Early symptomatic neurosyphilis and ocular syphilis: A comparative study between HIV-positive and HIV-negative patients

International audienceObjectives: Since the 2000s, there has been an increase in prevalence of neurosyphilis (NS) and ocular syphilis (OS). As data about symptomatic NS/OS is limited, this study aims to assess the characteristics of symptomatic NS/OS, according to HIV status.Methods: We compared the clinical and biological presentation of early symptomatic NS/OS and its outcome in HIV-positive and HIV-negative patients.Results: Ninety-six patients (93% men, 49% HIV-positive) were included from 2000 to 2016 in two centers, with 67 (69%) having OS, 15 (16%) NS, and 14 (14%) both. HIV-positive patients were younger (P = 0.006) and more likely to be males having sex with males (P = 0.00048) or to have a history of syphilis (P = 0.01). Among 81 OS, there were 43 posterior uveitis (57%), and bilateral involvement was more common in HIV-positive patients (62% versus 38%, P = 0.045). Among 29 NS there were 21 cases of cranial nerve involvement (72%), seven meningitis (24%) and 11 paresthesia (38%). Involvement of the VIIIth cranial nerve was the most common (16 cases). Treponemal tests were more commonly found positive in cerebrospinal fluid in HIV-positive patients (88% versus 76%, P = 0.04). Visual acuity (VA) always improved after treatment (initial VA logMAR 0.8 ± 0.8 versus 0.1 ± 0.1 at 3 months), but 32% and 18% of the patients still had neurological or ocular impairment respectively six and 12 months after treatment. Non-treponemal serological reversion was observed in 43/50 patients (88%) at six months.Conclusion: HIV infection has no consequence on the outcome of NS and OS. Sequelae are common, emphasizing the importance of prevention, and screening, and questioning enhanced treatment

Example of application of the new strategy proposed for the validation of chromatographic bioanalytical methods

peer reviewe

Méthodes chromatographiques de dosage dans les milieux biologiques : exemple d'application de la stratégie de validation - Rapport d'une commission SFSTP

peer reviewe

Méthodes chromatographiques de dosage dans les milieux biologiques : stratégie de validation - Rapport d'une commission SFSTP

peer reviewe

New strategy for the validation of chromatographic bioanalytical methods

peer reviewe

The SFSTP guide on the validation of chromatographic methods for drug bioanalysis: from the Washington Conference to the laboratory

On the basis of the guidelines given in the Washington Conference report and the ICH (International Conference of Harmonisation) recommendations some suggestions about experimental design and data evaluation are proposed by an SFSTP Commission dedicated to the validation of chromatographic methods in bioanalysis. In a series of meetings, members of this Commission have tried to elaborate a rational, practical and statistically reliable strategy to assure the quality of the analytical results generated. This strategy has been formalised in a guide and the main suggestions made by the Commission are summarised in the present paper. The SFSTP guide has been produced to help analysts from the pharmaceutical industry to validate their bioanalytical methods, It is the result of a consensus between professionals having expertise in bioanalytical and/or statistical fields. The suggestions presented in this paper should therefore help the analyst to design and perform the minimum number of validation experiments needed to obtain all the required information to establish and demonstrate the reliability of its analytical procedure. The SFSTP guide suggests a validation strategy in two steps: a pre-validation and the validation itself. An experimental design is described for each of these steps and the main aspects discussed in the paper are related to the selection of the most appropriate calibration model to fit experimental data and the most suitable way to determine the limit(s) of quantitation and subsequently the calibration range as well as the optimum number of experiments to be performed in the validation phase. (C) 1999 Elsevier Science B.V. All rights reserved

Harmonization of strategies for the validation of quantitative analytical procedures - A SFSTP proposal - part I

This paper is the first part of a summary report of a new commission of the Societe Francaise des Sciences et Techniques Pharmaceutiques (SFSTP). The main objective of this commission was the harmonization of approaches for the validation of quantitative analytical procedures. Indeed, the principle of the validation of theses procedures is today widely spread in all the domains of activities where measurements are made. Nevertheless. this simple question of acceptability or not of an analytical procedure for a given application, remains incompletely determined in several cases despite the various regulations relating to the good practices (GLP, GMP,...) and other documents of normative character (ISO, ICH. FDA,...). There are many official documents describing the criteria of validation to be tested, but they do not propose any experimental protocol and limit themselves most often to the general concepts. For those reasons, two previous SFSTP commissions elaborated validation guides to concretely help the industrial scientists in charge of drug development to apply those regulatory recommendations. If these two first guides widely contributed to the use and progress of analytical validations, they present, nevertheless, weaknesses regarding the conclusions of the performed statistical tests and the decisions to be made with respect to the acceptance limits defined by the use of an analytical procedure. The present paper proposes to review even the bases of the analytical validation for developing harmonized approach, by distinguishing notably the diagnosis rules and the decision rules. This latter rule is based on the use of the accuracy profile, uses the notion of total error and allows to simplify the approach of the validation of an analytical procedure while checking the associated risk to its usage. Thanks to this novel validation approach, it is possible to unambiguously demonstrate the fitness for purpose of a new method as stated in all regulatory documents. (C) 2004 Elsevier B.V. All rights reserved