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Introduction: The use of blotting paper as a support for quantification of viral load could improve the virological monitoring of patients on Human Immunodeficiency Virus treatment in Mali. The urgency is obvious to us that the coverage in charge is only 10% for the achievement of the 3rd 90. Objective: To assess the performance of viral load screening (sensitivity, specificity, concordance) of DBS from the one spot DBS protocol according to plasma in people living with the human immunodeficiency virus (PLHIV) in Bamako. Methods: A total of 130 blotting papers were made from blood samples received from five sites for monitoring live persons with HIV. These blotting papers thus made were analyzed with the Abbott m2000 apparatus for the purpose of quantifying the viral load with plasma as reference sample. The extraction was done with the m2000SP automatic extractor, following the protocol 1.0 mL HIV-RNA DBS Protocol for paper. Furthermore, the extraction of plasma RNA on the m2000SP was done according to the 0.6 mL HIV-1 RNA protocol. Results: With 130 samples with detectable viral loads, we obtained a correlation of r = 0.837 (p <0.001). In addition, the average difference between the viral load on blotting paper and plasma was 0.512 log / virological copies with a kappa coefficient = 0.708. The threshold of 1000 copies / mL defined as virological success in our study allowed us to obtain a sensitivity of 87% and a specificity of 100%. Conclusion: Decentralized zones or virological plasma monitoring is not accessible, the new Protocol one spot of Abbott laboratory offers an interesting opportunity for the follow-up of these patients with good performance at the threshold of 1000 copies. The use of DBS as a virological support can contribute effectively to the achievement of the 3rd 90. [ABSTRACT FROM AUTHOR]

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Copyright of Storia delle Donne is the property of Firenze University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Politique Africaine is the property of Karthala Editions Diffusion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mondes en Developpement is the property of De Boeck Universite and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Les débuts de l’emploi du sang collecté et séché sur papier buvard – « dried blood spot » (DBS) – remonte au milieu du XX e siècle. Le prélèvement DBS peut être réalisé en dehors des structures de soins, par ponction capillaire, transporté de manière simple et sûre par voie postale, et utilisé avec la plupart des méthodes de laboratoire pour l’analyse d’anticorps, d’antigène, ou d’acides nucléiques. Ces caractéristiques avantageuses expliquent l’intérêt croissant pour ce mode de prélèvement et de transport du sang. Le prélèvement DBS a montré son utilité clinique pour améliorer le diagnostic in vitro des maladies infectieuses dans les populations d’accès difficiles, les populations clés et chez les personnes vivant dans les pays à faibles ressources économiques. Le DBS est utilisable à toutes les étapes de la cascade thérapeutique : dépistage, confirmation, quantification des acides nucléiques, génotypages de résistances. C’est dans le domaine de la prise en charge du VIH et des hépatites virales B et C que le plus d’études basées sur le DBS ont été réalisées. Les performances des tests ARN VIH sur DBS pour l’identification de l’échec virologique sous traitements sont élevées mais pas optimales, du fait de la dilution du sang séché dans le tampon d’élution qui réduit la sensibilité analytique et de la contamination par l’ADN proviral intracellulaire. Des performances élevées sont rapportées pour le diagnostic VIH pédiatrique et le diagnostic des hépatites B et C. La variabilité des méthodes pré-analytiques – notamment la préparation des DBS et l’extraction des acides nucléiques – limite les possibilités de comparaisons inter-laboratoires. Trop peu de fabricants ont proposé des notices techniques pour l’usage de leurs trousses sur DBS et les approbations réglementaires des tests commercialisés pour l’usage sur DBS demeurent exceptionnelles. Le prélèvement sur DBS malgré ces limites et contraintes est un outil majeur pour améliorer l’accès au diagnostic des maladies infectieuses dans le monde et fait désormais l’objet de recommandations internationales. The use of blood collected and dried on filter paper - dried blood spot (DBS) - have started in the middle of the 20 th century. DBS sampling can be performed outside care facilities, by capillary puncture, transported in a simple and safe manner by mail, and used with most laboratory methods for antibodies, antigen, or nucleic acids testing. The benefits of this blood collection and transport means explain the growing interest for DBS in the recent years. DBS sampling has shown clinical utility to improve in vitro diagnostics of infectious diseases in hard to reach populations, key populations and people living in low-income countries. DBS can be used at all stages of the therapeutic cascade: screening, confirmation, quantification of nucleic acids, resistance genotyping. Numerous studies dedicated to HIV, viral hepatitis B and C diagnosis using DBS have been reported. The performance of HIV RNA testing on DBS to identified virological failure on therapy is high but not optimal due to the dilution of dried blood in the elution buffer that reduces the analytical sensitivity and due to the contamination by intracellular HIV DNA. Good sensibility and sensitivity have been reported for infant HIV diagnosis and diagnosis of hepatitis B and C using DBS. Variabilities in the pre-analytical steps - including DBS preparation and nucleic acid extraction - limit inter-laboratory comparisons. Too few manufacturers have proposed technical notes for using their assays on DBS and very few assays have pursued regulatory approval for in vitro diagnostic on DBS. Regulatory approvals remain exceptional. Despite these limitations, DBS sampling is a main tool to improve access to infectious disease diagnosis worldwide and is now recommended by international recommendations. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome induce account for over 40 million deaths in the past 20 years. Given that the currently available treatments to prevent HIV transmission and disease are not effective in eradicating the virus, vaccination likely represents the only efficacious adapted response to the global impact of this infection. This paper reviews the challenges encountered in the development of an HIV vaccine as well as the different vaccine approaches and main HIV vaccine candidates evaluated in clinical trials. Current knowledge and key points: In spite the tremendous progress in HIV research, the major challenges that are encountered in the development of an HIV vaccine remain of scientific order and include viral specificities, absence of correlates of immune protection and limitations of existing animal models. Over 30 vaccine candidates have been evaluated in clinical trials. These vaccine approaches include the use of recombinant envelope proteins, DNA vaccines, live-vectored recombinant vaccines, subunit vaccines and prime-boost regimens combining various vaccine candidates. Although the protective efficacy of these candidate vaccines has yet to be demonstrated, some vaccination regiments appear to dampen initial viremia and prolong disease-free survival. Future prospects and projects: Faced with the challenges in developing an HIV vaccine, international consortia and new methodologies have been proposed in order to accelerate the development and screening process of new candidate HIV vaccines. Moreover, in the absence of a protective vaccine, the impact of a vaccine that confers partial protection needs to be seriously considered. [Copyright &y& Elsevier]

Abstract: The aim of this paper is to present a method to apprehend the way in which patients exert their mastery on the antiretroviral-treatments. We refer to the concept of “mastery” as defined by Paul Denis (1992, 1997). We met seven HIV+ people under treatment. At first, we used the Rorschach (Exner method) to highlight the indices leading to the identification of “mastery” vector investment. Then, we focused on “mastery” investment quality by observing the formal quality of the answers obtained by Rorschach, according to the reported difficulties in taking the treatments. At last, we observed the way in which the subjects built their discourse according to the difficulties they had with the treatments. Independently of the difficulties in taking treatment, the patients expressed an over-investment of the “mastery” vector. The quality of this investment is different according to whether the people have or do not have difficulties in taking the treatment. Finally, the discourse analysis shows differences on the level of the structure of the discourse according to whether the persons have or do not have difficulties in taking the treatment. [Copyright &y& Elsevier]

Abstract: Attention to viral infection of the male genital tract has been renewed over the last 15 years as a result of the prolific ongoing research on AIDS. Epidemiological studies of the virus in sperm and male genital tract contributes to the understanding of STD physiopathology and helps assessing their impact on male fertility. Recent advances in this field have allowed to offer Assisted reproductive techniques to couples with chronic viral infection, under strict and specific protocols. This paper presents an overview of these recent developments. [Copyright &y& Elsevier]

HIV-infected patients are at greater risk for drug hypersensitivity than non-HIV-infected patients. Sulfonamides and anti-retroviral drugs are most often the responsible agents. We detail in this paper our 5-year experience with this problem. Ninety-three HIV-positive patients with a clear history of hypersensitivity to cotrimoxazole, nevirapine, nelfinavir or efavirenz were included in a tolerance-induction protocol. The clinical manifestations were as follows: 68 patients had had pruriginous maculo-papular eruptions including 17 with fever and 12 with other symptoms (conjunctivitis, asthenia, digestive symptoms, etc). Fourteen patients presented with urticaria, with fever in 4 of them. Twelve doses of the responsible drug, prepared the day of the challenge, were given orally at 30-minute intervals. We were successful in 90% of the cases. Therefore, tolerance induction may be an alternative for such patients. [Copyright &y& Elsevier]

A book published in 1999 hypothesized that the scientists who worked with the CHAT type 1 attenuated polio strain tested in the former Belgian Congo in the late 1950s had covertly prepared the vaccine in chimpanzee kidney cells contaminated with a simian immunodeficiency virus which evolved into HIV-1, group M. This paper summarizes the results of the investigation conducted by the author to determine the legitimacy of the accusation. Testimony by eye witnesses, documents of the time, epidemiological analysis, and ancillary phylogenetic, virologic and PCR data all concur to reject the hypothesis as false and without factual foundation. [Copyright &y& Elsevier]

Transitions into and out of correctional facilities for people living with HIV are a pivotal point in the HIV treatment cascade where adherence metrics are significantly affected. In this paper I use Alvesson and Sandberg’s problematization method of literature analysis to critique and understand the taken-for-granted assumptions underpinning how knowledge is generated within the intersecting fields of HIV, transitions, and corrections. Utilizing problematization, two assumptions underpinning knowledge generation are identified: the linearity of the HIV care continuum model and the tendency to create and perpetuate spatially segregating metaphors of transitions inside versus outside correctional facilities for people living with HIV. These assumptions are discussed in the context of how they shape dominant ways of thinking and practicing in the field. An alternative way to understand transitions for people living with HIV is proposed along with recommendations to guide the HIV care practices of nurses and other healthcare providers.

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: L'espérance de vie globale des personnes vieillissantes avec le VIH (PVVIH) tend à rejoindre celle des patients non infectés, grâce notamment à l'accès à des traitements antirétroviraux efficaces et de mieux en mieux tolérés et à l'amélioration de la prise en charge pluridisciplinaire. Certaines comorbidités ou l'exposition prolongée à un état inflammatoire lié au virus VIH lui-même pourraient être parmi les principaux déterminants physiologiques du phénotype de fragilité chez les PVVIH. La prévalence du phénotype de fragilité chez les PVVIH est fréquente (de 5 % à 28 % selon les études) et précoce (à 50 ans, cette prévalence serait identique à celle des plus de 65 ans en population générale). Le phénotype « pré-fragile » concernerait presque la moitié des patients infectés par le VIH avant 50 ans. L'intérêt de l'intégration de la mesure de la fragilité dans la prise en charge quotidienne des PVVIH n'est pas connu même si les premières données de faisabilité et de prédiction sont encourageantes. L'objectif du repérage précoce de la fragilité chez les PVVIH serait de permettre la mise en place d'interventions ciblées susceptibles d'améliorer l'état de santé globale et de retarder l'entrée dans la dépendance ou la mortalité précoce. The life-span of people aging with HIV (PHIV) tends to reach people without infection, reflecting the effectiveness and tolerance of antiretroviral treatment and improvement of multidisciplinary management. Comorbidities or HIV-inflammaging seems to be the main determinants of frailty phenotype in PHIV. Prevalence of frailty in PHIV is frequent (5% from 28%) and appears earlier than in general population (50 versus 65 years). Almost half of people with HIV present prefrail phenotype before 50 years. The usefulness of integrate routinely measures of frailty phenotype is not yet known but several data are encouraging in terms of feasibility and prediction. Early determination of frailty in PHIV could lead to target interventions to improve global health and decrease adverse outcomes such as incapacities and early death. [ABSTRACT FROM AUTHOR]

Copyright of Cahiers du Genre is the property of L'Harmattan Edition Diffusion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite the enormous victory that has been recorded in decreasing significantly HIV-TB related mortality and morbidity in Sub-Saharan Africa, enormous challenges continue to obstruct proper and enviable control of these conditions. These range from prioritization, ethics, funding, drug resistance and research gaps. Resistance to these diseases could constitute key treatment and prevention challenges to health care systems and the international community if not handled appropriately and promptly. This paper presents key shortcomings of the current funding, management and research policies and highlights possible action areas to remedy this situation. [ABSTRACT FROM AUTHOR]

Despite the enormous victory that has been recorded in decreasing significantly HIV-TB related mortality and morbidity in Sub-Saharan Africa, enormous challenges continue to obstruct proper and enviable control of these conditions. These range from prioritization, ethics, funding, drug resistance and research gaps. Resistance to these diseases could constitute key treatment and prevention challenges to health care systems and the international community if not handled appropriately and promptly. This paper presents key shortcomings of the current funding, management and research policies and highlights possible action areas to remedy this situation.

How to say ‘no’. Girls’ initiation as a mean to prevent the spreading of HIV-virus in Northern Zambia – The existence of girls’ initiation is still one of the main features of the Bemba-speaking region in Northern Zambia, in spite of its being considered as gradually disappearing. Among the many functions of this ritual, one is to let women express themselves by the way of symbols rather than words. Following a short presentation of the traditional initiation (survey 1931), this paper deals with the changes in the ritual in parallel with the UNICEF project for HIV prevention in the Copperbelt region of Northern Zambia (survey 1998). Two types of production are presented: songs composed by a group of women in relation to the UNICEF project, and the evolution of the ritual conceived by women as a possible answer to the objectives defined by the project for HIV prevention regarding young girls.

For many countries, in particular in sub-Saharan Africa, Demographic and Health Surveys (DHS) are the main estimates of HIV prevalence at national levels in general population. Several DHS collect longitude and latitude of surveyed clusters.In this paper, we present three methodological approaches for mapping spatial variations of HIV prevalence from DHS. These approaches are applied to DHS simulation sampled from a model country. The estimated surfaces are then compared with the initial surface of the model.We show that a method using kernel estimators with adaptive bandwidths of the same number of observed people allows estimating main regional trends of the epidemics. Its application to data from 2003 DHS of Burkina Faso give a plausible picture of the epidemiological situation in this country.

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)