Publications by authors named "Pialoux G"
Background: We evaluated 1-year engagement in pre-exposure prophylaxis (PrEP) care and associated factors among gay, bisexual, and other men who have sex with men (GBMSM) in a large cohort of oral PrEP users in the Paris region, France.
Methods: We included in this analysis cisgender GBMSM enrolled in the ANRS PREVENIR cohort study from 3 May 2017 to 28 February 2019. We categorized 1-year PrEP engagement into 4 categories: high (consistent visits, attendance, and prescription refills at months 3, 6, 9, and 12), low (missed visits or no prescription refills), disengagement (PrEP discontinuation), and lost to follow-up.
We report a case of persistent disseminated mpox evolving over >6 months in an HIV/hepatitis B virus co-infected patient in France who had <200 CD4+ cells/mm, pulmonary and hepatic necrotic lesions, persistent viremia, and nasopharyngeal excretion. Clinical outcome was favorable after 90 days of tecovirimat treatment and administration of human vaccinia immunoglobulins.
View Article and Find Full Text PDFArticle Synopsis
- Mpox, a disease first reported in France in May 2022, led to a recommendation for live Modified Vaccinia Ankara (MVA-BN) vaccination for multiple-partner men who have sex with men (MSM) starting July 11, 2022.
- A study analyzed the changes in sexual behaviors of MSM on HIV pre-exposure prophylaxis (PrEP) and assessed the effects of vaccination on mpox incidence, revealing significant behavioral shifts and a substantial decrease in infection rates post-vaccination.
- The results showed a notable drop in mpox incidence from 67.4 to 24.4 cases per 1000 person-months after the vaccination roll-out, indicating a 99% risk reduction
Article Synopsis
- - The study examined cytomegalovirus (CMV) risk factors in men who have sex with men, focusing on participants in the HIV pre-exposure prophylaxis trial IPERGAY-ANRS.
- - Of the 417 participants, 382 were already CMV positive, showing a high prevalence rate of 91.6%, and 10 new cases were identified during the study.
- - Findings suggest that having many sexual partners increases the likelihood of CMV, with shedding observed in participants who seroconverted.
Background: Increased rates of sexually transmitted infections (STIs) are reported among men who have sex with men (MSM) and new interventions are needed. We aimed to assess whether post-exposure prophylaxis (PEP) with doxycycline could reduce the incidence of chlamydia or syphilis (or both) and whether the meningococcal group B vaccine (4CMenB) could reduce the incidence of gonorrhoea in this population.
Methods: ANRS 174 DOXYVAC is a multicentre, open-label, randomised trial with a 2 × 2 factorial design conducted at ten hospital sites in Paris, France.
Incidence and factors associated with PrEP discontinuation in France.
J Antimicrob Chemother
July 2024
Objectives: HIV pre-exposure prophylaxis (PrEP) is effective in preventing HIV, but some seroconversions occur due to poor adherence or PrEP discontinuation. Our objective was to estimate the incidence of PrEP discontinuation and describe the reasons and factors associated with discontinuations.
Methods: A retrospective cohort was conducted in three French hospitals between January 2016 and June 2022.
Article Synopsis
- * Results showed that 61.7% of the participants acquired HIV after arriving in France, with 13.1% of those cases occurring within the first year of migration.
- * Factors such as older age at migration, region of origin, social disadvantage, and the number of sexual partners were linked to a higher likelihood of acquiring HIV within the first year.
Objective: It is unknown whether hepatitis C virus (HCV)-cured people with HIV (PWH) without cirrhosis reached the same mortality risk as HCV-uninfected PWH. We aimed to compare mortality in PWH cured of HCV by direct-acting antivirals (DAAs) to mortality in individuals with HIV monoinfection.
Design: Nationwide hospital cohort.
Article Synopsis
- The study focused on the prevalence and incidence of hepatitis E virus (HEV) among men who have sex with men (MSM) in a trial for pre-exposure prophylaxis (PrEP).
- Out of 416 MSM participants, 14.9% tested positive for HEV at the start, with only older age being a significant factor linked to positivity.
- The overall incidence rate for new HEV infections over an average follow-up of 2.1 years was low at 1.19% per 100 person-years, suggesting that sexual transmission is not a major concern for HEV in this group, unlike hepatitis A virus (HAV).
Article Synopsis
- Vaccination against hepatitis A (HAV) and hepatitis B (HBV) is strongly recommended for men who have sex with men (MSM), with a study evaluating vaccine uptake during the ANRS IPERGAY pre-exposure prophylaxis (PrEP) trial.
- Out of 427 MSM participants analyzed, a significant number were non-immune to HAV (50.4%), with high vaccination uptake: 96.1% received at least one dose of HAV vaccine, and 97.6% of HBV non-immune participants received at least one HBV vaccine dose.
- Overall, complete vaccination resulted in a high rate of immunity, showing that PrEP visits are crucial for offering vaccination to at-risk MSM who are
Article Synopsis
- - The study aimed to compare the outcomes of patients infected with Omicron BA.1 and BA.2 who were treated with either sotrovimab or nirmatrelvir to prevent severe COVID-19.
- - Of the 255 patients analyzed, nirmatrelvir resulted in faster negative PCR conversion (4 days) compared to sotrovimab (11.5 days), and a lower hospitalization rate was observed in nirmatrelvir-treated patients.
- - The findings suggest that nirmatrelvir may lead to quicker viral clearance than sotrovimab in high-risk patients, potentially reducing the spread of the virus.
Objectives: Our objective was to identify missed opportunities for the use of pre-exposure prophylaxis (PrEP) in people with recently acquired HIV, factors associated with PrEP knowledge, and reasons for not using PrEP.
Design: This was a French national cross-sectional multicentre study enrolling people diagnosed with recent HIV (incomplete Western blot or negative HIV test in the previous 6 months) in 28 HIV clinical centres. Data were gathered using a self-administered questionnaire (SAQ).
Background: There are few data available regarding the use of on-demand pre-exposure prophylaxis (PrEP) for HIV prevention. We aimed to assess PrEP effectiveness, adherence, and safety in adults using daily or on-demand PrEP.
Methods: We conducted a prospective observational cohort study (ANRS PREVENIR) at 26 sites in the Paris region, France.
Objectives: To assess humoral responses to SARS-CoV-2 Delta-variant in people with HIV (PWH) after BNT162b2-vaccination.
Design: Multicenter cohort study of PWH with CD4 + cell count less than 500 cells/μl and viral load less than 50 copies/ml on stable antiretroviral therapy for at least 3 months.
Methods: Anti-SARS-CoV-2 receptor-binding-domain IgG antibodies (anti-RBD IgG) were quantified and neutralization capacity was evaluated by ELISA/GenScript and virus-neutralization-test against the D614G-strain, beta and delta variants before vaccination (day 0) and 1 month after complete schedule (M1).
Background: The impact of the variant of concern (VOC) Alpha on the severity of COVID-19 has been debated. We report our analysis in France.
Methods: We conducted an exposed/unexposed cohort study with retrospective data collection, comparing patients infected by VOC Alpha to contemporaneous patients infected by historical lineages.
Article Synopsis
- A clinical trial was conducted to assess the effectiveness and safety of dexamethasone (DEX) alone versus combined with tocilizumab (TCZ) in patients with moderate-to-severe COVID-19 pneumonia requiring oxygen support.
- At day 14, the rates of mechanical ventilation or death were similar between the DEX group (14%) and the TCZ+DEX group (12%), indicating no significant improvement from the combination treatment.
- Despite no clear benefits in reducing mechanical ventilation or mortality with the TCZ+DEX treatment, both treatments had similar safety profiles; however, definitive conclusions are limited due to the broad confidence intervals in the results.
Article Synopsis
- Dolutegravir is an integrase strand-transfer inhibitor used for treating primary HIV infection (PHI), which is a stage with high viral loads and a greater risk of transmission.
- This study compared the effects of two different ART regimens—dolutegravir vs. darunavir—on HIV-RNA and HIV-DNA levels in the genital area of subjects with PHI.
- Both regimens effectively reduced HIV viral loads in semen over time, with no significant differences in outcomes, suggesting dolutegravir is a viable treatment option for reducing transmission risk during PHI.
Objective: High rates of sexually transmitted infections (STIs) have been reported among pre-exposure prophylaxis (PrEP) users. We wished to assess the incidence and risk factors for recurrent STIs.
Design: The ANRS IPERGAY trial was a prospective study investigating PrEP among MSM and transgender women in outpatient clinics in France and Canada.
Why are people still dying of drug-susceptible TB in Paris in the 21 century?
Int J Tuberc Lung Dis
February 2022
Although the burden of TB is lower in France than in low-income countries, patients continue to die from TB in Paris. Our goal was to describe TB-related deaths and to identify associated risk factors. We conducted a retrospective cohort study in two hospitals in Paris between 2013 and 2018.
View Article and Find Full Text PDFBackgroundDespite the availability of highly effective direct-acting antivirals (DAAs) and the expected treatment as prevention (TasP) effect, transmission of hepatitis C virus (HCV) persists in men who have sex with men (MSM) who engage in high-risk sexual behaviours.AimWe aimed to estimate the incidence of primary HCV infection among MSM living with HIV in France when DAA was readily available.MethodsWe used data from a large French hospital cohort of persons living with HIV (ANRS CO4-FHDH) prospectively collected between 2014 and 2017.
View Article and Find Full Text PDFWe report a case of black-grain eumycetoma co-localized with Mycobacterium tuberculosis infection, presenting as a painless leg abscess and associated with vertebral tuberculosis. The rare association of these two pathogens raises several challenges regarding foreseeable drug interactions, side effects, the most appropriate management, and the potential link between these two diseases.
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