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Sette AL, Pavese P, Lesprit P, Maillet M, Bourgeois G, Lutz MF, Baldeyrou M, Mondain V, Suy F, Contejean A, Diamantis S, Poitrenaud D, Touati S, Boussat B, François P. Survey on infectious disease telephone hotlines in primary care: General practitioners' satisfaction and compliance with advice. Infect Dis Now 2023; 53:104775. [PMID: 37634659 DOI: 10.1016/j.idnow.2023.104775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES Infectious disease (ID) advice is a major part of antimicrobial stewardship programs. The objective of this study was to assess general practitioners' (GPs)' opinions and compliance with advice given by ID hotlines. PATIENTS AND METHODS This multicenter survey was based on the 7-day assessment of initial advice requested by GPs to a hotline set up by volunteer hospital ID teams to record advice for 3 years. The primary endpoint was the GPs' satisfaction with the advice given by ID specialists. RESULTS Ten ID teams participated in the study and recorded 4138 requests for advice, of which 1325 requests included a proposal for antibiotic therapy and justified a follow-up call at seven days. Only 398 follow-up calls (30%) were carried out because many GPs were not reachable. GPs were very satisfied with ID hotlines: 58% considered them indispensable and 38% very useful. The recommendations provided by ID specialists were followed by GPs in more than 80% of cases. The two main motivations for GPs to call the hotline were to get quick advice (86%) and to receive help in managing a patient (76%). CONCLUSIONS The ID telephone consultations and advice systems for GPs are highly appreciated and are effective in terms of following the recommendations.
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Affiliation(s)
- A-L Sette
- Service d'épidémiologie et évaluation Médicale, Centre Hospitalier Régional de Grenoble-Alpes, France
| | - P Pavese
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional de Grenoble-Alpes, France
| | - P Lesprit
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional de Grenoble-Alpes, France
| | - M Maillet
- Service de Maladies Infectieuses, Centre Hospitalier Annecy-Genevois, Épagny-Metz-Tessy, France
| | - G Bourgeois
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Métropole Savoie, Chambéry, France
| | - M-F Lutz
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | - M Baldeyrou
- Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, 35033 Rennes, France
| | - V Mondain
- Service des Maladies Infectieuses et Tropicales, CHU de Nice, Nice, France
| | - F Suy
- Médecine Interne Infectieuse et Tropicale, MiiT médical selarl, Lyon-Villeurbanne, France
| | - A Contejean
- Équipe Mobile d'Infectiologie, APHP, Hôpital Cochin, F-75014, Paris, France
| | - S Diamantis
- Service de Maladies Infectieuses, Groupe Hospitalier Sud Île-de-France, Melun, France
| | - D Poitrenaud
- Maladies Infectieuses et Tropicales, Centre Hospitalier d'Ajaccio, Ajaccio, France
| | - S Touati
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional de Grenoble-Alpes, France
| | - B Boussat
- Service d'épidémiologie et évaluation Médicale, Centre Hospitalier Régional de Grenoble-Alpes, France; Laboratoire TIMC-IMAG, Université de Grenoble-Alpes, France
| | - P François
- Service d'épidémiologie et évaluation Médicale, Centre Hospitalier Régional de Grenoble-Alpes, France; Laboratoire TIMC-IMAG, Université de Grenoble-Alpes, France.
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Vannini M, Emery S, Lieutier-Colas F, Legueult K, Mondain V, Retur N, Gastaud L, Pomares C, Hasseine L. Epidemiology of candidemia in NICE area, France: A five-year study of antifungal susceptibility and mortality. J Mycol Med 2021; 32:101210. [PMID: 34768155 DOI: 10.1016/j.mycmed.2021.101210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 09/27/2021] [Accepted: 10/06/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the epidemiology of candidemia, the fungal susceptibility, the first-line therapy and the morality rate over 5 years. Knowing the differences of the yeasts in the candidemia local epidemiology, is essential to obtain information on fungal epidemiology to adapt antifungal strategies. MATERIALS/METHODS This retrospective study was conducted from January 2014 to December 2018. The susceptibility of the Candida strains were tested for amphotericin B, caspofungin, voriconazole and fluconazole. RESULTS The 304 strains were isolated from 290 patients (40 patients in 2014, 65 in 2015, 72 in 2016, 62 in 2017 and 51 in 2018). The three most common Candida spp isolated from blood cultures were Candida albicans (44%), Candida glabrata (22%) and Candida parapsilosis (13%). The proportion of non-albicans Candida decreased from 68% in 2014 to 45% in 2018. C. albicans and C. parapsilosis were to the four antifungals tested. As first-line therapy, 60% of patients received caspofungin and 26% fluconazole. There was no significant difference in the mortality between the two arms of patients (, 27% and 21%, p = 0.47 at 30 days respectively). Thirty day all-cause mortality was 31% and it decreased from 2014 (46%) to 2018 (18%). CONCLUSIONS We report that the absence of antifungal resistance of our C. albicans and C. parapsilosis candidemia suggests possible treatment after MALDI-TOF identification with fluconazole as first-line therapy in our hospital, as soon as possible and while continuing to perform the antifungal test.
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Affiliation(s)
- M Vannini
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de NICE 06200, France
| | - S Emery
- Service de la Pharmacie Centre Hospitalier Universitaire de NICE 06200, France
| | - F Lieutier-Colas
- Service de la Pharmacie Centre Hospitalier Universitaire de NICE 06200, France
| | - K Legueult
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de NICE 06200, France
| | - V Mondain
- Service d'Infectiologie, Centre Hospitalier Universitaire de NICE 06200, France
| | - N Retur
- Service de la Pharmacie Centre Hospitalier Universitaire de NICE 06200, France
| | - L Gastaud
- Unité de soins continus en hématologie, Centre Antoine Lacassagne, NICE 06000, France
| | - C Pomares
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de NICE 06200, France; INSERM 1065 Equipe 6 C3M, Université Côte d'Azur, France
| | - L Hasseine
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de NICE 06200, France.
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Feyeux H, Bertrand B, Deletie D, Retur N, Justine B, Bettira S, Mondain V, Boronad C, Collomp R, Lieutier F. Justification d’une antibiothérapie de plus de sept jours : évaluation des pratiques professionnelles dans quatre établissements de santé d’un GHT. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.431] [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: 12/01/2022]
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Mondain V, Retur N, Fontaine P, Carenco P, Risso K, Bertrand B, Lieutier-Colas F. Et si transparence et écotoxicité devenaient des nouveaux critères de prescription et d’achat des antibiotiques ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arlaud C, Prate F, Mondain V, Lieutier F, Degand N, Fosse T, Gonfrier G, Planchard J, Guérin O. Enquête d’opinion sur les freins à la vaccination antigrippale du personnel hospitalier dans un Centre hospitalo-universitaire. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Arlaud C, Chenesseau C, Degand N, Lieutier F, Mondain V. Facteurs de risque de mortalité à 3 mois des patients âgés de plus de 75 ans atteint d’infection à Clostridium difficile dans un centre hospitalier universitaire. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.194] [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: 10/14/2022]
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8
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Gregoire R, Bertrand B, Retur N, Collomp R, Mondain V, Roger P, Lieutier-Colas F. Audit régional sur les missions et outils des pharmaciens dans le Bon Usage des antibiotiques : des indicateurs nationaux à la « vraie vie ». Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.153] [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: 10/14/2022]
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Castan B, Lesprit P, Alfandari S, Bonnet E, Diamantis S, Gauzit R, Kerneis S, Leroy J, Lescure X, Meyssonnier V, Mondain V, Pavese P, Rabaud C, Stahl JP, Tattevin P, Roblot F, Pulcini C. [Antibiotic stewardship: A 2017 update]. Med Mal Infect 2017; 47:439-442. [PMID: 28781198 DOI: 10.1016/j.medmal.2017.06.007] [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] [Received: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/27/2022]
Affiliation(s)
- B Castan
- Unité fonctionnelle d'infectiologie régionale, CH Ajaccio, 20303 Ajaccio, France
| | - P Lesprit
- Infectiologie transversale, service de biologie clinique, hôpital Foch, 92151 Suresnes, France
| | - S Alfandari
- Service de réanimation et maladies infectieuses, CH de Tourcoing, 59200 Tourcoing, France
| | - E Bonnet
- Équipe mobile d'infectiologie, hôpital Joseph-Ducuing, 31300 Toulouse, France
| | - S Diamantis
- Service des maladies infectieuses et tropicales, CH Sud Île-de-France, 77011 Melun, France
| | - R Gauzit
- Équipe mobile d'infectiologie, AP-HP, hôpitaux universitaires Paris centre-site Cochin, université Paris Descartes, 75014 Paris, France
| | - S Kerneis
- Équipe mobile d'infectiologie, AP-HP, hôpitaux universitaires Paris centre-site Cochin, université Paris Descartes, 75014 Paris, France
| | - J Leroy
- ARLIN BFC/PRIMAIR, service d'hygiène hospitalière et service de maladies infectieuses, CHRU de Besançon, 25030 Besançon, France
| | - X Lescure
- IAME UMR 1137 Inserm, service de maladies infectieuses et tropicales, AP-HP, hôpital Bichat-Claude Bernard, faculté Paris Diderot, 75018 Paris, France
| | - V Meyssonnier
- CRIOAC, médecine interne, groupe hospitalier Diaconesses-Croix-Saint-Simon, 75020 Paris, France
| | - V Mondain
- Service des maladies infectieuses, CHU de Nice, Nice, France
| | - P Pavese
- Infectiologie, CHU, université Grenoble Alpes, 38700 Grenoble, France
| | - C Rabaud
- EA 4360 APEMAC, service de maladies infectieuses, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | - J P Stahl
- Infectiologie, CHU, université Grenoble Alpes, 38700 Grenoble, France
| | - P Tattevin
- Maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 35033 Rennes, France
| | - F Roblot
- Service de médecine interne, maladies infectieuses et tropicales et Inserm U1070, CHU de Poitiers, 86021 Poitiers, France
| | - C Pulcini
- EA 4360 APEMAC, service de maladies infectieuses, CHRU de Nancy, université de Lorraine, 54000 Nancy, France.
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Pradat P, Pugliese P, Poizot-Martin I, Valantin MA, Cuzin L, Reynes J, Billaud E, Huleux T, Bani-Sadr F, Rey D, Frésard A, Jacomet C, Duvivier C, Cheret A, Hustache-Mathieu L, Hoen B, Cabié A, Cotte L, Chidiac C, Ferry T, Ader F, Biron F, Boibieux A, Miailhes P, Perpoint T, Schlienger I, Lippmann J, Braun E, Koffi J, Longuet C, Guéripel V, Augustin-Normand C, Brochier C, Degroodt S, Pugliese P, Ceppi C, Cua E, Cottalorda J, Courjon J, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Fuzibet J, Garraffo R, Joulie A, Risso K, Mondain V, Naqvi A, Oran N, Perbost I, Pillet S, Prouvost-Keller B, Wehrlen-Pugliese S, Rosenthal E, Sausse S, Rio V, Roger P, Brégigeon S, Faucher O, Obry-Roguet V, Orticoni M, Soavi M, Geneau de Lamarlière P, Laroche H, Ressiot E, Carta M, Ducassou M, Jacquet I, Gallie S, Galinier A, Ritleng A, Ivanova A, Blanco-Betancourt C, Lions C, Debreux C, Obry-Roguet V, Poizot-Martin I, Agher R, Katlama C, Valantin M, Duvivier C, Lortholary O, Lanternier F, Charlier C, Rouzaud C, Aguilar C, Henry B, Lebeaux D, Cessot G, Gergely A, Consigny P, Touam F, Louisin C, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte M, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, Atoui N, Casanova M, Faucherre V, Jacquet J, Le Moing V, Makinson A, Merle De Boever C, Montoya-Ferrer A, Psomas C, Reynes J, Raffi F, Allavena C, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet C, Jovelin T, Hall N, Bernaud C, Morineau P, Reliquet V, Aubry O, Point P, Besnier M, Larmet L, Hüe H, Pineau S, André-Garnier E, Rodallec A, Choisy P, Vandame S, Huleux T, Ajana F, Alcaraz I, Baclet V, Huleux T, Melliez H, Viget N, Valette M, Aissi E, Allienne C, Meybeck A, Riff B, Bani-Sadr F, Rouger C, Berger J, N'Guyen Y, Lambert D, Kmiec I, Hentzien M, Lebrun D, Migault C, Rey D, Batard M, Bernard-Henry C, Cheneau C, de Mautort E, Fischer P, Partisani M, Priester M, Lucht F, Frésard A, Botelho-Nevers E, Gagneux-Brunon A, Cazorla C, Guglielminotti C, Daoud F, Lutz M, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Corbin V, Aumeran C, Baud O, Casanova S, Coban D, Hustache-Mathieu L, Thiebaut-Drobacheff M, Foltzer A, Gendrin V, Bozon F, Chirouze C, Abel S, Cabié A, Césaire R, Santos GD, Fagour L, Najioullah F, Ouka M, Pierre-François S, Pircher M, Rozé B, Hoen B, Ouissa R, Lamaury I. Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"? J Infect 2017; 75:234-241. [PMID: 28579302 DOI: 10.1016/j.jinf.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/17/2017] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients. METHODS All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection. RESULTS Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR. CONCLUSIONS HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.
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Affiliation(s)
- Pierre Pradat
- Center for Clinical Research, Department of Hepatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet, Nice, France
| | - Isabelle Poizot-Martin
- Immuno-hematology Clinic, Assistance Publique - Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, France; Aix-Marseille University, Inserm U912 (SESSTIM), Marseille, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Lise Cuzin
- CHU Toulouse, COREVIH, Toulouse, France; Université de Toulouse III, Toulouse, France; INSERM, UMR, 1027, Toulouse, France
| | - Jacques Reynes
- Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier, Montpellier, France
| | - Eric Billaud
- Department of Infectious Diseases, Hotel Dieu Hospital, Nantes, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, CHU, Reims, France; Université de Reims Champagne-Ardenne, Faculté de médecine, EA-4684/SFR CAP-SANTE, Reims, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg, France
| | - Anne Frésard
- Department of Infectious Diseases, CHU, Saint-Etienne, France
| | - Christine Jacomet
- Department of Infectious Diseases, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Claudine Duvivier
- Department of Infectious Diseases, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | - Antoine Cheret
- Department of Internal Medicine, CHU, Bicètre, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | | | - Bruno Hoen
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, and Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, and Inserm CIC 1424, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France
| | - André Cabié
- Department of Infectious Diseases, CHU de Martinique, Fort-de-France, France; Université des Antilles EA4537 and INSERM CIC1424, Fort-de-France, France
| | - Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France.
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Giacchero D, Yandza T, Benkiran L, Mondain V, Doyen D, Mounchit I. Dermatologie de la précarité : épidémiologie de la gale dans un centre d’accueil et d’urgence sociale et difficultés thérapeutiques. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Castan B, Lesprit P, Alfandari S, Bonnet E, Diamantis S, Gauzit R, Kernéis S, Leroy J, Lescure FX, Mondain V, Pavese P, Rabaud C, Stahl JP, Tattevin P, Roblot F, Pulcini C. [Antibiotic stewardship: What's new?]. Med Mal Infect 2016; 46:403-405. [PMID: 27856081 DOI: 10.1016/j.medmal.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022]
Affiliation(s)
- B Castan
- Unité fonctionnelle d'infectiologie régionale, centre hospitalier d'Ajaccio, 27, avenue Impératrice-Eugénie, 20303 Ajaccio, France
| | - P Lesprit
- Infectiologie transversale, service de biologie clinique, hôpital Foch, 40, rue Worth, 92151 Suresnes, France
| | - S Alfandari
- Service de réanimation et maladies infectieuses, centre hospitalier Tourcoing, 155, rue du Président-Coty, 59200 Tourcoing, France
| | - E Bonnet
- Équipe mobile d'infectiologie, hôpital Joseph-Ducuing, 15, rue Varsovie, 31300 Toulouse, France
| | - S Diamantis
- Service des maladies infectieuses, centre hospitalier de Melun, 2, rue Fréteau-de-Peny, 77011 Melun cedex, France
| | - R Gauzit
- Réanimation Ollier, CHU Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - S Kernéis
- Fédération d'infectiologie, université Paris Descartes, UMR 1181, Institut Pasteur, hôpital Cochin, AP-HP, 75014 Paris, France
| | - J Leroy
- PRIMAIR (Programme régional interdisciplinaire pour la maîtrise de la résistance aux anti-infectieux) ARLin B-FC, service d'hygiène hospitalière de maladies infectieuses, CHU de Besançon, 3, boulevard A.-Fleming, 25030 Besançon, France
| | - F X Lescure
- Service des maladies infectieuses et UMR 1137, Inserm, faculté de Paris Diderot, hôpital Bichat-Claude-Bernard, AP-HP, 5, rue Thomas-Mann, 75013 Paris, France
| | - V Mondain
- Infectiologie, hôpital de L'Archet, CHU de Nice, 4, avenue Reine-Victoria, 06003 Nice, France
| | - P Pavese
- Maladies infectieuses, CHU Grenoble-Alpes, boulevard de la Chantourne, 38700 La Tronche, France
| | - C Rabaud
- Fédération française d'infectiologie (CNP-FFI), 30, boulevard Pasteur, 75014 Paris, France
| | - J P Stahl
- Maladies infectieuses, CHU Grenoble-Alpes, boulevard de la Chantourne, 38700 La Tronche, France
| | - P Tattevin
- Maladies infectieuses et réanimation médicale, Inserm U 835, université Rennes-I, hôpital Pontchaillou, rue du Thabor, 35000 Rennes, France
| | - F Roblot
- Service de médecine interne et maladies infectieuses, Inserm U1070, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - C Pulcini
- Service de maladies infectieuses et Tropicales, université de Lorraine, EA 4360 APEMAC, hôpitaux de Brabois, CHRU de Nancy, 54511 Vandœuvre-Lès-Nancy cedex, France.
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Courjon J, Cua E, Bernard E, Mondain V, Roger PM. G-06: Évaluation de l’association fluoroquinolone + clindamycine au cours des infections ostéo-articulaires (IOA) à staphylocoques. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70175-1] [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: 10/25/2022]
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Mondain V, Lieutier F, Dumas S, Gaudart A, Fosse T, Roger PM, Bernard E, Farhad R, Pulcini C. An antibiotic stewardship program in a French teaching hospital. Med Mal Infect 2013; 43:17-21. [DOI: 10.1016/j.medmal.2012.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 09/24/2012] [Accepted: 10/31/2012] [Indexed: 12/01/2022]
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Charpentier C, Joly V, Larrouy L, Fagard C, Visseaux B, de Verdiere NC, Raffi F, Yeni P, Descamps D, Aumaitre H, Medus M, Neuville S, Saada M, Abgrall S, Bentata M, Bouchaud O, Cailhol J, Cordel H, Dhote R, Gros H, Honore-Berlureau P, Huynh T, Krivitzky A, Mansouri R, Poupard M, Prendki V, Radia D, Rouges F, Touam F, Warde B, de Castro N, Colin de Verdiere N, Delgado J, Ferret S, Gallien S, Kandel T, Lafaurie M, Lagrange M, Lascoux-Combe C, Le D, Molina JM, Pavie J, Pintado C, Ponscarme D, Rachline A, Rozenbaum W, Sereni D, Taulera O, Estavoyer JM, Faucher JF, Foltzer A, Hoen B, Hustache-Mathieu L, Dupon M, Dutronc H, Neau D, Ragnaud JM, Raymond I, Boucly S, Lortholary O, Viard JP, Bechara C, Delfraissy JF, Ghosn J, Goujard C, Kamouh W, Mole M, Quertainmont Y, Bergmann JF, Boulanger E, Castillo H, Parrinello M, Rami A, Sellier P, Lepeu G, Pichancourt G, Bernard L, Berthe H, Clarissou J, Gory M, Melchior JC, Perronne C, Stegman S, de Truchis P, Derradji O, Malet M, Teicher E, Vittecoq D, Chakvetadze C, Fontaine C, Lukiana T, Pialloux G, Slama L, Bonnet D, Boucherit S, El Alami Talbi N, Fournier I, Gervais A, Joly V, Iordache L, Laurichesse JJ, Leport C, Pahlavan G, Phung BC, Yeni P, Bennamar N, Brunet A, Guillevin L, Salmon-Ceron D, Tahi T, Chesnel C, Dominguez S, Jouve P, Lelievre JD, Levy Y, Melica G, Sobel A, Ben Abdallah S, Bonmarchand M, Bricaire F, Herson S, Iguertsira M, Katlama C, Kouadio H, Schneider L, Simon A, Valantin MA, Abel S, Beaujolais V, Cabie A, Liauthaud B, Pierre Francois S, Abgueguen P, Chennebault JM, Loison J, Pichard E, Rabier V, Delaune J, Louis I, Morlat P, Pertusa MC, Brunel-Delmas F, Chiarello P, Jeanblanc F, Jourdain JJ, Livrozet JM, Makhloufi D, Touraine JL, Augustin-Normand C, Bailly F, Benmakhlouf N, Brochier C, Cotte L, Gueripel V, Koffi K, Lack P, Lebouche B, Maynard M, Miailhes P, Radenne S, Schlienger I, Thoirain V, Trepo C, Drogoul MP, Fabre G, Faucher O, Frixon-Marin V, Gastaut JA, Peyrouse E, Poizot-Martin I, Jacquet JM, Le Facher G, Merle de Boever C, Reynes J, Tramoni C, Allavena C, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Francois C, Hue H, Mounoury O, Raffi F, Reliquet V, Aubry O, Esnault JL, Leautez-Nainville S, Perre P, Suaud I, Breaud S, Ceppi C, Dellamonica P, De Salvador F, Durant J, Ferrando S, Fuzibet JG, Leplatois A, Mondain V, Perbost I, Pugliese P, Rahelinirina V, Rosenthal E, Sanderson F, Vassalo M, Arvieux C, Chapplain JM, Michelet C, Ratajczak M, Revest M, Souala F, Tattevin P, Cheneau C, Fischer P, Lang JM, Partisani M, Rey D, Bastides F, Besnier JM, Le Bret P, Choutet P, Dailloux JF, Guadagnin P, Nau P, Rivalain J, Soufflet A, Aissi E, Melliez H, Pavel S, Mouton Y, Yazdanpanah Y, Boyer L, Burty C, Letranchant L, May T, Wassoumbou S, Blum L, Danne O, Arthus MA, Dion P, Certain A, Tabuteau S, Beuscart A, Agher N, Frosch A, Couffin-Cadiergues S, Diallo A. Role and evolution of viral tropism in patients with advanced HIV disease receiving intensified initial regimen in the ANRS 130 APOLLO trial. J Antimicrob Chemother 2012; 68:690-6. [DOI: 10.1093/jac/dks455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fafin C, Pugliese P, Durant J, Mondain V, Rahelinirina V, De Salvador F, Ceppi C, Perbost I, Rosenthal E, Roger P, Cua E, Dellamonica P, Esnault V, Pradier C, Moranne O. Increased Time Exposure to Tenofovir Is Associated with a Greater Decrease in Estimated Glomerular Filtration Rate in HIV Patients with Kidney Function of Less than 60 ml/min/1.73 m 2. Nephron Clin Pract 2012; 120:c205-14. [DOI: 10.1159/000342377] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 07/24/2012] [Indexed: 01/10/2023] Open
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Pulcini C, Hasseine L, Mondain V, Baudin G, Roger PM. Possible pandemic HIN1 influenza complicated by Pneumocystis jirovecii pneumonia in an HIV-infected patient. J Mycol Med 2012. [PMID: 23177819 DOI: 10.1016/j.mycmed.2011.11.003] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Immune response to a pandemic influenza A 2009 (H1N1) virus infection can influence the way a second unrelated pathogen is handled by the host. We report here a case of pandemic flu with marked CD4 T-cell lymphopenia complicated by a possible Pneumocystis jirovecii pneumonia in an HIV-infected patient.
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Affiliation(s)
- C Pulcini
- Service d'infectiologie, hôpital l'Archet-1, centre hospitalier universitaire de Nice, 151, route Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France.
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Fafin C, Pugliese P, Mondain V, Durant J, de Salvadore F, Sanderson F, Perbost I, Rosenthal E, Dellamonica P, Esnault V, Pradier C, Moranne O. Le temps d’exposition au Tenofovir est associé à une diminution du DFGe chez les patients VIH avec un DFGe. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pulcini C, Matta M, Mondain V, Gaudart A, Girard-Pipau F, Mainardi JL, Dellamonica P. A-03 Facteurs prédictifs de métastases septiques dans les bactériémies à Staphylococcus aureus. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74329-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lieutier F, Mondain V, Dumas M, Dantin T, Gari-Toussaint M, Hasseine L, Mousnier A. H-03 Diagnostic et traitement des aspergilloses invasives : intérêt d’une approche multidisciplinaire. Med Mal Infect 2008. [DOI: 10.1016/s0399-077x(08)73130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Marsé D, Roger P, Mondain V, Fosse T. Hémocultures : Enquête de Pratique en Soins Infirmiers. Med Mal Infect 2008; 38 Suppl 2:S119-20. [DOI: 10.1016/s0399-077x(08)73051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Obez C, Barisic AM, Chatelier W, Dellamonica MC, Falcot J, Koubi C, Mondain V, Dellamonica P. [The computer-assisted management programs for antibiotic therapies in connection with an application in geriatrics]. Pathol Biol (Paris) 2004; 52:589-96. [PMID: 15596308 DOI: 10.1016/j.patbio.2004.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2004] [Accepted: 07/13/2004] [Indexed: 05/01/2023]
Abstract
OBJECTIVES Improve antibiotic therapies in a geriatrics hospital by enhancing guidelines impact. Historical background. - Study of the uses of the data-processing tool: detection of adverse drug events and inappropriate therapies; diffusion of the probable bacteria and their sensitivities to antibiotics following the infected site; creating decisional algorithms leading to suggested antibiotic therapy concept. METHOD Referring to the conferences of consensus: drafting of local protocols of antibiotic therapies by using data processing if possible. Description of computer-systems implemented in Salt Lake City (USA) and Tubingen (Germany). With the assistance of an expert infectiologist, design of a database containing clinical details of the different situations in the pulmonary and urinary infections: once the clinical data are entered, a suggested antibiotic therapy appears on the screen, followed by a suggested prescription adapted to patient's specifications. During five years, survey of Defined Daily Dose per 1000 occupied bed-days; survey of sensitivities to antibiotics of urinary tract bacteria. RESULTS Decrease of overall antibiotic consumption; decrease of broad-spectrum agents; modifications of E. coli sensitivities lead to variations of suggested antibiotic therapy. DISCUSSION Seizure of the clinical determinants imposes a reducing effect; but it is necessary to apply to antibiotic therapies a hierarchicalbasis on account of bacterial resistances process and on account of "tonnage" of antibiotic prescriptions. CONCLUSION Computer-assisted decision in antibiotic therapy can draw prescribers' attention to guidelines. The adhesion of the physicians to the computerized decision-making system is consolidated by their direct participation in the design of this system.
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Affiliation(s)
- C Obez
- Unité des soins intensifs, clinique Les-Sources, CHU de Nice, 10, Camin-René-Pietruschi, 06100 Nice, France.
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Prouvost-Keller B, Hofliger P, Pradier C, Mondain V, Caselles D, Dellamonica P, Fuzibet JG, Pesce A. [Assessment of the habits of physicians involved in the management of HIV-infected patients. A clinical audit on the biological follow-up]. Presse Med 2003; 32:1599-603. [PMID: 14576581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the habits of hospital and community-based physicians involved in the management of HIV-infected patients and to measure the gap between their practice and follow-up guidelines. METHOD The guidelines considered as reference were the 1998 Dormont report. Data were prospectively collected from the medical files of the first 10 HIV-infected patients who presented for an out-patient visit (laboratory tests at initial consultation, type and frequency of follow-up during the previous year, relation between biological data and treatment strategy). RESULTS 22 physicians (14 hospital-based physicians (HP) and 8 community-based general practitioners (GP) participated in the survey. Initial biological data were available for 211 patients; 45% had tests strictly conforming to the recommendations (HP: 57%, GP 23%; p<0.001). Among patients followed by a GP, the initial biological assessment was adequate in 7% of cases when an opiate substitute was prescribed versus 33% in the absence of opiate substitute prescription (p=0.05). For all patients, syphilis serology was the test most frequently lacking (38%). Among 78 patients with HIV-RNA levels>5,000 copies/ml, 18% did not benefit from a change in treatment. Among the patients treated by a GP, 15% had a three-fold increase in HIV-RNA, compared to their initial measurement. Of these, 3/4 were redirected to a hospital out-patient unit. CONCLUSION This study highlights the discrepancy between initial laboratory testing and expert recommendations, particularly concerning patients attended by a GP. Improvement in data collection is essential. However, recommendations concerning patients' biological follow-up are applied, with the exception of the delay between the initial prescription or treatment modification and HIV-RNA measurement, which should be shortened.
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Chaillou S, Durant J, Garraffo R, Georgenthum E, Roptin C, Clevenbergh P, Dunais B, Mondain V, Roger PM, Dellamonica P. Intracellular concentration of protease inhibitors in HIV-1-infected patients: correlation with MDR-1 gene expression and low dose of ritonavir. HIV Clin Trials 2002; 3:493-501. [PMID: 12501133 DOI: 10.1310/0873-bvdp-akay-445u] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Protease inhibitors (PIs) are substrates for the P-glycoprotein (P-gp/170) encoded by the multi-drug resistance gene (MDR-1). HIV infection is associated with increased expression of P-gp. The role of MDR gene overexpression in clinical pharmacokinetics is not known. METHOD We determined by HPLC, at trough and peak levels, the current PI concentrations in plasma (P) and in peripheral blood mononuclear cells (PBMCs) (intracellular concentration [IC]) from 49 HIV-infected patients receiving different treatment combinations: nelfinavir ([NFV] n = 12); indinavir ([IDV] n = 10); amprenavir ([APV] n = 5); ritonavir (RTV) 100 bid/IDV 800 mg bid (n = 6); RTV 400 bid/IDV 400 mg bid (n = 3); RTV 100 bid/saquinavir (SQV) 600 mg tid (n = 9); APV 600 bid/RTV 100 mg bid (n = 4). We determined the mean ratio of intracellular/plasma PI concentration for each treatment group. The MDR-1 gene expression was determined by a semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR). HIV viral load was simultaneously measured. RESULTS 49 patients (mean age 41 +/- 8.7 years; mean CD4 cell count 418 [57-972]; mean HIV RNA 2.1 +/- 0.8 log(10)) were included in the study. Patients who overexpressed the MDR-1 gene had significantly lower trough intracellular PI levels (p =.02) or lower intracellular accumulation of PI (p =.042). Patients treated with low-dose RTV in combined regimens with detectable RTV intracellular concentration showed lack of MDR-1 gene expression (p =.01). Patients with HIV RNA < 40 copies/mL had significantly higher RTV intracellular accumulation (p =.029). CONCLUSION In HIV-infected patients, IC of PI is inversely correlated with MDR-1 gene overexpression. Undetectable viral load was associated with the use of low-dose RTV, probably linked to better intracellular accumulation of the drug. Nevertheless, further investigation is needed to confirm these results.
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Affiliation(s)
- S Chaillou
- Service des Maladies Infectieuses, Hôpital Archet 1, Nice, France.
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25
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Gari-Toussaint M, Pradines B, Mondain V, Keundjian A, Dellamonica P, Le Fichoux Y. [Senegal and malaria. True prophylactic failure of mefloquine]. Presse Med 2002; 31:1136. [PMID: 12162100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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26
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Clevenbergh P, Corcostegui M, Gérard D, Hieronimus S, Mondain V, Chichmanian RM, Sadoul JL, Dellamonica P. Iatrogenic Cushing's syndrome in an HIV-infected patient treated with inhaled corticosteroids (fluticasone propionate) and low dose ritonavir enhanced PI containing regimen. J Infect 2002; 44:194-5. [PMID: 12099750 DOI: 10.1053/jinf.2001.0928] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In HIV-infected patients, ritonavir, a potent cytochrome P450 inhibitor, is increasingly used to improve the pharmacokinetic profile of the associated protease inhibitor. HIV physicians are often faced with potential drug-drug interaction while treating associated diseases. We report the case of an HIV-infected patient with clinical features of Cushing's syndrome due to the interaction of low dose ritonavir with inhaled fluticasone propionate (FP). Safety of life-long CYP450 inhibition has still to be demonstrated.
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Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France.
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27
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Roger PM, Martin C, Taurel M, Fournier JP, Nicole I, Carles M, Mondain V, Fontas E, Bertrand F, Pradier C, Vandenbos F, Dellamonica P. [Motives for the prescription of antibiotics in the emergency department of the University Hospital Center in Nice. A prospective study]. Presse Med 2002; 31:58-63. [PMID: 11850986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES Since April 1999, we have set-up an infectious disease consultation in the emergency unit of the University Hospital in Nice. Unjustified antiobiotherapy is often initiated. We therefore conducted a survey to study the motives and validity of antibiotic prescriptions. METHOD This prospective study was conducted in two phases. The first consisted in asking the emergency physicians prescribing antibiotics to fill-in a questionnaire giving information on the diagnosis established and the antiobiotherapy proposed. In the second phase, the diagnoses and corresponding treatments were submitted to 4 experts who assessed the acceptability of the diagnoses and the antibiotics prescribed. The experts only had access to the clinical and para-clinical data available. Moreover, their therapeutic judgement was based on previously published consensuses. RESULTS The 6-month survey collected 117 questionnaires that could be analysed. The rate of error in diagnosis was of 33% (39/117). Thoracic x-rays could not be interpreted in 11% of cases. In single variant analysis, factors of erroneous diagnosis were due to its interpretation by an internist, the diagnostic category of "broncho-pulmonary infections" and the lack of documentation. In multi variant analysis, only the lack of documentation was related to erroneous diagnosis (OR = 5.5; IC 95% (2.03; 15.30), p < 0.0002). The rate of antibiotherapy not adapted to the diagnosis made by the physician was of 32% (37/117). In 24 cases the modalities of the prescription were incorrect and in 13 cases the prescription was unjustified. Only the status of the prescriber (internist) was statistically associated with an antibiotherapy not adapted to the diagnosis (OR = 2.2; IC 95% (0.93; 5.26), p < 0.05). CONCLUSION Unjustified antibiotherapy in an emergency unit is generally due to erroneous diagnosis of infection. The lack of documentation and inexperience of the prescribers appear to be the two elements contributing to unjustified antibiotherapy.
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Affiliation(s)
- P M Roger
- Service des Maladies Infectieuses et Tropicales, Hôpital de l'Archet 1, Centre Hospitalo-Universitaire de Nice, BP3079, F06202 Nice.
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Roger PM, Breittmayer JP, Cottalorda J, Ticchioni M, Mondain V, Dellamonica P, Bernard A. Persistent viral load in patients on HAART is associated with a higher level of activation-induced apoptosis of CD4(+) T cells. J Antimicrob Chemother 2001; 47:109-12. [PMID: 11152441 DOI: 10.1093/jac/47.1.109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Apoptosis is one of the mechanisms involved in the persistent CD4(+) T cell lymphopenia occurring in human immunodeficiency virus (HIV)-infected patients treated with highly active antiretroviral therapy (HAART). The aim of this study was to look at the relationship between the level of T cell apoptosis in patients on HAART and their HIV viral load measurement. Forty-five patients receiving HAART for a median time of 5 months were included: 13 had an undetectable viral load and 32 had a viral load > or = 200 copies/mL. No relationship was observed between the level of spontaneous T cell apoptosis and the viral load measurement. Patients with a viral load > or = 200 copies/mL exhibited a significantly higher level of CD4-induced apoptosis of CD4(+) T cells, compared with patients with undetectable viraemia (38 versus 15%, respectively, P = 0.03). Activation-induced apoptosis may be involved in the paucity of the immune reconstitution observed in HIV-infected patients treated with HAART.
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Affiliation(s)
- P M Roger
- Service des Maladies Infectieuses et Tropicales, Hôpital de l'Archet, Nice, France
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29
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Roger PM, Boissy C, Gari-Toussaint M, Foucher R, Mondain V, Vandenbos F, le Fichoux Y, Michiels JF, Dellamonica P. Medical treatment of a pacemaker endocarditis due to Candida albicans and to Candida glabrata. J Infect 2000; 41:176-8. [PMID: 11023765 DOI: 10.1053/jinf.2000.0640] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We describe a case of pacemaker infection due to two fungal species: Candida albicans and C. glabrata. Transthoracic echocardiography showed a large vegetation on the intraventricular wires. Because of severe underlying diseases, surgery was believed to be contraindicated. The patient was treated using high dose of fluconazole, resulting in clinical improvement and negative blood cultures. However, 2 months later, the patient underwent a fatal stroke. At autopsy, a large vegetation was found only all along the wires. Postmortem culture of the infected material was positive for both C. albicans and C. glabrata.
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Affiliation(s)
- P M Roger
- Service des Maladies Infectieuses et Tropicales, Hôpital de l'Archet, Route St Antoine de Ginestière, BP79, 06202 Nice, France
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30
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Clevenbergh P, Durant J, Halfon P, del Giudice P, Mondain V, Montagne N, Schapiro JM, Boucher CA, Dellamonica P. Persisting long-term benefit of genotype-guided treatment for HIV-infected patients failing HAART. The Viradapt Study: week 48 follow-up. Antivir Ther 2000; 5:65-70. [PMID: 10846595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE We report the 12 months follow-up of the patients who participated in the Viradapt study. METHODS A total of 108 HIV-infected patients failing antiretroviral (ARV) therapy (HIV RNA > 10,000 copies/ml, therapy > 6 months with nucleoside reverse transcriptase inhibitors, > 3 months with protease inhibitors (PIs) were randomized into two arms: standard of care in the control arm, and treatment according to the resistance mutations in the protease and reverse transcriptase genes in the study arm. After the first 6 months of the randomized study, open-label, genotype-guided treatment was offered in both arms. A multivariate analysis was performed to assess the predictive factors of treatment success (HIV RNA < 200 copies/ml). RESULTS The two arms were comparable in terms of risk factors, age, sex, previous treatments, CD4 cell count and log10 HIV-1 RNA at baseline. At week 24, an interim combined analysis showed a statistically significant difference in the drop in viral load at months 3 and 6 (P = 0.015, repeated measures analysis of variance) in favour of the genotype group. Patients in both arms were then offered open-label genotyping. Genotype analysis was performed every 3 months, and treatment changes could accordingly be made. As some of the patients in the control arm had already progressed to months 9 or 12, only 69% (30/43) of these patients received genotype-guided treatment changes. In the genotype arm, the mean drop in HIV RNA of 1.15 log10 copies/ml, obtained at month 6, persisted at months 9 and 12 (1.15 log10 copies/ml +/- 0.17). In the control arm, an additional drop in HIV RNA to 0.98 log10 +/- 0.22 copies/ml was observed by month 12. In control patients receiving open-label genotype, the percentage of patients with HIV-1 RNA levels below detection limit (200 copies/ml) rose from 14% at month 6 to 30.5% at month 12. This percentage in the study arm remained stable at 31.3% and 30% at months 9 and 12, respectively. Genotype-guided therapy, primary protease mutations and PI plasma concentrations were significantly correlated with virological success. CONCLUSION In this heavily pretreated patient population, genotype-guided therapy resulted in a sustained reduction in HIV RNA of greater than one log10 throughout a 1 year follow-up period. Performance of genotype-guided therapy may have contributed to the additional viral load reduction seen in patients in the control group who received open-label genotyping after the 6 months point. Multivariate analysis showed that the presence of primary protease mutations, performance of genotype-guided treatment changes and PI plasma concentrations independently affected virological response.
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Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France.
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31
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Clevenbergh P, Durant J, Halfon P, del Giudice P, Mondain V, Montagne N, Schapiro JM, Boucher CAB, Dellamonica P. Persisting Long-Term Benefit of Genotype-Guided Treatment for HIV-Infected Patients Failing Haart. The Viradapt Study: Week 48 Follow-Up. Antivir Ther 2000. [DOI: 10.1177/135965350000500102] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective We report the 12 months follow-up of the patients who participated in the Viradapt study. Methods A total of 108 HIV-infected patients failing antiretroviral (ARV) therapy (HIV RNA >10000 copies/ml, therapy >6 months with nucleoside reverse transcriptase inhibitors, >3 months with protease inhibitors (PIs) were randomized into two arms: standard of care in the control arm, and treatment according to the resistance mutations in the protease and reverse transcriptase genes in the study arm. After the first 6 months of the randomized study, open-label, genotype-guided treatment was offered in both arms. A multivariate analysis was performed to assess the predictive factors of treatment success (HIV RNA <200 copies/ml). Results The two arms were comparable in terms of risk factors, age, sex, previous treatments, CD4 cell count and log10 HIV-1 RNA at baseline. At week 24, an interim combined analysis showed a statistically significant difference in the drop in viral load at months 3 and 6 ( P=0.015, repeated measures analysis of variance) in favour of the genotype group. Patients in both arms were then offered open-label genotyping. Genotype analysis was performed every 3 months, and treatment changes could accordingly be made. As some of the patients in the control arm had already progressed to months 9 or 12, only 69% (30/43) of these patients received genotype-guided treatment changes. In the genotype arm, the mean drop in HIV RNA of 1.15 log10 copies/ml, obtained at month 6, persisted at months 9 and 12 (1.15 log10 copies/ml ±0.17). In the control arm, an additional drop in HIV RNA to 0.98 log10 ±0.22 copies/ml was observed by month 12. In control patients receiving open-label genotype, the percentage of patients with HIV-1 RNA levels below detection limit (200 copies/ml) rose from 14% at month 6 to 30.5% at month 12. This percentage in the study arm remained stable at 31.3% and 30% at months 9 and 12, respectively. Genotype-guided therapy, primary protease mutations and PI plasma concentrations were significantly correlated with virological success. Conclusions In this heavily pretreated patient population, genotype-guided therapy resulted in a sustained reduction in HIV RNA of greater than one log10 throughout a 1 year follow-up period. Performance of genotype-guided therapy may have contributed to the additional viral load reduction seen in patients in the control group who received open-label genotyping after the 6 month point. Multivariate analysis showed that the presence of primary protease mutations, performance of genotype-guided treatment changes and PI plasma concentrations independently affected virological response.
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Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France
| | - J Durant
- Department of Infectious Diseases, Nice University Hospital, France
| | - P Halfon
- Virology Department, Alphabio, Marseille, France
| | - P del Giudice
- Department of Infectious Diseases, Nice University Hospital, France
| | - V Mondain
- Department of Infectious Diseases, Nice University Hospital, France
| | | | - JM Schapiro
- National Haemophilia Centre, Tel Hashomer, Israel
| | - CAB Boucher
- Virology Department, University Hospital, Utrecht, The Netherlands
| | - P Dellamonica
- Department of Infectious Diseases, Nice University Hospital, France
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del Giudice P, Durant J, Counillon E, Mondain V, Bernard E, Roger PM, Dellamonica P. Mycobacterial cutaneous manifestations: a new sign of immune restoration syndrome in patients with acquired immunodeficiency syndrome. Arch Dermatol 1999; 135:1129-30. [PMID: 10490130 DOI: 10.1001/archderm.135.9.1129] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Roger PM, Carles M, Agussol-Foin I, Pandiani L, Keïta-Perse O, Mondain V, De Salvador F, Dellamonica P. Efficacy and safety of an intravenous induction therapy for treatment of disseminated Mycobacterium avium complex infection in AIDS patients: a pilot study. J Antimicrob Chemother 1999; 44:129-31. [PMID: 10459822 DOI: 10.1093/jac/44.1.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Monotherapy with macrolides for the treatment of disseminated Mycobacterium avium complex (MAC) bacteraemia leads to drug resistance and relapse of bacteraemia. Gastrointestinal intolerance is a common reason for treatment withdrawal of multidrug regimens. We have assessed the efficacy and safety of initial parenteral therapy together with a macrolide, for disseminated MAC infection, defined as two positive blood cultures, in AIDS patients. Patients received a daily infusion of amikacin 15 mg/kg + ethambutol 20 mg/kg + ciprofloxacin 400 mg/day, for 1 month, together with a macrolide by oral route. Fifteen patients were included and 13 (86%) achieved negative culture before the end of parenteral therapy.
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Affiliation(s)
- P M Roger
- Service des Maladies Infectieuses et Tropicales, Hôpital de l'Archet I, Nice, France
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Roger PM, Mondain V, St Paul MC, Peyrade F, Pesce A, Fuzibet JG, Michiels JF, Dellamonica P. [Influence of HIV-related immunodeficiency on the histopathology of chronic hepatitis C]. Presse Med 1998; 27:1617-20. [PMID: 9819599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE There is substantial evidence demonstrating the aggravating effect of human immunodeficiency virus (HIV) infection on the progression of chronic hepatitis C virus (HCV) infection. There is however, little data on the affect of certain factors which could affect liver pathology findings in patients with concomitant HIV infection such as the duration of HIV infection or T-cell subpopulation counts. We examined pathology findings in patients with concomitant HIV and HCV infections to determine the impact of immunodepression. PATIENTS AND METHODS We reviewed liver pathology data collected in patients with concomitant HIV and HCV infections grouping patients according to severity of the liver pathology: group 1 = cirrhosis or active hepatitis; group 2 = minimally active hepatitis or histologically normal liver. Transparietal liver biopsies were obtained for the work-up of viral hepatitis or because of long-term unexplained fever or suspected lymphoma. Epidemiological and biological data were obtained from medical files. The duration of the liver disease was estimated from the date of exposure to risk of immunodepression as determined by the peripheral CD4+ and CD8+ counts. All pathology specimens were read by two pathologists who established the Knodell score for each patient. RESULTS Fifty patients were included: 23 were classed in group 1 and 28 in group 2. The Knodell score was significantly different between the two groups, 11 +/- 4 and 4 +/- 3 respectively (p < 0.0001). Disease duration was similar for the two groups: mean 8 years. Mean CD4+ count was significantly higher in group 1: 312/mm3 versus 110/mm3 for group 2 (p = 0.0057); as was the mean CD8+ count (758/mm3 versus 360/mm3, p = 0.0013). For the entire study population, there was a significantly negative correlation (p < 0.05) between the Knodell score and the CD4+ count (r = 0.31) and for the CD8+ count (r = 0.41). CONCLUSION HCV-related liver pathology in patients co-infected with HIV depends on the level of immunodepression. CD8+ counts are better correlated with pathology findings than with CD4+ counts.
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Affiliation(s)
- P M Roger
- Service des Maladies infectieuses et tropicales, Hôpital de l'Archet I, Nice
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Bouadma L, Larroche C, Mondain V, Dray JM, Memain N, Blétry O. Syndrome hémophagocytaire chronique idiopathique chez un patient de 57 ans contrôlé par vépéside. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Tieulié N, Baldin B, Mondain V, Cassuto-Viguier E. Néphrite interstitielle à l'indinavir: première description. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Roger PM, Mondain V, Saint Paul MC, Carles M, Taillan B, Fuzibet JG, Michiels JF, Dujardin P, Dellamonica P. Liver biopsy is not useful in the diagnosis of mycobacterial infections in patients who are infected with human immunodeficiency virus. Clin Infect Dis 1996; 23:1302-4. [PMID: 8953075 DOI: 10.1093/clinids/23.6.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Liver biopsy (LB) has been advocated for the detection of mycobacterial infections in patients infected with human immunodeficiency virus (HIV). To determine the effect of the use of this procedure on survival, we compared it terms of yield with histological findings and noninvasive microbiological procedures. We reviewed the cases of 98 patients who underwent 106 LBs as part of the diagnostic screening for fever of unknown origin. LB revealed 17 cases of mycobacterial infection. For all but one patient, the results of at least one noninvasive procedure were positive. In 85 cases where infections were not diagnosed by LB, 17 had infections documented by other procedures. When all culture results are considered, the mean (+/- SD) incubation time to the first positive culture was 15 +/- 5 days, whereas the mean (+/- SD) incubation time to the first positive culture of an LB specimen was 28 +/- 9 days. The survival time was not significantly increased for patients who underwent LB and had positive Ziehl-Neelsen-stained smears; these patients survived a mean (+/- SD) of 12 +/- 11 months, whereas patients with negative smears survived a mean (+/- SD) of 9 +/- 10 months. Noninvasive studies are preferable to LB for the diagnosis of mycobacterial infections in HIV-infected patients.
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Affiliation(s)
- P M Roger
- Department of Infectious Disease and Tropical Medicine, Hôpital de l'Archet, Nice, France
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Roger PM, Carles M, Saint-Paul MC, Taillan B, Mondain V, Michiels JF, Fuzibet JG, Dujardin P, Dellamonica P. [Comparative profitability of hepatic biopsy and microbiological tests in patients with HIV infection]. Presse Med 1996; 25:1147-51. [PMID: 8949607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Diagnostic liver biopsy is proposed in HIV-positive patients who present unexplained fever. This invasive procedure is truly useful if it allows establishing a difficult diagnosis or improves survival rate. We conducted a retrospective study to determine the diagnostic and prognostic power of liver biopsy in HIV-positive patients with fever. METHODS One hundred thirty-eight liver biopsies were performed in 129 patients. Utility was defined as demonstration of the pathogen or identification of a tumoral process. RESULTS The liver biopsy met the utility criteria in 27 cases showing mycobacterial infections (n = 22) and herpes hepatitis, type 1 herpes simplex virus, cytomegalovirus and cryptococcosis infections (n = 1 each). These last 4 diagnoses were also possible with other tests. Comparing non-contributive liver biopsies (n = 111) with those demonstrating hepatic mycobacterial infection (n = 22) showed that the two groups were not different in terms of demographic data. Splenomegalia was more frequent in the non-contributive group (68% vs 37%, p = 0.007) as was superficial lymph node enlargement (45% vs 12%, p < 10(-3)). Laboratory tests were not discriminating. Mycobacterial infection was diagnosed in 22 patients in the non-contributive group. Bacteriological samples were positive for mycobacterium in 20 of the 22 patients in the contributive group. The mean delay to the first positive test for mycobacterium was 15 +/- 8 days compared with 30 +/- 10 days for liver tissue cultures. Mean survival after liver biopsy was 10 months: patients with a positive Ziehl-Neelson stain on the liver biopsy did not have a longer survival (9.7 +/- 7.6 vs 10.2 +/- 10.4 months). CONCLUSION In most cases, liver biopsy in HIV-positive patients with fever provides a diagnosis which can be obtained with non-invasive techniques without improving prognosis.
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Affiliation(s)
- P M Roger
- Service des Maladies infectieuses et tropicales, Hôpital de l'Archet, Nice
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Bernard E, Carles M, Pradier C, Boissy C, Roger PM, Hebuterne X, Mondain V, Michiels JF, Le Fichoux Y, Dellamonica P. [Persistent diarrhea in HIV infected patients: role of Enterocytozoon bieneusi]. Presse Med 1995; 24:671-4. [PMID: 7770414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To determine the epidemiologic, clinical and aetiologic features of chronic diarrhoea in patients with human immunodeficiency virus (HIV) infection. METHODS Between January 1992 and April 1993, all HIV positive patients with chronic diarrhoea were enrolled in a prospective study. There were 46 patients in the study group including 33 (22 homosexuals) in stage C according to the 1993 Centers for Disease Control classification. RESULTS Thirty-four pathogenic agents were isolated in 26 of the patients (57%). Enterocytozoon bieneusi was the most frequently found pathogen (11 patients, 24%) followed by Cryptosporidium sp (8 patients). Enterocytozoon bieneusi was found in association with other pathogens in 7 patients. All patients with microsporidiosis were in stage C (p = 0.04) and had a longer duration of diarrhoea (19.6 vs 9.8 weeks, p = 0.03), greater weight loss (9.6 vs 2.1 kg, p = 0.0003) and a lower Karnofsky index (48% vs 67%, p = 0.01). Prophylaxy with dapsone or pyrimethamine during the 3 months prior to inclusion had been more frequent (p = 0.04 and p = 0.05 respectively) in patients without microsporidiosis. CONCLUSION Microsporidiosis should be suspected as a probable cause of chronic diarrhoea in HIV positive patients with a CD4 count < 100/mm3. Multiple infections may be a factor leading to treatment failure. Microsporidiosis seems to be linked to homosexual intercourse.
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Affiliation(s)
- E Bernard
- Service de Maladies infectieuses et tropicales, Hôpital de l'Archet, Nice
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40
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Perrin C, Taillan B, Hofman P, Mondain V, Lefichoux Y, Michiels JF. Atypical cutaneous histological features of visceral leishmaniasis in acquired immunodeficiency syndrome. Am J Dermatopathol 1995; 17:145-50. [PMID: 8600779 DOI: 10.1097/00000372-199504000-00006] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Cutaneous lesions in Mediterranean visceral leishmaniasis (VL) are very unusual, except for the presence of Leishmania organisms in cutaneous Kaposi's sarcoma in patients with acquired immunodeficiency syndrome (AIDS). We have identified two unusual cutaneous histological features of VL in three patients with AIDS not described previously; two had "silent leishmaniasis," and in the third, Leishmania organisms were present in sweat ducts, suggesting transepithelial elimination through eccrine sweat glands and/or eccrine epithelial tropism.
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Affiliation(s)
- C Perrin
- Department of Pathology, University of Nice, France
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41
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Carsenti-Etesse H, Bensoussan M, Bensoussan F, Durant J, Pradier C, Mondain V, Bernard E, Dellamonica P. Effect of subinhibitory concentrations of pefloxacin in infection in mice due to susceptible or resistant strains. Drugs 1995; 49 Suppl 2:276-8. [PMID: 8549331 DOI: 10.2165/00003495-199500492-00069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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42
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Carsenti-Etesse H, Durant J, De Salvador F, Bensoussan M, Bensoussan F, Pradier C, Bernard E, Mondain V, Thabaut A, Dellamonica P. Possible prevention of in vitro selection of resistant Streptococcus pneumoniae by beta-lactamase inhibitors. Eur J Clin Microbiol Infect Dis 1994; 13:1058-62. [PMID: 7889969 DOI: 10.1007/bf02111828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The development of resistance in vitro in five strains of Streptococcus pneumoniae (3 with full susceptibility and 2 with intermediate susceptibility to penicillin) was investigated by serial passages in the presence of subinhibitory concentrations of amoxicillin and ampicillin. At the end of passaging, MICs of antibiotics for all the strains increased by a factor of four or more, reaching at least intermediate levels. MICs of cephalosporins, ampicillin and amoxicillin increased for almost all variants obtained. Similar results were obtained with amoxicillin plus clavulanic acid at a ratio of 2:1 and at a constant concentration of 2 micrograms/ml, and with ampicillin plus sulbactam at a ratio 2:1. In contrast, no significant modification of MIC was seen with ampicillin plus sulbactam at a constant concentration of 4 micrograms/ml sulbactam. These results suggest interaction of sulbactam with penicillin binding proteins as described previously for other bacterial species, and merit further investigation.
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43
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Michiels JF, Hofman P, Bernard E, Saint Paul MC, Boissy C, Mondain V, LeFichoux Y, Loubiere R. Intestinal and extraintestinal Isospora belli infection in an AIDS patient. A second case report. Pathol Res Pract 1994; 190:1089-93; discussion 1094. [PMID: 7746744 DOI: 10.1016/s0344-0338(11)80908-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 30-year-old black female, from Burkina Faso, had AIDS in 1990. She died in March 1993 following a cachexia secondary to a chronic intestinal isosporiasis. The autopsy revealed a massive parasitic infection by I. belli of the small intestine mesenteric and mediastinal lymph nodes and liver and spleen. The parasite stage observed in extra intestinal sites corresponded to unizoite tissue cysts. This is the first report of I. belli infection in liver and spleen.
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Affiliation(s)
- J F Michiels
- Laboratoire d'Anatomie Pathologique, Centre Hospitalier, France
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44
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Bondiau PY, Peyrade F, Birswitle I, Thyss A, Bruneton JN, Marcy PY, Mondain V. [Bone hydatidosis. Pseudosarcomatous aspect]. Presse Med 1993; 22:1367. [PMID: 8248072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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45
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Rosenthal E, Gueniffey D, Marty P, Bernard E, Fuzibet J, Pesce A, Taillan B, Mondain V, Vinti H, Reboulot B, Michiels J, Dujardin P, Dellamonica P, Cassuto J. Leishmaniose viscérale et infection par le VIH-1. Etude de 19 observations. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80344-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Carsenti-Etesse H, Durant J, Entenza J, Mondain V, Pradier C, Bernard E, Dellamonica P. Effects of subinhibitory concentrations of vancomycin and teicoplanin on adherence of staphylococci to tissue culture plates. Antimicrob Agents Chemother 1993; 37:921-3. [PMID: 8494393 PMCID: PMC187816 DOI: 10.1128/aac.37.4.921] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Bacterial adhesion is the first step in infection of medical devices. Staphylococcus aureus and Staphylococcus epidermidis are the pathogens recovered most often. The effects of subinhibitory concentrations of vancomycin and teicoplanin on the adherence of eight clinical strains of S. aureus and eight strains of S. epidermidis to tissue culture plates in vitro were tested. The mean relative inhibitions of adherence at one-fourth and one-eighth the MIC were statistically different for teicoplanin and vancomycin. Slime production seemed not to be involved in adherence.
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Carsenti-Etesse H, Durant J, Bernard E, Mondain V, Entenza J, Dellamonica P. Effect of subinhibitory concentrations of cefamandole and cefuroxime on adherence of Staphylococcus aureus and Staphylococcus epidermidis to polystyrene culture plates. Eur J Clin Microbiol Infect Dis 1992; 11:732-7. [PMID: 1425733 DOI: 10.1007/bf01989980] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The ability of cefamandole and cefuroxime to inhibit adherence of staphylococci to polystyrene culture plates was tested in an in vitro assay using eight strains each of Staphylococcus aureus and Staphylococcus epidermidis. The results indicated that subinhibitory concentrations of cefamandole and cefuroxime altered the adherence ability of both staphylococcal species, inhibition of adherence being more marked in the presence of cefamandole. It may be important to consider antiadherence properties in association with bactericidal activity when selecting agents for antibiotic prophylaxis.
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48
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Pradier C, Bernard E, Lubick C, Toussaint-Gari M, Pinier Y, Durant J, Mondain V, Le Fichoux Y, Dellamonica P. Does fluconazole prevent cryptococcal meningitis in human immunodeficiency virus-infected patients? J Infect Dis 1992; 165:787. [PMID: 1552218 DOI: 10.1093/infdis/165.4.787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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49
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Etesse-Carsenti H, Garraffo R, Bernard E, de Salvador F, Pradier C, Durant J, Mondain V, Drugeon HB, Dellamonica P. [Bactericidal effect of cefadroxil, amoxicillin alone or in combination with clavulanic acid in sera of healthy volunteers]. Pathol Biol (Paris) 1991; 39:972-7. [PMID: 1805138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Determination of minimal inhibitory concentrations (MICs) provides data on the susceptibility or resistance of a bacteria; however, in susceptible bacteria this parameter is not predictive of effectiveness of the antimicrobial agent. Bactericidal activities of cefadroxil, of amoxicillin, and of the amoxicillin-clavulanic acid combination on bacteria commonly found in ENT and lower respiratory tract disease were studied comparatively. The antibiotics were given by the oral route to six healthy volunteers. With beta-lactamase-producing and non-beta-lactamase-producing strains of Escherichia coli, amoxicillin produced MICs consistent with susceptibility but failed to exhibit a bactericidal effect, whereas cefadroxil was bactericidal. Combination of amoxicillin with an inhibitor did not modify this activity on E. coli and failed to produce a bactericidal effect on Klebsiella pneumoniae similar to that seen with cefadroxil. Amoxicillin with and without clavulanic acid exhibited comparable effectiveness on Streptococcus pyogenes and S. Pneumoniae. The bactericidal effect of cefadroxil on S. pneumoniae was of similar magnitude but shorter duration than that of amoxicillin. Cefadroxil and the amoxicillin-clavulanic acid combination had similar bactericidal effects against Staphylococcus aureus. These antibiotics exhibited a time-dependent effect on Gram positive microorganisms. These pharmacodynamic data, together with measures of bactericidal activity, may be very helpful for selecting the appropriate antibiotic and dosage.
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Affiliation(s)
- H Etesse-Carsenti
- Service des Maladies Infectieuses, Hôpital de l'Archet, Nice, France
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50
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Durant J, Bernard E, Benhamou P, Bonifassi L, Carles M, Pradier C, Mondain V, De Salvador F, Johanson F, Chabert JM. Analysis of survival in 281 patients with AIDS in southern France. J Infect Dis 1991; 164:1028-9. [PMID: 1940459 DOI: 10.1093/infdis/164.5.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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