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Saint-Maurice-la-Clouère, France

Larsen C.,National Institute for Public Health Surveillance InVS | Chaix M.-L.,University of Paris Descartes | Strat Y.,National Institute for Public Health Surveillance InVS | Velter A.,National Institute for Public Health Surveillance InVS | And 10 more authors.
PLoS ONE | Year: 2011

Objectives: The HEPAIG study was conducted to better understand Hepatitis C virus (HCV) transmission among human immuno-deficiency (HIV)-infected men who have sex with men (MSM) and assess incidence of HCV infection among this population in France. Methods and Results: Acute HCV infection defined by anti-HCV or HCV ribonucleic acid (RNA) positivity within one year of documented anti-HCV negativity was notified among HIV-infected MSM followed up in HIV/AIDS clinics from a nationwide sampling frame. HIV and HCV infection characteristics, HCV potential exposures and sexual behaviour were collected by the physicians and via self-administered questionnaires. Phylogenetic analysis of the HCV-NS5B region was conducted. HCV incidence was 48/10 000 [95% Confidence Interval (CI):43-54] and 36/10 000 [95% CI: 30-42] in 2006 and 2007, respectively. Among the 80 men enrolled (median age: 40 years), 55% were HIV-diagnosed before 2000, 56% had at least one sexually transmitted infection in the year before HCV diagnosis; 55% were HCV-infected with genotype 4 (15 men in one 4d-cluster), 32.5% with genotype 1 (three 1a-clusters); five men were HCV re-infected; in the six-month preceding HCV diagnosis, 92% reported having casual sexual partners sought online (75.5%) and at sex venues (79%), unprotected anal sex (90%) and fisting (65%); using recreational drugs (62%) and bleeding during sex (55%). Conclusions: This study emphasizes the role of multiple unprotected sexual practices and recreational drugs use during sex in the HCV emergence in HIV-infected MSM. It becomes essential to adapt prevention strategies and inform HIV-infected MSM with recent acute HCV infection on risk of re-infection and on risk-reduction strategies. © 2011 Larsen et al. Source


Descatha A.,University of Versailles | Descatha A.,Poincare University Hospital | Teysseyre D.,University of Versailles | Teysseyre D.,French Institute of Health and Medical Research | And 9 more authors.
Scandinavian Journal of Work, Environment and Health | Year: 2012

Objective We aimed to assess whether the risk factors for severe shoulder pain, especially exposure to arm elevation, were still relevant after a 12-year follow-up, even following retirement. Methods All men participating in the ARPEGE ancillary study of the GAZEL cohort (followed-up since 1989) and who answered the 1994 or 1995 general GAZEL self-administered questionnaire were included. Weight and self-reported exposure (arm elevation >90° with and without carrying loads) over the entire working life were collected at baseline (1994-1995). Shoulder pain and its intensity were recorded in 1994-1995 and again in 2006. Shoulder pain was measured on an intensity or discomfort 6-point scale in 1994-1995 and on an 8-point scale in 2006. Severe shoulder pain was defined as point-rated higher than the mid-points (>3/6 in 1994-1995 and >4/8 in 2006) while moderate pain was lower or equal to these thresholds. Results At baseline, 1786 47-51-year-old men were included. In 1994-1995, moderate pain was observed among 8.5% (N=151) of men and severe shoulder pain among 14.6% (N=261). Exposure to arm elevation >90° while carrying loads was significantly associated with severe shoulder pain with >25 years of exposure [adjusted odds ratio (ORadj) 4.2, 95% confidence interval (95% CI) 1.7-10.5], taking into account age, sports, smoking habits, history of shoulder trauma, and body mass index. In 2006, when most of the subjects had retired, 1482 men (83.0%) answered the questionnaire, 17.3% of them with severe shoulder pain; the association between exposure to arm elevation >90° while carrying loads and severe shoulder pain was still significant (ORadj 3.3, 95% CI 1.3-8.0), and remained so when subjects with shoulder pain at baseline were excluded. Conclusions Among men, the effect of high shoulder exposure (arm elevation >90° while carrying loads) during working life on severe shoulder pain remains even after retirement. Extended surveillance and prevention should be offered to these workers. Source


Descatha A.,French Institute of Health and Medical Research | Descatha A.,University of Versailles | Descatha A.,Poincare University Hospital | Cyr D.,French Institute of Health and Medical Research | And 14 more authors.
Scandinavian Journal of Work, Environment and Health | Year: 2011

Objective Little is known about the long-term effect of occupational determinants on knee pain. We aimed to assess whether the risk factors for severe knee pain, observed with a cross-sectional approach, were still relevant after retirement, 12 years later. Methods All men participating in the ARPEGE side study of the GAZEL cohort (employees of the French national utility for energy production and distribution, recruited in 1989) and who answered the 1994 or 1995 general GAZEL self-administered questionnaire, were included. Weight and self-reported exposures over the entire working life were collected at baseline. Knee pain and its intensity were recorded in 1994-1995 and again in 2006. Moderate and severe knee pain, defined from an intensity or discomfort scale (threshold 3 on a 6-level scale in 1994-1995, and 4 on an 8-level scale in 2006), were the main outcomes. Results At baseline, 1786 men were included. In 1994-1995, moderate knee pain was observed among 10.3% and severe pain in 12.8% of men. In 2006, 1482 men (83%) answered the questionnaire. Moderate and severe knee pain were observed in 18.6% and 16.3% of respondents, respectively. Working in a kneeling or squatting position was significantly associated with severe knee pain at baseline, taking into account age, sports, smoking habits, and body mass index [adjusted odds ratio (ORadj) 1.4, 95% confidence interval (95% CI) 1.1-1.9 for " ever exposed" and ORadj 2.0, 95% CI 1.3-3.1 for >25 years of exposure]. In 2006, when most subjects were retired, the association between working in a kneeling or squatting position and severe pain was weaker but still significant (ORadj 1.4, 95% CI 1.04-1.85). Conclusions The effect of high knee exposure in the working life on severe knee pain remains even after retirement, although decreased. An extended surveillance and prevention program for these workers could be proposed. Source

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