HBsAg, Hepatitis B virus, Epitopes, T-Lymphocyte, Biology, medicine.disease_cause, Epitope, Hepatitis B virus PRE beta, Evolution, Molecular, 03 medical and health sciences, 0302 clinical medicine, Hepatitis B, Chronic, Antigen, Viral envelope, Viral entry, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, medicine, Humans, Selection, Genetic, Sequence Deletion, chemistry.chemical_classification, Hepatitis B Surface Antigens, Virulence, Middle Aged, 3. Good health, 030104 developmental biology, Infectious Diseases, chemistry, Immunology, Mutation, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Epitopes, B-Lymphocyte, 030211 gastroenterology & hepatology, Glycoprotein
Abstract

International audience; The Hepatitis B virus (HBV) envelope glycoproteins are essential for viral entry into the hepatocyte and are also targets for host immune response. The study of these proteins could allow us to highlight molecular hot points influencing HBV fitness, which would subsequently modify the clinical evolution of the disease, both under anti-viral therapy or without treatment. The present short communication underlines the importance of the high variability in HBV envelope proteins, in regard with the literature and in our hands, for HBV-infected patients either on anti-HBV treatment or not. We report mutations in antigenic areas of S protein, i.e. CD8+/CD4+ T-cell epitopes and B-cell epitopes in the major hydrophilic region (MHR), such as sI126N and sG145R possibly involved in the rare coexisting Hepatitis B surface Antigen (HBsAg)/anti-HBs serological pattern. We mostly report serial mutations in preS region including preS1 deletion (aa 1-6, 31-71, 38-73, 72-104) and preS2 deletion (aa132-141) in patients with various clinical evolutions. Some of these viral envelope mutations, due to immune selection pressure, may result in a worsening of the hepatic disease.

Published
2017

19. Evaluation of effects of an operational multidisciplinary team on antibiotic use in the medium to long term at a French university hospital

Author

Sibylle Bevilacqua, Béatrice Demoré, Thierry May, Isabelle Clerc-Urmès, Emmanuelle Boschetti, Pauline Humbert, Céline Pulcini, Nathalie Thilly, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Faculté de Pharmacie [Nancy], Université de Lorraine (UL), Structure et Réactivité des Systèmes Moléculaires Complexes (SRSMC), Institut de Chimie du CNRS (INC)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], ESPRI-Biobase [CHRU Nancy] (Unité fonctionnelle de la plateforme d’aide à la recherche clinique), Relations Hôte-Environnement (RHEM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, and Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, medicine.medical_specialty, Pediatrics, Time Factors, Consumption, 030106 microbiology, Pharmaceutical Science, Pharmacy, Intervention, Toxicology, Disease cluster, 030226 pharmacology & pharmacy, Drug Prescriptions, law.invention, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Multidisciplinary approach, law, Antibiotics, Intervention (counseling), Drug Resistance, Bacterial, Medicine, Cluster Analysis, Humans, Pharmacology (medical), Pharmacology, Patient Care Team, business.industry, Public health, Multidisciplinary team, University hospital, Drug Utilization, 3. Good health, Term (time), Anti-Bacterial Agents, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Antimicrobial stewardship intervention, business, DDD
Abstract

International audience; Background Antibiotic-resistant bacteria are a major public health problem throughout the world. In 2006, in accordance with the national guidelines for antibiotic use, the CHRU of Nancy created an operational multidisciplinary antibiotic team at one of its sites. In 2011, a cluster-controlled trial showed that the operational multidisciplinary antibiotic team (the intervention) had a favourable short-term effect on antibiotic use and costs. Objective Our objective was to determine whether these effects continued over the medium to long term (that is, 2–7 years after creation of the operational multidisciplinary antibiotic team, 2009–2014). Setting The 1800-bed University Hospital of Nancy (France). Method The effect in the medium to long term is measured according to the same criteria and assessed by the same methods as the first study. A cluster controlled trial was performed on the period 2009–2014. The intervention group comprised 11 medical and surgical wards in settings where the operational multidisciplinary antibiotic team was implemented and the control group comprised 6 wards without this operational team. Main outcome measure Consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1000 patient-days) and costs savings (in €). Results The reduction in antibiotic use and costs continued, but at a lower rate than in the short term (11% between 2009 and 2014 compared with 33% between 2007 and 2009) at the site of the intervention. The principal decreases concerned fluoroquinolones and glycopeptides. At the site without an operational multidisciplinary antibiotic team (the control group), total antibiotic use remained stable. Between 2009 and 2014, costs fell 10.5% in the intervention group and 5.7% in the control group. Conclusion This study shows that it is possible to maintain the effectiveness over time of such an intervention and demonstrates its role in defining a hospital’s antibiotic policy.

Published
2017

20. Causes of death among HIV-infected patients in France in 2010 (national survey)

Author

Marie Chauveau, Caroline Roussillon, Geneviève Chêne, Thierry May, Dominique Salmon, Albertine Aouba, Bilghissa Diallo, Fabrice Bonnet, Eric Rosenthal, Sandrine Henard, Philippe Morlat, Patrice Cacoub, Dominique Costagliola, and Aurore Georget

Subjects
Adult, Male, medicine.medical_specialty, Hepatitis C virus, medicine.medical_treatment, Immunology, MEDLINE, HIV Infections, medicine.disease_cause, Malignancy, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Interquartile range, Cause of Death, Internal medicine, medicine, Humans, Immunology and Allergy, Hiv infected patients, Hepatitis B virus, Acquired Immunodeficiency Syndrome, business.industry, Middle Aged, Hepatitis B, medicine.disease, Hepatitis C, Infectious Diseases, Smoking cessation, Female, France, business
Abstract

Objective The Mortalite 2010 survey aimed at describing the causes of death among HIV-infected patients in France in 2010 and their evolution since 2000. Design and methods A national sample of clinical sites, providing HIV care and treatment, notified and documented deaths using a standardized questionnaire. Results The 90 participating wards notified 728 deaths. Median age at death was 50 years (interquartile range 45-58) and 75% were men. The main underlying causes of death were AIDS-related (25% in 2010 vs. 36% in 2005 and 47% in 2000), non-AIDS non-viral hepatitis-related malignancy (22 vs. 17 and 11%), liver-related (11 vs. 15 and 13%), cardiovascular diseases (10 vs. 8 and 7%) and non-AIDS-related infections (9 vs. 4 and 7%). Malignancies (AIDS and non-AIDS-related) accounted for a third of all causes of death. AIDS accounted for 33% of all causes of death among patients mono-infected with HIV vs. only 13% among those co-infected with hepatitis B virus or hepatitis C virus. Conclusion In 2010, 25% of the causes of death among HIV-infected patients remained AIDS-related. Improved screening and earlier HIV treatment should lead to a smaller proportion of deaths due to AIDS. The majority of patients died of various causes, whereas their HIV infection was well controlled under treatment. Improving case management of HIV-infected patients should include a multidisciplinary approach (prevention, screening, treatment), especially in oncology. Smoking cessation should be a priority goal.

Published
2014

21. Causes of Death in HIV-Infected Individuals with Immunovirologic Success in a National Prospective Survey

Author

Aissatou Paye, Dominique Salmon, Philippe Morlat, François Goehringer, Thierry May, Patrice Cacoub, Fabrice Bonnet, and Geneviève Chêne

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Sustained Virologic Response, Anti-HIV Agents, Immunology, HIV Infections, Disease, Malignancy, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Immune Reconstitution, Virology, Internal medicine, Cause of Death, Epidemiology, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Cause of death, Aged, business.industry, Middle Aged, medicine.disease, 030112 virology, Comorbidity, Infectious Diseases, Cohort, Observational study, Female, Medical emergency, France, business
Abstract

This prospective multi-center observational survey describes causes of death and their trends from 2000 to 2010 among treated HIV-infected patients with immunovirologic success (PIVS) in France. In 90 clinical sites providing HIV care and treatment, representing a cohort of 82,000 patients in 2010, the underlying causes of death and characteristics of deceased patients were prospectively recorded in 2000, 2005, and 2010 by using a standardized form. We provide data on PIVS, define as patients with a CD4+ T cell value above 500/mm3 and a plasma HIV-1 RNA below 50 copies/ml at their last periodic checkup before death, compare them with immunovirologic uncontrolled patients, and describe trends in these data from 2000 onward. The main underlying causes of death of the 120 PIVS recorded in 2010 were: a non-AIDS/nonviral hepatitis-related malignancy (19%), suicide (12.5%), cardiovascular disease (11.5%), and liver disease (11%). Only three PIVS died of an AIDS-related event. Socioeconomic difficulty was identified in 41% of PIVS in 2010. This percentage had constantly grown since 2000 (p .001). Median age at death also increased (40, 46, and 52 years in 2000, 2005, and 2010, respectively; p .001). The distribution of the main causes of death of PIVS was statistically different from that of uncontrolled patients (p .001). Although immunovirologic control is fundamental, a parallel multidisciplinary approach to care is essential to accurately detect and treat comorbidities, particularly cancer, psychiatric disorders, and cardiovascular disease. Psychosocial aspects must be considered.

Published
2016

22. Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study

Author

P. Braquet, F. Alla, C. Cornu, F. Goehringer, L. Piroth, C. Chirouze, M. Revest, C. Lechiche, X. Duval, V. Le Moing, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Bruno Hoen, Isabelle Patry, Lucie Vettoretti, Pascal Chavanet, Jean-Christophe Eicher, Marie-Christine Greusard, Catherine Neuwirth, André Péchinot, Lionel Piroth, Marie Célard, Catherine Cornu, François Delahaye, Malika Hadid, Pascale Rausch, Audrey Coma, Florence Galtier, Philippe Géraud, Hélène Jean-Pierre, Vincent Le Moing, Catherine Sportouch, Jacques Reynes, Nejla Aissa, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Thierry May, Christine Selton-Suty, Nathalie Bedos, Jean-Philippe Lavigne, Catherine Lechiche, Albert Sotto, Xavier Duval, Emila Ilic Habensus, Bernard Iung, Catherine Leport, Pascale Longuet, Raymond Ruimy, Eric Bellissant, Pierre-Yves Donnio, Fabienne Le Gac, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thebault, François Alla, Pierre Braquet, Marie-Line Erpelding, Laetitia Minary, Michèle Bès, Jérôme Etienne, Anne Tristan, François Vandenesch, Alex Van Belkum, Willem Vanwamel, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), CIC CHU Lyon (inserm), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Agroécologie [Dijon], Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-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], 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 ), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), 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), INSERA CIC, Hôpital Bichat - Claude Bernard, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique - Innovation Technologique ( CIC-IT ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et réanimation médicale, 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 ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), 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 ), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Centre d'Investigation Clinique - Innovation Technologique (CIC-IT), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), and Jonchère, Laurent

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, Staphylococcus aureus, medicine.drug_class, 030106 microbiology, Antibiotics, Bacteremia, Penicillins, Prognostic factors, Tertiary Care Centers, 03 medical and health sciences, Interquartile range, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Vancomycin, Internal medicine, Case fatality rate, medicine, Humans, Blood culture, Prospective Studies, Prospective cohort study, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, Antistaphylococcal penicillins, Cross Infection, medicine.diagnostic_test, business.industry, Septic shock, General Medicine, Middle Aged, Staphylococcal Infections, medicine.disease, Prognosis, Survival Analysis, 3. Good health, Surgery, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Bacteraemia, Antistaphylococcal penicillin, Female, France, business, medicine.drug
Abstract

International audience; Staphylococcus aureus bacteraemia (SAB) is a frequent and deadly disease. Given the lack of a randomized trial, optimal first-line antibiotic treatment is still debated. Our aim was to identify prognostic factors in SAB patients and to analyse the impact of first-line antibiotics. The VIRSTA prospective cohort study was conducted in eight tertiary care centres in France. Consecutive incident adults in whom a blood culture drawn in participating centres grew S. aureus between April 2009 and October 2011 were prospectively followed for 12 weeks. Factors associated with 12-week case-fatality were identified by multivariate logistic regression. We enrolled 2091 patients and analysed survival in 1972 (median age 67.8 years, interquartile range 55.5–78.9; females 692/1972, 35.1%). SAB was nosocomial or healthcare-related in 1372/1972 (69.6%) of cases and the primary focus was unknown in 414/1972 (21.0%) of cases. Week 12 case-fatality rate was 671/1972 (34.0%). The main independent prognostic factors on multivariate analysis were age (adjusted OR by 10-year increment 1.56; 95% CI 1.44–1.69), septic shock (OR 5.11; 95% CI 3.84–6.80), metastatic cancer (OR 4.28; 95% CI 2.88–6.38), and unknown primary focus (OR 2.62; 95% CI 2.02–3.41). In the 1538 patients with methicillin-sensitive S. aureus (MSSA) bacteraemia, first-line empiric antistaphylococcal penicillins (OR 0.40; 95% CI 0.17–0.95) and vancomycin (OR 0.37; 95% CI 0.17–0.83), alone or combined with an aminoglycoside, were associated with better outcome compared with other antibiotics. There are few modifiable prognostic factors for SAB. Initiating empiric antibiotics with antistaphylococcal penicillins or vancomycin may be associated with better outcome in MSSA bacteraemia. © 2016 European Society of Clinical Microbiology and Infectious Diseases

Published
2016

23. Déclinaison du plan national de lutte contre le VIH 2010/2014 au sein des COREVIH

Author

Christian Rabaud, Thierry May, Eliette Jeanmaire, Elisabeth Rouveix, and Eric Billaud

Subjects
Public Health, Environmental and Occupational Health
Abstract

Introduction : en France, 50 000 personnes ignorent leur seropositivite car elles auraient echappe au depistage. Chaque annee, pres de 7 000 nouvelles infections par le VIH sont denombrees. Dans ce contexte, le Ministere de la Sante et des Sports a publie un Plan National de lutte contre le VIH/Sida et autres infections sexuellement transmissibles 2010/2014. Une enquete nationale a ete realisee aupres des Coordinations Regionales de lutte contre l’infection a VIH (Corevih) pour s’assurer de leur approbation du Plan National et de la realite de leur financement.Methodes : un questionnaire a ete adresse aux presidents et coordonnateurs des 28 Corevih.Resultats : apres deux relances, 19 Corevih sur 28 ont repondu. Le Plan National a ete a l’origine d’un etat des lieux sur les pratiques ; s’accompagnant de la mise en place de nouvelles actions et de nouveaux groupes de travail. Les Corevih se sont largement engagees dans des actions d’incitation au depistage et egalement investies pour coordonner une formation regionale au depistage. Une reorganisation du dispositif actuel des CDAG/CIDDIST etait en reflexion dans 11 Corevih. Certaines Corevih ont coordonne l’offre regionale d’education therapeutique. La plupart des Corevih se sont egalement mobilisees dans la lutte contre les discriminations. Cependant, plusieurs freins dans la declinaison du plan ont ete identifies.Discussion : cette etude decrit l’implication des Corevih dans la declinaison du Plan National de lutte contre le VIH 2010-2014. Elle souligne que la mise en place d’une coordination regionale specifique d’un probleme de sante publique est possible et doit permettre d’etre l’effecteur decentralise de l’application des plans de sante publique.

Published
2013

24. Polylactic acidvs.polyacrylamide hydrogel for treatment of facial lipoatrophy: a randomized controlled trial [Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS) 132 SMILE]

Author

I. Madelaine, Loze B, Raphaël Porcher, Thierry May, J.-M. Molina, Dolivo M, Matthieu Lafaurie, Carbonnel E, Olivier Bouchaud, and Pierre-Marie Girard

Subjects
medicine.medical_specialty, biology, business.industry, Health Policy, Cheek, medicine.disease, biology.organism_classification, Gastroenterology, law.invention, Surgery, Infectious Diseases, medicine.anatomical_structure, Patient satisfaction, Randomized controlled trial, Quality of life, law, Subcutaneous nodule, Internal medicine, medicine, Pharmacology (medical), business, Adverse effect, Sida, Lipoatrophy
Abstract

Objectives The aim of the study was to demonstrate the noninferiority of polyacrylamide hydrogel (PH) vs. polylactic acid (PLA) for the treatment of facial lipoatrophy in HIV-infected adults. Methods A randomized, blinded, multicentre, noninferiority 96-week study was carried out. Patients with facial lipoatrophy were randomly assigned to receive intradermal injections with PH or PLA, and were blinded to the filler. The primary efficacy endpoint was patient satisfaction at week 48 assessed using a visual analogue scale score (VAS). Secondary efficacy end-points included cheek thickness and skin-fold, lipoatrophy grading and quality of life. Safety was assessed by the reporting of adverse events. Results A total of 148 patients were included in the study; 93% were men, the median age was 47 years, the median CD4 count was 528 cells/μL, and the median duration of antiretroviral therapy was 12 years. Mean VAS increased from 2.8 at baseline to 7.1 and 7.5 in the PLA and PH arms, respectively, at week 48 (P = 0.0002 for noninferiority) and was sustained at week 96 (6.7 and 7.9 in the PLA and PH arms, respectively; P = 0.003 for noninferiority). Cheek thickness and skin-fold increases and lipoatrophy improvement were similar in the two arms. Quality of life remained unchanged or improved depending on the questionnaire used. In injected patients, subcutaneous nodules emerged in 28 (41%) and 26 (37%) patients in the PLA and PH arms, respectively (P = 0.73). Four patients in the PH arm developed severe inflammatory nodules, a median of 17 months after the last injection. Conclusions PH and PLA have similar efficacies in the treatment of facial lipoatrophy, but PH may be associated with more delayed inflammatory nodules.

Published
2013

25. Vaccine Education of Medical Students: A Nationwide Cross-sectional Survey

Author

Solen Kernéis, Caroline Jacquet, Aurélie Bannay, Thierry May, Odile Launay, Pierre Verger, Céline Pulcini, Pierre Abgueguen, Séverine Ansart, Firouzé Bani-Sadr, Louis Bernard, Elisabeth Botelho-Nevers, David Boutoille, Nadim Cassir, Charles Cazanave, Elisa Demonchy, Olivier Epaulard, Manuel Etienne, Emmanuel Faure, Vincent Le Moing, Xavier Lescure, Zoha Maakaroun-Vermesse, Guillaume Martin-Blondel, Frédéric Méchai, Guillaume Mellon, Marie-Caroline Meyohas, Lionel Piroth, France Roblot, Jean-Luc Schmit, Albert Sotto, Pierre Tattevin, Renaud Verdon, Benjamin Wyplosz, Herrada, Anthony, CIC Cochin Pasteur (CIC 1417), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe hospitalier Broca-Université Paris Descartes - Paris 5 (UPD5)-Hôtel-Dieu-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Santé Publique, Information médicale et Enseignement multimédia Assisté par Ordinateur (SPI-EAO), Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), ORS PACA, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, Adult, Male, Educational measurement, medicine.medical_specialty, Medical psychology, Students, Medical, Epidemiology, Cross-sectional study, 030106 microbiology, Population, education, MEDLINE, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Health Education, Schools, Medical, Response rate (survey), education.field_of_study, Physician-Patient Relations, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Education, Medical, business.industry, 4. Education, Vaccination, Public Health, Environmental and Occupational Health, 3. Good health, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Preparedness, Family medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Perception, Clinical Competence, Educational Measurement, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Physicians play a primary role in vaccination of the population. Strong initial training of medical students is therefore essential to enable them to fulfill this role. This cross-sectional nationwide online survey conducted between September 2015 and January 2016 obtained 2,118 completed surveys from 6,690 eligible respondents (response rate, 32%) at 27 of 32 medical schools in France regarding their education about vaccination. The data were analyzed in April-June 2016. The survey covered their knowledge, attitudes, practices, and perceptions, and assessed their level of perceived preparedness for their future practice as interns. Around a third of the students (n=708, 34%) felt insufficiently prepared for questions about vaccination, especially for communicating with patients on side effects (n=1,381, 66%) and strategies to respond to vaccine hesitancy (n=1,217, 58%). The mean knowledge score was 26/45 (SD=7.9). Lecture courses, which are the main education method used in French medical schools (1,891/5,660 responses, 33%), were considered effective by only 11% of students (693/6,155 responses), whereas practical training was significantly associated with better perceived preparedness (p

Published
2016

26. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author

Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. Berger, Jean-Daniel Lelièvre, Dominique Perotin, Abdelkader Bemrah, Alain Lozniewski, Bernard Borstein, Hanna Eid, Diana Suatean, Virginie Mignaut, Jean-Claude N'guyen, Valérie Le Goff, Laurent Teillet, Christophe Rolland, Gwenaël Alfonsi, Florence Lachenal, Philippe Bossi, Yves Botreau, Florence Doucet Populaire, Henry Jardel, Nicolas Gallo, Elias Jabre-Sikias, Michel Dupon, Hélène Brihier, Isabelle Patry, Alexandre Leclercq, Bernadette Tourrand, Christophe Roussel, Jean-Emmanuel Kurtz, Bénédicte Paindaveine, Simon Elhadad, Richard Sanchez, Eric Sgro, Pierre Berger, Valérie Murbach, Anne Holstein, Florence Martin, Taoufik Merabet, Amélie Benbara, Milagros Ferreyra, Laure Esposito, Pierre Delobel, Antoine Andremont, Marc Bourlière, Carole-Anne Boudy, Jean-Baptiste Gaulthier, Laurent Tacchini, Olivier Marpeau, Sonia Tesseydre, Marie-Pierre Coulhon, Nathalie Hodee, Marie-Chrsitine Conroy, Pierre Weinbreck, Roland Leclercq, Laurent Souply, Christian Bidault, Annie Elbez, Marie-Annick Lebreton, Patrick Brisou, Agnès Ferroni, Jean-Louis Pourriat, Nadia Anguel, Christian Noel, Philippe Jouvencel, Eric Pichard, Xavier Martin, Mathieu Coste, Pierre Zuber, Catherine Neuwirth, Jean-Pierre Hacot, Paul Aye, Jérôme Guinard, Yves Pean, Jean-Christophe Dengo, Fabrice Petassou, Didier Viole, Thierry Messiaen, Jean Beytout, Philippe Petitjean, Ferdinand Savare, Patrice Cuvillier, Sophie Coignard, Hélène Anglaret, Nassim Kamar, Elisabeth Chachaty, Karine Guimard, Louis Braem, Hacene Fezoui, Pierre Martin, Jean-Paul Viard, Claire Larroche, Nicolai Claudiu-Plesa, Thierry Benoit-Cattin, Olivier Moquet, Thierry Pasdeloup, David Rosay, Rodolphe Jean, Jean-Bernard Mariette, Marc Debouverie, Hervé Peltier, Mustapha Terki, Jacques Daleas, Valérie Dattin-Dorrière, Michel Vergnaud, Emmanuel Grimprel, Sylvène Rosselli, Jean-Marc Didier, Pierre Faurie, Luc Frimat, Aziza Mandjee, Sabine Etchemendy, Pierre Tissières, Jean Nakhleh, Sylvie Mariette, Christian Perronne, Bruno Carbonne, Nathalie Houssiaux-Maisonneuve, Tristan Ferry, S Beague, Anthony Sebban, Marie-Thérèse Hili, Jean-Michel De Kermadec, Lucien Brasme, Gilles Blaison, Caroline Garandeau, Jean-Pierre Sollet, Laurent Tronchon, Thierry Samson, Julien Gesquière, Nicolas Ettahar, Alain Créange, Etienne Laurens, Véronique Equy, Fréderic Bart, Bernard Bouffandeau, Christine Vaillant, Valerie Pesque, Jean-Marc Lalot, Marc Levy, Michel Kaidomar, Mihaela Saplacan, Sterenn Yvenou, Marie-Isabelle Steibach, Emmanuelle Cambau, Agnès Riche, François Fourrier, François Raffi, Mélissa Lalu, Henri Bérard, Danielle Clave, Jean-Claude Mouries, Martine Porcheron, Jean Cabalion, Richard Lamarca, Nathalie Canu, Jean-Baptiste Roseau, Annabelle Stoclin, Luca Luminitan Elena Lupean, Rémi Gebeile, Celia Salanoubat, Carole Marmouset, Pierre Bigot, Anne-Laure Breton, Pierre Kalfon, Colette Vincent, Sophie Marty, Olivier Tandonnet, Alexis Redor, Xavier Valette, Ourida Aoudia, Jacques-Arnaud Seyrig, Bertrand Beaune, Hugues Aumaitre, Georges Pinon, Yann Leveneur, Sylvie Charachon, Raoul Herbrecht, Henriette de Valk, Gary David, Julien Pouyanne, Marc Dommergues, Majed Al Chaar, Véronique Blanc-Amrane, Pascale Guillarmé Grossmann, Bruno Abraham, Yves Morel, Philippe Suel, Denis Sautereau, Olivier Guilloy, Tu Anh Tran, Frédéric Laurent, Zahir Amoura, Jacques-Olivier Bay, Zoubida Elharie-Heraux, Joyce Sibony-Prat, Bernard Guillois, Dominique Rohmer-Heitz, Audrey Barrelet, Jérémie Courouble, Jean-Paul Herry, Daniel Vittecoq, Annie Vermesch-Langlin, Jean Auroux, Claude Aubert, Thierry Harvey, Ghislaine Lamoine-Gimet, J. Riahi, Florence Soraudeau, Bachar Al-Jalaby, Caroline Périsson, Khélifa Ayouz, Florence Cardot, François Maillet, Alain Goux, Théophile Magna, Bertille de Barbeyrac, Adrien May, Dominique Andreotti, Olivier Jonquet, Hélène Dumouchel, Didier Thibaud, Philippe Morlat, Pascal Chevalet, Pascal Ancelin, Guy Chambreuil, Cécile Le Boterff, Anne Ceriez, Olivier Detante, B Pangon, Claude C.A. Bernard, Vincent Cailleaux Pierre-Etienne Cailleux, Jordi Miatello, Pierre-Yves le Berruyer, Sylvain Kouaho, Michel Briaud, Hélène Delaby, Patrick Herbecq, Christine Segonds, Véronique Jault, Pascale Brunel, Christine Dussopt, Jean Thore, Jean-Marc Thouret, Jean-Marc Kerleau, François Le Baron, Slavius Matica, Sophie Leautez-Nainville, Matthieu Pecquet, Laurent Bret, Yacine Sedjelmaci, Pierre Metton, Habiboulaye Diallo, Jany Rey Zermati, Arnaud Delahaye, Hélène Chaussade, Laurent Mandelbrot, Emilie Bessede, Olivier Casanovas, Paul Pierrot, Annick Legras, Dominique Lauque, Hélène Gatti, Jean Catineau, Ebutu Likose, Gilles Capellier, Eric Kibbrecht, Freddy Thibaut, Patrick Valadier, Chantal Lemble, Joël Gaudelus, Joelle Mellier, Joëlle Brochen, Emmanuel Gascou, Stéphane Bonacorsi, Stéphanie Bannier, Bruno Fantin, Didier Raffenot, Valérie Revel, Hakim Amroun, Huguette Negrery, Anne-Laure Fauchais, Paul Mercury, Michel Chuzeville, Christian Zumbo, Nicolas Després, Pascal Roblot, Jérôme Pasche, Jean Claude Boufetteau, Jocelyne Caillon, Julien Boileau, V. Rabier, Benjamin Manéglier, Emilie Jourdes, Franck Ceppa, Christine Recule, Nicolas Degand, Benoît Henry, Thierry Baranger, Dominique Pateron, Agnès Pélaquier, Gérard Bouchet, Hélène Fiette, Ozel Guiden, Dana Ranta, Etienne Ruppé, Nabil Chiouk, Jacques Breuil, Dominique Leduc, Véronique Loustaud, Hervé Métenier, Michel Durand, Isabelle Mahé, Leila Karaoui, Marie-José Collus, Mehran Monchi, Olivier Belmonte, Romain Blondet, Jacques Thierry, Karine Humbert, Gilles Salama, Marie-Noelle Heurtaux, Cécile Goujard, Bruno Sivery, Martial Boisseau, Redouane Dahoumane, Pierre Delour, Christian Niels Meyer, Anne Faudon-Gibelin, Gérard Poulain, Roger-Charles Luciani, J.-C. Souquet, Olivier Grossi, François Vandenesch, Sylvain Mermont, Jacques Bronner, Sonia Dahan, Paul Marzouk, Pascal Pouedras, Noureddine Djafari, François-Xavier Caroli-Bosc, Jean-François Dessin, Brigitte Gruffat, Armelle Morin-Fatome, Sylvie Thoinet, Bano Konate, Jean-Winoc Decousser, Claire Poyart, Patrick Plessis, Olivier Millet, Vincent Cattoir, Françoise Geffroy, Manica Vasseur, Pierre Carli, Isabelle Citony, Christian Richard, Nicolas Sigur, Patrick Marthelet, Luwawu Mbimba, Pierre Feugier, Philippe Sauder, Hama Djerad, Evelyne Bourgerette, Hanen Chahtour, Adrien Lemaignen, Dominique Bechade, Patrick Ochocki, Antoine Vieillard Baron, Dominique Astruc, Marie-Pierre Moiton, Nicolas Dubois, Sylvie Ledru, Corinne Seknazi, Hélène Poupet, Jean-Philippe Brieux, Gérard Barthélémy, Aihem Yehia, Louis-Jean Couderc, Ahmed, Françoise Rigaux, Yohann N'guyen, Philippe Bethery, Damien Corberand, Etienne Auvray, Paul-Louis Woerther, Christian Combe, Sophie Delesalle, Jean-Marie Piala, Faraj Al Freijat, Philippe Juvin, Malcolm Lemyze, Hyacine Rey, Claire Larible, Noel Milpied, Lémia Zgarni, Julia Gaillard, Agnès Juven, Paola Otean, Adrien Melis, André Pechinot, Olivier Bouchaud, Olivier Chassin, Pierre Hausfater, Asma Trabelsi-Jnifen, Vincent Grobost, Didier Lemery, Pierre Soury, Françoise Brevet, Jacques Tankovic, Dominique Sansot, Jean Louis Salomon, Charlotte Cordonnier, Brigitte Lamy, Antoine Maisonneuve, Dominique Pressac, Claude Rémy, Rodolphe Sobesky, Stéphanie Cognet, Pierre Cougoul, Didier Jan, Dominique Perrotin, Cécile Hombrouk-Alet, Thierry André, Gilbert Pochmalicki, Serge Girard, Vincent Zerr, Guillaume Cadiot, Claudine Lasbasses, Michel Slama, Abderrazak El Yamani, Sophie Brovedani, Jean Armengaud, Romain Hernu, Géraldine Mascade, Aurélien Lorléa'ch, Ali Akkari, Mathieu Tourdjman, Christopher Payan, Eric Jullian, Nathalie Fonsale, Frédéric Riehl, Paul Strock, Geneviève Grise, Philippe Mottaz, Christian Floriot, Marie-Noëlle Ungeheuer, Denis Caillot, Arnaud Chalvon-Demersay, Catherine Branger, Stanislas Bruley des Varannes, Marc Paccalin, Marie-Pierre Danjean, Alexandre Mebazaa, Xavier Brunet, Roland De Varax, Laurence Delhoustal, Sophie Haro, Bruno Chabanon-Pouget, Isabelle Goidin, Dominique Chudersky, Corinne Costes, Delphine Chatellier, Maud Gelez, Damien Dassant, Pascal Joly, Jean-Michel Arnal, Zakaria Hamitou, Philippe Rondepierre, Carole Pignon, Valérie Crombe, Amanda Lopes, Chrystelle Kemenar, Olivia Raulin, Anne-Cécile Hochart, Sandrine Gérart Pons, Valérie Zeller, Guillermo Reyes Ortega, Mathilde Guérin, Audrey Migraine Bouvagnet, Florence Eboue, Isabelle Loury-Lariviere, Sophie Leotard, Suzanne Lima, Marie Kassis, Jean-Luc Donay, Jean-Pierre Audié, Guillaume Cartron, Arnaud Ribier, Fanny Buron, Mirela Tuca, Marius Semenescu, Arnaud Serre, Vincent Quentin, Denise Bouyssou-Destriau, Violaine Bresson, Christine Chandesris Joséphine Chapalain-Cagnon, Eric Cua, Henri Courtade, François Bénézit, Sébastien Lamache, Philippe Bonnefoy, Francis Schneider, Richard Monarchi, Adeline Schendel, Paramasiven Mootien, Ghislaine Gardes, Pierre-François Westeel, Jean-François Magny, François Caron, Jocelyn Michon, Didier Eyer, Isabelle Ronda, Pierre-Yves Robillard, Frédéric Renou, Anna Faucher, Jean-Robert Harlé, Anne Debernardi, Grégory Akerman, Benoît Fontenel, Pierre Hourdebaigt-Larrusse, Marie-Noëlle Adam, Aude Lessene, Abdelkader Hrichi, François Blot, Athéna Le Pierres, Romain Lemarie, Françoise Granier, Véronique Tardy, Marc Gatfosse, Pierre-Marie Roger, François Goupil, Saïd Aberrane, Franck Bernardi, Isabelle Plantier, Nathalie Funakoshi, Jean-Gilles Delecalle, Patricia Barbut, Jacques Reynes, Christophe Roy, Sophie Perreve, Michel Garre, David Ribes, Cyrille Ede, Jean-Claude Dausset, Francis Duchene, Jean Caussin, Michelle Becker-Schneider, Gilles Berthelot, Damien Dupont, Jean-Michel Gillot, Aurélie Messager, Jean-Marie Pannecouck, Jean-Christian Roussel, Alain Reynaud, Sylvie Cariou, Anne Dao, François Guillemot, Martin Martinot, Patrick Casali, Anne-Sophie Poirier, Aissa Kerchache, Necera Sakek, Eric Porthault, Christophe Decoene, Chantal Ache-Papillon, Brigitte Bicais, Jean-Claude Feugier, Thierry Masseron, Charles Marty-Ane, Daniele Goldgran Toledano, Jean-Christophe Dubus, Damien du Cheyron, Dominique Decré, Jean-Loup Pennaforte, Ahmed Tigaizin, Bernard Vache, Eric Oswald, Claire Moulinoux, Anne-Christine Jaouen, Caroline Charlier, Anne-Laure Virlouvet, Ali Kara, Jean-Luc Sicsic, Sylvie Goffart, Mathieu Zuber, Claudine Fèbre, Olivier Lortholary, Mathieu Dupont, Annie Vessieres, Thierry Helvadjian, Thomas Signouret, Cedric Daupin, Sandrine Essouri, Jean-Louis Jacob, Pascal Boileau, Caroline Blazejewski, Quentin Lepiller, Juan-Pablo Maureira, Eddy Lebas, Christophe Deschamps, Amévi Ananivi, Clovis Foguem, Daniel Adoue, Abdourahim Chamouine, Alain Michault, Bruno Guérin, Olivier Baud, Clara Vinci, Thierry Weitten, Jean-Marc Eychene, Marie Froidure, Julien Obiols, Patricia Roussellier, Marc Lecuit, André Cabié, Saskia Foucart, Karim Belhadj, Michel Cingotti, Bruno Dumoulard, Jean Puyhardy, Etienne Danquechin Dorval, Lucile Mendes-Martin, Enrique Casalino, Luc Jarrige, Fabien Lambiotte, Philippe Masson, Mohammed Mansouria, Pierre Thouvenot, Katy Jeannot, Martine Nyunga, Valérie Macci, Florent Masia, Claire Briere de la Hosseraye, Wassila Anteur, André Sommabère, Marie-Claude Germain, Isabelle Arnault, Bernard Carbonelle, Philippe Devos, Daniel Protar, Tiphaine Gaillart, Ludovic Lassel, Laurence Hamou-Plotkine, David Trystram, Thierry Bureau, Olivier Collard, Fanny Vuotto, Sophie Malhiere, Frederique Canis, Gillles Plainfosse, Catherine Lechiche, Bertrand Lassere, Martine Chouraqui, Jean Baptiste Michot, Fethi Radhouane-Khanjari, Carole Barbier, Pascal Bonitchi, Abdelaziz Benkhelil, Odile Salmon, Laurent Damaj Gandhi, Bertrand Minguet, Michel Wagner, Odile Falguières, Zahr-Eddine Ali Chaouche, Eric Zaoui, Isabelle Guichard, Bernard Huttin, Apollinaire Karirisi, Gaël Cinquetti, Christophe Plane, Lionel Rostaing, Yanne Henry-Andrieu, Daniel Re, Virginie Verrier, Pascal Bolot, Michel De Biasi, Laurence Vrigneaud, Mathilde Turpin, Marie-Claude Demachy, Etienne Roussel, Michèle Blancs, Olivier Join-Lambert, Yves Ville, Thierry Granger, Gilles Hilbert, Virginie Medeau, Daniel Villers, Benoit Pilmis, François Gouraud, Emmanuel Ardiet, Catherine Heyraud-Blanchet, Alain Devidas, Hélène Dieye, Julie Cremniter, Jean-François Bergmann, Rozenn Le Berre, Virginie Leguen, Daniel Royer, Gilles Le Maout, Christian Harou, Sylvie Gabriel-Soléan, Yves Regouby, Martine Pestel-Caron, Patrick Brunet, David Boutoille, Emmanuelle Bonnin, Patrice Coulon, Marc Sullice, Marianne Barbieux, Gilles Cambonie, Joëlle Tricoire, Marie-Nadège Bachelier, Delphine Briend, Céline Ramanantsoa, Nathalie Bednarek, Didier Lebreton, Julien Lagrandeur, Damien M'Bey, Philippe Audeguy, Elie Saliba, Lena Damaj, Hassan Fallouh, Pascal Couturier, Fabrice Prévost, Yves Domart, Marie-Odile Lafforgue, Anne Le Du, C. Beuscart, Pierre Guillet, Fabrice Larrazet, Marie-Hélène Hausermann, Henri Robert, Nicolas Fanjaud, François Goehringer, Thomas Bachelot Philippe Badia, Jean-Michel Coulaud, Cristel Fissore Magdelein, Renaud Defebvre, Anne-Sohie Moreau, Johan Courjon, Gilles Salles, Michel Mialon, Silvia Iacobelli, Emmanuelle Bille, Marie-Christine Barbier, Yves Aubard, Patrice Badila, Jean-Philippe Rasigade, Alban Deroux, Evelyne Lecaillon-Thibon, Michel Godin, Abdelmajid Djeffal, Viorica Badurescu, Meriem Canitrot, Pierre Blanchard, Antoine Legros, Laurence Got, Françoise Duluc, Mylène M. Maury, Gilles Dassieu, Nordine Khodeir, Jean-Marie Duez, Mathieu Morincomme, Jérôme Lacroix, Mathieu Revest, Koffi Blewoussi, Isabelle Barazer, Françoise Poitevin, Camille Seignovert, Stéphanie Honore Bouakline, Anne Heidt, Brigitte Malbruny, Julien Desblache, Christian Cattoen, Eric Jaunait, Bruno Chaminade, Claude Bazin, Jonathan Chelly, Anne Pottier, Alain Schmitt, Alain Tissot, Karim Dadoun, P. Rebattu, Claudine Contamin, Arnaud Guerard, Nathalie Ravet, Sandrine Khalifa-Thellier, Marlène Chatron, Gaëlle Dörr, Hélène Biessy, Emmanuel Forestier, Bruno Devaux, Jean-Jacques Grelaud, Xavier Tchenio, Marie-Cécile Ploy, Jérémie Violette, Michèle Burdin, Lionel Falchero, Dominique Jacomy, Jean-Christophe Rozé, Damien Labarriere, Stéphane Leroux, Corinne Meregnani, Assia Ferhat Carre, Paul Orode, Jean-Gabriel Paul, Catherine Godon, Agnès Vinay, Régine Barraduc, Dominique Dallay, Alexandre Ampère, Anne-Gaelle Kervegant, Guillaume Louart, Dominique Beal Ardisson, Francoise Leonetti, Jean-Yves Baril, Stéphanie Haiat, Bincy Darre, Jérôme Bay, Yvan Gauthier, Sylvie Radenne, Pierre-Yves Gueugniaud, Philippe Ravaud, Luc Landraud, Guillaume Ranchon, Loïc Chimot, Véronique Duval, Ilhem Agha-Mir, Sabine Camiade, Estelle Wafo, Jean-Patrick Laporte, Mariam Roncato-Saberane, Camille Bron, Patrice Laudat, Samir Kennouche, Nawel Afroukh, Dominique Neri, Hakim Kherouf, Yoar Hichri, Pierre-Edouard Bollaert, Gwenaelle Vary, Denis Castaing, Christine Lefort, Sébastien Rouget, René Robert, Christelle Guillet-Caruba, Catherine Simonin, Alain Vighetto, Severine Cabasson, Alain Brusset, Alexandra Doloy, Christel Cherlet, Ahmed Rouidi, Marina Salvucci, Réginald Pordes, René-Gilles Patrigeon, Emmanuelle Dupre-Narlet, Jacques Minet, Fethi Taleb, Anne-Marie Colingorski, Tahar Hadou, Sylvain Diamantis, Isabelle Glorieux, Thierry May, Jean-Claude Colombani, Anne Berth-Farges, Nicole Desplaces, Renaud de Tayrac, Elisabeth Walter, Fabienne Lorge, Pascal Reboul, Nathalie Dournon, Laurence Estépa, Marie-Lina Toubia, Mathilde Flahault, Thierry Delacour, Dominique Hurel, Hélinoro Andriamaneo, Cécile Bébéar, Denis Grasset, Miloud Serier, Oléna Orléva, Nadine Dubroca, Hervé Gentilhomme, Jean-Luc Baudel, Isabelle Lavenu, Salim Smati, Carlo Saroufim, Eric Placidi, Albert Sotto, Benoît Libeau, Hélène Leroy, François Golfier, Christophe Dollon, Laurence Desnoulez, Eric Barre, Daniel Cohen, Pascal Priollet, Thierry Marsepoil, Benoît Lionnet, Jacques Tebib, Pascale Penn, Antoine Bouissou, Christian Roth, Olivier Martinet, Anna Schmitt, Nathalie Fruleux, Fouzia Radaoui, Jean-Marc Lessinger, Virginie Morando, Jean-Jacques Maillet, Christophe Fruchart, François Boué, François Goffinet, Franck Lellouche, Martin Demarchi, Alain Geissler, Jean-Charles Picaud, David Assouline, Patricia Brazille, Philippe Guimier, Marie-Françoise Dabysing, Bruno Delpeuch, Vanessa Tran, Guy Gengembre, Delphine Deligne, Dominique Vodovar, Yvan Touze, Sabrina Parent, Anne Decoster, Camille Dewitte, Emmanuel Weiss, Thierry Lambert, Thomas Guimard, Vincent Caille, Claude Guérin, Françoise Evreux, Geneviève Barjon, Basile Ondze, Damien Fournier, Olivia Bandin, Sophie Mignart, Henri Demontclos, Didier Perez, Jacques Croize, Nicole Desbois-Nogard, Guenièvre Imbert, Clarisse Dupin, Khalid Ridah, Marie-Christine Varin, Guillaume Arlet, Edith De Clareuil, Marie-Line Eustache, Patricia Le Pimpec, Louise Fortin, Eugène Ngami, Fabrice Mihout, Cecilia Esnault, Vincent Bouden, Véronique Annaix, Yves Poinsignon, Aurélien Lorchleac'h, Jean-Marc Degreff, Marie Garofano, Renaud Mesnage, Anne-Marie Roque-Afonso, Alain Chevailler, Stéphane Hominal, Thierry Charbonnier, Adrianna Bildea, Fabien Fily, Benjamin Davido, Emmanuel Rassiat, Assi Assi, Stéphanie Brunet, Hervé Jacquier, Catherine Claise, Annie Durand, Yannick Monceau, Pierre Blanc, Jean-Marie Sire, Yves Sucin, Jean-Pierre Zarski, Nathalie Bronet, Ingrid Lafon, Philippe Rey, Jacques Markarian, Eric Sennevile, Olivier Wink, Guilène Barnaud, Anne-Sophie Peultier, Sabine Taylor, Rim Savatier, Patrick Valayer, Claude Negrier, Selim Jennane, Edouard Begon, Laura Hyerle, Delphine Bridoux, Claire Daurel, Benoît Dalle, Mathilde Lescat, Philippe Stolidi, Elodie Perrodeau, Xavier Heches, Pierre Castelnau, Philippe Bray, Jean-Claude Texier, Serge Rossignol, Maud Brung-Lefebvre, Jean-François Subra, Jean-Marie Delarbre, Morgane Schneerson, Guyro Jang, Mona Mehri, Nathalie Landgraf, Pierre-Marie Girard, Armand Goll, Zaineb Bekguesmia, Christophe Clement, Michel Collet, Vincent Maze, Amine Benjelloul, Solène Durliat-Ellie, Vincent Letouzey, François Schmitt, Valérie Martinez, Sarah Watson, Abderrezak Bouasria, François Barbier, Raphael Lauretta, Mirana Razafimahery, Cristina Sirbu, Patrick Malherbe, Anne Wuillai, Ludovic Lesecq, Philippe Gaudard, Serge Houssaye, Jacques Monsegu, Gilles Rival, Chantal Chaplain, Jean-Didier Grangé, Oana Zamfiri, Florence Nguyen-Khac, Marc Portneuf, Jean-Michel Pawlotsky, Delphine Bonnet, Laurent Traissac, Sophie Hamon-Charles, Didier Dreyfuss, Louis Bernard, Laurence Detourmignies, Olivier Martineau, François Pettinelli, Marc Zandecki, Michel Dreyfus, Alain Chapelle, Sébastien Sabbat, Anne-Sophie Labussiere, Jean-Louis Gaillard, Chloé Plouzeau-Jayle, Patrick Zoveda, Véronique Leflon, Marie Levy, Aurélie Labé, Bruno Soulie, Raoul Jacques Bensaude, Hecham Moussa, Sylviane Catteu, Nathalie Biron, Loïc Masson, Georges Mourad, Nejla Aissa, Dragos Ciocan, Hubert De Boysson, Jean-Luc Bouyer, Patrick Yeni, Thierry-Pascal Zame, Caroline Thomas, François Cavalié, Laurence Koulmann, Christophe Rioux, Olivier Barraud, François Bricaire, Marguerite Le Poulain, Marie-Noelle Noulard, René Thomas, Guy Semet, Laurent Mosser, Olivier Marret, Brigitte Rivière, Vincent Jarlier, Jean-Philippe Coindre, Marc Villemain, Martin Pierre, Yacine Benkaci, Philippe Chiron, Hoang Vu-Thien, Jérôme Gournay, Andrea Labaune-Kiss, Brigitte Lauzanne, Fanny Lemercier, Souad Silhadi, Imad Kansau, Christophe Poncelet, Olivier Baldesi, Francis Thuet, Olivier Leroy, Aurore Lamberet, Camille Petit Hoang, Sophie Micheli, Ayman Abokasem, Hakima Nesrine, Pierre Lureau, Christian Chidiac, Vincent Piriou, Fabien Zoulim, Dieudonné Nicobaharaye, Anne Tixier, Isabelle Matheron, Soumeth Abasse, Victoria Cacheux, Serge Herson, Christine Fuhrmann, Olivier Proost, Bernard Bedock, Olivier Rogeaux, Mostapha Hajjar, Anne Reverseau, René Courcol, Françoise Carmagnol, Yves Guénard, Céline Ménard, Bouchra Lamia, Bruno Lemmens, Damien Bouhour, L. Lequen, Gaëlle Baty, Cédric Bouet, Dominique Guerrot, Stéphane Blanc, Catherine Chirouze, Anne-Hélène Reboux, A. Vachée, Gregory Taurin, Myriam Mein-Bottini, Jean-Pierre Belot, Alain Lafeuillade, Patricia Gabez-Therou, Philippe Labrousse, Bernard Jarrousse, Philippe Noto, Vincent Brunot, Philippe Condominas, Marion Challier, Béatrice Berçot, Delphine Anuset, Mélanie Daval Cote, François Bernasconi, Y. Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)

Subjects
Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract

International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (

Published
2016

27. Tenofovir DF/emtricitabine and efavirenz combination therapy for HIV infection in patients treated for tuberculosis: The ANRS 129 BKVIR trial

Author

Olivier, Lortholary, Caroline, Roussillon, Céline, Boucherie, Christophe, Padoin, Marie-Laure, Chaix, Guillaume, Breton, Agathe, Rami, Nicolas, Veziris, Olivier, Patey, Eric, Caumes, Thierry, May, Jean-Michel, Molina, Jérome, Robert, Michel, Tod, Catherine, Fagard, Geneviève, Chêne, Y, Bennai, Centre d'infectiologie Necker-Pasteur [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], 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 ), Laboratoire National de Contrôle des Médicaments, Rabat, Morocco, Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Inserm, Institut Universitaire d'Hématologie, Université Paris Diderot - Paris 7 ( UPD7 ) -Hopital Saint-Louis, Assistance Publique Hopitaux de 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 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7), Agence Nationale de Recherches sur le Sida et les Hépatites Virales, Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Laboratoire de toxicologie - Hôpital Avicenne, Hôpital Avicenne [AP-HP], Laboratoire de Virologie [CHU Necker], Service de médecine interne [CHU Pitié-Salpétrière], 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), Hôpital Lariboisière-Fernand-Widal [APHP], Centre d'Immunologie et de Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence des Mycobactéries et de la Résistance aux Antituberculeux [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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), Service de Médecine Interne, Maladies Infectieuses et Tropicales [Villeneuve-Saint-Georges], Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges (CHIV), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), 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), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Service d’information Médicale [CHU de Bordeaux] (Pôle de Santé Publique), CHU Bordeaux [Bordeaux], The ANRS 129 BKVIR trial was sponsored and funded by ANRS (Agence Nationale de Recherches sur le SIDA et les Hépatites Virales)., Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Immunologie et des Maladies Infectieuses (CIMI), ALTARE, Frédéric, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre National de Référence des Mycobactéries et de la Résistance aux Antituberculeux [CHU Pitié-Salpêtrière] (CNR-MyRMA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]

Subjects
Cyclopropanes, Male, 0301 basic medicine, [SDV]Life Sciences [q-bio], Antitubercular Agents, HIV Infections, chemistry.chemical_compound, 0302 clinical medicine, Emtricitabine, Pharmacology (medical), 030212 general & internal medicine, Middle Aged, Viral Load, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, Infectious Diseases, Alkynes, [SDV.IMM]Life Sciences [q-bio]/Immunology, Drug Therapy, Combination, Female, France, Viral load, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Tuberculosis, Efavirenz, [SDV.IMM] Life Sciences [q-bio]/Immunology, Combination therapy, Anti-HIV Agents, 030106 microbiology, [ SDV.EE.SANT ] Life Sciences [q-bio]/Ecology, environment/Health, 03 medical and health sciences, Immune reconstitution inflammatory syndrome, Internal medicine, medicine, Humans, Tenofovir, Adverse effect, Pharmacology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, medicine.disease, Virology, Benzoxazines, chemistry, business, Rifampicin
Abstract

International audience; Background: HIV-infected patients with TB need simplified, effective and well-tolerated antiretroviral regimens. Methods: The French ANRS 129 BKVIR open trial evaluated the once-daily tenofovir DF/emtricitabine and efavirenz combination, started within 12 weeks after TB treatment initiation, in antiretroviral-naive HIV-1-infected patients. Success was defined as an HIV-1 RNA

Published
2016

28. Burden of HIV disease and comorbidities on the chances of maintaining employment in the era of sustained combined antiretoviral therapies use.: HIV disease, comorbidityand employment

Author

Rosemary, Dray-Spira, Camille, Legeai, Mariette, Le Den, François, Boué, Caroline, Lascoux-Combe, Anne, Simon, Thierry, May, Cécile, Goujard, Laurence, Meyer, Isabelle, Suaud, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de médecine interne, immunologie clinique [Béclère], AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine interne [CHU Pitié-Salpétrière], 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), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de médecine interne et maladies infectieuses, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), and ANRS COPANA Cohort Study Group

Subjects
Male, Gerontology, Health Status, HIV Infections, Kaplan-Meier Estimate, Comorbidity, Cohort Studies, 0302 clinical medicine, Cost of Illness, Employment status, Immunology and Allergy, Prospective Studies, 030212 general & internal medicine, 10. No inequality, Prospective cohort study, Depression (differential diagnoses), education.field_of_study, Depression, Hazard ratio, 1. No poverty, Middle Aged, 3. Good health, Infectious Diseases, Cardiovascular Diseases, Cohort, Female, France, HIV-related discrimination, 0305 other medical science, Cohort study, Adult, Employment, Anti-HIV Agents, Immunology, Population, Socioeconomic factors, Truth Disclosure, Article, 03 medical and health sciences, Diabetes Mellitus, medicine, Humans, education, Occupational Health, Proportional Hazards Models, 030505 public health, business.industry, Proportional hazards model, medicine.disease, HIV-1, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract

International audience; OBJECTIVES: Employment status is a major predictor of health status and living conditions, especially among HIV-infected people, a predominantly working-aged population. We aimed to quantify the risk of work cessation following HIV diagnosis in France in 2004-2010 and to measure the respective burden of HIV-related characteristics and of associated comorbidities on this risk. DESIGN: We used data from a multicenter cohort made of a diversified sample of recently diagnosed HIV-1-infected adults, antiretroviral treatment-naive at baseline in 2004-2008 (ANRS-COPANA cohort). Detailed information on living conditions and clinical and biological characteristics were collected prospectively. METHODS: The risk of work cessation among the 376 working-aged participants employed at baseline was estimated using the Kaplan-Meier method. Characteristics associated with the risk of work cessation were identified using multivariate Cox models. RESULTS: The cumulative probability of work cessation reached 14.1% after 2 years and 34.7% after 5 years. Diabetes, hypertension and, to a lesser extent, signs of depression were associated with increased risks of work cessation after accounting for socio-occupational characteristics [adjusted hazard ratios (95% confidence interval): 5.7 (1.7-18.8), 3.1 (1.5-6.4) and 1.6 (0.9-2.9), respectively]. In contrast, HIV disease severity and treatment and experience of HIV-related discrimination were not statistically associated with the risk of work cessation. CONCLUSION: The risk of work cessation during the course of HIV disease has remained substantial in the most recent period in France. Comorbidities, but not characteristics of HIV disease itself, substantially affect chances of maintaining employment. This provides insights into strategies for limiting the burden of HIV disease for individuals and society.

Published
2012

29. Amélioration de la prescription des fluoroquinolones dans les infections urinaires. Revue de pertinence à deux tours

Author

Hénard S, Gendrin, B. Demore, C. Burty, Thierry May, E. Frentiu, L Letranchant, le Réseau Antibiolor, and T. Doco-Lecompte

Subjects
medicine.medical_specialty, business.industry, Urinary system, Emergency medicine, Pharmacist, Medicine, General Medicine, Medical prescription, business, Infectious diseases physician
Abstract

OBJECTIVES Evaluating the impact of corrective measures on fluoroquinolones (FQ) prescriptions for urinary tract infections (UTI) during a 2-round relevance study on a regional scale. METHODS FQ prescriptions of voluntary hospitals were checked by an infectious diseases physician and a pharmacist according to regional guidelines. A first round (R1) took place in January 2008, with feedback and proposal for personalized corrective measures in January 2009. A second round (R2) was organized in June 2009. UTI data were extracted and the results of the two rounds were compared. RESULTS Four hundred and thirty-five and 302 FQ prescriptions for UTI, coming from 28 and 24 different hospitals, were analyzed at R1 and R2, respectively. Thirty-six percent and 55% of these prescriptions were entirely in accordance with regional guidelines, at respectively R1 and R2 (P

Published
2012

30. Relevance of fluoroquinolone use in hospitals in the Lorraine region of France before and after corrective measures: An investigation by the Antibiolor network

Author

Christian Rabaud, Thanh Doco-Lecompte, Béatrice Demoré, Christine Burty, Thierry May, Sandrine Henard, Emmanuelle Desmots, Emilia Frentiu, Celine Robert, Lakshmi Rughoo, Lorraine Letranchant, and Gregory Rondelot

Subjects
Adult, Male, Microbiology (medical), Pediatrics, medicine.medical_specialty, Adolescent, Treatment duration, Drug Prescriptions, Young Adult, Intervention (counseling), medicine, Humans, Relevance (information retrieval), Medical prescription, Child, Aged, Retrospective Studies, Aged, 80 and over, General Immunology and Microbiology, business.industry, General Medicine, Middle Aged, Drug Utilization, Anti-Bacterial Agents, Infectious Diseases, Family medicine, Practice Guidelines as Topic, Female, France, business, Fluoroquinolones
Abstract

This study of fluoroquinolone use was carried out before and after an educational intervention run by Antibiolor, a regional network to all hospitals in the Lorraine region of France.The relevance of fluoroquinolone prescription according to regional guidelines was assessed using a standard card filled out by physicians and pharmacists at the voluntarily participating hospitals. A therapeutic index of adequacy was established for each card. The initial survey took place in January 2008, with feedback and proposals for corrective measures in January 2009. The second survey was organized in June 2009. The results of the 2 surveys were compared.Twenty-four hospitals completed a total of 1336 cards in the first survey (S1) and 944 cards in the second (S2). The appropriateness of indications for fluoroquinolone use improved by 57% between the 2 surveys. All the criteria analyzed (choice of drug, dosage, treatment duration) were significantly improved in S2 compared to S1, as was the adequacy index (70% improvement).In view of the consequences of fluoroquinolone use, many hospitals in Lorraine were keen to participate in this study, confirming its feasibility over a large area. In view of the study results, the book of guidelines was re-examined and republished at the conclusion of S2. Greater adherence to guidelines was noted in S2, demonstrating the benefit of assessing the situation thoroughly before proposing corrective measures and evaluating their impact.

Published
2011

31. Fatal Histoplasma capsulatum Mitral Endocarditis in a French Patient Treated for Rheumatoid Arthritis

Author

Thierry May, Lorraine Letranchant, Anne Debourgogne, Thanh Doco-Lecompte, Nelly Contet-Audonneau, and Marie Machouart

Subjects
medicine.medical_specialty, Veterinary (miscellaneous), Histoplasma, Applied Microbiology and Biotechnology, Microbiology, Asymptomatic, Histoplasmosis, Serology, Arthritis, Rheumatoid, Immunocompromised Host, Fatal Outcome, fluids and secretions, Medical microbiology, medicine, Humans, Endocarditis, Travel, biology, business.industry, Middle Aged, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Dermatology, Surgery, Infectious disease (medical specialty), Rheumatoid arthritis, Female, France, medicine.symptom, business, Agronomy and Crop Science, Immunosuppressive Agents
Abstract

Histoplasmosis is an infectious disease caused by the inhalation of Histoplasma capsulatum spores, a fungus encountered in many diverse areas around the world. Although this infection is often asymptomatic, it may become dramatic in immunocompromised patients. In November 2005, an endocarditis due to Histoplasma capsulatum was diagnosed in a French woman treated for rheumatoid arthritis and who had traveled to South America 2 years earlier. We confirmed the biological diagnosis by mycological, serological, and histological methods. In spite of receiving the appropriate treatment, the patient died 3 months later of cardiac insufficiency. We report here this additional case of Histoplasma endocarditis, by hoping to help rapid and accurate diagnosis of such infections in their early stages of development, in non-endemic areas.

Published
2011

32. Effects of an operational multidisciplinary team on hospital antibiotic use and cost in France: a cluster controlled trial

Author

Emmanuelle Boschetti, Marie-Line Erpelding, Nathalie Thilly, Isabelle May, Sibylle Bevilacqua, Béatrice Demoré, Christian Rabaud, and Thierry May

Subjects
Imipenem, medicine.medical_specialty, Attitude of Health Personnel, medicine.drug_class, Total cost, Antibiotics, Pharmaceutical Science, Pharmacy, Pharmacists, Toxicology, law.invention, Randomized controlled trial, law, Multidisciplinary approach, medicine, Cluster Analysis, Humans, Pharmacology (medical), Intensive care medicine, Patient Care Team, Pharmacology, business.industry, Teicoplanin, Anti-Bacterial Agents, Clinical pharmacy, Emergency medicine, Costs and Cost Analysis, France, Pharmacy Service, Hospital, business, medicine.drug
Abstract

Objective The study objective was to evaluate the effectiveness of an operational multidisciplinary antibiotic team, including an infectious disease physician and a clinical pharmacist, in reducing the hospital antimicrobial consumption and costs. Setting The 1800-bed University Hospitals of Nancy (France). Method A cluster controlled ‘before-after’ study was performed. The intervention group comprised 11 medical and surgical wards in settings where the operational antibiotic team was implemented, and the control group comprised 6 wards without this operational team. The ‘before’ period (2005) preceded the implementation of the operational team in the intervention group and ‘after’ (July 2007 to June 2008) followed its full implementation. Main outcome measure We compared consumption of antibiotics overall and by therapeutic class (in defined daily doses per 1,000 patient days) and cost savings (in €) between ‘before’ and ‘after’ in both groups (control and intervention), using a mixed effect linear model. Results The overall consumption of antibiotics decreased after implementation of the operational team by 33.6% in the intervention group and by 3.3% in the control group (P = 0.003). Compared with the control group, the decrease in antibiotic use in the intervention group was significantly higher for various therapeutic classes (broad-spectrum penicillins, injectable fluoroquinolones, glycopeptides) and specific drugs (imipenem, ciprofloxacin, teicoplanin). For the same activity, the total cost savings were 14-fold higher in the intervention group. Conclusion Establishment of an operational multidisciplinary team may be an effective way to reduce hospital antibiotic use and cost, with a good acceptance rate among prescribers.

Published
2011

34. High rate of early virological failure with the once-daily tenofovir/lamivudine/nevirapine combination in naive HIV-1-infected patients

Author

Clotilde Allavena, Marie-Paule Schmitt, Bruno Hoen, Pascal Chavanet, P. Meyer, Michel Duong, J. M. Lang, David Rey, M. Diemer, Thierry May, Vincent Calvez, Bruno Spire, G. Hoizey, Gilles Peytavin, J. L. Schmit, Entente Interdépartementale pour la Démoustication, Région Rhône-Alpes, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de Recherches sur les lois Fondamentales de l'Univers ( IRFU ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Université Paris-Saclay, Laboratoire du Service d'Oncologie Médicale, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Chrono-environnement (UMR 6249) (LCE), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, MESH: CD4 Lymphocyte Count, HIV Infections, MESH : Viral Load, Gastroenterology, MESH: HIV-1, MESH : Adenine, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Female, Pharmacology (medical), 030212 general & internal medicine, MESH: Nevirapine, MESH: Anti-HIV Agents, MESH : Viral Proteins, MESH: Treatment Outcome, 0303 health sciences, MESH: Middle Aged, MESH: Drug Resistance, Viral, Reverse-transcriptase inhibitor, MESH : Lamivudine, Lamivudine, MESH: HIV Infections, Middle Aged, Viral Load, MESH : Adult, Resistance mutation, MESH: Amino Acid Substitution, 3. Good health, MESH : Drug Resistance, Viral, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Treatment Outcome, Infectious Diseases, Female, Viral disease, MESH: Viral Load, MESH : Phosphonic Acids, MESH : HIV-1, MESH: Lamivudine, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, MESH: Adenine, Nevirapine, Anti-HIV Agents, MESH : Male, MESH : Nevirapine, Mutation, Missense, Organophosphonates, MESH: Phosphonic Acids, MESH : Treatment Outcome, Biology, Viral Proteins, 03 medical and health sciences, Zidovudine, MESH : Amino Acid Substitution, Internal medicine, Drug Resistance, Viral, MESH : CD4 Lymphocyte Count, MESH : HIV Infections, medicine, Humans, MESH : Middle Aged, Tenofovir, Pharmacology, MESH: Mutation, Missense, MESH: Humans, 030306 microbiology, Adenine, MESH : Anti-HIV Agents, MESH : Humans, MESH: Adult, Interim analysis, MESH: Viral Proteins, Virology, MESH: Male, CD4 Lymphocyte Count, Regimen, Amino Acid Substitution, HIV-1, MESH: Female, MESH : Mutation, Missense
Abstract

International audience; BACKGROUND: The combination of one non-nucleoside reverse transcriptase inhibitor (NNRTI) with two nucleoside reverse transcriptase inhibitors is a validated first-line antiretroviral (ARV) therapy. The once-daily combination of lamivudine, tenofovirDF and nevirapine has not been evaluated in a clinical trial. METHODS: Randomized, open-label, multicentre, non-inferiority trial comparing lamivudine, tenofovirDF and nevirapine once daily (Group 2) with zidovudine/lamivudine and nevirapine twice daily (Group 1), in naive HIV-1-infected patients with a CD4 count

Published
2008

35. 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

36. Urolithiasis in HIV-Positive Patients Treated with Atazanavir

Author

Jean Luc Meynard, Lélia Escaut, Carine Couzigou, Françoise Borsa Lebas, Thierry May, Karine Asselah, Jean-Yves Liotier, Didier Neau, Jean-Louis Quencez, Michel Daudon, David Zucman, Daniel Vittecoq, and Denise Higueret

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Pyridines, Urinary system, medicine.medical_treatment, Atazanavir Sulfate, Human immunodeficiency virus (HIV), HIV Infections, Urine, medicine.disease_cause, Gastroenterology, Urolithiasis, Risk Factors, Internal medicine, Humans, Medicine, Protease inhibitor (pharmacology), In patient, Protease, business.industry, Water, virus diseases, HIV Protease Inhibitors, Hydrogen-Ion Concentration, Middle Aged, Atazanavir, Infectious Diseases, Endocrinology, Female, business, Oligopeptides, medicine.drug
Abstract

Among protease inhibitors, atazanavir has not been associated with urolithiasis in clinical studies. We describe 11 cases of atazanavir-associated urolithiasis in patients with human immunodeficiency virus (HIV) infection. Patients with low water intake, high urinary pH, and a prior history of urinary stones may have a higher risk of atazanavir-associated urine crystallization.

Published
2007

37. Late Antiretroviral Therapy (ART) Initiation Is Associated with Long-Term Persistence of Systemic Inflammation and Metabolic Abnormalities

Author

Corinne Vigouroux, Jean-Philippe Bastard, Laurence Meyer, Laurence Gérard, Jacqueline Capeau, Soraya Fellahi, Mathilde Ghislain, Anne Simon, Thierry May, Cécile Goujard, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), 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 Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service d'Immunopathologie [Hôpital Saint-Louis, Paris], Université Paris Diderot - Paris 7 (UPD7)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pitié-Salpêtrière [AP-HP], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de biochimie et hormonologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Laboratoire commun de biologie et génétique moléculaires [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Lipopolysaccharide Receptors, lcsh:Medicine, Systemic inflammation, Zidovudine, Insulin resistance, Internal medicine, Diabetes mellitus, Humans, Receptors, Tumor Necrosis Factor, Type II, Medicine, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Prospective Studies, Prospective cohort study, lcsh:Science, Immunodeficiency, Inflammation, Acquired Immunodeficiency Syndrome, Multidisciplinary, biology, Interleukin-6, business.industry, Insulin, C-reactive protein, lcsh:R, Middle Aged, medicine.disease, CD4 Lymphocyte Count, 3. Good health, C-Reactive Protein, Endocrinology, Anti-Retroviral Agents, HIV-1, biology.protein, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, medicine.symptom, business, Biomarkers, Research Article, medicine.drug
Abstract

International audience; ObjectivesHIV-induced immunodeficiency is associated with metabolic abnormalities and systemic inflammation. We investigated the effect of antiretroviral therapy (ART) on restoration of insulin sensitivity, markers of immune activation and inflammation.MethodsImmunological, metabolic and inflammatory status was assessed at antiretroviral therapy initiation and three years later in 208 patients from the ANRS-COPANA cohort. Patients were compared according to their pre-ART CD4+ cell count (group 1: ≤ 200/mm3, n = 66 vs. group 2: > 200/mm3, n = 142).ResultsMedian CD4+ cell count increased in both groups after 3 years of successful ART but remained significantly lower in group 1 than in group 2 (404 vs 572 cells/mm3). Triglyceride and insulin levels were higher or tended to be higher in group 1 than in group 2 at ART initiation (median: 1.32 vs 0.97 mmol/l, p = 0.04 and 7.6 vs 6.8 IU, p = 0.09, respectively) and remained higher after three years of ART (1.42 vs 1.16 mmol/L, p = 0.0009 and 8.9 vs 7.2 IU, p = 0.01). After adjustment for individual characteristics and antiretroviral therapy regimens (protease inhibitor (PI), zidovudine), insulin levels remained significantly higher in patients with low baseline CD4+ cell count. Baseline IL-6, sCD14 and sTNFR2 levels were higher in group 1 than in group 2. Most biomarkers of immune activation/inflammation declined during ART, but IL-6 and hsCRP levels remained higher in patients with low baseline CD4+ cell count than in the other patients (median are respectively 1.4 vs 1.1 pg/ml, p = 0.03 and 2.1 vs 1.3 mg/ml, p = 0.07).ConclusionAfter three years of successful ART, low pretreatment CD4+ T cell count remained associated with elevated insulin, triglyceride, IL-6 and hsCRP levels. These persistent metabolic and inflammatory abnormalities could contribute to an increased risk of cardiovascular and metabolic disease.

Published
2015

38. Five-Year Follow up of Once-Daily Therapy with Emtricitabine, Didanosine and Efavirenz (Montana ANRS 091 Trial)

Author

Thierry May, Philippe Morlat, Valérie Journot, Corinne Rancinan, André Furco, Pierre Palmer, Jean-Michel Molina, Geneviève Chêne, François Raffi, and Nathalie De Castro

Subjects
Adult, Cyclopropanes, Male, medicine.medical_specialty, Time Factors, Efavirenz, Combination therapy, Lipoproteins, HIV Infections, Emtricitabine, Antiviral Agents, Deoxycytidine, law.invention, chemistry.chemical_compound, Randomized controlled trial, law, Antiretroviral Therapy, Highly Active, Internal medicine, medicine, Humans, Pharmacology (medical), Didanosine, Pharmacology, Reverse-transcriptase inhibitor, business.industry, Five year follow up, Drug Tolerance, Lipids, Virology, Benzoxazines, CD4 Lymphocyte Count, Clinical trial, Cholesterol, Treatment Outcome, Infectious Diseases, chemistry, Alkynes, HIV-1, RNA, Viral, Female, France, business, medicine.drug
Abstract

Background Once-daily combination therapy with emtricitabine, didanosine and efavirenz has been highly effective in clinical trials but its long-term efficacy and safety has not been previously reported. Methods This multicentre, single-arm, open-label trial enrolled 40 antiretroviral-naive HIV-1-infected patients who received a once-daily regimen of emtricitabine, didanosine and efavirenz. The objective was to assess the long-term effects of this combination on plasma HIV RNA levels, CD4+ T-cell counts, safety and tolerability. Results After 5 years, 73% and 68% of patients had plasma HIV RNA levels + T-cell count of 294x106 cells/l. Only six patients discontinued study treatment, because of non-severe adverse events. Lipodystrophy was infrequent, and lipid and glucose profiles were favourable with a significant increase in high-density lipoprotein cholesterol. Conclusions A convenient once-daily regimen of emtricitabine, didanosine and efavirenz provided durable antiretroviral response and was well tolerated through 5 years of therapy.

Published
2006

39. Complications infectieuses et mésusage de la buprénorphine à haut dosage

Author

C. Cazorla, D. Grenier de Cardenal, Christian Rabaud, L. Thomas, Thierry May, H. Schuhmacher, and A. Wack

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medicine, General Medicine, business
Abstract

Resume Contexte La buprenorphine a haut dosage (BHD) a ete mise sur le marche en France en 1996 selon des modalites de prescription peu contraignantes. La poursuite des pratiques d’injection d’heroine chez les patients substitues, voire l’injection de la BHD, sont des phenomenes qui sont restes longtemps sous-estimes et qui peuvent etre a l’origine d’infections. Objectifs Description des complications infectieuses survenant chez les sujets substitues par BHD. Methodes Etude retrospective incluant les patients toxicomanes substitues par BHD s’injectant ou hautement suspects de s’injecter la BHD, hospitalises pour prise en charge d’une infection (hors VIH et hepatites virales) dans le service des maladies infectieuses et tropicales du CHU de Nancy. La periode de recueil des donnees s’est etendue de 1998 a 2003. Resultats Au total, 21 dossiers ont ete retenus dont 9 endocardites infectieuses, 8 abces cutanes, 2 infections osteo-articulaires, 1 meningite et 1 retinite a Candida . Le sex ratio etait de 1 femme pour 2 hommes, la moyenne d’âge de 29,8 ans. Au total, dans cette serie, 13 patients ont eu une infection systemique. Concernant la responsabilite potentielle de la BHD dans l’emergence de ces infections, dans 9 cas les patients reconnaissaient qu’il s’agissait du seul produit injecte (incluant le cas de candidose retinienne). Par contre, dans les 12 autres cas, les patients poursuivaient leurs injections d’heroine ; bien que la responsabilite du mesusage de la BHD soit fortement suspectee dans la genese de ces 12 infections, elle ne peut etre definitivement affirmee. L’evolution a ete favorable pour tous les patients sur le plan somatique. Le devenir psychosocial a long terme reste meconnu. Conclusion Les dossiers cliniques rapportes ici illustrent la double realite de l’inefficacite potentielle de la prescription de la BHD sur le plan de la substitution, certains patients ayant toujours recours aux injections d’heroine, et des consequences infectieuses potentielles du mesusage de la BHD. Le bilan de la substitution par BHD est mitige. Le rapport benefices-risques sur le plan individuel doit etre ameliore. Le travail en reseau est primordial, en particulier le binome “medecin-pharmacien”. En parallele, le dispositif de surveillance doit etre renforce.

Published
2005

40. Incidence of and Risk Factors for Adverse Drug Reactions in a Prospective Cohort of HIV-Infected Adults Initiating Protease Inhibitor--Containing Therapy

Author

Anne Waldner, Geneviève Chêne, Philippe Morlat, Xavier Duval, Thierry May, Valérie Journot, Catherine Leport, Michel Dupon, François Raffi, Roger Salamon, and Lise Cuzin

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Time Factors, Colic, Hepatitis, Viral, Human, Hepatitis C virus, Renal function, HIV Infections, Indinavir, medicine.disease_cause, Gastroenterology, Risk Factors, Internal medicine, medicine, Humans, Prospective Studies, Renal Insufficiency, Risk factor, Prospective cohort study, Transaminases, Probability, business.industry, Incidence, Hazard ratio, HIV Protease Inhibitors, Hepatitis B, medicine.disease, Infectious Diseases, Immunology, Elevated transaminases, Female, Kidney Diseases, business, medicine.drug
Abstract

8 Unite ´ de Maladies Infectieuses et Tropicales, Hotel-Dieu, Nantes, France Risk factors associated with the occurrence of protease inhibitor (PI)-related severe and serious adverse drug reactions (SADRs) were analyzed in a prospective cohort of 1155 patients who initiated PI-containing therapy. During a total follow-up of 2037 patient-years, 169 SADRs were reported, yielding a rate of 8 incidents per 100 patient-years (95% confidence interval (CI), 6.8-8.6). The most frequent SADRs were elevated transaminase levels (in 49 events); renal colic (27); abnormal hematological findings (23); and metabolic (18), neuromuscular (7), pancreatic (6), cutaneous (6), cardiovascular (5), and psychiatric disorders (5). Among baseline charac- teristics, plasma human immunodeficiency virus RNA levels of 5l og 10 copies/mL (hazard ratio (HR), 1.5; 95% CI, 1.1-2.2), elevated aspartate aminotransferase levels (HR, 1.1 for each 20 IU of elevation; 95% CI, 1.1- 1.2), creatinine clearance levels of !70 mL/min (HR, 2.1; 95% CI, 1.2-3.7), test results positive for hepatitis C virus antibodies or hepatitis B surface antigenemia (HR, 2.6; 95% CI, 1.8-3.7), and receipt of indinavir (HR, 1.7; 95% CI, 1.2-2.4) were independently predictive of a SADR. SADRs were frequent in the first 4 months after initiation of highly active antiretroviral therapy but continued to occur after that time period.

Published
2004

41. Malignancy-related causes of death in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy

Author

Dominique Salmon, Philippe Morlat, Fabrice Bonnet, Sibylle Bevilacqua, Laurence Heripret, Dominique Costagliola, Geneviève Chêne, Charlotte Lewden, Eric Jougla, and Thierry May

Subjects
Oncology, Cancer Research, medicine.medical_specialty, business.industry, Human immunodeficiency virus (HIV), medicine.disease_cause, Malignancy, medicine.disease, Antiretroviral therapy, Internal medicine, medicine, In patient, business
Published
2004

42. Facteurs prédictifs de la réponse virologique à un premier traitement antirétroviral

Author

C. Drobacheff, Bruno Hoen, L. Boyer, M. Froidure, Christophe Strady, Pascal Chavanet, J. M. Lang, B. Challier, Jean-François Faucher, P. Fischer, Thierry May, Catherine Chirouze, and F.-X. Lescure

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medicine, General Medicine, business, Predictive factor
Abstract

Resume Objectifs Au cours de l’annee 1999, les associations d’antiretroviraux de premiere ligne pour traiter l’infection par le VIH se sont diversifiees. L’objectif de notre travail est double : definir les facteurs associes d’une part au succes primaire, d’autre part a l’echappement virologique pour les patients chez qui un premier traitement antiretroviral (ARV) a ete debute entre 1999 et 2000. Methode Il s’agit d’une etude retrospective multicentrique rassemblant 6 CISIH (Centre d’information et de soins de l’immunologie humaine) du Nord-Est de la France. Les donnees sont issues des dossiers medicaux des patients. Le succes primaire correspond a une charge virale plasmatique (CVP) 1 000 copies ARN-VIH/ml, lors de 2 mesures consecutives apres un succes primaire. L’analyse statistique, monovariee et multivariee, a ete effectuee a l’aide du logiciel SAS 8.2 (Sas Institute Inc.). Resultats L’analyse concerne 123 patients, dont 19 % sont au stade C lorsque le traitement ARV est debute. La valeur mediane des CD4 est de 233/mm3 et celle de la charge virale plasmatique de 72 900 copies/ml. La duree mediane de suivi est de 20,7 mois moyenne (ecart type) : 20,6 (6,7). Les traitements initiaux sont distribues de la maniere suivante : 2 inhibiteurs nucleosidiques de la transcriptase inverse (INTI) + 1 inhibiteur non nucleosidique de la transcriptase inverse (INNTI), n = 66 (54 %) ; 2 INTI +1 inhibiteur de protease, n = 44 (36 %) ; 3 INTI, n = 13 (10 %). La proportion de succes primaire est de 81,3 % (100/123). La proportion d’echappement virologique est de 6 % (6/123). L’absence de modification du traitement ARV initial avant ou a M4 ainsi que la bonne observance therapeutique a M4 sont statistiquement associees au succes primaire en analyse univariee (p respectifs : 0,004 et 0,04) et multivariee (p a 0,009 et 0,03). La proportion d’echappement est plus elevee chez les patients dont le taux initial de CD4 est inferieur a 200/mm3 (p = 0,09). Conclusion Dans cette cohorte, la tolerance et l’observance du premier traitement sont associees au succes primaire. Ce travail souligne le role de l’observance dans le succes primaire et renforce la necessite d’une aide a l’observance.

Published
2004

43. Glycopeptides

Author

Christian Rabaud and Thierry May

Published
2004

44. Low Serum Procalcitonin Level Accurately Predicts the Absence of Bacteremia in Adult Patients with Acute Fever

Author

Bruno Hoen, Jean-Marie Estavoyer, Helder Gil, Hélène Schuhmacher, Christian Rabaud, Catherine Chirouze, Norbert Khayat, and Thierry May

Subjects
Adult, Calcitonin, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, Fever, medicine.drug_class, Calcitonin Gene-Related Peptide, Antibiotics, Bacteremia, Fever of Unknown Origin, Sensitivity and Specificity, Gastroenterology, Procalcitonin, Diagnosis, Differential, Predictive Value of Tests, Internal medicine, parasitic diseases, medicine, Humans, Blood culture, Protein Precursors, Gram-Positive Bacterial Infections, Aged, Aged, 80 and over, medicine.diagnostic_test, Receiver operating characteristic, biology, business.industry, C-reactive protein, Middle Aged, bacterial infections and mycoses, medicine.disease, Community-Acquired Infections, Infectious Diseases, Erythrocyte sedimentation rate, Predictive value of tests, Acute Disease, Immunology, biology.protein, Female, Gram-Negative Bacterial Infections, business, Biomarkers, hormones, hormone substitutes, and hormone antagonists
Abstract

The ability of measurement of serum procalcitonin (PCT) levels to differentiate bacteremic from nonbacteremic infectious episodes in patients hospitalized for community-acquired infections was assessed. Serum samples were obtained from adult inpatients with fever to determine the serum PCT level, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR). Of 165 patients, 22 (13%) had bacteremic episodes and 143 (87%) had nonbacteremic episodes. PCT levels, CRP levels, and ESRs were significantly higher in bacteremic patients than in nonbacteremic patients (P

Published
2002

45. Role of Long-Term Nucleoside-Analogue Therapy in Lipodystrophy and Metabolic Disorders in Human Immunodeficiency Virus--Infected Patients

Author

Philippe Morlat, Laurent Cotte, Thierry May, Jean-Marie Lang, Bernard Jarrousse, Gérard Lepeu, Emmanuelle Angelini, Geneviève Chêne, François Raffi, Michèle Grappin, Valérie Journot, Jean-Michel Molina, and Corinne Rancinan

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Lipodystrophy, Anti-HIV Agents, HIV Infections, Gastroenterology, Metabolic Diseases, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Humans, Lipoatrophy, Didanosine, Nucleoside analogue, business.industry, Stavudine, Metabolic disorder, Nucleosides, Odds ratio, medicine.disease, Infectious Diseases, Multivariate Analysis, Immunology, Drug Therapy, Combination, Female, business, Follow-Up Studies, medicine.drug
Abstract

The role of nucleoside analogues (NAs) in lipodystrophy (LD) syndrome in human immunodeficiency virus (HIV)-infected patients remains controversial. We studied the prevalence of LD in previously untreated patients randomized to receive different NA combinations (in the ALBI-ANRS 070 trial) for 6 months. At month 30 of follow-up, 37 (31%) of 120 patients had >/=1 morphologic change, and 21 (57%) of 37 had isolated peripheral lipoatrophy; corresponding values for the patients who received only NAs throughout follow-up were 20 (30%) of 66 and 14 (67%) of 21, respectively. In multivariate analysis, factors associated with presence of LD at month 30 were initial assignment to the group receiving stavudine and didanosine (odds ratio [OR], 6.7; P=.02), age (OR for being 10 years older, 3.6; P=.002), and HIV RNA level at month 30 (OR, 0.4; P=.007). No difference was observed in cholesterol and glucose levels as a function of any pattern of antiretroviral exposure. Exposure to stavudine and didanosine was associated with LD syndrome (predominantly lipoatrophy).

Published
2002

46. Varicella Arthritis in Childhood

Author

Sibylle Bevilacqua, Jean-Manuel Poircuitte, Thierry May, Véronique Venard, Laurence Boyer, and Pierre Lascombes

Subjects
Microbiology (medical), Herpesvirus 3, Human, medicine.medical_specialty, viruses, Arthritis, Real-Time Polymerase Chain Reaction, Synovial Fluid/chemistry/virology, Virus, Arthritis, Infectious/complications/diagnosis/virology, Chickenpox, Herpesvirus 3, Human/physiology, Synovial Fluid, DNA, Viral/analysis, medicine, Monoarthritis, Humans, Synovial fluid, Arthritis, Infectious, Hip, business.industry, virus diseases, Human physiology, Exanthema, medicine.disease, Dermatology, Rash, Surgery, Infectious Diseases, Child, Preschool, Varicella infection, DNA, Viral, Chickenpox/complications/diagnosis/virology, Pediatrics, Perinatology and Child Health, Female, France, Exanthema/complications/virology, medicine.symptom, business, Complication, Hip/pathology/virology
Abstract

Nonbacterial arthritis is a rare but well-recognized complication of acute varicella in children. Reported cases usually described monoarthritis of the knee that occurs at the onset of the rash or shortly after. Herein, we describe a case of arthritis of the hip that occurred in a 4-year-old girl 6 days before the onset of rash. The presence of varicella-zoster virus DNA in synovial fluid was confirmed by real-time polymerase chain reaction. A review of the literature reported 26 previous cases of aseptic arthritis due to varicella infection among children.

Published
2011

47. Real-life rilpivirine resistance and potential emergence of an E138A-positive HIV strain in north-eastern France

Author

Thierry May, François Goehringer, L. Boyer, Pascale Perrier, Aurélie Velay, Evelyne Schvoerer, Christian Rabaud, Nelly Agrinier, Anne Kennel, M. Foissac, Hélène Jeulin, Sandrine Henard, Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Service de Virologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), and Laboratoire d'histocompatibilité [CHU Nancy]

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Anti-HIV Agents, Non-nucleoside reverse transcriptase inhibitors, HIV Infections, Disease cluster, Virus, Men who have sex with men, chemistry.chemical_compound, Epidemiology, Drug Resistance, Viral, Nitriles, Medicine, Humans, Pharmacology (medical), Retrospective Studies, Pharmacology, business.industry, Rilpivirine, Retrospective cohort study, Virology, 3. Good health, Discovery and development of non-nucleoside reverse-transcriptase inhibitors, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Cross-Sectional Studies, Pyrimidines, chemistry, Cohort, NNRTIs, HIV-1, [SDV.IMM]Life Sciences [q-bio]/Immunology, Resistance-associated mutations, France, business
Abstract

International audience; To assess the prevalence of resistance to rilpivirine and mutations at position 138 in reverse transcriptase and to identify associated epidemiological and biological characteristics.This retrospective study included 238 patients with available HIV-1 nucleotide sequences analysed at the Laboratory of Virology at the University Hospital of Nancy between January 2011 and June 2013. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was evaluated according to the ANRS algorithm (version 23) and correlated with clinico-epidemiological and therapeutic data. The virus strains were analysed by evaluating the distance and distribution of the phylogenetic tree (MEGAv5).Among previously treated patients (111/238, 46.6%), 68/111 (61.3%) had received NNRTIs; all were rilpivirine-naive. The prevalence of rilpivirine resistance in the whole cohort was 12.6% (30/238), and was 10.2% (13/127) and 15.3% (17/111) in naive and pre-treated patients, respectively. The E138A mutation was the most frequent mutation associated with resistance to rilpivirine (PaEuroS < aEuroS0.0001). The prevalence of the E138A mutation tended to increase over time, from 3.6% (2/55) during the first half of 2011 to 9.3% (4/43) during the first half of 2013 (PaEuroS=aEuroS0.0614). Seven viral strains from seven naive male patients positive for the E138A mutation appeared in the same cluster.In our cohort of patients, we observed significantly increased resistance to rilpivirine, mostly because of the E138A mutation, probably due to an E138A strain circulating in newly diagnosed men who have sex with men. Taken together, our results emphasize the need to investigate the prevalence of rilpivirine resistance-associated mutations in the coming years both in France and abroad.

Published
2014

48. Primary Cerebral Alveolar Echinococcosis: Mycology to the Rescue

Author

Marie Machouart, Gérald Umhang, Franck Boué, Thierry May, François Goehringer, Anne Debourgogne, Guillaume Gauchotte, Sandrine Henard, Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Service de Parasitologie-Mycologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)

Subjects
Microbiology (medical), Male, Pathology, medicine.medical_specialty, Echinococcosis, Hepatic, Biopsy, Foxes, Strains, Alveolar echinococcosis, Case Reports, Biology, Polymerase Chain Reaction, Serology, X ray computed, Echinococcosis, medicine, Molecular diagnostic techniques, Humans, Favorable outcome, Brain Diseases, Microscopy, Ribosomal DNA, medicine.diagnostic_test, Histocytochemistry, Brain, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Multilocularis, 3. Good health, Tomography x ray computed, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Molecular Diagnostic Techniques, [SDV.IMM]Life Sciences [q-bio]/Immunology, Tomography, X-Ray Computed
Abstract

A case of primary cerebral alveolar echinococcosis with a favorable outcome is reported. A universal fungal PCR enabled this diagnosis, while the initial serological analysis remained noncontributive.

Published
2014

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