Low current and nadir CD4+ T-cell counts are associated with higher hepatitis C virus RNA levels in the Swiss HIV cohort study.

BACKGROUND: The aim of this study was to evaluate the effect of CD4+ T-cell counts and other characteristics of HIV-infected individuals on hepatitis C virus (HCV) RNA levels. METHODS: All HIV-HCV-coinfected Swiss HIV Cohort Study participants with available HCV RNA levels and concurrent CD4+ T-cell counts before starting HCV therapy were included. Potential predictors of HCV RNA levels were assessed by multivariate censored linear regression models that adjust for censored values. RESULTS: The study included 1,031 individuals. Low current and nadir CD4+ T-cell counts were significantly associated with higher HCV RNA levels (P = 0.004 and 0.001, respectively). In individuals with current CD4+ T-cell counts < 200/microl, median HCV RNA levels (6.22 log10 IU/ml) were +0.14 and +0.24 log10 IU/ml higher than those with CD4+ T-cell counts of 200-500/microl and > 500/microl. Based on nadir CD4+ T-cell counts, median HCV RNA levels (6.12 log10 IU/ml) in individuals with < 200/microl CD4+ T-cells were +0.06 and +0.44 log10 IU/ml higher than those with nadir T-cell counts of 200-500/microl and > 500/microl. Median HCV RNA levels were also significantly associated with HCV genotype: lower values were associated with genotype 4 and higher values with genotype 2, as compared with genotype 1. Additional significant predictors of lower HCV RNA levels were female gender and HIV transmission through male homosexual contacts. In multivariate analyses, only CD4+ T-cell counts and HCV genotype remained significant predictors of HCV RNA levels. Conclusions: Higher HCV RNA levels were associated with CD4+ T-cell depletion. This finding is in line with the crucial role of CD4+ T-cells in the control of HCV infection.

A high-throughput test to detect C.E.R.A. doping in blood.

C.E.R.A., a continuous erythropoietin receptor activator, is a new third-generation erythropoiesis-stimulating agent (ESA) that has recently been linked with abuse in endurance sports. In order to combat this new form of doping, we examined an enzyme-linked immunosorbent assay (ELISA) designed to detect the presence of C.E.R.A. in serum samples. The performance of the assay was evaluated using a pilot excretion study that involved six subjects receiving C.E.R.A. Validation data demonstrated an excellent reproducibility and ensured the applicability of the assay for anti-doping purposes. To maximize the chances of detecting the drug in serum samples, we propose the use of this specific ELISA test as a high-throughput screening method, combined with a classic isoelectric focusing test as a confirmatory assay. This strategy should make C.E.R.A. abuse relatively easy to detect, thereby preventing the future use of this drug as a doping agent.

How to confirm C.E.R.A. doping in athletes' blood?

C.E.R.A. (Continuous Erythropoietin Receptor Activator) is a new third-generation erythropoiesis-stimulating agent that has recently been linked with abuse in endurance sports. The anti-doping community rapidly reacted by releasing a high-throughput screening ELISA allowing the detection of C.E.R.A. doping in athletes' blood. In order to return adverse analytical findings, anti-doping laboratories, however, need, as far as possible, to confirm the presence of the drug in athletes' samples through orthogonal methods. This article focuses on the comparison of 2 proposed confirmation assays based on gel electrophoresis that were coupled with a new sample immunopurification method. IEF, the classical method used to target erythropoietin (EPO) and its recombinant analogues in athletes' samples, and SARKOSYL-PAGE were applied to the plasma samples of subjects having received a single injection of C.E.R.A. It was demonstrated that SARKOSYL-PAGE was at least 6 times more sensitive than IEF, with comparable specificity. A longer detection window coupled with easier interpretation criteria led us to recommend the use of SARKOSYL-PAGE to confirm C.E.R.A. presence in athletes' blood.

Caractéristiques des femmes victimes de violences graves dans un échantillon clinique

Bien que la violence contre les femmes en général soit actuellement reconnue comme un problème de santé publique, la sévérité des violences subies par les femmes est une problématique encore peu étudiée. Cette recherche vise à identifier le profil des femmes victimes des violences les plus graves parmi les patientes ayant consulté auprès d'une Unité de Médecine des Violences d'un hôpital Universitaire Suisse. Les données ont été récoltées à partir des dossiers complétés par l'infirmière pour chaque patiente ayant consulté à l'Unité durant l'année 2006. Une quinzaine de caractéristiques relatives à la victime elle-même ainsi qu'à l'évènement violent ont été systématiquement documentées par le consultant. Les résultats montrent que parmi les 183 cas de femmes analysés, 28% ont subi des violences graves et 72% des violences modérées. Si aucune différence significative entre les deux groupes de femmes n'a été relevée concernant l'âge, la nationalité, les expériences de violence dans l'enfance et la religion, les femmes victimes de leur partenaire (actuel ou ex) étaient plus à risque de subir des violences graves que celles victimes d'un autre agresseur. Les programmes de prévention devraient se centrer sur la gravité potentielle des actes de violence dans la sphère conjugale.

Littérature d'éducation et pratiques pédagogiques familiales à l'aune des écrits du for privé (Suisse romande, 1750-1820)

Cette contribution questionne l'influence de la littérature d'éducation sur les pratiques éducatives familiales. Les injonctions des pédagogues en faveur de l'observation promeuvent l'usage de journaux d'éducation à l'instar de celui rédigé par René-Guillaume-Jean Prevost-Dassier entre 1789 et 1807. Ce journal permet d'analyser la réception des écrits de J. Locke et J.-J. Rousseau et la façon dont ils conditionnent l'éducation que ce notaire genevois dispense à ses deux enfants.