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Couffignal C, Kolta S, Flamant M, Cazanave C, Haymann JP, Mentré F, Duval X, Leport C, Raffi F, Chêne G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vézinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Hardel L, Reboud P, Couffin-Cadiergues S, Marchand L, Assuied A, Carrieri P, Habak S, Couturier F, Jadand C, Perrier A, Préau M, Protopopescu C, Schmit J, Chennebault J, Faller J, Magy-Bertrand N, Chirouze C, Humbert P, Longy-Boursier, Neau D, Granier P, Ansart S, Verdon R, Merrien D, Chevojon P, Sobel A, Levy Y, Piroth L, Perronne C, Froguel E, Ceccaldi J, Chidiac C, Grégoire V, Reynes J, Fuzibet JG, Arsac P, Bouvet E, Bricaire F, Monsonego J, Girard P, Guillevin L, Herson S, Molina J, Pialoux G, Sain O, Sellier P, Roblot F, Bani-Sadr F, Michelet C, Lucht F, Debord C, Martin T, De Jaureguiberry J, Bernard L. Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy. AIDS Res Hum Retroviruses 2020; 36:399-405. [PMID: 31891665 DOI: 10.1089/aid.2019.0229] [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] [Indexed: 11/13/2022] Open
Abstract
We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm3. Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score (p = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.
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Affiliation(s)
- Camille Couffignal
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Sami Kolta
- Department of Rheumatology, University Hospital Cochin, Assistance Publique–Hôpitaux de Paris, INSERM UMR-1153, Paris, France
| | - Martin Flamant
- Department of Physiology, University Hospital Bichat, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Charles Cazanave
- Infectious Diseases Department, University Hospital Bordeaux, Bordeaux, France
| | - Jean-Philippe Haymann
- Department of Physiology, University Hospital Tenon, and INSERM UMR_S1155, Paris, France
| | - France Mentré
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Xavier Duval
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, and INSERM CIC1425, Paris, France
| | - Catherine Leport
- Unité COREB (Coordination du Risque Epidémique et Biologique), Assistance Publique–Hôpitaux de Paris, Paris, France
| | - François Raffi
- Infectious Diseases Department, University Hospital Hotel-Dieu, and INSERM CIC 1413, University of Nantes, Nantes, France
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Monsonego J, Zerat L, Syrjänen K, Zerat J, Smith J, Halfon P. Prévalence des génotypes d’HPV chez les femmes en France : implications pour le dépistage et la vaccination. ACTA ACUST UNITED AC 2013; 41:305-13. [DOI: 10.1016/j.gyobfe.2013.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 10/23/2012] [Indexed: 10/26/2022]
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Monsonego J. [HPV testing and cervical cancer screening. Evidences, resistances and current practices]. Gynecol Obstet Fertil 2012; 40:269-272. [PMID: 22521159 DOI: 10.1016/j.gyobfe.2012.02.014] [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] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Indexed: 05/31/2023]
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Monsonego J, Cortés J, Pereira da Silva D, Jorge AF, Klein P. [Perception and psychological impact of an abnormal Pap smear. Results of a comparative European survey]. Gynecol Obstet Fertil 2012; 40:213-218. [PMID: 22153154 DOI: 10.1016/j.gyobfe.2011.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 04/14/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The availability of information on HPV and Pap tests has increased dramatically with the introduction of national HPV vaccination programs. But data on the effectiveness of this information is limited. However, our desire is to reduce patient anxiety and promote better delivery of information. PATIENTS AND METHODS Therefore a questionnaire-based cohort study was conducted to investigate women's experience with the announcement of an abnormal Pap smear result, then the ensuing events, as well as their practitioner's management. This article focuses on the French experience, underpinned by comparative data with Spain and Portugal. RESULTS It shows that, face with stress reactions and patient's anxiety, the level of information from the medical profession is still seen as inadequate, while the Internet as an information source has its limitations and dangers. The close entourage is most relied on, which supports the need for better public information. DISCUSSION AND CONCLUSION Uniformity and standardization of information strategies is not yet on European time.
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Affiliation(s)
- J Monsonego
- Institute of the Cervix, 174, rue de Courcelles, 75017 Paris, France.
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Abstract
This report addresses several areas including the progress made toward global implementation of currently licensed human papillomavirus (HPV) vaccines, and monitoring impact of HPV vaccination programs that can be implemented within developed and less-developed countries. For the sake of completeness, a short update on the evolution of HPV testing in primary screening programs at present and after HPV vaccine introduction has also been included.
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Castellsagué X, Muñoz N, Pitisuttithum P, Ferris D, Monsonego J, Ault K, Luna J, Myers E, Mallary S, Bautista OM, Bryan J, Vuocolo S, Haupt RM, Saah A. End-of-study safety, immunogenicity, and efficacy of quadrivalent HPV (types 6, 11, 16, 18) recombinant vaccine in adult women 24-45 years of age. Br J Cancer 2011; 105:28-37. [PMID: 21629249 PMCID: PMC3137403 DOI: 10.1038/bjc.2011.185] [Citation(s) in RCA: 232] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 04/18/2011] [Accepted: 04/26/2011] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Previous analyses from a randomised trial in women aged 24-45 years have shown the quadrivalent human papillomavirus (qHPV) vaccine to be efficacious in the prevention of infection, cervical intraepithelial neoplasia (CIN), and external genital lesions (EGLs) related to HPV 6/11/16/18. In this report, we present end-of-study efficacy, safety, and immunogenicity data with a median follow-up time of 4.0 years. METHODS We enrolled 3819 24-45-year-old women with no history of cervical disease or genital warts in the past 5 years. Women received quadrivalent vaccine or placebo at day 1, and at months 2 and 6. Ascertainment of CIN/EGL was accomplished through Pap testing, genital inspection, and cervicovaginal sampling (every 6 months). The main analysis was conducted in a per-protocol efficacy population (that received three doses, was naive to the relevant HPV types at day 1, and remained free of infection through month 7). Efficacy was also estimated in other naive and non-naive populations. RESULTS Vaccine efficacy against the combined incidence of persistent infection, CIN/EGL related to HPV6/11/16/18 in the per-protocol population was 88.7% (95% CI: 78.1, 94.8). Efficacy for women who were seropositive and DNA negative for the relevant vaccine HPV type at the time of enrolment who received at least 1 dose was 66.9% (95% CI: 4.3, 90.6). At month 48, 91.5, 92.0, 97.4, and 47.9% of vaccinated women were seropositive to HPV 6/11/16/18, respectively. No serious vaccine-related adverse experiences were reported. CONCLUSIONS The qHPV vaccine demonstrated high efficacy, immunogenicity, and acceptable safety in women aged 24-45 years, regardless of previous exposure to HPV vaccine type.
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Affiliation(s)
- X Castellsagué
- Unit of Infections and Cancer, Cancer Epidemiology Research Program, IDIBELL, Institut Català d'Oncologia-ICO, CIBER-ESP, L'Hospitalet de Llobregat, Catalonia 08907, Spain.
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Masquelier B, Taieb A, Reigadas S, Marchou B, Cheneau C, Spire B, Charpentier C, Leport C, Raffi F, Chene G, Descamps D, Leport C, Raffi F, Chene G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vezinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Duval X, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Reboud P, Couffin-Cadiergues S, Marchand L, Bouteloup V, Bouhnik AD, Brunet-Francois C, Caron V, Carrieri MP, Courcoul M, Couturier F, Hardel L, Iordache L, Kurkdji P, Martiren S, Preau M, Protopopescu C, Surzyn J, Taieb A, Villes V, Schmit JL, Chennebault JM, Faller JP, Mgy-Bertrand N, Hoen B, Drobachef, Bouchaud O, Dupon M, Longy-Boursier, Morlat P, Ragnaud JM, Granier P, Garre M, Verdon R, Merrien D, Devidas A, Sobel A, Piroth L, Perronne C, Froguel E, Ceccaldi J, Peyramond D, Allard C, Reynes J, May T, Raffi F, Fuzibet JG, Dellamonica P, Arsac P, Bouvet E, Bricaire F, Bergmann P, Cabane J, Monsonego J, Girard PM, Guillevin L, Herson S, Leport C, Meyohas MC, Molina JM, Pialoux G, Salmon D, Roblot P, Jaussaud R, Michelet C, Lucht F, Debord T, Rey D, De Jaureguiberry JP, Marchou B, Bernard L. Cellular HIV-1 DNA quantification and short-term and long-term response to antiretroviral therapy. J Antimicrob Chemother 2011; 66:1582-9. [DOI: 10.1093/jac/dkr153] [Citation(s) in RCA: 10] [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] [Indexed: 12/20/2022] Open
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Monsonego J, Cortes J, Greppe C, Hampl M, Joura E, Singer A. Benefits of vaccinating young adult women with a prophylactic quadrivalent human papillomavirus (types 6, 11, 16 and 18) vaccine. Vaccine 2010; 28:8065-72. [PMID: 20971114 DOI: 10.1016/j.vaccine.2010.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 09/07/2010] [Accepted: 10/07/2010] [Indexed: 10/18/2022]
Abstract
Cervical cancer is a leading cause of cancer-related deaths worldwide. The causal role of human papillomavirus (HPV) infection in the pathogenesis of cervical cancer has prompted the development of vaccines against HPV. The highest risk of HPV infection is in women aged 16-25 years. Almost all young adult women can benefit from HPV vaccination. There is strong epidemiological and clinical support for vaccination programmes that target sexually active women in this age group to prevent HPV infection, and thus avert the development of HPV-related disease. Furthermore, the implementation of HPV vaccination programmes may benefit the development or awareness of cervical cancer prevention strategies and ultimately reduce the burden of cervical cancer and improve cervical cancer control.
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Affiliation(s)
- J Monsonego
- Institute of the Cervix, Federation Mutualiste Parisienne, 174 Rue de Courcelles, 75017 Paris, France.
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Monsonego J. Current direction in the prevention of cervical cancer. EUR J GYNAECOL ONCOL 2007; 28:433-434. [PMID: 18179131] [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: 05/25/2023]
Abstract
Cervical screening seems to benefit a minor part of the world female population, and yet women who benefit from it still prove its weaknesses. The fact that these genital lesions are the consequence of a chronic genital infection with HPV opens new and extraordinary opportunities for prevention through vaccination. The highest efficacy is demonstrated in young women naive to the virus types associated with the vaccines. The effectiveness of HPV vaccines are limited by two factors: all genital cancers and precancerous lesions are not induced exclusively by HPV types 16 and 18, and the optimal benefit is demonstrated in adolescents and young women before they have encountered these viruses. Vaccination and screening act complementarily and synergistically, and constitute to date the new standards of disease prevention.
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Monsonego J, Pintos J, Semaille C, Beumont M, Dachez R, Zerat L, Bianchi A, Franco E. Human papillomavirus testing improves the accuracy of colposcopy in detection of cervical intraepithelial neoplasia. Int J Gynecol Cancer 2006; 16:591-8. [PMID: 16681731 DOI: 10.1111/j.1525-1438.2006.00361.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 11/26/2022] Open
Abstract
To assess the performance of human papillomavirus (HPV) testing and colposcopy in detection of cervical pathology. A series of 389 women referred for colposcopy due to an abnormal Pap smear had cervical swabs analyzed for oncogenic (high-risk [HR]) HPV types using Hybrid Capture II (HC2) assay. Loop electrical excision procedure cone biopsy (88%) or colposcopic biopsy (11%) was used as the gold standard. Of the atypical squamous cells of undetermined significance (ASCUS) smears, 48% were positive for HR HPV, as compared to 76.3% of low-grade squamous intraepithelial lesions (LSIL) smears. HR HPV was detected in 66.7% and 90% of patients with cervical intraepithelial neoplasia (CIN) 1 and CIN2 (or higher), respectively. The sensitivity of the Pap smear using an ASCUS threshold in detecting high-grade CIN was 94.5% (95% confidence intervals (CI): 91-97%) and that of colposcopy 98.5% (95% CI: 95-99%). The respective specificities were 30% (95% CI: 17-28%) and 35.6% (CI: 29-42%). HC2 test had comparable sensitivity, 90% (95% CI: 85-93%), but higher specificity, 54.3% (95% CI: 47-61%). Combining HC2 test with Pap increased specificity, 66.7% and 41.3% for ASCUS and LSIL cutoff, respectively. The minor-abnormality threshold together with HC2 increased specificity of colposcopy with no changes in sensitivity. High viral load (>100 relative light unit/positive control) was associated with significant disease. HPV DNA testing improves the accuracy of colposcopy in the detection of high-grade CIN in women with ASCUS or LSIL smears.
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Halioua B, Bohbot JM, Monfort L, Nassar N, de Barbeyrac B, Monsonego J, Sednaoui P. Ano-rectal lymphogranuloma venereum: 22 cases reported in a sexually transmited infections center in Paris. Eur J Dermatol 2006; 16:177-80. [PMID: 16581572] [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] [Accepted: 12/16/2005] [Indexed: 05/08/2023]
Abstract
In January 2004 the European Surveillance of Sexually Transmitted Infections Network (ESSTI) issued an international alert regarding an outbreak of Lymphogranuloma venereum (LGV) in Rotterdam in a sexual network of men who have sex with men (MSM). Further to this alert, a retrospective survey was set up by the Institut de Veille Sanitaire and the reference laboratories for N.gonorrhoeae and Chlamydia in France. Our STI clinic in Paris carried out a clinico-biological retrospective study involving 154 MSM screened for anorectal sexually transmitted infections (STIs) between January 2002 and May 2004 and a prospective study between May 2004 and August 2004. Out of 216 swabs of rectal discharge from homosexual or bisexual males, a total of 32 were positive for C. trachomatis (14.8%) (3 patients in 2002, 11 in 2003 and 18 in 2004). C. trachomatis-positive rectal strains were genotyped to detect the specific C. trachomatis serovars and revealed serovars L(2) for 22 patients (respectively 1 in 2002, 9 in 2003 and 12 in 2004). Serum antibody titers for Chlamydia trachomatis were determined among 14 subjects and revealed strongly positive in 13 cases (1/512 to 1/16384) titers of IgG. These 22 patients with clinico-biologically confirmed anorectal lymphogranuloma venereum (ARLGV) were all homosexual men. They ranged from 28 to 52 years (mean age 39.2 years). 12 of 21 (57.1%) subjects with an ARLGV diagnosis were seropositive for human immunodeficiency virus (HIV) (one not done). Although rare, anorectal lymphogranuloma venereum (ARLGV) still exists in France and should not be forgotten in the differential diagnosis of rectal problems in male homosexuals.
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Affiliation(s)
- B Halioua
- Institut Alfred Fournier, Paris, France.
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Monsonego J. New prevention strategies of HPV infection and cervical cancer. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80705-5] [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: 11/24/2022]
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Monsonego J. [Assessment of human papilloma virus (HPV) testing in primary screening for cervical cancer in France (May 2004). Gynecol Obstet Fertil 2005;33:357-360]. Gynecol Obstet Fertil 2005; 33:952-5. [PMID: 16243571 DOI: 10.1016/j.gyobfe.2005.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Flahault A, Monsonego J, Sultan S, Vernay C, Duru G, Vainchtock A, Decuypere L, Aractingi S. C5 - Fréquence et prise en charge des condylomes acuminés externes en consultation libérale ou hospitalière et dans les dispensaires anti-vénériens (DAV), en France. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79626-5] [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: 10/15/2022]
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Monsonego J. HPV infections and cervical cancer prevention. Priorities and new directions. Highlights of EUROGIN 2004 International Expert Meeting, Nice, France, October 21–23, 2004. Gynecol Oncol 2005; 96:830-9. [PMID: 15721433 DOI: 10.1016/j.ygyno.2004.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2004] [Indexed: 11/17/2022]
Affiliation(s)
- J Monsonego
- EUROGIN, 174 rue de Courcelles, 75017 Paris, France.
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Abstract
The indications for colposcopy have changed recently because of the new Bethesda terminology, the introduction of HPV testing in clinical practice, and the latest consensus guidelines on management of patients with an abnormal cervical cytological test. Colposcopy remains the reference technique to assess patients with abnormal cytological test results, especially those with ASC-H, LSIL, HSIL, and AGC. In women with an ASC-US result, colposcopic examination of only those who test positive for high-risk HPV increases the specificity of the technique. When liquid-based cytology is used, HPV DNA testing is the preferred approach in these women. In primary screening using combined cytology and HPV DNA testing in women over the age of 30, colposcopy is indicated in patients with normal cytology and two HR HPV DNA positive tests performed at a nine month interval. For the follow up of untreated patients with ASC-US/LSIL and CIN I, colposcopy carried out at one year after a single HR HPV DNA positive test is as sensitive as colposcopy after two or three abnormal cytology tests. After excision or conization in patients with high-grade CIN, colposcopy after a single HR HPV DNA positive test is as sensitive as cytology testing and colposcopy at six months. Therapeutic decisions must not be based solely on the results of HPV DNA testing except in specific cases.
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Affiliation(s)
- J Monsonego
- Département de colposcopie, institut Alfred-Fournier, Paris, France.
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Lafuma A, Monsonego J, Moyal-Barracco M, Pribil C. [A model-based comparison of cost effectiveness of imiquimod versus podophyllotoxin for the treatment of external anogenital warts in France]. Ann Dermatol Venereol 2003; 130:731-6. [PMID: 14576602] [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: 04/27/2023]
Abstract
OBJECTIVES For the National health scheme, to compare the costs and the efficacy of treatment of external anogenital warts with imiquimod and podophyllotoxin and laser therapy in the case of failure or relapse. PATIENTS AND METHODS A model simulating the two successive treatments was built. In the first phase, the two topical treatments applied by the patients: podophyllotoxin for 4 weeks and imiquimod for 16 weeks were compared. In the case of failure or relapse, laser therapy that is widely used in France in this indication and, was applied. The efficacy of the topical treatments was assessed after reanalysis of the results of two controlled clinical trials versus placebo. These two trials were retained because they were comparable in method and had been recently published at the same time. A review of the literature assessed the results of laser therapy. A survey was conducted to collect the medical resources consumed by the different treatments. RESULTS Imiquimod provided a clearance rate of 49.5 p. 100, i.e., the disappearance of the lesions at 16 weeks, greater than that of podophyllotoxin (28.3 p. 100) at 4 weeks. The relapse rate was lowest with imiquimod (13.3 p. 100) than with podophyllotoxin (30.9 p. 100). The remission rate without relapse 3 months after the end of treatment was, including the laser, of 62 p. 100 following imiquimod and of 47 p. 100 following podophyllotoxin. The costs per patient cured was of 668 Euros for imiquimod and of 689 Euros for podophyllotoxin. CONCLUSION Imiquimod, because of its greater initial efficacy, is at least as cost-effective as podophyllotoxin the treatment of external genital warts.
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Monsonego J. EUROGIN 2003 Conference. Facts, figures and impact. EUR J GYNAECOL ONCOL 2003; 23:487-90. [PMID: 12556088] [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] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Monsonego J. EUROGIN 2003 Conference. Facts, figures and impact. Paris, Cité des Sciences--April 13-16, 2003. CLIN EXP OBSTET GYN 2003; 29:163-6. [PMID: 12519034] [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] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Monsonego J. [Metaplasia and high grade CIN. Diagnostic difficulties. Gynécol Obstét Fertil 2002; 30: 845-849]. Gynecol Obstet Fertil 2003; 31:317-8; author reply 319-20. [PMID: 12770814 DOI: 10.1016/s1297-9589(03)00053-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Patnick J, Monsonego J, de Wolf C, Verbeek A, Bonte J, Agnantis N, De Oliveira CF, Dexeus S, Maggino T, Onnis A, Zielinski J. ESGO consensus document on cervical cancer screening. European Society of Gynaecological Oncology. EUR J GYNAECOL ONCOL 2002; 22:99-101. [PMID: 11446489] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Monsonego J. Global challenges of cervical cancer prevention. CLIN EXP OBSTET GYN 2001; 28:5-13. [PMID: 11332590] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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26
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Monsonego J. Global challenges of cervical cancer prevention. EUR J GYNAECOL ONCOL 2001; 21:533-9. [PMID: 11214605] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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27
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Monsonego J, Autillo-Touati A, Bergeron C, Dachez R, Liaras J, Saurel J, Zerat L, Chatelain P, Mottot C. Liquid-based cytology for primary cervical cancer screening: a multi-centre study. Br J Cancer 2001; 84:360-6. [PMID: 11161401 PMCID: PMC2363733 DOI: 10.1054/bjoc.2000.1588] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The aim of this six-centre, split-sample study was to compare ThinPrep fluid-based cytology to the conventional Papanicolaou smear. Six cytopathology laboratories and 35 gynaecologists participated. 5428 patients met the inclusion criteria (age > 18 years old, intact cervix, informed consent). Each cervical sample was used first to prepare a conventional Pap smear, then the sampling device was rinsed into a PreservCyt vial, and a ThinPrep slide was made. Screening of slide pairs was blinded (n = 5428). All non-negative concordant cases (n = 101), all non-concordant cases (n = 206), and a 5% random sample of concordant negative cases (n = 272) underwent review by one independent pathologist then by the panel of 6 investigators. Initial (blinded) screening results for ThinPrep and conventional smears were correlated. Initial diagnoses were correlated with consensus cytological diagnoses. Differences in disease detection were evaluated using McNemar's test. On initial screening, 29% more ASCUS cases and 39% more low-grade squamous intraepithelial lesions (LSIL) and more severe lesions (LSIL+) were detected on the ThinPrep slides than on the conventional smears (P = 0.001), including 50% more LSIL and 18% more high-grade SIL (HSIL). The ASCUS:SIL ratio was lower for the ThinPrep method (115:132 = 0.87:1) than for the conventional smear method (89:94 = 0.95:1). The same trend was observed for the ASCUS/AGUS:LSIL ratio. Independent and consensus review confirmed 145 LSIL+ diagnoses; of these, 18% more had been detected initially on the ThinPrep slides than on the conventional smears (P = 0.041). The ThinPrep Pap Test is more accurate than the conventional Pap test and has the potential to optimize the effectiveness of primary cervical cancer screening.
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Affiliation(s)
- J Monsonego
- Institut Alfred Fournier, 25 boulevard Saint Jacques, Paris, 75014, France
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28
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May-Levin F, Clavel F, Monsonego J, Tristant H, Levy L. [Techniques and methods in public health applied in oncology]. Bull Cancer 2001; 88:23-34. [PMID: 11182650] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- F May-Levin
- Ligue nationale contre le cancer, 1, avenue Stephen-Pichon, 75013 Paris
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29
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Monsonego J, Semaille C. Local anesthesia of genital mucosa with a lidocaine/prilocaine combination cream before laser therapy of human papillomavirus lesions. Eur J Dermatol 2000; 10:607-10. [PMID: 11125322] [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: 02/18/2023]
Abstract
The objective was to assess the efficacy of the lidocaine 2. 5%/prilocaine 2.5% combination cream during CO2 laser vaporisation treatment of human papillomavirus-related anogenital lesions. The cream was applied 1 to 30 min beforehand. Patients assessed pain using a visual analogue scale. Regardless of the site and lesion surface area, anaesthesia was greatest when the cream was applied 5 to 15 min before treatment. Extra-cervical lesions (vagina, vulva, perineum, anus) were globally less painful than cervical lesions. Lesion surface area is a decisive factor in pre-operative anaesthesia. Small surface-area lesions (< 1 cm2) had significantly greater anaesthesia than larger surface area-lesions (> 5 cm2) (p<0.00001). The study cream proved particularly useful for complete anaesthesia in ambulatory treatment of anal (70%) and urethral (60%) mucosa lesions compared to the uterine cervix (p = 0.03). In terms of anaesthetic efficacy and cost-related benefits, the lidocaine/prilocaine cream is an effective and interesting alternative to locoregional intra-lesional anaesthesia or even to general anaesthesia, for excision and destruction of human papillomavirus-related anogenital lesions.
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Affiliation(s)
- J Monsonego
- Department of Colposcopy, Institut Alfred-Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France.
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30
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Bourgault Villada I, Bénéton N, Bony C, Connan F, Monsonego J, Bianchi A, Saiag P, Lévy JP, Guillet JG, Choppin J. Identification in humans of HPV-16 E6 and E7 protein epitopes recognized by cytolytic T lymphocytes in association with HLA-B18 and determination of the HLA-B18-specific binding motif. Eur J Immunol 2000; 30:2281-9. [PMID: 10940919 DOI: 10.1002/1521-4141(2000)30:8<2281::aid-immu2281>3.0.co;2-n] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [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: 11/09/2022]
Abstract
Human papilloma virus type 16 (HPV-16) is the HPV most frequently associated with cervical carcinoma in humans. For the prevention or treatment of cervical carcinoma, the E6 and E7 oncoproteins appear to be good targets for vaccine-induced cytotoxic T lymphocytes (CTL). Lipopeptide vaccination is an efficient way of stimulating cellular responses. However, to synthesize effective lipopeptides, it is necessary to define which epitopes are immunogenic. In this study we first determined that peptide 80 - 88 of the E6 protein was recognized by CTL from a healthy donor in association with the HLA-B18 molecule. We then defined the HLA-B18 anchoring peptide motif by testing the binding of various short peptides with the HLA-B18 molecule and showed that it was related to the HLA-A1-specific peptide motif. Furthermore, in analyzing the potential E7 epitopes susceptible to associating with HLA-B18, we demonstrated that peptide E7 44 - 52 gave the strongest binding. It could also be recognized by CTL from peripheral blood mononuclear cells (PBMC) of the same healthy donor. Finally, with PBMC from a patient with a cervical intraepithelial neoplasia grade 3, we found CTL which recognized the E6 80 - 88 epitope. We have hence identified two peptides encoded by the E6 and E7 proteins which are presented by the HLA-B18 molecule and could be included in a vaccine against HPV-16.
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Affiliation(s)
- I Bourgault Villada
- Institut Cochin de Génétique Moléculaire, Laboratoire d'Immunologie des Pathologies Infectieuses et Tumorales, INSERM U445, Université René Descartes, Hôpital Cochin, Paris, France.
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31
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Monsonego J. Role of HPV Testing in Secondary and Primary Screening of Cervical Neoplasia. J Low Genit Tract Dis 2000; 4:108-113. [PMID: 25950898] [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] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the performance of HPV testing in identifying cervical neoplasia. MATERIALS AND METHODS Minor cytologic atypia of the uterine cervix, particularly atypical squamous cells of undetermined significance (ASCUS) represent a vast group, at least three times more frequent than cytologic high-grade squamous intraepithelial lesions (HGSIL). Even though, individually, ASCUS smears correspond to a normal cervix in nearly 80% of cases, their marked prevalence in the screened population suggests that this category of smear is one of the main sources of histologically confirmed high-grade SIL.The recent recommendations by the National Agency of Accreditation and Evaluation (ANAES) for managing ASCUS smears indicate that it is possible to advise a follow-up smear at regular intervals or immediate colposcopy. The follow-up smear option has limitations related to its incomplete sensitivity (25-40% of existing high-grade SIL can go unrecognized). Colposcopy has optimal sensitivity in recognizing high-grade lesions, but falls short due to lack of specificity.The Hybrid Capture (HC II) (Digene, Silver Spring, MD) test is an objective and reproducible test that makes it possible to detect nononcogenic and oncogenic types of human papillomavirus (HPV) and the DNA viral load, thereby increasing the probability that significant cervical lesions will not go unrecognized. RESULTS The Hybrid Capture test is simple to perform and positive results for high-risk HPV strongly correlate with the presence of high-grade CIN (sensitivity of approximately 98%). The test's nearly 100% negative predictive value makes it possibly to fully reassure patients who have had an ASCUS smear, freeing them from regular cytologic follow-up, colposcopy, and biopsy. A Hybrid Capture II test that is positive for oncogenic HPV significantly increases the probability of recognizing significant, precancerous cervical lesions. When the reference smear has been done in a liquid suspension, the Hybrid Capture test can be done on the residual cells in the suspension, thereby avoiding an additional visit. CONCLUSION Recent French and international evaluations and publications should encourage the ANAES task force to propose the HPV test as a possible option for managing smears with minor atypia.▪.
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Dachez R, Monsonego J. [Cervico-uterine cytology in liquid media: procedures and results of the ThinPrep Pap Test]. Gynecol Obstet Fertil 2000; 28:250-3. [PMID: 10786407] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- R Dachez
- LCL (Laboratoire Claude-Lévy), Département de pathologie, Ivry-sur-Seine, France
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33
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Monsonego J. Cervical cancer screening and management, new challenges. EUR J GYNAECOL ONCOL 1999; 20:352-4. [PMID: 10609492] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- J Monsonego
- Center of Screening and Prevention of Genital Cancer, Department of Colposcopy Institut Fournier, Paris, France
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34
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Monsonego J. [The HPV test and clinical practice]. Contracept Fertil Sex 1999; 27:811-5. [PMID: 10676036] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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35
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Monsonego J, Valensi P, Zerat L, Clavel C, Birembaut P. Simultaneous effects of aneuploidy and oncogenic human papillomavirus on histological grade of cervical intraepithelial neoplasia. Br J Obstet Gynaecol 1997; 104:723-7. [PMID: 9197877 DOI: 10.1111/j.1471-0528.1997.tb11984.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate whether ploidy and oncogenic human papillomavirus types can be correlated with the histological grade of cervical intraepithelial neoplasia (CIN) in the same tissue sections. DESIGN Histological data were obtained from 292 dysplastic lesions of the cervix and classified according to the CIN and the Bethesda terminologies. The samples were analysed using Feulgen-stained image analysis cytometry for ploidy and Human papillomaviruses DNA typing by in situ hybridisation, respectively. SETTING Colposcopy Clinic at Alfred Fournier Institute, Paris. POPULATION Three hundred and forty women referred for an abnormal cervical smear. RESULTS The ploidy data strongly segregate high grade from low grade squamous intraepithelial lesions (aneuploidy 78% versus 21%; P < 0.0001). There was a significant association between aneuploidy and the severity of the lesions (94% for CIN 3, 55% for CIN 2 and 14% for CIN 1; P < 0.0001). Both classifications showed a significant association of histological grade with oncogenic human papillomavirus types (HPV 16-18-33; 20% in low grade and 78% in high grade squamous intraepithelial lesions, 31% and 75% in CIN 1 and CIN 3, respectively; P < 0.0001). The simultaneous effects of these viruses and ploidy demonstrate an association in aneuploid cells between the presence of oncogenic human papillomavirus types and histological grade (76% and 18% in high and low grade squamous intraepithelial lesions, respectively; P < 0.0001). Such an association was not observed in diploid cells (20% in both low and high grade squamous intraepithelial lesions). CONCLUSIONS High risk human papillomavirus types do not exert and an independent effect on the histological grade of cervical intraepithelial neoplasia.
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Affiliation(s)
- J Monsonego
- Department of Cyto-colposcopic Screening, Alfred Fournier Institute, Paris, France
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36
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Monsonego J. [Screening for cancer of the cervix. New realistic and acceptable dispositions, but quality remains the necessary counterpart for smears every 3 years]. Presse Med 1997; 26:668-9. [PMID: 9180886] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- J Monsonego
- Département de Dépistage cytocolposcopique, Institut Alfred Foumier, Paris
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37
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Bianchi A, Dachez R, Pollini G, Monsonego J, Alonso JM. [Role of macrophages in papillomavirus infections]. Pathol Biol (Paris) 1997; 45:165-8. [PMID: 9247039] [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: 02/04/2023]
Abstract
Papillomaviruses have naturally a strict tropism to epithelial cells in which they replicate during the cell differentiation. There is no histological evidence of any inflammatory reaction. No leucocyte recruitment is observed and thus, the role of macrophages during the early infectious process in the epithelium remains unknown. This silent, subacute or chronic infectious disease is characterized fundamentally by a dual pathogenic process, including an infectious process leading to the production of infective virus particles during the differentiation of infected epithelial cells, on the one hand, and an oncogenic process due to interactions of viral oncogenes with host cell regulatory proteins after integration of the virus to the cellular genome. The role of activated macrophages on the oncogenic process is clearly established. They contribute to regulate negatively the transcription of the non structural E6 E7 viral oncogenes and have cytotoxic effects to transformed cells by a direct intercellular contact without evidence of an effect due to a soluble factor such as tumor-necrotizing factor (TNF). Macrophages have, hence, a prominent role as cellular effectors of protective immunity against lesions due to papillomaviruses and particularly against the oncogenic process complicating these infections.
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Affiliation(s)
- A Bianchi
- Institut Alfred Fournier, Paris, France
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Franco E, Syrjänen K, de Wolf C, Patnick J, Ferenczy A, McGoogan E, Bosch X, Singer A, Muñoz N, Meheus A, Monsonego J. New developments in cervical cancer screening and prevention. Geneva, Switzerland, June 17-19 1996. Workshop. Cancer Epidemiol Biomarkers Prev 1996; 5:853-6. [PMID: 8896898] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- E Franco
- McGill University, Montreal, Canada
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39
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Monsonego J. [Advantages and disadvantages of consensus conferences]. Contracept Fertil Sex 1996; 24:261. [PMID: 8704797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Monsonego J, Cessot G, Ince SE, Galazka AR, Abdul-Ahad AK. Randomised double-blind trial of recombinant interferon-beta for condyloma acuminatum. Genitourin Med 1996; 72:111-4. [PMID: 8698357 PMCID: PMC1195619 DOI: 10.1136/sti.72.2.111] [Citation(s) in RCA: 4] [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: 02/01/2023]
Abstract
OBJECTIVE To evaluate the safety and efficacy of two intralesional doses of recombinant human interferon-beta (r-hIFN-beta: Rebif, Ares Serono), given 3 times a week for 3 weeks, in the treatment of condyloma acuminatum. DESIGN A randomised, double-blind, within-patient, placebo-controlled study. SUBJECTS 25 patients (24 males, 1 female) with a history of condyloma acuminatum. Twenty had failed previous treatment for condyloma acuminatum. In each patient, 3 distinct lesions were selected for treatment. Each selected lesion was randomly assigned to receive intralesionally one of the following: r-hIFN-beta 33,000 IU/day, r-hIFN-beta 1 x 10(6) IU/day, or matching placebo. SETTING Institut Alfred Fournier, Paris, France. OUTCOME MEASURES Response was evaluated colposcopically at the end of treatment (day 22) and 5 weeks later (month 2). Complete response (CR) was defined as disappearance of the treated lesion. Partial response (PR) was defined as at least a 50% reduction in size, but not disappearance of the treated lesion. RESULTS The higher dose of 1 x 10(6) IU achieved significantly more complete and partial remissions than placebo, both by the end of treatment, and 5 weeks later. CONCLUSIONS r-hIFN-beta appears to be safe and effective when administered intralesionally to patients with condyloma acuminatum. Most of the treated patients had failed previous treatments and were therefore a resistant population.
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Barrasso R, Monsonego J. [Is cervical screening justified in adolescents?]. Contracept Fertil Sex 1996; 24:101-3. [PMID: 8611929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Monsonego J. [Cellular and molecular pathogenesis of cancer of the cervix]. Contracept Fertil Sex 1995; 23:731-40. [PMID: 8556072] [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: 01/31/2023]
Abstract
There is now substantial evidence that specific human papillomavirus (HPV) types are probably an etiological factor of cervical cancer and its precursors. Virus infection, viral genes expression emerge as necessary but not sufficient for the cells transformation. The E6-E7 oncoproteins of "high risk" (HPV 16-18) papillomaviruses bind specifically, and with high affinity, to cellular tumor suppressor gene products p53 and pRb, in contrast to "low risk" (HPV 6-11) types. This bond disturbs the cell cycle and results in chromosomal instability, aneuploidy and is the probably starting point of the integration of viral DNA to the host genome. These endogenous modifications are reported to the morphological and colposcopical events of cervical intraepithelial neoplasia and seem to be most important in the pathogenesis of cervical cancer precursors lesions and tumor progression.
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43
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Monsonego J. [Role of papillomaviruses in oncobiology of cancers of the cervix uteri and their precursors]. Presse Med 1993; 22:460-2. [PMID: 8390050] [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: 01/30/2023] Open
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Monsonego J, Zerat L, Catalan F, Coscas Y. Genital human papillomavirus infections: correlation of cytological, colposcopic and histological features with viral types in women and their male partners. Int J STD AIDS 1993; 4:13-20. [PMID: 8381304 DOI: 10.1177/095646249300400104] [Citation(s) in RCA: 20] [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: 01/30/2023]
Abstract
To determine the incidence of anogenital papillomavirus infections and to assess the value of available diagnostic methods, we compared the cytological, colposcopic and histological features of anogenital papillomavirus-related lesions with their associated human papillomavirus types (HPV) in 300 women and in their male partners. HPV-type deoxyribonucleic acid was detected by blot hybridization in 398 out of 624 subclinical and clinically defined anogenital lesions. Whatever the site of the lesion, condylomas and low-grade intraepithelial neoplasia (IEN) were found in 84% of lesions associated with HPV 6-11, compared with 32% of lesions containing HPV 16-18 (P < 0.001). Among the HPV 16-18 associated lesions, high-grade cervical, vaginal, vulvar and anal intraepithelial neoplasias represented 45% (P < 0.001) of the lesions. In 65% of 23 cases of squamous anogenital cancer, HPV 16-18 and mixed types were present (P < 0.001). In 54% (161/300) of cases, the lesions were multicentric (161/300). On cytological examination, 27% of the samples gave false negative results. In cervical lesions, there was a good correlation between virological and colposcopic findings, but this was not true for extracervical mucous epithelia in the vagina or on the vulva. With peniscopy in the male partners 220 out of 410 had penile condylomatous lesions and more than half of the 350 male specimens examined by molecular hybridization contained HPV DNA. A correlation was found between the virus types in penile lesions or in cells of the distal urethra and in the cervical lesions of the sexual partner.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Monsonego
- Département de Dépistage Cytocolposcopique, Institut Alfred Fournier, Paris, France
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45
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Clavel C, Zerat L, Binninger I, Boutterin MC, Polette M, Monsonego J, Birembaut P. DNA content measurement and in situ hybridization in condylomatous cervical lesions. Diagn Mol Pathol 1992; 1:180-4. [PMID: 1342964] [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: 12/26/2022]
Abstract
The present study reports results obtained with DNA ploidy measurement by Feulgen cytophotometry and in situ hybridization (ISH) on the same sections of 36 cervical lesions containing human papillomavirus (HPV) DNA. Fifteen of 16 low grade lesions [11 flat condylomas and five condylomatous with intraepithelial neoplasias (CIN)-1, 1 with condylomatous features] were diploid. "Oncogenic" HPV (types 16 and 33) were detected in three of these cases, while the aneuploid case expressed HPV type 11. By contrast, in the 12 CIN-2 and eight CIN-3 with condylomas, there was a good correlation between presence of an aneuploid DNA pattern and detection of "oncogenic" HPVs. Demonstration of an aneuploid profile and "oncogenic" HPV as found in all our CIN-3, may indicative of a poor prognosis in low grade lesions. Hence, the combination of the two techniques (ISH and Feulgen cytophotometry) may provide significant prognostic information for condylomas and CINs.
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Affiliation(s)
- C Clavel
- Laboratoire Pol Bouin, I.N.S.E.R.M.-U.314, Hôpital Maison Blanchè, Reims, France
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46
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Monsonego J, Magdelenat H, Catalan F, Coscas Y, Zerat L, Sastre X. Estrogen and progesterone receptors in cervical human papillomavirus related lesions. Int J Cancer 1991; 48:533-9. [PMID: 1646176 DOI: 10.1002/ijc.2910480410] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.7] [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: 12/28/2022]
Abstract
According to recent studies showing that human papillomavirus (HPV) infections can be influenced by sex steroid hormones, we performed estrogen (ER) and progesterone (PgR) receptor assays in fresh frozen biopsies of genital-HPV-related lesions. Seventy-three women with normal cervix, condyloma, low- and high-grade CIN and squamous carcinoma were evaluated in comparison with 15 persons with vulvar and 9 with penile papillomavirus-associated lesions. HPV genotypes were determined by dot-blot hybridization. Non-cervical lesions did not express HR. Condyloma on squamous metaplasia of the cervix and high-grade CIN expressed high levels of HR, particularly PgR (mean 4,086 and 4,518 fmoles/g tissue, respectively). Cervical squamous carcinoma expressed very low concentrations of PgR in a limited number of cases. High levels of PgR were correlated with high-grade CIN (p less than 0.05), HPV16-18-associated lesions (p less than 0.01) and ER were correlated to HPV6-11-related lesions (p less than 0.01). The levels were independent of age, cycle stage and oral contraception. Morphological localization of PgR, using an immunocytochemical method using a monoclonal antibody (MAb) (PR-ICA), showed intense homogeneous staining in the nuclei of the stromal fibroblasts underlying dysplastic epithelium and condyloma on squamous metaplasia. These results suggest that, under in vivo conditions, sex steroid hormones, particularly progesterone, may act indirectly on HPV-infected epithelial cells and be implicated as co-factors in HPV-related cervical neoplasia. They could explain the relative predisposition to malignant transformation of the cervix as compared with vulvar and penile mucosa.
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Affiliation(s)
- J Monsonego
- Institut Alfred Fournier, Département de dépistage cytocolposcopique, Paris, France
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47
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Monsonego J, Destable MD, De Saint Florent G, Amouroux J, Kouyoundjian JC, Haour F, Breau JL, Israel L, Comaru-Schally AM, Schally AV. Fibrocystic disease of the breast in premenopausal women: histohormonal correlation and response to luteinizing hormone releasing hormone analog treatment. Am J Obstet Gynecol 1991; 164:1181-9. [PMID: 1852100 DOI: 10.1016/0002-9378(91)90680-p] [Citation(s) in RCA: 11] [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: 12/29/2022]
Abstract
Sixty-six patients with fibrocystic mastopathy were enrolled in the trial after being selected according to clinical, radioultrasonographic, and histologic criteria. No characteristic hormonal profile was noted in most patients (52%). Estrogen receptors or progesterone receptors, or both, were found in 57% of patients. Hormone receptor levels were correlated with atypical proliferative mastopathy (87.5%). Mastopathy was associated with a uterine fibroma or a fibromatous uterus in 73% of cases. All patients received intramuscular injections of a sustained delivery system (microcapsules) of luteinizing hormone releasing hormone agonist [D-Trp6]-LHRH, Ipsen-Biotech, Paris) for 3 to 6 months. In case of partial response at 3 months, an antiestrogen (tamoxifen, 40 mg/day, for estrogen receptor-predominant lesions) or a progestin (cyproterone acetate, 50 mg/day, for progesterone receptor-predominant lesions) was added to the luteinizing hormone releasing hormone agonist. A complete response was observed in more than half of the patients (n = 35, 53%) treated by [D-Trp6]-LHRH alone (n = 29) or associated with tamoxifen (n = 4) or cyproterone acetate (n = 2). A significant partial response was observed in 30 other patients (45%). Additionally, half of them received inhibitory drugs. The best responses were seen with cyst reformation (complete response, 100%) and fibrous block. Clinical responses to treatment with [D-Trp6]-LHRH alone were independent of hormone receptor status, but synergistic effects occurred with concomitant use of the corresponding inhibitory drugs. We conclude that chronic mastopathy, particularly when associated with uterine fibroma, can be successfully treated by luteinizing hormone releasing hormone analogs in premenopausal women.
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Affiliation(s)
- J Monsonego
- Oncology Department, Centre Hospitalier Universitaire, Bobigny, France
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Reinharez D, Monsonego J. [Veins and contraception]. Contracept Fertil Sex (Paris) 1985; 13:131-6. [PMID: 12280199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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