Éric Balestre - Academia.edu (original) (raw)

Papers by Éric Balestre

Research paper thumbnail of Impact of the Ebola epidemic on general and HIV care in Macenta, Forest Guinea, 2014

Objective: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. W... more Objective: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. We aimed at investigating its impact on general and HIV care at the only HIV care facility in the district.

Research paper thumbnail of Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration

BMC Infectious Diseases, 2015

Background: The causes of severe morbidity in health facilities implementing Antiretroviral Treat... more Background: The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities.

Research paper thumbnail of HIV Ascertainment through Repeat Home-based Testing in the Context of a Treatment as Prevention Trial (ANRS 12249 TasP) in Rural South Africa

AIDS Research and Human Retroviruses, 2014

Research paper thumbnail of Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

Journal of the International AIDS Society, 2013

Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significa... more Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods: HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results: A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30Á44] and their median CD4 count was 181 cells/mm 3 (IQR 97Á269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p B 10 (4 ) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (pB10 (2 ). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p B10 (4 ) and 45.3 (pB10 (3 ), respectively. Discussion: The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the follow-up of HAART-treated patients is a key component to restore HRQOL.

Research paper thumbnail of Virological response to HIV-1 nucleoside/nucleotide reverse transcriptase inhibitors-based, tenofovir DF-including regimens in the ANRS Aquitaine Cohort

Journal of Clinical Virology, 2006

Background: HIV-1 nucleoside/tide reverse transcriptase inhibitors (NRTI)-only based, comprising ... more Background: HIV-1 nucleoside/tide reverse transcriptase inhibitors (NRTI)-only based, comprising tenofovir DF(TDF) have been shown to lead to high rates of virological failures (VF), mainly in patients on first-line combination therapy. We wished to investigate the virological response to these regimens in a large cohort of antiretroviral (ARV)-treated patients. Methods: Patients followed-up in the Aquitaine Cohort in 2001-2003 and who had received NRTI-based, TDF-including regimens for at least 3 months were included. The VF was defined as: (i) a decrease in plasma HIV-1 RNA <0.5 log 10 copies/ml between M0 and M3; or (ii) a plasma HIV-1 RNA >50 copies/ml at M3 in patients with plasma HIV-1 RNA <50 copies/ml at M0. The baseline RT genotype was determined in a subgroup of patients. Results: Within 121 patients (95% ARV-experienced) who received either lamivudine (3TC)/didanosine (DDI)/TDF (n = 48), or abacavir (ABC)/3TC/TDF (n = 14), or 3TC/zidovudine (ZDV)/TDF (n = 27), or 3TC/ZDV/ABC/TDF (n = 20), or DDI/ABC/TDF (n = 12), the ABC/3TC/TDF and DDI/ABC/TDF combinations were associated with the highest frequencies of VF. In contrast the use of ZDV was related to a better virological response. The baseline RT genotype was also predictive of the virological outcome. Conclusion: NRTI-based, TDF-including therapies can lead to high rates of VF both in ARV-naïve and in ARV-experienced patients. Our data strongly suggest the interest of associating ZDV and TDF in these regimens.

Research paper thumbnail of Évolution des conditions d’initiation du traitement antirétroviral des patients infectés par le VIH en Afrique de l’Ouest

Medecine Et Maladies Infectieuses, 2010

ObjectiveWe studied the evolution of drug combinations used, as well as the clinical and immunolo... more ObjectiveWe studied the evolution of drug combinations used, as well as the clinical and immunological profile of patients at initiation of highly active antiretroviral therapy (HAART) between 1996 and 2006 in West Africa.

Research paper thumbnail of Impact of the Ebola epidemic on general and HIV care in Macenta, Forest Guinea, 2014

Objective: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. W... more Objective: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. We aimed at investigating its impact on general and HIV care at the only HIV care facility in the district.

Research paper thumbnail of Severe morbidity after antiretroviral (ART) initiation: active surveillance in HIV care programs, the IeDEA West Africa collaboration

BMC Infectious Diseases, 2015

Background: The causes of severe morbidity in health facilities implementing Antiretroviral Treat... more Background: The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance system established within a network of specialized care facilities in West African cities.

Research paper thumbnail of HIV Ascertainment through Repeat Home-based Testing in the Context of a Treatment as Prevention Trial (ANRS 12249 TasP) in Rural South Africa

AIDS Research and Human Retroviruses, 2014

Research paper thumbnail of Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

Journal of the International AIDS Society, 2013

Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significa... more Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods: HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results: A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30Á44] and their median CD4 count was 181 cells/mm 3 (IQR 97Á269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p B 10 (4 ) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (pB10 (2 ). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p B10 (4 ) and 45.3 (pB10 (3 ), respectively. Discussion: The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the follow-up of HAART-treated patients is a key component to restore HRQOL.

Research paper thumbnail of Virological response to HIV-1 nucleoside/nucleotide reverse transcriptase inhibitors-based, tenofovir DF-including regimens in the ANRS Aquitaine Cohort

Journal of Clinical Virology, 2006

Background: HIV-1 nucleoside/tide reverse transcriptase inhibitors (NRTI)-only based, comprising ... more Background: HIV-1 nucleoside/tide reverse transcriptase inhibitors (NRTI)-only based, comprising tenofovir DF(TDF) have been shown to lead to high rates of virological failures (VF), mainly in patients on first-line combination therapy. We wished to investigate the virological response to these regimens in a large cohort of antiretroviral (ARV)-treated patients. Methods: Patients followed-up in the Aquitaine Cohort in 2001-2003 and who had received NRTI-based, TDF-including regimens for at least 3 months were included. The VF was defined as: (i) a decrease in plasma HIV-1 RNA <0.5 log 10 copies/ml between M0 and M3; or (ii) a plasma HIV-1 RNA >50 copies/ml at M3 in patients with plasma HIV-1 RNA <50 copies/ml at M0. The baseline RT genotype was determined in a subgroup of patients. Results: Within 121 patients (95% ARV-experienced) who received either lamivudine (3TC)/didanosine (DDI)/TDF (n = 48), or abacavir (ABC)/3TC/TDF (n = 14), or 3TC/zidovudine (ZDV)/TDF (n = 27), or 3TC/ZDV/ABC/TDF (n = 20), or DDI/ABC/TDF (n = 12), the ABC/3TC/TDF and DDI/ABC/TDF combinations were associated with the highest frequencies of VF. In contrast the use of ZDV was related to a better virological response. The baseline RT genotype was also predictive of the virological outcome. Conclusion: NRTI-based, TDF-including therapies can lead to high rates of VF both in ARV-naïve and in ARV-experienced patients. Our data strongly suggest the interest of associating ZDV and TDF in these regimens.

Research paper thumbnail of Évolution des conditions d’initiation du traitement antirétroviral des patients infectés par le VIH en Afrique de l’Ouest

Medecine Et Maladies Infectieuses, 2010

ObjectiveWe studied the evolution of drug combinations used, as well as the clinical and immunolo... more ObjectiveWe studied the evolution of drug combinations used, as well as the clinical and immunological profile of patients at initiation of highly active antiretroviral therapy (HAART) between 1996 and 2006 in West Africa.