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Biomedical subjects

P Veyssier

Publications and source records attributed to P Veyssier.

At least 37 records · Page 2Linked to original sources
PubMed1998

Hepatitis C in France: a national survey in the Departments of Internal Medicine and Infectious Diseases. The GERMIVIC (Joint Study Group on Hepatitis C virus of the French National Society of Internal Medicine and the French Society of Infectious Diseases).

Infection with Hepatitis C virus is a significant public health problem that has important clinical and financial consequences. Understanding of the epidemiology of HCV is needed to help define future therapeutic and preventive strategies. So far, the importance and characteristics of the epidemics have been best appreciated in specialist units dealing with liver disease. The purpose of our study was to survey the number and characteristics of hepatitis C antibody positive patients in Departments of Internal Medicine and Infectious Diseases. We conducted a multicentre national prospective analysis of all positive HCV-antibody patients, either inpatient or outpatient, reported over a period of one month across France. Two thousand and two cases were identified. Epidemiological, clinical and therapeutic characteristics are described. Risk factors were identified in 86%. For 10% of the patients, hepatitis C seropositivity was discovered during the period of survey. At the time of first diagnosis, 47% of patients presented with no clinical or biological abnormality. Coinfection with HIV was frequent (59%). Only 20.3% of the patients had received or were receiving a treatment with interferon. Within the limits of the methodology used, this study shows that Hepatitis C infection is a substantial clinical problem in French Departments of Internal Medicine and Infectious Diseases. Our findings may help the public health authorities in better appreciating the impact of hepatitis C and making policy decisions.

Adolescent↗
PubMed1996

Relationship between sex steroid hormone levels and CD4 lymphocytes in HIV infected men.

The serum concentrations of the steroid, androgens and estrogens, in the HIV-positive male patients were studied. These men belonged to one of the three main behaviour groups: heterosexual (He), drug addicts (DA) and homosexual (Ho) at early stages (II and III) or at advanced stage of AIDS (IVC), classified according to the Centers for Disease Control (CDC). The circulating concentrations of sex steroids were then analysed with reference to the risk factors, absolute CD4 cell count and the progression of HIV infection. Regardless of risk factors, the stage II and III HIV-infected patients had serum dehydro-epiandrosterone sulfate (DHEAs) (+37%, p < 0.03), testosterone (T) (+24%, p < 0.006) and estrone (E1) (+170%, p < 0.0001) levels higher than those of controls. The patients IVC stage had low serum DHEAs (-48%, p < 0.0001) and elevated estradiol (E2) (+200%, p < 0.0001). According to risk factors, there were no significant differences in androgen and estrogen concentrations between the behaviour groups. There were significant positive correlations between the CD4 cell count and the serum concentrations of DHEAs (p < 0.0001), DHEA (p < 0.01) and E1 (p < 0.006). This suggests that there is a relationship between the circulating sex hormone levels, particularly DHEAs, and the progression of immune depression in HIV, whatever the risk factor. The observed association between DHEAs and the progression of HIV infection suggests that this androgen may play a role in the normal function of the immune system.

Adult↗
PubMed1996

Hypothalamo-pituitary-adrenal function in human immunodeficiency virus-infected men.

We prospectively studied adrenal function in 51 human immunodeficiency virus-positive male patients, including heterosexuals, homosexuals, and iv drug users, classified according to 1987 CDC criteria as belonging to stages II/III or IVC. Basal serum concentrations of cortisol (F), progesterone (P4) and 17 alpha-hydroxyprogesterone (17 alpha-OHP4) were determined during the two stages. In stage IVC patients, the circadian rhythms of ACTH and F were assessed, and ovine CRH (oCRH) and immediate cosyntropin-stimulating tests were evaluated. Serum concentrations of hormones were analyzed in relationship to the absolute CD4 cell count in all subjects. The mean serum F concentration in stage IVC patients, the mean P4 concentration in stage II/III and IVC patients, and the mean 17 alpha-OHP4 level in stage II/III patients were significantly increased compared to control values (P < 0.0001, P < 0.0001, and P < 0.002, respectively). The mean serum F concentration in stage IVC patients was significantly increased compared to that in stage II/III patients (P < 0.004), and the mean serum 17 alpha-OHP4 concentration in stage II/III patients was significantly increased compared to that in stage IVC patients (P < 0.02). In the 22 stage IVC patients, the circadian rhythms of ACTH and F were normal in all but 7 for ACTH and 5 for F, whereas oCRH test results indicated that 14 of them had reduced or blunted responses. By contrast, cosyntropin stimulation results were normal. CD4 cell counts were significantly negatively correlated with the serum F concentration (P < 0.02). In conclusion, during human immunodeficiency virus infection, the serum F concentration was negatively correlated with CD4 cell counts. Cosyntropin test results were normal, but 63% of the stage IVC men had abnormal responses to oCRH.

17-alpha-Hydroxyprogesterone↗
PubMed1995

Safety, pharmacokinetics, and antiviral activity of A77003, a C2 symmetry-based human immunodeficiency virus protease inhibitor.

A77003, an inhibitor of the human immunodeficiency virus type 1 (HIV-1) protease, was administered to asymptomatic HIV-1-infected patients in a phase I trial. The drug was given by continuous intravenous infusion at dosages of 0.035, 0.07, 0.14, and 0.28 mg/kg of body weight per h. The drug was given first for 24 h and then for up to an additional 4 weeks in a second infusion period following at least a 6-day washout. Apart from reversible increases in hepatic transaminase levels in some patients, no systemic toxicities occurred during extended infusion of the drug. Dose-related local vein irritation, despite dilution of the infusate, however, caused severe infusion site phlebitis precluding dosage escalation beyond 0.28 mg/kg/h. Pharmacokinetic analysis demonstrated dose linear increases in mean steady-state concentrations. However, clearance of the drug from plasma was unexpectedly high, averaging 62 liters/h across all groups. The concentrations of A77003 in plasma achieved the in vitro 50% inhibitory concentration (0.16 microgram/ml) only in the 0.28-mg/kg/h dosage group, but it did not attain the 90% inhibitory concentration (0.48 micrograms/ml). No statistically significant effect on CD4 cell numbers occurred in any of the groups, and there was no evidence of antiviral activity, as determined by HIV-1 p24 antigen level, quantitative plasma and cell culture, and quantitation of viral RNA in plasma. In conclusion, A77003, as formulated in the present study, causes severe phlebitis, which prevents administration of the infusates necessary to achieve high concentrations of the drug in plasma. In conclusion, A77003, as formulated in the present study, causes severe phlebitis, which prevents administration of the infusates necessary to achieve high concentrations of the drug in plasma. The lack of antiviral activity observed in the study may be a consequence of the low concentrations in plasma in all groups.

Adolescent↗
PubMed1995

[Giant hemangioma of the liver disclosed by fever and an inflammatory syndrome. Apropos of 3 cases].

Three cases of giant liver haemangioma were revealed by fever and biological inflammatory changes, which disappeared after resection of the haemangioma. These rare symptoms accompanying liver haemangioma may lead to misdiagnosis. Resection whenever possible results in the disappearance of symptoms. Anatomic necrotic changes inside the angioma seem to be the cause of these inflammatory patterns.

Aged↗
PubMed1995

Serum lipid concentration with reference to the clinical and immunological status of HIV infected men.

We investigated the serum concentrations of free fatty acids (FFA), cholesterol, phopholipids and triglycerides in HIV-positive men (n = 50) from three behaviour groups: heterosexuals (n = 16), drug addicts (n = 18) and homosexuals (n = 16) and a control group of HIV-negative men (n = 25). The circulating concentrations of lipids were analyzed with reference to the clinical status of infection and the absolute CD4 cell count. According to the clinical progression of HIV infection the patients were divided into two groups (CDC 1987 criteria): stages II and III (n = 28) and stage IVC (n = 22). HIV-positive men had higher polyunsaturated fatty acids (PUFA) (+100%), p < 0.001) only in the II and III stages, lower cholesterol (-25% to -40%, p < 0.001) and lower phospholipids (-25%, p < 0.001) for the two stages than in the controls. The triglycerides were increased only in stage IVC patients compared to the controls (+110%, p < 0.001). According to their CD4 cell count, the patients were divided into four groups: > 400 (n = 11), 400-150 (n = 9), 150-50 (n = 9) and < 50 (n = 19). Regardless of the CD4 count, the PUFA were significantly higher (+50% to +125%) and cholesterol (-35% to -45%) and phospholipids (-25% to -30%) lower than in the controls in all HIV-infected men except the patients with 400-150 CD4. Only the HIV-positive patients with < 50 CD4 cells had elevated triglycerides (+97%, p < 0.001). There was a significant negative correlation between the CD4 cell count and the serum triglyceride concentrations (r = -0.31, p < 0.03). In conclusion, the most elevated PUFA occurred in HIV-positive patients with > 400 CD4, while hypertriglyceridaemia is prevalent in very advanced stages of infection (with < 50 CD4). This suggests that there is a relationship between the circulating PUFA and triglycride levels and the progression of infection and immune suppression. The disturbances in lipid metabolism must now be correlated with the underlying metabolic, hormonal and cytokine changes and their role in the development of significant malnutrition and immune perturbations.

Adult↗
PubMed1994

[Streptococcus pneumoniae bacteremia and HIV infection. Retrospective study of 41 episodes in 30 patients].

OBJECTIVES: Pulmonary infections and bacteraemia, essentially due to Streptococcus pneumoniae and Haemophilus influenzae, are frequently reported in patients infected with the human immunodeficiency virus (HIV). We retrospectively analyzed episodes of bacteraemia in HIV-infected patients to determine whether supplementary risk factors could be ascertained and whether it would be advisable to propose vaccination. METHODS: From June 1986 to February 1992, 41 episodes of bacteraemia in 30 HIV-infected patients were observed in 7 different wards. Data on age, sex, risk group, Centers for Disease Control classification, CD4 counts and clinical outcome were recorded. RESULTS: There were 18 males and 12 females, mean age 34 years (range 26-67 years) in CDC class II (n = 11), III (n = 5) and IV (n = 16). There were 17 intravenous drug users (56.6%). There were 8 heterosexuals (26%), 3 homosexuals or bisexuals (n = 3) and 2 patients infected after blood transfusions (6%). All the heterosexual patients were of black-African or Carabean ethnic origin. Mean CD4 count was 239 mm3 (range 2-1148) during the episode of bacteraemia which occurred during an upper respiratory tract infection in 96% of the patients. Recurrent episodes were observed in 7 patients. Outcome of the infectious episode was favourable in 35/41 cases after antibiotic therapy. Six patients (all CDC class IV) died during the episode of bacteraemia. CONCLUSIONS: These observations showed that intravenous drug use and black-African ethnic origin are supplementary risk factors for S. pneumoniae infection in HIV-infected patients. The frequency of upper respiratory tract infections in these patients suggests that anti-S. pneumoniae vaccination should be evaluated further.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Efficacy and tolerance of cefotiam hexetil in the super-infected chronic sinusitis. A randomized, double-blind study in comparison with cefixime].

Efficacy and safety of a new oral third generation Cephalosporin, Cefotiam Hexetil (CTM) 200 mg bid were compared with those of Cefixime (CX) 200 mg bid over 10 day duration of treatment. One hundred and twenty two ambulatory adults suffering from chronic sinusitis were randomized by ENT specialists in this multicentre prospective double blind, doubled dummy study. Sinusitis diagnosis evocated in front of fascial pain, purulent nasal discharge and/or obstruction was confirmed with sinus X-ray. Use of antibiotics or corticosteroids concomitantly or 15 days prior inclusion represented one of the major exclusion criterion. One hundred and seventy one patients were evaluated for efficacy analysis (62 and 59 respectively in CTM and CX groups). Regarding demographic data, clinical and radiological signs, the two populations were comparable at inclusion excepted for sex and weight (female: 73% in CTM group versus 47% in CX group). The overall clinical success rate at the end of treatment (cure+improvement) was not significantly different between the two groups (CTM: 82% versus CX: 80%). The incidence of adverse events was less frequent in the CTM group (14.5% versus 19%). In conclusion, CTM 200 mg bid is as efficacious and as well tolerated as CX 200 mg bid in the treatment of chronic sinusitis in adults.

Anti-Infective Agents↗
PubMed1994

Antiphospholipid and anti-beta 2 glycoprotein I antibodies in monozygotic twin sisters.

We describe an 18-year-old woman with primary antiphospholipid syndrome whose monozygotic twin sister is as yet an asymptomatic carrier of the lupus anticoagulant, anticardiolipin, and anti-beta 2 glycoprotein I (beta 2GPI) antibodies. Serum concentrations of beta 2GPI were normal in the patient and elevated in her sister. HLA and complement C4 phenotypes showed the presence of class II antigens DR7 and DRw53 and of a C4AQ0 allele. This supports the theory that a genetic predisposition may influence the appearance of these autoantibodies.

Adolescent↗
PubMed1994

[African histoplasmosis: clinical and therapeutic aspects, relation to AIDS. Apropos of 4 cases, including a case with HIV-1-HTLV-1 co-infection].

The authors report 4 cases of African histoplasmosis in Zaïrans. The diagnostic was based ou cutaneous (4 patients), bones (3), lymph-nodes (2), and bowel-localizations (1) and was confirmed by the presence of Histoplasma duboisiis yeasts in cutaneous biopsy (4 patients), in pus of abscess or cutaneous lesions (3) and in stools (1). Two HIV seronegatives patients had a good outcome with amphotericin B. One patient died without any treatment. One HIV-1 and HTLV-1 seropositive patient had successful short-term outcome with ketoconazole. Seven others cases of association between African histoplasmosis and AIDS are noted in the literature. They suggest the opportunistic nature of this deep mycosis.

AIDS-Related Opportunistic Infections↗
PubMed1994

Safety of pentamidine prophylaxis for Pneumocystis carinii pneumonia on the endocrine pancreatic function in HIV patients.

We assessed the pancreatic beta cells function of HIV patients receiving either 300 mg per month of aerosolized pentamidine (n = 12) or oral trimethoprim-sulfamethoxazole (TMP-SMX), twice a day three times per week (TMP: 160 mg, SMX: 800 mg) (n = 10). Intravenous (i.v.) glucose tolerance tests were performed after i.v. injection of 0.5 glucose by kg of body weight in 30 seconds. Plasma insulin levels were assessed at baseline, 1, 2, 3 and 5 min. Moreover, in patients receiving inhaled pentamidine, plasma glucose amylase and insulin levels were measured every 30 min for 2 hours after the end of the aerosol. Plasma pentamidine levels were measured 30 min after the end of the aerosol. Those tests were performed every 2-3 months for one year. In most patients taking aerosol treatment, pentamidine levels were detectable, remaining under levels of 50 ng/ml. Pentamidine plasma levels increased in a time dependent manner. Baseline plasma glucose, amylase and insulin levels were in normal range and remained stable during the therapy. For 7 out of 12 patients, glucose tolerance tests showed an adequate insulin secretion: the addition of the two best insulin levels were higher than 70 IU/ml. When this criteria was not found (n = 5), a glucagon stimulation test allowed to exclude an endocrine pancreatic dysfunction. Due to its apparent short half-life, increased pentamidine levels could be related to an improvement of spray techniques as well as to a cumulative effect. Pancreatic function was preserved in pentamidine-treated patients compared to TMP-SMX-treated patients.

AIDS-Related Opportunistic Infections↗