Discordant responses to antiretroviral treatment: prevalence, risk factors and associated mortality in Rwanda

Mexico AIDS Conference 200

Weight evolution in patients after stavudine substitution for lipoatrophy in Rwanda: comparison of zidovudine with tenofovir/abacavir

Mexico AIDS Conference 200

Risk factors for hepatotoxicity of nevirapine-containing antiretroviral drug regimens in a large antiretroviral treatment program in Rwanda

Mexico AIDS Conference 200

Long‐term microbial community dynamics at two full‐scale biotrickling filters treating pig house exhaust air

In this study, the microbial community structure of two full-scale biotrickling filters treating exhaust air from a pig housing facility were evaluated using 16S metabarcoding. The effect of inoculation with activated sludge of a nearby domestic waste water treatment plant was investigated, which is a cheap procedure and easy to apply in practice. The study was performed at a three-stage and a two-stage full-scale biotrickling filter; of which, only the latter was inoculated. Both biotrickling filters evolved towards a rather similar community over time, which differed from the one in the activated sludge used for inoculation. However, the bacterial population at both biotrickling filters showed small differences on the family level. A large population of heterotrophic bacteria, including denitrifying bacteria, was present in both biotrickling filters. In the non-inoculated biotrickling filter, nitrite-oxidizing bacteria (NOB) could not be detected, which corresponded with the incomplete nitrification leading to high nitrite accumulation observed in this system. Inoculation with the wide spectrum inoculum activated sludge had in this study a positive effect on the biotrickling filter performance (higher ammonia removal and lower nitrous oxide production). It could thus be beneficial to inoculate biotrickling filters in order to enrich NOB at the start-up, making it easier to keep the free nitrous acid concentration low enough to not be inhibited by it

OCMW-verzelfstandiging

OCMW-verzelfstandiging is een onmisbaar boek voor lokale besturen die op zoek zijn naar het versterken van hun bestuurkracht door samenwerking of clustering. De auteurs bespreken alle mogelijkheden: van samenwerking in contractueel verband of door het uitwisselen van personeel met de gemeente, tot de oprichting van een verzelfstandigde entiteit zonder dat er van samenwerking sprake is en structurele samenwerking met meerdere besturen. Het boek geeft een antwoord op de vraag in welke situatie welke oplossing passend en mogelijk is. Van alle mogelijke vormen van verzelfstandiging en samenwerking wordt stap voor stap toegelicht hoe die in de praktijk kunnen uitgewerkt worden en er worden modelstatuten aangereikt voor de nieuwste vorm van vereniging. Er wordt toegelicht met wie kan worden samengewerkt en tegelijk ook wat de gevolgen zijn op vlak van de openbaarheid van bestuur, motiveringsplicht, taalwetgeving, overheidopdrachten, fiscaliteit, enzovoort. Voor het eerst wordt de verzelfstandiging van de OCMW’s in de diepte benaderd vanuit diverse disciplines zoals overheidsopdrachten en fiscaal recht. Dit alles komt uitgebreid aan bod in dit boek dat geschreven werd door auteurs die stuk voor stuk specialisten zijn in hun vakgebied. Het naslagwerk werd onder impuls van Wouter Verhille samengesteld door Wim Rasschaert, Luc Vermeiren en Brecht Warnez; en het bevat bijdragen van Cies Ghysen, Heleen Van Asch, Gitte Laenen, Wim Rasschaert, Marleen Denef, Evelyne Maes, Jens Debièvre, Brecht Warnez, Frederik Vandendriessche en Stijn Vastmans

Nevirapine- and efavirenz-associated hepatotoxicity under programmatic conditions in Kenya and Mozambique.

To describe the frequency, risk factors, and clinical signs and symptoms associated with hepatotoxicity (HT) in patients on nevirapine- or efavirenz-based antiretroviral therapy (ART), we conducted a retrospective cohort analysis of patients attending the ART clinic in Kibera, Kenya, from April 2003 to December 2006 and in Mavalane, Mozambique, from December 2002 to March 2007. Data were collected on 5832 HIV-positive individuals who had initiated nevirapine- or efavirenz-based ART. Median baseline CD4+ count was 125 cells/μL (interquartile range [IQR] 55-196). Over a median follow-up time of 426 (IQR 147-693) days, 124 (2.4%) patients developed HT. Forty-one (54.7%) of 75 patients with grade 3 HT compared with 21 (80.8%) of 26 with grade 4 had associated clinical signs or symptoms (P = 0.018). Four (5.7%) of 124 patients with HT died in the first six months compared with 271 (5.3%) of 5159 patients who did not develop HT (P = 0.315). The proportion of patients developing HT was low and HT was not associated with increased mortality. Clinical signs and symptoms identified 50% of grade 3 HT and most cases of grade 4 HT. This suggests that in settings where alanine aminotransferase measurement is not feasible, nevirapine- and efavirenz-based ART may be given safely without laboratory monitoring