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Marseille, France

Shlomai A.,Tel Aviv University | Halfon P.,Alphabio Laboratory | Goldiner I.,Tel Aviv University | Zelber-Sagi S.,Tel Aviv University | And 4 more authors.
Journal of Viral Hepatitis | Year: 2013

Serum bile acids (SBAs) are commonly elevated in cholestatic liver diseases, but it is unclear if SBA levels are also elevated in noncholestatic chronic liver diseases and whether those levels correlate with disease severity. We analysed SBA levels of 135 consecutive patients with chronic hepatitis C virus infection and correlated these levels with the degree of liver fibrosis as determined by liver biopsy. In addition, we assessed the accuracy of SBA levels as a noninvasive predictor for liver fibrosis by its comparison to the patients' FibroTest scores. Two-thirds (90/135 patients, 67%) of the study patients had nonsevere liver fibrosis (Metavir F0-F2), and the others (45/135, 33%) had severe fibrosis or cirrhosis (Metavir F3-F4). The SBA levels were significantly higher in patients with severe fibrosis as compared to nonsevere fibrosis (11.46 ± 10.01 vs 6.37 ± 4.69, P < 0.0001). Furthermore, a receiver operator characteristics curve based on a model that included serum bile acids, age, body mass index, serum AST, glucose and cholesterol levels suggested that this combination reliably predicts the degree of liver fibrosis and is not inferior to the current noninvasive FibroTest score (areas under the curve of 0.837 vs 0.83, respectively, P = 0.87). We conclude that measurement of SBA levels may have a clinical role as a simple noninvasive tool to assess the severity of HCV-induced liver disease. Combined with widely available laboratory parameters, SBA levels can predict disease severity with a high degree of accuracy. © 2012 Blackwell Publishing Ltd. Source


Nougairede A.,Aix - Marseille University | Salez N.,Aix - Marseille University | Cohen-Bacrie S.,Alphabio Laboratory | Ninove L.,Aix - Marseille University | And 6 more authors.
Emerging Infectious Diseases | Year: 2013

Five persons in France were infected with Orf virus after skin wounds were exposed to infected sheep tissues during Eid al-Adha, the Muslim Feast of Sacrifice. Infections were confirmed by electron microscopy, PCR, and sequence analysis. Prevention and control of this underdiagnosed disease can be achieved by educating physicians, slaughterhouse workers, and persons participating in Eid al-Adha. Source


Broccolo F.,University of Milan Bicocca | Fusetti L.,University of Pisa | Rosini S.,University of Chieti Pescara | Caraceni D.,Cytopathology Unit | And 6 more authors.
Journal of Medical Virology | Year: 2013

High-risk human papillomavirus (HR-HPV) genotype viral load and E6/E7 mRNA detection are proposed as surrogate markers of malignant cervical lesion progression. Currently, the use of commercially available DNA-based or mRNA-based tests is under investigation. In this study, the viral DNA load and E6/E7 mRNA detection of the five most common HR-HPV types detected in cervical cancer worldwide were compared in 308 cervical samples by using in-house type-specific quantitative real-time PCR assays and PreTect HPV-Proofer test, respectively. Sensitivity and negative predictive values were higher for the HPV-DNA assays combined (95.0% and 96.0%, respectively) than the RNA assays (77.0% and 88.0%, respectively); conversely, the mRNA test showed a higher specificity and higher positive predictive value (81.7% and 66.9%, respectively) than the DNA test (58.6% and 52.5%, respectively) for detecting histology-confirmed high-grade cervical intraepithelial neoplasia. A significantly higher association between viral DNA load and severity of disease was observed for HPV 16 and 31 (γ=0.62 and γ=0.40, respectively) than for the other HPV types screened. A good degree of association between the two assays was found for detection of HPV 16 (k=0.83), HPV 18 (k=0.72), HPV 33 (k=0.66), and HPV 45 (k=0.60) but not for HPV 31 (k=0.24). Sequence analysis in L1 and E6-LCR regions of HPV 31 genotypes showed a high level of intra-type variation. HR-HPV viral DNA load was significantly higher in E6/E7 mRNA positive than negative samples (P<0.001), except for HPV 31. These findings suggest that transcriptional and replicative activities can coexist within the same sample. © 2012 Wiley Periodicals, Inc. Source


Sancho-Garnier H.,Regional Cancer Center | Tamalet C.,Virology Unit | Halfon P.,Alphabio Laboratory | Leandri F.X.,Arcades | And 5 more authors.
International Journal of Cancer | Year: 2013

Today in France, low attendance to cervical screening by Papanicolaou cytology (Pap-smear) is a major contributor to the 3,000 new cervical cancer cases and 1,000 deaths that occur from this disease every year. Nonattenders are mostly from lower socioeconomic groups and testing of self-obtained samples for high-risk Human Papilloma virus (HPV) types has been proposed as a method to increase screening participation in these groups. In 2011, we conducted a randomized study of women aged 35-69 from very low-income populations around Marseille who had not responded to an initial invitation for a free Pap-smear. After randomization, one group received a second invitation for a free Pap-smear and the other group was offered a free self-sampling kit for HPV testing. Participation rates were significantly different between the two groups with only 2.0% of women attending for a Pap-smear while 18.3% of women returned a self-sample for HPV testing (p ≤ 0.001). The detection rate of high-grade lesions (≥CIN2) was 0.2‰ in the Pap-smear group and 1.25‰ in the self-sampling group (p = 0.01). Offering self-sampling increased participation rates while the use of HPV testing increased the detection of cervical lesions (≥CIN2) in comparison to the group of women receiving a second invitation for a Pap-smear. However, low compliance to follow-up in the self-sampling group reduces the effectiveness of this screening approach in nonattenders women and must be carefully managed. Copyright © 2013 UICC. Source


Cals P.,University of Angers | Cals P.,Angers University Hospital Center | Halfon P.,Alphabio Laboratory | Batisse D.,Hopital Europeen Georges Pompidou | And 16 more authors.
Journal of Hepatology | Year: 2010

Background & Aims: We compared 5 non-specific and 2 specific blood tests for liver fibrosis in HCV/HIV co-infection. Methods: Four hundred and sixty-seven patients were included into derivation (n = 183) or validation (n = 284) populations. Within these populations, the diagnostic target, significant fibrosis (Metavir F ≥2), was found in 66% and 72% of the patients, respectively. Two new fibrosis tests, FibroMeter HICV and HICV test, were constructed in the derivation population. Results: Unadjusted AUROCs in the derivation population were: APRI: 0.716, Fib-4: 0.722, Fibrotest: 0.778, Hepascore: 0.779, FibroMeter: 0.783, HICV test: 0.822, FibroMeter HICV: 0.828. AUROCs adjusted on classification and distribution of fibrosis stages in a reference population showed similar values in both populations. FibroMeter, FibroMeter HICV and HICV test had the highest correct classification rates in F0/1 and F3/4 (which account for high predictive values): 77-79% vs. 70-72% in the other tests (p = 0.002). Reliable individual diagnosis based on predictive values ≥90% distinguished three test categories: poorly reliable: Fib-4 (2.4% of patients), APRI (8.9%); moderately reliable: Fibrotest (25.4%), FibroMeter (26.6%), Hepascore (30.2%); acceptably reliable: HICV test (40.2%), FibroMeter HICV (45.6%) (p < 10-3 between tests). FibroMeter HICV classified all patients into four reliable diagnosis intervals (≤F1, F1 ± 1, ≥F1, ≥F2) with an overall accuracy of 93% vs. 79% (p < 10-3) for a binary diagnosis of significant fibrosis. Conclusions: Tests designed for HCV infections are less effective in HIV/HCV infections. A specific test, like FibroMeter HICV, was the most interesting test for diagnostic accuracy, correct classification profile, and a reliable diagnosis. With reliable diagnosis intervals, liver biopsy can therefore be avoided in all patients. © 2010 European Association for the Study of the Liver. Source

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