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Mafi S, Essig M, Rerolle JP, Lagathu G, Crochette R, Brodard V, Schvartz B, Gouarin S, Bouvier N, Engelmann I, Garstka A, Bressollette-Bodin C, Cantarovitch D, Germi R, Janbon B, Archimbaut C, Heng AE, Garnier F, Gomes-Mayeras M, Labrunie A, Hantz S, Alain S. Torque teno virus viremia and QuantiFERON ®-CMV assay in prediction of cytomegalovirus reactivation in R+ kidney transplant recipients. Front Med (Lausanne) 2023; 10:1180769. [PMID: 37425298 PMCID: PMC10323437 DOI: 10.3389/fmed.2023.1180769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/12/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Cytomegalovirus (CMV) is the most frequent infectious complication following solid organ transplantation. Torque teno viruses (TTV) viremia has been proposed as a biomarker of functional immunity in the management of kidney transplant recipients (KTR). The QuantiFERON®-CMV (QF-CMV) is a commercially available assay that allows the assessment of CD8+ T-cell responses in routine diagnostic laboratories. Methods In a prospective national multicenter cohort of 64 CMV-seropositive (R+) KTR, we analyzed the value of TTV load and the two markers of the QF-CMV assay [QF-Ag (CMV-specific T-cell responses) and QF-Mg (overall T-cell responses)], alone and in combination, in prediction of CMV reactivation (≥3 log10 IU/ ml) in the first post-transplant year. We compared previously published cut-offs and specific cut-offs optimized from ROC curves for our population. Results Using the conventional cut-off (3.45 log10 copies/ml), TTV load at D0 [inclusion visit on the day of transplantation before induction (D0)], or at M1 (1-month post-transplant visit) perform better in predicting CMV viremia control than CMV reactivation. Survival analyses suggest a better performance of our optimized TTV cut-offs (3.78 log10 copies/ml at D0 and 4.23 log10 copies/ml at M1) for risk stratification of CMV reactivation in our R+ KTR cohort. The QF-CMV (QF-Ag = 0.2 IU/ml, and QF-Mg = 0.5 IU/ml) also appears to better predict CMV viremia control than CMV reactivation. Moreover, survival analyses suggest that the QF-Mg would perform better than the QF-Ag in stratifying the risk of CMV reactivation. The use of our optimized QF-Mg cut-off (1.27 IU/ml) at M1 further improved risk stratification of CMV reactivation. Using conventional cut-offs, the combination of TTV load and QF-Ag or TTV load and QF-Mg did not improve prediction of CMV viremia control compared to separate analysis of each marker but resulted in an increase of positive predictive values. The use of our cut-offs slightly improved risk prediction of CMV reactivation. Conclusion The combination of TTV load and QF-Ag or TTV load and QF-Mg could be useful in stratifying the risk of CMV reactivation in R+ KTR during the first post-transplant year and thereby have an impact on the duration of prophylaxis in these patients. Clinical trial registration ClinicalTrials.gov registry, identifier NCT02064699.
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Affiliation(s)
- Sarah Mafi
- French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France
| | - Marie Essig
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Jean-Philippe Rerolle
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Gisèle Lagathu
- Virology Department, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Romain Crochette
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Véronique Brodard
- Virology Department, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Betoul Schvartz
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Stephanie Gouarin
- Virology Department, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Nicolas Bouvier
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Ilka Engelmann
- Virology Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Antoine Garstka
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Diego Cantarovitch
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Raphaële Germi
- Virology Department, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Benedicte Janbon
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Christine Archimbaut
- Virology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne-Elizabeth Heng
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Françoise Garnier
- French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France
| | - Melissa Gomes-Mayeras
- French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France
| | - Anaïs Labrunie
- Biostatistics Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Sébastien Hantz
- French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France
| | - Sophie Alain
- French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France
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Descamps A, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Amour S, L'Honneur AS, Fidouh N, Foulongne V, Lagathu G, Duval X, Merle C, Lina B, Carrat F, Launay O, Loubet P. In-hospital and midterm out-hospital complications of adults hospitalised with respiratory syncytial virus infection in France, 2017-2019: an observational study. Eur Respir J 2021; 59:13993003.00651-2021. [PMID: 34446468 DOI: 10.1183/13993003.00651-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To describe the clinical characteristics and in/out-hospital outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza. METHODS Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex RT-PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit (ICU) admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30/90-day all-cause mortality and 90-day readmission rates. RESULTS Overall, 1,428 hospitalised adults with ILI were included. RSV was detected in 8% (114/1428) and influenza virus in 31% (437/1428). Patients hospitalised with RSV were older than those with influenza (mean age, 73.0 versus 68.8 years; p=0.015) with a higher frequency of respiratory (52% versus 39%, p=0.012) or cardiac chronic diseases (52% versus 41%, p=0.039) and longer hospitalisation duration (median stay 8 versus 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV than influenza patients (20% versus 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (adjusted prevalence ratio (aPR)=1.5; 95% Confidence Interval (95% CI) 1.1-2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR=1.1; 95% CI 0.8-1.6). CONCLUSION RSV infection results in serious respiratory illness with in-hospital outcomes worse than influenza and with similar midterm post-discharge outcomes.
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Affiliation(s)
- Alexandre Descamps
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France
| | - Nezha Lenzi
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Florence Galtier
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1411, Montpellier University Hospital, Montpellier, France
| | - Fabrice Lainé
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1414, CHU Rennes, Rennes, France
| | - Zineb Lesieur
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Philippe Vanhems
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Sélilah Amour
- Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | | | | | - Vincent Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Gisèle Lagathu
- Laboratoire de virologie, Pôle micro-organismes, CHU Rennes, Rennes, France
| | - Xavier Duval
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, Paris, France.,Université de Paris, IAME, INSERM, Paris, France
| | - Corinne Merle
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Assistance Publique Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
| | - Odile Launay
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France.,Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Last authors contributed equally to this article
| | - Paul Loubet
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France .,Department of Infectious and Tropical Disease, VBMI, INSERM U1047, CHU Nîmes, Univ Montpellier, Nîmes, France.,Last authors contributed equally to this article
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Besombes J, Pronier C, Lefevre C, Lagathu G, Maillard A, Grolhier C, Thibault V. Performances of NeuMoDx™, a random-access system for hepatitis B virus DNA and hepatitis C virus RNA quantification. Clin Microbiol Infect 2021; 27:1693.e9-1693.e15. [PMID: 33677082 DOI: 10.1016/j.cmi.2021.02.023] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Monitoring of viral loads (VL) for hepatitis B and C viruses (HBV; HCV) is essential to evaluate disease progression and treatment response. Automated, random-access rapid systems are becoming standard to provide clinicians with reliable VL. The aim of this study was to evaluate the analytical performances of the recently launched NeuMoDx™ for HBV-DNA and HCV-RNA quantification. METHODS Clinical samples routinely quantified on the Beckman-Veris system were either retrospectively (frozen samples; HBV n = 178, HCV n = 249), or in parallel (fresh primary tubes; HBV n = 103, HCV n = 117) tested using NeuMoDx™. Linearity range was assessed on serial dilutions of high-titre plasmas containing different genotypes for HBV (A-E, n = 9) and HCV (1a,1b,2-5, n = 12). RESULTS Overall test failure, mostly internal control amplification failure, was 2.3% and was not influenced by matrix types (fresh or frozen). For HBV VL, κ agreement was 74%, with 27 (12.6%) discrepancies. Correlation between HBV assays on 72 quantified samples by both methods was excellent (r = 0.963) with a mean bias (NeuMoDx™-Veris) of 0.21 log IU/mL. For HCV VL, κ agreement reached 94%, with 9 (2.8%) discrepancies. The r correlation factor between assays on 104 samples was 0.960 with a mean bias of -0.14 log IU/mL (NeuMoDx™-Veris). Serial dilutions confirmed the claimed linear ranges for all analysed HBV and HCV genotypes. The mean turnaround time was 72 minutes (range 55-101 minutes) for HBV and 96 minutes (range 78-133 minutes) for HCV. CONCLUSION Results obtained on the NeuMoDx™ confirmed the overall good functionality of the system with a short turn-around-time, full traceability and easy handling. These results on HBV and HCV VL look promising and should be challenged with further comparisons.
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Affiliation(s)
- Juliette Besombes
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Charlotte Pronier
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Charles Lefevre
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Gisèle Lagathu
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Anne Maillard
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Claire Grolhier
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France
| | - Vincent Thibault
- Virology Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Rennes, France.
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4
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Pronier C, Gacouin A, Lagathu G, Le Tulzo Y, Tadié JM, Thibault V. Respiratory Influenza viral load as a marker of poor prognosis in patients with severe symptoms. J Clin Virol 2021; 136:104761. [DOI: 10.1016/j.jcv.2021.104761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/22/2021] [Accepted: 02/09/2021] [Indexed: 12/28/2022]
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Loubet P, Mathieu P, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Duval X, Postil D, Amour S, Rogez S, Lagathu G, L'Honneur AS, Foulongne V, Houhou N, Lina B, Carrat F, Launay O. Characteristics of human metapneumovirus infection in adults hospitalized for community-acquired influenza-like illness in France, 2012-2018: a retrospective observational study. Clin Microbiol Infect 2020; 27:127.e1-127.e6. [PMID: 32283266 PMCID: PMC7195031 DOI: 10.1016/j.cmi.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/05/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
Objectives To describe the prevalence, clinical features and complications of human metapneumovirus (hMPV) infections in a population of adults hospitalized with influenza-like illness (ILI). Methods This was a retrospective, observational, multicenter cohort study using prospectively collected data from adult patients hospitalized during influenza virus circulation, for at least 24 h, for community-acquired ILI (with symptom onset <7 days). Data were collected from five French teaching hospitals over six consecutive winters (2012–2018). Respiratory viruses were identified by multiplex reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens. hMPV + patients were compared with hMPV– patients, influenza+ and respiratory syncytial virus (RSV)+ patients using multivariate logistic regressions. Primary outcome was the prevalence of hMPV in patients hospitalized for ILI. Results Among the 3148 patients included (1449 (46%) women, 1988 (63%) aged 65 and over; 2508 (80%) with chronic disease), at least one respiratory virus was detected in 1604 (51%, 95% confidence interval (CI) 49–53), including 100 cases of hMPV (100/3148, 3% 95% CI 3–4), of which 10 (10%) were viral co-infection. In the hMPV + patients, mean length of stay was 7 days, 62% (56/90) developed a complication, 21% (14/68) were admitted to intensive care unit and 4% (4/90) died during hospitalization. In comparison with influenza + patients, hMPV + patients were more frequently >65 years old (adjusted odds ratio (aOR) = 3.3, 95% CI 1.9–6.3) and presented more acute heart failure during hospitalization (aOR = 1.8, 95% CI 1.0–2.9). Compared with RSV + patients, hMPV + patients had less cancer (aOR = 0.4, 95% CI 0.2–0.9) and were less likely to smoke (aOR = 0.5, 95% CI 0.2–0.9) but had similar outcomes, especially high rates of respiratory and cardiovascular complications. Conclusions Adult hMPV infections mainly affect the elderly and patients with chronic conditions and are responsible for frequent cardiac and pulmonary complications similar to those of RSV infections. At-risk populations would benefit from the development of antivirals and vaccines targeting hMPV.
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Affiliation(s)
- P Loubet
- VBMI, INSERM U1047, Department of Infectious and Tropical Disease, CHU Nîmes, Univ Montpellier, Nîmes, France; Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France.
| | - P Mathieu
- Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - N Lenzi
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - F Galtier
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1411, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - F Lainé
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Centre d'Investigations Cliniques, INSERM UMR CIC 1414, Hôpital Pontchaillou, Rennes, France
| | - Z Lesieur
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - P Vanhems
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - X Duval
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1125, Hôpital Bichat Claude Bernard, Paris, France
| | - D Postil
- CHU Dupuytren, CIC 1435, Limoge Cedex, France
| | - S Amour
- Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - S Rogez
- CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France
| | - G Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - A-S L'Honneur
- AHU, Service de Virologie, Hôpital Cochin, Paris, France
| | - V Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - N Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - B Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France
| | - F Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, F75013 Paris, France
| | - O Launay
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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Bénézit F, Loubet P, Galtier F, Pronier C, Lenzi N, Lesieur Z, Jouneau S, Lagathu G, L'Honneur AS, Foulongne V, Vallejo C, Alain S, Duval X, Houhou N, Costa Y, Vanhems P, Amour S, Carrat F, Lina B, Launay O, Tattevin P. Non-influenza respiratory viruses in adult patients admitted with influenza-like illness: a 3-year prospective multicenter study. Infection 2020; 48:489-495. [PMID: 32056143 PMCID: PMC7095392 DOI: 10.1007/s15010-019-01388-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 08/13/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To describe the burden, and characteristics, of influenza-like illness (ILI) associated with non-influenza respiratory viruses (NIRV). METHODS We performed a prospective, multicenter, observational study of adults admitted with ILI during three influenza seasons (2012-2015). Patients were screened for picornavirus, respiratory syncytial virus (RSV), coronavirus, human metapneumovirus, adenovirus, bocavirus, parainfluenza virus, and influenza, by PCR on nasopharyngeal samples. We excluded patients coinfected with NIRV and influenza. RESULTS Among 1421 patients enrolled, influenza virus was detected in 535 (38%), and NIRV in 215 (15%), mostly picornavirus (n = 61), RSV (n = 53), coronavirus 229E (n = 48), and human metapneumovirus (n = 40). In-hospital mortality was 5% (NIRV), 4% (influenza), and 5% (no respiratory virus). As compared to influenza, NIRV were associated with age (median, 73 years vs. 68, P = 0.026), chronic respiratory diseases (53% vs. 45%, P = 0.034), cancer (14% vs. 9%, P = 0.029), and immunosuppressive drugs (21% vs. 14%, P = 0.028), and inversely associated with diabetes (18% vs. 25%, P = 0.038). On multivariable analysis, only chronic respiratory diseases (OR 1.5 [1.1-2.0], P = 0.008), and diabetes (OR 0.5 [0.4-0.8], P = 0.01) were associated with NIRV detection. CONCLUSIONS NIRV are common in adults admitted with ILI during influenza seasons. Outcomes are similar in patients with NIRV, influenza, or no respiratory virus.
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Affiliation(s)
- François Bénézit
- Université Rennes-I, Service Des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex, France
| | - Paul Loubet
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Florence Galtier
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,CIC1411, CHU Montpellier, Hôpital Saint Eloi, 34295, Montpellier, France
| | - Charlotte Pronier
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - Nezha Lenzi
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Zineb Lesieur
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Stéphane Jouneau
- Université Rennes-I, Pneumologie, Hôpital Pontchaillou, Rennes, France.,Inserm, CIC 1414, Université Rennes-I, Hôpital Pontchaillou, Rennes, France
| | - Gisèle Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | | | - Vincent Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, 34295, Montpellier, France
| | | | - Sophie Alain
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, 87000, Limoges, France
| | - Xavier Duval
- CIC1125, Hôpital Bichat Claude Bernard, APHP, Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Nawal Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - Yolande Costa
- CIC1125, Hôpital Bichat Claude Bernard, APHP, Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Philippe Vanhems
- Service D'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, 69437, Lyon, France.,Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de La Recherche Scientifique, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
| | - Sélilah Amour
- Service D'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, 69437, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis D'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, 75013, Paris, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut Des Agents Infectieux (IAI), Centre National de Référence Des Virus Respiratoires France Sud, Hôpital de La Croix-Rousse, 69317, Lyon Cedex 04, France
| | - Odile Launay
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Pierre Tattevin
- Université Rennes-I, Service Des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex, France. .,Inserm, CIC 1414, Université Rennes-I, Hôpital Pontchaillou, Rennes, France.
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Luque-Paz D, Pronier C, Tattevin P, Bénézit F, Maillard A, Comacle P, Baldeyrou M, Lagathu G, Revest M, Thibault V. La grippe : une infection nosocomiale non rare, et grave. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.055] [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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8
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Kaplon J, Grangier N, Pillet S, Minoui-Tran A, Vabret A, Wilhelm N, Prieur N, Lazrek M, Alain S, Mekki Y, Foulongne V, Guinard J, Avettand-Fenoel V, Schnuriger A, Beby-Defaux A, Lagathu G, Pothier P, de Rougemont A. Predominance of G9P[8] rotavirus strains throughout France, 2014–2017. Clin Microbiol Infect 2018; 24:660.e1-660.e4. [DOI: 10.1016/j.cmi.2017.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/27/2022]
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Le Guillou-Guillemette H, Pivert A, Bouthry E, Henquell C, Petsaris O, Ducancelle A, Veillon P, Vallet S, Alain S, Thibault V, Abravanel F, Rosenberg AA, André-Garnier E, 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, Lemaire C. Natural non-homologous recombination led to the emergence of a duplicated V3-NS5A region in HCV-1b strains associated with hepatocellular carcinoma. PLoS One 2017; 12:e0174651. [PMID: 28394908 PMCID: PMC5386276 DOI: 10.1371/journal.pone.0174651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/13/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The emergence of new strains in RNA viruses is mainly due to mutations or intra and inter-genotype homologous recombination. Non-homologous recombinations may be deleterious and are rarely detected. In previous studies, we identified HCV-1b strains bearing two tandemly repeated V3 regions in the NS5A gene without ORF disruption. This polymorphism may be associated with an unfavorable course of liver disease and possibly involved in liver carcinogenesis. Here we aimed at characterizing the origin of these mutant strains and identifying the evolutionary mechanism on which the V3 duplication relies. METHODS Direct sequencing of the entire NS5A and E1 genes was performed on 27 mutant strains. Quasispecies analyses in consecutive samples were also performed by cloning and sequencing the NS5A gene for all mutant and wild strains. We analyzed the mutant and wild-type sequence polymorphisms using Bayesian methods to infer the evolutionary history of and the molecular mechanism leading to the duplication-like event. RESULTS Quasispecies were entirely composed of exclusively mutant or wild-type strains respectively. Mutant quasispecies were found to have been present since contamination and had persisted for at least 10 years. This V3 duplication-like event appears to have resulted from non-homologous recombination between HCV-1b wild-type strains around 100 years ago. The association between increased liver disease severity and these HCV-1b mutants may explain their persistence in chronically infected patients. CONCLUSIONS These results emphasize the possible consequences of non-homologous recombination in the emergence and severity of new viral diseases.
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Affiliation(s)
- Hélène Le Guillou-Guillemette
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Adeline Pivert
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Elise Bouthry
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | | | - Odile Petsaris
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Alexandra Ducancelle
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Pascal Veillon
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
| | - Sophie Vallet
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | | | | | - Florence Abravanel
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Arielle A. Rosenberg
- AP-HP, GHU Cochin, Laboratoire de Virologie, Université Paris Descartes, Paris, France
| | | | | | - Yazid Baazia
- Laboratoire de Virologie, CHU Avicenne, Bobigny, France
| | - Pascale Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin Tripode, CHU Bordeaux, France
| | - Patrice André
- Laboratoire de Virologie, Centre de Biologie Nord, Hôpital de la Croix Rousse, Lyon, France
| | | | | | - Sylvie Larrat
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Anne Signori-Schmuck
- Laboratoire de Virologie, UMI 3265 UJF-EMBL-CNRS, CHU, Unit of Virus Host Cell Interactions, Grenoble, France
| | - Hénia Saoudin
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratoire de Bactériologie-Virologie, CHU Saint-Etienne, France
| | | | | | | | | | - Jacques Izopet
- Laboratoire de Virologie, CNR VHE, Inserm U1043, CHU Purpan, Toulouse, France
| | - Christopher Payan
- Département de Bactériologie-Virologie-Hygiène Hospitalière et Parasitologie-Mycologie, CHRU, LUBEM, Brest, France
| | - Françoise Lunel-Fabiani
- Laboratoire de Virologie, CHU Angers, France
- HIFIH Laboratory, UPRES 3859, SFR 4208, LUNAM University, Angers, France
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Loubet P, Lenzi N, Valette M, Foulongne V, Krivine A, Houhou N, Lagathu G, Rogez S, Alain S, Duval X, Galtier F, Postil D, Tattevin P, Vanhems P, Carrat F, Lina B, Launay O. Clinical characteristics and outcome of respiratory syncytial virus infection among adults hospitalized with influenza-like illness in France. Clin Microbiol Infect 2016; 23:253-259. [PMID: 27903461 PMCID: PMC7128342 DOI: 10.1016/j.cmi.2016.11.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/20/2016] [Accepted: 11/22/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to analyse characteristics and outcome of respiratory syncytial virus (RSV) infection in adults hospitalized with influenza-like illness (ILI). METHODS Patients hospitalized with ILI were included in this prospective, multicentre study carried out in six French hospitals during three consecutive influenza seasons (2012-2015). RSV and other respiratory viruses were detected by multiplex PCR in nasopharyngeal swabs. Risk factors for RSV infection were identified by backward stepwise logistic regression analysis. RESULTS A total of 1452 patients hospitalized with ILI were included, of whom 59% (861/1452) were >65 years and 83% (1211/1452) had underlying chronic illnesses. RSV was detected in 4% (59/1452), and influenza virus in 39% (566/1452). Risk factors for RSV infection were cancer (adjusted OR 2.1, 95% CI 1.1-4.1, p 0.04), and immunosuppressive treatment (adjusted OR 2.0, 95% CI 1.1-3.8, p 0.03). Patients with RSV had a median length of stay of 9 days (6-25), and 57% of them (30/53) had complications, including pneumonia (23/53, 44%) and respiratory failure (15/53, 28%). Fifteen per cent (8/53) were admitted to an intensive care unit, and the in-hospital mortality rate was 8% (4/53). Pneumonia was more likely to occur in patients with RSV than in patients with RSV-negative ILI (44% (23/53) versus 26% (362/1393), p 0.006) or with influenza virus infection (44% versus 28% (157/560), p 0.02). CONCLUSION RSV is an infrequent cause of ILI during periods of influenza virus circulation but can cause severe complications in hospitalized adults. Risk factors for RSV detection in adults hospitalized with ILI include cancer and immunosuppressive treatment. Specific immunization and antiviral therapy might benefit patients at risk.
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Affiliation(s)
- P Loubet
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, France; Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - N Lenzi
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France
| | - M Valette
- CNR Virus Influenza, Institut des Agents Infectieux, GHN, Hospices Civils de Lyon, Lyon, France
| | - V Foulongne
- CHU de Montpellier, Laboratoire de Virologie, Hôpital Saint Eloi, Inserm U 1058, Montpellier, France
| | - A Krivine
- AP-HP, Hôpital Cochin Broca Hôtel-Dieu, Laboratoire de Virologie, Paris, France
| | - N Houhou
- AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris, France
| | - G Lagathu
- CHRU Pontchaillou, Laboratoire de Virologie, Rennes, France
| | - S Rogez
- CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France
| | - S Alain
- CHU Dupuytren, Laboratoire de Virologie, Limoge Cedex, France
| | - X Duval
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, France; Inserm CIC 1425, Hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - F Galtier
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France; CHU de Montpellier, Inserm CIC 1411, Hôpital Saint-Eloi, Montpellier, France
| | - D Postil
- CHU Dupuytren, CIC 1435, Limoge Cedex, France
| | - P Tattevin
- CHRU Pontchaillou, Maladies Infectieuses et Réanimation Médicale, CIC INSERM 1414, Rennes, France
| | - P Vanhems
- Service d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Edouard Herriot, Lyon, France; Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI) Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - F Carrat
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; Public health department, Hopital Saint-Antoine, APHP, Paris, France
| | - B Lina
- CNR Virus Influenza, Institut des Agents Infectieux, GHN, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Virpath, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Hospices Civils de Lyon, Univ Lyon, Lyon, France
| | - O Launay
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France; Inserm, CIC 1417, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Infectious Diseases, CIC Cochin Pasteur, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
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de Rougemont A, Kaplon J, Fremy C, Legrand-Guillien MC, Minoui-Tran A, Payan C, Vabret A, Mendes-Martins L, Chouchane M, Maudinas R, Huet F, Dubos F, Hober D, Lazrek M, Bouquignaud C, Decoster A, Alain S, Languepin J, Gillet Y, Lina B, Mekki Y, Morfin-Sherpa F, Guigon A, Guinard J, Foulongne V, Rodiere M, Avettand-Fenoel V, Bonacorsi S, Garbarg-Chenon A, Gendrel D, Lebon P, Lorrot M, Mariani P, Meritet JF, Schnuriger A, Agius G, Beby-Defaux A, Oriot D, Colimon R, Lagathu G, Mory O, Pillet S, Pozzetto B, Stephan JL, Aho S, Pothier P. Clinical severity and molecular characteristics of circulating and emerging rotaviruses in young children attending hospital emergency departments in France. Clin Microbiol Infect 2016; 22:737.e9-737.e15. [PMID: 27287887 DOI: 10.1016/j.cmi.2016.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/25/2016] [Accepted: 05/28/2016] [Indexed: 11/18/2022]
Abstract
Group A rotavirus (RVA) is the leading cause of acute gastroenteritis in young children worldwide. A prospective surveillance network has been set up to investigate the virological and clinical features of RVA infections and to detect the emergence of potentially epidemic strains in France. From 2009 to 2014, RVA-positive stool samples were collected from 4800 children <5 years old attending the paediatric emergency units of 16 large hospitals. Rotaviruses were then genotyped by RT-PCR with regard to their outer capsid proteins VP4 and VP7. Genotyping of 4708 RVA showed that G1P[8] strains (62.2%) were predominant. The incidence of G9P[8] (11.5%), G3P[8] (10.4%) and G2P[4] (6.6%) strains varied considerably, whereas G4P[8] (2.7%) strains were circulating mostly locally. Of note, G12P[8] (1.6%) strains emerged during the seasons 2011-12 and 2012-13 with 4.1% and 3.0% prevalence, respectively. Overall, 40 possible zoonotic reassortants, such as G6 (33.3%) and G8 (15.4%) strains, were detected, and were mostly associated with P[6] (67.5%). Analysis of clinical records of 624 hospitalized children and severity scores from 282 of them showed no difference in clinical manifestations or severity in relation to the genotype. The relative stability of RVA genotypes currently co-circulating and the large predominance of P[8] type strains may ensure vaccine effectiveness in France. The surveillance will continue to monitor the emergence of new reassortants that might not respond to current vaccines, all the more so as all genotypes can cause severe infections in infants.
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Affiliation(s)
- A de Rougemont
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France; UFR des Sciences de Santé, Université de Bourgogne, Dijon, France.
| | - J Kaplon
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France
| | - C Fremy
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France
| | | | | | - C Payan
- Centre Hospitalier Universitaire de Brest, France
| | - A Vabret
- Centre Hospitalier Universitaire de Caen, France
| | | | - M Chouchane
- Centre Hospitalier Universitaire de Dijon, France
| | - R Maudinas
- Centre Hospitalier Universitaire de Dijon, France
| | - F Huet
- UFR des Sciences de Santé, Université de Bourgogne, Dijon, France; Centre Hospitalier Universitaire de Dijon, France
| | - F Dubos
- Centre Hospitalier Régional Universitaire de Lille, France
| | - D Hober
- Centre Hospitalier Régional Universitaire de Lille, France
| | - M Lazrek
- Centre Hospitalier Régional Universitaire de Lille, France
| | - C Bouquignaud
- Groupement des Hôpitaux de l'Institut Catholique de Lille, France
| | - A Decoster
- Groupement des Hôpitaux de l'Institut Catholique de Lille, France
| | - S Alain
- Centre Hospitalier Universitaire de Limoges, France
| | - J Languepin
- Centre Hospitalier Universitaire de Limoges, France
| | | | - B Lina
- Hospices Civils de Lyon, France
| | - Y Mekki
- Hospices Civils de Lyon, France
| | | | - A Guigon
- Centre Hospitalier Universitaire d'Orléans, France
| | - J Guinard
- Centre Hospitalier Universitaire d'Orléans, France
| | - V Foulongne
- Centre Hospitalier Universitaire de Montpellier, France
| | - M Rodiere
- Centre Hospitalier Universitaire de Montpellier, France
| | | | - S Bonacorsi
- Assistance Publique Hôpitaux de Paris, France
| | | | - D Gendrel
- Assistance Publique Hôpitaux de Paris, France
| | - P Lebon
- Assistance Publique Hôpitaux de Paris, France
| | - M Lorrot
- Assistance Publique Hôpitaux de Paris, France
| | - P Mariani
- Assistance Publique Hôpitaux de Paris, France
| | - J-F Meritet
- Assistance Publique Hôpitaux de Paris, France
| | | | - G Agius
- Centre Hospitalier Universitaire de Poitiers, France
| | - A Beby-Defaux
- Centre Hospitalier Universitaire de Poitiers, France
| | - D Oriot
- Centre Hospitalier Universitaire de Poitiers, France
| | - R Colimon
- Centre Hospitalier Universitaire de Rennes, France
| | - G Lagathu
- Centre Hospitalier Universitaire de Rennes, France
| | - O Mory
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - S Pillet
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - B Pozzetto
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - J-L Stephan
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - S Aho
- Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Dijon, France
| | - P Pothier
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France; UFR des Sciences de Santé, Université de Bourgogne, Dijon, France
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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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Schuffenecker I, Henquell C, Mirand A, Coste-Burel M, Marque-Juillet S, Desbois D, Lagathu G, Bornebusch L, Bailly JL, Lina B. New introductions of enterovirus 71 subgenogroup C4 strains, France, 2012. Emerg Infect Dis 2014; 20:1343-6. [PMID: 25061698 PMCID: PMC4111202 DOI: 10.3201/eid2008.131858] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In France during 2012, human enterovirus 71 (EV-A71) subgenogroup C4 strains were detected in 4 children hospitalized for neonatal fever or meningitis. Phylogenetic analysis showed novel and independent EV-A71 introductions, presumably from China, and suggested circulation of C4 strains throughout France. This observation emphasizes the need for monitoring EV-A71 infections in Europe.
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Brichler S, Lagathu G, Chekaraou MA, Le Gal F, Edouard A, Dény P, Césaire R, Gordien E. African, Amerindian and European hepatitis B virus strains circulate on the Caribbean Island of Martinique. J Gen Virol 2013; 94:2318-2329. [PMID: 23884366 DOI: 10.1099/vir.0.055459-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Ten Hepatitis B virus (HBV) genotypes, as well as numerous subgenotypes, have been described in well-characterized ethnogeographical populations. Martinique has been at a crossroads between Africa, Europe, India and the Americas because of the slave trade (17th-19th centuries), followed by an important immigration of Indian and West African workers. In this work, we aimed to study the molecular epidemiology of HBV infection in Martinique according to this unique settlement pattern. To that end, blood samples from 86 consecutive HBV-infected patients from the main hospitals of the island, were retrospectively analysed. Direct sequencing of the pre-S1 or pre-C-C region or complete genome sequencing, followed by phylogenetic analyses were performed. HBV genotypes were: HBV/A1 (68.6 %), HBV/A2 (10.5 %), HBV/D, mainly HBV/D3 and HBV/D4 (8.1 %), HBV/F (3.5 %), and also HBV/E (2.3 %), two strains isolated from two West-African patients. Moreover, 74 % of the HBeAg-negative strains harboured classical pre-C-C mutations, and most HBV/A1 strains also containing specific mutations. Finally, various patterns of deletion mutants in pre-S and pre-C-C regions were found. In conclusion, our findings point to historical and migration-related issues in HBV-genotype distribution suggesting that HBV/A1, but not HBV/E, was imported from Africa during the slave trade, and further supporting the hypothesis that HBV/E has emerged recently in West Africa (<150 years). Potential origins of 'European' HBV/A2 and HBV/D3, 'Amerindian' HBV/F, and HBV/D4 strains are also discussed. Such HBV genetic diversity, beyond its epidemiological interest, may have a clinical impact on the natural history of HBV infection in Martinique.
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Affiliation(s)
- Ségolène Brichler
- Service de Bactériologie, Virologie-Hygiène, Assistance Publique-Hôpitaux de Paris; Hôpitaux Universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny; Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
| | - Gisèle Lagathu
- Service de Bactériologie, Virologie du Centre Hospitalier Régional et Universitaire de Rennes, Pontchaillou, France
| | - Mariama Abdou Chekaraou
- Service de Bactériologie, Virologie-Hygiène, Assistance Publique-Hôpitaux de Paris; Hôpitaux Universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny; Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
| | - Frédéric Le Gal
- Service de Bactériologie, Virologie-Hygiène, Assistance Publique-Hôpitaux de Paris; Hôpitaux Universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny; Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
| | - André Edouard
- Service d'Hépato-Gastro-Entérologie, Centre Hospitalier Universitaire de Fort-de-France, Martinique, France
| | - Paul Dény
- Centre de Recherche sur le Cancer, Équipe 16, INSERM U1052, CNRS UMR 5286, Lyon, France.,Service de Bactériologie, Virologie-Hygiène, Assistance Publique-Hôpitaux de Paris; Hôpitaux Universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny; Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
| | - Raymond Césaire
- Laboratoire de Virologie, Centre Hospitalier Universitaire de Fort-de-France, Martinique; EA 4537, Université Antilles-Guyane, France
| | - Emmanuel Gordien
- Service de Bactériologie, Virologie-Hygiène, Assistance Publique-Hôpitaux de Paris; Hôpitaux Universitaires de Paris Seine Saint-Denis, Site Avicenne, Bobigny; Laboratoire Associé au Centre National de Référence des Hépatites B, C et Delta, Université Paris Nord, Sorbonne Paris Cité, France
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15
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Revest M, Minjolle S, Veyer D, Lagathu G, Michelet C, Colimon R. Detection of HHV-6 in over a thousand samples: new types of infection revealed by an analysis of positive results. J Clin Virol 2011; 51:20-4. [PMID: 21376662 DOI: 10.1016/j.jcv.2011.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Revised: 01/28/2011] [Accepted: 02/02/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clinical manifestations of human herpesvirus-6 (HHV-6) have not been clearly defined, and the role of HHV-6 in human disease remains to be fully elucidated. OBJECTIVE To determine the frequency of HHV-6 infections at Rennes Teaching Hospital and to describe all possible symptoms of such infections. STUDY DESIGN We systematically analyzed in a retrospective study all the samples between May 2003 and December 2004 from patients with HHV-6 by polymerase chain reaction (PCR). Clinical records of patients with positive HHV-6 PCR were recorded. Diagnosis of HHV-6 infection was accepted if all other possible diagnoses had been eliminated. RESULTS Over the study period, 1591 PCRs were performed from various tissues, including blood, cerebrospinal fluid, ascitis and tissue biopsies. Forty-three samples from 25 patients tested positive (3%). We describe three groups of clinical manifestations of HHV-6 infection. The first group consisted of neurological complications (32% of patients), including convulsions, encephalitis and chronic psychiatric disorders in immunocompetent patients. The second group consisted of clinical problems relating to gastrointestinal tract, which was found in 9 of our patients (36%). All of these patients were immunocompromised. Four of them presented colitis, and one of them died one month after liver transplantation because of this colitis. The last group of clinical symptoms was associated with maternal-fetal infection leading to abortion following HHV-6 seroconversion during pregnancy. CONCLUSION Three clinical types of HHV-6 infections are described: neurological manifestations including encephalitis in non-immunocompromised patients, digestive problems in immunosuppressed patients and severe maternal-fetal infection.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child, Preschool
- DNA, Viral/blood
- DNA, Viral/cerebrospinal fluid
- Digestive System Diseases/virology
- Encephalitis, Viral/virology
- Female
- Fetal Diseases/virology
- Herpesvirus 6, Human/genetics
- Herpesvirus 6, Human/isolation & purification
- Herpesvirus 6, Human/pathogenicity
- Humans
- Immunocompetence
- Immunocompromised Host
- Infant
- Infant, Newborn
- Infant, Newborn, Diseases/virology
- Infectious Disease Transmission, Vertical
- Male
- Middle Aged
- Polymerase Chain Reaction/methods
- Pregnancy
- Pregnancy Complications, Infectious/virology
- Retrospective Studies
- Roseolovirus Infections/classification
- Roseolovirus Infections/virology
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Affiliation(s)
- Matthieu Revest
- Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes 35033, France.
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16
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Pommier de Santi V, Nicand E, Lagathu G, Michel R, Rosenmayr G, Raingeval JB, Samy J, Boutin JP, Marimoutou C. Incidence, etiology, and determinants associated with acute diarrhea among French forces deployed to Chad. J Travel Med 2011; 18:115-20. [PMID: 21366795 DOI: 10.1111/j.1708-8305.2010.00490.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study assesses, for the first time, the incidence, etiology, and determinants associated with traveler's diarrhea (TD) among French forces deployed to N'Djamena, Chad. METHODS A prospective study was conducted based on physician consultation for diarrhea during a 5-month French forces mandate. Diarrhea was defined as ≥3 loose stools in a 24-hour period or ≥2 loose stools within the last 8 hours. For each diarrheic episode, an anonymous physician-administered questionnaire was completed and a stool sample collected. Samples were tested for parasites, bacteria, and enteric viruses. Global incidence rate was calculated using the mean number of soldiers based in N'Djamena (n = 1,024) over the 5-month period, as denominator. Incidence rates were also estimated for each of the eleven 2-week periods of stay. A case-crossover analysis estimated determinants associated with diarrhea. RESULTS A total of 240 cases of diarrhea were notified by military physicians, resulting in a global incidence rate of 49 cases per 1,000 person-months (PM). The cumulative individual risk of developing diarrhea during the study period was 0.23. The incidence per 2-week stay began at 8.8/1,000 PM, rose to 54.4/1,000 PM after 1 month, and decreased after 2 months. Of the 240 cases reported, stool samples were obtained for 196 cases. Pathogens were identified in 40% of samples; enteric viruses were predominant (28.1%). Three determinants were associated with diarrhea by multivariate analysis: diarrhea in the close circle [OR: 3.8 (2.0-7.0)]; always eating at the military mess [OR: 0.2 (0.1-0.5)]; or staying in a temporary encampment [OR: 0.3 (0.1-0.8)]. CONCLUSIONS This study found a high frequency of enteric viruses and a high risk of person-to-person transmission associated with diarrhea. Eating at the military mess or staying in a temporary encampment conferred a protective effect. In addition to food-borne disease prevention, stringent hygiene measures are required to break transmission of diarrhea during military deployments.
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Affiliation(s)
- Vincent Pommier de Santi
- Département d'Épidémiologie et de Santé Publique Sud, Institut de Recherche Biomédicale des Armées, Marseille, France.
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17
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Bigaillon C, Tessé S, Lagathu G, Nicand E. Use of hepatitis E IgG avidity for diagnosis of hepatitis E infection. J Virol Methods 2009; 164:127-30. [PMID: 19961880 DOI: 10.1016/j.jviromet.2009.11.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Revised: 11/23/2009] [Accepted: 11/26/2009] [Indexed: 10/20/2022]
Abstract
The diagnosis of acute hepatitis E infection is based on the detection of HEV RNA or specific IgM in immunocompetent patients. Viraemia and excretion of HEV RNA in faeces are not observed in all patients and commercial kits vary in their performance for anti-HEV IgM detection. Additional diagnostic tests must therefore be considered. The value of anti-HEV IgG avidity index for differentiating between acute infection and previous exposure to HEV in countries of low endemicity was investigated. 132 specimens were included, with 39 serum samples from patients with known HEV infection, studied retrospectively. IgG avidity index was high (>60%) in patients with previous infection (n=16) or polyclonal activation (n=3) but was low (<40%) in patients with acute infection (n=20). Then, 93 serum samples from patients, checking for acute hepatitis (detection of anti-HEV IgM but not of HEV RNA) were investigated. IgG avidity index was <40% in 77 of these patients, consistent with acute infection. It exceeded 60% in 15 patients, providing evidence of contact with HEV up to six months previously. One patient had an uninterpretable biological profile, with an IgG avidity index between 40% and 60%. IgG mature slowly during HEV infection, over a period of six months. IgG avidity index can therefore be used to exclude primary infection. This method should improve the diagnosis of acute hepatitis E.
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Dussart P, Lavergne A, Lagathu G, Lacoste V, Martial J, Morvan J, Cesaire R. Reemergence of dengue virus type 4, French Antilles and French Guiana, 2004-2005. Emerg Infect Dis 2007; 12:1748-51. [PMID: 17283628 PMCID: PMC3372336 DOI: 10.3201/eid1211.060339] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
After 10 years of absence, dengue virus type 4 (DENV-4) has recently reemerged in Martinique, Guadeloupe, and French Guiana. Phylogenetic analyses of strains isolated from 2004 to 2005 showed that they belong to DENV-4 genotype II, but to a different cluster than strains isolated from 1993 to 1995.
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Dussart P, Labeau B, Lagathu G, Louis P, Nunes MRT, Rodrigues SG, Storck-Herrmann C, Cesaire R, Morvan J, Flamand M, Baril L. Evaluation of an enzyme immunoassay for detection of dengue virus NS1 antigen in human serum. Clin Vaccine Immunol 2006; 13:1185-9. [PMID: 16988003 PMCID: PMC1656554 DOI: 10.1128/cvi.00229-06] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We evaluated a one-step sandwich-format microplate enzyme immunoassay for detecting dengue virus NS1 antigen (Ag) in human serum by use of Platelia Dengue NS1 Ag kits (Bio-Rad Laboratories, Marnes La Coquette, France). We collected 299 serum samples from patients with dengue disease and 50 serum samples from patients not infected with dengue virus. For the 239 serum samples from patients with acute infections testing positive by reverse transcription-PCR and/or virus isolation for one of the four dengue virus serotypes, the sensitivity of the Platelia Dengue NS1 Ag kit was 88.7% (95% confidence interval, 84.0% to 92.4%). None of the serum samples from patients not infected with dengue virus tested positive with the Platelia Dengue NS1 Ag kit. A diagnostic strategy combining the Platelia Dengue NS1 Ag test for acute-phase sera and immunoglobulin M capture enzyme-linked immunosorbent assay for early-convalescent-phase sera increased sensitivity only from 88.7% to 91.9%. Thus, NS1 antigen detection with the Platelia Dengue NS1 Ag kit could be used for first-line testing for acute dengue virus infection in clinical diagnostic laboratories.
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Affiliation(s)
- Philippe Dussart
- Centre National de Référence des Arbovirus, Institut Pasteur de la Guyane, 23 avenue Pasteur, BP 6010, 97306 Cayenne cedex, French Guiana.
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20
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Yakova M, Lézin A, Dantin F, Lagathu G, Olindo S, Jean-Baptiste G, Arfi S, Césaire R. Increased proviral load in HTLV-1-infected patients with rheumatoid arthritis or connective tissue disease. Retrovirology 2005; 2:4. [PMID: 15686595 PMCID: PMC549050 DOI: 10.1186/1742-4690-2-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Accepted: 02/01/2005] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Human T-lymphotropic virus type 1 (HTLV-1) proviral load is related to the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and has also been shown to be elevated in the peripheral blood in HTLV-1-infected patients with uveitis or alveolitis. Increased proliferation of HTLV-1-infected cells in, or migration of such cells into, the central nervous system is also seen in HAM/TSP. In the present study, we evaluated the proviral load in a cohort of HTLV-1-infected patients with arthritic conditions. RESULTS HTLV-1 proviral load in the peripheral blood from 12 patients with RA and 6 patients with connective tissue disease was significantly higher than that in matched asymptomatic HTLV-1 carriers, but similar to that in matched HAM/TSP controls. HAM/TSP was seen in one-third of the HTLV-1-infected patients with RA or connective tissue disease, but did not account for the higher proviral load compared to the asymptomatic carrier group. The proviral load was increased in the synovial fluid and tissue from an HTLV-1-infected patient with RA, the values suggesting that the majority of infiltrated cells were HTLV-1-infected. In the peripheral blood from HTLV-1-infected patients with RA or connective tissue disease, HTLV-1 proviral load correlated with the percentages of memory CD4+ T cells and activated T cells, and these percentages were shown to be markedly higher in the synovial fluid than in the peripheral blood in an HTLV-1-infected patient with RA. CONCLUSIONS These biological findings are consistent with a role of the retrovirus in the development of arthritis in HTLV-1-infected patients. A high level of HTLV-1-infected lymphocytes in the peripheral blood and their accumulation in situ might play a central role in the pathogenesis of HTLV-1-associated inflammatory disorders. Alternatively, the autoimmune arthritis, its etiological factors or treatments might secondarily enhance HTLV-1 proviral load.
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Affiliation(s)
- Maria Yakova
- INSERM UMR433, antenne du Centre hospitalier universitaire de Fort-de-France, Martinique
- Service de Médecine interne et Rhumatologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Agnès Lézin
- INSERM UMR433, antenne du Centre hospitalier universitaire de Fort-de-France, Martinique
- Laboratoire de Virologie-Immunologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Fabienne Dantin
- Laboratoire de Virologie-Immunologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Gisèle Lagathu
- Laboratoire de Virologie-Immunologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Stéphane Olindo
- Service de Neurologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Georges Jean-Baptiste
- Service de Médecine interne et Rhumatologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Serge Arfi
- Service de Médecine interne et Rhumatologie, Centre hospitalier universitaire de Fort-de-France, Martinique
| | - Raymond Césaire
- INSERM UMR433, antenne du Centre hospitalier universitaire de Fort-de-France, Martinique
- Laboratoire de Virologie-Immunologie, Centre hospitalier universitaire de Fort-de-France, Martinique
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