[Incidence and risk factors of HCV infection in a cohort of intravenous drug users in the North and East of France]. / Incidence et facteurs de risque de la séroconversion au virus de l'hépatite C dans une cohorte d'usagers de drogue intraveineux du nord-est de la France.

BACKGROUND: In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among intravenous drug users we conducted a prospective cohort study of HCV and HIV negative IVDU in the North and East of France. METHODS: Two hundred and thirty-one IVDU who had injected drug at least once in their lifetime and were negative for anti-HCV and anti-HIV were followed-up every three months over a 12-month period. Serum anti-HCV and anti-HIV antibodies were tested at inclusion in the study and at the end of the follow-up. Data on injection practices and behaviours were collected at inclusion and at each visit, and a test for anti-HCV antibodies was performed on a saliva sample. When this proved positive, an ELISA test for serum anti-HCV antibodies was carried out. RESULTS: Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9% (95% CI: 4.6-13.4) person-years for HCV infection. Among IVDU who injected at least once during the last 6 months HCV infection incidence was 11% (95% CI: 4.7-17.1) person-years. The multivariate analysis carried out on the inclusion data found female sex alone to be an independent predictive factor of HCV seroconversion. In a Cox proportional hazard multivariate analysis that took into account time-dependent exposures and covariates, we found that syringe and cotton sharing were, after adjusting for other covariates, the only independent predictive factors of HCV seroconversion: hazard ratio: 6.3 [corrected] (95% CI: 1.1-35.4; [corrected] p<0.05) and 16.4 (95% CI: 1.4-190.6; [corrected] p<0.05), respectively. CONCLUSION: The transmission of the HCV virus persists among French IVDU despite an ongoing national harm reduction program. Injecting material and cotton sharing are the two major determinants of transmission in this cohort.

Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France.

In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among injecting drug users (IDUs), we conducted a prospective cohort study of HCV- and human immunodeficiency virus (HIV)-negative IDUs in the North and East of France. A total of 231 HCV and HIV IDUs who had injected drugs at least once in their lifetime were followed up every 3 months over a 12-month period. Serum anti-HCV and anti-HIV were tested at inclusion in the study and at the end of the follow-up. Data on injecting practices were collected at inclusion and at each visit. Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9/100 person-years (95% CI 4.6-13.4) for HCV infection. In a multivariable analysis, we found that syringe and cotton sharing were the only independent predictive factors of HCV seroconversion.

[Intoxications by hallucinogenic mushrooms]. / Intoxications par champignons hallucinogènes.

In the context of excessive use of natural or synthetic psychoactive substances, with stimulating, psychedelic and hallucinogenic effects, an increase, if not a recurrence, in consumption of Psilocybe semilanceata has been observed in France over some fifteen years. Psilocybin and psilocin are the active compounds, responsible for the hallucinogenic effects and are a part of the substance group, derived from tryptamine and characterized by an indole nucleus. We report a clinical case observed in an emergency unit and review the historical, epidemiological and pharmacological data now available for these intoxications. Of particular interests in hallucinogenic mushroom abuse are: increased consumption in the context of youth cultural and entertainment movements; possible difficulties in the diagnosis in emergency conditions; possibility of severe and fatal complications.