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Background & Aims: HBV coinfection is common among people living with HIV (PLWH) and is the most important cause of hepatocellular carcinoma (HCC). While risk prediction tools for HCC have been validated in patients with HBV monoinfection, they have not been evaluated in PLWH. Thus, we performed an external validation of PAGE-B in people with HIV/HBV coinfection.Methods: We included data on PLWH from four European cohorts who were positive for HBsAg and did not have HCC before starting tenofovir. We estimated the predictive performance of PAGE-B for HCC occurrence over 15 years in patients receiving tenofovir-containing antiretroviral therapy. Model discrimination was assessed after multiple imputation using Cox regression with the prognostic index as a covariate, and by calculating Harrell's c-index. Calibration was assessed by comparing our cumulative incidence with the PAGE-B derivation study using Kaplan-Meier curves.Results: In total, 2,963 individuals with HIV/HBV coinfection on tenofovir-containing antiretroviral therapy were included. PAGE-B was Conclusions: For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. Impact and implications: Chronic HBV infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV. Valid risk prediction may enable better targeting of HCC screening efforts to high-risk individuals. We aimed to validate PAGE-B, a risk prediction tool that is based on age, sex, and platelets, in 2,963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of

This review covers recent progress and advancements in bio‐templating nanomaterials for use in energy applications. Viruses, bacteria, and fungus, as well as plant and animal biomasses such as woods, coffee grounds, and crab shells, can be used as the templates or carbon sources for metal‐ and carbon‐based nanomaterials. Here we provide an overview of each of these materials as a template, with emphasis on the synthesis methods and qualities of nanomaterials fabricated using these templates. Research in this field is understandably diverse, as such, we aim to further its development by providing a timely summary of current research. We anticipate that this field will continue to prove highly applicable to the salient and growing topics of renewable energy.

Lithium phosphorus oxynitride (LiPON) has paved the way for thin film solid-state battery technology development and has shown application in a large range of fields since its first reported synthe...

Transition metal sulfides as electrode materials for lithium-ion batteries have attracted significant research attention due to their high theoretical capacity, excellent redox reversibility, and earth abundance. However, this material family still suffers from poor conductivity and experiences huge volume changes. Here, we demonstrate a facile and scalable electrospinning method to prepare Ni3S2 and Co9S8 nanoparticles embedded in sulfur doped carbon nanofiber networks as a free-standing anode material for lithium ion batteries. Similar to literature findings, the coupling of two different metal sulfides indeed synergistically promoted the electrochemical performance. Embedding them within individual carbon nanofibers not only enhances the intrinsic conductivity, but also provides a highly stable structure, which results in excellent battery performance. Furthermore, the individual carbon nanofibers intertwine with each other to form a free-standing 3D nanofiber network which acts as a freeway network for fast electron transfer and the pores between fibers allow easy penetration of the electrolyte, namely easy lithium ion access to active nanoparticles. When directly applied as the anode in lithium ion batteries, the free-standing nanofiber mat bypassed all slurry making steps and showed excellent cycling stability with a high specific capacity of 528 mA h g−1 after 200 cycles at a current density of 300 mA g−1. Good rate capability was also obtained. Additionally, the charge storage process analysis indicated that the pseudocapacitive behavior of the material is attributed to its good performance. This work introduces a facile strategy to simultaneously and in situ generate Co9S8 and Ni3S2 nanoparticles within a S-doped carbon fiber matrix via facile electrospinning followed by a one-step heating procedure. It is demonstrated that the free-standing transition bimetallic sulfide nanofibers prepared are very promising for light and small battery applications.

A growing literature shows an improvement of chronic hepatitis C virus (HCV)-related depression after successful treatment with direct-acting antivirals. However, depression after HCV cure remains insufficiently documented in people living with HIV (PLWH) and HCV, a population with specific mental health challenges. This study aimed to (i) document the prevalence of moderate-to-severe depression (PHQ-9 score ≥10) across different age classes in HCV-cured PLWH; (ii) identify associated socio-behavioral correlates.Descriptive analyses were performed on data collected during a cross-sectional survey (February 2018 - May 2019) nested in a prospective, multicenter cohort of individuals living with HIV and HCV (ANRS CO13 HEPAVIH). Socio-behavioral correlates of moderate-to-severe depression were identified using logistic regression.Among the 398 HCV-cured individuals in the study sample (median age [IQR]: 56 [53-59] years; 73.1% men), 23.9% presented with moderate-to-severe depression (PHQ-9 score ≥10). Depressive symptom prevalence rates were as follows: anhedonia: 52.3%; feeling 'down' or feelings of hopelessness: 48.3%; sleeping problems: 65.7%; lack of energy: 70.3%; eating disorders: 51.2%; lack of self-esteem: 34.3%; difficulty concentrating: 34.9%; sluggishness (in movement and voice) or restlessness: 24.6%; suicidal ideation: 17.1%. No significant difference was detected across age classes. Female sex, unhealthy alcohol use, sedentary lifestyle, and unhealthy eating behaviors were associated with increased odds of moderate-to-severe depression.Depressive symptoms were common in this sample of HCV-cured PLWH. Unlike findings for the French general population, the prevalence of depression did not decrease with age class. Mental health remains a key issue for HIV-HCV-coinfected individuals, even after HCV cure, especially in women and in individuals with unhealthy behaviors.Despite potential improvements in mental health after successful treatment with direct-acting antivirals, many people living with HIV (PLWH) and hepatitis C virus (HCV) - even in older age classes - still face depressive symptoms after HCV cure. In this population, women and people reporting unhealthy alcohol use, sedentary lifestyle, or unhealthy eating behaviors are more prone to report depressive symptoms after HCV cure. Mental health and lifestyle-related issues should be integrated in a global care model for PLWH living with or having a history of hepatitis C.

Finding optimal survival strategies of living systems embedded in fluctuating environments generally involves a balance between phenotypic diversification and sensing. If we neglect sensing mechanisms, it is known that slow, resp. fast, environmental transitions favor a regime of heterogeneous, resp. homogeneous, phenotypic response.We focus here on the simplest non-trivial case, i.e. two randomly switching phenotypes subjected to two stochastically switching environments. The optimal asymptotic (long term) growth rate of this model was studied elsewhere; we further expand these results by discussing finite time growth rate fluctuations. An exact asymptotic expression for the variance, alongside with approximations valid in different regimes, are tested numerically in details. Our simulations of the dynamics suggest a close connection between this variance and the extinction probability, understood as risk for the population. Motivated by an earlier trade-off analysis between average capital growth rate and risk in Kelly’s gambling model, we study the trade-off between the average growth rate and the variance in the present model. Despite considerable differences between the two models, we find similar optimal trade-off curves (Pareto fronts), suggesting that our conclusions are robust, and broadly applicable in various fields ranging from biology/ecology to economics.

International audience; No abstract available

During the past two decades, metal-organic frameworks (MOFs) have received significant interest because these materials possess beautiful structural motifs and unique applications. Light-emitting MOFs sensors are favorable because these materials have large surface area and excellent framework stability, which can differentiate analytical objects for applications toward environmental protection, homeland security and human health. In this work, under the powerful solvo-thermal conditions, a bi-functional ligand with large conjugated biphenyl aromatic backbones has been used to prepare the unique ultra-stable three-dimensional(3D) luminescent zinc(II) coordination compound {[Zn2(μ5-L)(μ3-OH)(H2O)2]·(0.75DMAC)}n (1) (DMAC = Dimethylacetamide). In 1, these penta-coordinated L3− ligands and the bridging ligand μ3-OH link together with these neighboring zinc(II) centers, which ultimately constructs the 3D nano-porous coordination material of 1. 1D rhombic channel with a corresponding edge distance of 12.167(6) A × 10.912(1) A can be found between central metal(II) vertices along the crystallographic b axis. The calculation using the PLATON program shows the total solvent area is 581.7 A3, which occupies 25.2% of the unit cell's volume (2306.9 A3). Powder X-ray diffraction (PXRD) pattern has been performed confirming the purity of these bulky samples 1. It is worth noting that 1 shows excellent chemical stability, which can maintain structural integrity not only in various solvents but also aqueous environments with pH varying from 2 to 12. Photo-luminescent measurements show that 1 can perform highly sensitive and real-time chemical sensing of nicotinamide with good reusability, high Ksv quenching efficiency (2.24 × 104 M−1) and low detection limit values (0.14 μM). Meanwhile 1 also shows visual photo-luminescent detection of tetraphenylboron (BPh4-, Ph = phenyl) anion in aqueous solutions with high Ksv quenching efficiency (1.16 × 105 M−1) and low detection limit values (0.028 μM). To the best of our knowledge, 1 presents the first example of an ultra-stable 3D zinc(II) nano-porous metal organic material as the bi-functional re-generable luminescent probe for nicotinamide and tetraphenylboron.

In recent years, self-cleaning and transparent surfaces have been widely studied for application on smart windows, solar panels, camera lenses, and other optoelectronic devices. The self-cleaning properties can possibly extend the lifetime of these products and decrease, even eliminate, the requirement of chemical detergents and high labor costs of cleaning. It can also promote the overall efficiency of outdoor optoelectronic devices (e. g. solar cell panels) since dirt accumulation and bacteria growth can be slowed down, even inhibited on such surfaces. In this mini review, the fundamentals and conditions that govern superhydrophobicity and transparency are introduced, followed by the discussion of roughness as the competing factor for superhydrophobicity and transparency. Representative examples of the surface design and fabrication are introduced and future perspectives are shared. This mini review can help the research community better understand such surfaces and further accelerate its development for innovative practical applications.

Currently, the highly sensitive detection of Alzheimer's Disease (AD) biomarkers, namely presenilin 1, amyloid β-protein (Aβ), and acetylcholine (ACh), is vital to helping us prevent and diagnose AD. In this work, a novel metal-organic framework [Er(L)(DMF)1.27]n (Er-MOF) (H3L = terphenyl-3,4'',5-tricarboxylic acid) has been synthesized by solvothermal and ultrasonic methods. Further, through the post-synthesis assembly strategy, the fluorescent dye thioflavine T (ThT) has been introduced into Er-MOF to construct a dual-emission ThT@Er-MOF ratiometric fluorescent sensor. This is the first time that ThT@Er-MOF has been successfully applied in the highly sensitive detection of three main Alzheimer's disease biomarkers in the cerebrospinal fluid through three different low cost and facile detection strategies. Firstly, with the spilted DNA strategy, this is the first time that ThT@Er-MOF can be applied in the label-free detection of SSODN (part of the presenilin 1 gene). Secondly, for the detection of Aβ, because ThT can be specifically combined with Aβ and has an excellent characteristic fluorescence band, the dual-emission ThT@Er-MOF sensor can be selectively applied to detect Aβ over the analog protein, which shows far more sensitivity than other Aβ sensors. Thirdly, through the acetylcholine esterase (AchE) enzymatic cleavage and release strategy, ThT@Er-MOF enhances the detection of acetylcholine (ACh) with a low limit of detection (LOD) value (0.03226 nM). It should be noticed that the three different detection methods are low cost and facile. This study also provides the first example of utilizing laser scanning confocal microscopy (LSCM) to investigate the fluorescence resonance energy transfer (FRET) detection mechanism by ThT@Er-MOF in more detail. The location of FRET occurrence and FRET efficiency can also be investigated by LSCM, which can be helpful to understand the FRET detection process by these unique MOF-based hybrid materials.

International audience; No abstract available

Solid state electrolytes are very promising to enhance the safety of lithium ion batteries. Two classes of solid electrolytes, polymer and ceramic, can be combined to yeild a hybrid electrolyte that can syngergistically combine the properties of both materials. Chemical stability, thermal stability, and high mechanical moduli of ceramaic electrolytes against dendrite penetration can be combined with the flexibility and ease of processing of polymer electrolytes. By laminating a polymer electrolyte with a ceramic electrolyte, the stability of the solid electrolyte is expected to improve against lithium metal, and the ionic conductivity could remain close to the value of the original polymer electrolyte as long as an appropriate thickness of the ceramic eletrolyte is applied. Here we report a bilayered lithium-ion conducting hybrid solid electrolyte consisting of a blended polymer electrolyte (BPE) laminated with a thin layer of the inorganic solid electrolyte lithium phosphorous oxynitride (LiPON). The hybrid system was thoroughly studied. First, we investigated the influence of polymer chain length and lithium salt ratio on the ionic conductivity of the BPE based on poly(ethylene oxide) (PEO) and poly(propylene carbonate) (PPC) with the salt lithium bis(trifluoromethanesulfonyl)imide (LiTFSI). The optimized BPE consisted of 100k molecular weight PEO, 50k molecular weight PPC, and 25(w/w) % LiTFSI, (denoted as PEO100PPC50LiTFSI25) which exhibited an ionic conductivity of 2.11x10-5 S/cm, and the ionic conductivity showed no thermal memory effects as the PEO crystallites were well distrupted by PPC and LiTFSI. Secondly, the effects of LiPON coating on the BPE were evaluated as a function of thickness down to 20 nm. The resulting bilayer structure showed an increase in the voltage window from 5.2 to 5.5V (vs Li/Li+) and thermal activation energies that approached the activation energy of the BPE when thinner LiPON layers were used, resulting in similar ionic conductivities for 30nm LiPON coatings on PEO100PPC50LiTFSI25. Coating BPEs with a thin layer of LiPON is shown to be an effective strategy to improve the long-term stability against lithium.

Solid-state electrolytes play an important role in the development of new generations of technology including lithium metal batteries. Lithium conducting solid materials offer a solution to the safety issues that are present in lithium-ion batteries (LIBs). Conventional LIBs typically use highly flammable organic solvents as a transport medium for lithium ions, potential risks that arise due to these solvents include fire, volatilization, and explosions. Solid polymer electrolytes (SPEs) are great as electrolyte material because fabrication of the electrolyte films is cheap, and processing is simple. However, SPEs can have stability issues when in contact with lithium metal for extended periods which is a problem for cells required to offer long lifetimes. Poly (ethylene oxide) (PEO) has been extensively studied since the conception of SPEs, due to its ability to solvate ions due to its polar ether groups. However, PEO, being a semi-crystalline polymer, exhibits thermal history effects due to recrystallization behavior. Amorphous SPEs are highly desirable because there are no recrystallization kinetics at play, and the properties are consistent regardless of the thermal history. Poly(propylene carbonate) (PPC), an amorphous, biodegradable polymer, can offer high ionic conductivities. Blending PEO and PPC offers a solution to resolve the thermal history effects of PEO by interfering with the crystalline structures in blended electrolyte systems with the salt lithium bis(trifluoromethanesulfonyl)imide (LiTFSI). Inorganic solid electrolytes (ISEs) can offer better chemical stability and excellent mechanical properties compared to SPEs; however, brittleness may decrease the structural stability over time. Thin films ISE’s also tend to cost much more than SPEs due to the fabrication methods required such as electron beam evaporation, and chemical vapor deposition. Lithium phosphorous oxynitride (LiPON), produced through RF magnetron sputtering, was developed in the 1990s at Oakridge National Laboratories and offers great electrochemical stability against lithium and relatively high ionic conductivities on the order of 10-6 S/cm at room temperature. A new bilayer lithium-ion conducting hybrid solid electrolyte (HSE) consisting of a blended polymer electrolyte (BPE) coated with a thin layer of the ISE LiPON, has been prepared. PEO and PPC are blended in a 1:1 mass ratio, then the salt LiTFSI is incorporated. BPE films are then produced through a facile solution casting method using acetonitrile as the solvent. Structure-property relationships are then systematically evaluated to understand the effects of molecular weight and mass loading of LiTFSI on the BPE systems. Influences of molecular weight and salt loading on crystallinity is observed though X-ray diffraction and optical microscopy of the BPE films. Ionic conductivity is evaluated through impedance spectroscopy between two stainless steel blocking electrodes, thermal history measurements were taken by heating and cooling the SPE while recording EIS at specified temperatures. The best BPE based on ionic conductivity, consists of 100k molecular weight PEO, 50k molecular weight PPC, and 25(w/w)% LiTFSI, (denoted as PEO100PPC50LiTFSI25) and exhibits an ionic conductivity of ~2x10-5S/cm. Temperature dependent EIS shows that the lowest molecular weight polymers offer lower activation energies as a result of the higher degree of free volume and molecular motion of the polymer chain. The optimized BPE system is then coated with various thicknesses of LiPON. The effects of LiPON coating are evaluated and show promise for the development of lithium stable solid electrolytes. Linear sweep voltammetry (LSV) is used to assess the anodic voltage stability against lithium metal. Incorporating very thin layers of LiPON down to 20nm on the BPE shows an increase in the voltage window of the electrolyte system from 5.2 to 5.5V (vs Li/Li+). However, the incorporation of LiPON decreases the ionic conductivity of the BPE. Thinner layers of LiPON show the ionic conductivity approaches that of the BPE, with thicker LiPON layers offering lower ionic conductivies. To assess the stability against lithium metal over time, impedance spectroscopy is used. Cells consisting of the solid electrolyte against lithium metal are prepared, and impedance measurements are taken over a 20-day period to assess the changes in charge transfer resistance. From these measurements, it has been shown that only a 30nm thin layer of LiPON is required to improve the stability of the resulting HSE. Therefore, coating BPEs with a thin layer of LiPON is shown to be an effective strategy to improve the long-term stability of solid-state lithium ion conductors.

The interactions of water with synthesized mesoporous ceria nanoparticles are studied as a function of temperature at two water vapor partial pressures, using in situ Diffuse Reflectance Fourier Transform Infrared Spectroscopy (DRIFTS). The Variable Temperature (VT)-DRIFTS spectra of mesoporous ceria nanoparticles exhibit six hydroxyl (OH) stretching bands, suggesting both molecular and dissociation of water coexist on mesoporous ceria surfaces and involve hydrogen-bonds. The vibration frequency of individual OH mode is repeatable and the adsorption of water is reversible on various sites between four annealing and water exposure cycles lasting for 60 h, suggesting that the same types of active sites are available on mesoporous ceria surface for water adsorption, with less than 10% of reduction in the numbers of adsorption sites. The results, from this study of reactivity of water on ordered mesoporous ceria nanoparticles under operando conditions, assist in processes benefiting from the hydroxylated surface for improved reaction outcomes, and rational design of mesoporous materials for their application in photocatalysis and heterogeneous catalysis.

This paper presents a photovoltaic (PV) lab with the following key characteristics: (i) it is remote controllable, (ii) it is designed for outdoor use and (iii) it is a low cost solution. In fact, incorporating Internet and remote labs into the practical work setting makes student learning experiences more dynamic, interactive, and interesting. In addition, as the experimentation system operates under real weather conditions, students can move from theory to practice and become capable of assessing the real PV performances, comparing them to those supplied by the manufacturer and evaluating a panel’s performance under real environmental conditions. Finally the low cost solution makes the series of very valuable PV-experiments that are presented in this paper everywhere easily available.

Excess and deficiency of iron(III) and antibiotics from normal permissible limits will induce serious disorders, so their detection is important but challenging. In this work, the asymmetric amino-functionalized tetra-carboxylate H4L (2′-amino-1,1’:4′,1″-terphenyl-3,3″,5,5″-tetracarboxylic acid) containing large conjugated ter-phenyl aromatic backbones have been synthesized and employed. Through a one-pot powerful solvo-thermal synthetic strategy, a series of unique tri-nuclear cluster-based CaII, MgII and CdII coordination polymers, namely [Ca1.5(μ8-HL)(DMF)]n (1), {[Mg1.5(μ7-HL)·(H2O)2]·3H2O}n (2) and {[Cd1.5(μ10-L)0.75]n·H2O·DMF}n (3) have been successfully prepared. 1–3 exhibit excellent photo-luminescent properties and good fluorescence stability. Structural analyses reveal that tri-nuclear CaII secondary building blocks (SBUS) are linked via HL3−, forming the 2D clustered-based micro-porous coordination polymer 1. As for 2, three carboxylate groups of partly de-pronated HL3− also link these neighboring tri-nuclear MgII SBUS, which constructs the 2D MgII coordination framework 2. As for 3, fully de-pronated L4− also links these neighboring tri-nuclear CdII SBUS, which ultimately constructs the 3D micro-porous coordination framework 3. Experimental powder x-ray diffraction (PXRD) patterns coincide well with the theoretical patterns, which indicate that we have successfully synthesized the pure phase material 1–3. Photo-luminescent experiments demonstrate that coordination polymers 1–3 can be successfully applied towards bi-functional sensing for sensitive detection of Fe3+ and the antibiotics NZF (Nitrofurazone). To the best of our knowledge, this is the first example of the application of amino-functionalized tri-phenyl tetra-carboxylate based MOFs towards bi-functional discrimination of Fe3+ and NZF antibiotics with high efficiency Ksv values (For Fe3+: 7.28 × 104 M−1 for 1; 3.38 × 104 M−1 for 2 and 3.29 × 104 M−1 for 3 and for NZF antibiotics: 4.47 × 103 M−1 for 1; 4 × 103 M−1 for 2 and 5.6 × 103 M−1 for 3).

Lithium ion batteries (LIBs) have been the dominant energy storage technology for a wide range of applications including portable electronic, electrical vehicles, and grid-scale energy storage. Recently with safety and performance in mind, TiNb2O7 (TNO) has been studied as a promising anode material. It offers a theoretical capacity of 387.6 mA h g-1, which is comparable to that of graphite (372 mA h g-1) and two times that of Li4Ti5O12 (175 mA h g-1). TNO also exhibits an operational voltage larger than 1.0 V (vs Li+/Li0), which helps to avoid formation of dendritic lithium and ensure safe operation. TNO with various morphology and size has been studied intensely since its discovery by Goodenough et. al. in 2011 including mesoporous microspheres, solid or porous nanoparticles, and solid or hollow 1D fibers. However, no comprehensive study which studies the structure-property-aspect of TNO has been completed. Here, we are trying to prepare TNO with various morphology, size, and porosity as well as to study the correlation of TNO properties with electrochemical performance. Electrospinning technology is used to synthesize target materials, which are formulated from using poly(lactic acid) as a carrier polymer in various solvents (dimethylformamide, acetone, and dichloromethane) and adding titanium and niobium precursors. Parameters that affect the morphology of spun fibers are concentration, flow rate, applied voltage, collector plate distance, viscosity, and surface tension. Those parameters, especially solution chemistry, are carefully tuned to control the resulting fiber morphology and other properties. For example, solid, hollow, and porous (surface porous, inner porous, or highly porous) TNO fibers can be obtained by careful solvent selection as solvents have been proven to strongly affect evaporation and phase separation processes. All prepared TNO are further tested as anode materials in lithium ion battery and the property-performance correlation is carefully analyzed.

Lithium ion batteries are promising as energy storage devices because of their high energy density; however, current technology for lithium ion batteries is not safe for large scale applications and general use. Traditional lithium ion batteries utilize an organic liquid electrolyte to transport lithium ions between electrodes. Organic liquids used in lithium ion batteries, such as diethyl carbonate, are highly flammable and volatile. Safety becomes an issue when the battery heats from charging, discharging, or if the battery shorts circuits due to dendrite formation in the cell; when this happens, the battery can potentially ignite. For this project, the research focus is developing novel solid polymer electrolytes for lithium ion batteries. Polypropylene carbonate (PPC), a copolymer of propylene oxide and carbon dioxide, has emerged as a promising candidate for solid polymer electrolytes (SPE) because of its good chemical stability, ionic conductivity, low flammability, as well as environmental friendliness. A versatile air-controlled electrospray technique is used to directly deposit PPC based electrolyte on cathodes with a selected range of thickness. Directing casting electrolyte films on electrode can greatly enhance the interface contact and lower ion transfer resistance. The composition of the SPE can be simply controlled by tuning the polymer solution. The thickness can be controlled by either the deposition time or flow rate. Several tests are to be performed to characterize the electrolyte material as well as battery performance. These tests include cyclic voltammetry, Fourier Transform Infrared Spectroscopy, AC Impedance Spectroscopy, and Scanning Electron Microscopy. The impact of solid electrolyte film on lithium dendrite formation are also monitored and analyzed.

EASL International Liver Congress, Barcelona, SPAIN, APR 13-17, 2016; International audience

An ultrahigh-resolution colocalization method based on the simultaneous acquisition and analysis of spectrally separated images of the excitation point-spread function of point-like fluorescent probes is reviewed. It is shown that molecular distances can be measured with accuracy better than 10 nm using conventional far-field optics. A detailed account of the methodology, theoretical considerations, signal processing, and data fitting algorithms is given.

We assessed the prognostic role of plasma levels of beta2-microglobulin, TNF-alpha, sTNFR-II, and IFN-gamma on the progression to AIDS in patients mostly treated with combination antiretroviral therapies. HIV-1-infected patients with advanced HIV disease (baseline CD4+ cell count between 50 and 250 x 10(6)/L) were included in a prospective cohort followed up for 36 months. In the 113 patients included, 22 first AIDS-defining events were reported. Cumulative probability of AIDS was 12% at M12, 18% at M24, and 20% at M36. Using a Cox model, the baseline level of sTNFR-II (hazard ratio of 3.75 for sTNFR-IIor =10 ng/ml vs10 ng/ml, P = 0.01) was associated with progression to AIDS. sTNFR-II remained a prognostic factor before and after the introduction of combinations of antiretrovirals. Whether or not this marker is of value in patients exclusively treated with highly active antiretroviral therapy needs to be assessed in specific studies.

We present single-pair fluorescence resonance energy transfer (spFRET) observations of individual opening and closing events of surface-immobilized DNA hairpins. Two glass-surface immobilization strategies employing the biotin-streptavidin interaction and a third covalent immobilization strategy involving formation of a disulfide bond to a thiol-derivatized glass surface are described and evaluated. Results from image and time-trace data from surface-immobilized molecules are compared with those from freely diffusing molecules, which are unperturbed by surface interactions. Using a simple two-state model to analyze the open and closed time distributions for immobilized hairpins, we calculate the lifetimes of the two states. For hairpins with a loop size of 40 adenosines and a stem size of either seven or nine bases, the respective closed-state lifetimes are 45 +/- 2.4 and 103 +/- 6.0 ms, while the respective open-state lifetimes are 133 +/- 5.5 and 142 +/- 22 ms. These results show that the open state of the hairpin is favored over the closed state of the hairpin under these conditions, consistent with previous diffusion fluorescence correlation spectroscopy (FCS) experiments on poly(A)-loop hairpins. The measured open-state lifetime is about 30 times longer than the calculated 3 ms open-state lifetime for both hairpins based on a closing rate scaling factor derived from a previous FCS study for hairpins in diffusion with 12-30 thymidines in their loops. As predicted, the closed-state lifetime is dependent on the stem length and is independent of the loop characteristics. Our findings indicate that current models should consider sequence dependence in calculating ssDNA thermostability. The surface immobilization chemistries and other experimental techniques described here should prove useful for studies of single-molecule populations and dynamics.

After initiation of a treatment for human immunodeficiency virus type 1 infection containing a protease inhibitor, immune restoration associated with increases in CD4-positive (CD4+) T lymphocyte count may be delayed. In a sample of patients who had been prescribed protease inhibitors for the first time, the authors tested to see whether there was a minimal duration of CD4+ cell count increase before the increase had an impact on the occurrence of opportunistic infections. The evolution (difference between time t and baseline) of CD4+ cell count was modeled using a mixed effects linear model. Changes in CD4+ count estimated by this model were then included as time-dependent covariates in a proportional hazards model. Finally, the authors tested for the existence of a CD4+ change x time interaction. The authors used a sample of 553 French patients first prescribed protease inhibitors in 1996 and followed for a median of 16 months. During the first 120 days, there was no association between CD4+ change and the rate of opportunistic infections. After 120 days, each 50-cell/mm3 increase in CD4+ count was associated with a 60% (95% confidence interval: 45, 72) reduction in the incidence of opportunistic infections. These results, based on modeling of CD4+ cell response, at least indirectly reinforce the concept of a delayed but possible immune recovery with the use of protease inhibitors. The findings support the potential for interruption of certain types of prophylaxis against opportunistic infections under reasonable conditions of duration of antiretroviral therapy and sustained CD4+ cell response.

In order to determine prognostic factors associated with treatment failure (TF) in advanced HIV-infected patients treated with a regimen including indinavir, a prospective cohort study of 80 patients was set up between 1 March and 31 December 1996. TF time was calculated using the Kaplan–Meier method, from treatment induction to the first of the following events: treatment modification for adverse event or lack of significant virological and/or immunological response, AIDS-defining diagnosis or death. Date of point was 31 December 1998. Multivariate analysis was performed using a Cox model. At baseline, 60% of the patients were AIDS-free, median viral load and CD4+ count were respectively 4.8 log/ml and 79/μl. After a median follow-up of 26 months, 70% of the patients experienced a TF in a median time of 8 months. Seventy-two per cent presented an hyperbilirubinaemia (>2 mg/dl). In multivariate analysis, initial AIDS stage (hazard ratios [HR]=1.94, P=0.04) and digestive intolerance (HR=2.32, P=0.003) were predictive of TF. Conversely, hyperbilirubinaemia was associated with a better outcome (HR=0.35, P

An optical ruler based on ultrahigh-resolution colocalization of single fluorescent probes is described in this paper. It relies on the use of two unique families of fluorophores, namely energy-transfer fluorescent beads (TransFluoSpheres) and semiconductor nanocrystal quantum dots, that can be excited by a single laser wavelength but emit at different wavelengths. A multicolor sample-scanning confocal microscope was constructed that allows one to image each fluorescent light emitter, free of chromatic aberrations, by scanning the sample with nanometer scale steps with a piezo-scanner. The resulting spots are accurately localized by fitting them to the known shape of the excitation point-spread function of the microscope. We present results of two-dimensional colocalization of TransFluoSpheres (40 nm in diameter) and of nanocrystals (3–10 nm in diameter) and demonstrate distance-measurement accuracy of better than 10 nm using conventional far-field optics. This ruler bridges the gap between fluorescence resonance energy transfer, near- and far-field imaging, spanning a range of a few nanometers to tens of micrometers.

This is an evaluation of professional practices (EPP) on antibiotic therapy in an internal medicine ward.A 6-month prospective review of antibiotic prescriptions and their comparisons with local and national guidelines (drug, daily dose, administration, and duration) were performed.Antibiotic therapy on 227 infectious episodes was collected. According to local guidelines, we found 56% of totally respected (lower respiratory tract infections: 38%, urinary tract infections: 88% and skin infections: 73%), 33% of partially respected and 11% of non-appropriate prescriptions. Considering national guidelines for lower respiratory tract infections as references, the results were: totally respected prescriptions 81%, partially respected prescriptions 16%, and non-appropriate prescriptions 3%.This evaluation of the prescriptions allowed setting up long-lasting actions to improve clinical practice. This approach anticipates the procedures of EPP that will be needed for hospital accreditation and highlights the importance of considering several guidelines for the interpretation of the results.

For many biotechnological applications it would be useful to better understand the effects produced by electric fields on lipid membranes. This review discusses several aspects of the electrostatic properties of a planar lipid membrane with its surrounding electrolyte in a normal DC or AC electric field. In the planar geometry, the analysis of electrokinetic equations can be carried out quite far, allowing to characterize analytically the steady state and the dynamics of the charge accumulation in the Debye layers, which results from the application of the electric field. For a conductive membrane in an applied DC electric field, we characterize the corrections to the elastic moduli, the appearance of a membrane undulation instability and the associated flows which are built up near the membrane. For a membrane in an applied AC electric field, we analytically derive the impedance from the underlying electrokinetic equations. We discuss different relevant effects due to the membrane conductivity or due to the bulk diffusion coefficients of the ions. Of particular interest is the case where the membrane has selective conductivity for only one type of ion. These results, and future extensions thereof, should be useful for the interpretation of impedance spectroscopy data used to characterize, for example, ion channels embedded in planar bilayers.

Resume Les auteurs rapportent 2 cas de paralysie faciale peripherique chez des sujets presentant une infection a VIH. A propos de ces 2 observations et de celles de la litterature, sont rappeles les caracteres cliniques et paracliniques de cette atteinte du VII. Les differentes hypotheses etiologiques sont discutees mais il est probable qu'il s'agisse en fait d'une atteinte directe du nerf par le virus. Ces paralysies faciales peuvent survenir quelque soit le chiffre des lymphocytes CD4 et ne semblent pas avoir de signification pronostique. Elles apparaissent cependant preferentiellement aux stades I, II et III, pouvant alors etre le mode de revelation de l'infection par le VIH.

A Nanosecond Repetitively Pulsed Plasma (NRPP) generator capable of delivering an electric pulse of 10 kV during 10 ns at a frequency of up to 30 kHz has been used to stabilize and improve the efficiency of a 25 kW lean premixed propane/air flame at atmospheric pressure. We had previously shown that, when placed in the recirculation zone of the flame, the plasma significantly increases the heat release and the combustion efficiency, thus allowing to stabilize the flame under lean conditions where it would not exist without plasma. In the present work we study the influence of the discharge’s repetition rate on the operating regimes of the burner and on both thermal and chemical effects. We present temperature and electron number density measurements based on the Stark-broadening effect of the Hβ Balmer line in the region where the discharge is created.

Portal vein thrombosis (PVT) seems rare among HIV infected patients. Even though, the report of such cases is of great interest because it may help to determine the factors of occurrence. We describe cases of PVT in 4 HIV-infected men, aged 32 - 64. Two of them were co-infected with hepatitis C virus (HCV). The four patients had a history of disseminated mycobacterial infection (one case of tuberculosis, 3 cases of mycobacterium avium complex infection) with abdominal lymphadenitis. Despite HAART, their immunodeficiency was profound (CD4: 65 to 216/mm(3)). At the time of diagnosis, two patients were treated with protease-inhibitor containing regimen: indinavir (one case), ritonavir-saquinavir (one case). PVT was revealed by haematemesis (one case), abdominal pain (ome case), anasarca (2 cases). In three patients, the diagnosis of PVT was confirmed by imagery (echo-doppler or angio- RMI), and for the last patient, PVT was found during the transjugular intrahepatic portosystemic shunt setup. A low level of C protein was diagnosed in one case. Cirrhosis was not found in HIV-HCV co-infected patients. Two patients died early after diagnosis, one patient died 3 years after the onset of symptoms. Various factors may cause the development of a PVT in HIV infected patient. Serious immunodeficiency, opportunistic infections such as tuberculosis and mycobacterium avium complex related infection with abdominal lymphadenitis can further the development of PVT. Protease-inhibitor might have facilitated the process. Due to the severe prognosis of advanced cases, early evocation of diagnosis is needed.

To describe efficacy and safety in clinical practice of pegylated interferon plus ribavirin (INFpeg-Riba) in the treatment of hepatitis C viral infection (HCV) in HIV infected patients.Monocentric retrospective study with inclusion of all patients who received at least once INFpeg-Riba before April 1st 2003. All patients were followed up to six months after the end of HCV therapy.Thirty two HIV-positive patients (23 men and 9 women) with chronic hepatitis C treated by INFpeg-Riba were included. The mean age was 43 years. Fourteen patients carried HCV genotype 2 or 3 (43 %) and 18 patients carried genotype 1 or 4 (57%). The Metavir score of fibrosis showed fibrosis F1 (N =3), F2 (N =14), F3 (N =7) and F4 - cirrhosis (N =8). Twenty six patients (81%) were naive for anti hepatitis C drugs. Thirty one per cent of patients were at AIDS stage and 84% were receiving antiretroviral drugs. The mean CD4 cell count was 469 /ml and the plasma RNA HIV was less than 50 copies /ml in 57% of the cases. Adverse events leading to reduction of dose of drugs occurred in 40% and adverse events leading to discontinuation treatment occurred in 12%. A decline of CD4 cell count200 CD4/ml was observed in 15%. Clearance of HCV-RNA in end of treatment was seen in 46 % and sustained virological response in 34 %. The main predictors of sustained virological response were HCV genotype 2 or 3 (P =0.04) and plasma HIV RNA less than 50 copies/ml (P =0.001). The predictive value of good virological response of a CD4 cell count350/ml before treatment was very near the statistical significancy (p =0.07).The efficacy of pegylated interferon plus ribavirin in HIV-HCV co-infected patients is disappointing mainly due to a poor tolerance. In addition to HCV genotype, plasma HIV RNA level and CD4 cell count were essential to predict INFpeg-Riba response and should be taken into account in the process leading to the initiation of such therapy in HIV-HCV co-infected patients.

We assessed the correlations between some plasma markers of immune activation (soluble receptors of interleukin 2 (sIL2-R) and TNFap75 (sTNFII-R) and usual markers of HIV infection in patients treated with protease-inhibitors (PI). Forty-six PI-naive HIV-1-infected adults were included in a 1-year prospective cohort from the initiation of a P1-containing regimen (M0). Measurements of CD4+cell count, plasma HIV-RNA, sIL2-R and sTNFII-R were performed at M0, M6, and M12. The evolution of sIL2-R from baseline to M12 was significantly different between immunological responders (IR) (CD4+count above 200/mm3 for subject having less than 200 CD4 +/mm3 at inclusion, or increase of at least 50 CD4+/mm3 for others) (58 UI/ml) and non-IR (+28 UI/ml) (P =0.01). The evolution of sTNFII-R between M0 and M12 was significantly different between virological responders (VR) (plasma HIV-1 RNA less than 500 copies/ml at M12) (-2.5 ng/ml) and non-VR (+0.2 ng/ml) (P = 0.02). Our study shows significative correlations between the evolutions of soluble interleukin-2 and TNFR-II receptors and those of CD4+T-lymphocytes or HIV-RNA responses in patients under HAART.

Although several reports of sarcoidosis have been reported in hepatitis C virus (HCV)-infected patients treated with interferon-alpha, this association has never been described in nontreated HCV patients. We report two cases of sarcoidosis associated with chronic hepatitis C infection. The patients developed multivisceral sarcoidosis (cutaneous, lungs, nodes) at two and at least six years after the presumed date of infection. One patient obtained remission of sarcoidosis with corticosteroid treatment but the other remained corticodependent. The levels of hepatic enzymes were not significantly modified throughout the course of corticosteroid therapy. In conclusion, these case reports suggest that HCV itself could induce a granulomatous reaction in chronic HCV-infected patients through the stimulation of the cellular immune system. It could be of interest to test for HCV infection all patients diagnosed with sarcoidosis and to watch over every treated or nontreated hepatitis C infected patient for the development of granulomatous lesions.

Since eradication of HIV is unlikely, long-term management of the disease necessitates careful evaluation of the combinations of currently available drugs to determine the most potent and useful rational sequencing of regimens.To determine the antiretroviral efficacy and tolerability of saquinavir soft gelatin capsule (SQV-SGC) plus zalcitabine (ddC) and stavudine (d4T), as first-line treatment in HIV-infected patients.Multicentre, open-label, non-comparative study.Thirty-five asymptomatic, HIV-infected adults with no prior antiretroviral treatment, a CD4 countor =250 cells/microL and baselineor = 5000 HIV RNA copies/mL were included in the study. Patients received SQV-SGC 1200 mg three times a day (tid), ddC 0.75 mg tid and d4T 30 or 40 mg twice a day (bid) for 24 weeks. Plasma HIV RNA, CD4 and CD8 cell counts, HIV reverse transcriptase and protease resistance genotypes, SQV plasma concentration and tolerability were evaluated.At baseline, median HIV RNA (interquartile range) was 4.99 (4.81-5.48) log10 copies/mL, and median CD4 count was 370 (318-504) cells/microL (n = 35). At week 24, the median decrease in HIV RNA was 3.05 (2.19-3.68) log10 copies/mL. A viral load below the level of quantification (200 copies/mL and 20 copies/mL) was achieved in 63% and 34% of patients, respectively (intent-to-treat analysis). The only mutations detected were L90M substitutions in two patients. At week 24, the median CD4 count increased (P0.0001), and CD8 cell counts decreased (P0.0001), relative to baseline. In total, there were five cases of peripheral neuropathy (14%). Mean triglyceride and cholesterol levels remained within normal ranges.Triple therapy with SQV-SGC plus ddC and d4T is a reasonably well tolerated regimen that markedly and rapidly reduces viral load with immunological improvement. This combination is an effective additional therapeutic option, with an efficacy that compares favourably to other triple regimens used in HIV treatment.

A retrospective study was set up to investigate active pathologic processes associated with sarcoidosis diagnosed in 32 patients.Eighteen patients had two identified granulomatous localizations (56%) and 14 patients had three localizations or more (27%). Comorbidity was noticed in nine patients (28% of cases). Sarcoidosis was associated with an infectious disease five times (hepatitis C virus [HCV] infection three times, including one case after recombinant interferon alpha therapy, and HIV and HCV co-infection two times). The association of sarcoidosis with a chronic immunologic inflammatory disease was noticed four times (lupus erythematosus two times, myasthenia and primary biliary cirrhosis). Finally, in two cases sarcoidosis was associated with a neoplasia (non-Hodgkin's lymphoma in a co-infected HIV-HCV patient, ovarian cystadenocarcinoma in another patient). Sarcoidosis preceded or revealed the comorbidity four times.

A new method for in vitro and possibly in vivo ultrahigh-resolution colocalization and distance measurement between biomolecules is described, based on semiconductor nanocrystal probes. This ruler bridges the gap between FRET and far-field (or near-field scanning optical microscope) imaging and has a dynamic range from few nanometers to tens of micrometers. The ruler is based on a stage-scanning confocal microscope that allows the simultaneous excitation and localization of the excitation point-spread-function (PSF) of various colors nanocrystals while maintaining perfect registry between the channels. Fit of the observed diffraction and photophysics-limited images of the PSFs with a two-dimensional Gaussian allows one to determine their position with nanometer accuracy. This new high-resolution tool opens new windows in various molecular, cell biology and biotechnology applications.

To describe the recent evolution of antiretroviral prescriptions and to look for clinical and biological changes among a population of HIV-infected patients.Patients received follow-up in the hospital-based information system of the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA), Southwestern France, from 1995 to 1997.Quarterly evolution of the prescriptions of antiretroviral treatments and of the population clinical and biological indicators were studied in this observational survey of computerized records obtained after each hospital contact.Overall numbers of patients who received follow-up and of hospital contacts remained stable. The proportion of untreated patients decreased from 38.5% to 10.5%. Monotherapies were progressively abandoned. Double combination therapies with two nucleoside analogues were used for 55% of the patients by early 1996 and then decreased, whereas triple combination therapies with one protease inhibitor (PI) rapidly increased to comprise up to 40% of the prescriptions in 1997. PIs were prescribed earlier and earlier in the course of HIV infection. Overall incidence of AIDS diagnoses and mortality rate decreased by 18% and 22%, respectively, in the first 9 months of use of PIs compared with the preceding 9 months, and by 47% and 56%, respectively, in the following 9 months (p.001). The number of hospitalizations and the proportion of patients with a CD4 cell count200/mm3 decreased. AIDS cases diagnosed after introduction of PIs had rarely been treated with PIs.Over this 3-year period, physicians prescribed antiretroviral treatments more and more frequently, and triple combination therapy with PI is now common practice in France. Patients clinical and biological patterns have improved 18 months after the introduction of PIs.

To describe the hospital-based information system developed by the GESCA (Clinical epidemiology group on AIDS in Aquitaine) and evaluate the main results obtained over the last 10 years, specifically data related to epidemiological monitoring, medico-economic analysis and clinical research in HIV infection.Inclusion criteria were HIV-1 seropositivity confirmed by Western blot, age over 13 years, consultation or hospitalization is one of the 18 participating units. Follow-up data were collected at each hospital visit.On December 31, 1995, 4268 subjects had been registered in the GECSA system, including 25.7% women. Contamination categories were homosexuals 33.4%, intravenous drug abusers 32.8%, heterosexuals 13.9%. A clear drop in the number of new cases in intravenous drug abusers and an increase in the number with heterosexual transmission was observed after 1988. The medico-economic analysis showed that patients followed in the system were in a more advanced stage at registry since 1992. More than half of the subjects are now taking antiretroviral therapy and prophylaxis for opportunistic infections. Clinically, after adjusting data for the major known prognosis factors, the risk of progression to AIDS is higher in homosexuals and intravenous drug abusers than in heterosexuals. Transmission route does not however have any significant effect on survival after development of AIDS. There is no significant difference in outcome of HIV infection between men and women and pregnancy is not associated with poorer outcome.This regional registry provides valuable data for epidemiological monitoring, medico-economic analysis, hospital management and clinical research.

Sarcoidosic neurological manifestations are uncommon. Isolated cranial nerve's injury is exceptional. The authors report the case of a 29 year-old woman with a trigeminal nerve tumor. Surgery and anatomopathology led to the diagnosis of sarcoidosic infiltration. No other neurological or extra-neurological localization was found. Cranial fifth nerve injury was observed in 14 cases of the literature. In all cases, trigeminal nerve injury was described as associated with another disease's localization (neurological and/or extra-neurological). This observation seems unusual due to isolated nature of the presentation and complete resolution after surgery. This case illustrated the diagnosis and nosologic difficulties raised by granulomatous lesions, symptomatic or not, in the absence of systemic localization.

A cross sectional survey was set up to study the relation between the prevalence of allergic-type reactions during HIV infection course. For each patient, a standardized interview about recent allergic-type manifestations (RATM), skin prick-tests to six common airborne allergens, IgE serum level were done. Among the 115 included patients, the mean CD4 lymphocyte count (CD4) was 214.7/mm3 (range: 0-1328/mm3). RATM were found in 8.8% of patients with CD450, in 30% of patients with CD4 between 51 and 200, in 36% of patients with CD4 between 201 and 350 and in 11.5% of patients with CD4350 (p = 0.03). The risk of presenting RATM was 4.8 times (95% confidence interval = 1.7-13.5) higher in patients with CD4 between 51 and 350 than in other patients (p = 0.003). The proportion of positive prick-tests did not significantly vary according to the level of CD4. The increased frequency of RATM in patients with CD4 between 51 and 350/mm3 could be due to an allergic predisposition acquired during the course of HIV infection. The mechanisms explaining the reduced frequency of allergic manifestations when immunodeficiency is profound (CD450/mm3) remain to be explained.

To describe trends in the incidence of HIV infection diagnosis since 1985 in different at-risk groups in Aquitaine, south-west France.We analyzed the data from two regional surveillance systems on HIV infection: the hospital-based system of the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA) and the laboratory-based system of the Observatoire Régional de la Santé d'Aquitaine (ORSA). The number of intravenous drug users (IVDUs) in Aquitaine was estimated from two sources: a study performed by the GECSA in IVDUs treatment centers (1990-1991 data) and the annual surveys undertaken by the Ministry of Health (SESI) in all the health facilities and social services of the region from 1988 to 1993.As of December 31st, 1993, 3478 HIV-infected patients had been reported to the GECSA, including 3031 Aquitaine residents. Among those, 1096 were IVDUs without any other at-risk behavior (36.2%), the largest transmission category. The annual incidence of HIV diagnoses has steadily and considerably changed over time for IVDUs: 175 new cases diagnosed in 1985, 218 in 1987, then falling to 38 in 1993. During the same period, there was no marked decrease for homosexuals and the incidence of diagnoses of heterosexually-acquired HIV infections increased. Between 1989 and 1993, the number of HIV tests performed by the laboratories involved in the ORSA surveillance system increased steadily from 80,310 to 176,250 per year, when the number of first positive tests in Aquitaine residents decreased from 744 to 319 per year (-57%). This decrease was greater for IVDUs (-80%) than for the other groups. The survey performed by the GECSA estimated that 990 IVDUs were followed annually by treatment centres in Aquitaine in 1990-1991. This figure was stable and in agreement with the results of the SESI surveys performed throughout the period.The incidence of new diagnoses of HIV infection has been decreasing in Aquitaine since 1988, particularly among IVDUs, suggesting that the epidemic is slowing down. It is essential to maintain these systems of epidemiological surveillance as a component of the HIV prevention program.

Eighty initial episodes of HIV-associated Pneumocystis carinii pneumonia (PCP) diagnosed at Bordeaux hospital between 1985 and 1993 are reported (57 were men and 23 women). PCP revealed HIV infection in 29 patients (36%). Others cases were patients with poor medical follow up (10%), with a CD4+ lymphocyte count above 200/mm3 at last follow-up (9%), non compliant with PCP prophylaxis (9%), or using aerolized pentamidine (AP+) (20%). The main clinical symptoms were fever (90%), dyspnea (68%), non productive (63%) and productive (17%) cough. Radiographic infiltrates were purely interstitial (59%), acinar and interstitial (25%), purely acinar (5%) and absent (11%). Thirty-eight percent of AP+ had upper lobe preferential involvement and 13% a pleural effusion. In all cases, Pneumocystis carinii was detected in bronchoalveolar lavage. Extrapulmonary localizations of pneumocystosis were noticed (eye, liver, spleen, ascitis) in two AP+. Mean CD4+ count was 54/mm3 in patients not having received aerolized pentamidine (AP-) and 22/mm3 in AP+. P24 antigenemia was positive in 53% (AP-) and 88% (AP+). PaO2 LDH and albuminemia were similar in both groups. Antimicrobial therapy (Cotrimoxazole in 91% of the cases) was combined with corticosteroids in 45% and mechanic ventilation in 19%. After 30 days of follow-up, 17 deaths were observed (21%) and 14 attributed to PCP: mortality was worse in AP+ (31%) than in AP- (19%). The main conclusions of our study are the followings: HIV related PCP is still in 1995 frequent and severe; atypical features should not rule out diagnosis; preventive measures are neither sufficient nor efficient. PCP remains in 1995 a priority in HIV related public health and therapeutical research.