Publications by authors named "Dominique Larrey"

Background: Hepatitis C virus genotype 5 (HCV-GT-5) is found mainly in South Africa. In our area in central France, the prevalence of HCV-GT-5 is 14%.

Methods And Results: Here we evaluated sustained virological response at week 12 post-treatment (SVR12) in 147 HCV-GT-5 patients from 14 French university hospitals (2014-2021) treated with direct-acting antivirals (DAA) in real-life.

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  • The study updates findings from the CREST study on the 8-week treatment of glecaprevir/pibrentasvir (GLE/PIB) for patients with chronic hepatitis C and compensated cirrhosis.
  • It analyzes 437 patients, showing a high sustained virologic response (SVR12) of 98.9%, especially among those with certain comorbidities and those on other medications.
  • The research highlights safety aspects, noting only a small percentage experienced adverse events, and emphasizes variations in healthcare resource use based on patients' employment status and drug use history.
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  • - This study investigates the severity and characteristics of checkpoint inhibitor-induced hepatitis, a significant side effect of cancer immunotherapy, focusing on patients with severe liver injury (grade 3 and 4) based on the Common Terminology Criteria for Adverse Events (CTCAE).
  • - A retrospective analysis of 100 patients revealed varying severity classifications and outcomes, indicating that the CTCAE may not effectively assess liver injury severity compared to hepatology-focused classification systems.
  • - The findings suggest that using traditional hepatology scores could provide better insights and avoid issues like unnecessary steroid treatments and hindered re-administration of immune checkpoint inhibitors.
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Although Hepatitis C virus (HCV) infection can be cured with direct-acting antivirals (DAA), some cured patients face a serious risk of advanced liver damage and early mortality. In order to avoid these two negative health outcomes, it is important to identify and assess related risk factors. Little is currently known about socioeconomic and behavioural factors in this context.

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Gene therapy is being successfully developed for the treatment of several genetic disorders. Various methods of gene transfer have been developed to enable the production of the deficient enzyme or protein. One of the most important is adeno-associated virus vectors, which have been shown to be viable for use in in vivo gene therapy.

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Background & Aims: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are the cornerstone of systemic therapy for patients with hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer. In the various therapeutic studies with CDK4/6 inhibitors, elevations in liver tests were more frequent than in the control groups. The mechanism of CDK4/6 inhibitor-induced liver toxicity is not well understood; moreover, natural history and appropriate management are poorly described.

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  • Immune checkpoint inhibitors (ICIs) can cause liver toxicity in up to 25% of patients, and this study aimed to explore patterns of ICI-induced hepatitis and their outcomes.
  • The study included 117 patients, finding that 38.5% had hepatocellular, 36.8% had cholestatic, and 24.8% had mixed liver injury, with severe cases linked to hepatocellular patterns.
  • Treatment varied based on the clinical pattern, with steroids used for hepatocellular cases and ursodeoxycholic acid for cholestatic ones, and about 43.6% of patients challenged again with ICIs experienced recurrence of liver injury.
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Hepatic encephalopathy (HE) is a frequent and severe complication of liver disease with poor patient outcomes. However, it is a poorly understood complication, with no consensus for diagnosis. Therefore, HE is often underdiagnosed.

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Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system and the association with other autoimmune diseases is well-documented. There are many therapeutic options for the treatment of MS. Most of the available drugs cause drug-induced liver injury (DILI) to variable extents with heterogeneous clinical and biological manifestations, including liver injury with or without signs of hypersensitivity and autoimmunity.

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  • Lomitapide is a drug designed to help patients with a severe genetic condition called homozygous familial hypercholesterolemia, and the study focuses on its long-term effects on liver health.
  • The research compiled data from multiple clinical trials and registries, observing liver function markers over an extended period, which led to conclusions about drug safety.
  • Results showed that, after years of treatment, lomitapide did not cause significant liver damage or clinically relevant changes in liver biomarkers, suggesting it is safe for long-term use.
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Background And Aim: The efficacy and safety profiles of elbasvir-grazoprevir (EBR/GZR) has been established in more than 10 clinical trials. However, the characteristics of patients treated in routine clinical practice may differ. The present study was therefore designed to assess the real-life effectiveness of EBR/GZR therapy in the general population and among subgroups with a high hepatitis C virus (HCV) prevalence in France.

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Purpose: The impact of direct-acting antivirals (DAAs) on extrahepatic complications in chronic hepatitis C (CHC) patients remains poorly described. We estimated the association of DAAs with cardiovascular events and extrahepatic cancers.

Methods: The prospective ANRS CO22 HEPATHER cohort was enriched with individual data until December 2018 from the French Health Insurance Database (SNDS).

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Background: Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations.

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  • People with chronic hepatitis B (HBV) face high risks of liver disease, which relates to metabolic disorders and dyslipidemia.
  • A study analyzed data from 4,746 HBV-infected patients about the effects of coffee consumption on metabolic health.
  • Drinking 3 or more cups of coffee daily was linked to increased risk of dyslipidemia but a decreased risk of hypertension, suggesting potential health impacts that need further investigation regarding mortality risk.
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In the last 5 years, the landscape of oncologic treatment has been deeply modified with the development and use of immune checkpoint inhibitors (ICIs) that exert their antitumoral effect by reverting the exhausted phenotype of tumor-infiltrating lymphocytes. This innovative therapeutic strategy has widely changed the prognosis of some advanced neoplastic diseases such as melanoma and lung cancer, providing durable remission for a significant number of patients. Unfortunately, immune-related adverse events (irAEs), especially ICI-induced hepatitis, may be very severe in some cases, impairing the prognosis of the patient.

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Background And Aims: Non-O blood group promotes deep vein thrombosis and liver fibrosis in both general population and hepatitis C. We aimed to evaluate the influence of Non-O group on the outcome of Child-Pugh A cirrhotic patients.

Methods: We used two prospective cohorts of Child-Pugh A cirrhosis due to either alcohol or viral hepatitis.

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Background And Aims: Late presentation for care of hepatitis C virus (HCV) infection - defined as having severe liver fibrosis when first consulting a specialist for HCV care - increases morbidity and mortality. Identifying the socio-behavioural correlates of late presentation is essential to improve HCV strategies to optimize HCV cascade of care. We investigated clinical and socio-behavioural correlates of late presentation for care in HCV mono-infected individuals.

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Objectives: HIV-coinfected patients experience higher incidences of non-liver-related cancers than HCV-monoinfected patients. Chronic inflammation, immunosuppression, but also higher tobacco or alcohol consumption and metabolic dysregulation could explain this higher risk. We aimed to estimate the direct, indirect and total effects of HIV coinfection on the risk of non-liver-related cancers in HCV participants treated with direct-acting antivirals (DAAs).

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Background & Aims: The factors predicting hepatocellular carcinoma (HCC) occurrence in chronic hepatitis B need to be precisely known to improve its detection. We identified pathways and individual predictive factors associated with HCC in the ANRS CO22 HEPATHER cohort.

Methods: The study analyzed HBV-infected patients recruited at 32 French expert hepatology centers from August 6, 2012, to December 31, 2015.

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Background: Lysosomal acid lipase deficiency (LALD, OMIM#278000) is a rare lysosomal disorder with an autosomal recessive inheritance. The main clinical manifestations are related to a progressive accumulation of cholesteryl esters, triglycerides or both within the lysosome in different organs such as the liver, spleen, and cardiovascular system. A wide range of clinical severity is associated with LALD including a severe very rare antenatal/neonatal/infantile phenotype named Wolman disease and a late-onset form named cholesteryl ester storage disease (CESD).

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Background: Obeticholic acid (OCA) and fibrates are second-line therapies for patients with primary biliary cholangitis (PBC) with an inadequate response to ursodeoxycholic acid (UDCA).

Aim: To know whether OCA and fibrates, administered together in combination with UDCA, have additive beneficial effects in patients with difficult-to-treat PBC.

Methods: PBC patients treated for ≥3 months with UDCA, OCA and fibrates (bezafibrate or fenofibrate) due to failure of either second-line therapy were included in a multicentre, uncontrolled retrospective cohort study.

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Thiazide diuretics are prescribed daily and rarely hepatotoxic. We report the case of 86-year-old woman who was admitted in hospital for jaundice after taking hydrochlorothiazide. All differential diagnoses have been eliminated.

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Background: The recommended monitoring tools for evaluating nucleot(s)ide analogue renal toxicity, such as estimated glomerular filtration rate (eGFR) and phosphatemia, are late markers of proximal tubulopathy. Multiple early markers are available, but no consensus exists on their use.

Aim: To determine the 24 mo prevalence of subclinical proximal tubulopathy (SPT), as defined with early biomarkers, in treated untreated hepatitis B virus (HBV)-monoinfected patients.

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Article Synopsis
  • Drug-induced liver injury (DILI) is a significant risk when using antituberculosis drugs like isoniazid, with a study analyzing genetic factors in both Indian and European populations.
  • A genome-wide association study (GWAS) discovered a significant genetic variant (rs117491755) in Europeans and identified the HLA-B*52:01 genotype as a risk factor for DILI.
  • The study also highlighted varying frequencies of the N-acetyltransferase 2 (NAT2) gene variants, showing a lower occurrence of NAT2*5 in DILI cases, while NAT2*6 and NAT2*7 were more common, suggesting a complex genetic influence on the risk of liver injury.
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