Carie dentaire, gingivite et VIH pédiatrique en Côte d’Ivoire

L’objectif est de déterminer la prévalence des caries et des gingivites chez des enfants ivoiriens infectés par le VIH et d’étudier leur association avec la sévérité de la maladie et son traitement. Une étude transversale a été conduite en 2004 dans une structure de recherche à Abidjan. Parmi 83 enfants examinés, l’âge médian était de 6,8 ans, le taux de CD4 médian de 20,1 % et 34 % étaient sous antirétroviraux; 11 % présentaient une gingivite et 76 % des caries dont 3 traités. L’âge était le principal facteur associé à la présence de caries (rapport de côte de prévalence ajusté [RCPA] : 1,3, intervalle de confiance [IC] à 95 % : 1,1-1,7), alors que la gingivite était plus fréquente chez les enfants présentant une immunosupression sévère (RCPA : 7,9, CI : 1,7-36,3). Dépistage des caries et traitement de la gingivite devraient être recommandés chez les enfants infectés par le VIH

Circadian desynchronization triggers premature cellular aging in a diurnal rodent

International audienceChronic jet lag or shift work is deleterious tohuman metabolic health, in that such circadian desynchronizationis associated with being overweight and the prevalenceof altered glucose metabolism. Similar metabolic changesare observed with age, suggesting that chronic jet lag andaccelerated cell aging are intimately related, but the associationremains to be determined.We addressed whether jet laginducesmetabolic and cell aging impairments in young grassrats (2–3mo old), using control old grass rats (12–18 mo old)as an aging reference. Desynchronized young and control oldsubjects had impaired glucose tolerance (+60 and +280%)when compared with control young animals. Despite no significantvariation in liver DNA damage, shorter telomereswere characterized, not only in old animal liver cells (218%),but also at an intermediate level in desynchronized young rats(29%). The same pattern was found for deacetylase sirtuin(SIRT)-1 (257 and229%), confirming that jet-lagged youngrats have an intermediate aging profile. Our data indicatethat an experimental circadian desynchronization in younganimals is associated with a precocious aging profile basedon 3 well-knownmarkers, as well as a prediabetic phenotype.Such chronic jet lag–induced alterations observed in a diurnalspecies constitute proof of principle of the need todevelop preventive treatments in jet-lagged persons and shiftworkers

Very High Concentrations of Active Intracellular Phosphorylated Emtricitabine in Neonates (ANRS 12109 Trial, Step 2)▿

Our objective was to investigate neonatal emtricitabine (FTC) plasma and intracellular pharmacokinetics. The study was designed as a phase I/II prospective trial in two sequential steps evaluating the combination of tenofovir disoproxil fumarate (TDF) and FTC for the prevention of mother-to-child-transmission (PMTCT) of HIV. HIV-1-infected pregnant women received two tablets of TDF (300 mg) and FTC (200 mg) at onset of labor and then one tablet daily for 7 days postpartum. Based on the data obtained in the first part of the Tenofovir/Emtricitabine in Africa and Asia (TEmAA) Study, single doses of 2 mg/kg of FTC and 13 mg/kg of TDF were given to the neonates within 12 h after birth. A total of 540 FTC plasma concentrations and 44 active intracellular phosphorylated metabolite FTC-TP concentrations were taken from the 36 enrolled women and their neonates. Concentrations were measured by the liquid chromatography-tandem mass spectrometry (LC-MS/MS) method and analyzed by a population approach. The proposed dose obtained by simulations based on plasma drug concentrations was confirmed. However, median FTC-TP exposures were, respectively, 5.9 and 6.8 times higher in the fetus and the neonate than in the adult. High FTC-TP concentrations were observed in the four children who had serious adverse events (SAEs), but the link between FTC-TP concentrations and SAEs in children was not formally identified. The exposure to the active form of FTC was high in neonates despite plasma drug concentrations equivalent to those in adults. Our results are similar to those obtained with zidovudine or lamivudine