Sanitary requirements for reception and maintenance of laboratory animals

Avant d’aborder les aspects pratiques du contrôle de l’état sanitaire des animaux, tant à l’arrivée que dans l’unité d’élevage ou de maintenance, il est procédé à un nécessaire rappel de la nomenclature utilisée, basée sur leur état microbiologique. Une finalité se dégage : faire concorder les conditions de l’environne ment d’accueil avec celles existant à l’origine, les procédures à respecter étant d’autant plus exigentes que le statut microbiologique initial est plus strictement défini. Après l’évocation de cas particuliers d’analyses propres aux espèces les plus utilisées, il est fait allusion aux équipements spécifiques selon le statut sanitaire des animaux à héberger, aux problèmes de la prophylaxie médicale et au rôle de l’homme au sein de l’unité animale, le chercheur, le visiteur ou le technicien. Quelques règles essentielles de contrôle sont rappelées en fin d’exposé.Before considering the practical aspects of the sanitary control of animals, either at their arrival or in the animal unit, devoted to breeding or maintainance, it is necessary to recall the terminology in use based on their microbiological status. A compulsory aim is to assure a concordance of environmental conditions at the arrival with those known to have existed originally. The procedures to be observed are even more compulsory with respect to the microbiological status which has to be strictly defined. After having mentioned the particular analysis proper to the species mostly utilized special reference is made to various equipments used according to the animal’s sanitary status, as to the prophylactic medical problems posed. Finally, the role of investigators, visitors or animal techniciens is des cribed. Some main rules of control are recalled at the end of the paper

Antiretroviral Therapy with a Twice-Daily Regimen Containing 400 Milligrams of Indinavir and 100 Milligrams of Ritonavir in Human Immunodeficiency Virus Type 1-Infected Women during Pregnancy▿

We evaluated the safety and efficacy of a twice daily regimen containing 400 mg of indinavir and 100 mg of ritonavir in 32 human immunodeficiency virus (HIV)-infected women during pregnancy. The median indinavir trough concentration was 208 ng/ml during the third trimester. At delivery, 26 of 28 women on indinavir-ritonavir had HIV RNA levels of <200 copies/ml. No infant was HIV infected. These data are encouraging for the use of this combination for prevention of mother-to-child transmission of HIV

HIV disease progression despite suppression of viral replication is associated with exhaustion of lymphopoiesis

The mechanisms of CD4+ T-cell count decline, the hallmark of HIV disease progression, and its relationship to elevated levels of immune activation are not fully understood. Massive depletion of CD4+ T cells occurs during the course of HIV-1 infection, so that maintenance of adequate CD4+ T-cell levels probably depends primarily on the capacity to renew depleted lymphocytes, that is, the lymphopoiesis. We performed here a comprehensive study of quantitative and qualitative attributes of CD34+ hematopoietic progenitor cells directly from the blood of a large set of HIV-infected persons compared with uninfected donors, in particular the elderly. Our analyses underline a marked impairment of primary immune resources with the failure to maintain adequate lymphocyte counts. Systemic immune activation emerges as a major correlate of altered lymphopoiesis, which can be partially reversed with prolonged antiretroviral therapy. Importantly, HIV disease progression despite elite control of HIV replication or virologic success on antiretroviral treatment is associated with persistent damage to the lymphopoietic system or exhaustion of lymphopoiesis. These findings highlight the importance of primary hematopoietic resources in HIV pathogenesis and the response to antiretroviral treatments

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