Publications by authors named "Jean Marc-Lacombe"
Purpose: Hepatitis C virus (HCV) cure after treatment with direct-acting antivirals (DAAs) can improve health-related quality of life (HRQoL). However, specific groups with chronic HCV may still exhibit worse post-cure HRQoL because of persisting severe liver fibrosis or social vulnerability factors (e.g.
View Article and Find Full Text PDFBackground And Aims: The liver cancer risk test (LCR1-LCR2) is a multianalyte blood test combining proteins involved in liver cell repair (apolipoprotein A1, haptoglobin), hepatocellular carcinoma (HCC) risk factors (gender, age, gamma glutamyl transpeptidase), a marker of fibrosis (alpha2-macroglobulin), and alpha-fetoprotein, a specific marker of HCC. The aim was to externally validate LCR1-LCR2 in hepatitis B.
Methods: Preincluded patients were from the Hepather cohort, a multicenter, multiethnic prospective study in 6071 patients.
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).
View Article and Find Full Text PDFBackground & Aims: The Liver Cancer Risk test algorithm (LCR1-LCR2) is a multianalyte blood test combining proteins involved in liver cell repair (apolipoprotein-A1 and haptoglobin), known hepatocellular carcinoma (HCC) risk factors (sex, age, and gamma-glutamyl transferase), a marker of fibrosis (alpha2-macroglobulin) and alpha-fetoprotein (AFP), a specific marker of HCC. The aim was to externally validate the LCR1-LCR2 in patients with chronic HCV (CHC) treated or not with antivirals.
Methods: Pre-included patients were from the Hepather cohort, a multicentre prospective study in adult patients with CHC in France.
Background & Aims: Direct-acting antivirals (DAA) lead to high sustained virological response (SVR) rates and decrease the risk of disease progression. We compared SVR rates and all-cause, liver- and non-liver-related deaths, liver-related events, and non-liver-related cancers in HIV/HCV-coinfected and HCV-monoinfected participants from 2 French cohort studies after initiation of DAA treatment.
Methods: Up to 4 HCV-monoinfected participants from the ANRS CO22 HEPATHER cohort were matched by age and sex to each HIV/HCV-coinfected patient from the ANRS CO13 HEPAVIH cohort; both are nationwide, prospective, multicentre, and observational.
Article Synopsis
- HIV-infected individuals typically have lower bone mineral density and a higher fracture risk compared to the general population, prompting a study on the impact of antiretroviral (ARV) drug exposure on osteoporotic fractures.* -
- The study involved assessing 861 cases of individuals with fractures and matching them to controls based on various factors such as age and sex, finding that a significant proportion had been exposed to Tenofovir Disoproxil Fumarate (TDF) and protease inhibitors (PIs).* -
- Results indicated no increased fracture risk associated with TDF or PIs after adjusting for multiple variables, highlighting the relevance of these findings in discussions about the safety of different ARVs like tenofovir
Objective: To assess CD4 recovery after combined antiretroviral therapy (cART) initiation with sustained virologic control.
Design: Cohort study based on the French Hospital Database on HIV (FHDH-ANRS CO4).
Methods: We selected naive HIV-1-infected individuals initiating cART between 2006 and 2014 with CD4 cell counts less than 500 cells/μl who achieved virologic control, defined as two consecutive viral loads less than 50 copies/ml.
Background: Etravirine (ETR), a non-nucleoside reverse transcriptase inhibitor (NNRTI) available in France since 2006, is indicated for antiretroviral-experienced HIV-infected adults, in combination with a ritonavir-boosted protease inhibitor (PI). To assess its clinical impact in routine care, we compared hospitalization rates according to ETR + PI prescription or not, among heavily treated HIV-1 infected individuals on failing regimens between 2005 and 2011.
Methods: From the French Hospital Database on HIV (ANRS CO4), we selected heavily treated individuals (prior exposure to at least 2 nucleoside reverse transcriptase inhibitor (NRTI), 2PI and 1 NNRTI) with viral load (VL) > 50 copies/mL who started a new antiretroviral (ARV) regimen between 2005 and 2011.
Background: In individuals with viral load (VL) suppression on a boosted protease inhibitor (PI) regimen, a switch to raltegravir (RAL) can be an option in case of comorbidities, but the SWITCHMRK trials challenged this strategy. Here, among individuals with VL suppression on a boosted PI, we compared outcomes between those who continued on the same regimen and those who switched to RAL.
Methods: In this cohort study from the French Hospital Database on HIV, each individual who switched to RAL was matched with up to 3 individuals who continued PI, were being followed up during the calendar period of the switch, and had the same duration of VL suppression (both ±6 months).
Background: Ensuring early universal access to HIV treatment is critical to reach the end of AIDS. The cascade of HIV care has become a critical metric to assess the coverage of treatment and viral suppression, but it does not provide any information on the elapsed times between becoming HIV-infected and reaching viral suppression.
Methods: We estimated the cascade of care, the distribution of times between steps of the care continuum, in France, in 2010, at the national level, overall and by HIV exposure groups, using statistical modelling and large datasets: the national HIV surveillance system, the general social insurance scheme, and the French Hospital Database on HIV.
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.
Introduction: Etravirine (ETR), a non-nucleoside reverse transcriptase inhibitor available in France since 2006, is indicated for the treatment of HIV-1 infection in combination with a ritonavir boosted protease inhibitor (PI) in antiretroviral treatment-experienced adult patients. To assess its impact in routine clinical care, our objective was to compare hospitalization rates in highly pre-treated failing HIV-1 infected individuals between 2005 and 2011 depending on whether or not they received ETR+PI.
Methods: From the French Hospital Database on HIV (ANRS CO4), we selected highly pre-treated individuals (prior exposure to at least 2NRTI, 2PI and 1 NNRTI) with a viral load (VL)>50 copies/mL initiating a new regimen between 2005 and 2011.
Introduction: A key objective of combined antiretroviral therapy (cART) is to reach and maintain high CD4 cell counts to provide long-term protection against AIDS-defining opportunistic infections and malignancies, as well as other comorbidities. However, a high proportion of patients present late for care. Our objective was to assess CD4 cell count recovery up to seven years in naïve patients initiating cART with at least three drugs in usual clinical care.
View Article and Find Full Text PDFBackground: Calendar trends in virologic failure (VF) among human immunodeficiency virus (HIV)-infected patients can help to evaluate the performance of healthcare systems and the need for new antiretroviral therapy (ART). We examined the time trend in the rate of VF beyond 6 months of ART between 1997 and 2011 in France.
Methods: We included patients from the French Hospital Database on HIV who received at least 6 months of ART.
The French Hospital Database on HIV (FHDH) is a hospital-based multicentre open cohort with inclusions ongoing since 1989. The research objectives focus mainly on mid- and long-term clinical outcomes and therapeutic strategies, as well as severe AIDS and non-AIDS morbidities, and public health issues relative to HIV infection. FHDH also serves to describe HIV-infected patients receiving hospital care in France.
View Article and Find Full Text PDFObjective: To determine whether incident AIDS-defining Kaposi sarcoma or Pneumocystis jiroveci pneumonia (PJP) is associated with combination antiretroviral therapy (cART) initiation.
Design: Compare risk for Kaposi sarcoma and PJP by time on cART and CD4 reconstitution.
Methods: : In the FHDH-ANRS CO4 cohort (N = 66 369), Kaposi sarcoma (N = 1811) and PJP (N = 1718) incidence rates were computed by demographic and HIV strata.
The aim of our study was to investigate whether depression assessed by different markers predicts the risk of incident dementia in elderly individuals. Data was derived from the 3C cohort study conducted in community-dwelling individuals aged 65 years and over, randomly recruited from electoral rolls of three French areas and followed up for four years (1999-2001 through 2004) with assessments every 2 years. The study sample comprised 7989 dementia-free individuals (mean age, 74.
View Article and Find Full Text PDFBackground: Seasonal variations of blood pressure-related diseases have been described in several populations. However, few studies have examined the seasonal variations of blood pressure in the elderly, a segment of the population particularly exposed to vascular diseases. The association of blood pressure with season and outdoor temperature was examined in 8801 subjects 65 years or older from the Three-City study, a population-based longitudinal study.
View Article and Find Full Text PDFBackground: Clinical studies reported that treatments for Alzheimer's disease may have an impact on behavioral and psychiatric disorders. We tested the hypothesis that memantine treatment initiation modifies psychotropic medication in real-life practice patients.
Methods: A 2-year follow-up cohort study was performed.
Objective: To examine the relationship between blood pressure and depression in a large sample of noninstitutionalized elderly people.
Methods: Cross-sectional community-based study in 9294 participants aged 65 years and over, living at home, in three French cities (Bordeaux, Dijon and Montpellier). Participants were categorized as depressive, based on three different markers of depression.
Clinical trials have shown modest effects of memantine, an N-methyl-D aspartate receptor antagonist, in Alzheimer disease patients and memantine effectiveness in routine clinical practice needs to be established further. In 2003, memantine was recommended in France for Alzheimer disease patients with disease severity ranging from 15 to 3 on the mini-mental state examination at the first prescription. Our study aimed at describing memantine use in real-world practice in a cohort of 5283 memantine-treated patients (mean age: 80.
View Article and Find Full Text PDFObjective: To study management of hypertension in the elderly in a large population-based study and to evaluate the prevalence of hypertension and factors related to awareness, treatment, and control.
Design: The Three City study, a population-based study among 9693 non-institutionalized individuals aged 65 years and over.
Methods: Blood pressure was measured with an automated electronic device, and treatment assessed, during home interview.