Assessement of Awareness of, Concerns and Attitudes Towards HIV-Related Court-Case Sentences in France in a Representative Sample of People Living with HIV (ANRS VESPA2 Survey)

International audienceSome of the 12 criminal trials and sentences in France for HIV transmission in 1998-2011 attracted substantial public attention , with a possible negative impact on people living with HIV (PLWH) through reinforced stigma and discrimination. This analysis aimed to characterize PLWH enrolled in the representative ANRS-VESPA2 survey, aware of and concerned about convictions for HIV transmission. Being a migrant from Sub-Saharan Africa, having difficult socioeconomic conditions, having unprotected sex with one's main partner and concealing one's HIV status were all factors statistically associated with concern about the sentences. Participants tempted to press charges against someone for infecting them were more likely to be younger, women, not living in a couple, unemployed, and to report a major depressive disorder. Concern about HIV-related criminal proceedings among the most vulnerable PLWH do not reflect the actual risk of prosecution they are exposed to. Resumen En Francia, algunos de los 12 juicios y sentencias relacionados con la contaminación del VIH en 1998-2011 suscitaron con-siderablemente el interés público. Esto pudo impactar negativamente las personas viviendo con VIH (PVVIH) aumentando su estigmatización y discriminación. Este análisis busca caracterizar las PVVIH, de la encuesta ANRS-VESPA2, informadas acerca de esos juicios e inquietos por la posibilidad de implicación en uno de ellos. Ser inmigrante subsahariano, las con-diciones socio-económicas desfavorables, las relaciones sexuales no protegidas con la pareja principal, y ocultar el VIH, están asociados a la posibilidad de ser implicados en un juicio. Por otro lado, aquellos que han intentado presentar cargos por contaminación del VIH fueron mayoritariamente jóvenes, mujeres, personas viviendo solas, desempleados, y personas en depresión. Los juicios por contaminación del VIH entre las PVVIH más vulnerables no reflejan el riesgo de acusación al que están expuestos

Baseline characteristics of the 116 patients.

<p>ART: antiretroviral therapy, ATV: atazanavir, DRV: darunavir, EFV: efavirenz, ETR: etravirine, FTC: emtricitabine, IQR: interquartile range, LPV: lopinavir, MVC: maraviroc, NNRTI: non nucleoside reverse transcriptase inhibitors, NRTI: nucleoside reverse transcriptase inhibitors, NVP: nevirapine, PI: protease inhibitors, RAL: raltegravir, TDF: tenofovir, /r: boosted with ritonavir.</p><p>Baseline characteristics of the 116 patients.</p

Distribution of tenofovir, emtricitabine and rilpivirine plasma concentrations at different time-points.

<p>Distribution of tenofovir, emtricitabine and rilpivirine plasma concentrations at different time-points.</p

Distribution of NRTI (a) and NNRTI (b) resistance-associated mutations detected in the historical genotypic resistance tests of the patients.

<p>NNRTI: non nucleoside reverse transcriptase inhibitors, NRTI: nucleoside reverse transcriptase inhibitors.</p

Baseline characteristics of the 116 patients.

<p>ART: antiretroviral therapy, ATV: atazanavir, DRV: darunavir, EFV: efavirenz, ETR: etravirine, FTC: emtricitabine, IQR: interquartile range, LPV: lopinavir, MVC: maraviroc, NNRTI: non nucleoside reverse transcriptase inhibitors, NRTI: nucleoside reverse transcriptase inhibitors, NVP: nevirapine, PI: protease inhibitors, RAL: raltegravir, TDF: tenofovir, /r: boosted with ritonavir.</p><p>Baseline characteristics of the 116 patients.</p

[18F]FDG Positron Emission Tomography for Initial Staging and Healing Assessment at the End of Therapy in Lymph Nodes and Bone Tuberculosis

International audienceObjective: In extra-pulmonary tuberculosis, therapeutic management is difficult in the absence of reliable tool to affirm healing at the end of treatment. In this prospective multicenter study, we evaluated [18F]FDG-PET for this purpose.Methods: Forty-two patients out of 55 included patients could be analyzed. Additionally to usual biological, histological and morphological explorations, [18F]FDG-PET was performed at diagnosis (PET1), at the end of treatment (PET2), indeed 6 months later. Then patients were followed until 12 months after end of prescribed treatment.Results: PET1 was positive in 97.6% of patients and discovered unknown injured sites in 52.7% of cases. PET2 was positive in 83.3% of uncured patients, and in 82.3% of cured patients. The sum and mean value of SUVmax measured in PET/CT lesions decreased between PET1 and PET2 in all patients. Mean value of SUVmax (MSUV) and sum value of SUVmax on PET2 showed the highest AUC on ROC curves for the diagnosis of healing at the end of prescribed treatment; MSUV 3.5 on PET2 had a sensitivity of 76.5% and a specificity of 80.0% to affirm healing at the end of prescribed treatment.Conclusions: [18F]FDG-PET/CT was useful at diagnosis, discovering unknown lesions in 52.7% of cases. MSUV on PET2 was the best criteria to affirm healing at the end of prescribed treatment