VIH, hépatites virales et comorbidités : épidémiologie clinique et santé publique – MORPH3Eus

Objectifs

The team will focus on three research axes using a multidisciplinary translational approach involving epidemiologists, biostatisticians, clinicians, immunologists, and health economists, and major research tools and platforms, i.e cohorts (ANRS CO3 Aquitaine, ANRS CO13 HEPAVIH, ANRS CO5 HIV-2), collaboration of European cohorts (COHERE, EuroCoord, ACHIEV2E), and clinical trials, all coordinated in our ISO certified clinical trial unit.

Axes

  • Nowadays, HIV-infected patients are mainly experiencing non-AIDS comorbidities such as malignancies, liver diseases, neurocognitive disorders, atherothrombosis and cardiovascular events, renal failure or osteoporosis in the context of widespread use of combination antiretroviral therapy. We will study the long term impact of HIV infection and durability of the impact of related long term treatment regarding the burden of multimorbidity in ageing HIV-1 and HIV-2 infected patients.
  • The introduction of direct-acting antivirals (DAAs) for HCV has resulted in much higher sustained virological rates and lower side effects have been observed. Next generation DAAs are more promising and may offer the potential for a cure in the large majority of HCV mono-infected patients. However, data for HIV/HCV co-infected patients are still scarce and a large-scale assessment of these drugs is lacking. We will investigate questions regarding treatment response, tolerability, drug-drug interactions, resistance, and effect on related co-morbidities in HIV/HCV co-infected patients. One major objective will be to study the effect and the tolerance of DAAs recently introduced in the routine care in HCV/HIV co-infected patients.
  • An estimated 80 000 HIV-infected patients are under medical care in France. The annual overall cost for the French public health system is 1.5 billion euros (including 1 billion for antiretroviral therapy). Therefore, we aim at analyzing the consumption of care according to different profiles of patients, depending on their immuno-virological status and the presence/absence of co-morbidities including co-infection with hepatitis B or C viruses. Data of the Aquitaine region (5000 HIV-infected patients), in 2013 then every two years, will be used.


Principales publications

  1. Wittkop L, Günthard HF, de Wolf F, Dunn D, Cozzi-Lepri A, de Luca A, Kücherer C, Obel N, von Wyl V, Masquelier B, Stephan C, Torti C, Antinori A, García F, Judd A, Porter K, Thiébaut R, Castro H, van Sighem AI, Colin C, Kjaer J, Lundgren JD, Paredes R, Pozniak A, Clotet B, Phillips A, Pillay D, Chêne G; EuroCoord-CHAIN study group. Effect of transmitted drug resistance on virological and immunological response to initial combination antiretroviral therapy for HIV (EuroCoord-CHAIN joint project): a European multicohort study. Lancet Infect Dis. 2011 May;11(5):363-71.
  2. Yazdanpanah Y, Fagard C, Descamps D, Taburet AM, Colin C, Roquebert B, Katlama C, Pialoux G, Jacomet C, Piketty C, Bollens D, Molina JM, Chêne G; ANRS 139 TRIO Trial Group. High rate of virologic suppression with raltegravir plus etravirine and darunavir/ritonavir among treatment-experienced patients infected with multidrug-resistant HIV: results of the ANRS 139 TRIO trial. Clin Infect Dis. 2009 Nov 1;49(9):1441-9.
  3. Bonnet F, Burty C, Lewden C, Costagliola D, May T, Bouteloup V, Rosenthal E, Jougla E, Cacoub P, Salmon D, Chêne G, Morlat P, Mortalité Study Group. Changes in cancer mortality among HIV-infected patients: The ANRS Mortalité 2005 survey. Clin Infect Dis 2009;48(5):633-639
  4. Lewden C, Bouteloup V, De Wit S, Sabin C, Mocroft A, Wasmuth JC, van Sighem A, Kirk O, Obel N, Panos G, Ghosn J, Dabis F, Mary-Krause M, Leport C, Perez-Hoyos S, Sobrino-Vegas P, Stephan C, Castagna A, Antinori A, d’Arminio Monforte A, Torti C, Mussini C, Isern V, Calmy A, Teira R, Egger M, Grarup J, Chêne G on behalf of COHERE, The Collaboration of Observational HIV Epidemiological Research Europe in EuroCoord. All-cause mortality in treated HIV-infected adults with CD4 >=500/mm3 compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol 2012;41(2):433-4455.
  5. Bruyand M, Thiébaut R, Lawson-Ayayi S, Joly P, Sasco AJ, Mercié P, Pellegrin JL, Neau D, Dabis F, Morlat P, Chêne G, Bonnet F; Groupe d’Epidémiologie Clinique du SIDA en Aquitaine (GECSA). Role of uncontrolled HIV RNA level and immunodeficiency in the occurrence of malignancy in HIV-infected patients during the combination antiretroviral therapy era: Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS) CO3 Aquitaine Cohort. Clin Infect Dis. 2009 Oct 1;49(7):1109-16.

Coordonnées

Centre de recherche INSERM U1219
Université de Bordeaux – ISPED Case 11
146 rue Léo-Saignat
33076 BORDEAUX cedex

Tél : +33 (0)5 57 57 45 40
Tél : +33 (0)5 57 57 13 92

  • Directrice :
    MD PhD
    Directrice du CMG-EC Inserm-ANRS – Maladies Infectieuses et Vaccinologie/Director of clinical trial unit Inserm-ANRS – Infectious Disease and Vaccinology

    Parcours


    2015  Habilitation, Ecole Doctorale Scoiétés, Politique, Santé Publique, Speciality: Public Health, University of Bordeaux, France
    2010    PhD in Science, Technology and Health, Speciality: Epidemiology and Public Health, University of Bordeaux, Bordeaux, France.
    2007   MD, Justus Liebig University, Giessen, Germany.
    2007  MSc in Epidemiology and Biostatics, University of Bordeaux, ISPED, Bordeaux, France.
    2004  Approbation – German official license to practice as a doctor, Federal State examination board for therapeutic professions – Hessisches Landesprüfungsamt für Heilberufe, Frankfurt am Main, Hessen, Germany.
    2003     Certificate of the Medical Examination, Federal State examination board for therapeutic professions – Hessisches Landesprüfungsamt für Heilberufe, Frankfurt am Main, Hessen, Germany.
    1997-2003  Medical School, Justus Liebig University, Giessen, Germany and Universidad Autonoma, Madrid, Spain.
  • Contacts : Audrey Legrand – Emilie Boschet


Informations

Membres


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