Publications (45) View all
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Article: Chronic hepatitis E resolution in a human immunodeficiency virus (HIV)-infected patient treated with ribavirin.
International journal of antimicrobial agents 03/2013; · 3.03 Impact Factor -
Article: Renal impairment in patients receiving a tenofovir-cART regimen: Impact of tenofovir trough concentration.
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ABSTRACT: OBJECTIVE.: Tenofovir (TDF) is known to induce renal dysfunction in HIV-infected patients. The aim of this retrospective study was to evaluate the correlation between TDF trough concentration (Ctrough-TDF) and glomerular filtration rate (GFR) in a cohort of patients on antiretroviral therapy. METHODS.: A total of 163 patients with at least one determination of Ctrough-TDF between 17-24 hours were retrospectively selected from a computerized database and distributed into three groups defined by TDF concentrations < 40 (11.7%), between 40 and 90 (36.8%), and > 90 (HL group, 51.5%) ng/ml. GFR was measured by Cockcroft-Gault, MDRD and CKD-EPI formulae at the times of TDF initiation and Ctrough-TDF determination, and after 12 months. RESULTS.: At the time of Ctrough-TDF measurement, median duration of TDF-based therapy was 21.1 months. GFR was significantly decreased in HL group (-8.5 ml/min; p<0.001) whatever the method used. GFR decline was significantly associated with an older age. Gender-stratified analysis showed that the early impact of Ctrough-TDF > 90 ng/ml was significant in women only. After 12 months, the decrease in GFR in patients with high Ctrough-TDF was observed in both men and women (-8.27; p=0.003). CONCLUSIONS.: The high prevalence of elevated Ctrough-TDF and its correlation with an increased risk of renal impairment support the usefulness of therapeutic drug monitoring for TDF, particularly in women and older patients.JAIDS Journal of Acquired Immune Deficiency Syndromes 11/2012; · 4.43 Impact Factor -
Article: Lack of benefit of 3-month intensification with enfuvirtide plus optimized background regimen (OBR) versus OBR alone in patients with multiple therapeutic failures: The INNOVE study.
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ABSTRACT: The objective of the present study was to evaluate the virological efficacy of a 3-month short-course intensification with enfuvirtide (ENF) associated with an optimized background regimen (OBR) in treatment-experienced patients infected with HIV-1 with multiple therapeutic failures. This was a prospective, randomized, open-label multicenter trial including patients infected with HIV-1 and harboring a multi-resistant virus that was still susceptible to at least 2 active compounds. Patients were randomized (1:1) to receive OBR + ENF or OBR alone. ENF was discontinued at Week 12. The primary endpoint was the proportion of patients with plasma viral load <50 copies/ml at Week 24. Fifteen patients were randomized into the OBR group and 14 into the OBR + ENF group with a median viral load of 4.1 log(10) copies/ml and a median CD4+ cell count of 346 cells/mm(3) . The primary endpoint was achieved in 93% (14/15) and 79% (11/14) of patients, respectively. Eighty-seven percent (13/15) of patients had a viral load <50 copies/ml as soon as Week 12 in the OBR group and 79% (11/14) in the OBR + ENF group. At Week 12, the median CD4+ cell count was 327 in the OBR and 437 in the OBR + ENF groups and at Week 24 they were comparable. Intensification with ENF had no significant impact on PBMCs HIV-DNA levels. A 3-month short-course intensified treatment with ENF did not improve Week-24 virological response in treatment-experienced patients infected with HIV-1 harboring resistant viruses that were still susceptible to two antiretroviral drugs. J. Med. Virol. 84:1710-1718, 2012. © 2012 Wiley Periodicals, Inc.Journal of Medical Virology 11/2012; 84(11):1710-1718. · 2.82 Impact Factor -
Article: Ribavirin and Abacavir drug interaction in HIV-HCV coinfected patients: fact or fiction?
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ABSTRACT: OBJECTIVE(S):: to examine the impact of ribavirin and abacavir coadministration on HCV virological response and trough ribavirin plasma concentration (Cmin) in HIV-HCV coinfected patients. DESIGN:: pharmacokinetic substudy on patients from the ANRS CO-13 HEPAVIH cohort. METHODS:: Patients receiving ribavirin plus Peg-IFN for whom a ribavirin steady state Cmin was prospectively determined were included. Rapid (RVR), early (EVR) and sustained (SVR) virological response as well as HCV-RNA decline were evaluated. RESULTS:: Overall, 124 HIV-HCV coinfected patients (95% on antiretroviral therapy) were enrolled. Of these patients, 22% received abacavir. The overall median (IQR) ribavirin Cmin was 1.6 mg/L (1.2-2.2) with no statistical difference between abacavir users and non-users [1.5 mg/L (0.99-2.1) and 1.7 (1.2-2.3), p = 0.15]. RVR and EVR were 52% and 72%, respectively. There was no difference observed in the proportion of abacavir users versus non-users achieving RVR (respectively 59% versus 50%, p = 0.40) or EVR (72% versus 73%, p = 0.94), or in the HCV-RNA decline at week 4 [-2.24 log10 IU/ml, (-3.58; -0.81) and -1.27 (-2.8; -0.47) p = 0.28] or at week 12 [-1.76 log10 IU/ml (-3.67; -0.35) and -1.85 (-3.13; -1.13) (p = 0.58)]. The SVR rate was 45% for abacavir users and 24% for abacavir non-users, but the difference was not statistically significant (p = 0.059). CONCLUSIONS:: In our study, there was no evidence that abacavir affected HCV treatment outcomes and the ribavirin Cmin was similar in abacavir users and non-users, confirming the absence of pharmacokinetic interaction between abacavir and ribavirin. An abacavir-containing regimen is therefore a safe treatment alternative for coinfected patients starting HCV treatment.AIDS (London, England) 07/2012; · 4.91 Impact Factor -
Article: Pharmacokinetic interaction between maraviroc and etravirine in HIV-infected patients receiving regimens containing both drugs and no ritonavir-boosted protease inhibitor.
Journal of Antimicrobial Chemotherapy 07/2012; 67(11):2779-81. · 5.07 Impact Factor
