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ABSTRACT: We investigated, in a prospective cohort follow-up study, whether substituting efavirenz (EFV) for protease inhibitors (PIs) could be safe in HIV-infected patients with optimal viral suppression achieved on PI-containing regimens. In patients with undetectable plasma viral load (pVL) <50 copies/ml who were naive to therapy with nonnucleoside reverse transcriptase inhibitors (NNRTIs), PIs were replaced by EFV whereas associated nucleoside analogs (NAs) were retained. 62 patients were enrolled. Median follow-up on EFV was 64 weeks (2-88 weeks). Side effects due to EFV occurred in 48 patients. Two patients experienced a high level viral rebound due to diminished compliance; 55 (88.7%) maintained a pVL <50 copies/ml; 3 showed one episode of viremia (52-89 copies/ml); 2 stopped EFV before any VL control. Mean CD4 cell count did not change significantly. One AIDS patient experienced a single cutaneous recurrence of Kaposi's sarcoma after 40 weeks on EFV. Replacing PI with EFV in patients with optimal pVL suppression appears to be safe both virologically and immunologically.
JAIDS Journal of Acquired Immune Deficiency Syndromes 08/2001; 27(5):459-62. · 4.43 Impact Factor
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ABSTRACT: Seven patients co-infected with hepatitis B virus (HBsAg and HBeAg carriers, quantifiable HBV DNA with the bDNA technic) and human immunodeficiency virus received a triple antiretroviral combination therapy, including lamivudine (150 mg twice a day). Hepatitis B viral load rapidly became undetectable in 6/7 patients. It remained below the level of detection in 2 subjects, after 20 and 22 months of treatment, with one of them achieving HBeAg/anti-HBe seroconversion. However, in the other 4 individuals, hepatitis B viremia increased again after 8 to 16 months of lamivudine-containing regimen. The last patient was a non-responder. The 4 relapsers developed a double mutation Leu(528) for Met(528) and Met(552) for Val(552), on hepatitis B virus polymerase, either concomitant (M8 and M16) with a hepatitis B virus DNA increase, or 2 months earlier (M10 and M12). The high frequency of hepatitis B virus resistance to lamivudine emphasizes the necessity of identifying more effective strategies, such as double combination therapies.
Gastroentérologie Clinique et Biologique 02/2000; 24(1):125-7. · 0.80 Impact Factor
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AIDS 12/1999; 13(16):2307. · 6.24 Impact Factor
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D Rey, E de Mautort,
C Saussine,
Y Hansmann,
J Waller,
R Herbrecht,
D Christmann,
V Lindner,
V Letscher-Bru,
H Koenig,
J M Lang
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ABSTRACT: Isolated renal Aspergillus abscess is a very rare complication of HIV infection. It usually occurs in patients with severe immune deficiency. The case of a 29-year-old HIV-infected homosexual male, a nonintravenous drug abuser, who developed a right renal Aspergillus abscess despite normalization of the CD4+ cell count after highly active antiretroviral treatment is described. When antimicrobial treatment failed (amphotericin B followed by itraconazole), he was cured by right nephrectomy and remains in good health 3 months later with no recurrence. In cases of Aspergillus renal abscess in HIV-infected patients, surgery is the treatment of choice, especially in the current era of highly active antiretroviral therapy.
European Journal of Clinical Microbiology 03/1999; 18(2):137-41. · 2.86 Impact Factor
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La Presse Médicale 01/1995; 23(39):1831. · 0.67 Impact Factor
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La Presse Médicale 03/1992; 21(8):394-5. · 0.67 Impact Factor
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La Presse Médicale 10/1989; 18(30):1480. · 0.67 Impact Factor
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D Rey,
E Frick-Michot,
M Partisani,
G Hess-Kempf,
C Cheneau,
M Priester,
C Bernard-Henry, E de Mautort,
M J Wendling,
P Meyer,
J M Lang
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ABSTRACT: The authors had for aim to prospectively study the hepatitis A seroprevalence of an HIV-infected population, followed-up in an outpatient clinic (CISIH Strasbourg).
Blood tests were performed on all patients from September 2003 to March 2004 to screen for hepatitis A (total antibodies with Elisa).
The overall seroprevalence was 219/514 (56.6%), similar in male and female patients. It increased with age, especially in European patients (P = 0.003). The seroprevalence was lower in European subjects: 46.3% (while it reached 100% in sub-Saharan Africans), the prevalence was similar whatever the HIV risk group (46% in homosexual as well as in heterosexual patients, 44% in intravenous drug users). Hepatitis B or C co-infection did not increase the seroprevalence of hepatitis A. The hepatitis A seroprevalence was similar in various CD4 T cell count categories.
Our results stress the utility of hepatitis A serology in HIV-infected patients (more than 50% of European patients are non immune), and the importance of assessing hepatitis A vaccination.
Médecine et Maladies Infectieuses 35(7-8):402-6. · 0.72 Impact Factor
