References of "Karasi, Jean Claude"
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See detailEvaluation of saliva as an alternative matrix for monitoring plasma Zidovudine, Lamivudine and nevirapine concentrations in Rwanda
Gras, A; Schneider, S; Karasi, Jean Claude ULg et al

in Current HIV Research (2011), 9(4), 223-8

Saliva may provide interesting advantages as matrix for compliance measurements, pharmacokinetic studies and therapeutic drug monitoring in resource limited countries. We investigated the feasibility of ... [more ▼]

Saliva may provide interesting advantages as matrix for compliance measurements, pharmacokinetic studies and therapeutic drug monitoring in resource limited countries. We investigated the feasibility of using saliva for compliance monitoring of zidovudine (ZDV), lamivudine (3TC) and nevirapine (NVP) in 29 HIV-1 infected patients from Rwanda. ZDV, 3TC and NVP drug levels were quantified by an LC/MS-MS method in plasma and stimulated saliva samples and compared using Bland-Altman analysis. Seven patients demonstrated undetectable saliva ZDV levels while five out of these seven also showed no 3TC salivary concentrations. For the other samples, we observed a good agreement between salivary and plasma concentrations of each antiretroviral drug. A significant relation between the difference in saliva and plasma ZDV concentrations and the average ZDV concentration in the two matrices was deduced as follow: y = -380.15 + 1.79 x. The log saliva and plasma concentration difference of both 3TC and NVP was consistent across the range of average log concentration. Overall, we showed large agreement limits suggesting a wide inter patient variability that may result to non-reliable plasma level predictions from saliva drug measurements. Therefore, our results indicate that saliva may serve as a valuable tool only for NVP compliance testing because of its high salivary concentration. [less ▲]

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See detailHigh correlation between the Roche COBAS(R) AmpliPrep/COBAS(R) TaqMan(R) HIV-1, v2.0 and the Abbott m2000 RealTime HIV-1 assays for quantification of viral load in HIV-1 B and non-B subtypes.
Karasi, Jean Claude ULg; Dziezuk, F; Quennery, L et al

in Journal of Clinical Virology (2011), 52(3), 181-6

BACKGROUND: HIV-1 viral load assays are critical tools to monitor antiretroviral therapy efficacy in HIV-infected patients. Two assays based on real-time PCR are available, the Abbott Real-Time HIV-1 ... [more ▼]

BACKGROUND: HIV-1 viral load assays are critical tools to monitor antiretroviral therapy efficacy in HIV-infected patients. Two assays based on real-time PCR are available, the Abbott Real-Time HIV-1 assay (Abbott assay) and the new Roche COBAS((R)) AmpliPrep/COBAS((R)) TaqMan((R)) HIV-1 test, v. 2.0 (TaqMan((R)) test v2.0). OBJECTIVES: We have compared the performance of the two assays in 546 clinical plasma specimens of group M strains from Luxembourg and Rwanda. STUDY DESIGN: Our analyses focused on subtype inclusivity and platforms accuracy for 328 low level viremia samples. RESULTS: Strong agreement and linear correlation were observed between the two assays (R(2) = 0.95) over a wide dynamic range. Bland-Altman analysis showed a mean difference of 0.04 log 10 indicating minimal overall viral load quantification differences between both platforms. One subtype C was severely underquantified by TaqMan((R)) test v2.0 for which sequence analysis revealed multiple mismatches between the viral sequence and the primer/probe regions. A non significant lower quantification of the Abbott assay was shown for subtype A1 with a mean log 10 difference of 0.24. For specimens under 200 cp/mL, the overall agreement was 90% at the cut-off of 50 cp/mL and 67% at assay's lower limit of detection of 20 and 40 cp/mL. 309 samples were retested by the COBAS((R)) AMPLICOR((R)) HIV-1 MONITOR Test, v. 1.5 and a lack of agreement between the three assays around their lower limit of quantification was revealed. CONCLUSIONS: Both real-time tests were closely comparable in the quantification of viral load specimens of ten HIV-1 subtypes and recombinant forms. [less ▲]

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See detailHealth systems strengthening through insurance subsidies: the GFATM experience in Rwanda
Kalk, A; Groos, N; Karasi, Jean Claude ULg et al

in Tropical Medicine & International Health [=TM & IH] (2010), 15(1), 94-7

The Global Fund Against AIDS, Tuberculosis and Malaria (GFATM) approved only three 'health systems strengthening' projects ever, one of them in Rwanda. This project intends to enhance financial access to ... [more ▼]

The Global Fund Against AIDS, Tuberculosis and Malaria (GFATM) approved only three 'health systems strengthening' projects ever, one of them in Rwanda. This project intends to enhance financial access to health care by subsidising health insurance for the poor in order to combat the three diseases successfully. It was submitted to a mid-term evaluation in 2007. The findings of this evaluation are presented and triangulated with experience gained through several years of membership in the Rwandan Country Coordinating Mechanism and the multi-stakeholder 'Working Group on Mutuelles': The GFATM-funded project improved dramatically the financial access of its target group, the very poor--reaching approximately one Rwandan in six. Because of the established rigid regulatory framework, its impact on other population strata was more ambiguous. Improved financial access went hand-in-hand with growing health service utilisation and improvements in the population's health status, including better control of AIDS, tuberculosis and malaria. This success was achieved with limited financial resources. In consequence, interventions that strengthen health systems should always be considered for a prominent--if not a priority role--in GFATM-funded projects. [less ▲]

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See detailExceptional genetic variability of hepatitis B virus indicates that Rwanda is east of an emerging African genotype E/A1 divide
Hubschen, J M; Mugabo, J; Peltier, C A et al

in Journal of Medical Virology (2009), 81(3), 435-40

In Western Africa, hepatitis B virus (HBV) genotype E predominates throughout a vast crescent spanning from Senegal to Namibia and at least to the Central African Republic to the East. Although from most ... [more ▼]

In Western Africa, hepatitis B virus (HBV) genotype E predominates throughout a vast crescent spanning from Senegal to Namibia and at least to the Central African Republic to the East. Although from most of the eastern parts of sub-Saharan Africa only limited sets of strains have been characterized, these belong predominantly to genotype A. To study how far the genotype E crescent extends to the East, a larger number of HBV strains from Rwanda were analyzed. Phylogenetic analysis of 45 S fragment sequences revealed strains of genotypes A (n = 30), D (n = 10), C (n = 4), and B (n = 1). Twelve genotype A sequences formed a new cluster clearly separated from the reference strains of the known sub-genotypes. Thus, with four genotypes and at least six sub-genotypes and a new cluster of genotype A strains, HBV shows an exceptional genetic variability in this small country, unprecedented in sub-Saharan Africa. Despite this exceptional genetic variability, not a single genotype E virus was found indicating that this country does not belong to the genotype E crescent, but is east of an emerging African genotype E/A1 divide. [less ▲]

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See detailAntiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real-life situation in 2002.
Fischer, A; Karasi, Jean Claude ULg; Kibibi, D et al

in HIV Medicine (2006), 7(1), 64-6

Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency ... [more ▼]

Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency and reasons for treatment interruptions but also antiviral efficay, resistance to ARVs and genotypic variability of the viruses present in Rwanda were analysed. Among the 233 patients included in the study, it appeared that a vast majority (91%) were under triple therapy and that half of them had experienced at least one treatment interruption caused mainly by drug shortage or financial difficulties. Among 60 blood samples analysed, 26 were in virological failure with a viral load above 1000 RNA copies/ml and 11 presented major drug resistance mutations. Finally, virological failure could mainly be explained by the high frequency of treatment interruptions but also by the emergence of drug resistance mutations. Consequently the major objective for the ESTHER programme to improve the situation in Rwanda will be to reduce the drug shortage and facilitate the financial accessibility of the treatments. [less ▲]

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See detailAdherence to first-line antiretroviral regimens in Rwanda.
Demeester, Remy; Omes, Christine; Karasi, Jean Claude ULg et al

in Journal of Acquired Immune Deficiency Syndromes [=JAIDS] (2005), 40(1), 113-4

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