Etude d'un marqueur diagnostique et pronostique dans les syndromes lymphoprolifératifs B CD5 positif (CLLU1)

Les syndromes lymphoprolifératifs (SLP) B CD5 positif regroupent la leucémie lymphoïde chronique (LLC) et le lymphome du manteau (MCL) bien identifiés. Mais il existe des cas de SLP B CD5 positif inclassables très peu étudiés à ce jour. Nous les avons défini par exclusion, non LLC (score de Matutes < 4) et non MCL (ne surexprimant pas la cycline D1). Récemment, un nouveau marqueur pronostique de LLC, CLLU1, a été découvert. Nous avons évalué l expression de CLLU1 dans ces 3 types de SLP et répertorié les données des autres marqueurs pronostiques de LLC. Pour la LLC, contrairement au MCL, on détecte une expression de CLLU1, corrélée aux autres marqueurs pronostiques péjoratifs classiques. Nous confirmons l intérêt diagnostique et pronostique de CLLU1 dans notre cohorte. Pour les SLP inclassables, l expression de CLLU1 est hétérogène. L étude comparative des caractéristiques cliniques, cytologiques et des marqueurs pronostiques de LLC a permis de différencier cette entité de la LLC.CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Erratum to 'Predominance of healthcare-associated cases among episodes of community-onset bacteraemia due to extended-spectrum β-lactamase-producing Enterobacteriaceae' [International Journal of Antimicrobial Agents 49/1 67-73]

International audienc

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