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1.
PLoS One ; 18(10): e0276038, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37862300

RESUMO

The burden of the first year of the coronavirus disease 2019 (COVID-19) pandemic was greater for vulnerable populations, such as immigrants, people living in disadvantaged urban areas, and people with chronic illnesses whose usual follow-up may have been disrupted. Immigrants receiving care for HIV in Seine-Saint-Denis' hospitals have a combination of such vulnerabilities, while nonimmigrant people living with HIV (PLWHIV) have more heterogeneous vulnerability profiles. The ICOVIH study aimed to compare the socioeconomic effects of the COVID-19 crisis as well as attitudes toward COVID-19 vaccination among immigrant and nonimmigrant PLWHIV. A questionnaire assessed vulnerabilities prior to the COVID-19 epidemic and the impact of the early epidemic on administrative, residential, professional, and financial fields. We surveyed 296 adults living with HIV at four hospitals in Seine-Saint-Denis, the poorest metropolitan French department, between January and May 2021. Administrative barriers affected 9% of French-born versus 26.3% of immigrant participants. Immigrants experienced financial insecurity and hunger more often than nonimmigrant participants (21.8% versus 7.1% and 6.6% versus 3%, respectively). Spontaneous acceptance of vaccination was higher among nonimmigrant than among immigrant participants (56.7% versus 32.1%), while immigrants were more likely to wait for their doctor's recommendation or for their doctor to convince them than their French-born counterparts (34.2% versus 19.6%). The trust-based doctor‒patient relationship established through HIV follow-up appeared to be a determining factor in the high acceptance of the COVID-19 vaccine among immigrant participants.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Infecções por HIV , Adulto , Humanos , Vacinas contra COVID-19 , Relações Médico-Paciente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Infecções por HIV/epidemiologia , Hospitais Públicos , Fatores Socioeconômicos , França/epidemiologia
2.
AIDS ; 34(12): 1771-1774, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32773476

RESUMO

: We performed an observational prospective monocentric study in patients living with HIV (PLWH) diagnosed with COVID-19. Fifty-four PLWH developed COVID-19 with 14 severe (25.9%) and five critical cases (9.3%), respectively. By multivariate analysis, age, male sex, ethnic origin from sub-Saharan Africa and metabolic disorder were associated with severe or critical forms of COVID-19. Prior CD4 T cell counts did not differ between groups. No protective effect of a particular antiretroviral class was observed.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por HIV/complicações , Pneumonia Viral/epidemiologia , Adulto , África Subsaariana/etnologia , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , COVID-19 , Infecções por Coronavirus/etnologia , Feminino , França/epidemiologia , Infecções por HIV/tratamento farmacológico , Humanos , Modelos Logísticos , Masculino , Doenças Metabólicas/complicações , Pessoa de Meia-Idade , Análise Multivariada , Pandemias , Pneumonia Viral/etnologia , Estudos Prospectivos , Medição de Risco , Fatores de Risco
3.
J Arthroplasty ; 33(7): 2246-2250, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29544969

RESUMO

BACKGROUND: Cutibacterium spp. (formerly Propionibacterium) are slow-growing cutaneous anaerobic commensals, rarely reported in prosthetic joint infections (PJIs). We describe epidemiological, clinical, biological, and radiological characteristics of 15 Cutibacterium avidum PJIs, their treatments, and outcomes. METHODS: This study is an observational, monocenter study (January 2004 to April 2017), with comparison of C avidum vs Cutibacterium acnes (n = 40) PJI characteristics. RESULTS: Among 1179 PJIs treated during the study period, 15 (1%) PJIs were due to C avidum (14 classified as late chronic and 1 as early postoperative). They involved only obese patients with hip arthroplasties (median age 65 years, body mass index 35 kg/m2). Twelve patients' PJIs developed after primary hip arthroplasty. Thirteen patients' last clean operation had used an anterior approach. Fourteen preoperative joint aspirate cultures yielded C avidum. The 14 chronic PJIs were treated with 1-stage exchange arthroplasty, the acute case with excision synovectomy. Antibiotic therapy was administered for 12 [6-13] weeks, intravenously for 4 [2-6] weeks. The most used first-line agents were intravenous clindamycin (n = 8) or cefazolin (n = 6). After median follow-up of 27 [3-136] months, 1 relapse occurred. Compared to C acnes PJI patients, those with C avidum PJIs were significantly younger, had higher body mass indices, had only hip involvement, and had more frequent anterior surgical approach. C acnes PJIs were more frequent after revision arthroplasty. CONCLUSION: C avidum is a rare PJI agent occurring in a particular subpopulation. Joint aspiration is the key diagnostic tool. Our results suggest that PJI risk factors include obesity, primary hip arthroplasty, and anterior surgical approach. Efforts to prevent these infections in high-risk patients should be developed.


Assuntos
Artrite Infecciosa/microbiologia , Artroplastia de Quadril/efeitos adversos , Prótese de Quadril/efeitos adversos , Propionibacterium , Infecções Relacionadas à Prótese/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/epidemiologia , Índice de Massa Corporal , Feminino , França/epidemiologia , Prótese de Quadril/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Propionibacterium acnes , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/epidemiologia , Fatores de Risco
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