Introduction au dossier thématique : La mort est mon métier.

International audienc

Relations de confiance et renforcement du contrôle

(VF)L’observation des relations de confiance dans un cabinet de conseil révèle qu’un haut niveau de confiance entre les dirigeants s’accompagne d’un renforcement de leur contrôle. Ce résultat plaide en faveur d’un dépassement de la thèse de la substitution pour analyser le lien confiance/contrôle. Il précise également les travaux de Breton et Wintrobe. Un fonctionnement efficace de la structure organisationnelle n’est pas uniquement le fait de relations de confiance verticales.(VA)The analysis of trust relationships in a consultancy firm shows that a high level of trust between the leaders is linked to a reinforcement of their control. This result adds to the analysis of Breton and Wintrobe. An effective organizational structure is not limited to vertical trust relationships.confiance;contrôle;cabinet de conseil;trust;control;consultancy firm

Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial

International audienceBackground:Intermittent treatment could improve the convenience, tolerability and cost of ART, as well as patients' quality of life. We conducted a 48 week multicentre study of a 4-days-a-week antiretroviral regimen in adults with controlled HIV-1-RNA plasma viral load (VL).Methods:Eligible patients were adults with VL  90%, with a power of 87% and a 5% type 1 error. The study was registered with ClinicalTrials.gov (NCT02157311) and EudraCT (2014-000146-29).Results:One hundred patients (82 men), median age 47 years (IQR 40-53), were included. They had been receiving ART for a median of 5.1 (IQR 2.9-9.3) years and had a median CD4 cell count of 665 (IQR 543-829) cells/mm3. The ongoing regimen included PI/r in 29 cases and NNRTI in 71 cases. At 48 weeks, 96% of participants (95% CI 90%-98%) had no failure while remaining on the 4-days-a-week regimen. Virological failure occurred in three participants, who all resumed daily treatment and became resuppressed. One participant stopped the strategy. No severe treatment-related events occurred.Conclusions:Antiretroviral maintenance therapy 4 days a week was effective for 48 weeks in 96% of patients, leading to potential reduction of long-term toxicities, high adherence to the antiretroviral regimen and drug cost saving