-FLUOROSULFURES ET -FLUOROSULFOXYDES, PRECURSEURS APPROPRIES A LA SYNTHESE DE FLUOROALCENES (Z)

CAEN-BU Sciences et STAPS (141182103) / SudocSudocFranceF

Synthèse de nouveaux précurseurs d'analogues fluorés de thionucléosides

CAEN-BU Sciences et STAPS (141182103) / SudocSudocFranceF

Application of Flow Thermolysis in Organic Synthesis: Easy Access to α,É-Bis Thienyl- and Bis Pyrrolyl- Alkanes from Methylene Derivatives of Meldrum's Acid

Thermal decomposition of Meldrum's acid derivatives and rearrangement of (alkylsulfanyl) or (propargylamino)methylene ketene intermediates leads in one step to bis thienyl- or bis pyrrolyl-alkanes

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