Incidence and risk factors of severe adverse events with nevirapine-based antiretroviral therapy in HIV-infected women. MTCT-Plus program, Abidjan, Côte d'Ivoire

<p>Abstract</p> <p>Background</p> <p>In resource-limited settings where nevirapine-containing regimen is the preferred regimen in women, data on severe adverse events (SAEs) according to CD4 cell count are limited. We estimated the incidence of SAEs according to CD4 cell count and identify their risk factors in nevirapine-treated women.</p> <p>Methods</p> <p>All HIV-infected women who initiated nevirapine-containing regimen in the MTCT-Plus operational program in Abidjan, Côte d'Ivoire, were eligible for this study. Laboratory and clinical (rash) SAEs were classified as grade 3 and 4. Cox models were used to identify factors associated with the occurrence of SAEs.</p> <p>Results</p> <p>From August 2003 to October 2006, 290 women initiated a nevirapine-containing regimen at a median CD4 cell count of 186 cells/mm³(IQR 124-266). During a median follow-up on treatment of 25 months, the incidence of all SAEs was 19.5/100 patient-years. The 24-month probability of occurrence of hepatotoxicity or rash was not different between women with a CD4 cell count >250 cells/mm³and women with a CD4 cell count ≤250 cells/mm³(8.3% <it>vs</it>. 9.9%, Log-rank test: p = 0.75). In a multivariate proportional hazard model, neither CD4 cell count >250 cells/mm³at treatment initiation nor initiation NVP-based regimen initiated during pregnancy were associated with the occurrence of SAEs.</p> <p>Conclusion</p> <p>CD4 cell count >250 cells/mm³was not associated with a higher risk of severe hepatotoxicity and/or rash, as well as initiation of ART during pregnancy. Pharmacovogilance data as well as meta-analysis on women receiving NVP in these settings are needed for better information about NVP toxicity.</p

Factors associated with verbal fluency in older adults living with HIV in West Africa: a longitudinal study

OBJECTIVE: Verbal fluency decline, observed both in aging and HIV infection, has been related to lower quality of life. This study aimed to evaluate the factors associated with verbal fluency in people living with HIV (PLHIV) aged ≥60 years living in West Africa. METHODS: In this longitudinal study, PLHIV aged ≥60 years, on antiretroviral therapy (ART) for ≥6 months were included in three clinics (two in Côte d'Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. Verbal fluency was evaluated with the Isaacs Set Test at 60 seconds at baseline and 2 years later. Factors associated with verbal fluency baseline performance and annual rates of changes were evaluated using multivariate linear regression models. RESULTS: 97 PLHIV were included with 41 of them (42%) having a 2-year follow-up visit. The median age was 64 (62-67), 45.4% were female, and 89.7% had an undetectable viral load. The median annual change in verbal fluency scores was -0.9 (IQR: -2.7 - 1.8). Low baseline verbal fluency performance and its decline were associated with older age and being a female. Low educational level was associated with low baseline verbal fluency performance but not with its decline. Verbal fluency decline was also associated with marital status and hypertension. CONCLUSIONS: Among older West African PLHIV, usual socio-demographic variables and hypertension were the main factors associated with low verbal fluency performance and/or its decline. Interventions that focus on supporting cardiometabolic health are highly recommended to prevent cognitive disorders in PLHIV. This article is protected by copyright. All rights reserved

Ten-year attrition and antiretroviral therapy response among HIV-positive adults: a sex-based cohort analysis from eight West African countries

INTRODUCTION: Sex differences have already been reported in sub-Saharan Africa for attrition and immunological response after antiretroviral therapy (ART) initiation, but follow-up was usually limited to the first two to three years after ART initiation. We evaluated sex differences on the same outcomes in the 10 years following ART initiation in West African adults. METHODS: We used cohort data of patients included in the IeDEA West Africa collaboration, who initiated ART between 2002 and 2014. We modelled no-follow-up and 10-year attrition risks, and immunological response by sex using logistic regression analysis, survival analysis with random effect and linear mixed models respectively. RESULTS: A total of 71,283 patients (65.8% women) contributed to 310,007 person-years of follow-up in 16 clinics in eight West African countries. The cumulative attrition incidence at 10-year after ART initiation reached 75% and 68% for men and women respectively. Being male was associated with an increased risk of no follow-up after starting ART (5.1% vs. 4.0%, adjusted Odds Ratio: 1.25 [95% CI: 1.15 to 1.35]) and of 10-year attrition throughout the 10-year period following ART initiation: adjusted Hazard Ratios were 1.22 [95% CI: 1.17 to 1.27], 1.08 [95% CI: 1.04 to 1.12] and 1.04 [95% CI: 1.01 to 1.08] during year 1, years 2 to 4 and 5 to 10 respectively. A better immunological response was achieved by women than men: monthly CD4 gain was 30.2 and 28.3 cells/mL in the first four months and 2.6 and 1.9 cells/μL thereafter. Ultimately, women reached the average threshold of 500 CD4 cells/μL in their sixth year of follow-up, whereas men failed to reach it even at the end of the 10-year follow-up period. The proportion of patients reaching the threshold was much higher in women than in men after 10 years since ART initiation (65% vs. 44%). CONCLUSIONS: In West Africa, attrition is unacceptably high in both sexes. Men are more vulnerable than women on both attrition and immunological response to ART in the 10 years following ART initiation. Innovative tracing strategies that are sex-adapted are needed for patients in care to monitor attrition, detect early high-risk groups so that they can stay in care with a durably controlled infection

Int J Cancer

As human papillomavirus (HPV) immunisation and HPV-based cervical cancer (CC) screening programmes expand across sub-Saharan Africa, we investigated the potential impact of human immunodeficiency virus (HIV) status on high-risk (HR)-HPV distribution among women with CC in Cote d'Ivoire. From July 2018 to June 2020, paraffin-embedded CC specimens diagnosed in Abidjan, Cote d'Ivoire were systematically collected and tested for HR-HPV DNA. Type-specific HR-HPV prevalence was compared according to HIV status. Of the 170 CC specimens analysed (median age 52 years, interquartile range: [43.0-60.0]), 43 (25.3%) were from women living with HIV (WLHIV) with a median CD4 count of 526 [373-833] cells/mm(3) and 86% were on antiretroviral therapy (ART). The overall HR-HPV prevalence was 89.4% [95% CI: 84.7-94.1]. All were single HR-HPV infections with no differences according to HIV status (P = .8). Among HR-HPV-positive CC specimens, the most prevalent HR-HPV types were HPV16 (57.2%), HPV18 (19.7%), HPV45 (8.6%) and HPV35 (4.6%), with no significant differences according to HIV status. Altogether, infection with HPV16/18 accounted for 71.1% [95% CI: 55.9-86.2] of CC cases in WLHIV vs 78.9% [95% CI: 71.3-86.5] in women without HIV (P = .3). The study confirms the major role of HPV16/18 in CC in Cote d'Ivoire and should support a regional scale-up of HPV16/18 vaccination programmes regardless of HIV status. However, vaccines targeting additional HR-HPV types, including HPV45 and HPV35, could further decrease future CC incidence in Cote d'Ivoire, both for WLHIV and women without HIV

Detection and Prevention of Cross-site Scripting Attack by Using Combined Approaches

[[abstract]]跨站點腳本攻擊是一種類型代碼注入，它使黑客能夠將惡意腳本代碼注入受信任的Web應用程序。當用戶嘗試請求注入的網頁時，他不知道惡意腳本代碼可能正在影響他的計算機。如今，攻擊者正在針對持有敏感數據（例如銀行交易，電子郵件，醫療保健和電子銀行）的Web應用程序，以竊取用戶信息並獲得對數據的完全訪問權限，從而使Web應用程序變得更加強大。脆弱的。這項研究提出了兩種方法，第三種是稱為“與人工智能（AI），IDPS和非軍事區（DMZ）集成的Web應用程序防火牆方法”的混合方法，以找到針對這一最具挑戰性的攻擊問題的解決方案。在第一種方法中，我們實施了隨機森林（RF），邏輯回歸（LR），k最近鄰（KNN）和支持向量機（SVM）來發現和分類XSS攻擊。在第二種方法中，實施了內容安全策略（CSP）方法以實時檢測XSS攻擊。在最後一種方法中，本研究提出了與人工智能（AI），IDPS和非軍事區（DMZ）集成的Web應用程序防火牆方法，以實時檢測和預防XSS攻擊。該研究實驗結果證明了AI算法的高性能。 CSP方法實時顯示檢測系統報告的結果。在第三種方法中，獲得了預期的系統實驗結果，這使WAF方法與AI，IDPS和DMZ集成在一起，比其他兩種方法更強大地解決了此研究問題[[abstract]]Cross-site scripting attack is a type code injection that allows a hacker to inject malicious script code into a trusted web application. When a user tries to request the injected web page, he is not aware that the malicious script code might be affecting his computer. Nowadays, attackers are targeting the web applications that holding a sensitive data (e.g., bank transaction, e-mails, healthcare, and e-banking) to steal users’ information and gain full access to the data which make the web applications to be more vulnerable. This research study presents two approaches and the third is hybrid approach called “Web Application Firewall approach integrated with artificial intelligence (AI), IDPS, and demilitarized zone (DMZ)” to find a solution to this most challenging attacks problems. In the first approach, we implemented random forest (RF), logistic regression (LR), k-Nearest Neighbors (KNN ), and support vector machine (SVM) to discover and classify XSS attack. In the second approach, the content security policy (CSP) approach is implemented to detect XSS attacks in real-time. In the last approach, Web Application Firewall approach integrated with artificial intelligence (AI), IDPS, and Demilitarized Zone (DMZ) is proposed in this research study to detect and prevent XSS attacks in real-time. This research experiment results demonstrated the high performance of AI algorithms. The CSP approach shows the results for the detection system report in real-time. In the third approach, the expected system results is obtained for experiment, that make the WAF approach integrated with AI, IDPS, and DMZ more powerful system tools to address this research problem than the other two approache

Hésiode, Les Travaux et les Jours ; Aristophane, Ploutos , Les Nuées.

Numérisation effectuée à partir d'un document de substitution.(ff. 1r-15r) Hésiode, Les Travaux et les jours : (f. 1r) [titre] ΗΣΙΟΔΟΥ ΤΟΥ ΑΣΚΡΑΙΟΥ ΕΡΓΑ ΚΑΙ ΗΜΕΡΑΙ, (f. 14r) ΗΣΙΟΔΟΥ ΗΜΕΡΑΙ.(ff. 17r-48r) Aristophane, Ploutos : [titre] Ἀριστοφάνους Πλοῦτος.(ff. 50r-86v) Aristophane, Les Nuées : [titre] Ἀριστοφάνους Νεφέλαι.La première partie de ce manuscrit est en fait constituée de deux quaternions issus d’un incunable. Ils proviennent d’un exemplaire de l’édition des Idylles de Théocrite réalisée à Milan, chez Bonus Accursius, aux alentours de 1480 (Gesamtkatalog der Wiegendrucke, M45823, Theocritus). Cette édition, dont on trouve un exemplaire complet dans les collections de la Bibliothèque nationale de France (cote RES- YB- 305), rassemblait les Idylles et Les Travaux et les jours et est peut-être l’œuvre de Démétrios Chalcondyle. Le poème d’Hésiode occupait les deux derniers cahiers, ε et ζ, signatures que l’on peut observer dans le Parisinus gr. 2718.La partie manuscrite de ce volume a donc été copiée par Constantin Lascaris, érudit byzantin qui s’installa en Italie après la chute de Constantinople. À en juger par le filigrane, ce manuscrit a été écrit dans la période milanaise de Constantin Lascaris (1458-1465), période qui précède son installation à Messine. L’activité exégétique de Lascaris autour des comédies d’Aristophane apparaît dans plusieurs témoins de la Bibliothèque nationale de Madrid. Le Ploutos du Matritensis 4677 (ff. 187r-205v) est de sa main. Et en 1490 il achète à Messine un manuscrit d’Aristophane relativement ancien qu’il complète (Matritensis 4683). Enfin le Matritensis 4629 contient dans les marges des Nuées et du Ploutos des annotations de sa main (voir Martínez Manzano, p. 203).Le Parisinus gr. 2718 provient de la bibliothèque des rois aragonais de Naples, en particulier des collections de Simone Guerrero. Une mention d’appartenance apparaît en effet dans la marge inférieure du f. [88]v (Semono Guerero). Un second manuscrit grec des collections de la bibliothèque nationale de France provient de ce même possesseur, le Parisinus gr. 1023, manuscrit de Jean Chrysostome. Dans les collections des manuscrits latins de la Bibliothèque nationale de France se trouve le Latin 3069, qui a aussi appartenu à Simone Guerrero. Ces manuscrits ont été rapportés de Naples par Charles VIII qui entra à Naples en 1495. Tous les manuscrits qui ont été rapportés du royaume de Naples par Charles VIII ont ensuite été réunis dans la bibliothèque royale de Blois par Louis XII. Cette bibliothèque fut transportée à Fontainebleau en 1544

Plutus. Nebulae. Ranae

[Ploutos (grec ancien). 1540][Les grenouilles (grec ancien). 1540][Nuées (grec ancien). 1540

Plutus / Aristophane ; [expliqué littéralement, traduit en français et annoté par M. Cattant,...]

[Ploutos (grec ancien-français)]Collection : Les auteurs grecs expliqués d'après une méthode nouvelle par deux traductions françaises...Avec mode text

Scène de la pauvreté : extrait du Plutus / Aristophane ; avec une analyse de la pièce, des notes... et des extraits du Timon de Lucien, par L. Humbert,...

[Ploutos (français). Extrait. 1875]Avec mode text