1
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Bonnafous P, Marlet J, Gaudy-Graffin C, Gautheret-Dejean A. Need for a better characterization of HHV-6 infections and associated clinical impacts. Am J Transplant 2019; 19:304-305. [PMID: 29985560 DOI: 10.1111/ajt.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- P Bonnafous
- CIMI-Paris UMRS CR7, Inserm U1135, Equipe 1 Infections Virales Persistantes, Faculté de médecine, Sorbonne Université, Paris, France
| | - J Marlet
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites, Inserm U1259, Université de Tours, Tours, France.,Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Tours, Tours, France
| | - C Gaudy-Graffin
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites, Inserm U1259, Université de Tours, Tours, France.,Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Tours, Tours, France
| | - A Gautheret-Dejean
- CIMI-Paris UMRS CR7, Inserm U1135, Equipe 1 Infections Virales Persistantes, Faculté de médecine, Sorbonne Université, Paris, France.,Service de Virologie, HU La Pitié Salpêtrière-Charles Foix, APHP, Paris, France.,Laboratoire de Microbiologie, équipe UPRES EA4065, Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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2
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Bonnafous P, Marlet J, Bouvet D, Salamé E, Tellier AC, Guyetant S, Goudeau A, Agut H, Gautheret-Dejean A, Gaudy-Graffin C. Fatal outcome after reactivation of inherited chromosomally integrated HHV-6A (iciHHV-6A) transmitted through liver transplantation. Am J Transplant 2018; 18:1548-1551. [PMID: 29316259 DOI: 10.1111/ajt.14657] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/26/2017] [Accepted: 12/30/2017] [Indexed: 01/25/2023]
Abstract
HHV-6A and HHV-6B are found as inherited and chromosomally integrated forms (iciHHV-6A and -6B) into all germinal and somatic cells and vertically transmitted in a Mendelian manner in about 1% of the population. They were occasionally shown to be horizontally transmitted through hematopoietic stem cell transplantation. Here, we present a clinical case of horizontal transmission of iciHHV-6A from donor to recipient through liver transplantation. Molecular analysis performed on three viral genes (7.2 kb) in the recipient and donor samples supports transmission of iciHHV-6A from the graft. Transmission was followed by reactivation, with high viral loads in several compartments. The infection was uncontrollable, leading to severe disease and death, despite antiviral treatments and the absence of resistance mutations. This case highlights the fact that physicians should be aware of the possible horizontal transmission of iciHHV-6 and its consequences in case of reactivation in immunocompromised patients.
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Affiliation(s)
- P Bonnafous
- Sorbonne Université, Faculté de médecine, INSERM, CIMI-Paris U1135, Equipe PVI, F-75013 Paris, France
| | - J Marlet
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites Tours, Inserm U1259, Université de Tours, Tours, France.,Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Tours, Tours, France
| | - D Bouvet
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites Tours, Inserm U1259, Université de Tours, Tours, France
| | - E Salamé
- Unité de Chirurgie Hépato-Biliaire et pancréatique-Transplantation hépatique, CHU de Tours, Tours, France
| | - A-C Tellier
- Réanimation Chirurgicale Tours, CHU de Tours, Tours, France
| | - S Guyetant
- Service d'Anatomie et Cytologie Pathologiques, CHU de Tours, Tours, France
| | - A Goudeau
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites Tours, Inserm U1259, Université de Tours, Tours, France.,Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Tours, Tours, France
| | - H Agut
- Sorbonne Université, Faculté de médecine, INSERM, CIMI-Paris U1135, Equipe PVI, F-75013 Paris, France.,Service de Virologie HU La Pitié Salpêtrière-Charles Foix Paris, APHP, Paris, France
| | - A Gautheret-Dejean
- Sorbonne Université, Faculté de médecine, INSERM, CIMI-Paris U1135, Equipe PVI, F-75013 Paris, France.,Service de Virologie HU La Pitié Salpêtrière-Charles Foix Paris, APHP, Paris, France.,Laboratoire de Microbiologie Paris, équipe UPRES EA4065, Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - C Gaudy-Graffin
- Morphogenèse et Antigénicité du VIH et des Virus des Hépatites Tours, Inserm U1259, Université de Tours, Tours, France.,Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Tours, Tours, France
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3
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Le Guillou-Guillemette H, Ducancelle A, Bertrais S, Lemaire C, Pivert A, Veillon P, Bouthry E, Alain S, Thibault V, Abravanel F, Rosenberg AR, Henquell C, André-Garnier E, Petsaris O, Vallet S, Bour JB, Baazia Y, Trimoulet P, André P, Gaudy-Graffin C, Bettinger D, Larrat S, Signori-Schmuck A, Saoudin H, Pozzetto B, Lagathu G, Minjolle-Cha S, Stoll-Keller F, Pawlotsky JM, Izopet J, Payan C, Lunel-Fabiani F. Identification of a duplicated V3 domain in NS5A associated with cirrhosis and hepatocellular carcinoma in HCV-1b patients. J Clin Virol 2015. [PMID: 26209408 DOI: 10.1016/j.jcv.2015.06.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The NS5A protein of the hepatitis C virus has been shown to be involved in the development of hepatocellular carcinoma. OBJECTIVES In a French multicenter study, we investigated the clinical and epidemiological features of a new HCV genotype 1b strain bearing a wide insertion into the V3 domain. STUDY DESIGN We studied NS5A gene sequences in 821 French patients infected with genotype 1b HCV. RESULTS We identified an uncharacterized V3 insertion without ORF disruption in 3.05% of the HCV sequences. The insertion comprised 31 amino-acids for the majority of patients; 3 patients had 27 amino-acids insertions and 1 had a 12 amino-acids insertion. Sequence identity between the 31 amino-acids insertions and the V3 domain ranged from 48 to 96% with E-values above 4e(-5), thus illustrating sequence homology and a partial gene duplication event that to our knowledge has never been reported in HCV. Moreover we showed the presence of the duplication at the time of infection and its persistence at least during 12 years in the entire quasispecies. No association was found with extrahepatic diseases. Conversely, patients with cirrhosis were two times more likely to have HCV with this genetic characteristic (p=0.04). Moreover, its prevalence increased with liver disease severity (from 3.0% in patients without cirrhosis to 9.4% in patients with both cirrhosis and HCC, p for trend=0.045). CONCLUSIONS We identified a duplicated V3 domain in the HCV-1b NS5A protein for the first time. The duplication may be associated with unfavorable evolution of liver disease including a possible involvement in liver carcinogenesis.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - A Ducancelle
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - S Bertrais
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - C Lemaire
- IRHS, PRES LUNAM, SFR QUASAV, Angers, France.
| | - A Pivert
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - P Veillon
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
| | - E Bouthry
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - S Alain
- Laboratoire de Virologie, CHU Limoges, France.
| | - V Thibault
- Laboratoire de Virologie, CHU Pitié-Salpêtrière, Paris, France.
| | - F Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - A R Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, EA 4474 "Hepatitis C Virology", Paris, France.
| | - C Henquell
- Laboratoire de Virologie, CHU Clermont-Ferrand, France.
| | | | - O Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - S Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - J B Bour
- Laboratoire de Virologie, CHU, Dijon, France.
| | - Y Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France.
| | - P Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France.
| | - P André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France.
| | - C Gaudy-Graffin
- Université François Rabelais, Inserm U966, CHU Tours, France.
| | - D Bettinger
- Laboratoire de Virologie, CHU Besançon, France.
| | - S Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - A Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France.
| | - H Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - B Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France.
| | - G Lagathu
- Laboratoire de Virologie, CHU Rennes, France.
| | | | - F Stoll-Keller
- Institut de Virologie, CHU Strasbourg, Inserm U748, Strasbourg, France.
| | - J M Pawlotsky
- Laboratoire de Virologie-Bactériologie, CHU Henri-Mondor, Créteil, France.
| | - J Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France.
| | - C Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, EA3882, Brest, France.
| | - F Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France; HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France.
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4
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Grammatico-Guillon L, Guillon A, Sonke J, Garot D, Chaillon A, Gaudy-Graffin C, Goudeau A. Utilisation de la PCR multiplex comme outil diagnostique de la pneumopathie aiguë communautaire. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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5
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Sonke J, Grammatico-Guillon L, Guillon A, Garot D, Chaillon A, Gaudy-Graffin C, Goudeau A. Évaluation de la PCR multiplex dans la prise en charge des patients hospitalisés pour pneumopathies communautaires au CHRU de Tours. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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6
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Bacq Y, Gaudy-Graffin C, Marchand S. [Prophylaxis of mother-to-infant transmission of hepatitis B virus]. Arch Pediatr 2015; 22:427-34. [PMID: 25725975 DOI: 10.1016/j.arcped.2014.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 09/19/2014] [Accepted: 12/28/2014] [Indexed: 02/07/2023]
Abstract
Hepatitis B virus (HBV) infection is a worldwide health problem and mother-to-infant (or vertical) transmission is the main source of chronic infection in Asian countries. Administration of HBV vaccine to the infant at birth, with or without concurrent specific immunoglobulin, efficiently prevents such transmission (efficacy>90%). In France, testing Ag HBs is mandatory during pregnancy in all pregnant women. Infants born to Ag HBs-positive mothers should receive the first injection of vaccine and one injection of specific immunoglobulins at birth. Vaccination should thereafter be completed according to a three-injection protocol (at 1 and 6 months) or a four-injection protocol in case of prematurity. Failure of immunoprophylaxis can be observed when the viral load is very high in the mother during pregnancy (HBV-DNA levels>200,000 IU/mL). In such women, antiviral therapy with analogs (lamivudine, telbivudine, or tenofovir) during the third trimester of pregnancy and 1 month post-partum, in association with accurate immunoprophylaxis, may prevent vertical transmission. The optimal cut-off value of maternal viral load for antiviral therapy in late pregnancy and post-partum to prevent vertical transmission is still under debate.
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Affiliation(s)
- Y Bacq
- Service d'hépatogastroentérologie, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex, France.
| | - C Gaudy-Graffin
- Inserm U966, faculté de médecine, université François-Rabelais, 37044 Tours cedex, France; Service de bactériologie et virologie, hôpital Bretonneau, CHRU de Tours, 37044 Tours cedex, France
| | - S Marchand
- Service de médecine pédiatrique, hôpital Clocheville, CHRU de Tours, 37044 Tours cedex, France
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7
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Bouvet D, Gaudy-Graffin C, Garot D, Sunder S, De Gialluly C, Goudeau A. Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex). ACTA ACUST UNITED AC 2015; 63:69-73. [PMID: 25596173 PMCID: PMC7126571 DOI: 10.1016/j.patbio.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 12/04/2014] [Indexed: 11/17/2022]
Abstract
Investigations of the etiologic agents of community-acquired acute respiratory illness may lead to better treatment decisions and patient outcomes. In a routine care setting, we assessed the diagnostic performance of a multiplex PCR assay with respect to conventional microbiological methods, in a continuous series of adult cases of community-acquired acute respiratory illness. We enrolled 279 adult patients hospitalised for community-acquired acute respiratory illness at Tours University Hospital during the winter of 2011–2012. Respiratory samples (mostly nasopharyngeal aspirates) were studied prospectively by indirect immunofluorescence assay and multiplex PCR, that enable detection of 8 viruses and 21 respiratory pathogens respectively. In total, 255 of the 279 (91.4%) samples had interpretable results by both methods. At least one respiratory pathogen was detected by multiplex PCR in 171 specimens (65%). Overall, 130 (76%) of the 171 positive samples were positive for only one respiratory pathogen, 37 (22%) samples were positive for two pathogens and four (2%) were positive for three pathogens. With indirect immunofluorescence assay, a respiratory virus was detected in 27 of the 255 (11%) specimens. Indirect immunofluorescence assay detected some of the influenza virus A (15/51, 29%) infections identified by multiplex PCR and some (7/15, 47%) human metapneumovirus and (5/12, 42%) respiratory syncytial virus infections, but it did not detect all the adenovirus infections. Thus, access to multiplex molecular assays improves the diagnostic spectrum and accuracy over conventional methods, increasing the frequency of identification of the respiratory pathogens involved in community-acquired acute respiratory illness.
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Affiliation(s)
- D Bouvet
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France
| | - C Gaudy-Graffin
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France.
| | - D Garot
- Service de réanimation médicale, hôpital Bretonneau, CHRU, 37000 Tours, France
| | - S Sunder
- Service de médecine interne et maladies infectieuses, hôpital Bretonneau, CHRU, 37000 Tours, France
| | - C De Gialluly
- Laboratoire de bactériologie et hygiène hospitalière, hôpital Trousseau, CHRU, 37000 Tours, France
| | - A Goudeau
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France
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8
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Haguenoer K, Sengchanh S, Gaudy-Graffin C, Boyard J, Fontenay R, Marret H, Goudeau A, Pigneaux de Laroche N, Rusch E, Giraudeau B. Vaginal self-sampling is a cost-effective way to increase participation in a cervical cancer screening programme: a randomised trial. Br J Cancer 2014; 111:2187-96. [PMID: 25247320 PMCID: PMC4260034 DOI: 10.1038/bjc.2014.510] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/08/2014] [Accepted: 08/20/2014] [Indexed: 01/05/2023] Open
Abstract
Background: Cervical cancer screening coverage remains insufficient in most countries. Our objective was to assess whether in-home vaginal self-sampling with a dry swab for high-risk human papillomavirus (HR-HPV) testing is effective and cost-effective in increasing participation in cervical cancer screening. Methods: In March 2012, 6000 unscreened women aged 30–65 years, living in a French region covered by a screening programme, who had not responded to an initial invitation to have a Pap smear were equally randomised to three groups: ‘no intervention' ‘recall', women received a letter to have a Pap smear; and ‘self-sampling', women received a self-sampling kit to return to a centralised virology laboratory for PCR-based HPV testing. Results: Participation was higher in the ‘self-sampling' than in the ‘no intervention' group (22.5% vs 9.9%, P<0.0001; OR 2.64) and ‘recall' group (11.7%, P<0.0001; OR 2.20). In the ‘self-sampling' group, 320 used the self-sampling kit; for 44 of these women with positive HR-HPV test results, 40 had the recommended triage Pap smear. The ICER per extra screened woman was 77.8€ and 63.2€ for the ‘recall' and ‘self-sampling' groups, respectively, relative to the ‘no intervention' group. Conclusions: Offering an in-home, return-mail kit for vaginal self-sampling with a dry swab is more effective and cost-effective than a recall letter in increasing participation in cervical cancer screening.
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Affiliation(s)
- K Haguenoer
- 1] INSERM, U1153, Paris, France [2] Cancer Screening Department, CHRU de Tours, Tours 37000, France
| | - S Sengchanh
- Cancer Screening Department, CHRU de Tours, Tours 37000, France
| | - C Gaudy-Graffin
- 1] Department of Bacteriology and Virology, CHRU de Tours, Tours 37000, France [2] Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours 37000, France [3] INSERM U966, Tours 37000, France
| | - J Boyard
- Cancer Screening Department, CHRU de Tours, Tours 37000, France
| | - R Fontenay
- Medico-Economic Evaluation Unit, CHRU de Tours, Tours 37000, France
| | - H Marret
- 1] Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours 37000, France [2] Department of Gynaecology and Obstetrics, CHRU de Tours, Tours 37000, France
| | - A Goudeau
- 1] Department of Bacteriology and Virology, CHRU de Tours, Tours 37000, France [2] Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours 37000, France [3] INSERM U966, Tours 37000, France
| | | | - E Rusch
- 1] Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours 37000, France [2] Medico-Economic Evaluation Unit, CHRU de Tours, Tours 37000, France [3] Université François-Rabelais, Équipe émergente de recherche Éducation, Éthique, Santé, Tours, France
| | - B Giraudeau
- 1] INSERM, U1153, Paris, France [2] Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours 37000, France [3] CHRU de Tours, INSERM CIC1415, Tours 37000, France
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9
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Haguenoer K, Giraudeau B, Gaudy-Graffin C, de Pinieux I, Dubois F, Trignol-Viguier N, Viguier J, Marret H, Goudeau A. Accuracy of dry vaginal self-sampling for detecting high-risk human papillomavirus infection in cervical cancer screening: A cross-sectional study. Gynecol Oncol 2014; 134:302-8. [DOI: 10.1016/j.ygyno.2014.05.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/23/2014] [Accepted: 05/28/2014] [Indexed: 11/17/2022]
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10
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Fouquet M, Gaudy-Graffin C, Goudeau A, Haillot O, Bruyere F. Prévalence urogénitale des différents papillomavirus humains dans le cancer de la prostate, l’hyperplasie bénigne de la prostate et l’inflammation chronique prostatique. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Gatault P, Halimi JM, Forconi C, Thibault G, Barbet C, Mérieau E, Gaudy-Graffin C, Marlière JF, Goudeau A, Bruyère F, Lebranchu Y, Büchler M, Baron C. CMV infection in the donor and increased kidney graft loss: impact of full HLA-I mismatch and posttransplantation CD8(+) cell reduction. Am J Transplant 2013; 13:2119-29. [PMID: 23731368 DOI: 10.1111/ajt.12298] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 03/29/2013] [Accepted: 04/02/2013] [Indexed: 01/25/2023]
Abstract
Despite a large body of literature, the impact of chronic cytomegalovirus (CMV) infection in donor on long-term graft survival remains unclear, and factors modulating the effect of CMV infection on graft survival are presently unknown. In this retrospective study of 1279 kidney transplant patients, we analyzed long-term graft survival and evolution of CD8(+) cell population in donors and recipients by CMV serology and antigenemia status. A positive CMV serology in the donor was an independent risk factor for graft loss, especially among CMV-positive recipients (R(+) ). Antigenemia was not a risk factor for graft loss and kidneys from CMV-positive donors remained associated with poor graft survival among antigenemia-free recipients. Detrimental impact of donor's CMV seropositivity on graft survival was restricted to patients with full HLA-I mismatch, suggesting a role of CD8(+) cells. In R(+) patients with positive CMV antigenemia during the first year, CD8(+) cell count did not increase at 2 years posttransplantation, in contrast to R(-) recipients. In addition, marked CD8(+) -cell decrease was a risk factor of graft failure in these patients. This study identifies HLA-I full mismatch and a decrease of CD8(+) cell count at 2 years as important determinants of CMV-associated graft loss.
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Affiliation(s)
- P Gatault
- EA4245 Cellules Dendritiques et Greffes, Université François-Rabelais, Tours, France.
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12
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Le Guillou-Guillemette H, Vallet S, Gaudy-Graffin C, Payan C, Pivert A, Goudeau A, Lunel-Fabiani F. Genetic diversity of the hepatitis C virus: Impact and issues in the antiviral therapy. World J Gastroenterol 2007; 13:2416-26. [PMID: 17552024 PMCID: PMC4146759 DOI: 10.3748/wjg.v13.i17.2416] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The hepatitis C Virus (HCV) presents a high degree of genetic variability which is explained by the combination of a lack of proof reading by the RNA dependant RNA polymerase and a high level of viral replication. The resulting genetic polymorphism defines a classification in clades, genotypes, subtypes, isolates and quasispecies. This diversity is known to reflect the range of responses to Interferon therapy. The genotype is one of the predictive parameters currently used to define the antiviral treatment strategy and the chance of therapeutic success. Studies have also reported the potential impact of the viral genetic polymorphism in the outcome of antiviral therapy in patients infected by the same HCV genotype. Both structural and non structural genomic regions of HCV have been suggested to be involved in the Interferon pathway and the resistance to antiviral therapy. In this review, we first detail the viral basis of HCV diversity. Then, the HCV genetic regions that may be implicated in resistance to therapy are described, with a focus on the structural region encoded by the E2 gene and the non-structural genes NS3, NS5A and NS5B. Both mechanisms of the Interferon resistance and of the new antiviral drugs are described in this review.
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Affiliation(s)
- H Le Guillou-Guillemette
- Laboratory of Virology, Department of Infectious Agents, University Hospital of Angers, 4 rue Larrey, 49933 Angers Cedex 9, France
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