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Spindler L, Etienney I, Abramowitz L, de Parades V, Pigot F, Siproudhis L, Adam J, Balzano V, Bouchard D, Bouta N, Bucau M, Carlo A, Chanal J, Charpentier C, Clifford G, Draullette M, Fathallah N, Ferré V, Fléjou JF, Fouéré S, Higuero T, Kassouri L, Kurt S, Laurain A, Leclerc E, Lepiller Q, Lesage AC, Mège D, Ménard A, Merle P, Mortreux P, Noël C, Péré H, Prétet JL, Roland D, Staumont G, Tracanelli L, Vuitton L, Wylomanski S, Zaegel-Faucher O. Screening for precancerous anal lesions linked to human papillomaviruses: French recommendations for clinical practice. Tech Coloproctol 2024; 28:23. [PMID: 38198036 PMCID: PMC10781838 DOI: 10.1007/s10151-023-02899-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024]
Abstract
In France, about 2000 new cases of anal cancer are diagnosed annually. Squamous cell carcinoma is the most common histological type, mostly occurring secondary to persistent HPV16 infection. Invasive cancer is preceded by precancerous lesions. In addition to patients with a personal history of precancerous lesions and anal cancer, three groups are at very high risk of anal cancer: (i) men who have sex with men and are living with HIV, (ii) women with a history of high-grade squamous intraepithelial lesions (HSILs) or vulvar HPV cancer, and (iii) women who received a solid organ transplant more than 10 years ago. The purpose of screening is to detect HSILs so that they can be treated, thereby reducing the risk of progression to cancer. All patients with symptoms should undergo a proctological examination including standard anoscopy. For asymptomatic patients at risk, an initial HPV16 test makes it possible to target patients at risk of HSILs likely to progress to cancer. Anal cytology is a sensitive test for HSIL detection. Its sensitivity is greater than 80% and exceeds that of proctological examination with standard anoscopy. It is indicated in the event of a positive HPV16 test. In the presence of cytological abnormalities and/or lesions and a suspicion of dysplasia on clinical examination, high-resolution anoscopy is indicated. Performance is superior to that of proctological examination with standard anoscopy. However, this technique is not widely available, which limits its use. If high-resolution anoscopy is not possible, screening by a standard proctological examination is an alternative. There is a need to develop high-resolution anoscopy and triage tests and to evaluate screening strategies.
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Affiliation(s)
- L Spindler
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
| | - I Etienney
- Service de Proctologie, Hôpital Diaconesses-Croix Saint Simon, Paris, France
| | - L Abramowitz
- Service de Proctologie, APHP Hôpital Bichat-Claude Bernard and Ramsay GDS Clinique Blomet, Paris, France
| | - V de Parades
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - F Pigot
- Service de Proctologie, Hôpital Bagatelle, Talence, France
| | - L Siproudhis
- Service d'Hépato-Gastroentérologie, CHU Pontchaillou, Rennes, France
| | - J Adam
- Service d'Anatomopathologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - V Balzano
- Service de Gastroentérologie et Oncologie Digestive, CHU Tours, Tours, France
| | - D Bouchard
- Service de Proctologie, Hôpital Bagatelle, Talence, France
| | - N Bouta
- Service d'Hépato-Gastroentérologie et de Proctologie, Clinique La Croix du Sud, Quint-Fonsegrives, France
| | - M Bucau
- Service d'Anatomopathologie, AP-HP Hôpital Bichat-Claude Bernard, Paris, France
| | - A Carlo
- Service d'Hépato-Gastroentérologie, CHU Pontchaillou, Rennes, France
| | - J Chanal
- Service de Dermatologie, AP-HP, Hôpital Tarnier, Paris, France
| | - C Charpentier
- Département de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, INSERM, IAME, Université de Paris, Paris, France
| | - G Clifford
- Early Detection, Prevention, and Infections Branch, International Agency for Research On Cancer, Lyon, France
| | - M Draullette
- Service d'Hépato-Gastroentérologie et Assistance Nutritive, AP-HP, Hôpital Beaujon, Clichy, France
| | - N Fathallah
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - V Ferré
- Département de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, INSERM, IAME, Université de Paris, Paris, France
| | - J-F Fléjou
- Service d'Anatomopathologie, Cerbapath, Paris, France
| | - S Fouéré
- Service de Dermatologie, AP-HP, Hôpital Saint-Louis, Université de Paris, Paris, France
- Centre des Maladies Sexuellement Transmises, AP-HP, Hôpital Saint-Louis, Paris, France
| | - T Higuero
- Gastro-entérologue, proctologue medico-chirurgical, Beausoleil, France
| | - L Kassouri
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - S Kurt
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Laurain
- Service de Proctologie, APHP Hôpital Bichat-Claude Bernard and Ramsay GDS Clinique Blomet, Paris, France
| | - E Leclerc
- Service d'Hépato-Gastroentérologie, CHU Clermont-Ferrand, Inserm, 3iHP, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Q Lepiller
- Laboratoire de Virologie, CHU de Besançon, Besançon, France
| | - A-C Lesage
- Service de Proctologie, Hôpital Diaconesses-Croix Saint Simon, Paris, France
| | - D Mège
- Service de Chirurgie Digestive, Université d'Aix Marseille, AP-HM, Hôpital de la Timone, Marseille, France
| | - A Ménard
- Institut Hospitalo-Universitaire Méditerranée Infection, AP-HM, Hôpital Nord, Université d'Aix Marseille, Marseille, France
| | - P Merle
- Service d'Hépato-Gastroentérologie et de Proctologie, Clinique La Croix du Sud, Quint-Fonsegrives, France
| | - P Mortreux
- Service de Gastroentérologie, Centre Hospitalier de Bethune Beuvry, Beuvry, France
| | - C Noël
- Service d'Hépato-Gastroentérologie, CHU de Brest, Brest, France
| | - H Péré
- Laboratoire de Virologie, Service de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Functional Genomics of Solid Tumors (FunGeST), Centre de Recherche des Cordelier, INSERM, Université de Paris, Sorbonne Université, Paris, France
| | - J-L Prétet
- EA3181, Université de Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, Besançon, France
- Centre National de Référence Papillomavirus, CHU de Besançon, Besançon, France
| | - D Roland
- Service de Proctologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - G Staumont
- Service d'Hépato-Gastroentérologie et de Proctologie, Clinique La Croix du Sud, Quint-Fonsegrives, France
| | - L Tracanelli
- Service de Proctologie, Hôpital Bagatelle, Talence, France
| | - L Vuitton
- Service de Gastroentérologie, CHU de Besançon, Université de Bourgogne Franche-Comté, Besançon, France
| | - S Wylomanski
- Service de Gynécologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - O Zaegel-Faucher
- Service d'Immuno-Hématologie Clinique, AP-HM, CHU Sainte-Marguerite, Marseille, France
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Brégigeon S, Lions C, Zaegel-Faucher O, Laroche H, Martinet P, Bertone H, Blanco-Betancourt C, Orticoni M, Soavi MJ, Poizot-Martin I. Consultation « santé sexuelle et affective » : quelles attentes pour les personnes vivant avec le VIH ? Sexologies 2019. [DOI: 10.1016/j.sexol.2017.12.006] [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: 10/18/2022]
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Poizot-Martin I, Obry-Roguet V, Zaegel-Faucher O, Lions C, Cano C, Ivanova A, Ritleng A, Debreux C, Bregigeon S. HIV infection and care pathway: From guidelines to clinical practice. Med Mal Infect 2018; 49:23-33. [PMID: 30195462 DOI: 10.1016/j.medmal.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/24/2017] [Revised: 01/31/2018] [Accepted: 07/24/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To quantify within a cohort of HIV-infected individuals the number of medical visits and procedures to be carried out according to comorbidities and risk factors to implement a personalized care pathway. PATIENTS AND METHODS Retrospective study of 915 patients consulting from January 1 to December 31, 2016 at an outpatient unit of multidisciplinary consultations, using an electronic patient record. We built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. The frequency of comorbidities was measured according to gender, transmission risk group, and nadir CD4 (<or>200/mm3). RESULTS Patients were mostly men (median age: 52 years), of whom 16% were aged≥60 years. Viral load was<40 copies/mL in 93.5% of treated patients and CD4 cell count≥500/mm3 for 73%. Overall, 74.5% of patients had at least one comorbidity. The number of comorbidities was similar in men and women but was significantly higher in patients with a nadir CD4 <200/mm3 and increased with age (irrespective of gender). The minimum number of consultations to be scheduled per year was 8123: 70% for the management of comorbidities with an average of six consultations/year/patient. Overall, 53% of patients should attend a proctology consultation. The minimum number of paramedical procedures to be performed was 5115. CONCLUSION The implementation of a personalized multidisciplinary management within a single facility seems to be a suitable care model to address the needs of HIV-infected individuals.
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Affiliation(s)
- I Poizot-Martin
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France; INSERM, IRD, SESSTIM, sciences économiques & Sociales de la Santé & Traitement de l'Information Médicale, AP-HM Sainte-Marguerite, service d'Immuno-hématologie clinique, biostatistique et technologies de l'information et de la communication, Aix Marseille Université, AP-HM, 13009 Marseille, France.
| | - V Obry-Roguet
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - O Zaegel-Faucher
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Lions
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Cano
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - A Ivanova
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - A Ritleng
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - C Debreux
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
| | - S Bregigeon
- Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France
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Cloarec N, Solas C, Ladaique A, Tamalet C, Zaegel-Faucher O, Bregigeon S, Canet B, Cano CE, Poizot-Martin I. Sub-therapeutic darunavir concentration and garlic consumption; a «Mediterranean» drug-food interaction, about 2 cases. Eur J Clin Pharmacol 2017; 73:1331-1333. [DOI: 10.1007/s00228-017-2300-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
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