Adipose Tissue Is a Neglected Viral Reservoir and an Inflammatory Site during Chronic HIV and SIV Infection

International audienceTwo of the crucial aspects of human immunodeficiency virus (HIV) infection are (i) viral persistence in reservoirs (precluding viral eradication) and (ii) chronic inflammation (directly associated with all-cause morbidities in antiretroviral therapy (ART)-controlled HIV-infected patients). The objective of the present study was to assess the potential involvement of adipose tissue in these two aspects. Adipose tissue is composed of adipocytes and the stromal vascular fraction (SVF); the latter comprises immune cells such as CD4+ T cells and macrophages (both of which are important target cells for HIV). The inflammatory potential of adipose tissue has been extensively described in the context of obesity. During HIV infection, the inflammatory profile of adipose tissue has been revealed by the occurrence of lipodystrophies (primarily related to ART). Data on the impact of HIV on the SVF (especially in individuals not receiving ART) are scarce. We first analyzed the impact of simian immunodeficiency virus (SIV) infection on abdominal subcutaneous and visceral adipose tissues in SIVmac251 infected macaques and found that both adipocytes and adipose tissue immune cells were affected. The adipocyte density was elevated, and adipose tissue immune cells presented enhanced immune activation and/or inflammatory profiles. We detected cell-associated SIV DNA and RNA in the SVF and in sorted CD4+ T cells and macrophages from adipose tissue. We demonstrated that SVF cells (including CD4+ T cells) are infected in ART-controlled HIV-infected patients. Importantly, the production of HIV RNA was detected by in situ hybridization, and after the in vitro reactivation of sorted CD4+ T cells from adipose tissue. We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection. These observations open up new therapeutic strategies for limiting the size of the viral reservoir and decreasing low-grade chronic inflammation via the modulation of adipose tissue-related pathway

Do school tobacco policies contribute to smoking inequalities within and across schools? An international cross-repeated study

Introduction Despite the evidence of the adverse health effects of smoking, more than one in five adolescents in Europe still smokes in 2015. In order to reduce this high smoking rate, tobacco control policies have been put in place, including school tobacco policies (STPs). The few studies that assessed the equity impact of tobacco control policies, showed either a negative or a neutral effect on equity across socio-economic status (SES), and only one study on STPs addressed smoking inequalities. Therefore, our aim is to determine whether STPs are equally effective, first, among adolescents of different SES groups within a school, and second, across different schools, according to the school SES status. Methods A cross-repeated study was carried out in 2013 and in 2016 in 38 schools from six European countries. A questionnaire was completed by 18,500 adolescents from 3rd and 4th grades and another one by school staff members. We conducted multilevel logistic regression analyses to estimate the effects of STPs on various smoking-related outcomes and stratified by SES. School was used as random effect and we controlled for age and parental smoking. Results A higher score of STP was associated with lower odds of smoking on school premises for both SES groups. However, STP was not associated with smoking just outside school premises, nor with smoking intention. Among low SES adolescents, a higher score of STP was associated with lower odds of being a weekly smoker. A higher score of STP was associated with lower odds of smoking on school premises among both high SES schools and low SES schools. STP was not associated with smoking just outside school premises, expect in high SES schools, where a higher score of STP lead to higher odds of smoking just outside school premises. Conclusions Gaining understanding of who is affected by STPs is important in order to protect the most vulnerable groups

Le tabagisme chez nos adolescents namurois,présentation des résultats du projet SILNE

Fatal pour un consommateur sur deux, le tabac est la première cause de mortalité évitable en Belgique. Néanmoins, il continue de compter chaque jour de nouveaux adeptes parmi les adolescents. Ces derniers tendent à multiplier l’expérimentation de comportements à risque pour la santé, et finissent trop souvent par s’y installer durablement[1]. De nombreux instruments réglementaires ont donc été mis en place au cours des dernières décennies pour prévenir le tabagisme chez les adolescents. Véritables outils de protection et de promotion de la santé, ces règlementations sont pourtant encore perçues comme des modes de répression et peinent à être implémentées efficacement. Jamais évaluée, la mise en œuvre de ces interdictions mérite cependant toute l’attention des autorités publiques. Une conviction qui est au cœur du projet de recherche européen SILN

Trends in adolescents smoking in 6 countries

Introduction Adolescents smoking has decreased steadily in the last decades. Yet, this decrease has been uneven across areas and across socio-economic groups. It is unclear which groups have been the least responsive to changes in smoking outcomes. We identify the levels and the groups associated with changes in smoking outcomes and in unequal change of smoking. Material and Methods The SILNE-R study performed a repeated full network cross-sectional study in schools from six European cities. Fifty schools initially recruited in 2013 were recontacted to participate three years later and 38 accepted to reparticipate. Results Tampere largely succeed in reducing both ever try and weekly smoking rates, Coimbra has particularly decrease the ever trying rate, and Hanover the weekly smoking rate. Yet, all other cities also acknowledge a significant decrease in their rates, but Latina, who both rates do not significantly decrease between the two waves. Absolute inequalities went down for all socio-economic groups and the decrease was more or less of the same magnitude across socio-economic groups. Friends smoking was a major contributor to smoking inequalities and to the slowing down of the smoking epidemic

The Diffusion of Smoking: Association Between School Tobacco Policies and the Diffusion of Adolescent Smoking in 38 Schools in 6 Countries

Social network research has evidenced the role of peer effects in the adoption of behaviours. Little is known, however, about whether policies affect how behaviours are shared in a network. To contribute to this literature, we apply the concept of diffusion centrality to school tobacco policies and adolescent smoking. Diffusion centrality is a measure of centrality which refers to a person’s ability to diffuse a given property—in our case, smoking-related behaviours. We hypothesized that stronger school tobacco policies are associated with less diffusion centrality of smoking on school premises and of smoking in general. A whole network study was carried out in 2013 and 2016 among adolescents (n = 18,805) in 38 schools located in six European cities. Overall, diffusion centrality of smoking in general and of smoking on school premises significantly decreased over time. Diffusion centrality of smoking significantly decreased both in schools where the policy strengthened or softened over time, but for diffusion of smoking on school premises, this decrease was only significant in schools where it strengthened. Finally, stronger school tobacco policies were associated with lower diffusion centrality of smoking on school premises and of smoking in general, though to a lesser extent. With such policies, smoking may, therefore, become less prevalent,less popular, and less clustered, thereby lowering the risk of it spreading within networks in, and even outside the school

‘[…] the situation in the schools still remains the Achilles heel.’ Barriers to the implementation of school tobacco policies—a qualitative study from local stakeholder’s perspective in seven European cities

School tobacco policies (STPs) are a crucial strategy to reduce adolescents smoking. Existing studies have investigated STPs predominantly from a school-related ‘insider’ view. Yet, little is known about barriers that are not identified from the ‘schools’ perspective’, such as perceptions of local stakeholders. Forty-six expert interviews from seven European cities with stakeholders at the local level (e.g. representatives of regional health departments, youth protection and the field of addiction prevention) were included. The analysis of the expert interviews revealed different barriers that should be considered during the implementation of STPs. These barriers can be subsumed under the following: (i) Barriers regarding STP legislature (e.g. inconsistencies, partial bans), (ii) collaboration and cooperation problems between institutions and schools, (iii) low priority of smoking prevention and school smoking bans, (iv) insufficient human resources and (v) resistance among smoking students and students from disadvantaged backgrounds. Our findings on the expert’s perspective indicate a need to enhance and implement comprehensive school smoking bans. Furthermore, collaboration and cooperation between schools and external institutions should be fostered and strengthened, and adequate human resources should be provided

Early Control of HIV-1 Infection in Long-Term Nonprogressors Followed Since Diagnosis in the ANRS SEROCO/HEMOCO Cohort

International audienceBackground: To clarify early correlates and natural history of HIV long-term nonprogressors (LTNPs) since HIV diagnosis.Methods: Patients enrolled in the French ANRS SEROCO/HEMOCO cohort with CD4 count >500 cells/mm3 at HIV diagnosis. LTNP status was defined as being asymptomatic, antiretroviral free, and with CD4 cell count >500 cells/mm3 for >8 years after HIV diagnosis. In LTNPs, we modeled the biological markers' progression through a joint model. Factors associated with loss of LTNP status were identified through a Cox model.Results: Sixty (9%) of 664 patients were identified as LTNPs during follow-up. At enrollment, HIV RNA was 1.85 log copies/10(6) PBMCs and high HIV DNA increase were associated with an increased risk of losing LTNP status [adjusted hazard ratio: 2.8 (1.2-6.8) and 2.2 (1.0-4.8), respectively].Conclusions: LTNP status is established in the first years of HIV infection, low HIV DNA level at enrollment and slow increase of HIV DNA being associated with maintained LTNP status

Greater diversity of HIV DNA variants in the rectum compared to variants in the blood in patients without HAART

International audienceThe gut-associated lymphoid tissue represents the largest reservoir of HIV-1. Improving knowledge of this reservoir by studying the diversity of viral population is a key step towards understanding the pathogenesis and dynamics of HIV. Obtaining samples is difficult and little information is available on gut viral quasispecies during the course of infection in humans. The aim of the study was to characterize rectal viral strains and their diversity and to investigate the relationships between the rectal tissue reservoir and viral variants in the blood. Phylogenetic analyses were performed on the env sequences for rectal HIV DNA, blood HIV DNA and HIV RNA clones, with maximum likelihood and neighbor-joining methods on seven patients. Genetic diversity was assessed. Higher diversity of HIV DNA clones was noted in the rectum compared to blood in 4 out of 5 patients without HAART. Viral diversity was present in the rectum from time of the primary infection. Similar degrees of diversity were observed in the rectum and blood during HAART. Rectal and blood HIV variants were interspersed partially or totally in the seven patients. A certain number of rectal HIV DNA clones were clustered together in six patients. These results suggest that variants in the rectum were more heterogeneous than variants in the blood from patients without HAART, probably because the activated milieu of gut-associated lymphoid tissue may provide an improved environment for viral replication, and indicate exchange of viral populations between blood and rectal tissues, reflecting the dynamics of HIV during course of infection

The effect of school smoke-free policies on smoking stigmatization : A European comparison study among adolescents

he increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper aims to measure (1) whether stigmatization among European adolescents varies according to smoking status and socioeconomic position (SES), and (2) whether stigmatization is greater in school environments in which smoking is denormalized (i.e. those with low smoking rates and strong school tobacco policies). Data on 12,991 adolescents were collected in 55 schools in seven European countries (SILNE R-survey, 2016/17). We applied Stuber’s adapted scale of perceived stereotyping and discrimination towards smokers to smoking status and five variables indicating a power shift towards non-smokers: the school’s tobacco control policy (STP) score, the percentage of adolescents in the school who smoke, parents’ level of education, students’ academic performance, and the percentage of their friends who smoke. Multilevel regressions were applied to the global score for perceived stigmatization. Discrimination against smokers and stereotyping of smokers were frequently reported. Smokers reported less ‘perceived stigmatization of smoking’ than non-smokers (Beta = -0.146, p < 0.001). High-SES students reported stereotyping and discrimination more frequently than lower-SES students. The perception of stigmatization was lower among students whose academic performance was poor (Beta = -0.070, p < 0.001) and among those who had friends who smoked (Beta = -0.141, p < 0.001). Stigmatization was lower in schools with greater exposure to smoking and was not associated with the school’s STP score. Perceived stigmatization of smoking is common among European adolescents. Smokers themselves, however, perceive stigmatization less often than non-smokers. Strong school tobacco policies do not increase stigmatization, but a social environment that is permissive of smoking decreases perceived stigmatization

New Highly Sensitive Real-Time PCR Assay for HIV-2 Group A and Group B DNA Quantification

International audienc