Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Raman spectroscopy of pigments and oxalates in situ within epilithic lichens: Acarospora from the Antarctic and Mediterranean

Fourier Transform laser Raman spectroscopy was used to generate diagnostic spectra for pigments and biodegradative calcium oxalate in situ in two yellow-pigmented species of the lichen genus Acarospora from contrasting sites in the Antarctic and the Mediterranean. This non-intrusive technique was used to identify the photoprotective pigments rhizocarpic acid and β-carotene by their unique Raman spectral fingerprints. The use of low energy near-IR excitation at 1064 nm eliminated interference from autofluorescence of photosynthetic pigments. The insensitivity of the technique to water permitted the use of field-fresh material. The dominant yellow pigment, rhizocarpic acid, gave a diagnostic pattern of corroborative bands at wavenumbers (ν) 1596, 1665, 1620 and 1000 cm−1. It was possible to discriminate between hydration states of calcium oxalate; the monohydrate (whewellite) featured a ν(CO) stretching band at 1493 cm−1 whereas the dihydrate (weddellite) had a contrasting ν(CO) stretching band at 1476 cm−1. Fourier Transform deconvolution and intensity measurements were used to obtain relative quantitative data for rhizocarpic acid by using its ν(CO) and ν(CONH) amide modes, for carotenoid pigment by its ν(C = C) band at 1520 cm−1 and for calcium oxalates by their ν(CO) bands. ν(CO), ν(CONH) and ν(C = C) are the vibrational stretching modes of the carbonyl C = O, protein amide 1 and alkenyl C = C moieties, respectively, in the pigments and metabolic products of the Acarospora lichens. The ability to determine the precise (20 μm spot diameter) spatial distribution of these key functional molecules in field-fresh thallus profiles and variegations has great potential for understanding the survival strategies of lichens, which receive high insolation, including elevated levels of UV-B, under extremes of desiccation and temperature in hot and cold desert habitats

Effect of grain size distribution on Raman analyses and the consequences for in situ planetary missions

International audienceRaman spectroscopy can be used for analysing both mineral and organic phases, thus allowing characterisation of the microbial-scale geological context as well as the search for possible traces of life. This method is therefore very useful for in situ planetary exploration missions. Compared with the myriad of sample preparation techniques available in terrestrial laboratories, the possibilities for sample preparation during in situ missions on other planetary bodies are extremely limited and are generally restricted to abrasion of rock surfaces or crushing of the target samples. Whereas certain techniques need samples to be prepared in powder form, such as X-ray diffraction, this kind of preparation is not particularly suitable for optical microscopy and/or Raman spectroscopy. In this contribution, we examine the effects of powdering rock and mineral samples on optical observations and Raman analyses. We used a commercial Raman spectrometer, as well as a Raman laser spectrometer that simulates the instrument being developed for the future ExoMars 2018 mission. The commercial Raman spectrometer documents significant modifications to the spectra of the powdered samples, including broadening of the peaks and shifts in their position, as well as the appearance of new peaks. These effects are caused by localised heating of the sample under the laser beam and amplification of nominal surface effects due to the increase in surface area in finer grain sizes. However, most changes observed in the Raman spectra using the Raman laser spectrometer system are negligible because the relatively large (50 µm diameter) laser spot size produces lower irradiance. Furthermore, minor phases were more easily detectable in the powdered samples. Most importantly, however, this sample preparation method results in the loss of the textural features and context, making identification of potential fossilized microbial remains more problematic

Raman spectroscopy as a key tool for the detection of biosignatures on Mars

International audienc

Functional dependence of resonant harmonics on nanomechanical parameters in dynamic mode atomic force microscopy

This article is part of the Thematic Series "Advanced atomic force microscopy".Micro and Nano Engineerin

Lack of clinical usefulness of interleukin-6 in long-term follow-up of acutely decompensated heart failure

ABSTRACT Introduction: Interleukin-6 (IL -6) has been identified as a predictor of death, new heart failure (HF) episodes and need for heart transplantation in patients with advanced HF. The aim of this study was to examine th

SuperCam_MastUnit

International audienceThis paper will describe and give a development status of SuperCam's mast unit. SuperCam will be carried on the Mars 2020 rover, and consists in an enhanced version of the ChemCam LIBS which is still performing at the surface of Mars, on Curiosity

SuperCam_MastUnit

International audienceThis paper will describe and give a development status of SuperCam's mast unit. SuperCam will be carried on the Mars 2020 rover, and consists in an enhanced version of the ChemCam LIBS which is still performing at the surface of Mars, on Curiosity