345 research outputs found

    A Carleman estimate and an energy method for a first-order symmetric hyperbolic system

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    For a symmetric hyperbolic system of the first order, we prove a Carleman estimate under some positivity condition concerning the coefficient matrices. Next, applying the Carleman estimate, we prove an observability L2-estimate for initial values by boundary data

    Inverse coefficient problems for a transport equation by local Carleman estimate

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    We consider the transport equation ∂tu(x,t)+(H(x) - ∇u(x,t))+p(x)u(x,t)=0 in Ω ×(0,t) where Ω ⊂ ℝn is a bounded domain, and discuss two inverse problems which consist of determining a vector-valued function p(x) or a real-valued function Ω by initial values and data on a subboundary of Ω. Our results are conditional stability of Hölder type in a subdomain D provided that the outward normal component of H(x) is positive on ∂D∩∂Ω. The proofs are based on a Carleman estimate where the weight function depends on H

    Raltegravir, tenofovir, and emtricitabine in an HIV-Infected patient with HCV chronic hepatitis, NNRTI intolerance and protease inhibitors-induced severe liver toxicity

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    <p>Abstract</p> <p>Background</p> <p>in HIV-infected patients with HCV-related chronic hepatitis, liver impairment and drug toxicity may substantially reduce the number of possible therapeutic options.</p> <p>Case Description</p> <p>we here describe the case of an HCV-HIV coinfected woman who had repeated severe episodes of drug-related liver toxicity with indinavir, saquinavir, fosamprenavir, and darunavir, with minimal further therapeutic options left in this class. Previous treatment-limiting side effects with efavirenz and nevirapine also precluded use of non-nucleoside reverse transcriptase inhibitors. Introduction of an integrase-inhibitor regimen based on raltegravir, tenofovir, and emtricitabine allowed a prompt achievement of undetectable viral load and a substantial rise of CD4 count to high levels, with no subsequent episodes of hepatic toxicity, and no other side effects.</p> <p>Conclusions</p> <p>given the relatively common prevalence of HCV-related chronic hepatitis among people with HIV, raltegravir might represent an important alternative option for a substantial number of patients who cannot be treated with protease inhibitors or NNRTI because of drug-related hepatic toxicity.</p

    Health related quality of life outcomes in HIV-Infected patients starting different combination regimens in a randomised multinational trial: the INITIO-QoL Substudy

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    The health-related quality of life (HRQoL) outcomes in HIV-infected, treatment-naive patients starting different HAART regimens in a 3-year, randomized, multinational trial were compared. HRQoL was measured in a subgroup of patients enrolled in the INITIO study (153/911), using a modified version of the MOS-HIV questionnaire. The regimens compared in the INITIO trial were composed by two NRTIs (didanosine + stavudine) plus either an NNRTI (efavirenz) or a PI (nelfinavir), or both (efavirenz + nelfinavir). Primary HRQoL outcomes were Physical and Mental Health Summary scores (PHS and MHS, respectively). During follow-up, an increase of PHS score was observed in all treatment arms. The MHS score remained substantially unchanged with the four-drug combination and showed with both NNRTI- and PI-based three-drug regimens a marked trend toward improvement, which became statistically significant when a multiple imputation method was used to adjust for missing data. Overall, starting all the combination regimens compared in the INITIO study was associated with a maintained or slightly improved HRQOL status, consistently with the positive immunological and virological changes observed in the main study. The observed differences in the MHS indicate a possible HRQoL benefit associated to the use of three-drug, two-class regimens and no additional benefit for the use of four-drug, three-class regimens, confirming that three-drug, two-class regimens that include two NRTIs plus either an NNRTI or a PI should be preferred as initial treatment of HIV infection

    Dynamics of SARS-CoV-2 exposure in Malawian infants between February 2020 and May 2021

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    Background: Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries. Objective: In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants. Study design: Blood samples (n = 250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain. Results: The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices. Conclusions: Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa

    Lipid profile during pregnancy in HIV-infected women

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    Purpose: We investigated the evolution of serum lipid levels in HIV-infected pregnant women and the potential effect of antiretroviral treatment during pregnancy using data from a national surveillance study. Method: Fasting lipid measurements collected during routine care in pregnancy were used, analyzing longitudinal changes and differences in lipid values at each trimester by protease inhibitors (Pls) and stavudine use. Multivariate analyses were used to control for simultaneous factors potentially leading to hyperlipidemia. Study population included 248 women. Results: Lipid values increased progressively and significantly during pregnancy: mean increases between the first and third trimesters were 141.6 mg/dL for triglycerides (p <.001), 60.8 mg/dL for total cholesterol (p <.001), 13.7 mg/dL for HDL cholesterol (p <.001), and 17.8 mg/dL for LDL cholesterol (p =.001). At all trimesters, women on PIs had significantly higher triglyceride values compared to women not on Pis. The effect of Pls on cholesterol levels was less consistent. Stavudine showed a dyslipidemic effect at first trimester only. Multivariate analyses confirmed these observations and suggested a potential role of other cofactors in the development of hyperlipidemia during pregnancy. Conclusion: The changes observed point to the need to further explore the causes and the clinical correlates of hyperlipidemia during pregnancy in women with HIV

    Declining partisan representation at the sub-national level: assessing and explaining the strengthening of local lists in Italian municipalities (1995–2014)

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    In Western democracies political representation at the national level is still dominated by (old and new) political parties. This article shows that, instead, the representative role of parties may have declined at the local level. In Italy, for instance, the average share of municipal seats held by non-partisan councillors has almost tripled in the last 20 years. By using an original data set, this article classifies different types of Italian local lists, assesses their relationship with traditional parties and explains territorial variation in their success. The results suggest that local lists have become substantially stronger in small municipalities, in regions characterised by weak or declining political subcultures and where regionalist parties are absent or irrelevant. Finally, contrary to the expectation that declining partisanship is linked to modernisation processes and direct civic engagement, local lists have achieved their best results in the less developed areas of the country
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