Conference highlights of the 5th international workshop on HIV persistence during therapy, 6-9 December 2011, St. Maartin, West Indies

The December 2011 5th International Workshop on HIV Persistence during Therapy addressed the issue of HIV persistence among 210 scientists from 10 countries involved in the study of HIV reservoirs and the search of an HIV cure. High quality abstracts were selected and discussed as oral or poster presentations. The aim of this review is to distribute the scientific highlights of this workshop outside the group as analyzed and represented by experts in retrovirology, immunology and clinical research

L’activité d’arboriste-élagueur en milieu urbain : la sécurité en action comme structurante pour le travail dans les arbres

Cet article a pour objectif de présenter la gestion de la sécurité dans l’activité réalisée par des arboristes-élagueurs. Au travers de l’observation des chantiers d’élagage et d’entretiens d’auto et allo-confrontation, les résultats mettent d’une part en lumière les conflits d’objectifs entre la dimension productive (efficience et efficacité) et la dimension sécuritaire de l’activité. D’autre part, il est montré que réaliser une taille harmonieuse (efficacité) demande des savoir-faire en arboriculture, mais également la maîtrise des déplacements dans l’arbre. Cette maîtrise est intimement liée aux dimensions de gestion de risques et d’efficience visant à réduire notamment les douleurs et la fatigue. À partir de ces résultats, nous démontrons que la gestion de la sécurité apparaît dans ce métier comme une sécurité en action structurante du travail dans les arbres, permettant à la fois l’efficience dans l’usage des équipements et des outils de travail - dont son propre corps - et l’efficacité des soins prodigués aux arbres.This paper explores how arborists incorporate safety management in their work activity. Data-gathering was based on both the observation of pruning sites and the auto- and allo-confrontation method in which four arborists commented 3 videos of pruning situations that they or their colleagues had directed. The results show the conflict that arises between efficient production and risk prevention strategies. Harmonious cutting requires tree cultivation know-how, but also the proper control of one’s movements in the tree when hanging from ropes. This control is intimately linked to the management of both risk and efficiency, particularly with regard to reducing pain and fatigue. Based on these results, we demonstrate that safety management is an integral dimension of tree work, permitting both the effective use of equipment and tools – including one’s own body – and efficient care for trees.Este artículo tiene como objetivo presentar la gestión de la seguridad en la actividad llevada a cabo por los podadores de árboles. A través de la observación de sitios de poda y entrevistas de auto-conforntación y allo-confrontación, los resultados destacan, por un lado, el conflicto de objetivos entre la dimensión productiva (eficiencia y efectividad) y la dimensión de seguridad en la actividad. Por otro lado, se demuestra que una poda armoniosa (eficiencia) requiere un saber-hacer en arboricultura, pero también el dominio de movimientos en el árbol. Este dominio está íntimamente ligado a las dimensiones de gestión de riesgos y eficiencia dirigidas a reducir el dolor y la fatiga. En base a estos resultados, mostramos que la gestión de la seguridad operacional aparece en este oficio como seguridad en acción estructurante del trabajo en los árboles, permitiendo al mismo tiempo la eficiencia en el uso de los equipos y herramientas de trabajo, incluyendo su propio cuerpo, y la eficacia del cuidado brindado a los árboles

Comparison of metabolic abnormalities and clinical lipodystrophy 48 weeks after switching from HAART to Trizivir versus continued HAART: the Trizal study

PURPOSE: To analyze the evolution of clinical lipodystrophy (LD) and metabolic abnormalities in patients continuing to receive HAART versus patients switched to Trizivir (zidovudine, lamivudine, abacavir) after 48 weeks. METHOD: Patients treated with HAART >6 months with plasma HIV-1 RNA viral load (VL) <400 copies/mL and <50 copies/mL at screening were randomly assigned to continue HAART (103 patients) or to receive Trizivir (106 patients). Clinical LD was evaluated using a standardized patient questionnaire only at baseline, weeks 4 and 8, and then every 8 weeks until Week 48. Laboratory evaluation was performed every 4 weeks. RESULTS: The proportion of patients exhibiting >or=1 LD symptom at baseline was 40% in the Trizivir arm and 50% in HAART arm (difference not significant). After 48 weeks, the prevalence was 28% and 42% respectively (p =.03), and the median number of LD symptoms per patient was 2 in the Trizivir arm and 4 in the continued HAART arm (p =.016). Median decreases in cholesterol levels over the 48-week study period were greater in the Trizivir arm than in the continued HAART arm (-0.80 vs. -0.44 mmol/L; p lt.001). Median triglyceride levels decreased in the Trizivir arm but increased in the continued HAART arm (-0.17 and +0.01 mmol/L; p =.006). Suppression of VL was maintained in most patients with no differences between the two arms. CONCLUSION: A switch from "standard" HAART to Trizivir was associated with an improvement in clinical LD and blood lipid abnormalities after 48 weeks

Highlights from the 20th International Symposium on HIV and Emerging Infectious Diseases (ISHEID) 16-18 May 2018, Marseille, France: from HIV and comorbidities to global health.

The 20th International Symposium on HIV and Emerging Infectious Diseases took place in Marseille, France. It had a refreshing European look with reinforced partnerships with the European AIDS Clinical Society and the British HIV Association and with international speakers and participants. Topics included HIV and global health, HIV and hepatitis cure, the microbiome and immunotherapies, clinical research and methodology, as well as chemsex, pre-exposure prophylaxis, sexually transmitted infections and emerging infectious diseases. Novel areas of research were also described, such as electronic technology in order to improve HIV management, and the expert patient

Evaluación de variedades de alfalfa con reposo invernal a tres distancias de la cortina forestal en el valle de Gobernador Gregores

La localidad de Gobernador Gregores, ubicada en el centro de Santa Cruz (cabecera del departamento Río Chico), abarca un valle irrigado con aptitud para la siembra de pasturas destinadas al corte. En el área, se destaca el cultivo de alfalfa con una superficie de 183 hectáreas destinadas a la producción de heno, con un rendimiento promedio histórico de 7500 kg MS/ha/año (Proyecto Censo Agropecuario 2002), y que abastece en su mayoría a las estancias de la zona cordillerana y del sur de la provincia como suplemento alimenticio durante el período invernal. Sin embargo, en la actualidad existe una demanda que supera la oferta del forraje de reserva, lo cual obliga a los productores a mejorar sus rendimientos productivos y ampliar la superficie destinada a este cultivo (Freiheit et al., 2005). Por su parte, en la actualidad es muy difícil disponer de cultivares de buenos rendimientos evaluados con anterioridad (Utrilla, 1997, 1996), desconociéndose la producción y calidad forrajera de las nuevas variedades existentes en el valle y la variación de ambos parámetros a diferentes distancias de la cortina cortaviento. En relación a esto último, ha sido comprobado que la implantación de una cortina cortaviento promueve un aumento de la producción de forraje de la superficie protegida determinado por los cambios micro climáticos que derivan de la disminución de la velocidad del viento (Peri y Utrilla, 1997). A partir de lo descripto, se inició un ensayo con el objetivo de evaluar el efecto del distanciamiento a la cortina forestal sobre el establecimiento, fenología, producción y calidad forrajera y cobertura de seis cultivares de alfalfa con reposo invernal (grados de reposo 5, 6 y 7) a diferentes distancias de una cortina forestal cortaviento. El período de estudio abarcó tres ciclos de crecimiento: 2006/07, 2007/08 y 2008/09.EEA Santa CruzFil: Utrilla, Víctor Ricardo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Grupo Producción Agropecuaria; Argentina.Fil: Utrilla, Víctor Ricardo. Universidad Nacional de la Patagonia Austral. Unidad Académica Río Gallegos. Santa Cruz; Argentina.Fil: Peri, Pablo Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz; Argentina.Fil: Peri, Pablo Luis. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Peri, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Freiheit, Astrid Elizabeth. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia de Extensión Rural Gobernador Gregores; Argentina.Fil: Felice, Monica. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia de Extensión Rural Gobernador Gregores; Argentina.Fil: Lafeuillade, Alexandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz. Agencia de Extensión Rural Gobernador Gregores; Argentina

Approach to Dyslipidemia, Lipodystrophy, and Cardiovascular Risk in Patients with HIV Infection

There is a significant prevalence (20%–80% depending on the population and the study) of lipid disorders and other cardiovascular risk factors in people living with HIV infection. This review focuses on HIV and HIV treatment–associated metabolic and cardiovascular concerns, including dyslipidemias, lipodystrophy syndromes, endothelial dysfunctions, and associated metabolic events such as insulin resistance. Emerging hypotheses of the underlying pathophysiology of these issues, with impact on selection of specific antiretroviral treatment (ART) strategies, therapy, and preventive approaches to decreasing cardiovascular risk and other problems associated with these syndromes are discussed. Screening for cardiovascular risk as part of the decision of starting antiretroviral therapy, and during care of patients with HIV regardless of ART therapy status, is suggested with particular areas of focus. Statins, other hyperlipidemic therapies, treatment for specific problems arising due to lipodystrophy, and implications on ART selection to avoid drug interactions and adverse effects are also discussed

Collaborative Robotics and Industry 4.0: An Engineering, Sociology and Activity-Centered Ergonomics Cross-Experience

This communication aims to present a cross-perspective – robotics, industrial engineering, sociology and ergonomics – research project experience dealing with development of collaborative robotics in SMEs. Our conviction is that Industry 4.0 must imply: (1) “departitioning” of disciplines involved in the design of work situations and (2) construction of hybrid approaches for understanding and transforming work. In this communication, we propose to relate such an experience on the basis of a research project - funded by the French National Agency for Research (ANR), and focused on transformation of French Small and Middle Companies (SMC’s) in relation to introduction of Collaborative Robotics. Collaborative Robotics is of particular interest for us as it embeds promises and pitfalls of articulation between technologies and work. However, these promises may be discussed and tempered by confronting them to actual design issues, work organization and transformation of work management.ANR HECTTO

Fast relapse and high drop out rate of 48 weeks daily interferon monotherapy in HIV-infected patients with chronic hepatitis C

BACKGROUND: The standard of care for HCV Hepatitis is the combination of interferon (IFN) plus Ribavirin. In HIV patients the use of this combination therapy may induce drug interactions, and reduces the adherence to HAART. The aim of this study is to evaluate safety and efficacy of a 48 weeks daily dose IFN schedule. METHODS: We evaluated 50 coinfected patients; alpha IFN 2a was administered at a dose of 3 MU daily. The baseline values were the following : CD4+ 515 cells/mmc (mean); HIV-RNA <50 copies/ml in all patients; HCV-RNA 28, 3 × 106 copies/ml. RESULTS: At 48 weeks, 10 patients (20%) achieved a biochemical and virological response according to an intention to treat analysis. Twenty four patients (48%) underwent a drop-out mainly by side effects related to overlapping toxicity of interferon and antiretroviral therapy. All the patients, who responded to the treatment, showed a fast relapse one month after the end of treatment. CONCLUSION: Although our results demonstrated a very poor outcome and a bad tolerance to interferon monotherapy, this approach should not be dropped out, mainly in patients at high risk for side effects and in those with cirrhosis who do not tolerate or are at increased risk for the use of ribavirin

Abacavir, efavirenz, didanosine, with or without hydroxyurea, in HIV-infected adults failing initial nucleoside/protease inhibitor-containing regimens

BACKGROUND: Hydroxyurea (HU) is an immunomodulatory agent that has been documented to enhance the antiretroviral activity of nucleoside reverse transcriptase inhibitors, such as abacavir (ABC) and didanosine (ddI), and would be expected to improve virologic efficacy. METHODS: A 48-week, phase IV, multicenter, open-label, proof-of-concept clinical trial was conducted to evaluate second-line, protease inhibitor (PI)-sparing therapy with ABC/efavirenz (EFV)/ddI plus HU or without HU in HIV-infected subjects failing to achieve HIV-1 RNA ≤ 400 copies/mL after ≥ 16 weeks of treatment with lamivudine/zidovudine or lamivudine/stavudine, plus 1 or 2 PIs. Subjects were assigned to ABC (300 mg twice daily)/ EFV (600 mg once daily)/ ddI (400 mg once daily) plus HU (500 mg twice daily) (n = 30) or this regimen without HU (n = 24). RESULTS: Baseline mean HIV-1 RNA was 3.86 log(10 )copies/mL and CD4+ cell count was 345 cells/mm(3). A similar percentage of subjects in the non-HU arm (58%) and HU arm (53%) completed the study. Intent-to-treat: missing = failure analysis showed no differences in proportions of subjects in the non-HU and HU arms achieving undetectable plasma HIV-1 RNA levels at week 24 (<400 copies/mL: 58% [14/24] vs 57% [17/30], P = 0.899; <50 copies/mL (50% [12/24] vs 47% [14/30], P = 0.780). Median change from baseline in CD4+ cell count in the non-HU and HU arms at week 48 was +114 cells/mm(3 )and -63 cells/mm(3 )(P = 0.007), respectively. Both regimens were generally well tolerated, although more subjects in the HU arm withdrew prematurely from the study due to adverse events (23% vs 4%). Four cases of possible ABC-related hypersensitivity were observed. CONCLUSION: ABC/EFV/ddI was an effective and well-tolerated second-line regimen for nucleoside/PI-experienced HIV-infected subjects. The addition of HU blunted the CD4+ cell response, did not appear to enhance antiviral activity, and resulted in more treatment-limiting adverse events

HIV Reservoirs and Immune Surveillance Evasion Cause the Failure of Structured Treatment Interruptions: A Computational Study

Continuous antiretroviral therapy is currently the most effective way to treat HIV infection. Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance. Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions. We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings. We anticipate that it is feasible to steer new clinical trials using computational models