PLoS One

AIM: Metabolic risk factors are poorly documented for the first generation of young adults who have lived with HIV since childhood. We compared their metabolic profile with that of adults of same age from the general population. METHODS: We conducted a cross-sectional analysis of data from two populations: (1) COVERTE (ANRS-CO19), a French national cohort of 18 to 30-year-old patients HIV-infected since childhood, and (2) ENNS, a national cross-sectional population-based household survey on nutrition. Body mass index (BMI), blood pressure, waist circumference, fasting glucose, triglycerides, and HDL-, LDL- and total cholesterol were measured in both studies. Direct standardization on overweight and education level and logistic regression were used to compare the prevalence of metabolic abnormalities between the two populations. RESULTS: Data from 268 patients from COVERTE and 245 subjects from ENNS were analyzed. Tobacco use was similar in both groups. HIV-infected patients had increased mean waist-to-hip ratio and triglycerides to HDL-cholesterol ratio and decreased mean HDL-cholesterol as compared to their counterparts from the general population in both genders. In HIV-infected patients, metabolic syndrome was identified in 13.2% of men (95% confidence interval [CI]: 7.1-19.2) and 10.4% (95% CI: 5.4-15.3) of women versus 10.6% (95%CI: 1.5-19.7) and 1.7% (95%CI: 0-4.1) in subjects from the general population, respectively. CONCLUSION: Young adults infected with HIV since childhood had a higher prevalence of dyslipidemia and metabolically detrimental fat distribution than adults of same age of the general population, supporting close monitoring for cardiometabolic diseases

Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study.

OBJECTIVES Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study. METHODS At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs. RESULTS Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55). CONCLUSION In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12

Literature Review and Case Histories of Histoplasma capsulatum var. duboisii Infections in HIV-infected Patients

African histoplasmosis during HIV infection is rare

Relationship between Regulatory T Cells and Immune Activation in Human Immunodeficiency Virus-Infected Patients Interrupting Antiretroviral Therapy

Persistent immune activation plays a central role in driving Human Immunodeficiency Virus (HIV) disease progression. Whether CD4+CD25+ regulatory T cells (Tregs) are harmful by suppressing HIV-specific immune responses and/or beneficial through a decrease in immune activation remains debatable. We analysed the relationship between proportion and number of regulatory T cells (Tregs) and immune activation in HIV-infected patients interrupting an effective antiretroviral therapy (ART). Twenty-five patients were included in a substudy of a prospective multicenter trial of treatment interruption (TI) (ANRS 116). Proportions and numbers of Tregs and the proportion of activated CD4 and CD8 T cells were assessed at baseline and month 12 (M12) of TI. Specific anti-HIV CD4 and CD8 responses were investigated at baseline and M12. Non parametric univariate analyses and multivariate linear regression models were conducted. At baseline, the proportion of Tregs negatively correlated with the proportion of HLA-DR+CD8+T cells (r = −0.519). Following TI, the proportion of Tregs increased from 6.3% to 7.2% (p = 0.029); absolute numbers of Tregs decreased. The increase in the proportion of HLA-DR+CD38+CD8+T cells was significantly related to the increase in proportion of Tregs (p = 0.031). At M12, the proportion of Tregs did not negatively correlate with CD8 T-cell activation. Nevertheless, Tregs retain a suppressive function since depletion of Treg-containing CD4+CD25+ cells led to an increase in lymphoproliferative responses in most patients studied. Our data suggest that Tregs are efficient in controlling residual immune activation in patients with ART-mediated viral suppression. However, the insufficient increase in the proportion and/or the decrease in the absolute number of Tregs result in a failure to control immune activation following TI

Pathologies liées à HHV-8 chez le patient infecté par le VIH (à propos d'un cas exemplaire)

L'infection à VIH est un problème de santé publique majeur, particulièrement dans les pays en voie de développement. Les traitements antirétroviraux actifs allongent considérablement la durée de vie des patients, ce qui conduit à la description de pathologies émergentes. L'infection chronique à HHV-8 est également prévalente dans de nombreuses populations de pays du Sud. Nous passons en revue trois pathologies liées à HHV-8 chez le patient infecté par le VIH à partir d'une observation exemplaire où se succèdent les diagnostics de sarcome de Kaposi, de maladie de Castleman et de lymphome des séreuses. La fréquence et les difficultés diagnostiques et thérapeutiques de ces pathologies, justifient leur connaissance. Nous faisons également le lien entre ces trois maladies rarement observées chez un même patient. L'objectif de ce travail étant d'alerter sur la nécessité d'une surveillance attentive des pathologies liées à HHV-8 chez les patients coinfectés par le VIH et par HHV-8, surtout si ils sont sous antirétroviraux efficacesHIV infection is a major health issue, particularly in developing countries. Active antiretroviral therapy considerably increases patients' life expectancy, which leads to the description of new pathologies. The HHV-8 chronical infection also touches many populations in countries in the Southern hemisphere. We will study three pathologies related to HHV-8 in patients infected with HIV, using a specific case, where the three following pathologies were successively diagnosed: the Kaposi's sarcoma, the Castleman disease and the Primary Effusion Lymphoma. The frequency of these pathologies and the diagnostic and therapeutic difficulties they imply, make it necessary to know them. We also study the link between these three diseases that are rarely observed in the same patient. The aim of this research is to alert the medical profession about the need for careful monitoring of HHV-8 pathologies in patients coinfected by HIV and HHV-8, particularly if they are using efficient antiretroviral therapyPARIS12-CRETEIL BU Médecine (940282101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Tuberculose inaugurale d'une seropositivité au VIH (quelle démarche thérapeutique adopter dans la prise en charge de cette co-infection?)

PARIS7-Villemin (751102101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Technologie laser en implantologie orale

NICE-Antenne de St Jean d'Angely (060882105) / SudocNICE-BU Médecine Odontologie (060882102) / SudocSudocFranceF

Uvéite de restauration immunitaire chez les patients VIH-1 (cas clinique)

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

Musée d'Art Moderne de la Ville de Paris

detail, sculpture "La Genie de la France" by Emile-Antoine Bourdelle, 193