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Praticien-chercheur
7 articles scientifiques publiés — formation continue solide
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CABINET DU DR PASCAL PUEL
PARC D ACTIVITES DE KERNOTER 13 RUE FRANCOIS LEMARIE, 29000 QUIMPER
CENTRE HOSPITALIER DOUARNENEZ
83 R LAENNEC CS 20021, 29177 DOUARNENEZ CEDEX
Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.
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Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).
Journal of virology · 2000
ABSTRACTHepatitis C virus (HCV) populations persist in vivo as a mixture of heterogeneous viruses called quasispecies. The relationship between the genetic heterogeneity of these variants and their responses to antiviral treatment remains to be elucidated. We have studied 26 virus strains to determine the influence of hypervariable region 1 (HVR-1) of the HCV genome on the effectiveness of alpha interferon (IFN-α) therapy. Following PCR amplification, we cloned and sequenced HVR-1. Pretreatment serum samples from 13 individuals with chronic hepatitis C whose virus was subsequently eradicated by treatment were compared with samples from 13 nonresponders matched according to the major factors known to influence the response, i.e., sex, genotype, and pretreatment serum HCV RNA concentration. The degree of virus variation was assessed by analyzing 20 clones per sample and by calculating nucleotide sequence entropy (complexity) and genetic distances (diversity). Types of mutational changes were also determined by calculating nonsynonymous substitutions per nonsynonymous site (Ka) and synonymous substitutions per synonymous site (Ks). The paired-comparison analysis of the nucleotide sequence entropy and genetic distance showed no statistical differences between responders and nonresponders. By contrast, nonsynonymous substitutions were more frequent than synonymous substitutions (P≤ 0.05) in responders, but there was no significant difference in nonresponders. Nonsynonymous substitutions tended to be more frequent than synonymous substitutions in women (P= 0.06) but not in men. Nucleotide entropy and genetic distances were significantly related to serum RNA concentration (P≤ 0.01). Our findings suggest that after controlling for the major determinants of interferon response, neither complexity nor diversity of the HVR-1 region is associated per se with virus eradication. Because a higher proportion of nonsynonymous substitutions than synonymous substitutions was found only in responders, host anti-HCV-specific immune response rather than viral factors may be playing an important role in the interferon response.
Journal of medical virology · 1998
Hepatology (Baltimore, Md.) · 1998
We studied the efficacy of three interferon alfa–2b (IFN–α2b) regimens for the retreatment of patients with chronic hepatitis C (CHC) with prior complete response followed by relapse. Consecutive patients with CHC who had a complete biochemical response but relapse after a first course of 6 months of IFN with 3 million units (MU) given subcutaneously three times per week were enrolled in the study. Six to 24 months after the end of the first treatment, the patients were randomly assigned to receive IFN with either the same regimen (group 1), a regimen of 12 months with 3 MU (group 2), or a regimen of 6 months with 10 MU (group 3). Sustained biochemical response was defined as normal serum alanine transaminase (ALT) values during the follow–up and sustained virological response as a clearance of hepatitis C virus (HCV) RNA from the serum at the end of follow–up (6 months' posttreatment). Histological improvement was defined as a decrease of 1 point in Metavir score between the first liver biopsy and a biopsy performed at 6 months' postretreatment. Two hundred forty–seven patients were randomized: 75 to group 1, 91 to group 2, and 81 to group 3. In an intent–to–treat analysis, 12%, 36.3%, and 18.5% of patients had a sustained biochemical response after retreatment in groups 1, 2, and 3, respectively (P < .001); 13.8%, 32.4%, and 17.2% of patients had a sustained virological response after retreatment in groups 1, 2, and 3, respectively (P < .05). A low viral load and patients in group 2 were independently associated with a sustained biochemical response. A low Knodell score index before treatment, patients with a high level of ALT before retreatment, genotype 3, low viral load, and patients in group 2 were independently associated with sustained virological response. Younger age, a high level of ALT, a low level of γ–glutamyl transferase before retreatment, low viral load, and patients in group 2 were independently associated with sustained biochemical and virological response. Among the 80 patients with repeated liver biopsies, 47.6% had improved histological activity scores; this improvement was associated with a sustained biochemical and virological response. In patients with CHC initially treated with 3 MU of IFN given subcutaneously three times per week over a 6–month period, and who subsequently developed a relapse after a biochemical response, retreatment with a regimen of 3 MU of IFN given three times per week for 12 months produced better biochemical and virological sustained response rates than regimens involving a higher dose or a shorter duration of retreatment. The biochemical and virological sustained response was associated with histological improvement.
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
Journal of medical virology · 1998 · Journal Article
Izopet J, Payen JL, Alric L, Sandres K, et al.
Revue du rhumatisme et des maladies osteo-articulaires · 1992 · Journal Article
Laroche M, Puech JL, Pouillès JM, Arlet J, et al.
Revue du rhumatisme et des maladies osteo-articulaires · 1987 · Case Reports
Arlet J, Arlet P, Arlet L, Legros R, et al.
Journal of medical virology · 2002 · Clinical Trial
Boulestin A, Sandres-Sauné K, Payen JL, Alric L, et al.
Journal of virology · 2000 · Journal Article
Sandres K, Dubois M, Pasquier C, Payen JL, et al.
Hepatology (Baltimore, Md.) · 1998 · Clinical Trial
Payen JL, Izopet J, Galindo-Migeot V, Lauwers-Cances V, et al.
Archives des maladies du coeur et des vaisseaux · 1986 · Case Reports
Boudjemaa B, Glock Y, Roux D, Bierme R, et al.