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Préau M, Mora M, Laguette V, Colombani C, Boufassa F, Meyer L, Spire B, Lambotte O. Identity, Representations, and Beliefs: HIV Controllers Living on the Frontier of Good Health and Illness. QUALITATIVE HEALTH RESEARCH 2016; 26:1483-1494. [PMID: 26631682 DOI: 10.1177/1049732315617739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Some people living with HIV spontaneously control the virus without antiretroviral treatment. They are called HIV controllers, and their status places them at the limits of bio-clinical normality. The objective of this study was to investigate HIV controllers' beliefs and representations of their individual trajectories using a qualitative approach. Fourteen HIV controllers were interviewed. Vertical analysis focused on examining how interviewees' specific beliefs and representational processes help these patients adapt to their particular situation. Horizontal analysis focused on how patients' biographic trajectories and identity positioning help them make sense of their situation. Results highlighted that perceiving oneself to be healthy or ill was linked to change or a lack of change in terms of disease perception, beliefs, and representations, when seropositivity was announced. This study of social representations and the processes involved provide crucial elements for health professionals caring for HIV controllers.
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Affiliation(s)
- Marie Préau
- GRePS, Université Lumière Lyon 2, Lyon, France INSERM, UMR912 (SESSTIM), Marseille, France Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marion Mora
- INSERM, UMR912 (SESSTIM), Marseille, France Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France Aix Marseille Université, Marseille, France
| | | | | | - Faroudy Boufassa
- Université Paris Sud, Le Kremlin Bicêtre, France APHP, Service de Médecine Interne, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France AP-HP Hôpital de Bicêtre, le Kremlin Bicêtre, France
| | - Laurence Meyer
- Université Paris Sud, Le Kremlin Bicêtre, France APHP, Service de Médecine Interne, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France AP-HP Hôpital de Bicêtre, le Kremlin Bicêtre, France
| | - Bruno Spire
- INSERM, UMR912 (SESSTIM), Marseille, France Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France Aix Marseille Université, Marseille, France
| | - Olivier Lambotte
- Université Paris Sud, Le Kremlin Bicêtre, France APHP, Service de Médecine Interne, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France
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Pernas M, Sanchez-Merino V, Casado C, Merino-Mansilla A, Olivares I, Yuste E, Lopez-Galindez C. HIV-1 Dual Infected LTNP-EC Patients Developed an Unexpected Antibody Cross-Neutralizing Activity. PLoS One 2015; 10:e0134054. [PMID: 26258485 PMCID: PMC4530867 DOI: 10.1371/journal.pone.0134054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/04/2015] [Indexed: 11/19/2022] Open
Abstract
This study evaluated the neutralization breadth in dually infected (DI) HIV-1 long-term non-progressor elite controller patients (LTNP-EC) using a representative minipanel of 6 viruses from 5 different subtypes. Our results showed an improved neutralization breadth in DI LTNP-EC patients when compared with matched LTNP single-infected patients. The role of viral diversity in neutralization was estimated with the Shannon Entropy and the p-distance in viral quasispecies. We found a positive correlation between neutralization breadth and diversity within the viral quasispecies. This correlation could explain why a group of LTNP-EC patients developed a broad neutralizing response despite having undetectable levels of viremia.
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Affiliation(s)
- Maria Pernas
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid 28220, Spain
- * E-mail:
| | - Victor Sanchez-Merino
- AIDS Research Unit, Institut d´Investigacions Biomediquès August Pi i Sunyer, Barcelona, Spain
- HIVACAT, Barcelona, Spain
| | - Concepcion Casado
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid 28220, Spain
| | - Alberto Merino-Mansilla
- AIDS Research Unit, Institut d´Investigacions Biomediquès August Pi i Sunyer, Barcelona, Spain
- HIVACAT, Barcelona, Spain
| | - Isabel Olivares
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid 28220, Spain
| | - Eloisa Yuste
- AIDS Research Unit, Institut d´Investigacions Biomediquès August Pi i Sunyer, Barcelona, Spain
- HIVACAT, Barcelona, Spain
| | - Cecilio Lopez-Galindez
- Centro Nacional de Microbiología (CNM), Instituto de Salud Carlos III, Majadahonda, Madrid 28220, Spain
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Frange P, Blanche S, Chaix ML. [Pediatric HIV infections in developed countries: current situation and future challenges]. Med Sci (Paris) 2014; 30:551-7. [PMID: 24939543 DOI: 10.1051/medsci/20143005019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In 2013, approximately 1500 HIV-infected children are followed in France. Antiretroviral therapy (ART) has greatly improved the survival of these children, whose long-term clinical outcomes are encouraging in high-resources countries. However, paediatricians continue to face difficulties for these children: missed opportunities for early HIV testing (especially in immigrant children born in Sub-Saharan African countries), high rates of virological failure in ART-experienced children, lack of studies evaluating the long-term toxicity of ART in perinatally-HIV-infected patients. Future challenges will imply to study to what extent very early ART in infants may alter the establishment of HIV infection and improve the long-term immunological and virological outcome of these children.
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Affiliation(s)
- Pierre Frange
- Unité d'immunologie, hématologie et rhumatologie pédiatriques, Assistance publique-hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France - EA 3620, université Paris Descartes, Sorbonne Paris Cité, Paris, France - Laboratoire de microbiologie, Assistance publique-hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France
| | - Stéphane Blanche
- Unité d'immunologie, hématologie et rhumatologie pédiatriques, Assistance publique-hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France - EA 3620, université Paris Descartes, Sorbonne Paris Cité, Paris, France - Institut IMAGINE, université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marie-Laure Chaix
- EA 3620, université Paris Descartes, Sorbonne Paris Cité, Paris, France - Laboratoire de microbiologie, Assistance publique-hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France
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Iannello A, Allam O, Samarani S, Ahmad A. [Interleukin-21: a key cytokine for controlling HIV and other chronic viral infections]. Med Sci (Paris) 2012; 28:605-11. [PMID: 22805136 DOI: 10.1051/medsci/2012286013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The differentiation, homeostatic proliferation and effector functions of different immune cells are controlled, to a large extent, by cytokines. Viruses often cause immune response dysfunctions by causing defects in the cytokine networks. The defects are often manifested by altered cytokine secretion and/or responsiveness to the cytokine. Among these cytokines, Interleukin-21 (IL-21) is a relatively recently discovered cytokine, which is mainly produced by CD4(+) T cells in the body, and exerts multiple and pleiotropic effects on various immune cells. Recent studies have shown that the cytokine is indispensable for controlling chronic viral infections. This review summarizes current knowledges concerning the biological effects of this cytokine on different components of the immune system. We also discuss how it contributes toward mounting efficient antiviral immunity and controlling chronic viral infections, especially HIV-1. The IL-1 cytokine represents a novel therapeutic agent for virus-infected patients as well as an adjuvant in antiviral vaccination strategies.
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Affiliation(s)
- Alexandre Iannello
- Département de microbiologie et d'immunologie, Université de Montréal, Montréal, Québec H3T 1C5, Canada.
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