HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data)

BACKGROUND

Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use.

METHODS

We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not.

RESULTS

Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction).

CONCLUSIONS

Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.

Motion of Long Levitating Drops in Tubes in an Anti-Bretherton Configuration

In his seminal paper, Bretherton studied the motion of long bubbles in capillary tubes. Here, we unveil the negative configuration wherein a long liquid drop is stably transported in a capillary tube and surrounded by a flow-induced air cushion. These drops are formed when a liquid plug is pushed above a critical velocity sufficient to induce an inversion of the front meniscus with a radius of curvature smaller than the tube radius. The drop shape and lubricating air film thickness is reminiscent of Bretherton's calculation and can be inferred from an adapted analytical theory.

Acoustic Sensing of Forces Driving Fast Capillary Flows

The popping sound of a bursting soap bubble is acquired using microphone arrays and analyzed using spherical harmonics decomposition. Using the theoretical framework of aeroacoustics, we demonstrate that this acoustic emission originates mainly from the capillary stresses exerted by the liquid soap film on the air and that it quantitatively reflects the out-of-equilibrium evolution of the flowing liquid film. This constitutes the proof of concept that the acoustic signature of violent events of physical or biological origin could be used to measure the forces at play during these events.

Sustained virological response to Do hepatitis C DAA treatments in migrants and non-migrants groups

Background

Although the efficacy of direct acting antivirals (DAA) against hepatitis C (HCV) has been widely proven, data lack on their effectiveness in the most vulnerable groups. In France, despite universal health coverage, migrants cumulate vulnerabilities including delays in screening that may affect both access to care and treatment effectiveness. We tested whether DAA-treated migrants had sustained virological response (SVR) rates comparable to not-migrants.

Methods

We used data collected in chronic HCV-infected patients of the ANRS CO22 HEPATHER cohort, receiving a first treatment with DAA, with follow-up from 2012 until 2022. SVR was measured by PCR, 12 weeks after the end of treatment. The main covariate was a 4-category variable comparing migrants and non-migrants, with or without other vulnerability conditions (including drug use, unhealthy alcohol use, living in poverty, being a man who have sex with men). We used a Poisson regression model to assess the relationship between this covariate and SVR after adjustment for significant predictors and potential confounders.

Results

The analysis included 5,080 individuals, of which 17% classified as migrants with at least one vulnerability, 10% as migrants with no vulnerability, 39% as non-migrants with at least one vulnerability and 35% as non-migrants with no vulnerability. Median [IQR] age was 57 [51-65] years, 56% of individuals were men, and 96% had SVR. The multivariable analysis showed no significant difference between the 4-category covariate and SVR. In addition, we found that SVR rates increased steadily during follow-up.

Conclusions

This is the first analysis exploring differences in SVR rates among migrants and not-migrants. The lack of significant differences found despite the power of the study suggests that migrants respond to DAA treatment as well as any other group of HCV-infected patients. These data can help advocating better screening and access to treatment for HCV-infected migrants in France.

Key messages

No significant differences were observed between migrants and non-migrants in terms of effectiveness of DAA treatment. These findings can help improving access to HCV care for migrants.

Nonspherical armoured bubble vibration

In this paper, we study the dynamics of cylindrical armoured bubbles excited by mechanical vibrations. A step by step transition from cylindrical to spherical shape is reported as the intensity of the vibration is increased, leading to a reduction of the bubble surface and a dissemination of the excess particles. We demonstrate through energy balance that nonspherical armoured bubbles constitute a metastable state. The vibration instills the activation energy necessary for the bubble to return to its least energetic stable state: a spherical armoured bubble. At this point, particle desorption can only be achieved through higher amplitude of excitation required to overcome capillary retention forces. Nonspherical armoured bubbles open perspectives for tailored localized particle dissemination with limited excitation power.

Dynamics of liquid plugs in prewetted capillary tubes: from acceleration and rupture to deceleration and airway obstruction

The dynamics of individual liquid plugs pushed at a constant pressure head inside prewetted cylindrical capillary tubes is investigated experimentally and theoretically. It is shown that, depending on the thickness of the prewetting film and the magnitude of the pressure head, the plugs can either experience a continuous acceleration leading to a dramatic decrease of their size and eventually their rupture or conversely, a progressive deceleration associated with their growth and an exacerbation of the airway obstruction. These behaviors are quantitatively reproduced using a simple nonlinear model [Baudoin et al., Proc. Natl. Acad. Sci. U. S. A., 2013, 110, 859] adapted here for cylindrical channels. Furthermore, an analytical criterion for the transition between these two regimes is derived and successfully compared with extensive experimental data. The potential implications of this work for pulmonary obstructive diseases are discussed.

Dynamics of sessile and pendant drops excited by surface acoustic waves: Gravity effects and correlation between oscillatory and translational motions

When sessile droplets are excited by ultrasonic traveling surface acoustic waves (SAWs), they undergo complex dynamics with both oscillations and translational motion. While the nature of the Rayleigh-Lamb quadrupolar drop oscillations has been identified, their origin and their influence on the drop mobility remains unexplained. Indeed, the physics behind this peculiar dynamics is complex with nonlinearities involved both at the excitation level (acoustic streaming and radiation pressure) and in the droplet response (nonlinear oscillations and contact line dynamics). In this paper, we investigate the dynamics of sessile and pendant drops excited by SAWs. For pendant drops, so-far unreported dynamics are observed close to the drop detachment threshold with the suppression of the translational motion. Away from this threshold, the comparison between pendant and sessile drop dynamics allows us to identify the role played by gravity or, more generally, by an initial or dynamically induced stretching of the drop. In turn, we elucidate the origin of the resonance frequency shift, as well as the origin of the strong correlation between oscillatory and translational motion. We show that for sessile drops, the velocity is mainly determined by the amplitude of oscillation and that the saturation observed is due to the nonlinear dependence of the drop response frequency on the dynamically induced stretching.

Cell detachment and label-free cell sorting using modulated surface acoustic waves (SAWs) in droplet-based microfluidics

We present a droplet-based surface acoustic wave (SAW) system designed to viably detach biological cells from a surface and sort cell types based on differences in adhesion strength (adhesion contrast) without the need to label cells with molecular markers. The system uses modulated SAW to generate pulsatile flows in the droplets and efficiently detach the cells, thereby minimizing the SAW excitation power and exposure time. As a proof of principle, the system shows efficient sorting of HEK 293 from A7r5 cells based on adhesion contrast. Results are obtained in minutes with sorting purity and efficiency reaching 97% and 95%, respectively.

Sound, infrasound, and sonic boom absorption by atmospheric clouds

This study quantifies the influence of atmospheric clouds on propagation of sound and infrasound, based on an existing model [Gubaidulin and Nigmatulin, Int. J. Multiphase Flow 26, 207-228 (2000)]. Clouds are considered as a dilute and polydisperse suspension of liquid water droplets within a mixture of dry air and water vapor, both considered as perfect gases. The model is limited to low and medium altitude clouds, with a small ice content. Four physical mechanisms are taken into account: viscoinertial effects, heat transfer, water phase changes (evaporation and condensation), and vapor diffusion. Physical properties of atmospheric clouds (altitude, thickness, water content and droplet size distribution) are collected, along with values of the thermodynamical coefficients. Different types of clouds have been selected. Quantitative evaluation shows that, for low audible and infrasound frequencies, absorption within clouds is several orders of magnitude larger than classical absorption. The importance of phase changes and vapor diffusion is outlined. Finally, numerical simulations for nonlinear propagation of sonic booms indicate that, for thick clouds, attenuation can lead to a very large decay of the boom at the ground level.

Droplet displacements and oscillations induced by ultrasonic surface acoustic waves: a quantitative study

We present an experimental study of a droplet interacting with an ultrasonic surface acoustic wave. Depending on the amplitude of the wave, the drop can either experience an internal flow with its contact line pinned, or (at higher amplitude) move along the direction of the wave also with internal flow. Both situations come with oscillations of the drop free surface. The physical origins of the internal mixing flow as well as the drop displacement and surface waves are still not well understood. In order to give insights of the underlying physics involved in these phenomena, we carried out an experimental and numerical study. The results suggest that the surface deformation of the drop can be related to a combination between acoustic streaming effect and radiation pressure inside the drop.

Preliminary findings from the National Pre-ESRD Education Initiative

Regardless of age or race, more patients preferred peritoneal dialysis (PD) than would be expected from the current ratio of patients treated with PD in the U.S. The percent of patients choosing PD seems to be largely influenced by the scope of information they receive prior to therapy initiation. In the absence of thorough treatment option education, a significant number of patients may be assigned a therapy when, in reality, they would have selected an alternative option. There is a need to further understand the correlation between a practice's PD utilization rate and the extent to which patients are given dialysis treatment options.

Brain damage in the premature infant. Early lesions and new aspects of sequelae

In spite of a significant decrease of the mortality and morbidity of neonates, cerebral damage in the premature infant remains the major concern for the neonatologist. Intraventricular hemorrhage (IVH) and necrosis of the white matter (leukomalacia) are the two main lesions. Early morphological aspects have been known for many years, but the use of computerized tomography (CT scan) and ultrasonography (US) through the anterior fontanelle have led to renewed interest and the general recognition of IVH. Localization, extent and frequency of the lesions can readily be established. However the early diagnosis of leukomalacia is still uncertain. Long survival, with mechanical ventilation of severely ill infants, has made it possible to follow the natural history of the lesions and has modified the relative frequency of their occurrence. Posthemorrhagic hydrocephalus, sclerosis of the centrum semiovale and multicystic encephalopathy are now commonly found at autopsy of infants who have survived for several weeks.