Abstract
Background
Sexually transmitted acute hepatitis C virus (HCV) infections (AHIs) have been mainly described in human immunodeficiency virus (HIV)–infected men who have sex with men (MSM). ...Cases in HIV-negative MSM are scarce. We describe the epidemic of AHI in HIV-infected and HIV-negative MSM in Lyon, France.
Methods
All cases of AHI diagnosed in MSM in Lyon University Hospital from 2014 to 2017 were included. AHI incidence was determined in HIV-infected and in preexposure prophylaxis (PrEP)–using MSM. Transmission clusters were identified by construction of phylogenetic trees based on HCV NS5B (genotype 1a/4d) or NS5A (genotype 3a) Sanger sequencing.
Results
From 2014 to 2017, 108 AHIs (80 first infections, 28 reinfections) were reported in 96 MSM (HIV-infected, 72; HIV-negative, 24). AHI incidence rose from 1.1/100 person-years (95 confidence interval CI, 0.7–1.7) in 2014 to 2.4/100 person-years (95 CI, 1.1–2.6) in 2017 in HIV-infected MSM (P = .05) and from 0.3/100 person-years (95 CI, 0.06–1.0) in 2016 to 3.4/100 person-years (95 CI, 2.0–5.5) in 2017 in PrEP users (P < .001). Eleven clusters were identified. All clusters included HIV-infected MSM; 6 also included HIV-negative MSM. All clusters started with ≥1 HIV-infected MSM. Risk factor distribution varied among clusters.
Conclusions
AHI incidence increased in both HIV-infected and HIV-negative MSM. Cluster analysis suggests initial transmission from HIV-infected to HIV-negative MSM through chemsex and traumatic sexual practices, leading to mixed patterns of transmission regardless of HIV status and no overlap with the general population.
An epidemic of acute hepatitis C virus infections in men who have sex with men (MSM) between 2014 and 2017 in Lyon, France, is reported. Ninety-six percent of cases belonged to clusters. Half the clusters included both human immunodeficiency virus (HIV)–infected and HIV-negative MSM. Risk factors varied widely among clusters.
To describe the unaccompanied minors' reasons for consulting and their health problems managed in a permanence of access to health care (PASS) at the Hospices civils de Lyon.
Consultation data of the ...unaccompanied minors cared for in 2016 and 2017 at the Edouard Herriot Hospital PASS, Lyon, were collected and coded according to the International Classification of Primary Care (CISP-2).
The majority of unaccompanied minors were male adolescents from French-speaking sub-Saharan African countries. Each consultation included an average of 1.6 reason for encounter (95%CI: 1.5-1.8) and 2.0 health problems diagnosed (95%CI: 1.9-2.1). Apart from the discussion of test results, the most frequent reasons for consultation were physical symptoms, particularly generalized abdominal pain (8.7%), headache (6.6%) or pruritus (6.5%). Health problems diagnosed were mainly digestive (11.4%), cutaneous (11.0%) and osteoarticular (7.0%) problems, psychic diagnoses being rare.
Unaccompanied minors seems to be apparently in good health, which probably results from under-diagnosing infectious diseases and psychic disorders. We recommend the implementation in the PASS of a common protocol for screening infectious conditions and detecting psychic disorders.
OBJECTIVETo describe the unaccompanied minors' reasons for consulting and their health problems managed in a permanence of access to health care (PASS) at the Hospices civils de Lyon. ...METHODSConsultation data of the unaccompanied minors cared for in 2016 and 2017 at the Edouard Herriot Hospital PASS, Lyon, were collected and coded according to the International Classification of Primary Care (CISP-2). RESULTSThe majority of unaccompanied minors were male adolescents from French-speaking sub-Saharan African countries. Each consultation included an average of 1.6 reason for encounter (95%CI: 1.5-1.8) and 2.0 health problems diagnosed (95%CI: 1.9-2.1). Apart from the discussion of test results, the most frequent reasons for consultation were physical symptoms, particularly generalized abdominal pain (8.7%), headache (6.6%) or pruritus (6.5%). Health problems diagnosed were mainly digestive (11.4%), cutaneous (11.0%) and osteoarticular (7.0%) problems, psychic diagnoses being rare. CONCLUSIONSUnaccompanied minors seems to be apparently in good health, which probably results from under-diagnosing infectious diseases and psychic disorders. We recommend the implementation in the PASS of a common protocol for screening infectious conditions and detecting psychic disorders.
Objectif : Décrire les motifs et les résultats de consultation (problèmes de santé) des mineurs non accompagnés (MNA) pris en charge dans une permanence d’accès aux soins (PASS) des Hospices civils ...de Lyon. Méthodes : Les données de consultations des MNA pris en charge en 2016 et 2017 à la PASS de l’hôpital Édouard-Herriot de Lyon ont été recueillies et codées selon la Classification internationale des soins primaires, version 2 (CISP-2). Résultats : Les MNA étaient en majorité des adolescents de sexe masculin originaires de pays francophones d’Afrique subsaharienne. Chaque consultation comportait en moyenne 1,6 motif de consultation (IC95% : 1,5–1,8) et 2,0 résultats de consultation (IC95% : 1,9–2,1). En dehors de la discussion de résultats d’examens, les motifs de consultation les plus fréquents étaient des symptômes physiques, en particulier une douleur abdominale généralisée (8,7 %), des céphalées (6,6 %) ou un prurit (6,5 %). Les résultats de consultation étaient principalement des pathologies digestives (11,4 %), cutanées (11,0 %) et ostéo-articulaires (7,0 %), les diagnostics psychiques étant rares (4,4 %). Conclusions : Les MNA présentent une bonne santé apparente, résultant vraisemblablement d’un sous-diagnostic des maladies infectieuses et des troubles psychiques. Nous préconisons la mise en place dans les PASS d’un protocole de dépistage des pathologies infectieuses et de détection des troubles psychiques.
A comprehensive clinical and microbiological assessments of COVID-19 in front-line healthcare workers (HCWs) is needed. Between April 10th and May 28th, 2020, 319 HCWs with acute illness were ...reviewed. In addition to SARS-CoV-2 RT-PCR screening, a multiplex molecular panel was used for testing other respiratory pathogens. For SARS-CoV-2 positive HCWs, the normalized viral load, viral culture, and virus neutralization assays were performed weekly. For SARS-CoV-2 negative HCWs, SARS-CoV-2 serological testing was performed one month after inclusion. Among the 319 HCWs included, 67 (21.0%) were tested positive for SARS-CoV-2; 65/67 (97.0%) developed mild form of COVID-19. Other respiratory pathogens were found in 6/66 (9.1%) SARS-CoV-2 positive and 47/241 (19.5%) SARS-Cov-2 negative HCWs (p = 0.07). The proportion of HCWs with a viral load > 5.0 log10 cp/mL (Ct value < 25) was less than 15% at 8 days after symptom onset; 12% of HCWs were positive after 40 days (Ct > 37). More than 90% of cultivable virus had a viral load > 4.5 log10 cp/mL (Ct < 26) and were collected within 10 days after symptom onset. Among negative HCWs, 6/190 (3.2%) seroconverted. Our data suggest that the determination of viral load can be used for appreciating the infectiousness of infected HCWs. These data could be helpful for facilitating their return to work.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Since the SARS-CoV-2 emergence in December 2019, one of the major concerns has been the duration of immune protection after a first episode. This question is of paramount importance for healthcare ...workers (HCWs), who are a highly exposed population and among the first targets of vaccination programmes. To date, the persistence of SARS-CoV-2 antibodies in HCWs 6 months after disease onset (ADO) has not been studied with both a virus neutralisation btest and commercial assays.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We conducted a prospective study about sexually transmitted infections (STIs) knowledge in different populations attending Lyon's University Hospitals in order to estimate awareness on STIs. ...Pre-exposure prophylaxis (PrEP)-users (PrEP group), persons living with HIV (PLWH group) and persons undergoing free STI screening (screening group) filled an anonymous questionnaire evaluating STI knowledge. A composite STI knowledge score was calculated and was correlated with patients’ characteristics. A total of 756 patients were enrolled in three groups: screening (n = 509), PrEP (n = 103) and PLWH (n = 144). STI transmission knowledge was better for HIV than for other STIs. The median STI knowledge score was significantly higher in PrEP-users than in the screening and PLWH groups. PrEP use and a previous STI diagnosis were independently associated with a higher score. PrEP-users have better STI knowledge than PLWH and persons undergoing free STI screening. Sexual health promotion interventions routinely reserved to PrEP-users in France seem to be effective in raising the awareness of this group for STIs. Continuous efforts are justified for PLWH and the younger layers of the population.
A comprehensive clinical and microbiological assessments of COVID-19 in front-line healthcare workers (HCWs) is needed. Between April 10th and May 28th, 2020, 319 HCWs with acute illness were ...reviewed. In addition to SARS-CoV-2 RT-PCR screening, a multiplex molecular panel was used for testing other respiratory pathogens. For SARS-CoV-2 positive HCWs, the normalized viral load, viral culture, and virus neutralization assays were performed weekly. For SARS-CoV-2 negative HCWs, SARS-CoV-2 serological testing was performed one month after inclusion. Among the 319 HCWs included, 67 (21.0%) were tested positive for SARS-CoV-2; 65/67 (97.0%) developed mild form of COVID-19. Other respiratory pathogens were found in 6/66 (9.1%) SARS-CoV-2 positive and 47/241 (19.5%) SARS-Cov-2 negative HCWs ( p = 0.07). The proportion of HCWs with a viral load > 5.0 log 10 cp/mL (Ct value < 25) was less than 15% at 8 days after symptom onset; 12% of HCWs were positive after 40 days (Ct > 37). More than 90% of cultivable virus had a viral load > 4.5 log 10 cp/mL (Ct < 26) and were collected within 10 days after symptom onset. Among negative HCWs, 6/190 (3.2%) seroconverted. Our data suggest that the determination of viral load can be used for appreciating the infectiousness of infected HCWs. These data could be helpful for facilitating their return to work.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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