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Antoine Adenis
Ecosystèmes Amazoniens et Pathologies Tropicales, EA3593, Université de Guyane, Cayenne, France

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Conference paper
Published: 31 August 2021 in Transplantation Proceedings
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Infectious complications in kidney transplant recipients (KTRs) are well studied in temperate countries but remain barely known in tropical ones. The main objective of this study was to describe infection-related hospitalizations in patients living in the Amazon, where it has never been described. All KTRs residing in French Guiana between 2007 and 2018 were included retrospectively. Infection-related hospitalizations were collected in the main medical centers of the territory. Eighty-two patients were included, and 42 were infected during the study period (51%). Eighty-seven infections were identified. The main sites of infection were urinary, in 29% of cases (25/87), and pulmonary, in 22% of cases (19/87). When documented (48/87), bacterial infections were predominant (35/48), followed by viral (8/48), fungal (4/48), and parasitic infections (1/48). Endemic so-called tropical infections accounted for 6% of infections (5/87). Histoplasma capsulatum was the most commonly isolated fungus (2/4). This study suggests that the spectrum of infections in KTRs in French Guiana differs little from that of temperate countries. Nevertheless, some tropical infections are described. More studies on fungal infections in KTRs should be undertaken to clarify the weight of histoplasmosis in these patients.

ACS Style

Laurene Cachera; Antoine Adenis; Jean-Marc Dueymes; Devi Rochemont; Basma Guarmit; Raoul Roura; Mohamed Meddeb; Mathieu Nacher; Felix Djossou; Loic Epelboin. What Is the Part of Tropical Diseases Among Infectious Complications in Renal Transplant Recipients in the Amazon? A 12-Year Multicenter Retrospective Analysis in French Guiana. Transplantation Proceedings 2021, 1 .

AMA Style

Laurene Cachera, Antoine Adenis, Jean-Marc Dueymes, Devi Rochemont, Basma Guarmit, Raoul Roura, Mohamed Meddeb, Mathieu Nacher, Felix Djossou, Loic Epelboin. What Is the Part of Tropical Diseases Among Infectious Complications in Renal Transplant Recipients in the Amazon? A 12-Year Multicenter Retrospective Analysis in French Guiana. Transplantation Proceedings. 2021; ():1.

Chicago/Turabian Style

Laurene Cachera; Antoine Adenis; Jean-Marc Dueymes; Devi Rochemont; Basma Guarmit; Raoul Roura; Mohamed Meddeb; Mathieu Nacher; Felix Djossou; Loic Epelboin. 2021. "What Is the Part of Tropical Diseases Among Infectious Complications in Renal Transplant Recipients in the Amazon? A 12-Year Multicenter Retrospective Analysis in French Guiana." Transplantation Proceedings , no. : 1.

Journal article
Published: 19 July 2021 in Journal of Fungi
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Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of Histoplasma capsulatum is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to describe the cytology of histoplasmosis diagnosed by bronchoalveolar lavage (BAL) in relation to patient characteristics. BAL-diagnosed pulmonary histoplasmosis concerned 17 patients (14 HIV+). BAL cellularity ranged from 76,000 to 125,000 cells/mL in HIV patients, and 117,000 to 160,000 cells/mL in non-HIV patients. Macrophages predominated in all HIV patients (from 60% to 88%), lymphocytic infiltrates ranged from 5% to 15%, and neutrophils were very heterogeneous (from 2% to 32%). The number of H. capsulatum at hot spots seemed greater in HIV-infected than in immunocompetent patients (9 to 375 vs. 4 to 10) and were inversely proportional to the CD4 counts. Yeasts were both intracellular and extracellular in 85.7% of the HIV patients. This is the most comprehensive series detailing the cytological aspects of BAL in the diagnosis of H. capsulatum, focusing on the number of yeasts and their clustering pattern. The cytological examination of the Gomori-Grocott-stained BAL allows a reliable diagnosis of histoplasmosis.

ACS Style

Kinan Drak Alsibai; Houari Aissaoui; Antoine Adenis; Morgane Bourne-Watrin; Felix Djossou; Loïc Epelboin; Denis Blanchet; Magalie Demar; Pierre Couppié; Mathieu Nacher. Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana. Journal of Fungi 2021, 7, 576 .

AMA Style

Kinan Drak Alsibai, Houari Aissaoui, Antoine Adenis, Morgane Bourne-Watrin, Felix Djossou, Loïc Epelboin, Denis Blanchet, Magalie Demar, Pierre Couppié, Mathieu Nacher. Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana. Journal of Fungi. 2021; 7 (7):576.

Chicago/Turabian Style

Kinan Drak Alsibai; Houari Aissaoui; Antoine Adenis; Morgane Bourne-Watrin; Felix Djossou; Loïc Epelboin; Denis Blanchet; Magalie Demar; Pierre Couppié; Mathieu Nacher. 2021. "Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana." Journal of Fungi 7, no. 7: 576.

Journal article
Published: 21 June 2021 in Vaccines
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Background: In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods: A cross-sectional survey was conducted from January 22 to March 26, 2021 among a sample of HCWs in French Guiana. They were asked about their willingness to get vaccinated against COVID-19 and vaccine hesitancy, vaccine uptake and vaccines attitudes. Factors associated with willingness to get vaccinated have been analyzed with ordinal logistic regression, using Stata software. Results: A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. HCWs were more willing to get vaccine if they were older, were worried about COVID-19 and were confident in the management of epidemic. Conversely, participants were less likely to have been vaccinated or willing to if they were nurses or of another non-medical profession, born in French Guiana, feared adverse effects, or if they did not trust pharmaceutical companies and management of the epidemic by authorities. Conclusion: Negative attitudes towards vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with Gamma VOC. General vaccine hesitancy and concerns about future side effects in particular represent important barriers. Low confidence in government and science are significant in COVID-19 vaccine refusal among non-medical staffs. Public health messaging with information on vaccine safety should be tailored to address these concerns. The specific challenges of HCWs from French Guiana must be taken into account.

ACS Style

Nicolas Vignier; Kepha Brureau; Sybille Granier; Jacques Breton; Céline Michaud; Mélanie Gaillet; Camille Agostini; Mathilde Ballet; Mathieu Nacher; Audrey Valdes; Philippe Abboud; Antoine Adenis; Félix Djossou; Loïc Epelboin; Maylis Douine. Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin. Vaccines 2021, 9, 682 .

AMA Style

Nicolas Vignier, Kepha Brureau, Sybille Granier, Jacques Breton, Céline Michaud, Mélanie Gaillet, Camille Agostini, Mathilde Ballet, Mathieu Nacher, Audrey Valdes, Philippe Abboud, Antoine Adenis, Félix Djossou, Loïc Epelboin, Maylis Douine. Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin. Vaccines. 2021; 9 (6):682.

Chicago/Turabian Style

Nicolas Vignier; Kepha Brureau; Sybille Granier; Jacques Breton; Céline Michaud; Mélanie Gaillet; Camille Agostini; Mathilde Ballet; Mathieu Nacher; Audrey Valdes; Philippe Abboud; Antoine Adenis; Félix Djossou; Loïc Epelboin; Maylis Douine. 2021. "Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin." Vaccines 9, no. 6: 682.

Journal article
Published: 02 June 2021 in The American Journal of Tropical Medicine and Hygiene
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Cutaneous leishmaniasis (CL) is firmly established in South America. We aimed to assess the detection of IgG antibodies against 14 and/or 16 kDa antigens by immunoblot (IB) for CL serological diagnosis in French Guiana, an area where many endemic pathogens could interfere with it. This study was performed retrospectively on sera from 141 patients at the Cayenne tertiary hospital: 30 were patients with confirmed CL, 71 were diagnosed with various other endemic pathogens, 11 were diagnosed with an autoimmune disease, and 29 controls had no history of CL. Antibodies bound to the 14 and/or 16 kDa antigens in 27 of the 30 CL patients’ sera and in 39 of the 111 non-CL patients’ sera (26 from the infectious diseases group, four from the autoimmune diseases group, and nine from the dermatology department). The method tested showed a high sensitivity (90%) and a low specificity (66%), and a diagnosis odds ratio of 17.5 (95% CI [4.6–78.0]). This IB may be helpful to exclude the diagnosis of CL, prompting physicians to look for another diagnosis in the case of a negative IB.

ACS Style

Estelle Menu; Romain Blaizot; Charles Mary; Stéphane Simon; Antoine Adenis; Denis Blanchet; Coralie L’Ollivier; Stéphane Ranque; Magalie Demar. Immunoblot for the Diagnosis of Cutaneous Leishmaniasis in French Guiana. The American Journal of Tropical Medicine and Hygiene 2021, 104, 2091 -2096.

AMA Style

Estelle Menu, Romain Blaizot, Charles Mary, Stéphane Simon, Antoine Adenis, Denis Blanchet, Coralie L’Ollivier, Stéphane Ranque, Magalie Demar. Immunoblot for the Diagnosis of Cutaneous Leishmaniasis in French Guiana. The American Journal of Tropical Medicine and Hygiene. 2021; 104 (6):2091-2096.

Chicago/Turabian Style

Estelle Menu; Romain Blaizot; Charles Mary; Stéphane Simon; Antoine Adenis; Denis Blanchet; Coralie L’Ollivier; Stéphane Ranque; Magalie Demar. 2021. "Immunoblot for the Diagnosis of Cutaneous Leishmaniasis in French Guiana." The American Journal of Tropical Medicine and Hygiene 104, no. 6: 2091-2096.

Journal article
Published: 27 May 2021 in Journal of Fungi
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Although the burden of histoplasmosis in patients with advanced HIV has been the focus of detailed estimations, knowledge about invasive fungal infections in patients living with HIV in an Amazonian context is somewhat scattered. Our goal was thus to adopt a broader view integrating all invasive fungal infections diagnosed over a decade in French Guiana. All patients hospitalized at Cayenne hospital from 1 January 2009 to 31 December 2018 with a proven diagnosis of invasive fungal infection were included (N = 227). Histoplasmosis was the most common (48.2%), followed by Cryptococcus infection (26.3%), and pneumocystosis (12.5%). For cryptococcal infection, there was a discordance between the actual diagnosis of cryptococcal meningitis n = (26) and the isolated presence of antigen in the serum (n = 46). Among the latter when the information was available (n = 34), 21(65.6%) were treated with antifungals but not coded as cryptococcocosis. Most fungal infections were simultaneous to the discovery of HIV (38%) and were the AIDS-defining event (66%). The proportion of major invasive fungal infections appeared to remain stable over the course of the study, with a clear predominance of documented H. capsulatum infections. Until now, the focus of attention has been histoplasmosis, but such attention should not overshadow other less-studied invasive fungal infections.

ACS Style

Laurène Cachera; Antoine Adenis; Basma Guarmit; Sébastien Rabier; Pierre Couppié; Felix Djossou; Loïc Epelboin; Alessia Melzani; Philippe Abboud; Denis Blanchet; Magalie Demar; Kinan Alsibai; Mathieu Nacher. Invasive Fungal Infections in Persons Living with HIV in an Amazonian Context: French Guiana, 2009–2019. Journal of Fungi 2021, 7, 421 .

AMA Style

Laurène Cachera, Antoine Adenis, Basma Guarmit, Sébastien Rabier, Pierre Couppié, Felix Djossou, Loïc Epelboin, Alessia Melzani, Philippe Abboud, Denis Blanchet, Magalie Demar, Kinan Alsibai, Mathieu Nacher. Invasive Fungal Infections in Persons Living with HIV in an Amazonian Context: French Guiana, 2009–2019. Journal of Fungi. 2021; 7 (6):421.

Chicago/Turabian Style

Laurène Cachera; Antoine Adenis; Basma Guarmit; Sébastien Rabier; Pierre Couppié; Felix Djossou; Loïc Epelboin; Alessia Melzani; Philippe Abboud; Denis Blanchet; Magalie Demar; Kinan Alsibai; Mathieu Nacher. 2021. "Invasive Fungal Infections in Persons Living with HIV in an Amazonian Context: French Guiana, 2009–2019." Journal of Fungi 7, no. 6: 421.

Journal article
Published: 16 May 2021 in Public Health in Practice
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Cervical cancer is the second most frequent cancer among women in French Guiana. The objective was to review a decade of cervical cancer data, and to study spatial and temporal trends. The design was retrospective and descriptive. The cancer registry of French Guiana compiled exhaustive data on cervical cancer throughout French Guiana between 2005 and 2015. Age-standardized incidence and mortality were computed and mapped to identify priority areas. With 232 new cases recorded in French Guiana between 2005 and 2014 (23 annual cases), cervical cancer ranked 5th among all incident cancers (11%) and was the 2nd most frequent cancer in women (12% of cancers among women). The standardized incidence rate over the period 2005–2014 was 23.8 cases of cervical cancer per 100 000 woman-years. Between 2005-2009 and 2010–2014 the incidence of cervical cancer decreased from 26.26 cases per 100 000 to 22.66 cases per 100 000 and the mortality rate from cervical cancer decreased from 6 deaths per 100 000 to 3.2 deaths per 100 000. Within French Guiana, the standardized incidence rates were very heterogenous with the highest rates in remote areas. The standardized death rate from cervical cancer over the 2005–2014 decade was 4.4 cases per 100 000 woman-years. The present results suggest there has been progress in French Guiana, but there are still areas where screening is challenging and should be expanded. The recent authorization of HPV testing is an opportunity that could help health professionals achieve this goal. HPV vaccination –with a nonavalent vaccine—is also an important public health endeavor that could alleviate the burden of cervical cancer among the cohorts of women benefitting from it.

ACS Style

Laure Manuella Imounga; Juliette Plenet; Sophie Belliardo; Elie Chow Chine; Antoine Adenis; Mélanie Gaillet; Nadia Thomas; Céline Michaud; Véronique Servas; Pierre Couppié; Kinan Drak Alsibai; Mathieu Nacher. Incidence and mortality of cervical cancer in French Guiana: Temporal and spatial trends. Public Health in Practice 2021, 2, 100138 .

AMA Style

Laure Manuella Imounga, Juliette Plenet, Sophie Belliardo, Elie Chow Chine, Antoine Adenis, Mélanie Gaillet, Nadia Thomas, Céline Michaud, Véronique Servas, Pierre Couppié, Kinan Drak Alsibai, Mathieu Nacher. Incidence and mortality of cervical cancer in French Guiana: Temporal and spatial trends. Public Health in Practice. 2021; 2 ():100138.

Chicago/Turabian Style

Laure Manuella Imounga; Juliette Plenet; Sophie Belliardo; Elie Chow Chine; Antoine Adenis; Mélanie Gaillet; Nadia Thomas; Céline Michaud; Véronique Servas; Pierre Couppié; Kinan Drak Alsibai; Mathieu Nacher. 2021. "Incidence and mortality of cervical cancer in French Guiana: Temporal and spatial trends." Public Health in Practice 2, no. : 100138.

Journal article
Published: 10 May 2021 in The American Journal of Tropical Medicine and Hygiene
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Disseminated histoplasmosis is the most frequent acquired immunodeficiency syndrome–defining illness in French Guiana. Paradoxically, central nervous system (CNS) involvement has been scarcely described. We aimed to identify CNS histoplasmosis in our territory. We conducted an observational, multicentric, descriptive, and retrospective study including patients with proven or probable CNS histoplasmosis according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MGS). The study population consisted of patients admitted in one of the hospitals of French Guiana between January 1, 1990 and December 31, 2019. During the study period, 390 cases of HIV-associated histoplasmosis were recorded, in which six of them had CNS infections with Histoplasma capsulatum. The male to female sex ratio was 0.25, and the median age at diagnosis was 37.5 years. The median CD4 count was 42 cells/mm3 ([IQR: 29–60]). All patients had disseminated histoplasmosis. Usual signs of meningitis were observed in three patients and focal signs in four patients. One patient had no neurological signs. The median time between the first cerebral symptoms and diagnosis was 22.4 days (IQR 9.5–36.2). Two patients died within a month after diagnosis. In conclusion, few proven CNS localizations of histoplasmosis were observed on 30-year study in French Guiana. This low proportion suggests that the documentation of CNS involvement is often not ascertained for lack of awareness of this particular presentation, and for lack of rapid and sensitive diagnostic tools.

ACS Style

Loïc Epelboin; Aïda Dione; Alexandra Serris; Denis Blanchet; Bastien Bidaud; Gaëlle Walter; Philippe Abboud; Emilie Mosnier; Mélanie Gaillet; Céline Michaud; Pierre Couppié; Magalie Demar; Mathieu Nacher; Félix Djossou; Antoine Adenis. Histoplasmosis of the Central Nervous System: A Case Series between 1990 and 2019 in French Guiana. The American Journal of Tropical Medicine and Hygiene 2021, -1, 125 -129.

AMA Style

Loïc Epelboin, Aïda Dione, Alexandra Serris, Denis Blanchet, Bastien Bidaud, Gaëlle Walter, Philippe Abboud, Emilie Mosnier, Mélanie Gaillet, Céline Michaud, Pierre Couppié, Magalie Demar, Mathieu Nacher, Félix Djossou, Antoine Adenis. Histoplasmosis of the Central Nervous System: A Case Series between 1990 and 2019 in French Guiana. The American Journal of Tropical Medicine and Hygiene. 2021; -1 (aop):125-129.

Chicago/Turabian Style

Loïc Epelboin; Aïda Dione; Alexandra Serris; Denis Blanchet; Bastien Bidaud; Gaëlle Walter; Philippe Abboud; Emilie Mosnier; Mélanie Gaillet; Céline Michaud; Pierre Couppié; Magalie Demar; Mathieu Nacher; Félix Djossou; Antoine Adenis. 2021. "Histoplasmosis of the Central Nervous System: A Case Series between 1990 and 2019 in French Guiana." The American Journal of Tropical Medicine and Hygiene -1, no. aop: 125-129.

Preprint content
Published: 22 April 2021
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BACKGROUND An interventional study named Malakit was implemented between 2018 and 2020 to address malaria on gold mining areas in French Guiana, in collaboration with Suriname and Brazil. This innovative intervention relied on the distribution of kits for self-diagnosis and self-treatment to gold miners after training by health mediators, named “facilitators” in the project. OBJECTIVE This paper aims to describe the process by which the information system was designed, developed and implemented to achieve the monitoring and evaluation of the Malakit intervention. METHODS The intervention was implemented in challenging conditions in five cross-border distribution sites which imposed strong logistical constraints for the design of the information system: isolation in the Amazon forest, tropical climate, lack of reliable electricity supply and Internet connection. Additional constraints originated from the interaction of the multicultural players involved in the study. The Malakit information system was developed as a patchwork of existing open-source, commercial services and tools developed in-house. Facilitators collected data from participants using Android tablets with ODK Collect, and sent encrypted form records to Ona when Internet was available. A custom R package (MalakitR) and a dashboard web app were developed to retrieve, decrypt, aggregate, monitor and clean data according to the feedback of facilitators and supervision visits on the field. RESULTS Between April 2018 and March 2020, nine facilitators generated a total of 4,863 form records, corresponding to an average of 202 records per month. Facilitators’ feedback was essential to adapt and improve mobile data collection and monitoring. Few technical issues were reported. The median duration of data capture was five minutes, suggesting that EDC was not overtaking time from participants, and it decreased over the course of the study as facilitators become more experienced. The quality of data collected by facilitators was satisfactory with only 3% of form records requiring correction. CONCLUSIONS The development of the information system for the Malakit project was a source of innovation that mirrored the inventiveness of the intervention itself. Our experience confirms that, even in a challenging environment, it is possible to produce good quality data and evaluate a complex health intervention by carefully adapting tools to field constraints and health mediators’ experience. CLINICALTRIAL ClinicalTrials.gov NCT03695770

ACS Style

Yann Lambert; Muriel Suzanne Galindo; Martha Cecilia Suárez-Mutis; Louise Mutricy; Alice Sanna; Laure Garancher; Hedley Cairo; Helene Hiwat; Jane Bordalo Miller; José Hermenegildo Gomes; Paola Marchesini; Antoine Adenis; Mathieu Nacher; Stephen Vreden; Maylis Douine. Tailoring Mobile Data Collection for Intervention Research in a Challenging Context: Development and Implementation in the Malakit Study (Preprint). 2021, 1 .

AMA Style

Yann Lambert, Muriel Suzanne Galindo, Martha Cecilia Suárez-Mutis, Louise Mutricy, Alice Sanna, Laure Garancher, Hedley Cairo, Helene Hiwat, Jane Bordalo Miller, José Hermenegildo Gomes, Paola Marchesini, Antoine Adenis, Mathieu Nacher, Stephen Vreden, Maylis Douine. Tailoring Mobile Data Collection for Intervention Research in a Challenging Context: Development and Implementation in the Malakit Study (Preprint). . 2021; ():1.

Chicago/Turabian Style

Yann Lambert; Muriel Suzanne Galindo; Martha Cecilia Suárez-Mutis; Louise Mutricy; Alice Sanna; Laure Garancher; Hedley Cairo; Helene Hiwat; Jane Bordalo Miller; José Hermenegildo Gomes; Paola Marchesini; Antoine Adenis; Mathieu Nacher; Stephen Vreden; Maylis Douine. 2021. "Tailoring Mobile Data Collection for Intervention Research in a Challenging Context: Development and Implementation in the Malakit Study (Preprint)." , no. : 1.

Communication
Published: 12 February 2021 in Journal of Fungi
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Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating Histoplasma antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines. Appropriate health education of providers, supportive supervision, and policy guidance for the care of PLHIV are required.

ACS Style

Freddy Perez; Diego Caceres; Nathan Ford; Giovanni Ravasi; Beatriz Gomez; Alessandro Pasqualotto; Paul Hine; Antoine Adenis; Mathieu Nacher; Tom Chiller; John Baddley; for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. Summary of Guidelines for Managing Histoplasmosis among People Living with HIV. Journal of Fungi 2021, 7, 134 .

AMA Style

Freddy Perez, Diego Caceres, Nathan Ford, Giovanni Ravasi, Beatriz Gomez, Alessandro Pasqualotto, Paul Hine, Antoine Adenis, Mathieu Nacher, Tom Chiller, John Baddley, for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. Summary of Guidelines for Managing Histoplasmosis among People Living with HIV. Journal of Fungi. 2021; 7 (2):134.

Chicago/Turabian Style

Freddy Perez; Diego Caceres; Nathan Ford; Giovanni Ravasi; Beatriz Gomez; Alessandro Pasqualotto; Paul Hine; Antoine Adenis; Mathieu Nacher; Tom Chiller; John Baddley; for the Guideline Development Group for diagnosing and managing disseminated histoplasmosis among people living with HIV. 2021. "Summary of Guidelines for Managing Histoplasmosis among People Living with HIV." Journal of Fungi 7, no. 2: 134.

Research article
Published: 22 January 2021 in PLOS Neglected Tropical Diseases
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Disseminated histoplasmosis is one the main AIDS-defining opportunistic infections in HIV-infected patients, notably in Latin America. The non-specific and proteiform clinical presentation leads to diagnostic delays that may lead to fatal outcomes. This retrospective multicentric study aimed to describe the frequency and manifestations of gastrointestinal histoplasmosis in French Guiana, and to compare patients with disseminated histoplasmosis with or without gastrointestinal involvement. Between January 1, 1981 and October 1, 2014 co-infections with HIV and histoplasmosis were enrolled. Inclusion criteria were: age >18 years, confirmed HIV infection; first proven episode of histoplasmosis. Among 349 cases of disseminated histoplasmosis, 245 (70%) had a gastrointestinal presentation. Half of patients with gastrointestinal signs had abdominal pain or diarrhea, mostly watery. Half of patients with abdominal pain had diarrhea (63/124) and half of those with diarrhea (63/123) had abdominal pain. A significant proportion of patients also had hepatomegaly and, to a lesser degree, splenomegaly. After adjusting for potential confounding, the presence of lymphadenopathies >2cm (AOR = 0.2, IC95 = 0.04–0.7, P = 0.01), Haitian origin (AOR = 0.04, IC95 = 0.004–0.4, P = 0.006) were associated with a lower prevalence of gastrointestinal signs and positive gastrointestinal presence of H. capsulatum. Persons with a gastrointestinal H. capsulatum were more likely to have a decreased prothrombin time, lower ferritin, lower liver enzymes, and lower concentrations of LDH than those without gastrointestinal signs and symptoms. They also had a shorter interval between symptoms onset and diagnosis. Patients with a positive gastrointestinal identification of H. capsulatum were less likely to die at 1 month than those without a gastrointestinal presentation (respectively, 4.6% vs 18.5%, P = 0.01). Subacute or chronic gastrointestinal presentations are very frequent during disseminated histoplasmosis, they seem less severe, and should lead to suspect the diagnosis in endemic areas. There were populational or geographic differences in the frequency of gastrointestinal manifestations that could not be explained.

ACS Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Dominique Louvel; Kinan Drak Alsibai; Pierre Couppié. Gastrointestinal disseminated histoplasmosis in HIV-infected patients: A descriptive and comparative study. PLOS Neglected Tropical Diseases 2021, 15, e0009050 .

AMA Style

Mathieu Nacher, Audrey Valdes, Antoine Adenis, Romain Blaizot, Philippe Abboud, Magalie Demar, Félix Djossou, Loïc Epelboin, Caroline Misslin, Balthazar Ntab, Dominique Louvel, Kinan Drak Alsibai, Pierre Couppié. Gastrointestinal disseminated histoplasmosis in HIV-infected patients: A descriptive and comparative study. PLOS Neglected Tropical Diseases. 2021; 15 (1):e0009050.

Chicago/Turabian Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Dominique Louvel; Kinan Drak Alsibai; Pierre Couppié. 2021. "Gastrointestinal disseminated histoplasmosis in HIV-infected patients: A descriptive and comparative study." PLOS Neglected Tropical Diseases 15, no. 1: e0009050.

Journal article
Published: 30 November 2020 in Journal of Fungi
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Identifying prognostic factors is important in order to guide the choice of first-line therapy for disseminated histoplasmosis. Our objective was to identify factors associated with death among a cohort of 330 patients compiled over 34 years of clinical practice in French Guiana. Survival analysis was performed with death as the failure event and date of symptom onset as the origin event. Incidence rates were and Cox proportional hazards models were computed. Overall, 330 HIV-infected patients with disseminated histoplasmosis were included in the analysis, with 126 deaths occurring. One-quarter of all patients died within 6 months of the first symptoms. Patients with dyspnea, renal failure, arterial blood pressure < 90 mmHG, and a WHO performance score > 2 had a greater incidence of death. Bivariate analyses showed that patients with increased LDH, low hemoglobin, low serum protein, low CD4 counts, and low platelets tended to have a greater incidence of death. After adjusting for potential confounders, patients with dyspnea, a WHO performance score > 2, serum protein < 60 g/L, and hemoglobin < 8.9 g/dL had an increased risk of dying. The interaction terms showed that patients treated with liposomal amphotericin B had a marked reduction in death among patients with renal failure; among renal failure patients, the elevation of LDH was associated with a significant risk of death.

ACS Style

Mathieu Nacher; Kinan Drak Alsibai; Audrey Valdes; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Antoine Adenis; Pierre Couppié. Risk Factors for Mortality among HIV-Infected Patients with Disseminated Histoplasmosis. Journal of Fungi 2020, 6, 326 .

AMA Style

Mathieu Nacher, Kinan Drak Alsibai, Audrey Valdes, Romain Blaizot, Philippe Abboud, Magalie Demar, Félix Djossou, Loïc Epelboin, Caroline Misslin, Balthazar Ntab, Antoine Adenis, Pierre Couppié. Risk Factors for Mortality among HIV-Infected Patients with Disseminated Histoplasmosis. Journal of Fungi. 2020; 6 (4):326.

Chicago/Turabian Style

Mathieu Nacher; Kinan Drak Alsibai; Audrey Valdes; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Antoine Adenis; Pierre Couppié. 2020. "Risk Factors for Mortality among HIV-Infected Patients with Disseminated Histoplasmosis." Journal of Fungi 6, no. 4: 326.

Journal article
Published: 23 November 2020 in Microorganisms
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Amerindian and Maroon populations of French Guiana have been living in isolation for generations and sexual networks remained mostly endogamous. The present study aimed to describe the phylogeny of E6 and E7 sequences of the most common high-risk HPV genotypes in these regions, to ascertain the diversity of intra-type variants and describe evolutionary relationships. There were 106 women with at least one of HPV16, 18, 31, 52, 58, and 68 genotypes. The most clear-cut phylogenetic pattern was obtained for HPV18 and HPV58 for which the major branches were crisply divided between Amerindian villages on the Oyapock and Maroon villages on the Maroni. Such clustering was less clear for HPV31 and 52. For HPV16, there was also some evidence of clustering on the Oyapock with type A European viruses and on the Maroni with type B and C African viruses among Maroon women. HPV68 showed the largest sequence heterogeneity of the six genotypes at both nucleotide and amino acid levels and was restricted to Maroon women. The present results show that there were significant geographically based differences of E6 and E7 oncogenes. These differences were compatible with different ancestral virus populations and local virus evolution in a context of prolonged population isolation.

ACS Style

Mathieu Nacher; Gersande Godefroy; Valentin Dufit; Maylis Douine; Fatiha Najioullah; Raymond Césaire; Nadia Thomas; Kinan Drak Alsibai; Antoine Adenis; Vincent Lacoste. E6/E7 Sequence Diversity of High-Risk Human Papillomaviruses in Two Geographically Isolated Populations of French Guiana. Microorganisms 2020, 8, 1842 .

AMA Style

Mathieu Nacher, Gersande Godefroy, Valentin Dufit, Maylis Douine, Fatiha Najioullah, Raymond Césaire, Nadia Thomas, Kinan Drak Alsibai, Antoine Adenis, Vincent Lacoste. E6/E7 Sequence Diversity of High-Risk Human Papillomaviruses in Two Geographically Isolated Populations of French Guiana. Microorganisms. 2020; 8 (11):1842.

Chicago/Turabian Style

Mathieu Nacher; Gersande Godefroy; Valentin Dufit; Maylis Douine; Fatiha Najioullah; Raymond Césaire; Nadia Thomas; Kinan Drak Alsibai; Antoine Adenis; Vincent Lacoste. 2020. "E6/E7 Sequence Diversity of High-Risk Human Papillomaviruses in Two Geographically Isolated Populations of French Guiana." Microorganisms 8, no. 11: 1842.

Research article
Published: 19 October 2020 in PLOS Neglected Tropical Diseases
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Histoplasmosis is the most frequent opportunistic infection and the first cause of mortality in HIV-infected patients in French Guiana and presumably in much of Latin America. Mucocutaneous lesions of histoplasmosis are considered as rare and late manifestations of the disease. It has been debated whether the greater proportion of cutaneo-mucous presentations in South America relative to the USA was the reflection of Histoplasma strains with increased dermotropism or simply delayed diagnosis and advanced immunosuppression. The objective of this study was to describe the clinical presentation, frequency, prognosis and temporal trends of cutaneomucous histoplasmosis in French Guiana. A retrospective study of patients with AIDS-related disseminated histoplasmosis followed in the three hospitals of French Guiana was performed between 1981 and 2014. Incident cases of histoplasmosis, proved by pathology and/or mycological examinations, were studied. Mucocutaneous histoplasmosis was confirmed by a positive cutaneous or mucosal biopsy. Mucocutaneous lesions were polymorphic. Ninety percent of patients were profoundly immunocompromised patients (CD4<50/mm3) and over 80% were not on antiretroviral treatment. The frequency of mucocutaneous forms and case fatality of disseminated histoplasmosis within one month of antifungal treatment significantly decreased over time (p<0,001). In this South American territory, diagnostic and therapeutic improvements have led to the quasi disappearance of cutaneous manifestations. There may be South American dermotropism in the laboratory but at the bedside early diagnosis seems to be the main parameter explaining the proportion of cutaneomucous presentations in South America relative to the USA. Histoplasmosis is the most frequent opportunistic infection and the first cause of mortality in HIV-infected patients in French Guiana and presumably in much of Latin America. Mucocutaneous lesions of histoplasmosis are considered as rare and late manifestations of the disease. It has been debated whether the greater proportion of cutaneo-mucous presentations in South America relative to the USA was the reflection of Histoplasma strains with increased dermotropism or simply delayed diagnosis and advanced immunosuppression. The objective of this study was to describe the clinical presentation, frequency, prognosis and temporal trends of cutaneomucous histoplasmosis in French Guiana. A retrospective study of patients with AIDS-related disseminated histoplasmosis followed in the three hospitals of French Guiana was performed between 1981 and 2014. Incident cases of histoplasmosis, proved by pathology and/or mycological examinations, were studied. Mucocutaneous histoplasmosis was confirmed by a positive cutaneous or mucosal biopsy. Ninety percent of patients were profoundly immunocompromised patients (CD4<50/mm3) and over 80% were not on antiretroviral treatment. The frequency of mucocutaneous forms and case fatality of disseminated histoplasmosis within one month of antifungal treatment significantly decreased over time. Hence, in this South American territory, diagnostic and therapeutic improvements have led to the quasi-disappearance of cutaneous manifestations. There may be South American dermotropism in the laboratory but at the bedside early diagnosis seems to be the main parameter explaining the proportion of cutaneomucous presentations in South America relative to the USA.

ACS Style

Sophie Morote; Mathieu Nacher; Romain Blaizot; Balthazar Ntab; Denis Blanchet; Kinan Drak Alsibai; Magalie Demar; Félix Djossou; Pierre Couppié; Antoine Adenis. Temporal trends of cutaneo-mucous histoplasmosis in persons living with HIV in French Guiana: Early diagnosis defuses South American strain dermotropism. PLOS Neglected Tropical Diseases 2020, 14, e0008663 .

AMA Style

Sophie Morote, Mathieu Nacher, Romain Blaizot, Balthazar Ntab, Denis Blanchet, Kinan Drak Alsibai, Magalie Demar, Félix Djossou, Pierre Couppié, Antoine Adenis. Temporal trends of cutaneo-mucous histoplasmosis in persons living with HIV in French Guiana: Early diagnosis defuses South American strain dermotropism. PLOS Neglected Tropical Diseases. 2020; 14 (10):e0008663.

Chicago/Turabian Style

Sophie Morote; Mathieu Nacher; Romain Blaizot; Balthazar Ntab; Denis Blanchet; Kinan Drak Alsibai; Magalie Demar; Félix Djossou; Pierre Couppié; Antoine Adenis. 2020. "Temporal trends of cutaneo-mucous histoplasmosis in persons living with HIV in French Guiana: Early diagnosis defuses South American strain dermotropism." PLOS Neglected Tropical Diseases 14, no. 10: e0008663.

Journal article
Published: 08 September 2020 in Journal of Fungi
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We aimed to describe the ways patients with disseminated histoplasmosis—a multifaceted and often lethal disease—present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was performed for the sampling sites and for the clinical signs and symptoms. The factor loadings of the principal components were selected for eigenvalues > 1. The most frequent signs and symptoms were an alteration of the WHO general performance status, fever, digestive tract, respiratory signs and symptoms and lymphadenopathies. The most common sites sampled were bone marrow, respiratory tract, blood, lymph node and liver biopsies, with significant variations in the number of sites from which samples were taken to try to identify the pathogen. The principal component analysis clinical signs and symptoms leading to the diagnosis showed four main lines of variation. The factor loadings of the four main components were compatible with four broad types of clinical presentations and four types of exploration strategies. Extracting simple algorithms was difficult, emphasizing the importance of clinical expertise when diagnosis depends on obtaining a sample where Histoplasma can be seen or grown. Histoplasma antigen detection tests will help simplifying the algorithms.

ACS Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Kinan Drak Alsibai; Caroline Misslin; Balthazar Ntab; Pierre Couppié. Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana. Journal of Fungi 2020, 6, 165 .

AMA Style

Mathieu Nacher, Audrey Valdes, Antoine Adenis, Romain Blaizot, Philippe Abboud, Magalie Demar, Félix Djossou, Loïc Epelboin, Kinan Drak Alsibai, Caroline Misslin, Balthazar Ntab, Pierre Couppié. Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana. Journal of Fungi. 2020; 6 (3):165.

Chicago/Turabian Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Kinan Drak Alsibai; Caroline Misslin; Balthazar Ntab; Pierre Couppié. 2020. "Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana." Journal of Fungi 6, no. 3: 165.

Journal article
Published: 07 September 2020 in Journal of Fungi
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Disseminated histoplasmosis is the main AIDS-defining infection of French Guiana. We aim to describe our therapeutic experience for 349 patients with disseminated histoplasmosis between 1 January 1981 and 10 January 2014 in French Guiana. Survival, delays for treatment initiation, duration of induction therapy, and associated initial treatments are described. The death rate was 14.9 per 100 person-years, with an early drop in survival. Among those who died, >1/3 died within a year of HIV diagnosis, and ¾ of all patients with histoplasmosis had been diagnosed for HIV within a year. As induction treatment, 29% received liposomal amphotericin B, 12.9% received deoxycholate amphotericin B, 54% received itraconazole alone, and 21.8% received liposomal amphotericin B and itraconazole. The median delay between symptoms-onset and hospitalization was 19.5 days (IQR = 5–105). Liposomal amphotericin B or itraconazole was initiated shortly after admission. Treatment initiation was often presumptive for liposomal amphotericin B (27%) and itraconazole (20%). The median duration of liposomal amphotericin B treatment was 7 days (IQR = 5–11 days). The present study shows that ¾ of the patients were profoundly immunocompromised and had been diagnosed for HIV within the past year. Antifungal treatment was often initiated presumptively on admission. Over time there was a significant gradual decline in early death.

ACS Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Kinan Drak Alsibai; Pierre Couppié. Disseminated Histoplasmosis in HIV-Infected Patients: A Description of 34 Years of Clinical and Therapeutic Practice. Journal of Fungi 2020, 6, 164 .

AMA Style

Mathieu Nacher, Audrey Valdes, Antoine Adenis, Romain Blaizot, Philippe Abboud, Magalie Demar, Félix Djossou, Loïc Epelboin, Caroline Misslin, Balthazar Ntab, Kinan Drak Alsibai, Pierre Couppié. Disseminated Histoplasmosis in HIV-Infected Patients: A Description of 34 Years of Clinical and Therapeutic Practice. Journal of Fungi. 2020; 6 (3):164.

Chicago/Turabian Style

Mathieu Nacher; Audrey Valdes; Antoine Adenis; Romain Blaizot; Philippe Abboud; Magalie Demar; Félix Djossou; Loïc Epelboin; Caroline Misslin; Balthazar Ntab; Kinan Drak Alsibai; Pierre Couppié. 2020. "Disseminated Histoplasmosis in HIV-Infected Patients: A Description of 34 Years of Clinical and Therapeutic Practice." Journal of Fungi 6, no. 3: 164.

Journal article
Published: 12 August 2020 in Journal of Fungi
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Introduction: Histoplasmosis is the main opportunistic infection and cause of death in HIV-infected persons living with HIV in French Guiana and probably in most of Latin America. The objective of the present study was to compare cutaneomucous histoplasmosis to non-cutaneomucous histoplasmosis in French Guiana. Methods: Between 1981 and 2014 AIDS-related disseminated histoplasmosis patients followed in the three hospitals of French Guiana were retrospectively studied. Only proven incident cases of histoplasmosis, either by pathology and/or mycological analysis, were considered. Mucocutaneous histoplasmosis was ascertained by a positive mucosal or cutaneous biopsy. Results: Thirty-one patients had mucocutaneous lesions, and 318 had no mucocutaneous lesions. Patients with cutaneomucous lesions were more likely to have had prior opportunistic infections (35.5%) than those who did not have cutaneomucous lesions (19.5%). They were more likely to be very severely immunocompromised (CD4 count < 50) (90.3% versus 62.8%) and less likely to have digestive signs (32.3% versus 74.1%) and superficial adenopathies (29% versus 50.2%) than those without cutaneomucous lesions. In terms of simple biological examinations, patients with cutaneomucous lesions had fewer signs of cholestasis. The diagnosis was significantly more likely to be performed by direct examination and pathology in those with cutaneomucous lesions than in those without such lesions. On the contrary, patients with cutaneomucous lesions were less likely to be diagnosed by fungal culture than those without cutaneomucous lesions. There was a greater but non-significant risk of early death in those with cutaneomucous lesions relative to those without (OR = 2.28 (95%CI = 0.83–5.7), p = 0.056. Conclusions: Mucocutaneous forms were associated with more profound immunosuppression and perhaps risk of early death. They are easily accessible for diagnosis.

ACS Style

Sophie Morote; Mathieu Nacher; Romain Blaizot; Balthazar Ntab; Denis Blanchet; Kinan Drak Alsibai; Magalie Demar; Félix Djossou; Pierre Couppié; Antoine Adenis. Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana. Journal of Fungi 2020, 6, 133 .

AMA Style

Sophie Morote, Mathieu Nacher, Romain Blaizot, Balthazar Ntab, Denis Blanchet, Kinan Drak Alsibai, Magalie Demar, Félix Djossou, Pierre Couppié, Antoine Adenis. Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana. Journal of Fungi. 2020; 6 (3):133.

Chicago/Turabian Style

Sophie Morote; Mathieu Nacher; Romain Blaizot; Balthazar Ntab; Denis Blanchet; Kinan Drak Alsibai; Magalie Demar; Félix Djossou; Pierre Couppié; Antoine Adenis. 2020. "Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana." Journal of Fungi 6, no. 3: 133.

Research article
Published: 24 July 2020 in PLOS ONE
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In the past decade, new diagnostic methods and strategies have appeared, HIV testing efforts and the generalization of antiretroviral therapy may have influenced the number of opportunistic diagnoses and mortality of HIV-infected patients. To test this hypothesis we compiled data on the top opportunistic infections and causes of early death in the HIV cohort of French Guiana. HIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals from 2010 to 2019 were studied. Annual incidence of different opportunistic infections and annual deaths are compiled. For patients with opportunistic infections we calculated the proportion of early deaths. At the time of analysis, among 2 459 patients, (treated and untreated) 90% had a viral load <400 copies, 91% of the patients in the cohort were on antiretroviral treatment, and 94.2% of patients on treatment for over 6 months had undetectable viral loads. Only 9% of patients had CD4 counts under 200 per mm3. Histoplasmosis clearly remained the most frequent (128 cases) opportunistic infection among HIV-infected persons followed by cerebral toxoplasmosis (63 cases) and esophageal candidiasis (41 cases). Cryptococcal meningitis was ranked 5th most frequent opportunistic infection as was tuberculosis (31 cases). The trend for a sharp decline in early deaths continued (3.9% of patients). Despite the successes of antiretrovirals, patients presenting with advanced HIV are still common and they are still at risk of dying. Improved diagnosis, and notably systematic screening with appropriate tools are still important areas of potential progress.

ACS Style

Mathieu Nacher; Antoine Adenis; Basma Guarmit; Aude Lucarelli; Denis Blanchet; Magalie Demar; Felix Djossou; Philippe Abboud; Loïc Epelboin; Pierre Couppié. What is AIDS in the Amazon and the Guianas in the 90-90-90 era? PLOS ONE 2020, 15, e0236368 .

AMA Style

Mathieu Nacher, Antoine Adenis, Basma Guarmit, Aude Lucarelli, Denis Blanchet, Magalie Demar, Felix Djossou, Philippe Abboud, Loïc Epelboin, Pierre Couppié. What is AIDS in the Amazon and the Guianas in the 90-90-90 era? PLOS ONE. 2020; 15 (7):e0236368.

Chicago/Turabian Style

Mathieu Nacher; Antoine Adenis; Basma Guarmit; Aude Lucarelli; Denis Blanchet; Magalie Demar; Felix Djossou; Philippe Abboud; Loïc Epelboin; Pierre Couppié. 2020. "What is AIDS in the Amazon and the Guianas in the 90-90-90 era?" PLOS ONE 15, no. 7: e0236368.

Pearls
Published: 14 May 2020 in PLOS Pathogens
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ACS Style

Mathieu Nacher; Pierre Couppié; Loic Epelboin; Félix Djossou; Magalie Pierre Demar; Antoine Adenis. Disseminated Histoplasmosis: Fighting a neglected killer of patients with advanced HIV disease in Latin America. PLOS Pathogens 2020, 16, e1008449 .

AMA Style

Mathieu Nacher, Pierre Couppié, Loic Epelboin, Félix Djossou, Magalie Pierre Demar, Antoine Adenis. Disseminated Histoplasmosis: Fighting a neglected killer of patients with advanced HIV disease in Latin America. PLOS Pathogens. 2020; 16 (5):e1008449.

Chicago/Turabian Style

Mathieu Nacher; Pierre Couppié; Loic Epelboin; Félix Djossou; Magalie Pierre Demar; Antoine Adenis. 2020. "Disseminated Histoplasmosis: Fighting a neglected killer of patients with advanced HIV disease in Latin America." PLOS Pathogens 16, no. 5: e1008449.

Heart failure and cardiomyopathies
Published: 12 May 2020 in Open Heart
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IntroductionCardiomyopathies are a heterogeneous heart diseases group in terms of morphology and aetiology. Hypothesising a tropical specificity and given an absence of data in French Guiana, the primary objective of our study was to describe morphologies and aetiologies of cardiomyopathies observed at Cayenne General Hospital.MethodsA cross-sectional study was conducted in Cayenne Hospital from 1 January 2009 to 1 June 2014 in the hospital database. Only patients with the definition of the European Society of Cardiology (ESC) were included, based on the first transthoracic ultrasonography found during the study period. Medical files were consulted.ResultsWith 182 patients included, the prevalence of cardiomyopathies among heart diseases was estimated at 4.3% (95% CI 3.7% to 4.9%). Twelve patients had a familial or genetic aetiology (6.6%) and 170 a non-familial or non-genetic aetiology (93.4%). The morphological spectrum was: dilated for 114 patients (62.6%), hypertrophic for 27 (14.8%), unclassified for 1 (0.5%) and non-classifiable for 13 (7.1%). This group was constituted of patients with a systolic and/or diastolic functional impairment without morphological abnormality. The aetiological spectrum found 184 aetiologies including: 70.9% undetermined, 8.7% infectious (with 6.5% chagasic and 0.5% related with human immunodeficiency virus) and 6.0% with toxins.ConclusionsCardiomyopthies are a common and severe clinical problem. The frequency of infectious aetiologies and dilated impairment are arguments for cardiomyopathies with tropical particularities. However, the preponderance of undetermined aetiologies justifies the development of further research programmes.

ACS Style

Paul Leménager; Yves-Kenol Franck; Florine Corlin; Nicolas Bouscaren; Mathieu Nacher; Antoine Adenis. Aetiological and morphological spectrum of cardiomyopathies in French Guiana: a retrospective study. Open Heart 2020, 7, e001206 .

AMA Style

Paul Leménager, Yves-Kenol Franck, Florine Corlin, Nicolas Bouscaren, Mathieu Nacher, Antoine Adenis. Aetiological and morphological spectrum of cardiomyopathies in French Guiana: a retrospective study. Open Heart. 2020; 7 (1):e001206.

Chicago/Turabian Style

Paul Leménager; Yves-Kenol Franck; Florine Corlin; Nicolas Bouscaren; Mathieu Nacher; Antoine Adenis. 2020. "Aetiological and morphological spectrum of cardiomyopathies in French Guiana: a retrospective study." Open Heart 7, no. 1: e001206.

Preprint content
Published: 13 March 2020
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IntroductionIn the past decade, new diagnostic methods and strategies have appeared, HIV testing efforts and the generalization of antiretroviral therapy may have influenced the number of opportunistic diagnoses and mortality of HIV-infected patients. To test this hypothesis we compiled data on the top opportunistic infections and causes of early death in the HIV cohort of French Guiana.MethodsHIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals from 2010 to 2019 were studied. The annual incidence of different opportunistic infections and annual deaths were compiled. For patients with opportunistic infections we calculated the proportion of early deaths.ResultsAt the time of analysis, among 2 459 patients, (treated and untreated) 90% had a viral load th most frequent opportunistic infection as was tuberculosis (31 cases). The trend for a sharp decline in early deaths continued (3.9% of patients).ConclusionsDespite the successes of antiretrovirals, patients presenting with advanced HIV are still common and they are still at risk of dying. Improved diagnosis, and notably systematic screening with appropriate tools are still important areas of potential progress.Author summaryIn the past decade, new diagnostic methods and strategies have appeared, HIV testing efforts and the generalization of antiretroviral therapy may have influenced the number of opportunistic diagnoses and mortality of HIV-infected patients. To test this hypothesis we compiled data on the top opportunistic infections and causes of early death in the HIV cohort of French Guiana. HIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals from 2010 to 2019 were studied. The annual number of different opportunistic infections and annual deaths were compiled. For patients with opportunistic infections we calculated the proportion of early deaths. At the time of analysis, most patients were virologically controlled and had restored immunity. However, histoplasmosis clearly remained the most frequent (128 cases) opportunistic infection among HIV-infected persons followed by cerebral toxoplasmosis (63 cases) and esophageal candidiasis (41 cases). Cryptococcal meningitis was ranked 5th most frequent opportunistic infection as was tuberculosis (31 cases). The trend for a sharp decline in early deaths continued (3.9% of patients). Despite the successes of antiretroviral therapy, patients presenting with advanced HIV are still common and they are still at risk of dying. Improved diagnosis, and notably systematic screening with appropriate tools are still important areas of potential progress.

ACS Style

Mathieu Nacher; Antoine Adenis; Basma Guarmit; Aude Lucarelli; Denis Blanchet; Magalie Demar; Felix Djossou; Philippe Abboud; Loïc Epelboin; Pierre Couppié. What is AIDS in the Amazon and the Guianas in the 90-90-90 era? 2020, 1 .

AMA Style

Mathieu Nacher, Antoine Adenis, Basma Guarmit, Aude Lucarelli, Denis Blanchet, Magalie Demar, Felix Djossou, Philippe Abboud, Loïc Epelboin, Pierre Couppié. What is AIDS in the Amazon and the Guianas in the 90-90-90 era? . 2020; ():1.

Chicago/Turabian Style

Mathieu Nacher; Antoine Adenis; Basma Guarmit; Aude Lucarelli; Denis Blanchet; Magalie Demar; Felix Djossou; Philippe Abboud; Loïc Epelboin; Pierre Couppié. 2020. "What is AIDS in the Amazon and the Guianas in the 90-90-90 era?" , no. : 1.