Virological outcomes in ARV-naïve patients switching or not from a first successful boosted PI-regimen to efavirenz, nevirapine or abacavir regimens

International audiencen.

Improved Survival of HIV-1-Infected Patients with Progressive Multifocal Leukoencephalopathy Receiving Early 5-Drug Combination Antiretroviral Therapy

Progressive multifocal leukoencephalopathy (PML), a rare devastating demyelinating disease caused by the polyomavirus JC (JCV), occurs in severely immunocompromised patients, most of whom have advanced-stage HIV infection. Despite combination antiretroviral therapy (cART), 50% of patients die within 6 months of PML onset. We conducted a multicenter, open-label pilot trial evaluating the survival benefit of a five-drug cART designed to accelerate HIV replication decay and JCV-specific immune recovery.All the patients received an optimized cART with three or more drugs for 12 months, plus the fusion inhibitor enfuvirtide during the first 6 months. The main endpoint was the one-year survival rate. A total of 28 patients were enrolled. At entry, median CD4+ T-cell count was 53 per microliter and 86% of patients had detectable plasma HIV RNA and CSF JCV DNA levels. Seven patients died, all before month 4. The one-year survival estimate was 0.75 (95% confidence interval, 0.61 to 0.93). At month 6, JCV DNA was undetectable in the CSF of 81% of survivors. At month 12, 81% of patients had undetectable plasma HIV RNA, and the median CD4+ T-cell increment was 105 per microliter. In univariate analysis, higher total and naive CD4+ T-cell counts and lower CSF JCV DNA level at baseline were associated with better survival. JCV-specific functional memory CD4+ T-cell responses, based on a proliferation assay, were detected in 4% of patients at baseline and 43% at M12 (P = 0.008).The early use of five-drug cART after PML diagnosis appears to improve survival. This is associated with recovery of anti-JCV T-cell responses and JCV clearance from CSF. A low CD4+ T-cell count (particularly naive subset) and high JCV DNA copies in CSF at PML diagnosis appear to be risk factors for death.ClinicalTrials.gov NCT00120367

A 1-Year Prospective French Nationwide Study of Emergency Hospital Admissions in Children and Adults with Primary Immunodeficiency.

PURPOSE: Patients with primary immunodeficiency (PID) are at risk of serious complications. However, data on the incidence and causes of emergency hospital admissions are scarce. The primary objective of the present study was to describe emergency hospital admissions among patients with PID, with a view to identifying "at-risk" patient profiles. METHODS: We performed a prospective observational 12-month multicenter study in France via the CEREDIH network of regional PID reference centers from November 2010 to October 2011. All patients with PIDs requiring emergency hospital admission were included. RESULTS: A total of 200 admissions concerned 137 patients (73 adults and 64 children, 53% of whom had antibody deficiencies). Thirty admissions were reported for 16 hematopoietic stem cell transplantation recipients. When considering the 170 admissions of non-transplant patients, 149 (85%) were related to acute infections (respiratory tract infections and gastrointestinal tract infections in 72 (36%) and 34 (17%) of cases, respectively). Seventy-seven percent of the admissions occurred during winter or spring (December to May). The in-hospital mortality rate was 8.8% (12 patients); death was related to a severe infection in 11 cases (8%) and Epstein-Barr virus-induced lymphoma in 1 case. Patients with a central venous catheter (n = 19, 13.9%) were significantly more hospitalized for an infection (94.7%) than for a non-infectious reason (5.3%) (p = 0.04). CONCLUSION: Our data showed that the annual incidence of emergency hospital admission among patients with PID is 3.4%. The leading cause of emergency hospital admission was an acute infection, and having a central venous catheter was associated with a significantly greater risk of admission for an infectious episode

One Year of Surface-Based Temperature Inversions at Dome C, Antarctica

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Approche multi-échelles des relations entre les caractéristiques d'habitat et les populations de truite commune (Salmo trutta L.) dans les Pyrénées centrales

L'influence des échelles d'espace du tronçon, de la séquence et du faciès d'écoulement sur le taux d'occupation par les truites communes (Salmo trutta L.) de I'habitat physique défini par la méthode des microhabitats a été étudiée sur 264 faciès d'écoulement appartenant à 15 rivières des Pyrénées centrales. L'utilisation d'un modèle d'analyse de la variance a permis, à partir de variables caractéristiques des différentes échelles, d'expliquer respectivement 51,1 % et 69,8 % de la variabilité des taux d'occupation de I'habitat physique par les densités et les biomasses totales de truite. Les résultats sont discutés en terme d'apport d'une approche multi-échelles dans la définition du concept de capacité d'accueil d'un cours d'eau à Salmonidés, et de relation entre processus biologiques et échelles d'hétérogénéité de I'habitat

Softpest: a website on the usage of pesticides & biocontrol agents in soft fruits

The usage of plant protection products and biocontrol agents in soft fruit production has always been an important subject for the IOBC/WPRS Working Group "Integrated rotection of Fruit Crops" Study Group "Soft Fruits". The usage of pesticides and biological control methods varies considerably between countries and it is very difficult to get a good overview on the range of products that are applied or in development in soft fruits. In order to share and facilitate the flow of information, the Study Group "Soft Fruit" initiated a survey on the availability and usage of active ingredients and biocontrol agents in the different European countries in 2007. First, the most important pests and diseases in strawberry and raspberry production were identified. Then members of the different countries listed available products on the domestic market and indicated their usage in the field. So far 15 countries have contributed to the survey. The received data are accessible on the website http://www.any3.ch/IOBC/Softpest/index.htm