Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: End-Stage renal disease (ESRD) causes considerable morbidity and mortality, and significantly alterspatients’ quality of life. There are very few published data on this problem in the French Overseas territories. Thedevelopment of a registry on end stage renal disease in French Guiana in 2011 allowed to describe the magnitudeof this problem in the region for the first time.Methods: Using data from the French Renal Epidemiology and Information Network registry (R.E.I.N). Descriptivestatistics on quantitative and qualitative variables in the registry were performed on prevalent cases and incidentcases in 2011, 2012 and 2013.Results: French Guiana has one of the highest ESRD prevalence and incidence in France. The two main causes ofESRD were hypertensive and diabetic nephropathies. The French Guianese population had a different demographicprofile (younger, more women, more migrants) than in mainland France. Most patients had at least one comorbidity,predominantly (95.3%) hypertension. In French Guiana dialysis was initiated in emergency for 71.3% of patients versus33% in France (p < 0.001).Conclusion: These first results give important public health information: i) End stage renal disease has a very highprevalence relative to mainland France ii) Patients have a different demographic profile and enter care late in thecourse of their renal disease. These data are closer to what is observed in the Caribbean or in Latin America than inMainland France.
ISSN: 1471-2369

inserm-01567222
http://www.hal.inserm.fr/inserm-01567222
http://www.hal.inserm.fr/inserm-01567222/document
http://www.hal.inserm.fr/inserm-01567222/file/2017%2C%20Rochemont%20-%20End%20stage%20renal%20disease.pdf
DOI : 10.1186/s12882-017-0614-6

Éditeur(s) : HAL CCSD MDPI
Résumé : International audience
Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. We investigated the association between congenital anomalies and mothers' exposure to air pollution during pregnancy by combining risk estimates for a variety of air pollutants (SO2, NO2, PM10, PM2.5, CO and O3) and anomaly defect outcomes. Seventeen articles were included in the systematic review and thirteen studies were taken into account in the meta-analysis. Combined estimated were calculated separately according to whether the exposure metric was continuous or categorical. Only one significant combination was; NO2 concentrations were significantly associated with coarctation of the aorta (OR = 1.20 per 10 ppb, 95% CI, (1.02, 1.41)). This finding could stem from strong heterogeneity in study designs. Improved exposure assessment methods, in particular more accurate spatial measurements or modeling, standardized definition of cases and of better control of confounders are highly recommended for future congenital anomalies research in this area.
ISSN: 1660-4601

hal-01118609
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118609
PUBMED : 25089772
DOI : 10.3390/ijerph110807642
PUBMEDCENTRAL : PMC4143824

Éditeur(s) : HAL CCSD
Résumé : International audience
Reports on dengue morbidity in patients with sickle cell disease (SCD) are scarce. Dengue is arthropod-borne viroses due to dengue virus (DENV) and affects populations with a high prevalence of SCD; therefore, the risk of morbidity may be increased.To determine the impact of dengue infection in SCD patients, we reviewed medical records during a vast outbreak of dengue virus serotype-2 (DENV-2) in French Guiana in 2012-2013. We identified 10 cases of laboratory-confirmed dengue infection;these were classified into A, B and C categories based on levels of severity of dengue according to World Health Organisation (WHO). The average age of SCD patients was 18.2 years. 1, 6 and 3 cases were classified as A, B and C WHO severity criteria, respectively. All patients had an important decrease in haematocrit (while one of the WHO severity criteria is the increase of haematocrit). Only one patient had decreased platelet count. Seven cases had vaso-occlusive crisis (VOC), six patients developed acute hepatitis and eight had a simultaneous bacterial infection. Six of them needed a blood transfusion. The results suggested that the WHO severity laboratory criteria of hemoconcentration and platelet counts were not helpful in themanagement of SCD patients. The morbidity was mainly caused by specific complications of SCD, especially VOC, likely facilitated by vascular endothelial damages consecutive to dengue fever, severe haemolysis, hepatitis and bacterial co-infections.
Journal of Virology and Retrovirology

Droits : info:eu-repo/semantics/OpenAccess
inserm-01419456
http://www.hal.inserm.fr/inserm-01419456
http://www.hal.inserm.fr/inserm-01419456/document
http://www.hal.inserm.fr/inserm-01419456/file/2015%2C%20Mosnier%20-%20Dengue%20infection%20in%20sickle%20cell%20patients%20in%20French%20Guiana.pdf

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Cytomegalovirus (CMV) infection is common among HIV-infected patients but its repercussion on the course of CD4+ and CD8+ T cells after cART initiation remains elusive. The French Dat'AIDS cohort enrolled 5,688 patients on first-line cART, from which we selected patients who achieved HIV suppression for at least 12 months without modification of cART, and for whom CMV serostatus was available. Five hundred and three patients fulfilled the selection criteria (74% male, median age 43 yrs, 15.5% CDC stage C), of whom 444 (88.3%) were seropositive for CMV (CMV+). Multivariate analyses using mixed-linear models adjusted for the time from HIV suppression, sex, age, transmission risk group, duration of HIV follow-up, the interaction between time from HIV suppression and CMV+ serol-ogy, and the nadir CD4 count revealed a negative correlation between CMV+ and CD4: CD8 ratio (coeff. =-0.16; p = 0.001). This correlation was also observed among patients displaying optimal CD4 recovery (!500 cells/mm3 at M12; coeff. =-0.24; p = 0.002). Hence, CMV+ serostatus antagonizes normalization of the CD4:CD8 ratio, although further analyses of the impact of co-morbidities that associate with CMV serostatus, like HCV infection, are needed to elucidate this antagonism formally. However, this might reflect a premature T cell senescence, thus advocating for a close monitoring of T cells in CMV co-infected patients. In addition, our results raise the question of the benefit of treatment for asymptomatic CMV co-infection in HIV-infected patients.
ISSN: 1932-6203

inserm-01418700
http://www.hal.inserm.fr/inserm-01418700
http://www.hal.inserm.fr/inserm-01418700/document
http://www.hal.inserm.fr/inserm-01418700/file/journal.pone.0165774.PDF
DOI : 10.1371/journal.pone.0165774