Publications by authors named "Jean Luc Meynard"

Article Synopsis
  • Human metapneumovirus (hMPV) is a major cause of respiratory infections, and this study focused on adult patients with hMPV-related lower respiratory tract infections to evaluate their clinical features and outcomes.
  • A total of 208 patients were studied, with a median age of 74 years; most patients had coexisting health issues, and common symptoms included difficulty breathing and cough, while pneumonia was the most frequent diagnosis.
  • The study found that 18% of patients had a complicated course requiring intensive care, with a notable increased risk in those with bacterial coinfections, suggesting the need for careful monitoring and potential early intervention in this population.
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A case of a male with human immunodeficiency virus with plasma genotyping detecting no resistance and a CRF02_AG subtype had a controlled HIV RNA on antiretroviral therapy since 2010. We introduced intramuscular therapy with cabotegravir and rilpivirine. One month later, his HIV RNA was 1500 copies/mL; genotyping found a subtype B with many mutations.

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The emergence of SARS-CoV-2 Omicron variant has led to a complete reconfiguration of the therapeutic landscape, with all monoclonal antibodies having lost any neutralization activity. We report here a case series of 75 immunocompromised patients infected by the Omicron variant who benefited from COVID-19 convalescent plasma (CCP). At Day 28, the overall survival was 76% (95% CI 67-86) with no significant difference in the clinical outcome between patients with hematological malignancies, solid organ transplantation or autoimmune diseases.

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Background: Many studies have reported weight gain in ART-naive people living with HIV (PWH) initiating an integrase strand-transfer inhibitor-based regimen. We studied the impact of early or advanced presentation and that of individual drugs in PWH initiating combined ART (cART) between 2012 and 2018.

Methods: From the French Hospital Database HIV cohort, we assessed factors associated with a weight gain  ≥10%, weight change after cART initiation or BMI increase  ≥5 kg/m2 up to 30 months.

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Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is a growing concern in the aging population with human immunodeficiency virus (HIV). Screening for NAFLD is recommended in patients with metabolic risk factors or unexplained transaminitis. This study aimed to prospectively assess the prevalence and associated factors of liver steatosis and advanced fibrosis (AF) in HIV-monoinfected patients at risk of NAFLD.

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Patients with hematological malignancy and COVID-19 display a high mortality rate. In such patients, immunosuppression due to underlying disease and previous specific treatments impair humoral response, limiting viral clearance. Thus, COVID-19 convalescent plasma (CCP) therapy appears as a promising approach through the transfer of neutralizing antibodies specific to SARS-CoV-2.

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Background: HIV-infected individuals undergoing effective antiretroviral therapy (ART) present an increased risk of atherosclerotic cardiovascular disease. We identified serum metabolites associated with carotid intima-media thickness (c-IMT) and its evolution.

Methods: One hundred forty-three hydrophilic serum metabolites were measured by ultraperformance liquid chromatography coupled with high-resolution mass spectrometry in 49 HIV+ ART+, 48 HIV+ ART-naïve and 50 HIV-negative, age-matched, never-smoking male triads.

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Background: During antiretroviral therapy (ART), HIV-1-infected patients may present with ultralow (UL) HIV-RNA viral loads (VLs) below quantification levels of current assays. Reasons for UL-VL detection and its relation to virological rebound (VR) are unclear.

Methods: HIV-1-infected, ART-naïve patients followed at 2 university hospitals were included.

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Background: Protease inhibitor monotherapy is a simplified treatment strategy for virally suppressed HIV-positive patients that has the potential for cost savings, as fewer drugs are used than with combination therapy. However, evidence for its economic value is limited.

Objectives: We assessed the cost-effectiveness of lopinavir/ritonavir monotherapy followed by treatment intensification in case of viral load rebound versus combination antiretroviral therapy (cART) with efavirenz/emtricitabine/tenofovir in HIV-1 infected patients with viral suppression in the ANRS 140 DREAM trial.

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Article Synopsis
  • The study analyzed trends in myocardial infarction (MI) rates and diagnosis ages among HIV-1 patients in France from 2000 to 2009, focusing on gender differences.
  • Findings revealed that women had higher absolute rates and relative risks of MI compared to men, but trends differed: men showed a decrease in SIRs while women’s rates remained stable.
  • Patients with a CD4 count ≥500/μL and controlled viral load on antiretroviral treatment (cART) showed no elevated MI risk, and both sexes experienced an earlier MI diagnosis compared to the general population, especially women.
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Article Synopsis
  • The study investigates the impact of geographic origin on the risk of severe illness and death among HIV-infected individuals on cART in France, particularly focusing on heterosexuals from different backgrounds.
  • A sample of 4,930 individuals was analyzed, revealing that male migrants from sub-Saharan Africa (SSA) and female migrants from SSA and non-French West-Indies (NFW) had a significantly higher risk of non-AIDS infections compared to French natives.
  • The results suggest a need for targeted interventions to prevent infectious diseases among HIV-infected migrants, given their elevated risk of complications compared to local French populations.
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Objectives: To investigate the extent to which drug resistance can be evaluated from proviral HIV-1 DNA genotype compared with RNA genotype at different timepoints.

Patients And Methods: In HIV-1-infected patients routinely seen at a university hospital, who needed to change their current ART, antiretroviral drug resistance was determined from DNA genotype and was compared with past RNA genotype (group 1) or same-day RNA genotype (group 2). A 'resistance sum' was defined as the sum of agents to which resistance was present and was calculated across NRTI, NNRTI and PI.

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Background: Using 3 randomized Protease inhibitor (PI) monotherapy studies: Kalesolo, Dream and Monoi, we performed a pooled-analysis. Our objective was to determine in PI monotherapy and standard tritherapy: 1) distribution of ultrasensitive viral load (USVL) at week 96 (W96); 2) factors associated with virological failure (VF) at W96 and 3) factors associated with USVL<1 copy at W96.

Methods: VF was defined as 2 consecutive measurements of Human Immunodeficiency Virus Type 1 RNA viral load>50 copies/mL and analysed in Intention-To-Treat.

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Background: Sparing of antiretroviral drug classes could reduce the toxicity and cost of maintenance treatment for HIV infection.

Objectives: To evaluate the non-inferiority of efficacy and the safety of lopinavir/ritonavir (r) monotherapy versus a single-tablet regimen of efavirenz, emtricitabine and tenofovir (EFV/FTC/TDF) over 2 years.

Methods: Adults on stable ART with plasma HIV-1 RNA viral load <50 copies/mL for the past 12 months and no documented treatment failure were randomized to receive either lopinavir/r or EFV/FTC/TDF for 2 years.

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Article Synopsis
  • Metabolic syndrome (MetS) and nonalcoholic fatty liver disease are increasingly common among HIV-infected patients, but the details of liver fibrosis in this group are not well understood.
  • A study analyzed HIV-1-monoinfected individuals, revealing that those with MetS had a significantly higher prevalence of advanced liver fibrosis (≥F2) compared to those without MetS.
  • The findings suggest that adipose tissue and macrophage activation might be critical in the development of liver fibrosis in these patients, indicating that MetS significantly increases the risk for liver issues in HIV-infected individuals.
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For many patients living with HIV-1, the efficacy of combined ART (cART) has made the infection turn to a chronic disease. Because cART is associated with a risk of long-term toxicity, switching patients with virological success to another therapy remains a major issue. Studies undertaken and published over recent years have shown that switching patients exhibiting virological suppression to less-drug regimens (LDR) is a possible option of maintenance strategy.

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Article Synopsis
  • The study investigates how geographic origin, sex, and HIV transmission group impact outcomes after starting first-line combined antiretroviral therapy (cART) among HIV-1-infected adults in France from 2006 to 2011.
  • It finds that migrants are more likely than French natives to start cART with low CD4 cell counts and experience poorer treatment outcomes, especially in terms of viral load undetectability and CD4 recovery.
  • Nonhomosexual men, regardless of geographic origin, showed higher risks for negative health outcomes, indicating disparities in HIV management and treatment effectiveness.
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Objective: To determine radiographic hand osteoarthritis (HOA) prevalence in patients with HIV-1 infection in comparison with the general population and to address whether metabolic syndrome (MetS) may increase the risk of HOA during HIV-1 infection.

Patients: Patients with HIV-1 infection and MetS (International Diabetes Federation, IDF criteria) aged 45-65 years were matched by age and gender to HIV-1-infected subjects without MetS and underwent hand radiographs. Framingham OA cohort was used as general population cohort.

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Introduction: Extra-gastro-intestinal tract manifestations associated with Clostridium difficile infection (CDI), including reactive arthritis (ReA), are uncommon.

Method: We report a case of ReA associated with a relapse of CDI in a 46-year-old woman. A toxigenic C.

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Article Synopsis
  • A study examined the effect of statins on all-cause mortality in HIV-infected individuals, finding that the impact was similar to what has been observed in the general population.
  • Out of 1,776 participants, 138 were statin users, and during a median follow-up of 53 months, 76 deaths occurred, with a higher death rate seen in statin users (11% vs 7%).
  • The analysis adjusted for various health factors and concluded that statins may not significantly alter mortality risk in HIV-infected individuals compared to the broader population.
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