Publications by authors named "Fabrice Bonnet"
Introduction: Anti-retroviral therapy (ART) simplification strategies are needed for treatment-experienced people with HIV (PWH) and multidrug-resistant viruses. These individuals are commonly treated with boosted ART regimens and are thereby at risk for harmful drug-drug interactions (DDI). In this trial, we aim to assess the efficacy of the combination doravirine, dolutegravir and lamivudine (DOR/DTG/3TC) among people with a history of virological failure who receive boosted ART.
View Article and Find Full Text PDFObservational studies suggest a reduction in fatal or severe COVID-19 disease with the use of ACE2 inhibitors and statins. We implemented a randomized controlled tree-arm open label trial evaluating the benefits of adding telmisartan (TLM) or atorvastatin (ATV) to lopinavir boosted ritonavir (LPVr) on the SARS-CoV-2 nasopharyngeal viral load in patients with mild / moderate COVID-19 infection in Côte d'Ivoire. RT-PCR positive COVID-19 patients ≥ 18 years, with general or respiratory symptoms for less than 7 days were randomized (1:1:1) to receive LPVr (400 mg/100 mg twice daily), LPVr + TLM (10 mg once daily) or LPVr + ATV (20 mg once daily) for 10 days.
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- CAB + RPV LA is an HIV-1 treatment regimen given every 2 months that was evaluated in the CARISEL study for its effectiveness and patient outcomes after 12 months.
- The study involved 430 patients who switched from daily oral therapy to this long-acting treatment, and the majority maintained low viral loads, with only a small percentage showing signs of treatment failure.
- Overall, CAB + RPV LA was found to be safe, well-tolerated, and effective in keeping patients' HIV levels suppressed.
Background: People with HIV (PWH) are aging. Frailty is an age-related condition predictive of hospitalization and mortality. Here, we assessed the frequency and factors associated with frailty transitions at 1-year follow-up in elderly PWH.
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- Diabetic nephropathy (DKD) is a leading cause of kidney failure globally, and current clinical practices show gaps in the effective screening and management of the condition, particularly in primary care settings.
- There are barriers to starting important treatments like SGLT2 inhibitors for patients with DKD, especially among the elderly, with difficulties in achieving blood pressure goals also noted.
- Real-world data suggest that SGLT2 inhibitors not only slow kidney decline and lower acute kidney injury risk better than GLP-1 receptor agonists but also highlight the need for a comprehensive strategy to improve care for diabetic patients with kidney issues.
Introduction: People living with HIV (PLWH) live longer and face new health challenges resulting from the confluence of chronic HIV infection and the natural effect of aging and comorbidities. However, there is a dearth of information on the long-term impact of HIV infection on the health and wellbeing of PLWH in sub-Saharan Africa. This research aimed to fill this gap by reporting on physical, functional and social outcomes among PLWH treated at a referral center in Abidjan, Ivory Coast, and comparing them with those of a control group.
View Article and Find Full Text PDFObjective: Interruptions in care of people with HIV (PWH) on antiretroviral therapy (ART) are associated with adverse outcomes, but most studies have relied on composite outcomes. We investigated whether mortality risk following care interruptions differed from mortality risk after first starting ART.
Design: Collaboration of 18 European and North American HIV observational cohort studies of adults with HIV starting ART between 2004 and 2019.
Article Synopsis
- Mortality rates among people with HIV significantly dropped after the introduction of combination antiretroviral therapy, particularly between 1999 and 2009, but remained stable from 2010 to 2020.
- The study analyzed data from over 55,000 participants, revealing that AIDS-related deaths were most common in the earlier period, while deaths from non-AIDS-related malignancies increased in the later years.
- Despite the decline in overall mortality, the reduction was not entirely attributed to better immune function or the presence of other risk factors, suggesting other contributing elements may be at play.
This study aims to assess the safety, virological, and clinical outcomes of convalescent plasma transfusion (CPT) in immunocompromised patients hospitalized for coronavirus disease 2019 (COVID-19). We conducted a retrospective multicenter cohort study that included all immunosuppressed patients with COVID-19 and RNAemia from May 2020 to March 2023 treated with CPT. We included 81 patients with hematological malignancies (HM), transplants, or autoimmune diseases (69% treated with anti-CD20).
View Article and Find Full Text PDFBackground: The burden of herpes zoster (shingles) virus and associated complications, such as post-herpetic neuralgia, is higher in older adults and has a significant impact on quality of life. The incidence of herpes zoster and post-herpetic neuralgia is increased in people living with HIV (PLWH) compared to an age-matched general population, including PLWH on long-term antiretroviral therapy (ART) with no detectable viremia and normal CD4 counts. PLWH - even on effective ART may- exhibit sustained immune dysfunction, as well as defects in cells involved in the response to vaccines.
View Article and Find Full Text PDFObjectives: Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic's impact on antiretroviral therapy (ART) initiation and HIV viral load (VL) monitoring in 3 West African countries.
Methods: We used routinely collected data from 5 clinics contributing to the International epidemiologic Database to Evaluate AIDS collaboration in Burkina Faso, Côte d'Ivoire, and Nigeria.
Aim: The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination of nephroprotection targets at baseline (glycated haemoglobin <7.0%, urinary albumin-creatinine ratio <300 mg/g, blood pressure <130/80 mmHg, renin-angiotensin system inhibition) was associated with better cardiorenal outcomes and lower mortality.
View Article and Find Full Text PDFBackground: Switching to the 2-drug regimen dolutegravir/lamivudine demonstrated durable non-inferior efficacy vs continuing 3- or 4-drug tenofovir alafenamide-based regimens for maintaining virologic suppression in people with HIV-1 through Week 144 in TANGO.
Setting: 134 centers, 10 countries.
Methods: Adults with HIV-1 RNA <50 copies/mL for >6 months and no history of virologic failure were randomized to switch from stable tenofovir alafenamide-based regimens to dolutegravir/lamivudine on Day 1 (early-switch group) for 196 weeks.
Article Synopsis
- This study examines central catheter-related bloodstream infections (CRBIs) at a tertiary care hospital over two years, focusing on complications caused by various bacteria, particularly Staphylococcus aureus (SA).
- Among 254 patients, 14% experienced complications such as suppurative thrombophlebitis and endocarditis, with risk factors including prolonged bacteremia, hemodialysis, and infections by SA.
- The findings suggest that patients with persistent bacteremia, especially those with SA and on hemodialysis, require thorough monitoring for potential complications to improve outcomes.
Article Synopsis
- The study investigates HCV reinfection rates among HIV-positive individuals after the introduction of direct-acting antivirals (DAAs) and determines how much of the new HCV cases are due to reinfections.
- Using data from six international cohorts, researchers analyzed the incidence of HCV reinfection before and after DAAs became widely available, focusing on patient demographics and reinfection timelines.
- Results showed that the incidence of HCV reinfection remained stable before the introduction of DAAs, with a follow-up of 6144 HIV-positive participants over more than 17,000 person-years.
Article Synopsis
- A recent observational study raised concerns about a potentially higher risk of cardiovascular events in ART-naive individuals with HIV on integrase strand-transfer inhibitor (INSTI)-based ART compared to those on other ART regimens.
- Researchers aimed to mimic target trials to assess the 4-year cardiovascular event risk in ART-naive and ART-experienced individuals using INSTI versus non-INSTI ART.
- The study analyzed clinical data from 12 HIV cohorts in Europe and North America, focusing on specific criteria for participant eligibility and using logistic regression models to evaluate the impact of treatment strategies on cardiovascular health.
Article Synopsis
- The CORIPLASM trial aimed to assess whether covid-19 convalescent plasma is effective in treating hospitalized adults with moderate covid-19, including those with weakened immune systems.
- Conducted across 19 hospitals in France, the trial included 120 participants randomly assigned to receive either convalescent plasma or usual care between April 2020 and April 2021.
- Key outcomes measured included the proportion of patients experiencing worsening symptoms by day 4 and survival without needing assisted ventilation by day 14, while secondary outcomes assessed overall survival and recovery times.
Article Synopsis
- Effective diabetes management involves controlling daily glucose fluctuations and quarterly HbA1c levels for near-normal glycemic control.
- The coefficient of variation (CV) is a better metric than standard deviation for measuring glucose variability, as it accounts for the relationship between mean and SD values.
- A CV of 36% indicates stable glucose levels, while a CV of <27% is needed to minimize hypoglycemia risk, and a long-term CV of <5% is recommended to prevent negative health outcomes.
Article Synopsis
- A study assessed the quality of life (QoL) of people living with HIV in Nouvelle Aquitaine, France, revealing that while 63.5% reported good/very good QoL, significant improvements are still needed.
- The highest QoL scores were in physical and environmental domains (both median 69), while social and psychological scores were notably lower (both median 56).
- Factors like having three or more comorbidities, experiencing HIV-related stigma, and a monthly income below €1500 were linked to poorer QoL, highlighting the need to address both health and social issues to improve outcomes for all PLWH.
Article Synopsis
- The study investigated the effects of the COVID-19 pandemic on the initiation and success of antiretroviral therapy (ART) for people diagnosed with HIV in the Aquitaine region of France, comparing cases from the pandemic period (2020-2021) to those diagnosed before (2018-2020).
- It involved adults diagnosed with HIV-1 and assessed key metrics such as the time from diagnosis to ART initiation and achieved viral suppression.
- Results showed that individuals diagnosed during the pandemic had a higher likelihood of starting therapy and achieving viral suppression than those diagnosed earlier, but the study noted fewer foreign-born individuals were diagnosed during the pandemic, suggesting potential barriers to care.
Objective: Evaluate whether prefrail and frail people with HIV (PWH) have a higher risk of cognitive impairment on screens.
Methods: Analysis of PWH aged 70 or older included in the ANRS EP66 SEPTAVIH cohort, on antiretroviral therapy for at least 12 months and with a MoCA test at enrolment. Adjusted risk of a Montreal Cognitive Assessment (MoCA) less than 26 was compared in frail/prefrail versus robust PWH.