Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model.Methods: The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups wereconsidered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals,intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence dataobserved in the cohort between 2012 and 2015.Results: On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosedpatients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatmentcoverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalenceamong HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCVprevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalencein HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70%would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients wouldaccount for 34% of HCV infections in 2026.Conclusions: Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most riskgroups, including LR MSM. Elimination in HR MSM will require increased TC.
ISSN: 1741-7015

Droits : info:eu-repo/semantics/OpenAccess
inserm-01685739
http://www.hal.inserm.fr/inserm-01685739
http://www.hal.inserm.fr/inserm-01685739/document
http://www.hal.inserm.fr/inserm-01685739/file/2017%2C%20Virlogeux%20-%20Modeling%20HIV-HCV%20coinfection.pdf
DOI : 10.1186/s12916-017-0979-1

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Diagnosis of toxoplasmic encephalitis (TE) in patients with AIDS is not straightforward because clinicians rely initially on an empiric diagnosis based on clinical and radiographic improvement to specific anti-Toxoplasma gondii therapy. There is therefore a need for biological tools to improve the diagnosis of TE, especially in tropical areas where this diagnosis is likely to be underestimated. The use of PCR testing in blood samples for the diagnosis of TE has been limited by its poor sensitivity in the studies conducted in Europe. In tropical South America, the results of PCR sensitivity in blood samples were controversial. Considering that T. gondii strains from tropical South America have substantial genetic and pathogenic differences with those from USA and Europe, it is therefore important to re-evaluate the performance of the PCR assay in blood samples for the diagnosis of TE in AIDS patients from this region. Our results showed that the only interest of PCR would be in the most severe forms of TE with altered consciousness because PCR is more likely to be positive. We also provided important genotyping data on T. gondii strains isolated in human cases of toxoplasmosis in the Caribbean and in South America.
ISSN: 1935-2727

hal-01503761
https://hal-unilim.archives-ouvertes.fr/hal-01503761
https://hal-unilim.archives-ouvertes.fr/hal-01503761/document
https://hal-unilim.archives-ouvertes.fr/hal-01503761/file/journal.pntd.0004790.pdf
DOI : 10.1371/journal.pntd.0004790

Éditeur(s) : HAL CCSD American Society of Hematology
Résumé : International audience
Zika fever is an Aedes-borne disease caused by a flavivirus (Zika virus, ZIKV, genus Flavivirus). During the past years ZIKV spread in Polynesia, South-America and the Caribbean. Most ZIKV infections are asymptomatic or result in mild febrile disease with rash and conjunctivitis. Attention was recently drawn to non-vectored ZIKV transmission, including sexual, probable blood-borne and mother-to-fetus transmission, and to severe forms such as Guillain-Barré syndrome, acute neurological infections and fetal abnormalities (including microcephaly). Many aspects of Zika fever natural history remain unknown, e.g. the proportion of asymptomatic cases and the duration of viremia. Estimating the prevalence of Zika infections is difficult because a large proportion of infected individuals do not seek medical attention and seroprevalence studies are hampered by antigenic cross-reactivity with other flaviviruses, e.g. dengue virus. Here, we present a study of ZIKV infection in blooddonors from Martinique island (French West Indies, Caribbean region), with novel epidemiological, biological and clinical information that refine the picture of Zika fever in adults.
ISSN: 0006-4971

inserm-01415646
http://www.hal.inserm.fr/inserm-01415646
http://www.hal.inserm.fr/inserm-01415646/document
http://www.hal.inserm.fr/inserm-01415646/file/2016%2C%20Gallian%20et%20al%20-%20Zika%20virus%20in%20asymptomatic%20blood%20donors%2C%20Martinique%20%281%29.pdf
DOI : 10.1182/blood-2016-09-737981

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Cancer is the main complication of transplantation surgery. The literature concerning renal transplant recipients among the Afro-Caribbean population is scant. The aim of this study was to determine the incidence of cancer in these patients, with the secondary objective being to identify predisposing factors for cancer. This was an epidemiological and retrospective study that included all Guadeloupians of phototype V-VI undergoing renal transplantation from 01/01/2004 to 31/12/2011. Skin cancer screening was performed before transplantation and during an annual dermatological consultation following transplantation. Screening for non-cutaneous cancers was guided by clinical symptoms or by the results of the screening examinations recommended in the current guidelines. At the study time-point (31/12/2011), all patients were examined by a dermatologist. One hundred and two patients were included : 42 women and 60 men (mean age: 52.1±11.6 years at transplantation). Eight cancers were diagnosed. The cumulative incidence of cancer was 7.8% at 3 years. Three factors were associated with more rapid onset of cancer: personal history or familial history of cancer, and genital lesion induced by HPV. Our results suggest a low incidence of cancer in Afro-Caribbean renal transplant patients. Personal or family history of cancer and HPV-induced genital lesions would appear to accelerate the onset of cancer in this population.
ISSN: 0151-9638

hal-01260468
https://hal.archives-ouvertes.fr/hal-01260468
https://hal.archives-ouvertes.fr/hal-01260468/document
https://hal.archives-ouvertes.fr/hal-01260468/file/2015%2C%20Ameline.pdf
https://hal.archives-ouvertes.fr/hal-01260468/file/14%20148%20Fig%201%20ap.pdf

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
ObjectivesTo compare the efficacy, in current clinical practice, of ă first regimens containing abacavir with lamivudine (ABC/3TC) or ă tenofovir with emtricitabine (TDF/FTC) in patients with baseline viral ă load 100000 HIV-1 RNA copies/mL. ă MethodsUsing a prospective cohort, we selected all patients starting a ă first HIV regimen based either on ABC/3TC or on TDF/FTC. The propensity ă score (PS) method was used to limit the indication bias due to the ă observational nature of the data. Adjusting and weighting methods via PS ă were used to compare the effectiveness of a first regimen containing ă ABC/3TC or TDF/FTC. The primary outcome was treatment failure by month ă 12 (M12). ă ResultsOverall, 2781 patients started an antiretroviral (ARV) regimen ă with ABC/3TC or TDF/FTC each in combination with efavirenz, boosted ă atazanavir or boosted darunavir. Among the 2472 uncensored patients ă before M12, 962 (39%) had a baseline viral load 100000 copies/mL of ă whom 294 were in treatment failure at or before M12. Our analyses showed ă no difference between ABC/3TC and TDF/FTC in the risk of treatment ă failure at M12 in patients starting an ARV regimen with a high viral ă load (100000 copies/mL). ă ConclusionsUsing a large prospectively collected cohort of patients ă seeking care in France, we found no evidence that ABC/3TC based regimens ă led to more failures than TDF/FTC based ones in patients with high ă baseline viral loads.
ISSN: 1464-2662

hal-01482656
https://hal.archives-ouvertes.fr/hal-01482656
DOI : 10.1111/hiv.12306

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
The aim of the study was to investigate the impact of first-line combined antiretroviral therapy (cART) regimen on the course of CD8 + T-cell counts in human immunodeficiency virus (HIV)-infected patients. A retrospective observational study conducted on the French DAT'AIDS Cohort of HIV-infected patients. We selected 605 patients initiating a first-line cART between 2002 and 2009, and which achieved a sustained undetectable HIV plasma viral load (pVL) for at least 12 months without cART modification. The evolution of CD8 + T-cell counts according to cART regimen was assessed. CD8 + T-cell counts were assessed in 572 patients treated with 2NRTIs+1PI/r (n= 297), 2NRTIs+1NNRTI (n= 207) and 3NRTIs (n= 68). In multivariate analysis, after 12 months of follow-up, the 3NRTIs regimen was associated with a significantly smaller decrease of CD8 + T-cell count compared with NNRTI-containing regimens (–10.2 cells/mL in 3NRTIs vs –105.1 cells/mL; P=0.02) but not compared with PI-containing regimens (10.2 vs –60.9 cells/mL; P=0.21). After 24 months, the 3NRTIs regimen was associated with a smaller decrease of CD8 + T-cell count and % compared with PI/r-and NNRTI-containing regimens (0.2 in 3NRTIs vs –9.9 with PI/r-regimens, P=0.001, and vs –11.1 with NNRTI-regimens, p < 0.0001). A focus analysis on 11 patients treated with an INSTI-containing cART regimen during the study period showed after 12 months of follow-up, a median decrease of CD8 + T-cell count of –155 [inter quartile range: –302; –22] cells/mL. Our data highlight the fact that cART regimens have differential effects on CD8 pool down regulation. Abbreviations: cART = combined antiretroviral therapy, HIV = human immunodeficiency virus, INSTI = integrase strand transfer inhibitor, NNRTI = non-nucleotide reverse transcriptase inhibitor, NRTI = nucleotide reverse transcriptase inhibitor, PI/r = Ritonavir-boosted protease inhibitor, pVL = plasma viral load.
ISSN: 0025-7974

inserm-01408002
http://www.hal.inserm.fr/inserm-01408002
http://www.hal.inserm.fr/inserm-01408002/document
http://www.hal.inserm.fr/inserm-01408002/file/2016%2C%20Poizot-Martin%20-%20First-line%20cART%20regimen%20impacts%20the%20course%20of%20CD8%2B%20T-cell%20counts%20in%20HIV-infected%20patients.pdf
DOI : 10.1097/MD.0000000000005087

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
MR and MDHD contributed equally to this work. Summary Painful vaso-occlusive crisis, a hallmark of sickle cell anaemia, results from complex, incompletely understood mechanisms. Red blood cell (RBC) damage caused by continuous endogenous and exogenous oxidative stress may precipitate the occurrence of vaso-occlusive crises. In order to gain insight into the relevance of oxidative stress in vaso-occlusive crisis occurrence , we prospectively compared the expression levels of various oxidative markers in 32 adults with sickle cell anaemia during vaso-occlusive crisis and steady-state conditions. Compared to steady-state condition, plasma levels of free haem, advanced oxidation protein products and myeloperoxi-dase, RBC caspase-3 activity, as well as the concentrations of total, neutrophil-and RBC-derived microparticles were increased during vaso-occlusive crises, whereas the reduced glutathione content was decreased in RBCs. In addition, natural anti-band 3 autoantibodies levels decreased during crisis and were negatively correlated with the rise in plasma advanced oxidation protein products and RBC caspase-3 activity. These data showed an exacerbation of the oxidative stress during vaso-occlusive crises in sickle cell anaemia patients and strongly suggest that the higher concentration of harmful circulating RBC-derived microparticles and the reduced anti-band 3 autoantibodies levels may be both related to the recruitment of oxidized band 3 into membrane aggregates.
ISSN: 0007-1048

inserm-01476067
http://www.hal.inserm.fr/inserm-01476067
http://www.hal.inserm.fr/inserm-01476067/document
http://www.hal.inserm.fr/inserm-01476067/file/2016%2C%20Hierso%20-%20Exacerbation%20of%20oxidative%20stress%20during%20sickle%20vaso-occlusive%20crisis.pdf
DOI : 10.1111/bjh.14476

Éditeur(s) : HAL CCSD Cambridge University Press (CUP)
Résumé : International audience
Cervical cancer is the second most frequent cancer in women in French Guiana. Studies have shown that populations living in the remote areas of the interior have early sexual debut and that multiple sexual partnerships are common. The objective of the present study was thus to determine the prevalence of human papillomavirus (HPV) infection in these areas. A study was conducted in women aged 20-65 years with previous sexual activity. Women were included on a voluntary basis after using local media and leaders to inform them of the visit of the team. HPV infection was defined by the detection of HPV DNA using the Greiner Bio-One kit. In addition to HPV testing cytology was performed. The overall age-standardized prevalence rate was 35%. There was a U-shaped evolution of HPV prevalence by age with women aged >50 years at highest risk for HPV, followed by the 20-29 years group. Twenty-seven percent of women with a positive HPV test had normal cytology. Given the high incidence of cervical cancer in French Guiana and the high prevalence of HPV infections the present results re-emphasize the need for screening for cervical cancer in these remote areas. Vaccination against HPV, preferably with a nonavalent vaccine, also seems an important prevention measure. However, in this region where a large portion of the population has no health insurance, this still represents a challenge.
ISSN: 0950-2688

inserm-01476015
http://www.hal.inserm.fr/inserm-01476015
http://www.hal.inserm.fr/inserm-01476015/document
http://www.hal.inserm.fr/inserm-01476015/file/High%20prevalence%20HPV%20infection%20in%20women%20living%20in%20the%20remote%20territories%20of%20French%20Guiana%20STD.pdf
http://www.hal.inserm.fr/inserm-01476015/file/Table%203.pdf

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction La leptospirose est une zoonose de répartition mondiale avec une incidence en augmentation. Elle représente un problème de santé publique en zone tropicale. L’objectif de notre étude était de faire un état des lieux de la leptospirose en Guyane Française afin d’en améliorer la prise en charge.
17es Journées Nationales d’Infectiologie
Lille, France

Droits : info:eu-repo/semantics/OpenAccess
inserm-01410984
http://www.hal.inserm.fr/inserm-01410984
http://www.hal.inserm.fr/inserm-01410984/document
http://www.hal.inserm.fr/inserm-01410984/file/2016%2C%20Le%20Turnier%20-%20PADS%202-07.pdf
PUBMED : 27495624

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Hemorheological abnormalities have been well characterized in sickle cell disease (SCD) and seem to modulate the clinical severity [1]. For instance, increased blood viscosity raises the risk for frequent vaso-occlusive crisis (VOC) and increased red blood cell (RBC) aggregates robustness (i.e., RBC disaggregation threshold) enhances the risks for acute chest syndrome (ACS) [2]. Moreover, patients with the most rigid RBCs are characterized by high hemolytic rate, which increases the risks to develop leg ulcers or glomerulopathy [3]. However, except few studies supporting an effect of alpha-thalassemia and oxidative stress [1] on RBC rheological properties of SCD patients, very few experiments focused on the genetic and cellular factors modulating blood rheology in this disease.
ISSN: 1079-9796

hal-01263890
https://hal.archives-ouvertes.fr/hal-01263890
https://hal.archives-ouvertes.fr/hal-01263890/document
https://hal.archives-ouvertes.fr/hal-01263890/file/Ferdinand%20et%20al.%20eNOS%20and%20RBC%20rheology%20in%20SCD_BCMD.pdf
PUBMED : 26142331

Éditeur(s) : HAL CCSD
Résumé : International audience
Résumé :Introduction : Les départements Français d’Amérique sont à la fois parmi les territoiresfrançais les plus affectés par le VIH et parmi les territoires français les plus impactés par laconsommation de crack. L’épidémie de VIH en Guyane est une épidémie concentrée quitouche plus spécifiquement certains groupes vulnérables. Parmi ces groupes, les usagers decrack sont particulièrement touchés.Matériel et Méthodes : Une étude a été réalisée simultanément dans les trois départements en2012 dans le but de décrire les connaissances, les attitudes et les pratiques vis-à-vis du VIH etdes IST chez les usagers de crack. Au total 640 personnes ont été interrogées. La méthoded’échantillonnage utilisée était non probabiliste et combinait un échantillonnage deconvenance dans les associations recevant ce public (75% de l’échantillon), et unéchantillonnage en boule de neige en dehors afin d’atteindre les personnes ne fréquentant pasles structures (25% de l’échantillon).Résultats : Un tiers des personnes n’utilisait pas systématiquement le préservatif avec lespartenaires occasionnels (36,2%) ou avec les partenaires commerciaux (32,3%), et 64%n’utilisaient pas le préservatif à chaque fois avec les partenaires réguliers. Différents facteursprédictifs de la non utilisation du préservatif ont été identifiés selon le type de partenaire àl’aide d’un modèle log-binomial. Parmi les différents facteurs repérés, deux étaient communsà chaque type de partenaire : la perception élevée de son risque face au VIH et le fait de nepas se sentir à l’aise pour persuader un partenaire à utiliser le préservatif.Discussion : Dans un contexte de multipartenariat, de violences sexuelles fréquentes et dedépistage insuffisant du VIH, la non utilisation systématique du préservatif peut avoir unimpact non négligeable dans la diffusion de l’épidémie. Bien que la non utilisation dupréservatif soit sensiblement inférieure à ce que l’on retrouve dans la littérature, cesproportions traduisent un réel problème.La capacité à persuader un partenaire sexuel à utiliser un préservatif était négativementcorrélée avec la non utilisation du préservatif quel que soit le type de partenaire. Ainsi, ilsemble que lorsque les personnes se sentaient capables de négocier l'utilisation du préservatif,elles l’utilisaient de manière plus systématique. La capacité personnelle perçue est souventconsidérée comme un levier important pour adapter les comportements de santé. Or, elle peutêtre affectée dans des situations de stigmatisation, d’addiction ou de relation violente. Cesrésultats soulignent l’importance d’interventions spécifiques de prévention parmi les usagersde crack et notamment des interventions visant à améliorer le sentiment d’efficacitépersonnelle (perceived self-efficacy) et d’estime de soi.
Colloque ATHS Biarritz
Biarritz, France

inserm-01621896
http://www.hal.inserm.fr/inserm-01621896
http://www.hal.inserm.fr/inserm-01621896/document
http://www.hal.inserm.fr/inserm-01621896/file/2017%2C%20Parriault%20-%20Comportements%20sexuels%20%C3%A0%20risque%20%26%20crack.pdf

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Background: Squamous cell carcinoma (SCC) is considered the most frequent skin cancer in black people. Its incidence is not known in the Afro-Caribbean population.Objective: To assess the incidence of SCC in Guadeloupe, the largest island of the Lesser Antilles (405 000 inhabitants, mostly black people of African and European descent). The second objective was to characterize clinical and histological patterns of SCC occurring in the Afro-Caribbean community.Methods: This retrospective study was conducted over an 11-year period (2000-2010). Data regarding 723 histological confirmed cases of SCC identified using the three Guadeloupean pathology laboratories computerized databases were retrieved from the records of 551 patients. Private practice dermatologists and general practitioners were contacted to obtain any missing data. Results: The annual age-adjusted incidence of SCC was 15 per 100.000 residents in Guadeloupe. In the Afro-Caribbean community, SCC had a greater size (i.e.: 2.8±2.8 cm versus 1.5±1.0 cm, p<0.001), was more often located on the anogenital area (i.e. :48/79-60.8% versus 14/320-4.4%, p<0.001) in association with an underlying dermatosis due to HPV infection (15/71- 21.1% versus 3/366, 0.8%, p<0.001) and led more frequently to metastasis (13/84-15.5% versus 10/366-2.7%, p<0.001) and/or fatal evolution (11/83-13.3% versus 7/365-1.9%, p<0.001). Conclusions: The results of this original study, which first estimated the incidence of SCC in West Indies, suggest that anogenital examination should be routinely performed in skin cancer screening of Afro-Caribbean people in order to detect the presence of SCC at an early stage.
ISSN: 0926-9959

inserm-01513116
http://www.hal.inserm.fr/inserm-01513116
http://www.hal.inserm.fr/inserm-01513116/document
http://www.hal.inserm.fr/inserm-01513116/file/2017%2C%20Cordel%20-%20Squamous%20cell%20carcinoma%20in%20the%20Afro-Caribbean%20community.pdf
http://www.hal.inserm.fr/inserm-01513116/file/CordeletalJ%20Eur%20Acad%20Dermatol%20Venereol2017.pdf

Éditeur(s) : HAL CCSD SAGE Publications
Résumé : International audience
The French overseas territories in the Americas are the French territories most affected by HIV. Crack cocaine users are particularly impacted. The objective of this study was to describe sexual risk behaviors and inconsistent condom use among crack cocaine users. A total of 640 crack cocaine users were interviewed. The sampling method was non-probabilistic. An anonymous standardized questionnaire of 110 questions was used. Over a third of persons did not use condoms systematically with casual sex partners (36.2%) or commercial sex partners (32.3%), and 64% did not use condoms systematically with regular sex partners. In a context of multiple sexual partnerships, frequent forced sex, and insufficient HIV testing, the lack of systematic condom use may favor the spread of HIV. Different predictive factors of inconsistent condom use were identified, depending on the type of partner, with a log binomial regression. However, among the predictor variables identified, two predictive factors frequently occur among the different type of sex partners: high perceived risk of HIV and self-perceived capacity to persuade a sex partner to use condom. These results pointed towards interventions improving access to rights and raising perceived self-efficacy.
ISSN: 0956-4624

inserm-01566193
http://www.hal.inserm.fr/inserm-01566193
http://www.hal.inserm.fr/inserm-01566193/document
http://www.hal.inserm.fr/inserm-01566193/file/2017%2C%20Parriault%20-%20Sexual%20risk%20behaviors.pdf
DOI : 10.1097/COH.0b013e3283536ab2

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction-objectifsBien que la prise en charge de personnes vivant avec le VIH (PVVIH) s’améliore globalement en Guyane, les disparités régionales et communautaires restent importantes. L’objectif est ici de décrire pour la première fois les caractéristiques épidémiologiques, spatiales et cliniques des PVVIH suivies en zones isolées. Matériels et MéthodesLes données présentées sont issues du suivi clinique réalisé en Centres Délocalisés de Prévention et de Soins (CDPS) de janvier 2014 à novembre 2015. Ces données ont été analysées et comparées aux données des PVVIH suivis dans les 3 centres hospitaliers de Guyane issues du logiciel Nadis®.Résultats 174 PVVIH ont étés pris en charge en CDPS et comparés à 2143 patients suivis sur le littoral. L’évolution du taux annuel de découvertes de séropositivité VIH montre une arrivée plus tardive mais particulièrement active en zones isolées par rapport au littoral, notamment chez les patients d’origine brésilienne (p<0,005). L’âge médian est de 43,8 ans, le sex ratio homme/femme est de 0,98. En zone isolées comme sur le littoral 1/3 des PVVIH sont dépistés tardivement (<200 CD4/mm3). Le succès virologiques après 6 mois de traitement est de 80% vs 88% sur le littoral (p=0,135), la moyenne des derniers CD4 (424 vs 569/mm3) est plus basse que sur le littoral (p<0,005) enfin la charge virale moyenne est plus élevée que sur le littoral (8960 vs 5317 copies /mL) (p<0,005). L’histoplasmose est la première cause d’infection opportuniste retrouvée. La répartition spatiale des patients suivis montre une incidence et prévalence de cas particulièrement élevée dans les villes frontalières charnières que constituent Maripasoula et Saint Georges de l’Oyapock. ConclusionLe caractère particulièrement actif et original de l’épidémie et les indicateurs de suivi moins bons que sur le littoral rappellent l’importance de compléter les moyens de la prise en charge des PVVIH en zones isolées en Guyane.
SFLS 2016 - XVIIème Congrès de la Société française de lutte contre le sida
Montpellier, France

inserm-01475954
http://www.hal.inserm.fr/inserm-01475954
http://www.hal.inserm.fr/inserm-01475954/document
http://www.hal.inserm.fr/inserm-01475954/file/2016%2C%20Mosnier%20-%20Les%20p%C3%A9riph%C3%A9ries%20de%20l%27%C3%A9pid%C3%A9mie%20de%20VIH%20en%20Guyane.pdf

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND:In French Guiana, cervical cancer is the second most frequent cancer in females. The objective of the present study was to describe the prevalence of HPV infections in women with normal cervical cytology living in the remote villages of French Guiana.METHODS:Before the study, the study team communicated in the remote villages on the importance of screening. All women from the target population were offered to participate. They signed informed consent during inclusion and then had a concomitant HPV-test and cervical smear. Only women with normal cytology and a good quality smear were analyzed. The detection of HPV-DNA was performed using the GREINER-BIO-ONE kit.RESULTS:Overall, 27.2% of women with normal cervical cytology had a positive HPV-test. There was a U-shaped evolution of prevalence with women over 50 years having the highest HPV prevalence, followed by the 20 to 29 years group. The most prevalent HPV genotypes were HPV 53(3.52%), 68(3.33%), 52(2.59%), 31(2.22%) and 16 (1.85%). The proportion of HPV 16 among HPV-infected women was 6.8%.CONCLUSIONS:HPV prevalence in cytologically normal women was very high. The most prevalent genotypes were very different from what is usually described in the world, and notably in South America.
ISSN: 1471-2458

pasteur-01583545
https://hal-riip.archives-ouvertes.fr/pasteur-01583545
https://hal-riip.archives-ouvertes.fr/pasteur-01583545/document
https://hal-riip.archives-ouvertes.fr/pasteur-01583545/file/2017%20Adenis%20et%20al.BMC%20Public%20Health.pdf
DOI : 10.1056/NEJMoa0808516

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
INTRODUCTION:The frequency, the clinical characteristics, and the prognosis of dengue is highly variable. Dengue fever is associated with a range of neurological manifestations. The objective of the present study was to determine the incidence of neurological signs and their predictive factors using data from cases of dengue seen and followed in Cayenne Hospital during the Dengue 2 epidemic in 2013.METHODS:In 2013, a longitudinal study using data from all cases of dengue seen in Cayenne hospital was collected. Medical records used a standardized form to collect demographic information, clinical signs and biological results and the date at which they were present. The analysis used Cox proportional modeling to obtain adjusted Hazard ratios.RESULTS:A total of 1574 patients were included 221 of whom developed central nervous system signs. These signs were spontaneously resolutive. There were 9298person days of follow-up and the overall incidence rate for central nervous system signs was 2.37 per 100 person-days. The variables independently associated with central nervous system anomalies were headache, Adjusted Hazard ratio (AHR) = 1.9(95%CI = 1.4-2.6), bleeding AHR = 2 ((95%CI = 1.3-3.1), P = 0.001, abdominal pain AHR = 1.9 ((95%CI = 1.4-2.6), P<0.001, aches AHR = 2.1 ((95%CI = 1.5-2.9), P<0.001, and fatigue AHR = 1.5 ((95%CI = 1.3-1.7), P<0.001.DISCUSSION:Overall, the present study suggests that neurological signs of dengue are not exceptional even in patients without the most severe features of dengue. These manifestations were spontaneously resolutive. Here it was not possible to distinguish between encephalitis or encephalopathy. Further studies would require more in depth exploration of the patients.
ISSN: 1932-6203

inserm-01421218
http://www.hal.inserm.fr/inserm-01421218
http://www.hal.inserm.fr/inserm-01421218/document
http://www.hal.inserm.fr/inserm-01421218/file/2016%2C%20Djossou%20-%20Incidence%20and%20Predictive%20Factors%20of%20Central%20Nervous%20System%20Dysfunction%20in%20Patients%20Consulting.pdf
DOI : 10.1371/journal.pone.0150828.t003

Éditeur(s) : HAL CCSD Masson
Résumé : International audience
In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for 3-years period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%).Although the methodological difference did not allow comparisons with mainland France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers implemented in French Guiana since 2012.
ISSN: 0037-9085

hal-01260391
https://hal.archives-ouvertes.fr/hal-01260391
https://hal.archives-ouvertes.fr/hal-01260391/document
https://hal.archives-ouvertes.fr/hal-01260391/file/2015%2C%20Douine%20-%20Servical%20cancer.pdf

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Background: The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors. Methods: In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N). Results: There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of trans-aminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST.1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST .10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake. Conclusions: Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol.
ISSN: 0035-9203

inserm-01475594
http://www.hal.inserm.fr/inserm-01475594
http://www.hal.inserm.fr/inserm-01475594/document
http://www.hal.inserm.fr/inserm-01475594/file/2016%2C%20Djossou%20-%20Incidence%20and%20predictive%20factors%20of%20transaminase.pdf
DOI : 10.1093/trstmh/trv117

Éditeur(s) : HAL CCSD European Centre for Disease Prevention and Control
Résumé : International audience
In 2002, the French Food Safety Agency drew attention to the lack of information on the prevalence of human cryptosporidiosis in the country. Two years later, the ANOFEL Cryptosporidium National Network (ACNN) was set up to provide public health authorities with data on the incidence and epidemiology of human cryptosporidiosis in France. Constituted on a voluntary basis, ACNN includes 38 hospital parasitology laboratories (mainly in university hospitals). Each laboratory is engaged to notify new cases of confirmed human cryptosporidiosis, store specimens (e.g. stools, duodenal aspirates or biopsies) and related clinical and epidemiological data, using data sheet forms. From January 2006 to December 2009, 407 cryptosporidiosis cases were notified in France and 364 specimens were collected. Of the notified cases, 74 were children under four years of age, accounting for 18.2%. HIV-infected and immunocompetent patients represented 38.6% (n=157) and 28% (n=114) of cases, respectively. A marked seasonal pattern was observed each year, with increased number of cases in mid to late summer and the beginning of autumn. Genotyping of 345 isolates from 310 patients identified C. parvumin 168 (54.2%) cases, C. hominis in 113 (36.4%) and other species in 29 (9.4%), including C. felis (n=15), C. meleagridis (n=4), C. canis (n=4), Cryptosporidium chipmunk genotype (n=1), Cryptosporidium rabbit genotype (n=1) and new Cryptosporidium genotypes (n=4). These data represent the first multisite report of laboratory-confirmed cases of cryptosporidiosis in France.
ISSN: 1560-7917

hal-00926813
https://hal-unilim.archives-ouvertes.fr/hal-00926813
PUBMED : 20739000

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction Le chikungunya (CHIKV) est un alphavirus ré-émergent depuis 10 ans responsable de nombreuses épidémies. Chez certains patients, il est à l'origine de troubles musculo-squelettiques et de polyarthropathies inva-lidants et persistants plus de 3 mois, définissant la forme chronique du chikun-gunya (CHIKC). Afin de déterminer la prévalence du CHIKC, nous avons mené une cohorte prospective de patients ambulatoires lors de la dernière épi-démie en outre-mer. Secondairement, nous avons recherché les facteurs de risques associés.
Médecine et maladies infectieuses 46 (2016) 15-16
Lille, France

inserm-01413489
http://www.hal.inserm.fr/inserm-01413489
http://www.hal.inserm.fr/inserm-01413489/document
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01%20%281%29.pdf
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01.pdf