📇 Rhumatologue · LISIEUX · (14) · Libéral

M NOUREDDINE MESSAFEUR

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29 articles scientifiques publiés — un praticien à la pointe de la recherche
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📍 LISIEUX (14)LibéralRPPS 10002116266

✨ Génération du profil synthétique IA en cours…

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Top publications · les plus citées

Addressing Cardiometabolic Challenges in HIV: Insights, Impact, and Best Practices for Optimal Management-A Narrative Review

Health science reports · 2025

📚 6 citations🎯 RCR 2.68🔓 Open Access📄 PDF gratuit ↗

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ABSTRACTIntroductionSince the advent of highly active antiretroviral therapy (HAART), morbidity and mortality rates associated with human immunodeficiency virus (HIV) have significantly decreased leading to prolonged life span of Individuals living with HIV due to the effectiveness of antiretroviral therapy. However, this prolonged lifespan alone does not fully account for the increased incidence of cardiometabolic complications. These complications result from a complex interplay of factors such as chronic inflammation, immune activation, ART‐related metabolic effects, and lifestyle changes. which contribute to elevated morbidity and mortality rates, therefore requiring a deeper understanding and setting effective management strategies. This review aims at providing insights and a nuanced understanding of the relationship between HIV and cardiometabolic disorders, explore their clinical implications and adapt optimal management strategies to address the multifaceted challenges at the intersection of HIV and cardiometabolic health, ultimately enhancing patient outcomes and quality of life.MethodsData retrieval was conducted using a predetermined search strategy from medical journals that were published in bibliographical databases like PubMed, Science Direct and Embase. This review systematically considered and synthesized current literature on the association between cardiometabolic challenges and HIV.ResultsThis review provides a detailed exploration of the interrelationship between HIV and cardiometabolic challenges, with an emphasis on insights, impact, and best practices for optimal management. It underscores the high risk of cardiovascular disease, insulin resistance, dyslipidemia, and lipodystrophy in people living with HIV. Recommendations include evidence‐based approaches such as routine cardiometabolic risk. Prevention, screening, management, lifestyle interventions (diet and exercise), and optimizing ART regimens to reduce the negative health outcomes experienced by people living with HIV and to direct clinical practice. To reduce health issues, enhance clinical results, and improve the long‐term quality of life for people living with HIV, it is important to early identify cardiovascular risk factors and to follow customized prevention and management methods.ConclusionThis review shows that early detection through regular screening is pivotal through collaboration between healthcare providers, researchers, and policymakers which will allow for timely interventions and drive innovation and address evolving challenges to enhancing the quality of life for individuals living with HIV. Continuing to do research and advocacy efforts, will not only advance knowledge but also optimize the long‐term health outcomes for people living with HIV.

Real-World Tolvaptan Use in Autosomal Dominant Polycystic Kidney Disease: Insights from Two US Medical Centers

Kidney360 · 2025

📚 4 citations🔓 Open Access

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Key Points Twenty-seven percent of patients with autosomal dominant polycystic kidney disease discontinued tolvaptan in a real-world cohort in the midwestern United States.Most patients maintained tolvaptan on lower doses than trials, and a minority tolerated above the 45 mg (am)/15 mg (pm) starting dosage.Adverse effects, specifically aquaretic side effects, strongly influenced tolvaptan tolerability, dosage titration, and discontinuation. Background Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disease leading to kidney failure. Tolvaptan, a vasopressin V2 receptor antagonist, is the only medication approved by the US Food and Drug Administration for slowing kidney growth in individuals with rapidly progressive ADPKD, but its long-term tolerability and effective implementation has yet to be studied, particularly in real-world clinical settings within the United States. Methods This retrospective cohort study examined adults with ADPKD treated with tolvaptan at the University of Kansas Medical Center and the University of Iowa Hospitals & Clinics from May 2018 to April 2023. Data on demographics, clinical characteristics, tolvaptan dosage, and treatment duration were collected from electronic health records for an average follow-up duration of 28.2 months (interquartile range: 8.5–47.1 months). The study focused on examining tolvaptan dosage trends, treatment discontinuation reasons, and the impact of aquaretic side effects on dosage and adherence. Results Of 134 patients, 27% stopped tolvaptan during the observational period, with 10.4% of the cohort withdrawing from treatment due to intolerance of aquaretic side effects. Most patients maintained a lower tolvaptan dosage (≤45/15 mg) than in clinical trials, with two thirds of individuals who underwent dosage adjustment undergoing net decrease in dosage. Adverse effects significantly influenced and dosage decisions, presenting a potential early barrier for adherence, particularly in female patients. Conclusions The study highlights real-world challenges in the use of tolvaptan for ADPKD, particularly for side effects leading to high discontinuation rates and dosage adjustments. These findings underscore the need for standardized and improved management strategies to enhance tolerability and adherence, offering insights for future research and practice in the treatment of ADPKD with tolvaptan.

AI-enhanced telemedicine for personalized antiretroviral therapy in HIV patients with neurological comorbidities: a narrative review

Postgraduate medical journal · 2025

📚 3 citations

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Abstract Background Human immunodeficiency virus (HIV), while now manageable as a chronic health condition with highly active antiretroviral therapy (HAART), often precipitates the onset of neurological comorbidities such as HIV-associated neurocognitive disorders (HAND) and a number of neuropathies. ART, though effective, may lead to neurotoxic adverse drug reactions, impacting patient adherence and clinical outcomes. Innovative approaches are warranted to balance ART efficacy with minimized neurological risk. Objective This paper investigates how artificial intelligence (AI) may improve telemedicine for individualized ART management to reduce neurotoxicity and raise patient adherence to medication regimes. Methods A comprehensive literature review was conducted using PubMed/MEDLINE, and Google Scholar, among other electronic search databases, with keywords comprising “Artificial Intelligence,” “Telemedicine,” “HIV,” and “Neurological Comorbidities.” Studies were selected based on relevance to AI applications in personalized HIV care. Inclusion criteria included peer-reviewed articles, systematic reviews, and clinical trials on AI in HIV care. Exclusion criteria omitted non-peer-reviewed articles and studies lacking direct AI relevance. Titles and abstracts were screened before full-text review. Results There is potential for individualized ART management with AI-integrated telemedicine. By anticipating clinical concerns pertaining to ART-associated neurotoxicity, machine learning systems allow for preemptive therapeutic modifications. Wearable technology and AI-powered mHealth apps enable real-time adherence and symptom monitoring, facilitating the prompt adjustments to therapy if necessitated whilst lowering neurotoxic adverse drug reactions. Conclusions AI-enhanced telemedicine promotes customized ART regimens that bolster clinical outcomes and individual quality of life, providing a revolutionary approach to HIV management in populations affected by neurological sequalae. In order to provide fully personalized HIV care, future research should concentrate on improving AI model accuracy across a range of demographics while tackling moral issues pertaining to patient confidentiality and data privacy.

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M NOUREDDINE MESSAFEUR

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Top publications · les plus citées

Publications scientifiques (29) — classées par pathologie

Pédiatrie7

Transversal5

Épidémiologie & registres4

Revue générale3

Case report / série2

Génétique2

Santé mentale / fatigue2

Lupus1

Microbiote1

Ostéoporose1

Pharmacovigilance1

Revue / méta-analyse1

Risque cardio-vasculaire1

Vascularites des gros vaisseaux1

Vraie vie / RWE1

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