Risk factors of acute and subacute low back pain in a cohort of French Loire Valley region’s workers

International audienceAbstractObjectives In recent years, emphasis was placed on the determinants of chronic low back pain (LBP) in a tertiary prevention perspective. However, prevention of acute and subacute LBP should remain a goal of primary prevention in the workplace. The objective of this study was to investigate the risk factors for common acute and subacute LBP related to the individual characteristics or occupational exposure factors in a large sample of workers.Methods This longitudinal study assessed the main biomechanical, psychological and organisational risk factors for LBP, by self-administered questionnaire, between 2002 and 2005, among a sample of 3,710 workers. A total of 2,332 of them were followed-up between 2007 and 2009 for the occupational becoming, health and working conditions. The risk modelling of different durations of LBP was performed using a multinomial logit model with a variable response into four categories: no LBP, short acute LBP ( 30 days during the preceding 12 months, but not daily). Individuals reporting chronic LBP were excluded. In addition, analyses were stratified by gender.Results The prevalence of LBP was 52.4% among men and 51.2% among women and decreased according to the duration of LBP regardless of gender (24.8% of short acute LBP and 11.6% of subacute LBP). The combination of a high perceived physical exertion with frequent bending of the trunk was a risk factor for LBP for both genders. In addition, whole-body vibration and low social support were risk factors in men and high tall in women.Conclusions The impact of biomechanical factors seems to be more important than organisational and psychosocial factors. analyses failed to identify risk factors specifically related to the duration of LBP

Measurement of a subpicosecond coherence time in a quasi-steady-state XUV laser

International audienc

Med Mal Infect

OBJECTIVES: Limited data on Mycoplasma genitalium infection has been reported among PrEP users. The aim of this study was to estimate the prevalence and macrolide resistance of M. genitalium infection among enrollees in a French PrEP program. PATIENTS AND METHODS: M. genitalium infection screening was systematically and prospectively proposed to patients of the Bordeaux PrEP program (between January 2016 and February 2017). Macrolide resistance was evaluated in M. genitalium-positive patients. RESULTS: Among 89 clients, M. genitalium infection prevalence was 10% (mainly asymptomatic) with a high rate of macrolide resistance (58%). CONCLUSIONS: Because of a high level of macrolide resistance, a systematic search for M. genitalium macrolide resistance associated-mutations may be recommended in PrEP users before initiating the antibiotic therapy

Statistical strategies for relating metabolomics and proteomics data: a real case study in nutrition research area

International audienceThe current investigations were carried out in the context of a nutritional case study aiming at assessing the postnatal impact of maternal dietary protein restriction during pregnancy and lactation on rat offspring plasma metabolome and hypothalamic proteome. Although data generated by different "Omics" technologies are usually considered and analyzed separately, their interrelation may offer a valuable opportunity for assessing the emerging 'integrated biology' concept. The overall strategy of analysis first investigated data pretreatment and variable selection for each dataset. Then, three multivariate analyses were applied to investigate the links between the abundance of metabolites and the expression of proteins collected on the same samples. Unfold principal component analysis and regularized canonical correlation analysis did not take into account the presence of groups of individuals related to the intervention study. On the contrary, the predictive MultiBlock Partial Least Squares method used this information. Regularized canonical correlation analysis appeared as a relevant approach to investigate of the relationships between the two datasets. However, in order to highlight the molecular compounds, proteins and metabolites, associated in interacting or common metabolic pathways for the experimental groups, MultiBlock partial least squares was the most appropriate method in the present nutritional case study

Protease inhibitors exposure is not related to lung cancer risk in HIV smoker patients: a nested case-control study

International audienceOBJECTIVE: We aimed at assessing in persons living with HIV with a smoking history an association between lung cancer risk and protease inhibitors exposure, especially ritonavir. DESIGN: A nested case-control study was conducted within the ANRS CO4 FHDH, CO3 Aquitaine and Tenon's Hospital Cohorts. METHODS: Cases and controls were eligible if they were ex-smokers or current smokers at the index date, and had a CD4 cell count reported in the year preceding the index date. Cases were incident cases of lung cancer diagnosed between 1 January 2000 and 31 December 2011. All cancer cases were validated and histological types identified when available. Three controls were randomly selected by incidence density sampling using calendar time as the time axis, with individual matching on cohort, age (± 5 years), route of HIV acquisition, sex and hospital. Analyses were performed using conditional logistic regression adjusted for nadir CD4 cell count and smoking status. Ritonavir and protease inhibitors exposures were represented in separate models using categorical variables (never exposed, ever exposed). Several sensitivity analyses were performed. RESULTS: This study performed in 1447 persons living with HIV with a smoking history (383 lung cancer cases and 1064 control patients) did not evidence any association between lung cancer risk and protease inhibitors exposure including ritonavir. CONCLUSION: These results suggest that the risk of lung cancer is not influenced by pharmacologically induced P450 cytochrome protease inhibitors inhibition among smokers or ex-smoker

Switch to rilpivirine/emtricitabine/tenofovir single-tablet regimen of human immunodeficiency virus-1 RNA-suppressed patients, Agence Nationale de Recherches sur le SIDA et les hepatites virales CO3 Aquitaine Cohort, 2012-2014

Background. The purpose of this study was to assess the efficacy and tolerability of combined antiretroviral therapy (cART) in human immunodeficiency virus (HIV)-1 virologically suppressed patients who switched to rilpivirine (RPV)/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) as a single-tablet regimen (STR). Methods. A retrospective multicenter cohort study was performed between September 2012 and February 2014 in Bordeaux University Hospital-affiliated clinics. Patients with a plasma HIV viral load (VL) lower than 50 copies/mL and switching to STR were evaluated at baseline, 3, 6, 9, and 12 months from switch time (M3, M6, M9, M12) for VL and other biological parameters. Change from baseline in CD4 cell counts was evaluated at M6 and M12. Virological failure (VF) was defined as 2 consecutive VL >50 copies/mL. Results. Three hundred four patients were included in the analysis. Single-tablet regimen switch was proposed to 116 patients with adverse events, mostly efavirenz (EFV)-based (n = 59), and to 224 patients for cART simplification. Thirty of 196 patients with available genotype resistance test results displayed virus with >= 1 drug resistance mutation on reverse-transcriptase gene. After 12 months of follow-up, 93.4% (95.5% confidence interval, 89.9-96.2) of patients remained virologically suppressed. There was no significant change in CD4 cell count. During the study period, 5 patients experienced VF, one of them harboring RPV resistance mutation. Clinical cART tolerability improved in 79 patients overall (29.9%) at M6, especially neurological symptoms related to EFV. Fasting serum lipid profiles improved, but a significant estimated glomerular function rate decrease (-11 mL/min/1.73 m(2); P < 10(-4)) was observed. Conclusions. Overall, virologic suppression was maintained in patients after switching to RPV/TDF/FTC. This STR strategy was associated with improved tolerability

Open Forum Infect Dis

BACKGROUND: Ritonavir-boosted darunavir (DRV/r) is a protease inhibitor (PI) indicated for the treatment of na�ve and pretreated HIV-infected patients since 2007. Our study aims to describe DRV/r-treated patients experiencing virological failure (VF) documented with HIV resistance testing. METHODS: Data from patients belonging to the ANRS CO3 Aquitaine Cohort treated with a regimen including DRV/r between February 2007 and December 2015 were analyzed. Baseline characteristics of patients experiencing VF (defined by 2 consecutive plasma viral loads >50 copies/mL) were compared with those without VF. We then described factors associated with VF as emergence of IAS DRV resistance-associated mutations (RAMs). RESULTS: Among the 1458 patients treated at least once with a DRV/r-based regimen, 270 (18.5%) patients experienced VF during follow-up, including 240 with at least 1 genotype resistance test (GRT). DRV RAMs were detected in 29 patients (12%). Among them, 25/29 patients had ?2 DRV RAMs before DRV/r initiation, all of whom had experienced VF during previous PI treatments. For 18/29, DRV/r was maintained after VF, and controlled viremia was restored after modification of DRV-associated antiretroviral molecules or increased DRV dose. Finally, only 6/29 patients selected new DRV RAMs after DRV/r initiation. All of these experienced previous VFs while on other PIs. CONCLUSIONS: These results highlight the efficacy and robustness of DRV/r, as the emergence of DRV RAMs appeared in <0.4% of patients receiving a DRV/r-based regimen in our large cohort

Clin Microbiol Infect

Objectives: Bacterial infections remain one of the main causes of morbidity and death in people living with HIV (PLHIV) in the most recent years. Several studies have demonstrated a protective effect of statins in the primary prevention of bacterial infections in other immunocompromised populations, but this effect remains controversial. The objective of this study was to evaluate the effect of statin use on the occurrence of a first episode of severe bacterial infection (SBI) in PLHIV in the ANRS CO3 Aquitaine cohort between 2000 and 2018. Methods: All individuals included in the prospective ANRS CO3 Aquitaine cohort who had at least two follow-up visits between 2000 and 2018 were included. The primary endpoint was the occurrence of a first episode of bacterial infection leading to hospitalization of ≥48 hours or death. Statin exposure was updated during follow-up. Marginal Cox structural models were developed to consider the potential indication bias and time-dependent confusion. Numerous sensitivity analyses were carried out. Results: In this study 51 658 person-years were followed. The overall incidence of a first episode of SBI was 12.4/1000 person-years. No effect of statins on the occurrence of SBI was demonstrated when subjects were considered on statins throughout their follow-up after treatment initiation (HR = 0.97; 95%CI: 0.75–1.25). The results were similar for the effect of statins on the risk of pneumonia and for all sensitivity analyses. Conclusion: In this large cohort of PLHIV with 18 years of follow-up and a high risk of severe infections, we found no effect of statins on the risk of occurrence of SBI or pneumonia

Incidence of lung and HPV-associated malignancies in HIV-infected patients

OBJECTIVE: Cancers represent one of the leading cause of mortality/morbidity in patients living with HIV (PLHIV) in industrialized countries. The objective of our study was to compare incidence of lung and HPV-related cancers among PLHIV with general population over the 2010-2017 period.Design: Prospective and multicenter cohort study. METHODS: The study included patients with lung and HPV-related cancers from the ANRS CO3 Aquitaine cohort (PLHIV) and the general population-based cancer registry in Gironde area. We calculated incidence rates (IR) for 100,000 Person Year (PY) and Incidence Rate Ratios (IRR). RESULTS: Among the 3,572 PLHIV, 70 cancers were diagnosed in 68 patients including 35 lung and 35 HPV-related cancers (18 oropharyngeal, 11 anal, 6 cervix). IR of lung and HPV-related-cancers were 311.1 in PLHIV and 209.8 in general population for 100,000 PY, respectively. IRR were significantly increased in PLHIV for lung 1.8 [1.4; 2.2] and HPV-related cancer 1.3 [1.0; 1.6] and particularly high for patients between 40-49 years-old (IRR 4.4 [2.3; 8.4] for lung cancer and 3.7 [2.1; 6.5] for HPV-related cancer). CONCLUSIONS: We emphasized the persistent high risk of lung and HPV-related cancer despite advent of antiretroviral therapies, particularly in the age strata of 40-49 years. Screening procedures should take into account this finding

Association of immune-activation and senescence markers with non-AIDS-defining comorbidities in HIV-suppressed patients

International audienc