BACKGROUND. Increasing numbers of children perinatally infected with human immunodeficiency virus (HIV) are reaching adolescence, largely because of advances in treatment over the past 10 years, but little is known about their current health status. We describe here the living conditions and clinical and immunovirologic outcomes at last evaluation among this pioneering generation of adolescents who were born before the introduction of prophylaxis for vertical transmission and whose infections were diagnosed at a time when treatment options were limited. METHODS. The eligible population consisted of HIV-1-infected children who were born before December 1993 and who were included at birth in the prospective national French Perinatal Cohort (EPF/ANRS CO10). RESULTS. Of the 348 eligible children, 210 (60%; median age, 15 years) were still alive and regularly followed up. Current treatment was highly active antiretroviral therapy (HAART) in 77% and 2 nucleoside analogues in 5.0%; 16% had stopped treatment, and 2% had never been treated. The median CD4 cell count was 557 cells/microL, and 200 cells/microL was exceeded in 94% of patients. The median viral load was 200 copies/mL. Viral load was undetectable in 43% of the adolescents and in 54.5% of those receiving HAART. Median height, weight, and body mass index were similar to French reference values for age, and school achievement was similar to nationwide statistics. Better immunologic status was associated with being younger and with having begun HAART earlier. Undetectable viral load was associated with maternal geographic origin and current HAART. CONCLUSIONS. Given the limited therapeutic options available during the early years of these patients' lives and the challenge presented by treatment adherence during adolescence, the long-term outcomes among this population are encouraging.
ABSTRACT:The objective of this study was to investigate the relationships between starch melt transition characteristics, extrusion conditions, and final product properties. Cornstarch was extruded using a corotating twin-screw extruder at varying moisture content, medium/high screw configuration, and 300/400-rpm screw speeds. Extrudates were evaluated for bulk density, expansion ratio, cell structure, bending strength, thermal and pasting properties. Temperature change ( T) was defined as the temperature difference between the native starch melting temperature and its melt temperature just behind the die during extrusion at a given moisture content. T was significantly affected by starch moisture content and mechanical shearing, which controlled the melting behavior of the starch in the barrel. Amylose-lipid complex formation during extrusion increased as T increased and leveled off at T of about 20• C. Pasting peak viscosity of the starch extrudates decreased as T increased and leveled off at T of about 15• C. Within the same range of mechanical shearing intensity, extrudate bulk density and bending strength decreased linearly as T increased. Extrudate expansion was negatively correlated to bulk density. C
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