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Parfut A, Tripon S, Gantner P, Chaffraix F, Laugel E, Wendling MJ, Erol F, Wiedemer C, Doffoel M, Saviano A, Royant M, Habersetzer F, Fafi-Kremer S, Velay A. Impact of anti-HDV reflex testing at HBs antigen positive discovery in a single center France: Support for primary HDV screening in France. J Clin Virol 2024; 171:105650. [PMID: 38350177 DOI: 10.1016/j.jcv.2024.105650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/14/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Hepatitis Delta virus (HDV) infection is a major cause of liver-related morbidity and mortality in patients infected with HBV, with a global HDV prevalence uncertain. In France, 2 to 5 % of HBs antigen (HBsAg) carriers present anti-HDV antibodies (anti-HDV). The EASL recommends testing for anti-HDV in all HBsAg-positive patients. Since January 2022, we have systematically carried out anti-HDV serology when a positive HBsAg is discovered (new HBsAg carriers). OBJECTIVES We evaluated the benefit of anti-HDV reflex testing after one year of practice by comparing anti-HDV and HBsAg serology data over the last six years, among the new HBsAg carriers and all the HBsAg carriers. STUDY DESIGN HBsAg and anti-HDV were screened using the Abbott Architect HBsAg quanti kit and the DIA.PRO HDVAb kit. Serological, demographic, virological, and clinical data were analyzed. RESULTS Implementing anti-HDV reflex testing leads to more than a 2-fold increase in diagnoses of HDV infection among all HBsAg carriers. If the anti-HDV positive rate remains stable among the new HBsAg carriers, a significant increase in the anti-HDV positive rate from 6.8 % to 10.3 % was observed considering all HBsAg carriers. Interestingly, the discovery of anti-HDV carriage increased from 3.9 % to 6.5 % in 2022, allowing earlier identification of HBV-HDV-infected patients and a fast referral to hepatologists for adequate clinical management and, in some cases, the introduction of bulevirtide-based therapy. CONCLUSIONS Our preliminary results at one year seem promising and evaluating the cost-effectiveness of reflex tests in real life with feedback would be helpful.
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Affiliation(s)
- Assilina Parfut
- Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Simona Tripon
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - Pierre Gantner
- Unité Mixte de Recherche (UMR) S1109 Labex Transplantex, Institut National de la Santé et de la Recherche Médicale (Inserm) Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg France, Department of Virology, Institut de Virologie, Strasbourg University Hospital, 3 rue Koeberlé, Strasbourg F67000, France
| | - Fréderic Chaffraix
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - Elodie Laugel
- Unité Mixte de Recherche (UMR) S1109 Labex Transplantex, Institut National de la Santé et de la Recherche Médicale (Inserm) Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg France, Department of Virology, Institut de Virologie, Strasbourg University Hospital, 3 rue Koeberlé, Strasbourg F67000, France
| | | | - Furkan Erol
- Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Carine Wiedemer
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - Michel Doffoel
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - Antonio Saviano
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - Maude Royant
- Service Expert de Lutte Contre les Hépatites Virales d'Alsace (SELHVA), Pôle Hépato-Digestif, Strasbourg University Hospital, Strasbourg, France
| | - François Habersetzer
- Service Hépato-Gastroentérologie et Pôle Hépato-Digestif, Hôpitaux Universitaire de Strasbourg, Université de Strasbourg, Inserm 1110, Strasbourg, Strasbourg, France
| | - Samira Fafi-Kremer
- Unité Mixte de Recherche (UMR) S1109 Labex Transplantex, Institut National de la Santé et de la Recherche Médicale (Inserm) Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg France, Department of Virology, Institut de Virologie, Strasbourg University Hospital, 3 rue Koeberlé, Strasbourg F67000, France
| | - Aurélie Velay
- Unité Mixte de Recherche (UMR) S1109 Labex Transplantex, Institut National de la Santé et de la Recherche Médicale (Inserm) Fédération de Médecine Translationnelle, Strasbourg University, Strasbourg France, Department of Virology, Institut de Virologie, Strasbourg University Hospital, 3 rue Koeberlé, Strasbourg F67000, France.
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Doffoel M, Ernwein F, Chaffraix F, Haumesser L, Tripon S, Bader R, Lang JP, Lang A, Paya D, Royant M, Velay-Rusch A, Tebacher M, Meyer N, Habersetzer F, Baumert T. Characteristics and care of chronic hepatitis C treated with direct-acting antivirals in migrants. Eur J Gastroenterol Hepatol 2022; 34:664-670. [PMID: 34974466 DOI: 10.1097/meg.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIMS Hepatitis C is poorly documented in migrants. The published studies mainly concern the screening in this population and are limited to some countries in Europe and North America. This study aimed to evaluate the characteristics and care of chronic hepatitis C in this population compared to the nonmigrant population, in the era of direct-acting antivirals (DAAs). METHOD We performed a retrospective analysis based on data presented at the multidisciplinary team meetings of our tertiary care center between 2015 and 2019. RESULTS We included 277 migrant- and 1390 nonmigrant patients mono-infected with hepatitis C virus (HCV) and treated with DAAs. The majority of the migrants were from Eastern European countries. In multivariable analysis, BMI classes associated with more obesity (OR = 1.84; 95% CI, 1.37-2.49; P < 0.001) and therapeutic patient education (OR = 3.91; 95% CI, 2.38-6.49; P < 0.001) were positively associated with migrant status, whereas age (OR = 0.92; 95% CI, 0.90-0.94; P < 0.001), female gender (OR = 0.46; 95% CI, 0.28-0.74; P = 0.002), modes of contamination with less drug use, transfusion history or nosocomial risk, as well more unknown mode (OR = 0.70; 95% CI, 0.50-0.96; P = 0.031), alcohol consumption (OR = 0.48; 95% CI, 0.29-0.73; P = 0.001), types of structures with less care in a general hospital or health network of general practitioners and more care in a university hospital or primary addictology center (OR = 0.78; 95% CI, 0.60-0.99; P = 0.046) and opioid substitution therapy (OR = 0.25; 95% CI, 0.08-0.68; P = 0.008) were negatively associated with migrant status. The substained virologic response 12 was close to 97% in both groups. CONCLUSION Despite multiple differences in characteristics and therapeutic care between the two populations, the chances of healing hepatitis C were the same among migrant- compared with nonmigrant patients.
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Affiliation(s)
- Michel Doffoel
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Florence Ernwein
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Frédéric Chaffraix
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Lucile Haumesser
- Groupe méthode en recherche clinique, Pôle de santé publique au travail, Hôpitaux universitaires, Strasbourg, France
| | - Simona Tripon
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Robert Bader
- service d'hépatogastroentérologie et médecine tropicale, Pôle pathologies digestives et urologiques, Hôpital Emile Muller, Groupement hospitalier régional mulhouse sud alsace (GHRMSA), Mulhouse
| | - Jean-Philippe Lang
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Anais Lang
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | | | - Maude Royant
- Service expert de lutte contre les hépatites virales d'alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | | | - Martine Tebacher
- Centre régional de pharmacovigilance grand est, Hôpitaux universitaires
| | - Nicolas Meyer
- Groupe méthode en recherche clinique, Pôle de santé publique au travail, Hôpitaux universitaires, Strasbourg, France
| | - François Habersetzer
- Service d'hépato gastroentérologie, Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires
| | - Thomas Baumert
- INSERM U-1110 Institut de recherche sur les maladies virales et hépatiques, Université de strasbourg, Strasbourg, France
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Brunet J, Pesson B, Royant M, Lemoine JP, Pfaff AW, Abou-Bacar A, Yera H, Fréalle E, Dupouy-Camet J, Merino-Espinosa G, Gómez-Mateos M, Martin-Sanchez J, Candolfi E. Molecular diagnosis of Pseudoterranova decipiens s.s in human, France. BMC Infect Dis 2017; 17:397. [PMID: 28583155 PMCID: PMC5460327 DOI: 10.1186/s12879-017-2493-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 07/04/2016] [Accepted: 05/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background Anisakis and Pseudoterranova are the main genera involved in human infections caused by nematodes of the Anisakidae family. Species identification is complicated due to the lack of differential morphological characteristics at the larval stage, thus requiring molecular differentiation. Pseudoterranova larvae ingested through raw fish are spontaneously eliminated in most cases, but mechanical removal by means of endoscopy might be required. To date, only very few cases of Pseudoterranova infection have been reported in France. Case presentation A 19-year-old woman from Northeastern France detected, while brushing her teeth, a larva exiting through her mouth. The patient who presented with headache, diarrhea, and abdominal cramps reported having eaten baked cod. The worm was a fourth-stage larva with a size of 22 × 0.9 mm, and molecular biology identified it as Pseudoterranova decipiens sensu stricto (s. s.). In a second P. decipiens infection case, occurring a few months later, a worm exited through the patient’s nose after she had eaten raw sea bream. Conclusion These two cases demonstrate that Pseudoterranova infection is not uncommon among French patients. Therefore, molecular techniques should be more widely applied for a better characterization of anisakidosis epidemiology in France.
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Affiliation(s)
- Julie Brunet
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France. .,Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, F-67000, Strasbourg, France.
| | - Bernard Pesson
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France
| | - Maude Royant
- Service des consultations externes, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France
| | - Jean-Philippe Lemoine
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France
| | - Alexander W Pfaff
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France.,Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, F-67000, Strasbourg, France
| | - Ahmed Abou-Bacar
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France.,Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, F-67000, Strasbourg, France
| | - Hélène Yera
- Service de Parasitologie-Mycologie, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, 27 rue du Faubourg St Jacques, F-75015, Paris, France
| | - Emilie Fréalle
- CHU Lille, Laboratoire de Parasitologie-Mycologie et Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity, Lille, France
| | - Jean Dupouy-Camet
- Service de Parasitologie-Mycologie, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, 27 rue du Faubourg St Jacques, F-75015, Paris, France
| | - Gema Merino-Espinosa
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja s, /n 18071, Granada, Spain
| | - Magdalena Gómez-Mateos
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja s, /n 18071, Granada, Spain
| | - Joaquina Martin-Sanchez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja s, /n 18071, Granada, Spain
| | - Ermanno Candolfi
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, BP 426, F-67091, Strasbourg cedex, France.,Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, F-67000, Strasbourg, France
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