Reemergence of Syphilis in Martinique, 2001–2008

Syphilis reemerged in Martinique in 2004 and initially affected 3 HIV-infected patients. By March 2008, syphilis was diagnosed for 37 men and 18 women. As of October 31, 2009, this outbreak had not yet been brought under control. It initially affected mainly men who had sex with men before it spread to heterosexual persons, minority group members, and crack cocaine users

Rôle fonctionnel des récepteurs nicotiniques dans l'apoptose induite (Interaction nicotine, bléomycine sur la lignée HL-60)

Rôle fonctionnel des récepteurs nicotiniques dans l'apoptose induite. Intéraction nicotine, bléomycine sur la lignée HL-60.Nous avons montré que le taux d'apoptose induite ex vivo, par la bléomycine (BLM) dans les cellules mononucléées du sang périphérique (PBMCs) de fumeurs est supérieur à celui trouvé dans les PBMCs des non-fumeurs. Or, on sait que ces cellules possèdent des récepteurs nicotiniques à l'acétylcholine (nAChRs). Le but de cette étude est de rechercher l'impact de la nicotine sur les mécanismes d'apoptose en étudiant (i) la modulation par la nicotine de l'apoptose induite par la BLM sur les cellules de la lignée leucémique humaine HL-60 et (ii) la pharmacologie de ces nAChRs. Les effets de la nicotine sur l'apoptose induite par la BLM sont analysés après un prétraitement de 30 min par des doses croissantes de 0,6 à 6000 nM. L'apoptose est quantifiée en microscopie optique après coloration par le Giemsa. La nicotine seule n'induit pas de phénotype apoptotique, ni de clivage internucléosomal de l'ADN. Par contre, l'apoptose induite par la BLM est significativement augmentée en présence de nicotine aux concentrations de 0,6 et 600 nM ; la réponse est bimodale. L'étude pharmacologique montre, que non seulement les récepteurs nicotiniques sont impliqués dans la modulation de l'apoptose induite par la BLM mais que ceux-ci n'appartiennent qu'à la "famille a7". Cet effet bimodal est équivalent à celui trouvé ex vivo, au niveau des PBMCs de sujets non-fumeurs. Notre modèle peut donc servir de base pour l'étude de l'implication des nAChRs des PBMCs dans l'apoptose induite.REIMS-BU Sciences (514542101) / SudocSudocFranceF

Antiretroviral Therapy in Resource-Poor Countries: Illusions and Realities

The prospects for antiretroviral therapy in resource-poor settings have changed recently and considerably with the availability of generic drugs, the drastic price reduction of brand-name drugs, and the simplification of treatment. However, such cost reductions, although allowing the implementation of large-scale donor programs, have yet to render treatment accessible and possible in the general population. Successfully providing HIV treatment in high-prevalence/high-caseload countries may require that we redefine the problem as a public health mass therapy program rather than a multiplication of clinical situations. The public health goal cannot simply be the reduction of morbidity and mortality for those treated but must be the reduction in morbidity and mortality for the many, that is, at a population level

First case of visceral leishmaniasis caused by Leishmania martiniquensis.

International audienceWe report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern

Phylogeographic Analyses Reveal the Early Expansion and Frequent Bidirectional Cross-Border Transmissions of Non-pandemic HIV-1 Subtype B Strains in Hispaniola

International audienceThe human immunodeficiency virus-type 1 (HIV-1) subtype B has probably been circulating on the island of Hispaniola since the 1960s, but information about the early viral history on this Caribbean island is scarce. In this study, we reconstruct the dissemination dynamics of early divergent non-pandemic subtype B lineages (designated BCAR) on Hispaniola by analyzing a country-balanced dataset of HIV-1 BCAR pol sequences from Haiti (n = 103) and the Dominican Republic (n = 123). Phylogenetic analyses supported that BCAR strains from Haiti and the Dominican Republic were highly intermixed between each other, although the null hypothesis of completely random mixing was rejected. Bayesian phylogeographic analyses placed the ancestral BCAR virus in Haiti and the Dominican Republic with the same posterior probability support. These analyses estimate frequent viral transmissions between Haiti and the Dominican Republic since the early 1970s onwards, and the presence of local BCAR transmission networks in both countries before first AIDS cases was officially recognized. Demographic reconstructions point that the BCAR epidemic in Hispaniola grew exponentially until the 1990s. These findings support that the HIV-1 epidemics in Haiti and the Dominican Republic have been connected by a recurrent bidirectional viral flux since the initial phase, which poses a great challenge in tracing the geographic origin of the BCAR epidemic within Hispaniola using only genetic data. These data also reinforce the notion that prevention programs have successfully reduced the rate of new HIV-1 transmissions in Hispaniola since the end of the 1990s

A Cluster of Acute Diarrhea Suspected to Be Cholera in French Travelers in Haiti, December 2010

International audienceA cluster of 21 cases of watery diarrhea suspected to be cholera that involved French military policemen and young volunteers occurring in the context of the Haiti cholera outbreak is described. The attack rate (AR) was higher among young volunteers (71.4%) than among policemen (15.3%) (p < 0.0001). There was a significant association between raw vegetables consumption and watery diarrhea in the young volunteer group. If we consider the raw vegetables consumers only, AR was lower among doxycycline-exposed subjects (relative risk: 0.2; 95% confidence interval: 0.1–0.4). The main aspect that is of scientific interest is the potential prophylactic effect of doxycycline used for malaria prophylaxis on the watery diarrhea AR