ABSTRACT
In August 2011, a case of canine rabies was notified to the French veterinary services. The dog was a three-month-old puppy illegally imported from Morocco that presented behavioural changes on 1 August and was admitted to a veterinary clinic on 6 August. It died the following day and the body was shortly sent to the national reference centre where rabies was laboratory-confirmed on 11 August. Contact tracing and post-exposure treatment were initiated immediately.
Subject(s)
Contact Tracing , Dog Diseases/diagnosis , Rabies virus/isolation & purification , Rabies/diagnosis , Animals , Commerce , Dog Diseases/transmission , Dog Diseases/virology , Dogs , Fluorescent Antibody Technique, Direct , France , Humans , Jurisprudence , Morocco , Post-Exposure Prophylaxis , RNA, Viral , Rabies/transmission , Rabies/veterinary , Rabies/virology , TravelABSTRACT
OBJECTIVE: To describe safety and long-term efficacy of nevirapine (NVP) in a real-life setting. RESULTS: From 1996 to 2008, among the 745 patients who received NVP, 592 were still followed in our center; of these, 231 had stopped NVP because of failure (42%), side effects (28%), other causes (30%). Twenty-seven percent of discontinuations occurred in the first 3 months; 68% were related to adverse events. In June 2008, 361/592 patients (61%) were still on NVP for a median duration of 176 weeks (range, 0.3-600), including 18% of naïve patients, 15% of patients who initiated NVP in the context of virologic failure, and 66% of patients with an undetectable viral load (switch strategy). Median CD4 cell count increased from 377/microL (range, 8-1449) to 549/microL (range, 144-1621). Viral load was below 200 copies/mL at the latest visit in 97%, 96%, and 100% of the patients in the naïve, failure, and switch groups, respectively. Over a 5-year period, the rate of antiretroviral drug persistence was 60.9% for NVP, 41.4% for efavirenz, and 23% for lopinavir/ritonavir (P < .0001). CONCLUSIONS: In a real-life setting, NVP demonstrates sustained efficacy and good safety and is very convenient to use as reflected by a high rate of persistency.