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Introduction
Skills and Expertise
Publications
Publications (60)
Background
Randomized trials (RCTs) from low- and middle-income settings suggested early initiation of antiretroviral therapy (ART) leads to higher mortality among people with HIV (PWH) who present with cryptococcal meningitis (CM). There is limited information about impact of ART timing on mortality in similar people in high-income settings.
Meth...
Objective
To characterize HPV genotype distribution in HSIL and ICC- biopsies, of WLWH, in Europe, as compared to HIV-negative women.
Design
Cohort- and nested -case control study.
Method
We characterized HPV genotype distribution by performing PCR on HSIL and ICC biopsies from WLWH (n = 170); 85 cases were compared to 85 HIV-negative matched con...
Introduction:
Procalcitonin is a marker for bacterial diseases and has been used to guide antibiotic prescription. Procalcitonin accuracy, measured at admission, in patients with community-acquired pneumonia (CAP), is unknown in the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
Objectives:
To evaluate the diagnos...
Invasive histoplasmosis is the most common AIDS-defining event in endemic regions such as South America. In non-endemic regions, less familiar to the diagnosis, invasive histoplasmosis can be mistakenly diagnosed as miliary tuberculosis leading to a high mortality rate. Here we present the case of an invasive histoplasmosis mistakenly diagnosed as...
Background
Tenofovir alafenamide (TAF), a prodrug of tenofovir (TFV), is included in the majority of the recommended first-line antiretroviral regimens for patients living with HIV, but there are limited data on TAF use in pregnant women. We aimed to examine the plasma pharmacokinetics of TAF and TFV in pregnant women from Europe.
Methods
Pregnant...
Background
This study compares the management and outcome of high grade squamous intraepithelial lesions (HSIL) in HIV-positive and -negative women and identifies risk factors for treatment failure.
Methods
This retrospective, controlled study includes 146 HIV-positive women, matched for HSIL, age and year of diagnosis, with 146 HIV-negative women...
BACKGROUND: A persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgki...
Clinical manifestations of severe acute respiratory syn-
drome coronavirus 2 (SARS-CoV-2) are disparate and
range from common symptoms such as fever, cough, and
dyspnoea to less frequent symptoms such as asthenia and
fatigue [1]; these symptoms are unspecific and are also
found in pneumonia caused by other viruses or bacteria.
Severe illness w...
Objective: The aim of our study was to review cases of S. cerevisiae fungemia along with the corresponding risk factors (including S. boulardii probiotic intake), treatment and outcomes.
Patients and methods: Retrospective study (2005-2017) of S. cerevisiae fungemia. All the data were extracted from medical files.
Results: We identified 10 patients...
Favipiravir (FVP) is an RNA polymerase inhibitor with broad anti‐viral activity1. FVP is a pro‐drug which is ribosylated and phosphorylated intracellularly to form the active metabolite and has a short half‐life (2‐5.5 hours) after oral administration2. This article is protected by copyright. All rights reserved.
Aims:
In the absence of a commonly agreed dosing protocol based on pharmacokinetic considerations, the dose and treatment duration for hydroxychloroquine (HCQ) COVID-19 disease currently vary across national guidelines and clinical study protocols. We have used a model-based approach to explore the relative impact of alternative dosing regimens pr...
This phase 4 study investigated the influence of pregnancy on the pharmacokinetics of elvitegravir/cobicistat in 14 women with human immunodeficiency virus type 1. The results support the recommendation against elvitegravir/cobicistat use during pregnancy, as the elvitegravir concentration at the end of the dosing interval (Ctrough) was reduced by...
We report a case of Argentine hemorrhagic fever diagnosed in a woman in Belgium who traveled from a disease-endemic area. Patient management included supportive care and combination therapy with ribavirin and favipiravir. Of 137 potential contacts, including friends, relatives, and healthcare and laboratory workers, none showed development of clini...
Background:
Pharmacokinetic and efficacy data on dolutegravir in pregnant women living with human immunodeficiency virus (HIV) are still limited but needed to support its use as one of the preferred antiretroviral agents.
Methods:
Within the multicenter Pharmacokinetics of ANtiretroviral agents in HIV-infected pregNAnt women (PANNA) study, pregn...
Objectives:
To characterize the risk factors, impact of screening, and clinical burden of colonization and/or infection by carbapenemase-producing bacteria (CPB) in hospitalized patients.
Method:
Retrospective study in a tertiary care hospital between 2008 and 2016.
Results:
Among 88 included patients, 41% were colonized, 59% developed an infe...
Objectives:
HPV infection may differ in women who are HIV-positive since birth (perinatally infected, P-HIV) and those who acquire HIV later in life (non-perinatally infected, NP-HIV). We assessed the HPV prevalence in relation to the HIV acquisition route and HPV vaccination status.
Study design:
Case control study comparing 22 P-HIV with 22 NP...
Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included...
BACKGROUND: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of...
We compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. We analyzed cohort data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) and the Collaboration of Observational HIV Epidemiolo...
Ecthyma gangrenosum (EG) is a potentially lethal skin infection, most commonly due to Pseudomonas aeruginosa with bacteremic dissemination and affecting mostly immunocompromised patients. We present two cases of EG in two men in Belgium recently admitted to our hospital, caused by a suspected coinfection by group A Streptococcus and Staphylococcus...
Aim
To compare the performances of molecular and non-molecular tests to diagnose respiratory viral infections and to evaluate the pros and contras of each technique.
Methods
Two hundred ninety-nine respiratory samples were prospectively explored using multiplex molecular techniques (FilmArray Respiratory Panel, Clart Pneumovir), immunological tec...
Aim:
To evaluate the contribution of a multiplex PCR for respiratory viruses on antibiotic and antiviral prescription, ancillary test prescription, admission and length of stay of patients.
Methods:
Two hundred ninety-one adult and pediatric patients visiting the emergency department during the 2015-2016 influenza epidemic were prospectively inc...
Leptospirosis is an ubiquitous zoonosis. Clinical presentation is variable ranging from mild to severe symptomatology with multiorgan failure. We report the case of a young man who presented with a severe form of leptospirosis with hepatitis and acute renal failure. The diagnosis was confirmed by the microscopic agglutination test revealing the hig...
Background: Inherited CARD9 deficiency constitutes a primary immunodeficiency predisposing uniquely to chronic and invasive fungal infections. Certain mutations are shown to negatively impact CARD9 protein expression and/or NF-κB activation, but the underlying biochemical mechanism remains to be fully understood.
Objectives: To investigate a possib...
Atopobium vaginae is an anaerobic Gram-positive bacterium recognized as a causative agent of bacterial vaginosis and associated with preterm delivery. Invasive infection and bacteremia have been rarely reported. We describe the case of a woman expecting her firstborn child who presented with a A. vaginae bacteremia during labor. Identification was...
Emerging evidence indicates that migrants fromPlasmodium falciparumendemic regions are at risk of delayed presentation ofP. falciparummalaria. We report three cases ofP. falciparummalaria occurring years after arrival in Europe. All patients were originally from Sub-Saharan Africa. Two subjects had controlled HIV infection and one was a pregnant wo...
Imported malaria is a pathology mainly due to Plasmodium falciparum. For patients with co- morbidities, such as HIV or believing themselves immune, the risk of malaria is more severe. We present the case of a HIV patient carrier with a cerebral malaria of letal evolution despite a rapid decline in its parasitaemia using Artesunate. This case descri...
Background:
The interactions between antiretroviral therapy (ART) and high-risk human papillomavirus (HPV) and cervical lesions in women living with HIV are poorly understood. We reviewed the association of ART with these outcomes.
Methods:
We did a systematic review and meta-analysis by searching MEDLINE and Embase databases for cross-sectional...
Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe and potentially fatal syndrome that is characterized by increased proliferation and activation of benign macrophages with hemophagocytosis throughout the reticuloendothelial system. This syndrome is classified as primary (genetic) or secondary when acquired in the context of...
Background:
The use of antiretroviral therapy during pregnancy is important for control of maternal HIV disease and the prevention of perinatal HIV transmission. Physiological changes during pregnancy can reduce antiretroviral exposure. We studied the pharmacokinetics of rilpivirine 25 mg once daily (QD) in HIV-1-positive women during late pregnan...
Purpose:
The aim of this study was to compare the outcomes of in vitro fertilization (IVF) for couples where one or both partners were positive for the human immunodeficiency virus (HIV) to matched control couples.
Methods:
A matched case-control retrospective study was performed. Data for 104 couples where the woman was HIV-positive; for 90 cou...
Campylobacter rectus is rarely associated with invasive infection. Both isolation and identification requirements of C. rectus are fastidious, probably contributing to an underestimation of its burden. We report the case of a 66-year-old man who developed several skull base and intracerebral abscesses after dental intervention. C. rectus was isolat...
Current population displacements favor the re-emerging of diseases, nowadays very rare in Europe. We report two cases of 'imported' relapsing fever in two Somali asylum seekers occurring shortly after their arrival in Belgium. A diagnosis of relapsing fever should be considered in all migrants coming from endemic regions or having traveled in low h...
Objective:
HIV-positive men who have sex with men (MSM) are at increased risk of anal cancer. We evaluate the risk factors for anal high-grade squamous intraepithelial lesion (HSIL) (the precursor of anal cancer) in HIV-positive MSM.
Methods:
In this cross-sectional study within a cohort, 320 HIV-positive MSM were screened by anal cytology follo...
Objective:
To describe the pharmacokinetics of abacavir 600 mg once daily (QD) in HIV-1-positive women during pregnancy and postpartum.
Design:
A non-randomized, open-label, multi-centre, phase-IV study.
Methods:
HIV-positive pregnant women receiving abacavir 600 mg QD as part of clinical care were included. Intensive 24-hour pharmacokinetic s...
Background:
Worldwide, human papillomavirus (HPV) 16 and 18 represents 70% of high-risk (HR) HPV found in cervical cancer. However HIV-positive women are more frequently infected by HRHPV other than HPV 16 or 18 (OHR). We aimed to analyse the HRHPV genotype distribution in a cohort of HIV-positive women and to estimate the potential protection off...
Since 2007, two prophylactic vaccines against Human Papillomavirus (HPV) infection and HPV. induced lesions (both precancerous dysplasia and cancer) have been registered in Belgium. In multicentre randomized trials including more than 64,000 patients, these vaccines were shown to be highly efficient against the occurrence of condyloma and of dyspla...
HPV and HIV each display interactions favoring the other infection at the cellular level. HPV infection favors HIV acquisition in women and men, and HIV-infected individuals encompass a heavier burden of HPV-induced dysplasia and cancer due to progressive immune suppression. Both infections contribute to a vicious circle that may account for the sc...
For septic patients, delaying the initiation of antimicrobial therapy or choosing an inappropriate antibiotic can considerably worsen their prognosis. This study evaluated the impact of rapid microbial identification (RMI) from positive blood cultures on the management of patients with suspected sepsis. During a 6-month period, RMI by matrix-assist...
Background:
Studies analyzing the impact of combination antiretroviral therapy (cART) on cervical infection with high-risk human papillomavirus (HR-HPV) have generated conflicting results. We assessed the long-term impact of cART on persistent cervical HR-HPV infection in a very large cohort of 652 women who underwent follow-up of HIV infection fo...
Introduction
Cervical infection with high-risk human papillomavirus (HRHPV) induces cervical cancer and is present in 14% of women in Europe. We assessed the prevalence and incidence of cervical HRHPV in a cohort of HIV-positive women living in Belgium.
Methods
Prospective observational program of screening and follow up of HRHPV cervical infectio...
The history of HIV treatment is characterised by a rapid development. In 1987, 6 years after the discovery of AIDS, the US
Food and Drug administration approved the first drug against HIV. Since then three different classes of antiretroviral drugs
including 16 drugs are currently available, others have reached phase III studies and immunotherapy an...
Whether hepatitis B (HBV) coinfection affects outcome in HIV-1-infected patients remains unclear.
To assess the prevalence of HBV (assessed as HBsAg) coinfection and its possible impact on progression to AIDS, all-cause deaths, liver-related deaths and response to highly active antiretroviral therapy (HAART) in the EuroSIDA cohort.
Data on 9802 pat...
To compare the efficacy and tolerability of indinavir (IDV)/ritonavir (RTV) at 800/100 and 400/100 mg twice daily (bid) in antiretroviral therapy (ART)-naive patients.
An open comparison of two groups of ART-naive patients treated with IDV/RTV 800/100 or 400/100 mg bid plus two nucleoside analogues was carried out. Viral load, CD4 cell count and to...
To assess whether adequate strategies are used for the management of cervical intraepithelial neoplasia (CIN) in HIV-positive patients.
Setting: Retrospective study in a HIV reference university hospital. Sixty-eight HIV-infected patients who had undergone a cervical biopsy between January 1995 and March 2002 were matched for CIN and age with HIV-n...
Brain abscesses are classical complications of congenital heart disease (CHD) in children and adolescents. This association is rarely observed in adults. We report a 46-year-old man presenting a fronto-parietal abscess associated with an asymptomatic atrial septal defect. Positron emission tomography (PET) study revealed high uptake of l-[methyl-11...
Projects
Project (1)
