Effectiveness and safety of integrase strand transfer inhibitors in Spain: a prospective real-world study

IntroductionSecond-generation integrase strand transfer inhibitors (INSTIs) are preferred treatment options worldwide, and dolutegravir (DTG) is the treatment of choice in resource-limited settings. Nevertheless, in some resource-limited settings, these drugs are not always available. An analysis of the experience with the use of INSTIs in unselected adults living with HIV may be of help to make therapeutic decisions when second-generation INSTIs are not available. This study aimed to evaluate the real-life effectiveness and safety of dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), and raltegravir (RAL) in a large Spanish cohort of HIV-1-infected patients.MethodsReal-world study of adults living with HIV who initiated integrase INSTIs DTG, EVG/c, and RAL-based regimens in three settings (ART-naïve patients, ART-switching, and ART-salvage patients). The primary endpoint was the median time to treatment discontinuation after INSTI-based regimen initiation. Proportion of patients experiencing virological failure (VF) (defined as two consecutive viral loads (VL) ≥200 copies/mL at 24 weeks or as a single determination of VL ≥1,000 copies/mL while receiving DTG, EVG/c or RAL, and at least 3 months after INSTI initiation) and time to VF were also evaluated.ResultsVirological effectiveness of EVG/c- and RAL-based regimens was similar to that of DTG when given as first-line and salvage therapy. Treatment switching for reasons other than virological failure was more frequent in subjects receiving EVG/c and, in particular, RAL. Naïve patients with CD4+ nadir <100 cells/μL were more likely to develop VF, particularly if they initiated RAL or EVG/c. In the ART switching population, initiation of RAL and EVG/c was associated with both VF and INSTI discontinuation. There were no differences in the time to VF and INSTI discontinuation between DTG, EVG/c and RAL. Immunological parameters improved in the three groups and for the three drugs assessed. Safety and tolerability were consistent with expected safety profiles.DiscussionWhereas second-generation INSTIs are preferred treatment options worldwide, and DTG is one of the treatment of choices in resource-limited settings, first-generation INSTIs may still provide high virological and immunological effectiveness when DTG is not available

The elusive tidal tails of the Milky Way globular cluster NGC 7099

We present results on the extra-tidal features of the Milky Way globular cluster NGC 7099, using deep gr photometry obtained with the Dark Energy Camera (DECam). We reached nearly 6 mag below the cluster's main sequence (MS) turnoff, so that we dealt with the most suitable candidates to trace any stellar structure located beyond the cluster tidal radius. From star-by-star reddening corrected color-magnitude diagrams (CMDs), we defined four adjacent strips along the MS, for which we built the respective stellar density maps, once the contamination by field stars was properly removed. The resulting, cleaned, field star stellar density maps show a short tidal tail and some scattered debris. Such extra-tidal features are hardly detected when much shallower Gaia DR2 data sets are used and the same CMD field star cleaning procedure is applied. Indeed, by using 2.5 mag below the MS turnoff of the cluster as the faintest limit (G < 20.5 mag), cluster members turned out to be distributed within the cluster's tidal radius, and some hints for field star density variations are found across a circle of radius 3.5° centered on the cluster and with similar CMD features as cluster stars. The proper motion distribution of these stars is distinguishable from that of the cluster, with some superposition, which resembles that of stars located beyond 3.5° from the cluster center.Fil: Piatti, Andres Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Carballo Bello, Julio A.. Universidad de Tarapacá; ChileFil: Mora, Marcelo D.. Pontificia Universidad Católica de Chile; ChileFil: Cenzano, Carolina. Pontificia Universidad Católica de Chile; ChileFil: Navarrete, Camila. European Southern Observatory Santiago; Chile. Instituto Milenio de Astrofísica; ChileFil: Catelan, Márcio. Universidad Católica de Chile; Chile. Instituto Milenio de Astrofísica; Chil

The search for extratidal star candidates around Galactic globular clusters NGC 2808, NGC 6266, and NGC 6397 with Gaia DR2 astrometry

International audienceContext. Extratidal stars are stellar bodies that end up outside the tidal radius of a cluster as a result of internal processes or external forces acting upon it. The presence and spatial distribution of these stars can give us insights into the past evolution of a cluster inside our Galaxy. Aims. Previous works suggest that globular clusters, when explored in detail, show evidence of extratidal stars. We aim to search for possible extratidal stars in the Galactic globular clusters NGC 6397, NGC 2808, and NGC 6266 using the photometry and proper motion measurements from Gaia DR2 database. Methods. The extratidal stars for the clusters were selected on the basis of: their distance from the cluster center, similarity in their proper motions to the cluster population, and their position on the color-magnitude diagram of the clusters. Each cluster was explored in an annulus disk from the tidal radius up to five times the tidal radii. The significance level of the number of selected extratidal stars was determined on the basis of the distribution of Milky Way stars according to the Besançon Galaxy model and Gaia data. To understand the observed extratidal features, the orbits of the clusters were also determined using GravPot16 . Results. Finally, 120, 126, and 107 extratidal candidate stars were found lying outside the tidal radius of the globular clusters NGC 6397, NGC 2808, and NGC 6266, respectively. 70%, 25.4%, and 72.9% of the extratidal stars found are located outside the Jacobi radius of NGC 6397, NGC 2808, and NGC 6266, respectively. The spatial distribution of the extratidal stars belonging to NGC 6397 appears S-like, extending along the curved leading and trailing arms. NGC 2808 has an overdensity of stars in the trailing part of the cluster and NGC 6266 seems to have overdensities of extratidal stars in its eastern and northern sides. Conclusions. Proper motions and color-magnitude diagrams can be used to identify extratidal candidate stars around GCs. Nonetheless, depending on how different the kinematics and stellar populations of a cluster are compared to the Milky Way field, the fraction of contamination can be larger. All three clusters are found to have extratidal stars outside their tidal radii. For NGC 6397 and NGC 2808, these stars may be the result of a combined effect of the disc shocks and tidal disruptions. For NGC 6266, the distribution of extratidal stars is symmetrical around it, most likely indicating that the cluster has an extended stellar envelope