Publications by authors named "Jean Michel Pawlotsky"

Chronic hepatitis virus infections remain a major public health problem, despite significant therapeutic advances over the past two decades. Considerable progress has been made in the treatment of chronic viral hepatitis, but continued efforts are needed to develop and bring to market new drugs to fill the gaps in the current therapeutic armamentarium. Thus, clinical trials to assess the safety and efficacy of these new therapeutic approaches, including the selection of reliable and objective treatment endpoints, are still needed.

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  • Bulevirtide is a new antiviral therapy specifically designed to treat chronic hepatitis D, and researchers aimed to understand its effectiveness alone and in combination with pegylated-interferon (Peg-IFN).
  • Mathematical modeling of data from 183 patients showed that bulevirtide effectively blocks cell infection by 90.3%, while Peg-IFN blocks viral production at 92.4%, leading to enhanced outcomes when combined.
  • Results indicated that combining bulevirtide with Peg-IFN resulted in a higher rate of viral decline and a better chance of achieving a cure, suggesting the need for further randomized clinical trials to assess treatment effectiveness.
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Background: A notable increase in severe cases of COVID-19, with significant hospitalizations due to the emergence and spread of JN.1 was observed worldwide in late 2023 and early 2024. However, no clinical data are available regarding critically-ill JN.

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The high genetic diversity of hepatitis C virus (HCV) has led to the emergence of eight genotypes and a large number of subtypes in limited geographical areas. Currently approved pangenotypic DAA regimens have been designed and developed to be effective against the most common subtypes (1a, 1b, 2a, 2b, 2c, 3a, 4a, 5a and 6a). However, large populations living in Africa and Asia, or who have migrated from these regions to industrialised countries, are infected with 'unusual', non-epidemic HCV subtypes, including some that are inherently resistant to currently available direct-acting antiviral (DAA) drugs due to the presence of natural polymorphisms at resistance-associated substitution positions.

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  • This study investigates COVID-19-associated pulmonary aspergillosis (CAPA) among critically ill patients during the Omicron variant wave, finding it affects 5.1% of patients and 9.1% of those on invasive mechanical ventilation.
  • CAPA patients showed higher rates of immunosuppression and required more intensive care measures, like vasopressors and renal therapy, compared to non-CAPA patients.
  • While CAPA did not significantly impact day-28 mortality, it was linked to longer mechanical ventilation and ICU stays, suggesting a shift in outcomes with emerging SARS-CoV-2 variants.
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Background: Respiratory syncytial virus (RSV) infection is gaining interest due to the recent development of vaccines but is still misdiagnosed in the elderly. The primary objective was to compare all-cause mortality at day 30. Secondary objectives were to compare clinical presentation and rates of consolidative pneumonia, hospitalization, and intensive care unit (ICU) admission.

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Objective: Little is known about the effect of gut microbial and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) carriage, particularly in the general population. The aim of this study was to identify microbiota signatures uniquely correlated with ESBL-E carriage.

Methods: We conducted a case-control study among individuals seeking care at the Sexual Health Clinic or Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, Paris, France.

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  • From 2019 to 2022, the French NRC identified 25 metallo-β-lactamase-producing isolates of sequence type (ST)1740, all originating from the Lyon area, prompting further analysis on their spread and genetic evolution.
  • The study involved demographic data collection, genomic sequencing, and investigation of clonal relationships, revealing that the isolates were closely related with minimal genetic variation (≤ 27 SNPs), indicating a clonal dissemination.
  • The outbreak was tied to a specific clone that not only possessed a chromosome-encoded NDM-1 gene but also acquired plasmids for other resistance mechanisms, highlighting the need for comprehensive epidemiological and environmental investigations alongside microbiological studies.
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  • Primary liver cancer can originate from two cell types, leading to different types of tumors: hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICCA), with combined tumors (cHCC-CCA) displaying mixed characteristics.
  • Researchers utilized deep learning to categorize tumors in a study involving 405 cHCC-CCA patients, successfully distinguishing between HCC and ICCA types.
  • This deep learning method showed potential for enhancing treatment strategies and improving patient outcomes for those with complex liver cancers.
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SARS-CoV-2 variants with undetermined properties have emerged intermittently throughout the COVID-19 pandemic. Some variants possess unique phenotypes and mutations which allow further characterization of viral evolution and Spike functions. Around 1,100 cases of the B.

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Severe coronavirus disease 2019 (COVID-19) is related to dysregulated immune responses. We aimed to explore the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants on the immune response by nasopharyngeal transcriptomic in critically-ill patients. This prospective monocentric study included COVID-19 patients requiring intensive care unit (ICU) admission between March 2020 and 2022.

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  • RSV infection is a significant cause of pneumonia in adults, but its genetic diversity and clinical outcomes are not well understood.
  • A study of 100 hospitalized RSV patients from January 2019 to December 2022 found that 72 were infected with RSV-B, and the severity of infection did not correlate with genetic clustering.
  • Patients with RSV-B and risk factors for severe pneumonia showed greater fusion protein diversity, but no mutations linked to resistance to the treatment nirsevimab were identified.
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Background & Aims: Mitochondrial permeability transition pore (mPTP) opening is critical for mediating cell death during hepatic ischaemia-reperfusion injury (IRI). Blocking mPTP opening by inhibiting cyclophilin D (CypD) is a promising pharmacological approach for the treatment of IRI. Here, we show that diastereoisomers of a new class of small-molecule cyclophilin inhibitors (SMCypIs) have properties that make them attractive candidates for the development of therapeutic agents against liver IRI.

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  • * A study identified 37 clinical cases of NDM-14-producing bacteria using whole genome sequencing and found that they all belonged to sequence type ST147.
  • * The NDM-14 clone has a high mutation rate and is resistant to most antimicrobials, emphasizing the need for vigilant surveillance in healthcare settings to control its spread.
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  • A study was conducted on 158 adult patients with acute respiratory failure due to SARS-CoV-2, focusing on the impact of various Omicron sublineages, including BA.2, BA.4/BA.5, and BQ.1.1.
  • Patients infected with the recent BQ.1.1 variant displayed a higher rate of obesity and a lower rate of immunosuppression compared to those with earlier sublineages.
  • Despite these differences in patient characteristics, there was no significant variation in disease severity at ICU admission, organ support needs, or 28-day mortality across the different sublineage groups.
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How infection by a viral variant showing antigenic drift impacts a preformed mature human memory B cell (MBC) repertoire remains an open question. Here, we studied the MBC response up to 6 months after SARS-CoV-2 Omicron BA.1 breakthrough infection in individuals previously vaccinated with three doses of the COVID-19 mRNA vaccine.

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Procoagulant platelets are associated with an increased risk for thrombosis. Procoagulant platelet formation is mediated via Cyclophilin D (CypD) mediated opening of the mitochondrial permeability transition pore. Inhibiting CypD activity could therefore be an interesting approach to limiting thrombosis.

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We aimed to explore the relationships between specific viral mutations/mutational patterns and ventilator-associated pneumonia (VAP) occurrence in COVID-19 patients admitted in intensive care units between October 1, 2020, and May 30, 2021. Full-length SARS-CoV-2 genomes were sequenced by means of next-generation sequencing. In this prospective multicentre cohort study, 259 patients were included.

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Hepatitis of undetermined origin can be caused by a wide variety of pathogens, sometimes emerging pathogens. We report the discovery, by means of routine shotgun metagenomics, of a new virus belonging to the family Circoviridae, genus Circovirus, in a patient in France who had acute hepatitis of unknown origin.

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  • A study investigated the prevalence of unusual HCV genotype 1 subtypes in patients who did not achieve sustained virological response after first-line antiviral treatment, focusing on a population with significant representation from sub-Saharan Africa.
  • Among 640 treatment failures, 7.3% involved patients with these unusual genotypes, who exhibited genetic polymorphisms leading to reduced effectiveness of direct-acting antivirals.
  • The findings suggest that while these patients are less likely to respond to initial treatment, retreatment with a specific combination of antiviral drugs is usually effective in achieving a cure.
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In early 2020, the novel pathogenic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, and rapidly propagated worldwide causing a global health emergency. SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) protein for cell entry, followed by proteolytic cleavage of the Spike (S) protein by the transmembrane serine protease 2 (TMPRSS2), allowing fusion of the viral and cellular membranes. Interestingly, TMPRSS2 is a key regulator in prostate cancer (PCa) progression which is regulated by androgen receptor (AR) signaling.

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