[Injectable soft tissue fillers: are they medical devices or drugs? Implications for HIV lipodystrophy]. / Produits de comblement du visage: dispositifs médicaux ou médicaments? Implication pour les patients VIH+ atteints de lipoatrophie.

Physical modifications associated to lipodystrophy syndrome in HIV+ patients remain a challenge for management, even in a well controlled chronic infection. Indications, evaluation and filling treatments of facial lipoatrophy are described. Many exogenous filling products are on the market and their use and tolerance profile better known. These medical devices should be closely followed in patients with chronic HIV infection.

First reported case of Rothia dentocariosa spondylodiscitis in an immunocompetent patient.

Rothia dentocariosa is part of the normal human oropharyngeal microflora and is frequently associated with dental caries and periodontal disease. Invasive disease has been described essentially in immunocompromised hosts and/or patients with underlying conditions as predisposing factors. We present a case of an otherwise healthy 46-years old male with spondylodiscitis caused by this pathogen. Treatment with ceftriaxone and rifampin was successful. To our knowledge, this is the first R. dentocariosa spondylodiscitis reported in an immunocompetent patient, and the second one in the literature overall.

Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study.

BACKGROUND: According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study. METHODS: All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events. RESULTS: 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4+ T-cell count <350 cells/mm3 decreased from 85% to 52% in the periods 2002-2006 to 2007-2015. Tenofovir use, among those taking cART, increased from 4% in 2002 to 73% in 2015. Compared to West, tenofovir use was lower in East in 2005 (7% versus 42%), and remained lower in 2015 (63% versus 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. 27 of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas 10 started pegylated interferon. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (n=51), adjusted incidence rate ratio (IRR) 0.64 (95% CI 0.35, 1.18) for comparing patients on tenofovir with those off tenofovir. CONCLUSIONS: Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.