Bruno Marchou

Epstein-Barr virus (EBV) has been implicated in lymphomagenesis of HIV-related classical Hodgkin lymphoma (HIV-cHL). The utility of EBV molecular and serological biomarkers has scarcely been examined in HIV-cHL in the recent combined antiretroviral therapy (cART) era. We evaluated EBV DNA load and a panel of EBV antibodies in HIV-cHL patients prospectively enrolled in the French ANRS-CO16 Lymphovir cohort between 2008 and 2015. Pretreatment whole blood (WB), plasma EBV DNA load and serological profiles were analyzed in 63 HIV-infected patients diagnosed with cHL. For the 42 patients with available material, comparisons were performed between values at diagnosis and 6 months after the initiation of chemotherapy. Pretreatment WB and plasma EBV DNA loads were positive in 84% and 59% of HIV-cHL patients, respectively. Two-year progression-free survival estimates did not differ between the patients with pretreatment WB (n = 53) or plasma (n = 37) EBV DNA(+) and the patients with pretreatment WB (n = 10) or plasma (n = 26) EBV DNA(−) (92% vs 80% or 89% vs 92%, p = 0.36 and 0.47, respectively). At diagnosis, 47% of patients harbored an EBV reactivation serological profile. Following chemotherapy, WB and plasma EBV DNA levels significantly declined from medians of 1570 (interquartile range, 230–3760) and 73 (0–320) copies/mL to 690 (0–1830) and 0 (0–0) copies/mL, respectively (p = 0.02 and p < 0.0001, respectively). Anti-EBV IgG antibody level significantly dropped at 6 month follow-up (p = 0.004). WB and plasma EBV DNA loads do not constitute prognostic markers in HIV-cHL patients in the modern cART era.

Teicoplanin is often used in Enterococcus faecalis infective endocarditis as a relay in case of penicillin side effects, or in outpatients. We assessed the efficacy of teicoplanin used as continuation therapy after initial standard treatment of E. faecalis endocarditis.

Objectives: The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)‐coinfected patients according to their HCV status.Methods: The nested cross‐sectional study, untitled HEPAVIH‐Psy survey, was performed in a subset of HIV/HCV‐coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0).Results: Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment‐naïve patients.Conclusions: Psychiatric disorders were frequent in HIV/HCV‐coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders.