Elderly HIV-positive women: A gender-based analysis from the Multicenter Italian \u201cGEPPO\u201d Cohort

BACKGROUND: HIV-positive patients are facing age-and disease-related comorbidities. Since gender differences in viro-immunological, clinical and therapeutic features have been described, aim of this analysis was to explore such differences in elderly HIV-positive females compared to males coming from the same cohort. DESIGN: Cross-sectional study. SETTING: Ten Infectious Diseases Center participating to a new multicenter Italian geriatric Cohort aiming at describing health transition over time in HIV-positive individuals. PARTICIPANTS: HIV-positive patients aged 6565 years old. MEASUREMENTS: We recorded clinical, viro-immunological and therapeutical data. RESULTS: We included 210 women (17%) out of 1237 patients. Compared to males, elderly females were less likely to present a HIV-RNA <50 copies/mL (74.3% vs. 81.8%, OR 0.64, 95%CI 0.44-0.93); they showed higher CD4+/CD8+ ratio (p = 0.016). Combined antiretroviral therapy (cART) strategies were similar between genders (p>0.05), although women were less likely to be treated with protease Inhibitors (PIs) (p = 0.05); specifically, in triple-drug regimens females received less PIs (28% vs 38% p = 0.022) and more integrase inhibitors (30% vs. 20% p = 0.012). Bone disease was more common in females (p<0.001) while males presented more frequently cardiovascular disease (CVD) (p<0.001). In females with bone disease, PIs and boosted regimens (38% vs. 53.7% p = 0.026 and 30.4 vs 44.0% p = 0.048 respectively) were prescribed less frequently. Polypharmacy was common and similar in both genders (20% vs. 22.8%, p = >0.05). A higher use of lipid-lowering drugs (20.5% vs. 14.8%, p = 0.04) was observed in females and yet they were less likely to receive anti-thrombotic agents (18.6% vs. 26.3%, p = 0.019) even when CVD was recorded (57.1% vs. 83.1%, p = 0.018). In multivariate analysis, we found that female gender was independently associated with a higher CD4+/CD8+ ratio but not with virological suppression. CONCLUSIONS: Elderly HIV-positive women display a worse virologic response despite a better immune reconstitution compared to males. The burden of comorbidities as well as the medications received (including cART) may slightly differ according to gender. Our data suggest that more efforts and focused interventions are needed in this population

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

Eloy d'Amerval : Missa Dixerunt discipuli

En 1901, dans un article publié dans la Revue d'histoire et de critique musicales, Michel Brenet attribue la Missa Dixerunt discipuli à Eloy d'Amerval, un poète et musicien connu pour son immense poème, le Livre de la Deablerie. Depuis, les musicologues n'ont cessé de confirmer cette attribution, faisant référence à la fois à la source unique de cette messe, simplement signée “ Eloy ” et aux écrits de Johannes Tinctoris et Franchinus Gaffurius. Tant Gaffurius dans sa Practica Musice que Tinctoris dans son Proportionale musices évoquent un certain “ Eloy ”, “ in modis doctissimum ”. Il est vrai que, lorsqu'il séjournait à Orléans, Tinctoris a pu rencontrer un musicien et poète Eloy d'Amerval.[...] [...] La Missa Dixerunt discipuli est pour le moins étrange, et pose quelques problèmes de transcription. Ces deux caractéristiques tiennent à la nature même de l'œuvre. Il a été dit de la Missa Dixerunt discipuli qu'elle manifeste une intention pédagogique, pour l'unique raison qu'Eloy y exemplifie les quatre niveaux de mensuration. Mais plutôt que la décrire comme une tentative d'exemplification, il conviendrait de la lire comme un lieu d'expérimentation d'où n'est évidemment pas exclue de vocation pédagogique. Les solutions et les problèmes soulevés par Eloy affectent plusieurs niveaux du processus de composition

La valeur de l’émotion musicale

Au sein des recherches actuelles sur l’émotion musicale, ce livre possède une approche originale : il ne s’agit pas tant de décrire la nature, les opérations et les fonctions de cette émotion, que de s’interroger sur les enjeux conceptuels, culturels, sociaux et artistiques de sa valorisation ou de sa dévalorisation. Autour de ce souci axiologique, il s’agit donc d’articuler des perspectives anthropologiques, esthétiques, historiques et pragmatiques afin de poser la question : au nom de quoi, en vue de quoi et dans quels moments de la musique occidentale, les acteurs impliqués par son exercice et sa compréhension revendiquent-ils ou refusent-ils l’émotion ? Dans la mesure où cette question engage les propriétés de la création, de l’exécution et de l’expérience musicale individuelle et collective, l’ouvrage tente de déterminer les points de vue multiples (religieux, philosophique, éthique, politique, esthétique et artistique) à partir desquels sont posées la valorisation ou la dévalorisation de l’émotion, tant dans les discours que dans les pratiques. Appréhender historiquement et conceptuellement la relation entre musique et émotion ; étudier certaines époques qui ont posé les termes du débat de façon cruciale ; explorer les dispositifs, les pratiques et les rôles joués par le compositeur, l’interprète et l’auditeur ; saisir le rapport que tel et tel type de musique ou genre musical (opéra, rock, jazz) entretient avec l’émotion, telles sont les quatre finalités de cet ouvrage

Correction to: The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa

The original version of this article unfortunately contained a mistake. The given name and family name of Filippo Parretti was transposed in the original publication. The correct name is as shown above

The diagnosis and treatment of urogenital schistosomiasis in Italy in a retrospective cohort of immigrants from Sub-Saharan Africa

To evaluate ultrasound and praziquantel to, respectively, assess and reduce urogenital schistosomiasis (UGS)-associated morbidity in migrants from Sub-Saharan Africa (SSA)

La musique en Picardie du XIVe au XVIIe siècle

Pendant plusieurs siècles qui vont de l'édification des grandes cathédrales gothiques à la fin du règne d'Henri IV, la Picardie fut le berceau d'une production musicale fascinante. En témoignent des sources musicales incontournables (le graduel 239 de Laon), la lyrique profane des trouvères picards, les 'organa' de l''Ars vetus' ou la polyphonie de la Renaissance. Trois siècles durant, des générations de chantres formés dans des maîtrises picardes allaient devenir des interprètes recherchés et des compositeurs adulés. Ils envahissent les plus prestigieuses institutions musicales européennes, constituant une nation éclatée de musiciens que l'histoire dira " franco-flamands ". Cet ouvrage tente de tracer les conditions de l'émergence de ces générations, en parcourant un vaste territoire aux frontières fluctuantes, en scrutant les rares sources conservées, en visitant les lieux de formation et de pratique, en suivant des destins pour les uns banals, pour les autres brillants

Antiretroviral therapy in geriatric HIV patients: The GEPPO cohort study

Background: GEPPO is a prospective observational multi-centric cohort including HIV-infected geriatric patients. We hypothesized that the GEPPO cohort may help characterize antiretroviral (ARV) prescribing criteria used in real life by Italian infectious disease (ID) physicians. Methods: This was a cross-sectional study describing the current ARV regimen in a geriatric HIV population ( 6565 years). Antiretroviral strategies were categorized as follows: (i) multidrug regimens (MDRs), which comprised triple or mega ART combinations; (ii) less drug regimens (LDRs), which comprised fewer than three ART compounds. Multi-morbidity (MM) was defined as the presence of three or more non-communicable diseases, and polypharmacy (PP) as the use of five or more medications in chronic use. Four alternative combinations (MM+PP+, MM+PP-, MM-PP+, MM-PP-) were used in logistic regression analyses. Results: A total of 1222 HIV-positive patients were included (median age 70 years). Females composed 16% of the cohort. Median duration of HIV infection was 17 years; 335 population members had been infected for .20 years. MM was present in 64% and PP in 37% of the patients. Treatment consisted of triple therapy in 66.4%, dual therapy in 25.3%, monotherapy in 6.5% and 'mega-ART' with more than three drugs in 1.64% of the patients. In multivariate logistic regression MM and PP were predictive for mono-dual, NRTI-sparing and tenofovir disoproxil fumarate (TDF)-sparing combinations. Female gender and age were predictors of unboosted ARV regimens. Conclusions: High prevalence of non-conventional ARV regimens in elderly HIV patients suggests that clinicians try to tailor ARV regimens according to age, HIV duration,MMand PP

Antiretroviral therapy in geriatric HIV patients: the GEPPO cohort study

GEPPO is a prospective observational multi-centric cohort including HIV-infected geriatric patients. We hypothesized that the GEPPO cohort may help characterize antiretroviral (ARV) prescribing criteria used in real life by Italian infectious disease (ID) physicians