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  1. Article ; Online: HIV positive asylum seekers receiving the order to leave the Belgian territory.

    Demeester, Remy / Legrand, Jean-Claude

    Journal of the International AIDS Society

    2014  Volume 17, Issue 4 Suppl 3, Page(s) 19592

    Abstract: Introduction: In a human rights based approach, the Parliamentary Assembly of the Council of Europe has recently released a resolution about migrants and refugees and the fight against HIV (1). It states that "an HIV positive migrant should never be ... ...

    Abstract Introduction: In a human rights based approach, the Parliamentary Assembly of the Council of Europe has recently released a resolution about migrants and refugees and the fight against HIV (1). It states that "an HIV positive migrant should never be expelled when it is clear that he will not receive adequate health care and assistance in the country to which he is being sent back. To do otherwise would amount to a death sentence for that person." Nevertheless, in Belgium, for the last 2 years, none of the HIV-infected migrants in care in the AIDS Reference Centers (ARC) received the right to stay in Belgium for medical reasons.
    Methods: We identified all HIV-infected asylum seekers in care between 1 July 2012 and 1 July 2014 in the ARC of Charleroi, Belgium, and we analyzed their medical and social files.
    Results: Among the 302 patients in active follow up in our ARC, 45 HIV positive asylum seekers were in care during the last 2 years. Male/female ratio was 0/96. Mean age was 35 years. Countries of origin and reasons for migration are detailed in the Table 1. 18% (8/45) knew their seropositivity before arriving in Europe. All the patients introduced an asylum request, 29 (64%) have received a negative answer and an order to leave the territory, 4 (9%) were regularized for non-medical reasons (see Table 1), 4 (9%) are waiting for an answer and for 8 (18%) outcome is unknown due to lost follow up (LFU). 31 (69%) patients have also introduced a request to stay for medical reasons: 18 (58%) have received a refusal, 7 (23%) are still waiting for an answer, and 6 (19%) are LFU. Only 23 (51%) patients are still in care in our ARC on 1 July 2014 (see Table 1). The immigration office bases its decisions on availability of the treatment in the country even if accessible only to a limited number of patients.
    Conclusions: Decisions taken by the Belgian authorities for the last two years concerning HIV-infected asylum seekers do not guarantee the continuity of care of those patients and push them towards illegality. Such decisions ignore the international commitments of Belgium in the fight against HIV (2) and are contradictory with the recommendations of the recent resolution of the Council of Europe (1). An approach more respectful of Human Rights in the decisions concerning the seropositive asylum seekers patients taken by the authorities is urgently needed in Belgium. We invite our European colleagues to describe the situation of the HIV asylum seekers in their countries.
    Language English
    Publishing date 2014
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2467110-1
    ISSN 1758-2652 ; 1758-2652
    ISSN (online) 1758-2652
    ISSN 1758-2652
    DOI 10.7448/IAS.17.4.19592
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Prevalence and European AIDS Clinical Society (EACS) criteria evaluation for proximal renal tubular dysfunction diagnosis in patients under antiretroviral therapy in routine setting.

    Pitisci, Lorenzo / Demeester, Rémy / Legrand, Jean-Claude

    Journal of the International AIDS Society

    2014  Volume 17, Issue 4 Suppl 3, Page(s) 19564

    Abstract: Introduction: Tenofovir (TDF) is an antiretroviral drug often used in combination regimen in HIV-positive patients. Adverse effects affecting kidneys consist in an increase or a new onset proteinuria, a decrease of glomerular filtration rate (GFR), and/ ... ...

    Abstract Introduction: Tenofovir (TDF) is an antiretroviral drug often used in combination regimen in HIV-positive patients. Adverse effects affecting kidneys consist in an increase or a new onset proteinuria, a decrease of glomerular filtration rate (GFR), and/or a proximal renal tubular dysfunction (PRTD) that rarely leads to Fanconi's syndrome. EACS guidelines propose to screen PRTD in patients with chronic renal insufficiency, with a sudden decrease of eGFR, with hypophosphataemia (if non-renal causes such as vitamin D deficiency are excluded) and with a new onset proteinuria. We aim to evaluate the prevalence of PRTD by comparing the group of patients under TDF to the group free of TDF, in our cohort of 300 patients. We also aim to evaluate the accuracy of EACS criteria for screening PRTD in routine settings and to assess the utility of urinary samples in PRTD diagnosis.
    Materials and methods: During two consecutive years, we collected annually blood and urine samples at the same time in our outpatient clinic. We assessed kidney function, plasma levels and fractional excretion of phosphate, uric acid, potassium, plasma glucose and proteinuria. PRTD was defined by the presence of at least two out of the five following criteria: fractional excretion (FE) of phosphate >20% (or >10% when serum phosphate <0.8 mmol/L), non-diabetic glycosuria (positive urine glucose with plasma glucose <70 mg/dL), renal tubular acidosis (urinary pH >5.5 and serum bicarbonate <21 mmol/L), uric acid FE >10% or potassium FE >10%. After the first year, patients with TDF regimen who were diagnosed with PRTD were shifted to TDF-free regimen and included again in the study.
    Results: For PRTD (first line), they are expressed in number of diagnoses/total number of patients in this group. The second line resumes the number of PRTD diagnose patients who should have been screened according to EACS criteria.
    Conclusions: PRTD screening according to EACS criteria is not sufficient to diagnose every case, especially minor PRTD, mainly because the prevalence is low and its diagnosis remains difficult in routine settings. We recommend performing a urine test including proteinuria every year for patients undergoing TDF treatment. The next step will be to follow PRTD patients to evaluate the time laps until full recovery after TDF shift.
    Language English
    Publishing date 2014
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2467110-1
    ISSN 1758-2652 ; 1758-2652
    ISSN (online) 1758-2652
    ISSN 1758-2652
    DOI 10.7448/IAS.17.4.19564
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Early relapse of endometrial cancer in a patient infected with HIV.

    Riera, Catherine / Legrand, Jean-Claude / Marechal, Marc / Nagel, Julie

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2013  Volume 31, Issue 21, Page(s) e377–9

    MeSH term(s) Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/virology ; Female ; HIV Infections/complications ; Humans ; Middle Aged ; Recurrence
    Language English
    Publishing date 2013-07-20
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.2012.46.1491
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Abacavir/lamivudine/zidovudine maintenance after standard induction in antiretroviral therapy-naïve patients: FREE randomized trial interim results.

    Sprenger, Herman G / Langebeek, Nienke / Mulder, Paul G H / Ten Napel, Chris H H / Vriesendorp, Robert / Hoepelman, Andy I M / Legrand, Jean-Claude / Koopmans, Peter P / Van Kasteren, Marjo E E / Bravenboer, Bert / Ten Kate, Reinier W / Groeneveld, Paul H P / van der Werf, Tjip S / Gisolf, Elisabeth H / Richter, Clemens

    AIDS patient care and STDs

    2010  Volume 24, Issue 6, Page(s) 361–366

    Abstract: Maintenance with a triple nucleoside reverse transcriptase Inhibitor (NRTI) regimen after successful induction with a dual NRTI/protease inhibitor (PI) combination may be advantageous, because of low pill burden, favorable lipids, and less drug ... ...

    Abstract Maintenance with a triple nucleoside reverse transcriptase Inhibitor (NRTI) regimen after successful induction with a dual NRTI/protease inhibitor (PI) combination may be advantageous, because of low pill burden, favorable lipids, and less drug interactions. This strategy to become free of PI-related problems without losing viral efficacy has not been formally tested. We performed a randomized, open-label, multicenter, 96-week comparative study in antiretroviral therapy (ART)-naïve patients with CD4 <or=350 cells/mm(3) and HIV-1 RNA concentrations (viral load [VL]) greater than 30,000 copies per milliliter. Patients were randomized after reaching VL less than 50 copies per milliliter on two consecutive occasions between 12 and 24 weeks after start of zidovudine/lamuvidine and lopinavir/ritonavir combination. Eligible subjects switched to abacavir/lamivudine/zidovudine (TZV) or continued the PI-containing regimen. Here we present the 48-week data with virologic success rate (failure: VL > 50 copies per milliliter). Two hundred seven patients had similar baseline (BL) characteristics: median CD4 180 cells/mm(3), median VL 5.19 log(10) copies per milliliter. One hundred twenty subjects (58%) met randomization criteria. Baseline VL differed significantly between dropouts and randomized subjects (median 5.41 versus 5.06 log(10) copies per milliliter, p = 0.017), as did CD4 cells (median 160 and 200 cells/mm(3), p = 0.044). Sixty-one subjects received TZV and 59 subjects continued NRTIs/PI. At week 48, 2 patients in the TZV group and 5 in the PI group did not have a sustained virologic suppression (log rank test; p = 0.379). CD4 counts increased significantly in both arms. In ART-naïve patients, TZV maintenance had similar antiviral efficacy compared to continued standard ART at 48 weeks after baseline. Patients on successful standard ART can be safely switched to a NRTI-only regimen, at least for the tested time period.
    MeSH term(s) Adult ; Aged ; Anti-HIV Agents/therapeutic use ; CD4 Lymphocyte Count ; Dideoxynucleosides/therapeutic use ; Drug Therapy, Combination ; Female ; HIV Infections/drug therapy ; HIV Infections/virology ; HIV-1/drug effects ; HIV-1/genetics ; Humans ; Lamivudine/administration & dosage ; Lamivudine/therapeutic use ; Male ; Middle Aged ; RNA, Viral/blood ; Reverse Transcriptase Inhibitors/therapeutic use ; Treatment Outcome ; Viral Load ; Young Adult ; Zidovudine/administration & dosage ; Zidovudine/therapeutic use
    Chemical Substances Anti-HIV Agents ; Dideoxynucleosides ; RNA, Viral ; Reverse Transcriptase Inhibitors ; Lamivudine (2T8Q726O95) ; Zidovudine (4B9XT59T7S) ; abacavir (WR2TIP26VS)
    Language English
    Publishing date 2010-06
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1326868-5
    ISSN 1557-7449 ; 0893-5068 ; 1087-2914
    ISSN (online) 1557-7449
    ISSN 0893-5068 ; 1087-2914
    DOI 10.1089/apc.2009.0236
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Ciclosporin-Nicardipine Interaction

    Deray, Gilbert / Aupetit, Brigitte / Martinez, Franck / Baumelou, Alain / Worcel, Alexandre / Benhmida, Mohamed / Legrand, Jean Claude / Jacobs, Claude

    American Journal of Nephrology

    1989  Volume 9, Issue 4, Page(s) 349

    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000167993
    Database Karger publisher's database

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  6. Article ; Online: Plasma Levels of Atrial Natriuretic Factor in Inappropriate Secretion of Antidiuretic Hormone Syndrome

    Deray, Gilbert / Maistre, Geneviéve / Eurin, Joelle / Martinez, Franck / Barthelemy, Christine / Legrand, Jean-Claude / Baumelou, Alain / Jacobs, Claude

    American Journal of Nephrology

    1988  Volume 8, Issue 6, Page(s) 510–511

    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000167671
    Database Karger publisher's database

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  7. Article ; Online: Renal and Hemodialysis Clearances of Endogenous Natriuretic Peptide

    Deray, Gilbert / Maistre, Geneviève / Cacoub, Patrice / Barthelemy, Christine / Eurin, Joelle / Carayon, Alain / Masson, Françoise / Martinez, Franck / Baumelou, Alain / Legrand, Jean Claude / Jacobs, Claude

    Nephron

    1990  Volume 54, Issue 2, Page(s) 148–153

    Abstract: The purpose of the present study was to assess the plasma levels of atrial natriuretic peptide (ANP) in chronically uremic patients not submitted to dialysis and to determine the predialysis plasma concentration of ANP, the effect of ultrafiltration on ... ...

    Abstract The purpose of the present study was to assess the plasma levels of atrial natriuretic peptide (ANP) in chronically uremic patients not submitted to dialysis and to determine the predialysis plasma concentration of ANP, the effect of ultrafiltration on plasma levels of ANP (hemodialysis, (HD), and the HD clearance of ANP in a population of adult patients treated with maintenance HD. The mean plasma ANP concentration (pg/ml) in HD was 370.2 ± 35.5 pg/ml (mean ± SEM) before HD and decreased to 165.3 ± 15.2 after HD (p < 0.01). Both value were significantly higher than in controls (28 ± 2; n = 39). The changes in plasma ANP levels correlated inversely with those in plasma protein concentration (r = -0.53; p < 0.03; y = 48.6 ± 0.8 x). ANP clearance across the cuprophan membrane averaged 13 ± 6.4 ml/mn. Resting plasma ANP values in the 16 uremic patients ranged between 16 and 227 pg/ml (124 ± 11 pg/ml). These levels were significantly higher than those observed in controls (p < 0.01). In these patients there was a highly significant correlation between serum creatinine and plasma ANP concentrations (p < 0.01; r = 0.75; y = 0.2 x + 3). Furthermore we report the results of the determination of the renal clearance of ANP in normal dogs. In all dogs a fall in plasma ANP concentration was recorded between the aorta (28.6 ± 4.5 pg/ml) and the renal vein (14.2 ± 2.7 pg/ml). The renal extraction ratio averaged 51.3 ± 3.7%. Mean ANP renal clearance was 38.2 ± 5.2 ml/ mn. These data support the hypothesis that in hemodialyzed patients high circulating concentrations of the natriuretic peptide are due to sodium and water loading. Furthermore, in patients with renal failure an altered rate of ANP metabolism may contribute to the raised plasma ANP levels that are observed. In fact in normal dog our data indicate that the kidney contributes to the clearance of endogenous ANP.
    Keywords Atrial natriuretic peptide ; Renal clearance ; Hemodialysis ; Chronic renal failure
    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 207121-6
    ISSN 1423-0186 ; 0028-2766 ; 1660-8151 ; 0028-2766 ; 1660-8151
    ISSN (online) 1423-0186
    ISSN 0028-2766 ; 1660-8151
    DOI 10.1159/000185836
    Database Karger publisher's database

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