Publications by authors named "Blanche S"

Background: No study has compared the virological and immunological status of young people with perinatally-acquired HIV infection (P-HIV) with that of people with HIV adulthood (A-HIV) having a similar duration of infection.

Methods: 5 French cohorts of P-HIV and A-HIV patients with a known date of HIV-infection and receiving antiretroviral treatment (ART), were used to compare the following proportions of: virological failure (VF) defined as plasma HIV RNA ≥ 50 copies/mL, CD4 cell percentages and CD4:CD8 ratios, at the time of the most recent visit since 2012. The analysis was stratified on time since infection, and multivariate models were adjusted for demographics and treatment history.

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The burden of CMV infection and disease is important in pediatric hematopoietic stem cell transplantation (HSCT), notably in the subgroup of patients with inborn errors of immunity (IEIs). Letermovir (LMV) is now a standard of care for CMV prophylaxis in adult sero-positive (R+) recipients, but is not yet labeled for children. Published pediatric studies are still scarce.

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Objectives: Although widely recommended, data on bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) efficacy in HIV-1-infected children/adolescents are mainly extrapolated from studies in adults and one paediatric trial in which subjects have good treatment adherence. This study aimed to provide data about the risk of virological failure (VF) and acquired genotypic resistance in children and adolescents receiving BIC/FTC/TAF in a real-world setting.

Methods: This retrospective monocentric study included 74 paediatric patients who received BIC/FTC/TAF during ≥6 months in 2019-2023.

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Background: Primary immunodeficiencies (PID) are a heterogeneous group of rare inborn immunity defects. As management has greatly improved, morbidity and mortality are reduced in this population, while our knowledge on pregnancy's unfolding and outcome remains scarce.

Objective: We conducted a retrospective monocentric study to study pregnancy outcomes in women with PID.

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Article Synopsis
  • Aicardi-Goutières syndrome (AGS) is an immune-mediated disorder primarily affecting the nervous system, and conventional treatments are largely ineffective.
  • A study on JAK1/2 inhibitors showed significant improvement in systemic symptoms of AGS over a median follow-up of 17 months, although neurological benefits were less clear.
  • The findings highlight the need for better treatment strategies for AGS's neurological symptoms, emphasizing early diagnosis and potential intrathecal drug delivery for improved outcomes.
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  • Metagenomic next-generation sequencing (mNGS) was utilized to study patients with primary or secondary immune deficiencies (PIDs and SIDs) who exhibited immunopathological issues.
  • The study involved 30 symptomatic and 59 asymptomatic patients, with mNGS revealing Aichi virus (AiV) in tissue from some infected patients, confirming the potential link between AiV and immunodysregulation.
  • Results showed that AiV was associated with significant clinical symptoms, including multiorgan involvement, and symptoms improved after treatment, supporting the idea that AiV may be a causal factor in these patients.
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  • X-linked chronic granulomatous disease (CGD) causes serious infections because the body can't fight germs properly.
  • A gene therapy trial was done on four patients, where two showed good results while the other two had problems with treatment working.
  • Scientists found that the patients who struggled had fewer important cells (HSCs) and specific gene changes that could explain why the treatment didn't work, suggesting new ways to help these patients.
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  • Allogenic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) are potential cures for severe combined immunodeficiency (SCID), but patients often face late-onset issues like persistent hepatitis.
  • A study of SCID patients revealed that 11 out of 44 experienced persistent hepatitis linked to chronic enteric viral infections, particularly enteric viruses not found in non-hepatitis SCID patients.
  • Treatments like retransplantation or gene therapy showed promise, as 5 patients achieved remission of hepatitis and viral clearance, highlighting the importance of addressing immune dysregulation in these patients.
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Mucopolysaccharidosis type I-H (MPS I-H) is a rare lysosomal storage disorder caused by α-L-Iduronidase deficiency. Early haematopoietic stem cell transplantation (HSCT) is the sole available therapeutic option to preserve neurocognitive functions. We report long-term follow-up (median 9 years, interquartile range 8-16.

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Effectiveness of anti-HIV in the prevention of perinatal transmission has been established. Assessing the tolerance of drug exposure during pregnancy is of the utmost importance given the number of children exposed. HIV integrase and the recombinase-activating gene enzyme involved in the establishment of the T-lymphocyte repertoire show structural similarity.

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Allogeneic hematopoietic stem cell transplantation (alloSCT) is curative for severe inborn errors of immunity (IEIs), with recent data suggesting alloSCT in adulthood is safe and effective in selected patients. However, questions remain regarding the indications for and optimal timing of transplant. We retrospectively compared outcomes of transplanted vs matched nontransplanted adults with severe IEIs.

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Article Synopsis
  • Long-term multilineage hematopoietic donor chimerism is a rare occurrence in patients receiving solid organ transplants, particularly those from lymphoid-rich organs like the intestine or liver.
  • Unlike other organs, there has been no evidence of kidney-resident hematopoietic stem cells in mammals, but new findings suggest they may exist.
  • A case study of a pediatric kidney transplant recipient indicates that these kidney-derived stem cells can reside in bone marrow long-term, ultimately replacing the host's stem cells and achieving full donor chimerism in blood lineages.
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Epstein-Barr virus (EBV) can infect smooth muscle cells causing smooth muscle tumors (SMTs) or leiomyoma. Here, we report a patient with a heterozygous 22q11.2 deletion/DiGeorge syndrome who developed a unique, broad, and lethal susceptibility to EBV characterized by EBV-infected T and B cells and disseminated EBV+SMT.

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Objectives: Increased weight gain with dolutegravir use is increasingly scrutinized in adults, but published data in paediatrics are limited and conflicting. This study aimed to provide long-term data about changes in body mass index (BMI) in French children (aged 3-9 years) and adolescents (aged 10-17 years) receiving dolutegravir.

Patients And Methods: This retrospective monocentric study included 97 subjects who received a dolutegravir-based regimen for ≥12 months in 2014-2021.

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Severe combined immunodeficiencies (SCIDs) correspond to the most severe form of primary immunodeficiency. Allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy are curative treatments, depending on the donor's availability and molecular diagnostics. A partially human leukocyte antigen (HLA)-compatible donor used has been developed for this specific HSCT indication in the absence of a matched donor.

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In the ANRS French Perinatal Cohort, we compared outcomes in 830 HIV1-exposed infants who received either nevirapine (NVP) or zidovudine postnatal prophylaxis. At 1 month, anemia grade ≥2 was less frequent on NVP than zidovudine (2.9% vs.

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Sickle cell disease (SCD) and transfusion-dependent β-thalassemia (TDT) are the most prevalent monogenic disorders worldwide. Trial HGB-205 ( NCT02151526 ) aimed at evaluating gene therapy by autologous CD34 cells transduced ex vivo with lentiviral vector BB305 that encodes the anti-sickling β-globin expressed in the erythroid lineage. HGB-205 is a phase 1/2, open-label, single-arm, non-randomized interventional study of 2-year duration at a single center, followed by observation in long-term follow-up studies LTF-303 ( NCT02633943 ) and LTF-307 ( NCT04628585 ) for TDT and SCD, respectively.

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Background: There is no gold standard for tuberculosis diagnosis in children. Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children were proposed by international experts in 2012 and updated in 2015. We aimed to compare the 2012 and 2015 Clinical Case Definitions in HIV-infected children with suspected tuberculosis.

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Background: Hematopoietic stem cell transplantation (HSCT) represents a curative treatment for patients with severe combined immunodeficiency (SCID), a group of monogenic immune disorders with an otherwise fatal outcome.

Objective: We performed a comprehensive multicenter analysis of genotype-specific HSCT outcome, including detailed analysis of immune reconstitution (IR) and the predictive value for clinical outcome.

Methods: HSCT outcome was studied in 338 patients with genetically confirmed SCID who underwent transplantation in 2006-2014 and who were registered in the SCETIDE registry.

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Objectives: Although widely recommended, data about dolutegravir efficacy in HIV-1-infected children/adolescents are scarce, limited to short-term follow-up and mainly extrapolated from studies in adults with good adherence to treatment. This study aimed to provide long-term data about the risk of virological failure (VF) and acquired genotypic resistance in children and adolescents receiving dolutegravir.

Methods: This retrospective monocentric study included 134 paediatric patients who received a dolutegravir-based regimen for ≥ 12 months in 2014-2020.

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Background: Early combined antiretroviral therapy (cART) limits the total HIV-DNA load in children. However, data on its impact in older children and adolescents remain scarce. This study compares HIV reservoirs in children (5-12 years) and adolescents (13-17 years) who started cART <6 months (early [E-] group) or >2 years (late [L-] group).

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Among 143 patients with elastase, neutrophil-expressed (ELANE)-related neutropenia enrolled in the French Severe Chronic Neutropenia Registry, 94 were classified as having severe chronic neutropenia (SCN) and 49 with cyclic neutropenia (CyN). Their infectious episodes were classified as severe, mild or oral, and analysed according to their natural occurrence without granulocyte-colony stimulating factor (G-CSF), on G-CSF, after myelodysplasia/acute leukaemia or after haematopoietic stem-cell transplantation. During the disease's natural history period (without G-CSF; 1913 person-years), 302, 957 and 754 severe, mild and oral infectious events, respectively, occurred.

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