Publications by authors named "Brunet L"
Evidence-based HIV programming focused on populations at risk of HIV is critical for sustainable disease prevention. In response to the Tennessee Department of Health decision to reject federal HIV guidance, the present study examines the potential impact of Southern US states adopting policies that direct HIV prevention and testing efforts away from populations "disproportionately affected" (DA) by HIV toward populations "non-disproportionately affected" (NDA). Descriptive and projection analyses with publicly available data explored the influence of policies emphasizing NDA populations on HIV cases.
View Article and Find Full Text PDFIn 2021, for the first time, a legal framework organizing the care of children with a variation in genital development (VGD), sometimes referred to as "intersex children" or "children with differences in sex development" (DSD), was introduced in France (article L. 2131-6 of the Code of Public Health). It should be immediately apparent that the chosen term, "variation" rather than "anomalies" or "disorders" - which was previously used in the medical world - reflects a political will to renew both the way of thinking and the medical practices in this field.
View Article and Find Full Text PDFBackground: Two-drug regimens (2DRs) have been introduced in recent years to potentially reduce antiretroviral therapy (ART) toxicities and drug-drug interactions while demonstrating comparable efficacy to three-drug regimens (3DRs) for people with HIV (PWH). The objective of this study was to compare the real-world effectiveness and durability of a single-tablet 2DR of dolutegravir/lamivudine (DTG/3TC) with that of commonly prescribed 3DRs in ART-experienced, virologically suppressed PWH during the first 24 months of DTG/3TC availability in the United States.
Methods: Virologically suppressed (viral load [VL] < 200 copies/mL) adult PWH initiating DTG/3TC 2DR, bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), or a DTG-based 3DR between 01MAY2019 and 31OCT2020 were identified in the OPERA cohort and followed through 30APR2021.
[Extension of the Use of Gametes in Intra-couple (EUGIC): How to use trans woman' spermatozoa?].
Gynecol Obstet Fertil Senol
January 2025
Article Synopsis
- The French Bioethics Law now allows lesbian couples and single women to access medically assisted reproduction, including the use of cryopreserved gametes, raising questions about new applications of these gametes among various couples, particularly those including transgender individuals.
- The study analyzes scenarios where a transgender woman's sperm is used within couples, rather than relying on gamete donation, highlighting existing practices and challenges faced by healthcare professionals.
- There are inconsistencies and legal gaps related to using a trans woman's sperm under the new EUGIC framework, resulting in complexities for medical practitioners and raising issues around the rights and interests of the unborn child.
Article Synopsis
- Fostemsavir is a new drug used alongside other treatments for adults with multidrug-resistant HIV-1, focusing on its real-world effects in the OPERA cohort.
- The study analyzed immunological (CD4 T-cell counts) and virological (viral load) responses in participants starting fostemsavir, categorizing results based on their initial viral load and CD4 count.
- Results showed that while most individuals with suppressed viral loads maintained their status, those with low CD4 counts had notable improvements in immune response with fostemsavir, despite limited virological success in those who were viraemic.
The effect of family socioeconomic status (SES) on academic achievement in literacy and numeracy has been extensively studied with educational inequalities already witnessed in preschoolers. This is presumably explained by the effect of family SES on cognitive and socioemotional abilities associated with academic achievement. Metacognition which refers to knowledge and regulation skills involving reflexivity about one's own cognitive processes is one of these abilities.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluates the effectiveness of the two-drug regimen (DTG/3TC) for HIV treatment, focusing on individuals transitioning from a three-drug regimen while maintaining a viral load under 50 copies/mL.
- It includes 787 treatment-experienced participants followed for a median of 13.6 months, finding low rates of virologic failure and loss of viral control.
- Results indicate that DTG/3TC is a viable and generally well-tolerated option for HIV treatment across different age, sex, and racial groups.
Article Synopsis
- The study assessed the CHORUS™ app's effectiveness in improving adherence to monthly CAB + RPV long-acting injectable injections.
- Healthcare centers were split into two groups: one with access to the app and one without, to compare adherence rates.
- Although access to the app didn't significantly increase adherence, using the app did raise adherence rates, particularly in smaller healthcare centers lacking established procedures.
HIV-associated wasting (HIVAW) is an underappreciated AIDS-defining illness, despite highly effective antiretroviral therapy (ART). We (a) assessed the association between incident HIVAW/low weight and all-cause mortality and (b) described virologic outcomes after people with HIV (PWH) experienced HIVAW/low weight while on ART. In the Observational Pharmaco-Epidemiology Research & Analysis (OPERA) cohort, PWH without prior HIVAW/low weight who were active in care in 2016-2020 were followed through the first of the following censoring events: death, loss to follow-up, or study end (October 31, 2021).
View Article and Find Full Text PDFBackground: Chondroblastomas are uncommon primary bone tumors localized in long bone epiphyses in children and young adults. The risk of metastasis is rare, but they have a high capacity for local recurrence. Surgical curettage with bone grafting or bone substitute is the preferred treatment.
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- The study reviews the effectiveness and adherence to the new long-acting injectable HIV treatment, cabotegravir + rilpivirine (CAB + RPV LA), which is approved for individuals with stable virus levels and no treatment history issues.
- In a sample of 321 adults receiving this treatment, 90% of injections were administered on schedule, and almost all patients maintained undetectable or suppressed viral loads during follow-ups.
- Overall, the findings suggest that CAB + RPV LA is effective in real-world clinical settings, with minimal impact from minor delays in injection schedules on patient outcomes.
Lactate accumulation and acidification in tumours are a cancer hallmark associated with the Warburg effect. Lactic acidosis correlates with cancer malignancy, and the benefit it offers to tumours has been the subject of numerous hypotheses. Strikingly, lactic acidosis enhances cancer cell survival to environmental glucose depletion by repressing high-rate glycolysis and lactic fermentation, and promoting an oxidative metabolism involving reactivated respiration.
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- - The study analyzed HIV-associated wasting (HIVAW) and low weight in people with HIV in the U.S. using data from the OPERA cohort, finding a consistent prevalence rate of 12% over two time periods (2012-2015 and 2016-2020).
- - Among a large cohort of adults with HIV who had not previously experienced low weight, 7% developed HIVAW over a median of 64 months post-diagnosis, with demographic factors like age, sex, and race influencing odds of weight issues.
- - The findings highlight that advanced HIV and comorbid conditions are strong predictors of HIVAW, suggesting a need for increased awareness among healthcare providers, particularly for older and fra
Article Synopsis
- The study aimed to compare immune responses and treatment outcomes among advanced HIV patients in the USA who started different antiretroviral therapy (ART) regimens.
- A total of 1349 participants were monitored for around 22 months after starting either bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF), boosted darunavir (bDRV), dolutegravir (DTG), or elvitegravir (EVG/c).
- Results indicated that those on B/F/TAF experienced quicker CD4 cell recovery and better virological outcomes, while the CD4:CD8 ratio improvements were similar across all regimens.
Article Synopsis
- - The study compared clinical outcomes between heavily treatment-experienced (HTE) and non-HTE people living with HIV (PLWH), focusing on their ART regimens and resistance to treatments over a median follow-up of 28 months.
- - Results indicated that HTE PLWH had lower chances of achieving undetectable viral loads and maintaining adequate CD4 cell counts compared to non-HTE PLWH, and they were also more likely to need changes in their treatment regimens.
- - Both groups experienced non-AIDS defining morbidities, with a higher prevalence in HTE PLWH (45%) versus non-HTE (35%), though serious morbidities and deaths were relatively rare.
[EUGIC (Extension of the Use of Gametes in Intra-Conjugal): New uses of gametes within the couple].
Gynecol Obstet Fertil Senol
April 2023
Objective: New possibilities for using gametes within a couple were created by the French law of August 2, 2021 related to bioethics by opening Assisted Reproductive Technics (ART) to all women. It concerns previously self-preserved gametes, thus avoiding the need for gamete donation. The objective of our study is to evaluate the perception of these new uses by ART practitioners.
View Article and Find Full Text PDFPurpose: Hip resection arthroplasty as a definitive treatment is an uncommon indication, although still in use selectively. This study evaluates a cohort of patients who have undergone hip resection arthroplasty surgery indicated as a definitive treatment, in order to assess the rate of re-operation, the rate of infection, and the mortality rates.
Methods: We conducted a retrospective, observational, descriptive analysis of a cohort of patients who had undergone a hip resection arthroplasty intended as a definitive treatment, in two University Hospitals from 1994 to 2020.
Article Synopsis
- The study assessed whether identifying people with HIV (PWH) at risk of falling out of care, along with automated outreach prompts, improved retention in care across 20 healthcare centers in the U.S.
- Results indicated that 56% of PWH in care were flagged, and both the intervention and control groups had similar visit rates after being flagged, but intervention centers slightly outperformed controls.
- The proportion of at-risk PWH achieving viral load suppression improved more significantly in intervention centers, suggesting potential benefits of integrating automated flags into existing care systems.
Excessive Weight Gain: Current Antiretroviral Agents in Virologically Suppressed People with HIV.
AIDS Res Hum Retroviruses
October 2022
Article Synopsis
- A study investigated weight gain in people with HIV who were virologically suppressed and switched to new medication regimens including tenofovir alafenamide/emtricitabine (TAF/FTC) combined with various antiretroviral drugs.
- Out of 5,536 participants, 18% gained at least 5% of their weight within 28 weeks, and 9% gained 10% or more within 54 weeks, but no significant differences in weight gain were found among the different treatment regimens.
- Overall, while some individuals did experience excessive weight gain, the average weight changes remained small and consistent across the different medication groups over the follow-up period.
Objective: The aim of this study was to describe the evolution of patients admitted for elective orthopaedic surgery during the immediate post-COVID-19 peak of the pandemic.
Methods: This is a multi-center, observational study conducted in 8 high complexity hospitals of Catalonia, one of the highest COVID-19 incidence areas in Spain. We included patients ≥18 years of age undergoing elective surgery (total knee or hip arthroplasty, knee or hip revision arthroplasty, shoulder or knee arthroscopy, hand or wrist surgery, forefoot surgery, or hardware removal) after the COVID-19 peak (between May 5th and June 30th, 2020).
Article Synopsis
- About 20% of new HIV cases in the U.S. involve advanced HIV infection, and research on effective antiretroviral therapy (ART) for these cases is limited.
- A study compared several ART regimens (B/F/TAF, boosted darunavir, dolutegravir, and elvitegravir/cobicistat) among ART-naïve individuals with advanced HIV and assessed their regimen discontinuation and effectiveness.
- Results showed that those on B/F/TAF were less likely to discontinue treatment and more successful in achieving viral suppression compared to those on boosted darunavir, but no significant differences were found with other integrase inhibitors.
Article Synopsis
- * Researchers found that low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) increased significantly, particularly during the first 9 to 16 months after switching to TAF.
- * The observed lipid increases were consistent even when accounting for other medications, suggesting that the TDF to TAF switch directly contributed to these changes.