Hepatitis A outbreak in HIV-infected patients in Southeastern France: questions and responses?

During the 2017 European hepatitis A (HA) outbreak we assessed HA incidence in our cohort of 2300 HIV-infected patients, implemented preventive measures and evaluated practices and knowledge on sexually transmitted diseases (STD). HA incidence was assessed between 1 January 2017 and 31 December 2017 and included all symptomatic patients with virologically confirmed HA. Preventive measures consisted in identifying at risk and not immunised patients to propose them a free HAV vaccination, and an anonymous survey related to transmission routes of STD and to sexual behaviours. Twenty HA were diagnosed. All were homosexual men recently diagnosed with HIV and another STD. None were vaccinated against hepatitis A virus (HAV). Hospitalisation was required for 52%. We identified 250 patients at risk to acquire HAV and invited them to a free immunisation program. A total of 110 (44%) were vaccinated, of whom 74 responded to our survey. A majority of them (84%) reported recent active anal and oral sexuality with multiple (52%) male partners (81%), and ChemSex consumption (14%). Internet was the meeting link for 58%. Another STD history was found in 69%. One third of these individuals had no idea about STD transmission modes. This HA outbreak pointed the insufficient vaccine coverage against HAV and knowledge on STD, which may be improved by Internet.

Longitudinal growth of French singleton children born after in vitro fertilization and intracytoplasmic sperm injection. Body mass index up to 5 years of age.

BACKGROUND: The literature presents conflicting results on the epigenetic effect of in vitro fertilization (IVF) on the short-term and mid-term growth of children. These contradictory results may be related to the use of heterogeneous methodologies and non-longitudinal data. The goal of this study was to compare the body mass index (BMI) of children conceived via IVF and spontaneous conception (SC) children, using longitudinal data from birth to 5 years. METHODS: This study compared 118 singleton children born after in vitro fertilization, with or without intracytoplasmic sperm injection (ICSI), selected from a pre-existing single-center cohort to 320 SC children from the same geographic area. BMI and its evolution were analyzed using the mixed-effect model during three periods: before standing acquisition (from birth to 1 year of age), during standing acquisition, and the following period from 2 to 5 years of age. RESULTS: BMI means were not significantly different between groups regardless of the period, when adjusting for confounding factors related to parents, pregnancy, and children's characteristics and lifestyle. Nevertheless, during the standing acquisition period, children born after IVF-ICSI presented a less significant decrease in BMI (P<0.05). In addition, for each period we identified influencing factors (maternal BMI, level of wealth indicator) associated with BMI. CONCLUSION: In the study population, the suspected epigenetic influence of IVF reported in the literature was not observed for BMI from birth to 5 years of age. Further investigations need to be conducted to determine if the suspected influence of IVF on adiposity could be expressed through other parameters.

[Procedure used to follow-up a cohort of IVF children. Interests and limits of tools performed to longitudinal follow up for a monocentric cohort]. / Procédure de suivi d'une cohorte d'enfants FIV. Intérêts et limites de l'outil développé pour un suivi longitudinal et monocentrique.

BACKGROUND: Follow-up of in vitro fertilization (IVF) children is recommended by the French health authorities. Follow-up procedures were set-up in a medically assisted reproduction unit at the Saint-Joseph Hospital in Marseille. The objective was to ensure effective follow-up. In this context, it is important to determinate weather the designated tools are appropriate for evaluating the desired developmental outcomes. This study was designed to describe the surveillance tool and to demonstrate its usefulness and limitations. METHODS: The procedure was initiated in 2004. All existing data for every livebirth child were collected, including data concerning all IVF attempts, medical reports of pregnancy, and child health records. Parents were asked to complete questionnaires and provide their child's personal health records since birth. The quality of the data was evaluated using prenatal and postnatal analysis. The longitudinal anthropometric data of the health records were used to describe the percentiles of weights and heights from birth to 6 years in this population at age-specific reference intervals. RESULTS: The follow-up concerned 2081 children born since 1995 with a response rate of 68,9%. A brief descriptive analysis was performed for the cohort and for a group of 1053 children aged five years and older, 225 representative personal health records were used to estimate quintiles for anthropometric data. CONCLUSION: The procedure adopted for the follow-up of in vitro fertilization children meets the established qualitative health requirements. This method provides many benefits with no risk for the children. Data collection from personal health records enabled an exploitation of growth data by including the calculation of anthropometric percentiles in this IVF population. This report presents the first set of IVF child growth standards used as health indicator and health trend measurement.