Assessing Zika Virus Transmission Within Households During an Outbreak in Martinique, 2015-2016.

Since 2015, Zika virus (ZIKV) has caused large epidemics in the Americas. Households are natural targets for control interventions, but quantification of the contribution of household transmission to overall spread is needed to guide policy. We developed a modeling framework to evaluate this contribution and key epidemic features of the ZIKV epidemic in Martinique in 2015-2016 from the joint analysis of a household transmission study (n = 68 households), a study among symptomatic pregnant women (n = 281), and seroprevalence surveys of blood donors (n = 457). We estimated that the probability of mosquito-mediated within-household transmission (from an infected member to a susceptible one) was 21% (95% credible interval (CrI): 5, 51), and the overall probability of infection from outside the household (i.e., in the community) was 39% (95% CrI: 27, 50). Overall, 50% (95% CrI: 43, 58) of the population was infected, with 22% (95% CrI: 5, 46) of infections acquired in households and 40% (95% CrI: 23, 56) being asymptomatic. The probability of presenting with Zika-like symptoms due to another cause was 16% (95% CrI: 10, 23). This study characterized the contribution of household transmission in ZIKV epidemics, demonstrating the benefits of integrating multiple data sets to gain more insight into epidemic dynamics

Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

TEM measurement of the misfit stress by a curvature method in semiconducting epitaxial system

The misfit stress induced by a lattice mismatch is determined by a curvature analysis performed by Transmission Electron Microscopy on plan view samples. The different samples examined consist of Ga$_{1-x}$InxAs layers grown by molecular beam epitaxy on a (100) GaAs substrate, with a nominal mismatch of 0.7 and 1.4%. The layer thicknesses are lower than the critical thickness for plastic relaxation. The curvature radius as well as the substrate thickness are determined directly by bend contour analysis. For each sample, the measurement was performed on different areas corresponding to different substrate thicknesses. The experimental value of the in-plane component of the stress is deduced by applying the Stoney's formula over the whole range of substrate thickness. The accuracy of the method is better than 15%. Experimental values of the misfit stress are ten to fifty per cent lower than the theoretical value calculated for pseudomorphic layers. This discrepancy is discussed in terms of partial relaxation

Geometrical criteria required for the determination of the epitaxial stress from the transmission electron microscopy curvature method

International audienceThe epitaxial stress of a Ga0.8In0.2As thin layer deposited on a GaAs substrate has been measured by the curvature method adapted to transmission electron microscopy. It is shown that even if the geometrical characteristics of the specimens thinned to be observed by transmission electron microscopy are very different from the ones of a thick sample, the conditions of validity of the model can still be verified. Finite element calculations have been performed to determine the geometry of the specimen answering to these conditions. Once these conditions are satisfied, the stress measured on a Ga0.8In0.2As layer is −1.30±0.13GPa

VIH-02 - Le dépistage de l’infection par le VIH : étude des pratiques des médecins généralistes en Martinique

National audienceIntroduction En France, la proportion de personnes infectées par le VIH et ignorant leur statut était de 25 % en 2010. On estime que ces personnes seraient à l’origine de 60 % des nouvelles contaminations. Les offres et les moyens de dépistagesont régulièrement élargis et améliorés, sollicitant notamment les médecins généralistes. Cependant, les opportunités manquées de diagnostic sont nombreuses : pour 82 % des nouvelles découvertes de séropositivités VIH en 2009-2010. Une étude des pratiques de dépistage a eu lieu auprès des généralistes de métropole en 2009. Aucune étude de ce type n’a été réalisée en Martinique, département pourtant très touché par l’épidémie de VIH. Nous avons voulu réaliser unétat des lieux des pratiques de dépistage de l’infection par le VIH par les généralistes en Martinique

Detection by polymerase chain reaction of

Detection of the repetitive sequence pPra specific for Trichinella spiralis was carried out by PCR in the blood of 37 patients infected tout to six weeks previously, during a horse-meat related outbreak of trichinellosis (Paris, 1993). Only two patients of 37 wete PCR-positive. Human blood was sampled during the febrile phase of the disease, before any antihelminthic treatment. To assess the validity of the method, blood was taken from mice, 7, 10, and 13 days after infection by a Trichinella spiralis isolate obtained during the human outbreak. Trichinella DNA was detected in blood of mice, but only on day 7 post infection

Transmission electron microscopy and Raman measurements of the misfit stress in a Si tensile strained layer

International audienceA tensile-strained Si layer grown on a Si0.8Ge0.2 pseudo substrate with a nominal lattice mismatch of −0.76% has been studied by transmission electron microscopy using a curvature method and Raman scattering in order to determine experimentally the in-plane component of the epitaxial stress. The stress is obtained by measuring the curvature and the thickness on different areas of a thinned sample. Experimental values of the stress given by the two methods are in good agreement and are close to the nominal one