To our knowledge, this study is the
first to explore the incidence of ICC and CIN in a Caribbean population of HIV-infected women. The strengths of this study are its regionally representative estimates and its exploration of individual CIN grades. This study also has some limitations. The small number of women with ICC in our cohort precluded the assessment of interactions with other risk factors (CD4 cell counts, parity, use of oral contraceptives, smoking and other sexually JQ1 in vitro transmitted diseases). Furthermore, no information on HPV serotypes was available. In conclusion, this study shows that, in a population in which HIV-infected women receive treatment for their infection and have access to ICC prevention services, there was no increase in the risk of cervical cancer, despite an increase in the occurrence of cervical cancer precursors. Therefore, our data support the statement that there is little evidence to support the designation of ICC as an AIDS-defining cancer , especially for populations which have a high level of medical care and access to HAART. We thank Drs A. Marrell, B. Téron-Aboud, M. Trival, C. Ghighi, C. Lelarge and F. Lemarche for selleck chemicals collecting pathology data. “
“Transmitted HIV strains may harbour drug resistance mutations. HIV-1 drug resistance mutations are currently detected
in plasma viral RNA. HIV-1 ADP ribosylation factor proviral DNA could be an alternative marker, as it persists in infected cells. This was a prospective study assessing the prevalence and persistence of HIV-1 drug resistance mutations in DNA from CD4 cells before and after protease inhibitor (PI)- or nonnucleoside reverse transcriptase inhibitor (NNRTI)-based therapy initiation in 69 drug-naïve patients. Before therapy, 90 and 66% of detected mutations were present in CD4 cells and
plasma, respectively. We detected seven key mutations, and four of these (M184M/V, M184M/I, K103K/N and M46M/I) were only found in the cells. When treatment was started, 40 patients were followed; the mutations detected at the naïve stage remained present for at least 1 year. Under successful treatment, new key mutations emerged in CD4 cells (M184I, M184M/I and Y188Y/H). The proportion of mutations detected in the DNA was statistically significantly higher than that detected in standard RNA genotyping, and these mutations persisted for at least 1 year irrespective of therapy. The pre-existence of resistance mutations did not jeopardise treatment outcome when the drug concerned was not included in the regimen. Analysis of HIV-1 DNA could be useful in chronic infections or when switching therapy in patients with undetectable viraemia. The efficacy of initial therapy for HIV infection may be jeopardized by the presence of drug resistance mutations, which reduce the probability of durable suppression of viral replication.