Mandatory immunizations for health students in Lyon (France), overview and evaluation / Obligations d'immunisation des étudiants en santé de Lyon, état des lieux et évaluation

OBJECTIVES: To establish an overview of vaccination amongst health students in Lyon 1 University and to evaluate the implementation of a new verification system of immunization obligations with an electronic vaccination card (EVC) from the “MesVaccins.net” website. METHODS: A questionnaire was sent by the Lyon 1 University Student Health Service (SHS) to the first-year health studies students over the age of 18 in Lyon in 2020-2021 who shared their EVC; exploitation of these EVCs’ data. RESULTS: Amongst all students, 67.4% transmitted their information to the SHS. They reported organizational difficulties in updating (33.3%) and certifying their EVC with a healthcare professional (55.9%). Global satisfaction of the students was 78.0%. This study highlighted many differences between Lyon Est and Lyon Sud campuses, especially about general knowledge of the SHS, visibility of the promotion campaign, rate of students who transmitted their information to the SHS and rate of up-to-date students. Regarding mandatory immunization, 83.4% of the students were up-to-date with diphtheria-tetanus-poliomyelitis, 56.8% with hepatitis B, and 64.7% had done a tuberculin intradermal test; 43.4% of the students were simultaneously up-to-date with these three immunizations. CONCLUSION: The rate of up-to-date students is insufficient. This study stresses the necessity of an early campaign of immunizations promotion, with better access to healthcare professionals able to certify EVCs.

Objectifs: Établir un état des lieux de la vaccination des étudiants en santé de l'université Lyon 1 et évaluer la mise en place d'un nouveau dispositif de vérification des obligations d'immunisation à l'aide du carnet de vaccination électronique (CVE) MesVaccins.net. Méthodes: Questionnaire envoyé par le Service de santé universitaire (SSU) de Lyon 1 aux étudiants majeurs en première année de santé en 2020-2021 ayant partagé leur CVE ; exploitation des données de ces CVE. Résultats: Les étudiants étaient 67,4 % à avoir transmis leurs informations au SSU. Ils ont rapporté des difficultés organisationnelles pour se mettre à jour (33,3 %) et pour faire valider leur CVE par un professionnel de santé (55,9 %). La satisfaction globale des étudiants vis-à-vis de ce dispositif était de 78,0 %. Cette étude a mis en avant plusieurs différences entre les campus de Lyon Est et Lyon Sud, notamment sur la connaissance du SSU, la visibilité de la campagne, le pourcentage d'étudiants qui ont transmis leurs informations et le pourcentage d'étudiants à jour. Concernant les immunisations obligatoires, 83,4 % des étudiants étaient à jour du vaccin diphtérie-tétanos-poliomyélite, 56,8 % de l'hépatite B et 64,7 % avaient pratiqué une intradermoréaction ; 43,4 % des étudiants étaient à jour simultanément de ces trois immunisations. Conclusion: Le pourcentage d'étudiants à jour est insuffisant. Cette étude souligne la nécessité d'une campagne précoce de promotion des immunisations avec un meilleur accès des étudiants à des professionnels de santé validant les CVE.

[Urban caregivers helping students]. / Les professionnels de santé libéraux au secours des étudiants.

In this period of pandemic, urban caregivers are directly concerned by the mental or social distress of students. In addition to university health services, psychologists through associations, social workers, doctors and nurses are listening to young people for individual situations, but sometimes also for group situations. So many access to health to propose to the suffering students as well as to their families.

Detectable HIV-RNA in semen of HIV controllers.

BACKGROUND: Whether spontaneous low levels of HIV-1 RNA in blood plasma correlate with low levels of HIV-1 RNA in seminal plasma has never been investigated in HIV controller (HIC) men so far. METHODS: HIC men enrolled in the ANRS CODEX cohort were eligible for the present study if they had no symptoms of sexually transmitted infections (STI). Two paired samples of blood and semen were collected four weeks apart. HIV-RNA was quantified in blood plasma (bpVL) and in seminal plasma (spVL), and cell-associated HIV-DNA was quantified in peripheral blood mononuclear cells (PBMC) and in non-sperm cells (NSC). Spearman rho tests were used to estimate correlations between bpVL and spVL. RESULTS: Ten men were enrolled. At Day 0 (D0), spVL was detectable in four patients: 458; 552; 256 copies/mL and PCR signal detectable below limit of quantification (LoQ, 40 copies/mL). At Day 28 (D28), spVL was detectable in the same four participants in whom spVL was detectable at D0 with 582; 802; 752 and 50 copies/mL, respectively. HIV-DNA was detectable below LoQ in NSC of one patient at D0 visit. No patient had detectable HIV-DNA in NSC at D28 visit. At D0, bpVL and spVL were highly positively correlated (Spearman rho: 0.94; p = 0.0001). Similar results were found at D28. CONCLUSION: We show that HIV-RNA can be detected in the semen of HIC men, with levels positively correlated with those measured concomitantly in blood plasma. HIC men should be aware of the risk of HIV genital shedding, especially if viral blips are reported.

Good response to lopinavir/ritonavir-containing antiretroviral regimens in antiretroviral-naive HIV-2-infected patients.

In 29 antiretroviral-naive HIV-2-infected patients starting lopinavir/ritonavir-containing regimen, the median CD4 cell count change from baseline (142 cells/microl) was +71 cells/microl at week 24 and +132 cells/microl at week 96. Seventeen (59%) patients had a CD4 cell count increase of at least 50 cells/microl and undetectable HIV-2 RNA at week 24 and were considered as responders to treatment. This sustained elevation of CD4 cell count in the first 2 years of combination antiretroviral therapy shows the potential for lopinavir/ritonavir regimens as first-line therapy in HIV-2 infection.

[Contraception and neurology]. / Contraception et Neurologie.

The purpose of this article is to clarify interactions between oral contraception (using low- and high-dose oral contraceptives) and the main neurological diseases occurring in genitally active women. Vascular disorders predominate, since contraception is in itself a well-recognized a risk factor, especially in case of other intercurrent risk factors (high blood pressure, smoking, diabetes, history of vascular event) contradicting contraception. Low-dose oral contraception can be proposed for women free of these risk factors. There is however a formal contraindication for oral contraception, even with mini-dose contraceptives, for women with a history of cerebral venous thrombosis. In case of migraine headache, which is also a risk factor of vascular disease (especially in case of aura), oral contraceptives should be discussed on an individual basis, depending on the presence of other risk factors. Contraception has no effect on epilepsy but oral contraceptives may be inhibited by inducing anti-seizure drugs. Non-inducing drugs are preferable. The course of certain brain tumors known to express estrogen or progesterone receptors (particularly meningiomas and hemangioblastomas) may worsen with oral contraception, which is formally contradicted except when search for hormone receptors is negative. Oral contraception has no influence in other disease such as multiple sclerosis