New insights into agriculture in northwestern France from the Bronze Age to the Late Iron Age: a weed ecological approach

International audienceNew plant macrofossil studies in northwestern France enable a better insight into agriculture through the Bronze and Iron Age. Most of the previous analyses, carried out in Calvados (Normandy) on Late Iron Age dwellings, suggested distinctive characteristics such as the increase of Avena (oat) and the abundance of pulses in storage pits. The collection of a new database with 25 sites was done in response to the previous lack of studies, which became an issue in Brittany, Normandy and the Loire region, which are known for their western location and trade links throughout Europe. This paper deals with farming practices and their changes during the Bronze and Iron Ages. The aim was to gather new evidence related to sowing times, tilling of fields and fertility management of soils in order to discuss extensive or intensive cultivation in northwestern France. The crop cultivation techniques were investigated by studying the weed flora composition according to the FIBS approach (Functional interpretation of botanical survey). The results reveal combinations of evidence and a pattern of intra-regional diversity

Does changing antiretroviral therapy in the first trimester for pregnancy-related concerns have an impact on viral suppression ?: Changing ART in pregnancy and viral suppression ?

International audienceOBJECTIVE:To determine whether changing antiretroviral therapy (ART) during pregnancy because of concern about fetal risks led to poorer virological outcomes.METHODS:All pregnancies in women with HIV-1 infection enrolled in the national multicenter prospective French Perinatal cohort at 14 week gestation or more were included between January 2005 and December 2015, if the mother was on ART at conception with a plasma viral load <50 copies/mL. The reasons for a change in the ART were analyzed according to treatment guidelines at the time of the pregnancy and defined as for safety concerns in the absence of reported maternal intolerance. Virological and pregnancy outcomes were studied by survival analysis and logistic regression adjusted for a propensity score established for each patient according to baseline characteristics.RESULTS:Of 7079 pregnancies in the overall cohort, 1797 had ART at conception with a viral load <50 copies/mL before 14 week gestation. Of these, 22 changed regimens in the first trimester for intolerance, and 411 of the remaining 1775 (23%) solely for safety concerns. The proportion of change was higher when the initial treatment was not recommended in the national guidelines (OR adjusted: 23.1 [14.0-38.2]), than when it was an alternative option (ORa: 2.2 [1.3-3.7]), as compared to recommended first-line regimens. Treatment changes for safety concerns did not lead to poorer virological control, compared with pregnancies without such changes (19.3% vs. 15.6%, HRa: 1.0 [0.7-1.4]).CONCLUSIONS:Changing ART early in pregnancy to regimens considered safer for pregnancy, and neonatal health did not have a destabilizing effect on viral suppression

L’Antiquité tardive dans l’Est de la Gaule, II

Les actes du colloque « Antiquité tardive dans l'Est de la Gaule, 2 », qui s'est tenu à Châlons-en-Champagne en septembre 2010, rassemblent vingt-six contributions portant sur l'archéologie de l'Antiquité tardive du Nord et de l'Est de la Gaule. La première partie de l'ouvrage présente quatorze travaux sur les sépultures, nécropoles et pratiques funéraires dans les provinces de Lyonnaise I et IV, de Belgique I et II et de Séquanaise, tant en milieu urbain que dans les campagnes. Ils s'attachent, entre autres, à traiter les questions de topographie funéraire, d'organisation interne des nécropoles, d'architecture funéraire et des pratiques de déposition dans les sépultures et révèlent la transformation progressive de la topographie funéraire, particulièrement en milieu urbain, mais aussi des pratiques spécifiques propres à la période, tant dans l'aménagement de la sépulture que dans le mobilier déposé. La seconde partie de l'ouvrage regroupe douze contributions illustrant l'actualité de la recherche dans ces régions, qu'il s'agisse de découvertes récentes ou de travaux de synthèse portant sur des sites ou des mobiliers.Die Publikation derTagung „L'Antiquité tardive dans l'Est de la Gaule, 2" die im September 2010 in Chälons-en-Champagne stattfand, versammelt 26 Beiträge,die sich mit der Archéologie der Spätantike im Norden und Osten Galliens befassen. Der erste Abschnitt des Tagungsbandes umfasst 14 Artikel, die sich mit den Gräbern, Gräberfeldern und den Bestattungssitten im Gebiet der Provinzen der Gallia Lugdunensis I und IV, der Belgica I und II sowie der Provinz Maxima Sequanorum befassen und die sich sowohl den Grabbefunden und -sitten im städtischen Umfeld wie auch denjenigen im ländlichen Raum widmen. Neben anderen Aspekten werden dabei Fragen der Gräberfeldtopografie, der inneren Organisation der Graberfelder, der Grabarchitektur sowie der Beigabensitten in den Gräbern behandelt. Die Untersuchungen bezeugen einefortschreitende Veränderung der Gräberfeldtopografie, insbesondere im städtischen Umfeld, jedoch ebenfalls der Bestattungsbrauche, die typisch für die jeweilige Période sind und die einerseits die Anlage und Ausgestaltung der Grablegen, andererseits die niedergelegten Beigaben betreffen. Die zweite Teil des Bandes präsentiert 12 Beiträge,die neueste Forschungsergebnisse ausdiesen Regionen vorstellen, gleich ob es sich dabei um jüngste Neuentdeckungen handelt oder um Synthesen, die sich mit den Fundplätzen oder dem archäologlschen Fundgut befassen

Maintenance darunavir/ritonavir monotherapy to prevent perinatal HIV transmission, ANRS-MIE 168 MONOGEST study

International audienceObjectives: Because NRTIs can have fetal toxicities, we evaluated a perinatal NRTI-sparing strategy to prevent perinatal HIV transmission. Our primary objective was to determine the proportion maintaining a viral load (VL) of 50 copies/mL. Neonates received nevirapine prophylaxis for 14 days.Results: Of 89 patients switching to darunavir/ritonavir monotherapy, 4 miscarried before 22 weeks' gestation, 2 changed treatment for elevated liver enzymes without virological failure, and 83 were evaluable for the main outcome. Six had virological failure confirmed on a repeat sample (median VL=193 copies/mL; range 78-644), including two before switching to monotherapy. In these six cases, ART was intensified with tenofovir disoproxil fumarate/emtricitabine. The success rate was 75/83, 90.4% (95% CI, 81.9%-95.7%) considering two patients with VL missing at delivery as failures, and 77/83, 92.8% (95% CI, 84.9%-97.3%) when considering them as successes since both had undetectable VL on darunavir/ritonavir throughout pregnancy. In ITT, the last available VL before delivery was <50 copies/mL in all of the patients. There was no case of perinatal HIV transmission.Conclusions: Darunavir/ritonavir maintenance monotherapy required intensification in nearly 10% of cases. This limits its widespread use, thus other regimens should be evaluated in order to limit exposure to antiretrovirals, particularly NRTIs, during pregnancy

Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?

International audienceBackgroundSafety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.ObjectivesTo describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.MethodsIn the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010–18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (<50 copies/mL) before 14 weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (≥50 copies/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC.ResultsAmong 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was <50 copies/mL in 95.6% of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0% versus 0.0%, P = 0.046). Delivery outcomes were similar between groups (overall birth defects, 3.8/100 live births; pregnancy losses, 2.0%; preterm deliveries, 10.6%). No HIV transmission occurred.ConclusionsIn virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes