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Burgel PR, Paillasseur JL, Durieu I, Reynaud-Gaubert M, Hamidfar R, Murris-Espin M, Danner-Boucher I, Chiron R, Leroy S, Douvry B, Grenet D, Mely L, Ramel S, Moncouquiol S, Burnet E, Ouaalaya EH, Sogni P, Da Silva J, Martin C. Multisystemic Effects of Elexacaftor-Tezacaftor-Ivacaftor in Adults with Cystic Fibrosis and Advanced Lung Disease. Ann Am Thorac Soc 2024. [PMID: 38579175 DOI: 10.1513/annalsats.202312-1065oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 04/07/2024] Open
Abstract
RATIONALE Limited data exist on safety and effectiveness of elexacaftor-tezacaftor-ivacaftor (ETI) in people with cystic fibrosis (pwCF) and advanced lung disease. OBJECTIVE To evaluate the effects of ETI in an unselected population of pwCF and advanced lung disease. METHODS A prospective observational study, including all adults, aged 18 years and older, with a percent predicted FEV1 (ppFEV1)≤ 40 who initiated ETI from December 2019 to June 2021 in France was conducted. PwCF were followed until August 8th, 2022. RESULTS ETI was initiated in 434 pwCF with a median [interquartile range, IQR] ppFEV1=30 [25; 35], including 27 with severe CF liver disease and 183 with diabetes. PwCF were followed for a median [IQR] 587 [396; 728] days after ETI initiation. Discontinuation of ETI occurred in 12 (2.8%) pwCF and was mostly due to lung transplantation (n=5) or death (n=4). Absolute increase in ppFEV1 by a mean +14.2% (95% CI, 13.1-15.4) occurred at 1 month and persisted throughout the study. Increase in ppFEV1 in the younger age quartile was almost twice that of the oldest quartile (P<0.001); body mass index <18.5 kg/m2 was found in 38.6% at initiation vs. 11.3% at 12 months (P=0.0001). Increase in serum concentrations of vitamin A and E, but not 25OHD3, was observed. Significant reduction in the % of pwCF using oxygen therapy, noninvasive ventilation, nutritional support, inhaled and systemic therapies (including antibiotics) were observed; insulin was discontinued in 12% of diabetics. CONCLUSION ETI is safe in pwCF and advanced lung disease with multisystem pulmonary and extrapulmonary benefits.
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Affiliation(s)
| | | | - Isabelle Durieu
- Hospices Civils de Lyon, 26900, Service de médecine interne, Pierre Bénite, Auvergne-Rhône-Alpes , France
| | | | - Rebecca Hamidfar
- Centre Hospitalier Universitaire de Grenoble-Alpes, Service Hospitalo-Universitaire de Pneumologie et Physiologie, Pôle Thorax et Vaisseaux, , La Tronche, France
| | - Marlène Murris-Espin
- Centre Hospitalier Universitaire de Toulouse, 36760, Pulmonology, Toulouse, Midi-Pyrénées, France
| | | | | | - Sylvie Leroy
- University Hospital of Nice, Service de Pneumologie, Nice, France
| | - Benoit Douvry
- Centre Hospitalier Intercommunal de Creteil, 26949, Creteil, Île-de-France, France
| | | | | | | | | | - Espérie Burnet
- Cochin hospital, APHP, Respiratory Medicine, Paris, France
| | | | | | | | - Clémence Martin
- Groupe Hospitalier Cochin-Hotel Dieu, AP-HP, Pulmonary Department and Adult CF Centre, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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2
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Tzedakis S, Yzhaky Shapira O, Schwarzinger M, Katsahian S, Lazzati A, Dohan A, Coriat R, Sogni P, Pol S, Fuks D, Mallet V. COVID-19 and excess mortality of patients with liver cancer in France, January 2020-September 2022. Br J Surg 2024; 111:znad359. [PMID: 37951599 DOI: 10.1093/bjs/znad359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Stylianos Tzedakis
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-chirurgicales, Service de Chirurgie Hépatobiliaire, Digestive et Endocrinienne, Paris, France
- NSERM, UMR 1138, Centre de Recherche des Cordeliers, Centre Inria de Paris, Équipe HeKA, Paris, France
| | - Ortal Yzhaky Shapira
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-chirurgicales, Service de Chirurgie Hépatobiliaire, Digestive et Endocrinienne, Paris, France
| | - Michaël Schwarzinger
- CHU Bordeaux, Service de Soutien Méthodologique et d'Innovation en Prévention, Bordeaux, France
- INSERM, UMR 1219-Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| | - Sandrine Katsahian
- Université Paris Cité, Paris, France
- NSERM, UMR 1138, Centre de Recherche des Cordeliers, Centre Inria de Paris, Équipe HeKA, Paris, France
- AP-HP Centre, Hôpital Européen Georges-Pompidou, Service d'Épidémiologie et de Biostatistiques, Paris, France
| | - Andrea Lazzati
- Centre Intercommunal de Créteil (CHIC), Service de Chirurgie Générale, Digestive et de l'Obésité, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Anthony Dohan
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Imagina, Service de Radiologie, Paris, France
| | - Romain Coriat
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-chirurgicales, Service de Gastroentérologie, d'Endoscopie et d'Oncologie Digestive, Paris, France
| | - Philippe Sogni
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, Paris, France
| | - Stanislas Pol
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, Paris, France
| | - David Fuks
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-chirurgicales, Service de Chirurgie Hépatobiliaire, Digestive et Endocrinienne, Paris, France
| | - Vincent Mallet
- Université Paris Cité, Paris, France
- AP-HP Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, Paris, France
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3
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Parlati L, Sakka M, Retbi A, Bouam S, Hassani L, Meritet JF, Rufat P, Bonnefont-Rousselot D, Batista R, Terris B, Bellanger A, Thabut D, Vozy A, Spano JP, Coriat R, Goldwasser F, Aractingi S, Sogni P, Pol S, Mallet V. Burden of grade 3 or 4 liver injury associated with immune checkpoint inhibitors. JHEP Rep 2023; 5:100880. [PMID: 38074948 PMCID: PMC10701119 DOI: 10.1016/j.jhepr.2023.100880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND & AIMS There is concern about the burden of liver injury in patients with cancer exposed to immune checkpoints inhibitors (ICIs). METHODS In a retrospective cohort study, we evaluated the likelihood of grade 3/4 liver injury, of grade 3/4 cholestatic liver injury, and of liver failure, as per the Common Terminology Criteria for Adverse Events (CTCAE) version 5, following treatment with ICIs. We compared these occurrences with a group of cancer patients who were propensity-matched and treated with conventional chemotherapy. For all ICI patients experiencing grade 3/4 liver injury, we conducted a causality assessment using the RUCAM method and examined patient outcomes. RESULTS Among 952 patients (median [IQR] age 66 [57-73] years, 64% males) who were treated with ICI between January 1, 2015, and December 31, 2019, a total of 86 (9%) progressed to grade 3/4 liver injury, and liver failure was not observed. Anti-PD-(L)1/anti-CTLA-4 antibodies combinations (adjusted hazard ratio 3.36 [95% CI: 1.67-6.79]; p <0.001), and chronic hepatitis B (adjusted hazard ratio 5.48 [95% CI: 1.62-18.5]; p = 0.006], were independent risk factors. Liver injury was attributed to ICI treatment in 19 (2.0%) patients. Patients with ICI toxicity typically presented with granulomatous hepatitis or cholangiocyte inflammation. ICI withdrawal was associated with cancer progression and mortality. Re-introduction of ICI was not associated with recurrent grade 3/4 liver injury. Compared with matched patients treated with conventional, non-ICI-based chemotherapy, anti-PD-(L)1/anti-CTLA-4 combinations (p <0.001) and anti-PD-(L)1 monotherapies (p = 0.053) increased the risk of grade 3/4 liver injury and of grade 3/4 cholestatic liver injury, respectively. CONCLUSIONS An increased risk of grade 3/4 liver injury under anti-PD-(L)1/anti-CTLA-4 antibodies was observed, whereas no substantial increase in the likelihood of liver failure occurred even after treatment reintroduction. IMPACT AND IMPLICATIONS There is concern about liver injury in patients with cancer exposed to immune checkpoints inhibitors (ICIs). We investigated the burden of grade 3/4 liver injury after treatment with ICIs in a multicentric cohort of patients with cancer. Overall, a 9% incidence of grade 3/4 liver injury was detected after ICIs, and direct ICI hepatotoxicity was demonstrated in 2% of patients. Anti-PD-(L)1/Anti-CTLA-4 antibody combinations, and chronic HBV infection were independent risk factors. ICI withdrawal for grade 3/4 liver injury was associated with cancer progression. Re-introduction of ICI treatment was not associated with recurrent grade 3/4 liver injury.
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Affiliation(s)
- Lucia Parlati
- Université Paris Cité, Paris, France
- Service de Maladies du foie, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Mehdi Sakka
- Service de Biochimie Métabolique, AP-HP.Sorbonne Université, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Aurelia Retbi
- Département d’Information Médicale, AP-HP.Sorbonne Université, DMU Esprit, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Samir Bouam
- Unité d’Information Médicale, AP-HP.Centre, DMU Prime, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Lamia Hassani
- Pharmacie à Usage Intérieur, AP-HP.Sorbonne Université, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Jean-François Meritet
- Service de Virologie, AP-HP.Centre, DMU Biophygen, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Pierre Rufat
- Département d’Information Médicale, AP-HP.Sorbonne Université, DMU Esprit, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Dominique Bonnefont-Rousselot
- Université Paris Cité, Paris, France
- Service de Biochimie Métabolique, AP-HP.Sorbonne Université, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
- CNRS, INSERM, UTCBS, Paris, France
| | - Rui Batista
- Pharmacie Clinique, AP-HP.Centre, DMU Prime, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Benoit Terris
- Université Paris Cité, Paris, France
- Service d’Anatomopathologie, AP-HP.Centre, DMU Prime, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Agnès Bellanger
- Département d’Information Médicale, AP-HP.Sorbonne Université, DMU Esprit, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Dominique Thabut
- Université Paris-Sorbonne, Paris, France
- Service d’Hépatogastroentérologie, AP-HP.Sorbonne Université, DMU Sapere, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Aurore Vozy
- Université Paris-Sorbonne, Paris, France
- Service d’Oncologie Médicale, AP-HP.Sorbonne Université, DMU Orphe, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Jean-Philippe Spano
- Université Paris-Sorbonne, Paris, France
- Service d’Oncologie Médicale, AP-HP.Sorbonne Université, DMU Orphe, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France
| | - Romain Coriat
- Université Paris Cité, Paris, France
- Service de Gastroentérologie et Oncologie Digestive, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - François Goldwasser
- Université Paris Cité, Paris, France
- Service de Cancérologie, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Selim Aractingi
- Université Paris Cité, Paris, France
- Département de Dermatologie, AP-HP.Centre, DMU Endromed, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Philippe Sogni
- Université Paris Cité, Paris, France
- Service de Maladies du foie, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Stanislas Pol
- Université Paris Cité, Paris, France
- Service de Maladies du foie, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
| | - Vincent Mallet
- Université Paris Cité, Paris, France
- Service de Maladies du foie, AP-HP.Centre, DMU Cancérologie et Spécialités Médico-Chirurgicales, Groupe Hospitalier Cochin Port Royal, Paris, France
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Cadranel JFD, Ollivier-Hourmand I, Cadranel J, Thevenot T, Zougmore H, Nguyen-Khac E, Bureau C, Allaire M, Nousbaum JB, Loustaud-Ratti V, Causse X, Sogni P, Hanslik B, Bourliere M, Peron JM, Ganne-Carrie N, Dao T, Thabut D, Maitre B, Debzi N, Smadhi R, Sombie R, Kpossou R, Nouel O, Bissonnette J, Ruiz I, Medmoun M, Dastis SN, Deltenre P, Artru F, Raherison C, Elkrief L, Lemagoarou T. International survey among hepatologists and pulmonologists on the hepatic hydrothorax: plea for recommendations. BMC Gastroenterol 2023; 23:305. [PMID: 37697230 PMCID: PMC10496231 DOI: 10.1186/s12876-023-02931-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND The Hepatic hydrothorax is a pleural effusion related to portal hypertension; its diagnosis and therapeutic management may be difficult. The aims of this article are which follows: To gather the practices of hepatogastroenterologists or pulmonologists practitioners regarding the diagnosis and management of the hepatic hydrothorax. METHODS Practitioners from 13 French- speaking countries were invited to answer an online questionnaire on the hepatic hydrothorax diagnosis and its management. RESULTS Five hundred twenty-eight practitioners (80% from France) responded to this survey. 75% were hepatogastroenterologists, 20% pulmonologists and the remaining 5% belonged to other specialities. The Hepatic hydrothorax can be located on the left lung for 64% of the responders (66% hepatogastroenterologists vs 57% pulmonologists; p = 0.25); The Hepatic hydrothorax can exist in the absence of clinical ascites for 91% of the responders (93% hepatogastroenterologists vs 88% pulmonologists; p = 0.27). An Ultrasound pleural scanning was systematically performed before a puncture for 43% of the responders (36% hepatogastroenterologists vs 70% pulmonologists; p < 0.001). A chest X-ray was performed before a puncture for 73% of the respondeurs (79% hepatogastroenterologists vs 54% pulmonologists; p < 0.001). In case of a spontaneous bacterial empyema, an albumin infusion was used by 73% hepatogastroenterologists and 20% pulmonologists (p < 0.001). A drain was used by 37% of the responders (37% hepatogastroenterologists vs 31% pulmonologists; p = 0.26).An Indwelling pleural catheter was used by 50% pulmonologists and 22% hepatogastroenterologists (p < 0.01). TIPS was recommended by 78% of the responders (85% hepatogastroenterologists vs 52% pulmonologists; p < 0.001) and a liver transplantation, by 76% of the responders (86% hepatogastroenterologists vs 44% pulmonologists; p < 0.001). CONCLUSIONS The results of this large study provide important data on practices of French speaking hepatogastroenterologists and pulmonologists; it appears that recommendations are warranted.
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Affiliation(s)
| | | | | | | | - Honoré Zougmore
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
| | | | | | - Manon Allaire
- Hepatogastroenterology Department, La Pitié Salpétrière, Paris, France
| | | | | | | | | | | | - Marc Bourliere
- Hepatogastroenterology department, Saint-Joseph, Marseille, France
| | | | | | - Thong Dao
- Hepatogastroenterology department, CHU Caen, Caen, France
| | - Dominique Thabut
- Hepatogastroenterology Department, La Pitié Salpétrière, Paris, France
| | | | - Nabil Debzi
- Hepatology Department CHU Mustapha, Alger, Algérie, Algeria
| | - Ryad Smadhi
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
- Hepatology Department CHU Mustapha, Alger, Algérie, Algeria
| | - Roger Sombie
- Gastroenterology Department, CHU Yalgado Ouedraogo Ouagadougou, Ouagadougou, Burkina Faso
| | - Raimi Kpossou
- Hepatogastroenterology Deparment, National Hospital and University Center Hubert Koutoukou Maga, Cotonou, Benin
| | - Olivier Nouel
- Hepatogastroenterology Department, St Brieuc, France
| | - Julien Bissonnette
- Department of Hepatology and Liver Transplantation, University of Montreal Hospital, Montreal, Canada
| | - Isaac Ruiz
- Department of Hepatology and Liver Transplantation, University of Montreal Hospital, Montreal, Canada
| | - Mourad Medmoun
- Hepatogastroenterology and Nutrition Department GHPSO Boulevard Laennec, 60100, Creil, France
| | | | | | - Florent Artru
- Hepatogastroenterology Department, Lausanne, Suisse, Switzerland
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5
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Parlati L, Marcin K, Terris B, Vallet-Pichard A, Corouge M, Hollande C, Sogni P, Mallet V, Pol S. Histological Characteristics and Management of Hepatitis on Immune Checkpoint Inhibitors: A Retrospective Descriptive Study. J Clin Med 2023; 12:jcm12113751. [PMID: 37297945 DOI: 10.3390/jcm12113751] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND AND AIMS the side effects of immune checkpoint inhibitors (ICI) pose a problem for the clinical management of cancer patients. There is a lack of knowledge of the value of liver biopsy in patients with ICI-related drug-induced liver injury (ICI-DILI). The aim of this study was to explore the impact of liver biopsy on clinical management and response to corticosteroids, according to histological findings. METHODS We conducted a retrospective, single-center study to evaluate the biochemical, histological and clinical data of 35 patients with ICI-DILI between 2015 and 2021 in a university hospital in France. RESULTS Of the 35 patients with ICI-DILI (median [interquartile range] age 62 [48-73] years, 40% males) studied, 20 underwent a liver biopsy. There was no difference in the management of ICI-DILI according to liver biopsy in terms of ICI withdrawal, reduction or rechallenge. According to the histological profile, patients with toxic and granulomatous profiles had a better response to corticosteroids, while patients with cholangitic lesions had the worst response. CONCLUSION In ICI-DILI, liver biopsy must not delay patient care but may be useful in identifying patients with a cholangitic profile who have a poorer response to corticosteroids.
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Affiliation(s)
- Lucia Parlati
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | - Kennie Marcin
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | - Benoit Terris
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU IMAGINA, Service de Pathologie, F-75014 Paris, France
| | - Anaïs Vallet-Pichard
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | - Marion Corouge
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | | | - Philippe Sogni
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | - Vincent Mallet
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
| | - Stanislas Pol
- Faculty of Medicine, Université Paris Cité, Cochin Site, 24 rue du Faubourg Saint-Jacques, F-75006 Paris, France
- AP-HP. Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et Spécialités Médico-Chirurgicales, Service d'Hépatologie, F-75014 Paris, France
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6
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Chouchana L, Terris B, Sogni P, Treluyer JM, Costedoat-Chalumeau N, Loriot MA. Azathioprine-induced vanishing bile duct syndrome: the value of early thiopurine metabolism assessment. Br J Clin Pharmacol 2023. [PMID: 37218386 DOI: 10.1111/bcp.15797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
About 15 to 28% of treated patients with thiopurines experienced adverse drug reactions, such as hematological and hepatic toxicities. A part of them is related to the polymorphic activity of the thiopurine S-methyltransferase (TPMT), the key detoxifying enzyme of thiopurine metabolism. We report here a case of thiopurine-induced ductopenia with a comprehensive pharmacological analysis on thiopurine metabolism. A 34-year-old woman, with a medical history of severe systemic lupus erythematosus with recent introduction of azathioprine therapy, presented with mild fluctuating transaminase blood levels consistent with an hepatocellular patter, which evolved to a cholestatic pattern over the next weeks. A blood thiopurine metabolite assay revealed low 6-thioguanine nucleotides (6-TGN) level and a dramatically increased 6-methylmercaptopurine ribonucleotides (6-MMPN) level, together with an unfavorable [6-MMPN:6-TGN] metabolite ratio and a high TPMT activity. After a total of about six months of thiopurine therapy, a transjugular liver biopsy revealed a ductopenia and azathioprine discontinuation led to further clinical improvement. In line with previous reports from the literature, our case supports the fact that ductopenia is a rare adverse drug reaction of azathioprine. The mechanism of reaction is unknown but may involve high 6-MMPN blood level, due to unusual thiopurine metabolism (switched metabolism). Early therapeutic drug monitoring with measurement of 6-TGN and 6-MMPN blood levels may help physicians to identify patients at risk of similar duct injury.
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Affiliation(s)
- Laurent Chouchana
- Centre Régional de Pharmacovigilance, Service de Pharmacologie périnatale, pédiatrique et adulte, Hôpital Cochin, AP-HP.Centre Université Paris Cité, Paris, France
| | - Benoit Terris
- Université Paris Cité. Paris, France
- Service de Pathologie, Hôpital Cochin, AP-HP.Centre Université Paris Cité, Paris, France
| | - Philippe Sogni
- Université Paris Cité. Paris, France
- Service d'hépatologie, Hôpital Cochin, AP-HP.Centre Université Paris Cité, Paris, France
| | - Jean-Marc Treluyer
- Centre Régional de Pharmacovigilance, Service de Pharmacologie périnatale, pédiatrique et adulte, Hôpital Cochin, AP-HP.Centre Université Paris Cité, Paris, France
- Université Paris Cité. Paris, France
| | - Nathalie Costedoat-Chalumeau
- Centre de référence maladies auto-immunes et systémiques rares d'Ile de France, Département de Médecine interne, Hôpital Cochin, AP- HP.Centre Université Paris Cité, Paris, France
- Université Paris Cité, Paris, France ; INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Marie-Anne Loriot
- Unité de Pharmacogénétique, Service de Biochimie, Hôpital européen Georges Pompidou, AP-HP.Centre Université Paris Cité, Paris, France
- Université Paris Cité, Paris, France ; INSERM U1147, Médecine Personnalisée Pharmacogénomique et Optimisation Thérapeutique (MEPPOT), Paris, France
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Monribot A, Huillard O, Khoudour N, Préta LH, Blanchet B, Cabanes L, Batista R, Pallet N, Chouchana L, Goldwasser F, Sogni P, Thomas-Schoemann A. Cardiac toxicity associated with pharmacokinetic drug-drug interaction between crizotinib and sofosbuvir/velpatasvir: A case report. Br J Clin Pharmacol 2023; 89:1486-1490. [PMID: 36709977 DOI: 10.1111/bcp.15674] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/30/2022] [Accepted: 01/14/2023] [Indexed: 01/31/2023] Open
Abstract
This case report describes a pharmacokinetic drug-drug interaction between crizotinib, a tyrosine kinase inhibitor, and sofosbuvir/velpatasvir, a direct-acting antiviral drug, leading to cardiac toxicity. A 75-year-old man, with no cardiovascular history but a diagnosis of metastatic nonsmall cell lung cancer with mesenchymal-epithelial transition exon-14 deletion and hepatitis C virus infection genotype 1A, received both crizotinib and sofosbuvir/velpatasvir. Crizotinib was well tolerated, but 1 week after sofosbuvir/velpatasvir initiation, the patient experienced bilateral lower-limb oedema and class III New York Heart Association dyspnoea. We assumed that increased exposure to crizotinib could account for this cardiac toxicity. Drug causality was probable according to the Naranjo scale. We hypothesized a reciprocal interaction between crizotinib and velpatasvir, mediated by both cytochrome 3A4 (CYP3A4) and P-glycoprotein (P-gp). Clinicians should be aware of the risk of drug-drug interactions between direct-acting antiviral agents that inhibit CYP3A4 (glecaprevir) and/or P-gp (voxilaprevir, velpatasvir) and anticancer tyrosine kinase inhibitors that are mostly CYP3A4 and/or P-gp substrates (gefitinib, afatinib, erlotinib, crizotinib, ceritinib, lorlatinib, brigatinib, capmatinib etc.).
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Affiliation(s)
- Anthia Monribot
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, University of Paris, Paris, France
| | - Olivier Huillard
- Department of Medical Oncology, Cochin Hospital, AP-HP, Université de Paris, Paris, France.,Sorbonne Paris Cite, Faculty of Medicine, University of Paris Descartes, France
| | - Nihel Khoudour
- Department of Pharmacokinetics and Pharmacochemisty, Cochin Hospital, AP-HP, Paris, France; CARPEM, Paris, France
| | - Laure-Hélène Préta
- Regional Center of Pharmacovigilance, Department of Pharmacology, Cochin Hospital, AP-HP, Paris, University of Paris, Paris, France
| | - Benoit Blanchet
- Department of Pharmacokinetics and Pharmacochemisty, Cochin Hospital, AP-HP, Paris, France; CARPEM, Paris, France.,UMR8038 CNRS, U.1268 INSERM, Faculty of Pharmacy, University Paris Descartes, PRES Sorbonne Paris Cité, Paris, France
| | - Laure Cabanes
- Department of Cardiology, Cochin Hospital, AP-HP, University of Paris, Paris, France
| | - Rui Batista
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, University of Paris, Paris, France
| | - Nicolas Pallet
- Department of Biochemistry, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; University of Paris Descartes, INSERM U.1147, Paris, France
| | - Laurent Chouchana
- Regional Center of Pharmacovigilance, Department of Pharmacology, Cochin Hospital, AP-HP, Paris, University of Paris, Paris, France
| | - François Goldwasser
- Department of Medical Oncology, Cochin Hospital, AP-HP, Université de Paris, Paris, France.,Sorbonne Paris Cite, Faculty of Medicine, University of Paris Descartes, France.,Cochin Institute, INSERM U.1016, Paris, France
| | - Philippe Sogni
- Department of Hepatology, Cochin Hospital, AP-HP, Paris, France; University of Paris Descartes, Sorbonne Paris Cité, Paris, France.,Institut Pasteur, U.1223, INSERM, Paris, France
| | - Audrey Thomas-Schoemann
- Department of Clinical Pharmacy, Cochin Hospital, AP-HP, University of Paris, Paris, France.,Department of Medical Oncology, Cochin Hospital, AP-HP, Université de Paris, Paris, France.,UMR8038 CNRS, U.1268 INSERM, Faculty of Pharmacy, University Paris Descartes, PRES Sorbonne Paris Cité, Paris, France
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Bronowicki J, Miailhes P, Hanslik B, Ouzan D, Larrey D, Riachi G, Truchi R, Jouannaud V, Pospait D, Abergel A, Causse X, Perot S, Skrzypski J, De Hautecloque A, Spampinato A, Mariot P, Sogni P. An observational, prospective, multicenter study on the utilization and effectiveness of elbasvir-grazoprevir treatment association for chronic hepatitis C in France (ZEPHYR study). Health Sci Rep 2022; 6:e619. [PMID: 36479389 PMCID: PMC9721088 DOI: 10.1002/hsr2.619] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/11/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND AIM The efficacy and safety profiles of elbasvir-grazoprevir (EBR/GZR) has been established in more than 10 clinical trials. However, the characteristics of patients treated in routine clinical practice may differ. The present study was therefore designed to assess the real-life effectiveness of EBR/GZR therapy in the general population and among subgroups with a high hepatitis C virus (HCV) prevalence in France. METHODS The Zephyr study was designed as a French, multicentre, prospective, observational study on EBR/GZR use and effectiveness in current practice in chronic hepatitis C patients. These results are based on data regarding the adult patients who received at least one dose of EBR/GZR between December 2017 and June 2019 in 67 French hospitals and clinics. RESULTS Overall, 478 patients were included. The Full Analysis Set corresponded to the 467 patients who met all the inclusion criteria and none of the exclusion criteria. Gender was balanced and the mean age was 55.7 ± 13.3 years. The patients were mainly treatment-naive (89.5%) and infected with Genotype 1b (70.4%). Among the 75 patients with HCV Gt1a genotype, 56% had HCV RNA ≥ 800,000 IU/ml. F3-F4 fibrosis stage involved 24.2% of our population. Our subgroups were distributed among 110 migrants (23.6%), 58 (15.3%) using opioid agonist treatment, including people who inject drugs, 30 (6.8%) with chronic kidney disease Stages 3-5, 9 (1.9%) with an inherited blood disorder, and 4 (0.9%) coinfected with HIV. The remaining 269 (58.7%) were included in the general population subgroup. Overall, sustained virologic response 12 weeks after the end of treatment reached 98.0% and remained consistent among genotype, HCV RNA values, fibrosis stage, and the subgroup of interest. The rate of Alcohol Use Disorders Identification Test-Consumption and Life Habit questionnaire completion was high at each visit, with data suggesting alcohol consumption decrease and an improvement in quality of life. CONCLUSIONS Using real-world evidence data on a French population representative of HCV patients, we confirmed the results obtained during EBR/GZR development program.
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Affiliation(s)
- Jean‐Pierre Bronowicki
- Hépato‐gastroentérologie, CHRU Nancy, INSERM 1256, Université de Lorraine, Nancy, CHRU Vandoeuvre les NancyNancyFrance
| | | | | | - Denis Ouzan
- Institut Arnault TzanckSaint Laurent Du VarFrance
| | | | | | | | | | - Dan Pospait
- Gastroenterology Unit, Hôpital Bichat‐Claude BernardParisFrance
| | | | | | | | | | | | | | | | - Philippe Sogni
- Paris‐University and Liver Unit, Cochin HospitalParisFrance
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Barré T, Carrat F, Ramier C, Fontaine H, Di Beo V, Bureau M, Dorival C, Larrey D, Delarocque-Astagneau E, Mathurin P, Marcellin F, Petrov-Sanchez V, Cagnot C, Carrieri P, Pol S, Protopopescu C, Alric L, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Ahmed SNS, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Faure M, Froissart B, Hilleret MN, Zarski JP, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Samuel D, Antonini T, Coilly A, Duclos-Vallée JC, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Sebal F, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Bourlière M, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Cagnot C. Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort. J Cannabis Res 2022; 4:31. [PMID: 35690798 PMCID: PMC9188079 DOI: 10.1186/s42238-022-00138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection. Methods Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models. Results Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37–0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19–0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38–0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI. Conclusions We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure. Trial registration ClinicalTrials.gov identifier: NCT01953458.
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10
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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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Barré T, Sogni P, Zaegel-Faucher O, Wittkop L, Marcellin F, Carrieri P, Gervais A, Levier A, Rosenthal E, Salmon-Céron D, Protopopescu C. Cannabis Use as a Protective Factor Against Overweight in HIV-Hepatitis C Virus Co-Infected People (ANRS CO13 HEPAVIH Cohort). AIDS Educ Prev 2022; 34:272-290. [PMID: 35994579 DOI: 10.1521/aeap.2022.34.4.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Overweight is increasingly prevalent in people living with HIV (PLWH), and is a high risk factor for metabolic disorders in this population. PLWH co-infected with hepatitis C virus (HCV) have a higher risk of metabolic disorders than their mono-infected counterparts. The putative relationship between cannabis use and body weight found in the general population has never been documented in HIV-HCV co-infected people. We tested whether cannabis use is associated with body mass index (BMI), overweight, and underweight in HCV co-infected PLWH (N = 992). Mixed-effects linear and logistic regression models were used to study the association between cannabis use and the three outcomes over time. After multivariable adjustment, cannabis use was inversely associated with BMI. Cannabis use was associated with a lower and higher risk of overweight and underweight, respectively. Cannabis use should be assessed and taken into account in the clinical management of the HIV-HCV co-infected population.
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Affiliation(s)
- Tangui Barré
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), and Institut Sciences de la Santé Publique d'Aix-Marseille (ISSPAM), Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France, INSERM U1223, Institut Pasteur, Paris, France, and Service d'Hépatologie, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Olivia Zaegel-Faucher
- Clinical Immuno-Hematology Department, Aix-Marseille University, and Sainte-Marguerite University Hospital, Marseille, France
| | - Linda Wittkop
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France, and Service D'information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Fabienne Marcellin
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), and Institut Sciences de la Santé Publique d'Aix-Marseille (ISSPAM), Marseille, France
| | - Patrizia Carrieri
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), and Institut Sciences de la Santé Publique d'Aix-Marseille (ISSPAM), Marseille, France
| | - Anne Gervais
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris, France
| | - Axel Levier
- ANRS I Emerging Infectious Diseases, Department of Clinical Research, Paris, France
| | - Eric Rosenthal
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), and Institut Sciences de la Santé Publique d'Aix-Marseille (ISSPAM), Marseille, France
- ANRS I Emerging Infectious Diseases, Department of Clinical Research, Paris, France
- Université Côte d'Azur, Nice, France
| | - Dominique Salmon-Céron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France, and Université Paris Descartes, Paris, France
| | - Camelia Protopopescu
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), and Institut Sciences de la Santé Publique d'Aix-Marseille (ISSPAM), Marseille, France
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Ramier C, Marcellin F, Sogni P, Salmon-céron D, Wittkop L, Carrieri P, Protopopescu C. Qualité de vie liée à la santé chez les personnes vivant avec le VIH et l'hépatite C : Propriétés psychométriques de la version française de l’échelle WHOQOL-HIV BREF (ANRS CO13 HEPAVIH). Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.031] [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] Open
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, 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 AM, 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, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, 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, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, 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, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, 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, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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Carrieri P, Carrat F, Di Beo V, Bourlière M, Barré T, De Ledinghen V, Pageaux GP, Bureau M, Cagnot C, Dorival C, Delarocque-Astagneau E, Marcellin F, Pol S, Fontaine H, Protopopescu C, Laurent Alric, Bonnet D, Payssan-Sicart V, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Si Ahmed SN, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Froissart B, Hilleret MN, Costentin C, Gerster T, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Duclos Vallée JC, Samuel D, Antonini T, Coilly A, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Marc Bourlière, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Boston A, Diallo A, Cagnot C, Bousselet A, Caralp M. Severe liver fibrosis in the HCV cure era: major effects of social vulnerability, diabetes, and unhealthy behaviors. JHEP Rep 2022; 4:100481. [PMID: 35514789 PMCID: PMC9065909 DOI: 10.1016/j.jhepr.2022.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022] Open
Abstract
Background & Aims After HCV cure, not all patients achieve significant liver fibrosis regression. We explored the effects of clinical and socio-behavioral factors on liver fibrosis, before and after HCV cure with direct-acting antivirals. Methods We analyzed data from the ongoing ANRS CO22 HEPATHER cohort, which prospectively collects clinical and socio-behavioral data on HCV-infected patients. Mixed-effects logistic regression models helped identify predictors of longitudinal measures of severe liver fibrosis, defined as a fibrosis-4 index >3.25. We also estimated the adjusted population attributable fractions (PAFs) for modifiable risk factors. Results Among the 9,692 study patients (accounting for 24,687 visits over 4 years of follow-up, 48.5% of which were post-HCV cure), 26% had severe fibrosis at enrolment. After multivariable adjustment, HCV-cured patients had an 87% lower risk of severe fibrosis. An inverse dose-response relationship was found for coffee consumption, with the risk of severe fibrosis diminishing by 58% per additional cup/day (adjusted odds ratio (aOR 0.42; 95% CI 0.38-0.46). Unemployment, low educational level, and diabetes were associated with a higher severe fibrosis risk (aOR 1.69; 95% CI 1.32-2.16, aOR 1.50; 95% CI 1.20-1.86, and aOR 4.27; 95% CI 3.15-5.77, respectively). Severe fibrosis risk was 3.6/4.6-fold higher in individuals with previous/current unhealthy alcohol use than in abstinent patients. All these associations remained valid after HCV cure. The risk factors accounting for the greatest severe fibrosis burden were unemployment, low education level, and diabetes (PAFs: 29%, 21%, and 17%, respectively). Conclusions Monitoring liver fibrosis after HCV cure is crucial for patients with low socioeconomic status, previous/current unhealthy alcohol use, and diabetes. Innovative HCV care models for the most socially vulnerable individuals and interventions for healthier lifestyles are needed to reinforce the positive effects of HCV cure on liver health. Lay summary After hepatitis C virus (HCV) cure, not all patients achieve significant liver fibrosis regression. Herein, we studied the effects of clinical and socio-behavioral factors on the risk of severe liver fibrosis. Coffee consumption was strongly inversely associated with severe fibrosis, while diabetes, previous and current unhealthy alcohol use were associated with a 4.3-, 3.6- and 4.6-fold higher risk of severe fibrosis, respectively. Unemployment and low educational level were also associated with a higher risk of severe fibrosis. All these associations remained valid after HCV cure. These results demonstrate the need to continue liver fibrosis monitoring in at-risk groups, and to facilitate healthier lifestyles after HCV cure as a clinical and public health priority. Liver fibrosis assessment is a key prognostic tool in the hepatitis C cure era. Significant liver fibrosis regression does not always occur after hepatitis C cure. Coffee intake displays protective effects on severe fibrosis even after HCV cure. Social vulnerability, diabetes, and unhealthy alcohol use predict severe fibrosis. Socio-behavioral factors are associated with severe fibrosis even after HCV cure.
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Marcellin F, Zucman D, Ramier C, Lotto M, Miailhes P, Piroth L, Aumaitre H, Mercié P, Barré T, Wittkop L, Sogni P, Salmon-Ceron D, Carrieri P. Tobacco use in people living with HIV: The need for complementary descriptive data to see beyond the smoke screen. Int J Drug Policy 2022; 102:103616. [PMID: 35182840 DOI: 10.1016/j.drugpo.2022.103616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - David Zucman
- Hôpital Foch, Service de Médecine Interne, Suresnes, France
| | - Clémence Ramier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Marta Lotto
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Lionel Piroth
- Département d'infectiologie, CHU de Dijon, Inserm CIC 1432, Université de Bourgogne, Dijon, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Patrick Mercié
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Pôle Médecine Interne, Service de Médecine Interne et Immunologie Clinique, Bordeaux, France
| | - Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Linda Wittkop
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France; Service D'information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France; Université Paris Descartes, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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De Broucker C, Plessier A, Ollivier-Hourmand I, Dharancy S, Bureau C, Cervoni JP, Sogni P, Goria O, Corcos O, Sartoris R, Ronot M, Vilgrain V, de Raucourt E, Zekrini K, Davy H, Durand F, Payancé A, Fidouh-Houhou N, Yazdanpanah Y, Valla D, Rautou PE. Multicenter study on recent portal venous system thrombosis associated with cytomegalovirus disease. J Hepatol 2022; 76:115-122. [PMID: 34563580 DOI: 10.1016/j.jhep.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/23/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Recent non-malignant non-cirrhotic portal venous system thrombosis (PVT) is a rare condition. Among risk factors for PVT, cytomegalovirus (CMV) disease is usually listed based on a small number of reported cases. The aim of this study was to determine the characteristics and outcomes of PVT associated with CMV disease. METHODS We conducted a French multicenter retrospective study comparing patients with recent PVT and CMV disease ("CMV positive"; n = 23) to patients with recent PVT for whom CMV testing was negative ("CMV negative"; n = 53) or unavailable ("CMV unknown"; n = 297). RESULTS Compared to patients from the "CMV negative" and "CMV unknown" groups, patients from the "CMV positive" group were younger, more frequently had fever, and had higher heart rate, lymphocyte count and serum ALT levels (p ≤0.01 for all). The prevalence of immunosuppression did not differ between the 3 groups (4%, 4% and 6%, respectively). Extension of PVT was similar between the 3 groups. Thirteen out of 23 "CMV positive" patients had another risk factor for thrombosis. Besides CMV disease, the number of risk factors for thrombosis was similar between the 3 groups. Heterozygosity for the prothrombin G20210A gene variant was more frequent in "CMV positive" patients (22%) than in the "CMV negative" (4%, p = 0.01) and "CMV unknown" (8%, p = 0.03) groups. Recanalization rate was not influenced by CMV status. CONCLUSIONS In patients with recent PVT, features of mononucleosis syndrome should raise suspicion of CMV disease. CMV disease does not influence thrombosis extension nor recanalization. More than half of "CMV positive" patients have another risk factor for thrombosis, with a particular link to the prothrombin G20210A gene variant. LAY SUMMARY Patients with cytomegalovirus (CMV)-associated portal venous system thrombosis have similar thrombosis extension and evolution as patients without CMV disease. However, patients with CMV-associated portal venous system thrombosis more frequently have the prothrombin G20210A gene variant, suggesting that these entities act synergistically to promote thrombosis.
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Affiliation(s)
- Chloé De Broucker
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Aurélie Plessier
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Isabelle Ollivier-Hourmand
- Service d'Hépato-Gastroentérologie et Nutrition, Centre Hospitalo-Universitaire Côte de Nacre, Caen, France
| | - Sébastien Dharancy
- Service d'Hépatologie et de Gastroentérologie, Hôpital Huriez, Centre Hospitalo-Universitaire de Lille, Lille, France
| | - Christophe Bureau
- Service d'Hépatologie, Centre Hospitalo-Universitaire de Toulouse, Université Paul Sabatier Toulouse 3, Toulouse, France
| | - Jean-Paul Cervoni
- Service d'hépatologie et de soins intensifs digestifs, Centre Hospitalo-Universitaire Régional Jean-Minjoz, Besançon, France
| | - Philippe Sogni
- Université de Paris, APHP, Service d'Hépatologie, Hôpital Cochin, Paris, France
| | - Odile Goria
- Service d'Hépatologie et de Gastroentérologie, Hôpital Charles Nicolle, Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - Olivier Corcos
- Université de Paris, AP-HP, Hôpital Beaujon, Service de Gastroentérologie Assistance Nutritive, DMU DIGEST, Paris, France
| | - Riccardo Sartoris
- Service de radiologie, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France
| | - Maxime Ronot
- Service de radiologie, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France
| | - Valérie Vilgrain
- Service de radiologie, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France
| | - Emmanuelle de Raucourt
- Service d'hématologie biologique, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France
| | - Kamal Zekrini
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Hortense Davy
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - François Durand
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Audrey Payancé
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Nadira Fidouh-Houhou
- Université de Paris, Department of Virology Unit, APHP, Bichat-Claude Bernard University Hospital, Paris, France
| | - Yazdan Yazdanpanah
- Université de Paris, APHP, Bichat-Claude Bernard University Hospital, Department of Infectious and Tropical Diseases, IAME, Inserm, Umr 1137, Paris, France
| | - Dominique Valla
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France
| | - Pierre-Emmanuel Rautou
- Université de Paris, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de recherche sur l'inflammation, Inserm, UMR 1149, Paris, France.
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Barré T, Mercié P, Marcellin F, Esterle L, Duvivier C, Teicher E, Bureau M, Chas J, Salmon-Céron D, Sogni P, Carrieri MP, Wittkop L, Protopopescu C. HCV Cure and Cannabis Abstinence Facilitate Tobacco Smoking Quit Attempts in HIV-HCV Co-Infected Patients (ANRS CO13 HEPAVIH Cohort Study). AIDS Behav 2021; 25:4141-4153. [PMID: 33903998 DOI: 10.1007/s10461-021-03277-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Accepted: 04/19/2021] [Indexed: 12/16/2022]
Abstract
In Western countries, tobacco smoking is highly prevalent among patients co-infected with HIV and hepatitis C virus (HCV). In the era of antiretrovirals and HCV cure, smoking-related health damages contribute greatly to morbidity and mortality in HIV-HCV co-infected patients. We used longitudinal data from the ANRS CO13 HEPAVIH cohort to identify the correlates of tobacco smoking quit attempts (TSQA) in HIV-HCV co-infected patients. TSQA were modelled using a multivariable discrete-time Cox proportional hazards model in 695 HIV-HCV co-infected tobacco smokers. HCV cure was associated with a 76% higher chance of TSQA (adjusted hazard ratio [95% confidence interval]: 1.76 [1.06-2.93], p = 0.029), and cannabis use with a 37% lower chance (0.63 [0.40-1.00], p = 0.049), independently of the mode of HIV transmission, other psychoactive substance use, and body mass index. Patients should be screened for tobacco and cannabis use at HCV treatment initiation and during follow-up. They should also be provided with comprehensive counselling and referral to addiction services. Non-smoking routes of cannabis administration should be promoted for cannabis users who wish to quit smoking tobacco.
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Affiliation(s)
- Tangui Barré
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrick Mercié
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Pôle Médecine Interne, Service de Médecine Interne Et Immunologie Clinique, Bordeaux Population Health Research Center UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France
| | - Fabienne Marcellin
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France.
- UMR 1252 SESSTIM, Aix-Marseille Univ, Faculté de Médecine, 3e étage - Aile Bleue, 27, boulevard Jean Moulin, 13385, Marseille cedex 5, France.
| | - Laure Esterle
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France
| | - Claudine Duvivier
- Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, APHP-Hôpital Necker-Enfants Malades, Paris, France
- IHU Imagine, Paris, France
- Institut Cochin-CNRS 8104-INSERM U1016-RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France
- Centre Médical de L'Institut Pasteur, Institut Pasteur, Paris, France
| | - Elina Teicher
- Centre Hépato-Biliaire, AP-HP Hôpital Paul-Brousse, Villejuif, France
- DHU Hepatinov, Villejuif, France
- Service de Médecine Interne, AP-HP Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Morgane Bureau
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France
| | - Julie Chas
- Service Maladies Infectieuses et Tropicales, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Dominique Salmon-Céron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France
- Université Paris Descartes, Paris, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France
- INSERM U1223, Institut Pasteur, Paris, France
- Hôpital Cochin, Paris, France
| | - Maria Patrizia Carrieri
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France
| | - Linda Wittkop
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France
- Service D'information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Camelia Protopopescu
- INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Aix Marseille Univ, Marseille, France
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18
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Marcellin F, Di Beo V, Esterle L, Abgrall S, Pialoux G, Barré T, Wittkop L, Salmon-Ceron D, Sogni P, Carrieri P. Post-HCV cure self-reported changes in physical activity, eating behaviours, and fatigue in people living with HIV (ANRS CO13 HEPAVIH). J Viral Hepat 2021; 28:1665-1667. [PMID: 34472662 DOI: 10.1111/jvh.13605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/09/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Laure Esterle
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France
| | - Sophie Abgrall
- Université Paris-Saclay, UVSQ, INSERM U1018, CESP, Le Kremlin-Bicêtre, France.,APHP, Hôpital Béclère, Service de Médecine Interne, Clamart, France
| | - Gilles Pialoux
- Department of Infectious Diseases, AP-HP Hôpital Tenon, Sorbonne Université, Paris, France
| | - Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Linda Wittkop
- ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France.,Service D'information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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19
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Mallet V, Beeker N, Bouam S, Sogni P, Pol S. Prognosis of French COVID-19 patients with chronic liver disease: A national retrospective cohort study for 2020. J Hepatol 2021; 75:848-855. [PMID: 33992699 PMCID: PMC8302931 DOI: 10.1016/j.jhep.2021.04.052] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS The impact of chronic liver disease on outcomes in patients with COVID-19 is uncertain. Hence, we aimed to explore this association. METHODS We explored the outcomes of all adult inpatients with COVID-19 in France, in 2020. We computed adjusted odds ratios to measure the associations between chronic liver disease, alcohol use disorders, mechanical ventilation and day-30 in-hospital mortality. RESULTS The sample comprised 259,110 patients (median [IQR] age 70 (54-83) years; 52% men), including 15,476 (6.0%) and 10,006 (3.9%) patients with chronic liver disease and alcohol use disorders, respectively. Death occurred in 38,203 (15%) patients, including 7,475 (28%) after mechanical ventilation, and 2,941 (19%) with chronic liver disease. The adjusted odds ratios for mechanical ventilation and day-30 mortality were 1.54 (95% CI 1.44-1.64, p <0.001) and 1.79 (1.71-1.87, p <0.001) for chronic liver disease; 0.55 (0.47-0.64, p <0.001) and 0.54 (0.48-0.61, p <0.001) for mild liver disease; 0.64 (0.53-0.76; p <0.001) and 0.71 (0.63-0.80, p <0.001) for compensated cirrhosis; 0.65 (0.52-0.81, p <0.001) and 2.21 (1.94-2.51, p <0.001) for decompensated cirrhosis; 0.34 (0.24-0.50; p <0.001) and 1.38 (1.17-1.62, p <0.001) for primary liver cancer; and 0.82 (0.76-0.89; p <0.001) and 1.11 (1.05-1.17; p <0.001) for alcohol use disorders. Chronic viral hepatitis; non-viral, non-alcoholic chronic hepatitis; organ, including liver, transplantation, and acquired immunodeficiency syndrome were not associated with COVID-19-related death. CONCLUSION Chronic liver disease increased the risk of COVID-19-related death in France in 2020. Therapeutic effort limitation may have contributed to COVID-19-related death in French residents with a liver-related complication or an alcohol use disorder. LAY SUMMARY We studied the outcomes, including mechanical ventilation and day-30 mortality, of all adults with COVID-19 who were discharged from acute and post-acute care in France in 2020 (N = 259,110). Patients with mild liver disease; compensated cirrhosis; organ, including liver, transplantation; or acquired immunodepression syndrome were not at increased risk of COVID-19-related mortality. Patients with alcohol use disorders, decompensated cirrhosis, or primary liver cancer were at increased risk of COVID-19-related mortality but were less likely to receive mechanical ventilation. Our results suggest that therapeutic effort limitation may have contributed to the excess mortality in French residents with a liver-related complication or an alcohol use disorder.
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Affiliation(s)
- Vincent Mallet
- Université de Paris, AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et spécialités médico-chirurgicales, Service d'Hépatologie, Paris, France.
| | - Nathanael Beeker
- AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU PRIME, Unité de Recherche Clinique, Paris, France
| | - Samir Bouam
- AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU PRIME, Unité d'Information Médicale, Paris, France
| | - Philippe Sogni
- Université de Paris, AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et spécialités médico-chirurgicales, Service d'Hépatologie, Paris, France
| | - Stanislas Pol
- Université de Paris, AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU Cancérologie et spécialités médico-chirurgicales, Service d'Hépatologie, Paris, France
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20
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Chalouni M, Pol S, Sogni P, Fontaine H, Lacombe K, Lacombe JM, Esterle L, Dorival C, Bourlière M, Bani-Sadr F, de Ledinghen V, Zucman D, Larrey D, Salmon D, Carrat F, Wittkop L, Martinez V. Direct, indirect and total effect of HIV coinfection on the risk of non-liver-related cancer in hepatitis C virus-infected patients treated by direct-acting antivirals: a mediation analysis. HIV Med 2021; 22:924-935. [PMID: 34402547 DOI: 10.1111/hiv.13153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES HIV-coinfected patients experience higher incidences of non-liver-related cancers than HCV-monoinfected patients. Chronic inflammation, immunosuppression, but also higher tobacco or alcohol consumption and metabolic dysregulation could explain this higher risk. We aimed to estimate the direct, indirect and total effects of HIV coinfection on the risk of non-liver-related cancers in HCV participants treated with direct-acting antivirals (DAAs). METHODS Up to four HCV-monoinfected participants from the ANRS CO22 HEPATHER cohort were matched by age and sex to HIV/HCV-coinfected participants from the ANRS CO13 HEPAVIH cohort. Participants were followed from DAA initiation until the occurrence of a non-liver-related cancer. Counterfactual mediation analysis was carried out to estimate the direct (chronic inflammation and immunosuppression), indirect (tobacco and alcohol consumption and metabolic syndrome) and total effect of HIV coinfection on the risk of non-liver-related cancers. RESULTS 548 HIV/HCV-coinfected and 2016 monoinfected participants were included. Overall, HIV coinfection was associated with a 3.7-fold [95% confidence interval (CI): 1.7-7.0] higher risk of non-liver-related cancers in HCV participants. This increased risk was explained by significant direct effect [hazard ratio (HR) = 3.4, 95% CI: 1.7-6.6] but not indirect effect (HR = 1.1, 95% CI: 0.8-1.5) of HIV coinfection. CONCLUSIONS In HCV participants treated with DAAs, the direct effect of HIV coinfection, reflecting chronic inflammation and immunosuppression, was associated with a 3.7-fold higher risk of non-liver-related cancer. By contrast, the indirect effect of HIV coinfection, reflecting higher tobacco and alcohol consumption and metabolic dysregulation, was not significantly associated with the risk of non-liver-related cancers.
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Affiliation(s)
- Mathieu Chalouni
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Stanislas Pol
- Université de Paris, Assistance Publique - Hôpitaux de Paris Centre, Hôpital Cochin, Département d'Hépatologie, INSERM U-1223, Institut Pasteur, Paris, France.,Université de Paris, Paris, France
| | - Philippe Sogni
- Université de Paris, Assistance Publique - Hôpitaux de Paris Centre, Hôpital Cochin, Département d'Hépatologie, INSERM U-1223, Institut Pasteur, Paris, France.,Université de Paris, Paris, France
| | - Helene Fontaine
- Université de Paris, Assistance Publique - Hôpitaux de Paris Centre, Hôpital Cochin, Département d'Hépatologie, INSERM U-1223, Institut Pasteur, Paris, France
| | - Karine Lacombe
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.,APHP. Est, Hôpital Saint-Antoine, Service de Maladies Infectieuses et Tropicales, Paris, F75012, France
| | | | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Céline Dorival
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, F75012, Paris, France
| | - Marc Bourlière
- Department of Hepatology and Gastroenterology, Hôpital Saint Joseph, Marseille, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Victor de Ledinghen
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépatologie, Bordeaux, France.,INSERM U1053, Université de Bordeaux, Bordeaux, France
| | - David Zucman
- Hôpital Foch, service de médecine interne, Suresnes, France
| | - Dominique Larrey
- Service des maladies de l'appareil digestif, Hôpital Saint Eloi, IBR- Inserm, Montpellier, France
| | - Dominique Salmon
- Université de Paris, Paris, France.,Service Maladies infectieuses et tropicales, AP-HP. Centre, Hôpital Cochin Hôtel Dieu, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.,AP-HP. Est, Hôpital Saint-Antoine, Unité de Santé Publique, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France.,CHU de Bordeaux, Pôle de santé publique, F-33000 Bordeaux, France
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21
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Chalouni M, Wittkop L, Bani-Sadr F, Lacombe K, Esterle L, Gilbert C, Miailhes P, Zucman D, Valantin MA, Brégigeon-Ronot S, Morlat P, Billaud E, Piroth L, Naqvi A, Sogni P, Salmon D. Risk of severe clinical events after sustained virological response following direct-acting antiviral therapy in HIV and hepatitis C virus coinfected participants. HIV Med 2021; 22:791-804. [PMID: 34212476 DOI: 10.1111/hiv.13127] [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: 03/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Sustained virological response (SVR) decreases the risk of hepatitis C virus (HCV)-related events. Nevertheless, a substantial risk of events persists. We estimated incidences and identified factors associated with severe clinical events after SVR following treatment with a direct-acting antiviral (DAA) in HIV/HCV-coinfected patients. METHODS Participants from the ANRS CO13 HEPAVIH were included if they reached SVR. Incidence rates of overall mortality, liver-related events, AIDS-defining events, ischaemic events and non-liver non-AIDS-defining cancers (NLNA) were estimated. Factors associated with the risk of those events were identified using Poisson models adjusted on age at SVR and sex. RESULTS In all, 775 participants were included. Incidence rates (95% confidence interval) of liver-related events, overall mortality, AIDS-defining events, ischaemic events and NLNA cancers per 1000 person-years were 5.9 (3.3-10.3), 22.2 (16.8-29.5), 0.6 (0.1-4.5), 7.3 (4.4-12.2) and 13.7 (9.4-20.0), respectively. For all events, incidence rates were higher in cirrhotic than in non-cirrhotic participants. Cirrhosis, liver stiffness and CD4 count were associated with liver-related events. Factors associated with overall mortality were age, cirrhosis, liver stiffness and gamma-glutamyl transferase (GGT). For ischaemic events and NLNA cancers, associated factors were total cholesterol and CD4 count, respectively. CONCLUSIONS After SVR following a DAA treatment, liver-related and AIDS-defining events were observed less frequently than NLNA cancers. Severity of liver disease was associated with the risk of liver-related events and of overall mortality but not with ischaemic events and NLNA cancers. Factors reflecting HIV infection were associated with NLNA cancers and liver-related events.
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Affiliation(s)
- Mathieu Chalouni
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, Bordeaux, France
| | - Linda Wittkop
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, Bordeaux, France.,Department of Public Health, CHU de Bordeaux, Bordeaux, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Karine Lacombe
- INSERM Pierre Louis Institute of Epidemiology and Public Health, IPLESP, Sorbonne University, Paris, France.,Infectious Diseases Department, Saint-Antoine Hospital, APHP, Paris, France
| | - Laure Esterle
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, Bordeaux, France
| | - Camille Gilbert
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, Bordeaux, France
| | - Patrick Miailhes
- Department of Infectious and Tropical Diseases, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - David Zucman
- Internal Medicine Unit, Hôpital Foch, Suresnes, France
| | - Marc Antoine Valantin
- Inserm, Department of Infectious Diseases, Pierre Louis Institute of Epidemiology and Public Health, Pitié-Salpêtrière Hospital, Sorbonne University, AP-HP, Paris, France
| | - Sylvie Brégigeon-Ronot
- Clinical Immunohematology Department, Marseille Public University Hospital System (AP-HM), Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France
| | - Philippe Morlat
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, Bordeaux, France.,Department of Internal Medicine and Infectious Diseases, Saint André Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Eric Billaud
- Infectious Disease Unit, CHU Nantes, CIC 1413 INSERM, COREVIH, Pays de la Loire, Nantes, France
| | - Lionel Piroth
- Infectious Diseases Department, Dijon University Hospital, Dijon, France.,University of Bourgogne-Franche-Comté, Dijon, France
| | - Alissa Naqvi
- Infectious Diseases Department, Nice University Hospital, Archet Hospital, Nice, France
| | - Philippe Sogni
- Hepatology Department, APHP, Cochin Hospital, INSERM U-1223 and ICD, Pasteur Institute, Paris University, Paris, France.,Paris University, Paris, France
| | - Dominique Salmon
- Paris University, Paris, France.,Infectious and Tropical Diseases Department, AP-HP Centre, Cochin Hospital, Hôtel Dieu, Paris, France
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22
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David C, Chaigne B, Hollande C, Terris B, Cohen P, Dunogue B, Terrier B, Sogni P, Goulvestre C, Mouthon L. Primary biliary cholangitis and systemic sclerosis (Reynolds syndrome): A case-control study. Autoimmun Rev 2021; 20:102842. [PMID: 33971338 DOI: 10.1016/j.autrev.2021.102842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Clémence David
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France.
| | - Clémence Hollande
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France; Service d'Hépatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Benoit Terris
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France; Département d'Anatomopathologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Pascal Cohen
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Bertrand Dunogue
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Benjamin Terrier
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Philippe Sogni
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France; Service d'Hépatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Claire Goulvestre
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France; Laboratoire d'Immunologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
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23
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Marcellin F, Miailhes P, Santos M, Mercié P, Di Beo V, Salmon-Céron D, Barré T, Wittkop L, Protopopescu C, Zucman D, Sogni P, Carrieri P. Cannabis Use and Plasma Human Immunodeficiency Virus (HIV) RNA Levels in Patients Coinfected With HIV and Hepatitis C Virus Receiving Antiretroviral Therapy: Data From the ANRS CO13 HEPAVIH Cohort. Clin Infect Dis 2021; 71:2536-2538. [PMID: 32055846 DOI: 10.1093/cid/ciaa117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Melina Santos
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrick Mercié
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Pôle Médecine Interne, Service de Médecine Interne et Immunologie Clinique, Bordeaux, France
| | - Vincent Di Beo
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Dominique Salmon-Céron
- Université Paris Descartes, Paris, France.,Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Tangui Barré
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France.,CHU de Bordeaux, Pole de Sante Publique, Bordeaux, France
| | - Camelia Protopopescu
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - David Zucman
- Hôpital Foch, Service de Médecine Interne, Suresnes, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U-1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ., INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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24
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Barré T, Rojas Rojas T, Lacombe K, Protopopescu C, Poizot-Martin I, Nishimwe ML, Zucman D, Esterle L, Billaud E, Aumaitre H, Bouchaud O, Rey D, Piroth L, Salmon-Ceron D, Wittkop L, Sogni P, Carrieri MP, Serfaty L, Marcellin F. Cannabis use and reduced risk of elevated fatty liver index in HIV-HCV co-infected patients: a longitudinal analysis (ANRS CO13 HEPAVIH). Expert Rev Anti Infect Ther 2021; 19:1147-1156. [PMID: 33538612 DOI: 10.1080/14787210.2021.1884545] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Cannabis use and elevated fatty liver index (FLI≥ 60) (a biomarker of hepatic steatosis in the general population) have been identified as predictors of HCV-related and overall mortality, respectively, in HIV-HCV co-infected patients. However, the relationship between cannabis use and the risk of elevated FLI has never been explored.Methods: Using five-year follow-up data from 997 HIV-HCV co-infected patients (ANRS CO13 HEPAVIH cohort), we analyzed the relationship between cannabis use and FLI using mixed-effects multivariable logistic (outcome: elevated FLI yes/no) and linear (outcome: continuous FLI) regression models.Results: At the last follow-up visit, 27.4% of patients reported regular or daily cannabis use and 27.8% had elevated FLI. After multivariable adjustment, regular or daily cannabis use was associated with a 55% lower risk of elevated FLI (adjusted odds ratio [95% confidence interval]: 0.45 [0.22; 0.94]; p = 0.033) and lower FLI values (adjusted model coefficient: -4.24 [-6.57; -1.91], p < 0.0001).Conclusions: Cannabis use is associated with a reduced risk of elevated fatty liver index in HIV-HCV co-infected patients. Further research is needed to confirm whether and how cannabinoids may inhibit the development of hepatic steatosis or other metabolic disorders in high-risk populations.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Teresa Rojas Rojas
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France.,APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France.,UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Marie Libérée Nishimwe
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - David Zucman
- Department of Internal Medicine, Réseau Ville Hôpital Val De Seine, Foch Hospital, Suresnes, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Bordeaux, France
| | - Eric Billaud
- Department of Infectious Disease, CHU Hôtel-Dieu, Nantes, France.,COREVIH Pays De La Loire, CHU Hôtel-Dieu, Nantes, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Avicenne Hospital, Bobigny, France.,Laboratoire d'Educations et Pratiques en Santé EA 3412, Université Sorbonne Paris Nord, Bobigny, France
| | - David Rey
- Le Trait d'Union, HIV-Infection Care Center, Hôpitaux Universitaires De Strasbourg, Strasbourg, France
| | - Lionel Piroth
- Department of Infectiology, Dijon University Hospital Center, Dijon, France.,INSERM-CIC 1342, Bourgogne University, Dijon, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses Et Tropicales, AP-HP, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Bordeaux, France.,Pole De Sante Publique, CHU De Bordeaux, Bordeaux, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U-1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, Hôpital Cochin, Assistance Publique - Hôpitaux De Paris, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Lawrence Serfaty
- Service d'Hépato-gastroentérologie, Hôpital Hautepierre, Hôpitaux Universitaires De Strasbourg, France.,INSERM UMR 938, Université Paris Sorbonne, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales De La Santé & Traitement De l'Information Médicale, Marseille, France.,Ors Paca, Observatoire Régional De La Santé Provence-Alpes-Côte d'Azur, Marseille, France
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25
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Mora M, Goodyear T, Marcellin F, Shoveller J, Di Beo V, Calzolaio C, Sogni P, Wittkop L, Zucman D, Poizot-Martin I, Lacombe K, Salmon-Céron D, Knight R, Carrieri P. Life after hepatitis C cure in HIV-infected people who inject drugs and men who have sex with men treated with direct-acting antivirals in France: Health perceptions and experiences from qualitative and quantitative findings (ANRS CO13 HEPAVIH). J Viral Hepat 2020; 27:1462-1472. [PMID: 32810905 PMCID: PMC7935320 DOI: 10.1111/jvh.13378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
There remains a substantial gap in our understandings of the life experiences of patients following HCV cure among HIV-HCV-co-infected people who inject drugs (PWID) and men who have sex with men (MSM), two key populations targeted for HCV elimination. We described the experiences and perspectives of HIV-positive PWID and MSM, HCV-cured following treatment with direct-acting antivirals (DAA). We used an exploratory sequential mixed approach using both qualitative data (semi-structured interviews with 27 PWID and 20 MSM) and quantitative data (self-administered questionnaires with 89 PWID) via the prospective ANRS CO13 HEPAVIH cohort. PWID reported improvements in physical health-related quality of life (HRQL) and self-reported symptoms following treatment, but no significant change in mental HRQL. During interviews, several MSM, more recently diagnosed with HCV, expressed less concern regarding HCV than HIV infection and interpreted improvements in their overall well-being after HCV cure to be more related to a closer connection with healthcare providers than with viral elimination. By contrast, PWID, particularly those previously exposed to interferon-based treatments, described major improvements in their physical HRQL. Both MSM and PWID reported improvements in cognitive or psychological wellbeing, and a majority of them reported some degree of concern over potential HCV reinfection. To conclude, though health benefits of HCV cure concern both groups, HIV-infected PWID and MSM may have different representations and experiences following DAA treatment, related to their history with HCV. They are thus likely to benefit from holistic, post-treatment follow-up care that is responsive to their evolving health and social contexts.
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Affiliation(s)
- Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Trevor Goodyear
- British Columbia Centre on Substance Use, Vancouver, BC, Canada,School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Jeannie Shoveller
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Chiara Calzolaio
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,Ecole des Hautes Etudes en Sciences Sociales (EHESS), Institut de Recherche Interdisciplinaire Sur Les Enjeux Sociaux (Iris), Paris, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France,INSERM U1223, Institut Pasteur, Paris, France,Service d’Hépatologie, AP-HP, Hôpital Cochin, Paris, France
| | - Linda Wittkop
- University of Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France,CHU de Bordeaux, Pole de santé Publique, Bordeaux, France
| | - David Zucman
- Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,Aix Marseille Univ, APHM Sainte- Marguerite, Service d’Immuno-Hématologie Clinique, Marseille, France
| | - Karine Lacombe
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Service Maladies infectieuses et tropicales, Paris, France,UMPC (Université Pierre et Marie Curie), UMR S1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
| | - Dominique Salmon-Céron
- Université Paris Descartes, Paris, France,Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service Maladies infectieuses et tropicales, Paris, France
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, BC, Canada,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
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26
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David C, Chaigne B, Hollande C, Sogni P, Terris B, Goulvestre C, Mouthon L. Cholangite biliaire primitive et sclérodermie systémique (syndrome de Reynolds) : une association à risque ? Résultats d’une étude rétrospective monocentrique sur 1028 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.058] [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: 10/22/2022]
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27
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Barré T, Protopopescu C, Bani-Sadr F, Piroth L, Rojas Rojas T, Salmon-Ceron D, Wittkop L, Esterle L, Sogni P, Lacombe K, Chas J, Zaegel O, Chaix ML, Miailhes P, Serfaty L, Marcellin F, Carrieri MP. Elevated Fatty Liver Index as a Risk Factor for All-Cause Mortality in Human Immunodeficiency Virus-Hepatitis C Virus-Coinfected Patients (ANRS CO13 HEPAVIH Cohort Study). Hepatology 2020; 71:1182-1197. [PMID: 31466125 DOI: 10.1002/hep.30914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 03/05/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-coinfected patients are at high risk of metabolic complications and liver-related events, which are both associated with hepatic steatosis and its progressive form, nonalcoholic steatohepatitis, a known risk factor for mortality. The fatty liver index (FLI), a noninvasive steatosis biomarker, has recently drawn attention for its clinical prognostic value, although its capacity to predict mortality risk in HIV-HCV-coinfected patients has never been investigated. Using a Cox proportional hazards model for mortality from all causes, with data from the French National Agency for Research on Aids and Viral Hepatitis CO13 HEPAVIH cohort (983 patients, 4,432 visits), we tested whether elevated FLI (≥60) was associated with all-cause mortality. APPROACH AND RESULTS After multiple adjustment, individuals with FLI ≥ 60 had almost double the risk of all-cause mortality (adjusted hazard ratio [95% confidence interval], 1.91 [1.17-3.12], P = 0.009), independently of the following factors: HCV cure (0.21 [0.07-0.61], P = 0.004), advanced fibrosis (1.77 [1.00-3.14], P = 0.05), history of hepatocellular carcinoma and/or liver transplantation (7.74 [3.82-15.69], P < 10-3 ), history of indirect clinical signs of cirrhosis (2.80 [1.22-6.41], P = 0.015), and HIV Centers for Disease Control and Prevention clinical stage C (2.88 [1.74-4.79], P < 10-3 ). CONCLUSIONS An elevated FLI (≥60) is a risk factor for all-cause mortality in HIV-HCV-coinfected patients independently of liver fibrosis and HCV cure. In the present era of nearly 100% HCV cure rates thanks to direct-acting antivirals, these findings encourage the more systematic use of noninvasive steatosis biomarkers to help identify coinfected patients with higher mortality risk.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Firouzé Bani-Sadr
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Reims, Hôpital Robert Debré, Reims, France.,Université Reims Champagne Ardenne, EA-4684/SFR CAP-SANTE, Reims, France
| | - Lionel Piroth
- Département d'infectiologie, CHU de Dijon, Inserm CIC 1432, Université de Bourgogne, Dijon, France
| | - Teresa Rojas Rojas
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Dominique Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Linda Wittkop
- Université de Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France.,Service d'information Médicale, CHU de Bordeaux, Pôle de santé publique, Bordeaux, France
| | - Laure Esterle
- Université de Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France.,INSERM U1223, Institut Pasteur, Paris, France.,Service d'Hépatologie, AP-HP, Hôpital Cochin, Paris, France
| | - Karine Lacombe
- Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, AP-HP, Paris, France.,Sorbonne Universités, INSERM, UPMC Université de Paris 06, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Julie Chas
- Service Maladies Infectieuses et Tropicales, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Olivia Zaegel
- Service d'Immuno-Hématologie Clinique, Aix-Marseille Université, APHM Sainte-Marguerite, Marseille, France
| | - Marie-Laure Chaix
- Department of Virology, National Reference Centre for HIV, Denis Diderot-Paris 7 University, INSERM U941, APHP, Saint-Louis Hospital, Paris, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Lawrence Serfaty
- Service d'Hépato-gastroentérologie, Hôpital Hautepierre, Hôpitaux Universitaires de Strasbourg, INSERM UMR 938, Université Paris Sorbonne, Paris, France
| | - Fabienne Marcellin
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Maria Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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28
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Marcellin F, Di Beo V, Aumaitre H, Mora M, Wittkop L, Duvivier C, Protopopescu C, Lacombe K, Esterle L, Berenger C, Gilbert C, Bouchaud O, Poizot-Martin I, Sogni P, Salmon-Ceron D, Carrieri P, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Poizot-Martin I, 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, Lebrasseur-Longuet D, 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, J M, Paccalin F, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duau 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, Binois R, Simonet-Lann A, Croisier-Bertin D, 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, 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, Zelie J, 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, Desvallees M, Esterle L, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Tezkratt S, Barré T, Baudoin M, Santos M, Di Beo V, Nishimwe M, Wittkop L. Patient-reported symptoms during direct-acting antiviral treatment: A real-life study in HIV-HCV coinfected patients (ANRS CO13 HEPAVIH). J Hepatol 2020; 72:588-591. [PMID: 31924411 DOI: 10.1016/j.jhep.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de santé publique, F-33000 Bordeaux, France
| | - Claudine Duvivier
- AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, IHU Imagine, Université de Paris, INSERM, U1016, Institut Cochin, CNRS, UMR8104, Paris, France; Institut Pasteur, Medical Center of Institut Pasteur, Necker-Pasteur Infectiology Center, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France; UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Cyril Berenger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Publics Hospitals, Avicenne Hospital, Bobigny, France; Paris 13 Nord University, Bobigny, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U-1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France; Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Costentin CE, Sogni P, Falissard B, Barbare JC, Bendersky N, Farges O, Goutte N. Geographical Disparities of Outcomes of Hepatocellular Carcinoma in France: The Heavier Burden of Alcohol Compared to Hepatitis C. Dig Dis Sci 2020; 65:301-311. [PMID: 31346950 DOI: 10.1007/s10620-019-05724-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Data on alcohol-related HCC are limited. AIMS Our aim was to describe the incidence, management, and prognosis of alcohol compared to Hepatitis C (HCV)-related HCC at a national level. METHODS Incident cases of HCC were identified in French healthcare databases between 2009 and 2012 and analyzed retrospectively. Demographic data, type, location, and annual HCC-caseload of the hospitals where patients were first managed were retrieved. Survival of incident cases was computed from the time of diagnosis and adjusted for potential confounding variables. RESULTS The study population included 14,060 incident cases of alcohol and 2581 HCV-related HCC. Alcohol-related HCC was more frequent than HCV-related HCC (29.37 and 5.39/100,000 adults/year, respectively) with an heterogeneous distribution on the French territory. The optimal treatment was less frequently curative (20.5% vs 35.9%; p < 0.001), and survival was significantly shorter (9.5 [9.0-10.0] versus 16.8 [15.5-18.7] months p < 0.001) in alcohol compared to HCV-related HCC, with marked variations between regions for a given risk factor. In multivariable analysis in the whole study population, curative treatment was a strong predictor of survival (adjusted HR 0.28 [0.27-0.30] months p < 0.001). Being managed at least once in a teaching hospital during follow-up was independently associated with receiving a curative treatment and survival. CONCLUSION In France, incidence of alcohol-related HCC is high and prognosis is poor compared to HCV-related HCC, with marked variations between regions. These results should guide future health policy initiatives pertaining to HCC care. Importantly, increasing patient' referral in expert centers could increase chances to receive curative treatment and improve outcomes.
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Affiliation(s)
- Charlotte E Costentin
- Clinique Universitaire d'Hépato-gastroentérologie, Pôle Digidune, University Hospital Grenoble Alpes, La Tronche, France. .,Grenoble Alpes University, Inserm U1041, Grenoble, France.
| | - Philippe Sogni
- INSERM U-1223, Pasteur Institute, Paris and Hepatology, Cochin Hospital, Assistance Publique - Hopitaux de Paris, France, Paris-Descartes University, Paris, France
| | | | - Jean-Claude Barbare
- Amiens University Hospital, délégation à la recherche clinique et à l'innovation, site sud, 80054, Amiens, France
| | | | - Olivier Farges
- Hepato-biliary Surgery, Beaujon Hospital, Clichy, France
| | - Nathalie Goutte
- Paris XI University, INSERM UMRS-1193, DHU Hépatinov and Centre hépatobiliaire, Paul-Brousse Hospital, Assistance Publique - Hôpitaux de Paris, Villejuif, France
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30
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Mallet V, Parlati L, Vallet-Pichard A, Terris B, Tsochatzis E, Sogni P, Pol S. [FIB-4 index to rule-out advanced liver fibrosis in NAFLD patients]. Presse Med 2019; 48:1484-1488. [PMID: 31767251 DOI: 10.1016/j.lpm.2019.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 09/21/2019] [Accepted: 10/03/2019] [Indexed: 12/29/2022] Open
Abstract
The FIB-4 index is a biomarker of advanced hepatic fibrosis in a context of fatty liver disease. The calculation of the FIB-4 index requires of age, serum ALT and AST transaminase levels and platelet count. A FIB-4 index<1.45 in a context of fatty liver disease excludes clinically significant hepatic fibrosis. Additional explorations are mandatory to excluded hepatic fibrosis for a a FIB-4 index>1.45 in a context of fatty liver disease. A complete hepatological workup is mandatory for a FIB-4 index>3.25 in a context of fatty liver disease.
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Affiliation(s)
- Vincent Mallet
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service hépatologie, 75014 Paris, France; Institut Pasteur, U.1223, Inserm, 75015 Paris, France.
| | - Lucia Parlati
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service hépatologie, 75014 Paris, France; Institut Pasteur, U.1223, Inserm, 75015 Paris, France
| | - Anaïs Vallet-Pichard
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service hépatologie, 75014 Paris, France; Institut Pasteur, U.1223, Inserm, 75015 Paris, France
| | - Benoit Terris
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service d'anatomopathologie, 75014 Paris, France
| | - Emmanuel Tsochatzis
- UCL Institute for Liver and Digestive Health, Royal Free Hospital et UCL, Londres, Royaume-Uni
| | - Philippe Sogni
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service hépatologie, 75014 Paris, France; Institut Pasteur, U.1223, Inserm, 75015 Paris, France
| | - Stanislas Pol
- AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, service hépatologie, 75014 Paris, France; Institut Pasteur, U.1223, Inserm, 75015 Paris, France
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31
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Barré T, Protopopescu C, Bani-Sadr F, Piroth L, Sogni P, Salmon-Ceron D, Wittkop L, Lacombe K, Serfaty L, Marcellin F. Elevated fatty liver index as a risk factor for all-cause mortality in HIV-HCV co-infected patients. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Thanks to innovation in treatment, people living with HIV and/or HCV now live longer but are growingly facing non-communicable disease burden. HIV-HCV co-infected patients are at high risk of metabolic complications and liver-related events, which are both associated with hepatic steatosis and its progressive form, non-alcoholic steatohepatitis (NASH), a known risk factor for mortality. The fatty liver index (FLI), a non-invasive steatosis biomarker, has recently drawn attention for its clinical prognostic value, but has never been applied to HIV-HCV co-infected patients. We aimed at testing whether elevated FLI (≥60) was associated with all-cause mortality in co-infected patients.
Methods
Our study is based on data from ANRS CO13 HEPAVIH, a French national prospective cohort of HIV-HCV co-infected patients. Socio-behavioral and clinical data from patients clinically followed-up were used in the analysis. Using a Cox proportional hazards model for mortality from all causes (983 patients; 4,432 visits), we computed hazard ratios associated with risk factors and confounders.
Results
After multiple adjustment, individuals with FLI≥60 had almost double the risk of all-cause mortality (adjusted hazard ratio [95% confidence interval]: 1.91 [1.17-3.12], p = 0.009), independently of HCV cure (0.21 [0.07-0.61], p = 0.004), advanced fibrosis (1.77 [1.00-3.14], p = 0.05), history of hepatocellular carcinoma and/or liver transplantation (7.74 [3.82-15.69], p < 10-3), history of indirect clinical signs of cirrhosis (2.80 [1.22-6.41], p = 0.015), and HIV CDC clinical stage C (2.88 [1.74-4.79], p < 10-3).
Conclusions
An elevated fatty liver index is a risk factor for all-cause mortality in HIV-HCV co-infected patients independently of liver fibrosis and HCV cure. In the present era of nearly 100% HCV cure rates, these findings encourage the more systematic use of non-invasive steatosis biomarkers to help identify co-infected patients with higher mortality risk.
Key messages
A FLI≥60 is strongly associated with mortality in HIV-HCV co-infected patients. FLI could be calculated routinely to identify most at-risk patients.
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Affiliation(s)
- T Barré
- SESSTIM, AMU/INSERM/IRD, Marseille, France
- ORS PACA, Marseille, France
| | - C Protopopescu
- SESSTIM, AMU/INSERM/IRD, Marseille, France
- ORS PACA, Marseille, France
| | - F Bani-Sadr
- EA-4684/SFR CAP-SANTE, CHU Reims, University Reims Champagne, Reims, France
| | - L Piroth
- Inserm CIC 1432, CHU Dijon, University Bourgogne, Dijon, France
| | - P Sogni
- Université Paris Descartes, Paris, France
- INSERM U1223, Institut Pasteur/AP-HP/Hôpital Cochin, Paris, France
| | - D Salmon-Ceron
- Service Maladies Infectieuses et Tropicales, AP-HP/Hôpital Cochin, Paris, France
- Université Paris Descartes, Paris, France
| | - L Wittkop
- MORPH3EUS, UMR 1219, CIC-EC 1401, University Bordeaux, INSERM, ISPED, Bordeaux, France
- Service d’Information Médicale, CHU Bordeaux, Bordeaux, France
| | - K Lacombe
- Department of Infectious and Tropical Diseases, AP-HP/Hôpital St Antoine, Paris, France
- IPLESP UMRS 1136, INSERM/University Sorbonne/University Paris 6, Paris, France
| | - L Serfaty
- INSERM UMR 938, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- Université Paris Sorbonne, Paris, France
| | - F Marcellin
- SESSTIM, AMU/INSERM/IRD, Marseille, France
- ORS PACA, Marseille, France
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Willemse S, Smit C, Sogni P, Sarcletti M, Uberti-Foppa C, Wittkop L, Raben D, D'Arminio Monforte A, Dabis F, Van Der Valk M. Low compliance with hepatocellular carcinoma screening guidelines in hepatitis B/C virus co-infected HIV patients with cirrhosis. J Viral Hepat 2019; 26:1224-1228. [PMID: 31136059 PMCID: PMC6851829 DOI: 10.1111/jvh.13146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Sophie Willemse
- Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,ATHENA, The Netherlands
| | - Colette Smit
- ATHENA, The Netherlands.,Stichting HIV-monitoring, The Netherlands
| | - Philippe Sogni
- INSERM U-1223, Pasteur Institute, Paris-Descartes University, Paris, France.,Department of Hepatology, Cochin Hospital, Paris, France.,ANRS CO13 HEPAVIH, France
| | - Mario Sarcletti
- Department of Dermatology and Venereology, Medical University Innsbruck, Innsbruck, Austria.,AHIVCOS, Austria
| | - Caterina Uberti-Foppa
- Department of Infectious Diseases, Scientific Institute San Raffaele Hospital (HSR), Milan, Italy
| | - Linda Wittkop
- ANRS CO13 HEPAVIH, France.,Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Univ. Bordeaux, ISPED, Bordeaux, France.,CHU de Bordeaux, Pôle de santé publique, Service d'information médicale, Bordeaux, France
| | - Dorthe Raben
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Francois Dabis
- ANRS CO13 HEPAVIH, France.,Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, Univ. Bordeaux, ISPED, Bordeaux, France.,CHU de Bordeaux, Pôle de santé publique, Service d'information médicale, Bordeaux, France
| | - Marc Van Der Valk
- ATHENA, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Boccara F, Tan BK, Chalouni M, Salmon Ceron D, Cinaud A, Esterle L, Gilbert C, Bani-Sadr F, Dabis F, Sogni P, Wittkop L. P5341Predictive factors of atherosclerotic cardiovascular diseases events in HIV-HVC co-infected patients: results from hepavih ANRS co13 cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Several studies highlighted an increased risk of cardiovascular disease (CVD) in HIV-HCV co-infected patients without clearly identifying specific virologic factors associated with atherosclerotic CVD (ASCVD) events.
Purpose
Hence, we analyzed data collection from the French nationwide ANRS CO13 HEPAVIH cohort to determine the incidence of ASCVD events in HIV-HCV co-infected patients and the predictive factors associated with its occurrence.
Methods
The French multicenter nationwide ANRS CO13 HEPAVIH clinic-based cohort collected prospective clinical and biological data from HIV-HCV co-infected patients followed-up in 28 different university hospitals between December 2005 to November 2016. Participants with at least one year of follow-up were included. Primary outcome was the occurrence of major ASCVD events (cardiovascular death, acute coronary syndrome, coronary revascularization and stroke). Secondary outcomes were total ASCVD events including major ASCVD events and minor ASCVD events (peripheral arterial disease [PAD]). Incidence rates were estimated using Aalen-Johansen method and factors associated with ASCVD identified with Cox proportional hazards models.
Results
A total of 1213 patients were included: median age 45.4 years [42.1–49.0], 70.3% men, current smoking 70.2%, overweight 19.5%, liver cirrhosis 18.9%, chronic alcohol consumption 7.8%, diabetes mellitus (5.9%), personal history of CVD 2.7%, and statins use 4.1%. After a median follow-up of 5.1 years [3.9–7.0], 44 participants experienced at least one ASCVD event (26 major ASCVD event, and 20 a minor event). Incidences for total, major and minor ASCVD events were of 6.98 [5.19; 9.38], 4.01 [2.78; 6.00], and 3.17 [2.05; 4.92] per 1000 person-years, respectively. Personal history of CVD (Hazard Ratio (HR)=13.94 [4.25–45.66]), high total cholesterol (HR=1.63 [1.24–2.15]), low HDL cholesterol (HR=0.08 [0.02–0.34]) and undetectable HIV viral load (HR=0.41 [0.18–0.96]) were identified as independent factors associated with major ASCVD events while cirrhosis status, liver fibrosis and HCV sustained viral response were not.
Cumulative incidence of CV events
Conclusion
HIV-HCV co-infected patients experience a high incidence of ASCVD events both coronary and peripheral artery diseases. Traditional CV risk factors are the main determinants of ASCVD whereas undetectable HIV viral load seems to be protective. Management of cholesterol abnormalities and controlling viral load are essential to modify this high cardiovascular risk.
Acknowledgement/Funding
Agence Natoinale de Recherche sur le SIDA et les Hépatites virales
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Affiliation(s)
- F Boccara
- AP-HP - Hospital Saint Antoine, Paris, France
| | - B K Tan
- Hospital Cochin, Internal Medicine, Paris, France
| | - M Chalouni
- University of Bordeaux, ISPED, Bordeaux, France
| | - D Salmon Ceron
- Hospital Hotel-Dieu, Infectious Diseases Federation, Paris, France
| | - A Cinaud
- Hospital Hotel-Dieu, Cardiology, Paris, France
| | - L Esterle
- University of Bordeaux, ISPED, Bordeaux, France
| | - C Gilbert
- University of Bordeaux, ISPED, Bordeaux, France
| | - F Bani-Sadr
- University of Bordeaux, ISPED, Bordeaux, France
| | - F Dabis
- University of Bordeaux, ISPED, Bordeaux, France
| | - P Sogni
- Hospital Cochin, Hepatology, Paris, France
| | - L Wittkop
- Hospital Cochin, Hepatology, Paris, France
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34
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de Tymowski C, Dépret F, Soussi S, Nabila M, Vauchel T, Chaussard M, Benyamina M, Ferry A, Cupaciu A, Jully M, Oueslati H, Fratani A, Coutrot M, Sogni P, Mimoun M, Chaouat M, Zagdanski AM, De Kerviler E, Mebazaa A, Moreau R, Mallet V, Legrand M. Contributing factors and outcomes of burn-associated cholestasis. J Hepatol 2019; 71:563-572. [PMID: 31152758 DOI: 10.1016/j.jhep.2019.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/04/2019] [Accepted: 05/14/2019] [Indexed: 12/04/2022]
Abstract
BACKGROUND & AIMS Cholestasis often occurs after burn injuries. However, the prevalence of cholestasis and its effect on outcomes in patients with severe burn injuries are unknown. The aim of this study was to describe the course and the burden of cholestasis in a cohort of severely burned adult patients. METHODS We investigated the relationship between burn-associated cholestasis (BAC) and clinical outcomes in a retrospective cohort of patients admitted to our unit for severe burn injuries between 2012 and 2015. BAC was defined as an increased level of serum alkaline phosphatase (ALP) ≥1.5x the upper limit of normal (ULN) with an increased level of gamma-glutamyltransferase (GGT) ≥3x ULN, or as an increased level of total bilirubin ≥2x ULN. RESULTS A total of 214 patients were included: 111 (52%) patients developed BAC after a median (IQR) stay of 9 (5-16) days. At 90 days, the mortality rate was 20%, including 34 and 9 patients with and without BAC (p <0.001), respectively, which corresponded to a 2.5-fold higher (95% CI 1.2-5.2, p = 0.012) risk of 90-day mortality for patients with BAC. After being adjusted for severity of illness, patients with BAC, hyperbilirubinemia and without elevated ALP and GGT levels had a hazard ratio of 4.51 (95% CI 1.87-10.87) for 90-day mortality. BAC was associated with the severity of the burn injury, shock and bacteraemia. BAC was present in 38 (51%) patients at discharge, and 7 (18%) patients had secondary sclerosing cholangitis. These patients maintained elevated levels of ALP and GGT that were 5.8x (1.7-15) the ULN and 11x the ULN (4.5-22), respectively, 20 months (3.5-35) after discharge. CONCLUSION BAC is prevalent among patients with severe burn injuries and is associated with worse short-term outcomes, especially when total bilirubin levels were increased without elevated ALP and GGT levels. BAC survivors are at risk of developing sclerosing cholangitis. LAY SUMMARY Cholestasis is common after burn injuries and is associated with burn severity, sepsis, organ failure and mortality. Patients with hyperbilirubinemia without elevated alkaline phosphatase and gamma-glutamyltransferase levels after the burn injury have a poor prognosis. Patients with burn-associated cholestasis may develop sclerosing cholangitis and secondary biliary cirrhosis.
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Affiliation(s)
- Christian de Tymowski
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation CRI, Paris, France; Laboratoire d'Excellence (Labex) Inflammex, ComUE Sorbonne Paris Cité, Paris, France
| | - François Dépret
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR INSERM 942, Lariboisière Hospital University Paris Diderot, F-75475, & F-CRIN INI-CRCT Network, Paris, France
| | - Sabri Soussi
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Moreno Nabila
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Biochemistry Laboratory, Paris, France
| | - Thomas Vauchel
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Maité Chaussard
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Mourad Benyamina
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Axelle Ferry
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Alexandru Cupaciu
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Marion Jully
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Haikel Oueslati
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Alexandre Fratani
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France
| | - Maxime Coutrot
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France
| | - Philippe Sogni
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité 1223; Institut Pasteur, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Maurice Mimoun
- University Paris Diderot, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Plastic Surgery, Paris, France
| | - Marc Chaouat
- University Paris Diderot, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Plastic Surgery, Paris, France
| | - Anne-Marie Zagdanski
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Radiology, Paris, France
| | - Eric De Kerviler
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Radiology, Paris, France
| | - Alexandre Mebazaa
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR INSERM 942, Lariboisière Hospital University Paris Diderot, F-75475, & F-CRIN INI-CRCT Network, Paris, France
| | - Richard Moreau
- University Paris Diderot, Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation CRI, Paris, France; Laboratoire d'Excellence (Labex) Inflammex, ComUE Sorbonne Paris Cité, Paris, France; Département Hospitalo-Universitaire (DHU) UNITY, Service d'hépatologie, Hôpital beaujon APHP, Clichy, France
| | - Vincent Mallet
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité 1223; Institut Pasteur, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France.
| | - Matthieu Legrand
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR INSERM 942, Lariboisière Hospital University Paris Diderot, F-75475, & F-CRIN INI-CRCT Network, Paris, France.
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Salmon-Ceron D, Nahon P, Layese R, Bourcier V, Sogni P, Bani-Sadr F, Audureau E, Merchadou L, Dabis F, Wittkop L, Roudot-Thoraval F. Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Co-infected Patients With Cirrhosis Are No Longer at Higher Risk for Hepatocellular Carcinoma or End-Stage Liver Disease as Compared to HCV Mono-infected Patients. Hepatology 2019; 70:939-954. [PMID: 30569448 DOI: 10.1002/hep.30400] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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] [Received: 03/09/2018] [Accepted: 10/24/2018] [Indexed: 12/12/2022]
Abstract
It is widely accepted that human immunodeficiency virus (HIV) infection is a risk factor for increased severity of hepatitis C virus (HCV) liver disease. However, owing to better efficacy and safety of combination antiretroviral therapy (cART), and increased access to HCV therapy, whether this condition remains true is still unknown. Overall, 1,253 HCV mono-infected patients and 175 HIV/HCV co-infected patients with cirrhosis, included in two prospective French national cohorts (ANRS CO12 CirVir and CO13 HEPAVIH), were studied. Cirrhosis was compensated (Child-Pugh A), without past history of complication, and assessed on liver biopsy. Incidences of liver decompensation (LD), hepatocellular carcinoma (HCC), and death according to HIV status were calculated by a Fine-Gray model adjusted for age. Propensity score matching was also performed to minimize confounding by baseline characteristics. At baseline, HIV/HCV patients were younger (47.5 vs. 56.0 years; P < 0.001), more frequently males (77.1% vs. 62.3%; P < 0.001), and had at baseline and at end of follow-up similar rates of HCV eradication than HCV mono-infected patients. A total of 80.4% of HIV/HCV patients had an undetectable HIV viral load. After adjustment for age, 5-year cumulative incidences of HCC and decompensation were similar in HIV/HCV and HCV patients (8.5% vs. 13.2%, P = 0.12 and 12.8% vs. 15.6%, P = 0.40, respectively). Overall mortality adjusted for age was higher in HIV/HCV co-infected patients (subhazard ratio [SHR] = 1.88; 95% confidence interval [CI], 1.15-3.06; P = 0.011). Factors associated with LD and HCC were age, absence of sustained virological response, and severity of cirrhosis, but not HIV status. Using a propensity score matching 95 patients of each group according to baseline features, similar results were observed. Conclusion: In HCV-infected patients with cirrhosis, HIV co-infection was no longer associated with higher risks of HCC and hepatic decompensation. Increased mortality, however, persisted, attributed to extrahepatic conditions.
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Affiliation(s)
- Dominique Salmon-Ceron
- APHP, Hôpitaux Universitaires Paris Centre, Infectious Diseases Federation, Paris, France.,Paris Descartes University, Paris, France
| | - Pierre Nahon
- AP-HP, Hôpital Jean Verdier, Hepatology Department, Bondy, France.,Paris 13 University, Sorbonne Paris Cité, "Equipe Labellisée Ligue Contre le Cancer," Saint-Denis, and Inserm UMR 1162, Paris, France
| | - Richard Layese
- AP-HP, Hôpital Henri-Mondor, Public Health Department, 94000, Créteil, France.,AP-HP, Hôpital Henri-Mondor, Clinical Research Unit (URC-Mondor), 94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB-EA CEpiA (Clinical Epidemiology and Ageing) Unit EA7376, 94000, Créteil, France
| | - Valérie Bourcier
- AP-HP, Hôpital Jean Verdier, Hepatology Department, Bondy, France
| | - Philippe Sogni
- Paris Descartes University, Paris, France.,INSERM U-1223, Institut Pasteur and APHP, Hôpitaux Universitaires Paris Centre, Hepatology Department, Paris, France
| | - Firouze Bani-Sadr
- Centre Hospitalier Universitaire de Reims, Internal Medicine Department, Infectious Diseases and Clinical Immunology Unit, Reims, France.,Reims University, Champagne-Ardenne, France
| | - Etienne Audureau
- AP-HP, Hôpital Henri-Mondor, Public Health Department, 94000, Créteil, France.,AP-HP, Hôpital Henri-Mondor, Clinical Research Unit (URC-Mondor), 94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB-EA CEpiA (Clinical Epidemiology and Ageing) Unit EA7376, 94000, Créteil, France
| | - Laurence Merchadou
- Bordeaux University, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000, Bordeaux, France
| | - François Dabis
- Bordeaux University, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Public Health and Medical Information Department, F-33000, Bordeaux, France
| | - Linda Wittkop
- Bordeaux University, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Public Health and Medical Information Department, F-33000, Bordeaux, France
| | - Françoise Roudot-Thoraval
- AP-HP, Hôpital Henri-Mondor, Public Health Department, 94000, Créteil, France.,AP-HP, Hôpital Henri-Mondor, Clinical Research Unit (URC-Mondor), 94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB-EA CEpiA (Clinical Epidemiology and Ageing) Unit EA7376, 94000, Créteil, France
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Shili-Masmoudi S, Sogni P, de Ledinghen V, Esterle L, Valantin MA, Poizot-Martin I, Simon A, Rosenthal E, Lacombe K, Pialoux G, Bouchaud O, Gervais-Hasenknoff A, Goujard C, Piroth L, Zucman D, Dominguez S, Raffi F, Alric L, Bani-Sadr F, Lascoux-Combe C, Garipuy D, Miailhes P, Vittecoq D, Duvivier C, Aumaître H, Neau D, Morlat P, Dabis F, Salmon D, Wittkop L. Increased liver stiffness is associated with mortality in HIV/HCV coinfected subjects: The French nationwide ANRS CO13 HEPAVIH cohort study. PLoS One 2019; 14:e0211286. [PMID: 30682180 PMCID: PMC6347250 DOI: 10.1371/journal.pone.0211286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/10/2018] [Accepted: 01/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background The association between liver stiffness measurements (LSM) and mortality has not been fully described. In particular the effect of LSM on all-cause mortality taking sustained virological response (SVR) into account needs further study. Methods HIV/HCV participants in the French nation-wide, prospective, multicenter ANRS CO13 HEPAVIH cohort, with ≥1 LSM by FibroScan (FS) and a detectable HCV RNA when the first valid FS was performed were included. Cox proportional hazards models with delayed entry were performed to determine factors associated with all-cause mortality. LSM and SVR were considered as time dependent covariates. Results 1,062 patients were included from 2005 to 2015 (69.8% men, median age 45.7 years (IQR 42.4–49.1)). 21.7% had baseline LSM >12.5 kPa. Median follow-up was 4.9 years (IQR 3.2–6.1). 727 (68.5%) were ever treated for HCV: 189 of them (26.0%) achieved SVR. 76 deaths were observed (26 liver-related, 10 HIV-related, 29 non-liver-non-HIV-related, 11 of unknown cause). At the age of 50, the mortality rate was 4.5% for patients with LSM ≤12.5 kPa and 10.8% for patients with LSM >12.5 kPa. LSM >12.5 kPa (adjusted Hazard Ratio [aHR] = 3.35 [2.06; 5.45], p<0.0001), history of HCV treatment (aHR = 0.53 [0.32; 0.90], p = 0.01) and smoking (past (aHR = 5.69 [1.56; 20.78]) and current (3.22 [0.93; 11.09]) versus never, p = 0.01) were associated with all-cause mortality independently of SVR, age, sex, alcohol use and metabolic disorders. Conclusion Any LSM >12.5 kPa was strongly associated with all-cause mortality independently of SVR and other important covariates. Our results suggest that close follow-up of these patients should remain a priority even after achieving SVR.
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Affiliation(s)
- Sarah Shili-Masmoudi
- Univ Bordeaux, ISPED, Inserm Bordeaux Population Health, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Service d’Hépatologie, Bordeaux, France
| | - Philippe Sogni
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service d’Hépatologie, Paris, France
- INSERM U-1223 –Institut Pasteur, Paris, France
- Université Paris Descartes, Paris, France
| | - Victor de Ledinghen
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Service d’Hépatologie, Bordeaux, France
- Univ Bordeaux, Inserm, UMR 1053, Bordeaux, France
| | - Laure Esterle
- Univ Bordeaux, ISPED, Inserm Bordeaux Population Health, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
| | - Marc-Antoine Valantin
- Assistance Publique des Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Service Maladies infectieuses et tropicales, Paris, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, APHM Sainte-Marguerite, Service d’Immuno-hématologie clinique, Marseille, France
- Inserm U912 (SESSTIM) Marseille, France
| | - Anne Simon
- Assistance Publique des Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Département de Médecine Interne et Immunologie Clinique, Paris, France
| | - Eric Rosenthal
- Centre Hospitalier Universitaire de Nice, Service de Médecine Interne et Cancérologie, Hôpital l’Archet, Nice, France
- Université de Nice-Sophia Antipolis, Nice, France
| | - Karine Lacombe
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Service Maladies infectieuses et tropicales, Paris, France
- UMPC (Université Pierre et Marie Curie), UMR S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Gilles Pialoux
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service Maladies infectieuses et tropicales, Paris, France
| | - Olivier Bouchaud
- Assistance Publique des Hôpitaux de Paris, Hôpital Avicenne, Service Maladies infectieuses et tropicales, Bobigny, France
- Université Paris 13 Nord, Bobigny, France
| | - Anne Gervais-Hasenknoff
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Service des maladies infectieuses et tropicales, Paris, France
| | - Cécile Goujard
- Assistance Publique des Hôpitaux de Paris, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud, Service Médecine interne et Immunologie clinique, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin-Bicêtre, France
| | - Lionel Piroth
- Centre Hospitalier Universitaire de Dijon, Département d’Infectiologie, Dijon, France
- Université de Bourgogne, Dijon, France
| | | | - Stéphanie Dominguez
- Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Service Immunologie clinique et maladies infectieuses, Immunologie clinique, Créteil, France
| | - François Raffi
- Centre Hospitalier Universitaire de Nantes, Service Maladies infectieuses et tropicales, Nantes, France
| | - Laurent Alric
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Médecine interne, Toulouse, France
- Université Toulouse III, Paul Sabatier, Toulouse, France
| | - Firouzé Bani-Sadr
- Centre Hospitalier Universitaire de Reims, Service de médecine interne, maladies infectieuses et immunologie clinique, Reims, France
- Université de Reims, Champagne-Ardenne, Reims, France
| | - Caroline Lascoux-Combe
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Louis, Service Maladies infectieuses et tropicales, Paris, France
| | - Daniel Garipuy
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Maladies infectieuses et tropicales, Toulouse, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, CHU Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Daniel Vittecoq
- Université Paris Sud, Le Kremlin-Bicêtre, France
- Assistance Publique des Hôpitaux de Paris, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud, Service Maladies infectieuses et tropicales, Le Kremlin-Bicêtre, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants malades, Service de Maladies Infectieuses et Tropicales, Paris, France
- Centre d'Infectiologie Necker-Pasteur, Paris, France
| | - Hugues Aumaître
- Centre Hospitalier de Perpignan, Service Maladies infectieuses et tropicales, Perpignan, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service Maladies infectieuses et tropicales Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | - Philippe Morlat
- Univ Bordeaux, ISPED, Inserm Bordeaux Population Health, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Service de médecine interne, hôpital Saint-André, Bordeaux, France
| | - François Dabis
- Univ Bordeaux, ISPED, Inserm Bordeaux Population Health, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Dominique Salmon
- Université Paris Descartes, Paris, France
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service Maladies infectieuses et tropicales, Paris, France
| | - Linda Wittkop
- Univ Bordeaux, ISPED, Inserm Bordeaux Population Health, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Pôle de Santé Publique, Bordeaux, France
- * E-mail:
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Parlati L, Vallet-Pichard A, Batista R, Hernvann A, Sogni P, Pol S, Mallet V. Incidence of grade 3-4 liver injury under immune checkpoints inhibitors: A retrospective study. J Hepatol 2018; 69:1396-1397. [PMID: 30292476 DOI: 10.1016/j.jhep.2018.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/01/2018] [Accepted: 08/15/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Lucia Parlati
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, France
| | - Anais Vallet-Pichard
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, France
| | - Rui Batista
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Pharmacy Service, Paris, France
| | - Alain Hernvann
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Biology Service, Paris, France
| | - Philippe Sogni
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, France; Institut Pasteur, Inserm, Unité 1223, Paris, France
| | - Stanislas Pol
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, France; Institut Pasteur, Inserm, Unité 1223, Paris, France
| | - Vincent Mallet
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, France; Institut Pasteur, Inserm, Unité 1223, Paris, France.
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Salmon D, Trimoulet P, Gilbert C, Solas C, Lafourcade E, Chas J, Piroth L, Lacombe K, Katlama C, Peytavin G, Aumaitre H, Alric L, Boué F, Morlat P, Poizot-Martin I, Billaud E, Rosenthal E, Naqvi A, Miailhes P, Bani-Sadr F, Esterle L, Carrieri P, Dabis F, Sogni P, Wittkop L. Factors associated with DAA virological treatment failure and resistance-associated substitutions description in HIV/HCV coinfected patients. World J Hepatol 2018; 10:856-866. [PMID: 30533186 PMCID: PMC6280155 DOI: 10.4254/wjh.v10.i11.856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/10/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions (RAS).
METHODS Human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients starting a first direct-acting antiviral (DAA) regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defined as: (1) non-response [HCV-RNA remained detectable during treatment, at end of treatment (EOT)]; and (2) relapse (HCV-RNA suppressed at EOT but detectable thereafter). Sequencing analysis was performed to describe prevalence of drug class-specific RAS. Factors associated with failure were determined using logistic regression models.
RESULTS Among 559 patients, 77% had suppressed plasma HIV-RNA < 50 copies/mL at DAA treatment initiation, 41% were cirrhotic, and 68% were HCV treatment-experienced. Virological treatment failures occurred in 22 patients and were mainly relapses (17, 77%) then undefined failures (3, 14%) and non-responses (2, 9%). Mean treatment duration was 16 wk overall. Post-treatment NS3, NS5A or NS5B RAS were detected in 10/14 patients with samples available for sequencing analysis. After adjustment for age, sex, ribavirin use, HCV genotype and treatment duration, low platelet count was the only factor significantly associated with a higher risk of failure (OR: 6.5; 95%CI: 1.8-22.6).
CONCLUSION Only 3.9% HIV-HCV coinfected patients failed DAA regimens and RAS were found in 70% of those failing. Low platelet count was independently associated with virological failure.
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Affiliation(s)
- Dominique Salmon
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Hôtel Dieu, Unité des Maladies infectieuses et tropicales, Paris 75004, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris 75006, France
| | - Pascale Trimoulet
- CHU de Bordeaux, Hôpital Pellegrin, Laboratoire de Virologie, Bordeaux 33000, France
- CNRS-UMR 5234, Microbiologie fondamentale et Pathogénicité, Université de Bordeaux, Bordeaux 3000, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
| | - Caroline Solas
- APHM, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, Marseille 13005, France
| | - Eva Lafourcade
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
| | - Julie Chas
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service Maladies infectieuses et tropicales, Paris 75020, France
| | - Lionel Piroth
- Centre Hospitalier Universitaire de Dijon, Département d’Infectiologie, Dijon cedex 21079, France
- INSERM-CIC 1342 Université de Bourgogne, Dijon 21000, France
| | - Karine Lacombe
- Assistance Publique des Hôpitaux de Paris, GHUEP site Saint-Antoine, Services Maladies infectieuses et tropicales, Paris 75011, France
- Université Pierre et Marie Curie, UMR S1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris 75646, France
| | - Christine Katlama
- Université Paris-Sorbonne, Paris 75005, France
- Assistance Publique des Hôpitaux de Paris Hôpital Pitié Salpêtrière, Services Maladies infectieuses et tropicales, Paris 75013, France
| | - Gilles Peytavin
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Laboratoire de Pharmacologie, Paris 75877, France
- IAME, UMR 1137, Sorbonne Paris Cité, INSERM, Université Paris Diderot, Paris 75890, France
| | - Hugues Aumaitre
- Centre Hospitalier de Perpignan, Service Maladies infectieuses et tropicales, Perpignan 66000, France
| | - Laurent Alric
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Service Médecine interne-Pôle Digestif, Toulouse 31300, France
- UMR 152 IRD Université Toulouse III, Paul Sabatier, Toulouse 31330, France
| | - François Boué
- Hôpital Antoine-Béclère, Assistance Publique des Hôpitaux de Paris, Université Paris Sud, Service Médecine interne et immunologie, Clamart 92140, France
| | - Philippe Morlat
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
- Centre Hospitalier Universitaire de Bordeaux, Service de médecine interne, Hôpital Saint-André, Bordeaux 33000, France
| | - Isabelle Poizot-Martin
- Aix-Marseille Univ, APHM Sainte-Marguerite, Service d’Immuno-hématologie clinique, Marseille 13274, France
- Sciences Economiques and Sociales de la Santéand Traitement de l’Information Médicale, UMR912 INSERM, Aix-Marseille Université, IRD, Marseille 13009, France
| | - Eric Billaud
- Department of Infectious Diseases, CHU de Nantes and CIC 1413, Inserm, Nantes 44000, France
| | - Eric Rosenthal
- Centre Hospitalier Universitaire de Nice, Service de Médecine Interne, Hôpital l’Archet, Nice 06202, France
- Université de Nice-Sophia Antipolis, Nice 06100, France
| | - Alissa Naqvi
- Centre Hospitalier Universitaire de Nice, Service d’Infectiologie, Hôpital l’Archet, Nice 06100, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon 69004, France
| | - Firouzé Bani-Sadr
- Centre Hospitalier Universitaire de Reims, Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Reims 51100, France
- Faculté de Médecine EA-4684/SFR CAP-SANTE, Université de Reims, Champagne-Ardenne, Reims 51100, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
| | - Patrizia Carrieri
- Sciences Economiques and Sociales de la Santéand Traitement de l’Information Médicale, UMR912 INSERM, Aix-Marseille Université, IRD, Marseille 13009, France
| | - François Dabis
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
| | - Philippe Sogni
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service d’Hépatologie, Paris 75014, France
- Inserm U-1223 - Institut Pasteur, Paris 75015, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux F-33000, France
- CHU de Bordeaux, Pôle de santé Publique, Service dâinformation médicale, Bordeaux F-33000, France
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Yaya I, Roux P, Marcellin F, Wittkop L, Esterle L, Spire B, Dominguez S, Elegbe BA, Piroth L, Sogni P, Salmon-Ceron D, Carrieri MP. Evolution of patients' socio-behavioral characteristics in the context of DAA: Results from the French ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients. PLoS One 2018; 13:e0199874. [PMID: 29975764 PMCID: PMC6033422 DOI: 10.1371/journal.pone.0199874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 06/15/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Direct-acting antivirals (DAA) have dramatically increased HCV cure rates with minimal toxicity in HIV-HCV co-infected patients. This study aimed to compare the socio-behavioral characteristics of patients initiating pegylated-interferon (PEG-IFN)-based HCV treatment with those of patients initiating DAA-based treatment. METHODS ANRS CO13 HEPAVIH is a national multicenter prospective cohort started in 2005, which enrolled 1,859 HIV-HCV co-infected patients followed up in French hospital outpatient units. Both clinical/biological and socio-behavioral data were collected during follow-up. We selected patients with socio-behavioral data available before HCV treatment initiation. RESULTS A total of 580 patients were included in this analysis. Of these, 347 initiated PEG-IFN-based treatment, and 233 DAA-based treatment. There were significant differences regarding patient mean age (45 years±6 for the PEG-IFN group vs. 52 years±8 for the DAA group, p<0.001), unstable housing (21.4% vs. 11.2%, p = 0.0016), drug use (44.7% vs. 29.6%, p = 0.0003), regular or daily use of cannabis (24.3% vs. 15.6%, p = 0.0002), a history of drug injection (68.9% vs 39.0%, p<0.0001) and significant liver fibrosis (62.4% vs 72.3%, p = 0.0293). In multivariable analysis, patients initiating DAA-based treatment were older than their PEG-IFN-based treatment counterparts (aOR = 1.17; 95%CI [1.13; 1.22]). Patients receiving DAA treatment were less likely to report unstable housing (0.46 [0.24; 0.88]), cannabis use (regular or daily use:0.50 [0.28; 0.91]; non-regular use: 0.41 [0.22; 0.77]), and a history of drug injection (0.19 [0.12; 0.31]). CONCLUSION It is possible that a majority of patients who had socio-economic problems and/or a history of drug injection and/or a non-advanced disease stage were already treated for HCV in the PEG-IFN era. Today, patients with unstable housing conditions are prescribed DAA less frequently than other populations. As HCV treatment is prevention, improving access to DAA remains a major clinical and public health strategy, in particular for individuals with high-risk behaviors.
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Affiliation(s)
- Issifou Yaya
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
- * E-mail:
| | - Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
- CHU de Bordeaux, Pole de sante publique, Service d’information medicale, Bordeaux, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, Bordeaux, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Stéphanie Dominguez
- INSERM U955, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Immunologie Clinique et Maladies Infectieuses, Créteil, France
| | - Boni Armand Elegbe
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Lionel Piroth
- Département d'Infectiologie, Centre Hospitalier Universitaire and INSERM CIC 1432, Université de Bourgogne, Dijon, France
| | - Philippe Sogni
- Université Paris Descartes, INSERM U-1223, Institut Pasteur, Service d'Hépatologie, hôpital Cochin, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
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40
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Alnuaimi K, Lavolé J, Lascoux-Combes C, Roque Afonso AM, Sogni P, Pol S, Mallet V. Chronic hepatitis E in patients with indolent lymphoma after treatment with rituximab and bendamustine. Hepatology 2018; 67:2468-2470. [PMID: 29194671 DOI: 10.1002/hep.29697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/17/2017] [Accepted: 11/28/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Khaled Alnuaimi
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France
| | - Julie Lavolé
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France
| | - Caroline Lascoux-Combes
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Louis, Infectious Diseases Service, Paris, France
| | - Anne-Marie Roque Afonso
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Paul Brousse, Virology Service, Paris, France.,Université Paris-Sud, Orsay, France.,Institut National de la Santé et de la Recherche Médicale unité 1193, Villejuif, France
| | - Philippe Sogni
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France.,Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; all in Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Stanislas Pol
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France.,Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; all in Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Vincent Mallet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service, Paris, France.,Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; all in Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
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41
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Marcellin F, Fontaine H, Serfaty L, Sogni P, Carrieri MP. Cannabinoids and reduced risk of hepatic steatosis in HIV-HCV co-infection: paving the way for future clinical research. Expert Rev Anti Infect Ther 2018; 16:377-380. [DOI: 10.1080/14787210.2018.1473764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Hélène Fontaine
- INSERM, U1016, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, Paris, France
- Hepatology Unit, Groupe hospitalier Cochin-Hôtel Dieu, AP-HP, Paris, France
| | - Lawrence Serfaty
- Service d'Hépato-Gastro-Entérologie et d'Assistance Nutritive, Hôpital de Hautepierre, Strasbourg, France
| | - Philippe Sogni
- Service d’Hépatologie, AP-HP, Hôpital Cochin, Paris, France
- Université Paris Descartes, Paris, France
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, Marseille, France
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42
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Duracinsky M, Thonon F, Lert F, Lalanne C, Zucman D, Sogni P, Leluong T, Joseph O, Roudot-Thoraval F, Normand I, Chassany O. 4.10-P17A new strategy for screening for infectious diseases amongst migrants: the STRADA study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Duracinsky
- EA 7334 Remes/URC éco, France
- AP-HP, Bicetre Hospital, Internal Medicine & Infectious Disease Department, France
| | | | | | | | - D Zucman
- Hôpital Foch, Hépatologie, France
| | | | - T Leluong
- Office Français de l'Immigration et de l'Intégration, France
| | - O Joseph
- Office Français de l'Immigration et de l'Intégration, France
| | | | - I Normand
- Office Français de l'Immigration et de l'Intégration, France
| | - O Chassany
- EA 7334 Remes/URC éco, France
- University Paris Diderot, Paris Sorbonne Cité, France
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43
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Nordmann S, Vilotitch A, Roux P, Esterle L, Spire B, Marcellin F, Salmon-Ceron D, Dabis F, Chas J, Rey D, Wittkop L, Sogni P, Carrieri P. Daily cannabis and reduced risk of steatosis in human immunodeficiency virus and hepatitis C virus-co-infected patients (ANRS CO13-HEPAVIH). J Viral Hepat 2018; 25:171-179. [PMID: 28984055 DOI: 10.1111/jvh.12797] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 09/13/2017] [Indexed: 12/27/2022]
Abstract
Liver steatosis is common in human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-co-infected patients. Some recent studies have found that cannabis use is negatively associated with insulin resistance in the general population and in HIV-HCV-co-infected patients. Given the causal link between insulin resistance and steatosis, we hypothesized that cannabis use has a positive impact on steatosis. Therefore, we aimed to study whether cannabis use in this population was associated with a reduced risk of steatosis, measured by ultrasound examination. ANRS CO13-HEPAVIH is a French nationwide multicentre cohort of HIV-HCV-co-infected patients. Medical and socio-behavioural data from clinical follow-up visits and annual self-administered questionnaires were prospectively collected. A cross-sectional analysis was conducted using data from the first visit where both ultrasound examination data for steatosis (positive or negative diagnosis) and data on cannabis use were available. A logistic regression model was used to evaluate the association between cannabis use and steatosis. Among study sample patients (n = 838), 40.1% had steatosis. Fourteen per cent reported daily cannabis use, 11.7% regular use and 74.7% no use or occasional use ("never or sometimes"). Daily cannabis use was independently associated with a reduced prevalence of steatosis (adjusted odds ratio [95% CI] = 0.64 [0.42;0.99]; P = .046), after adjusting for body mass index, hazardous alcohol consumption and current or lifetime use of lamivudine/zidovudine. Daily cannabis use may be a protective factor against steatosis in HIV-HCV-co-infected patients. These findings confirm the need for a clinical evaluation of cannabis-based pharmacotherapies in this population. Eudract.ema.europa.eu number, DGS050367.
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Affiliation(s)
- S Nordmann
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - A Vilotitch
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - P Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - L Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team MORPH3EUS, Bordeaux, France
| | - B Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - F Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - D Salmon-Ceron
- Université Paris-Sud et Université Paris Descartes, UMR-S0669, Paris, France.,Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin Port-Royal, Paris, France
| | - F Dabis
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team MORPH3EUS, Bordeaux, France.,CHU de Bordeaux, Pole de sante publique, Service d'Information Médicale, Bordeaux, France
| | - J Chas
- Infectious Diseases Department, Hopital Tenon-APHP, Paris, France
| | - D Rey
- Le Trait d'Union, centre de Soins de l'Infection par le VIH, VHC, CHU de Strasbourg, Strasbourg, France
| | - L Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, UMR 1219, Team MORPH3EUS, Bordeaux, France.,CHU de Bordeaux, Pole de sante publique, Service d'Information Médicale, Bordeaux, France
| | - P Sogni
- Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin Port-Royal, Paris, France.,INSERM U-1223-Institut Pasteur, Paris, France.,Université Paris Descartes, Paris, France.,Service Service d'Hépatologie, AP-HP, Hôpital Cochin, Paris, France
| | - P Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Laurain A, Kramer L, Sultanik P, Vallet-Pichard A, Sogni P, Pol S. Mortality associated with the treatment of HCV with direct-acting antivirals. Gut 2018; 67:197-198. [PMID: 28341750 DOI: 10.1136/gutjnl-2017-313869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 12/08/2022]
Affiliation(s)
- Anne Laurain
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
| | - Laura Kramer
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
| | - Philippe Sultanik
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
| | - Anaïs Vallet-Pichard
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
| | - Philippe Sogni
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
| | - Stanislas Pol
- Université Paris Descartes; APHP, Unité d'Hépatologie, Hôpital Cochin; INSERM U1223 and USM20, Institut Pasteur, Paris, France
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Laurent L, Lemaitre C, Minello A, Plessier A, Lamblin G, Poujol-Robert A, Gervais-Hasenknopf A, Pariente EA, Belenotti P, Mostefa-Kara N, Sogni P, Legrand M, Cournac JM, Tamion F, Savoye G, Bedossa P, Valla DC, Vilgrain V, Goria O. Cholangiopathy in critically ill patients surviving beyond the intensive care period: a multicentre survey in liver units. Aliment Pharmacol Ther 2017; 46:1070-1076. [PMID: 29023905 DOI: 10.1111/apt.14367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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] [Received: 06/15/2017] [Revised: 06/29/2017] [Accepted: 09/18/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The outcome of cholangiopathy developing in intensive care unit (ICU) is not known in patients surviving their ICU stay. AIM To perform a survey in liver units, in order to clarify the course of cholangiopathy after surviving ICU stay. METHODS The files of the liver units affiliated to the French network for vascular liver disease were screened for cases of ICU cholangiopathy developing in patients with normal liver function tests on ICU admission, and no prior history of liver disease. RESULTS Between 2005 and 2015, 16 cases were retrieved. Extensive burns were the cause for admission to ICU in 11 patients. Serum alkaline phosphatase levels increased from day 11 (2-46) to a peak of 15 (4-32) × ULN on day 81 (12-511). Magnetic resonance cholangiography showed irregularities or frank stenosis of the intrahepatic ducts, and proximal extrahepatic ducts contrasting with a normal aspect of the distal common bile duct. Follow-up duration was 20.6 (4.7-71.8) months. Three patients were lost to follow-up; 2 patients died from liver failure and no patient was transplanted. One patient had worsening strictures of the intrahepatic bile ducts with jaundice. Nine patients had persistent but minor strictures of the intrahepatic bile ducts on MR cholangiography, and persistent cholestasis without jaundice. One patient had normal liver function tests. CONCLUSIONS In patients surviving their ICU stay, ICU cholangiopathy is not uniformly fatal in the short term or clinically symptomatic in the medium term. Preservation of the distal common bile duct appears to be a finding differentiating ICU cholangiopathy from other diffuse cholangiopathies.
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Lavolé J, Le Goff M, Oudjit A, Sogni P, Mallet V. Abdominal computed tomography angiography in post-transplantation sinusoidal obstruction syndrome associated with R-DHAOX/BEAM toxicity. Br J Haematol 2017; 180:629. [DOI: 10.1111/bjh.15017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Julie Lavolé
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service; Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; Université Paris Descartes; Paris France
| | - Marielle Le Goff
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service; Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; Université Paris Descartes; Paris France
| | - Amar Oudjit
- Assistance Publique - Hôpitaux de Paris (AP-HP); Hôpital Cochin, Radiology Service; Paris France
| | - Philippe Sogni
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service; Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; Université Paris Descartes; Paris France
| | - Vincent Mallet
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Cochin, Hepatology Service; Institut National de la Santé et de la Recherche Médicale unité 1223; Institut Pasteur; Université Paris Descartes; Paris France
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47
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Knight R, Roux P, Vilotitch A, Marcellin F, Rosenthal E, Esterle L, Boué F, Rey D, Piroth L, Dominguez S, Sogni P, Salmon-Ceron D, Spire B, Carrieri MP. Significant reductions in alcohol use after hepatitis C treatment: results from the ANRS CO13-HEPAVIH cohort. Addiction 2017; 112:1669-1679. [PMID: 28430385 DOI: 10.1111/add.13851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/09/2016] [Accepted: 04/18/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Few data exist on changes to substance use patterns before and after hepatitis C virus (HCV) treatment. We used longitudinal data of HIV-HCV co-infected individuals to examine whether receiving pegylated interferon (Peg-IFN)-based therapy irrespective of HCV clearance could modify tobacco, cannabis and alcohol use. DESIGN A prospective cohort of HIV-HCV co-infected individuals was enrolled from 2006. Participants' clinical data were retrieved from medical records and socio-demographic and behavioural characteristics were collected by yearly self-administered questionnaires. SETTING Data were collected across 17 hospitals in France. PARTICIPANTS All HIV-HCV co-infected patients who initiated HCV treatment during follow-up and answered items regarding substance use in at least one yearly questionnaire (258 patients, 671 visits). INTERVENTION HCV treatment consisted of Peg-IFN-based regimens. MEASUREMENTS Four time-varying outcomes: hazardous alcohol use (Alcohol Use Disorders Identification Test-C > 3/4 for women/men), number of alcohol units/month, binge drinking, cannabis and tobacco use. Mixed models assessed the effect of HCV treatment status (not yet treated, treated and HCV-cleared, treated and HCV-chronic) on each outcome. FINDINGS A significant decrease (more than 60% reduction) in both hazardous alcohol use and binge drinking and a reduction of 10 alcohol units/month was observed after HCV treatment (irrespective of HCV clearance). No significant effect of HCV treatment status was found on tobacco use and regular cannabis use, but HCV 'clearers' reported less non-regular use of cannabis. CONCLUSIONS Hepatitis C virus (HCV) treatment appears to help HIV-HCV co-infected patients reduce alcohol use.
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Affiliation(s)
- Rod Knight
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Perrine Roux
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Antoine Vilotitch
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Eric Rosenthal
- Service de Médecine Interne et Cancérologie, Hôpital l'Archet, Centre Hospitalier Universitaire de Nice, France.,Université de Nice-Sophia Antipolis, Nice, France
| | - Laure Esterle
- INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
| | - François Boué
- Université Paris Sud, Paris, France.,Service Médecine interne et immunologie, AP-HP, Groupe Hospitalier Paris Sud, Hôpital Antoine-Béclère, Clamart, France
| | - David Rey
- Department of Infectious Diseases, Hôpitaux Universitaires, Strasbourg, France
| | - Lionel Piroth
- Centre Hospitalier Universitaire Dijon, and Unité Mixte de Recherche 1347, Université de Bourgogne, Dijon, France
| | - Stéphanie Dominguez
- Service Immunologie clinique et maladies infectieuses, Immunologie clinique, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Philippe Sogni
- Service d'Hépatologie, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Cochin, Paris, France.,INSERM U-1223-Institut Pasteur, Paris, France.,Université Paris Descartes, Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France.,Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Bruno Spire
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Maria Patrizia Carrieri
- Aix Marseille Université, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Michel L, Lions C, Winnock M, Lang JP, Loko MA, Rosenthal E, Marchou B, Valantin MA, Morlat P, Roux P, Sogni P, Spire B, Poizot-Martin I, Lacombe K, Lascoux-Combe C, Duvivier C, Neau D, Dabis F, Salmon-Ceron D, Carrieri MP. Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort]. HIV Med 2017; 17:758-765. [PMID: 27187027 DOI: 10.1111/hiv.12382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. METHODS The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). RESULTS Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. CONCLUSIONS Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders.
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Affiliation(s)
- L Michel
- Inserm U1178, Paris, France. .,UMRS1178, Paris-Sud University and Paris Descartes University, Paris, France. .,Centre Pierre Nicole, French Red Cross, Paris, France.
| | - C Lions
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | | | - J-P Lang
- CHRU Strasbourg, Strasbourg, France
| | | | | | | | - M-A Valantin
- Groupe Hospitalier La Pitié Salpêtrière, Paris, France
| | - P Morlat
- Hôpital Saint-André, Bordeaux, France
| | - P Roux
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | - P Sogni
- Hôpital Cochin, Paris, France
| | - B Spire
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
| | | | - K Lacombe
- Hôpital Saint-Antoine, Paris, France
| | | | | | - D Neau
- Hôpital Pellegrin, Bordeaux, France
| | - F Dabis
- Inserm U897, Bordeaux, France
| | | | - M P Carrieri
- Inserm U912 (SESSTIM), Marseille, France.,IRD, UMR-S912, Aix Marseille University, Marseille, France.,Regional Center for Disease Control Provence Alpes Côte d'Azur, Marseille, France
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49
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Piroth L, Wittkop L, Lacombe K, Rosenthal E, Gilbert C, Miailhes P, Carrieri P, Chas J, Poizot-Martin I, Gervais A, Dominguez S, Neau D, Zucman D, Billaud E, Morlat P, Aumaitre H, Lascoux-Combe C, Simon A, Bouchaud O, Teicher E, Bani-Sadr F, Alric L, Vittecoq D, Boué F, Duvivier C, Valantin MA, Esterle L, Dabis F, Sogni P, Salmon D. Efficacy and safety of direct-acting antiviral regimens in HIV/HCV-co-infected patients - French ANRS CO13 HEPAVIH cohort. J Hepatol 2017; 67:23-31. [PMID: 28235612 DOI: 10.1016/j.jhep.2017.02.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There is little data available on the use of new oral direct-acting antiviral (DAA) regimens to treat human immunodeficiency virus and hepatitis C virus (HIV/HCV) co-infected patients in real-life settings. Here, the efficacy and safety of all-oral DAA-based regimens in HIV/HCV-co-infected patients enrolled in the French nationwide ANRS CO13 HEPAVIH observational cohort are reported. METHODS HIV/HCV-co-infected patients enrolled in the ANRS CO13 HEPAVIH observational cohort were included if they began an all-oral DAA-based regimen before 1st May 2015 (12-week regimens) or 1st February 2015 (24-week regimens). Treatment success (SVR12) was defined by undetectable HCV-RNA 12weeks after treatment cessation. Exact logistic regression analysis was used to identify factors associated with SVR12. RESULTS A total of 323 patients (74% men) with a median age of 53years were included, 99% of whom were on combination antiretroviral therapy (cART). HIV RNA load was <50 copies/ml in 88% of patients; median CD4 cell count was 540/mm3; 60% of patients were cirrhotic; 68% had previously received unsuccessful anti-HCV treatment. cART was protease inhibitor (PI)-based in 23%, non-nucleoside reverse transcriptase inhibitor (NNRTI)-based in 15%, and integrase inhibitor (II)-based in 38%, while 24% of patients received other regimens. The SVR12 rate was 93.5% overall (95% confidence interval [CI]: 90.2-95.9), 93.3% (88.8-96.4) in patients with cirrhosis and 93.8% (88.1-97.3) in patients without cirrhosis. The SVR12 rates were 93.1% (84.5-97.7), 91.8% (80.4-97.7) and 95.8% (90.5-98.6) respectively, in patients receiving PI-based, NNRTI-based and II-based cART. In adjusted analysis, SVR12 was not associated with HIV RNA load, the cART regimen, cirrhosis, prior anti-HCV treatment, the duration of anti-HCV therapy, or ribavirin use. The most common adverse effects were fatigue and digestive disorders. CONCLUSIONS New all-oral DAA regimens were well-tolerated and yielded high SVR12 rates in HIV/HCV-co-infected patients. LAY SUMMARY We evaluated efficacy and safety of all-oral DAA regimens in a large French nationwide observational cohort study of HIV/HCV co-infected patients. Sustained virological response 12weeks after treatment cessation was 93.5% overall. The all-oral DAA regimens were well-tolerated and most common adverse effects were fatigue and digestive disorders.
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Affiliation(s)
- Lionel Piroth
- Centre Hospitalier Universitaire de Dijon, Département d'Infectiologie, Dijon, France; Université de Bourgogne, Dijon, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de sante publique, Service d'information medicale, F-33000 Bordeaux, France.
| | - Karine Lacombe
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Service Maladies infectieuses et tropicales, Paris, France; UMPC (Université Pierre et Marie Curie), UMR S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric Rosenthal
- Centre Hospitalier Universitaire de Nice, Service de Médecine Interne, Hôpital l'Archet, Nice, France; Université de Nice-Sophia Antipolis, Nice, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, CHU Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Julie Chas
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service Maladies infectieuses et tropicales, Paris, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, APHM Sainte-Marguerite, Service d'Immuno-hématologie clinique, Marseille, France
| | - Anne Gervais
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Service des Maladies Infectieuses et tropicales, Paris, France
| | - Stéphanie Dominguez
- Assistance Publique des Hôpitaux de Paris, Hôpital Henri Mondor, Service Immunologie clinique et Maladies Infectieuses, Immunologie clinique, Créteil, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service Maladies infectieuses et tropicales Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | | | - Eric Billaud
- Centre Hospitalier Universitaire de Nantes, Service Maladies infectieuses et tropicales, Nantes, France
| | - Philippe Morlat
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, hôpital Saint-André, Bordeaux, France
| | - Hugues Aumaitre
- Centre Hospitalier de Perpignan, Service Maladies infectieuses et tropicales, Perpignan, France
| | - Caroline Lascoux-Combe
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Louis, Service Maladies infectieuses et tropicales, Paris, France
| | - Anne Simon
- Assistance Publique des Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Département de Médecine Interne et Immunologie Clinique, Paris, France
| | - Olivier Bouchaud
- Assistance Publique des Hôpitaux de Paris, Hôpital Avicenne, Service Maladies infectieuses et tropicales, Bobigny, France; Université Paris 13 Nord, Bobigny, France
| | - Elina Teicher
- Assistance Publique des Hôpitaux de Paris, GH Paris Sud : Service Médecine Interne et Immunologie clinique, Hôpital Bicêtre, Le Kremlin-Bicêtre; Centre Hépato-Biliaire, Hôpital Paul-Brousse,Villejuif, France
| | - Firouzé Bani-Sadr
- Centre Hospitalier Universitaire de Reims, Service de Médecine Interne, Maladies Infectieuses et immunologie clinique, Reims, France; Université de Reims, Champagne-Ardenne, Reims, France
| | - Laurent Alric
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Service Médecine Interne-Pôle Digestif, Toulouse, France; UMR 152 IRD Université Toulouse III, Paul Sabatier, Toulouse, France
| | - Daniel Vittecoq
- Université Paris Sud, Le Kremlin-Bicêtre, France; Assistance Publique des Hôpitaux de Paris, Hôpital Bicêtre, Hôpitaux universitaires Paris Sud, Service Maladies infectieuses et tropicales, Le Kremlin-Bicêtre, France
| | - François Boué
- Université Paris Sud, Le Kremlin-Bicêtre, France; Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Paris Sud, Hôpital Antoine-Béclère, Service Médecine Interne et immunologie, Clamart, France
| | - Claudine Duvivier
- Assistance Publique des Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'infectiologie Necker-Pasteur, IHU Imagine, Paris, France
| | - Marc-Antoine Valantin
- Assistance Publique des Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Service Maladies infectieuses et tropicales, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - François Dabis
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de sante publique, Service d'information medicale, F-33000 Bordeaux, France
| | - Philippe Sogni
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service d'Hépatologie, Paris, France; INSERM U-1223 - Institut Pasteur, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Dominique Salmon
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Service Maladies infectieuses et tropicales, Paris, France
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50
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Salmon D, Gilbert C, Bottero J, Sogni P, Esterle L, Piroth L, Bani-Sadr F. Persistance du risque de décès et d’évènement hépatique après guérison de l’hépatite C chez les patients coinfectés VIH/VHC–cohorte ANRS CO13 Hepavih. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.020] [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: 10/19/2022]
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