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B Taverne

Publications and source records attributed to B Taverne.

5 recordsLinked to original sources
PubMed2006

[Efavirenz (Sustiva) in pregnancy: a study about 12 HIV patients].

OBJECTIVE: In developed countries, where the mother-to-child transmission rate of HIV is low (1 to 1,5%), a major medical concern is the safety of new therapies during pregnancy. Teratogenicity has been described with an NNRTI, efavirenz (Sustiva), in animal model, regarding neural tube defects. PATIENTS AND METHODS: We have made a retrospective study of pregnancies starting with efavirenz with a special focus on foetal and infant abnormalities. RESULTS: Three abnormalities were notified no one linked to a neural tube defect. DISCUSSION AND CONCLUSION: In the English literature published, although the prevalence of abnormalities in human is low (1,7%) during pregnancy, due to the potent teratogenicity, efavirenz is contraindicated in the first trimester and should be used with caution in women of childbearing potential.

Abnormalities, Drug-Induced↗
PubMed2003

[Free dispensing of antiretroviral treatments in Africa].

The bio-clinical efficacy of ART in Africa has now been proven. In 2001, the resolution adopted by the UNGASS meeting confirms that "effective prevention, care and treatment strategies will require [...] a non-discriminatory access to [...] anti-retroviral therapies". Most of the programmes that give access to ART initiated in the sub-Saharan region in 1998 are based on the principle that the patients participate financially to the purchases of ART. Some countries (Côte d'Ivoire, Senegal, and Mali) subsidize ART medications to favour a better access. The financial contribution of patients is supposed to: 1/ translate patient support into government action; 2/ favour a closer therapeutic adherence; 3/ assure the access programmes sustainability. However, despite the subsidies provided by some states, the cost of medical treatment greatly exceeds the resources available to most of the sufferers. The analysis of ART access programmes, specifically in Senegal and Côte d'Ivoire, shows that: 1/ Patient support to government action does not need to be more demonstrated while general access to treatment is officially recognised and recommended by the United Nations. 2/ Patient involvement and better adherence have been noted with patients that receive free ART. 3/ Patient contribution represents less than 10% of the medication's purchasing cost, thus, the cost recovery is marginal and does not allow for sustainable ART access programmes. The cost charged to patients for ARV still represents a major obstacle for proper medical management. Care programmes in African countries should implement free access to ART as a priority.

Africa↗
PubMedDate not supplied

[Representations of mother to child transmission of AIDS, perception of the risk and health information messages in Burkina Faso].

In Burkina Faso, in rural Mossi areas, popular contemporary representations of the transmission of HIV from mother to child are based on the idea that "the disease is in the blood" and that the fetus is conceived by "mixing the blood" of its parents. Infection of the child is seen as inevitable and systematic and is believed to occur in utero. Maternal milk is thought to have the same potential for infection because "milk is blood" but its role in transmission is seen as secondary, with transmission occurring before birth. However, breast feeding is believed to be responsible for the transmission of the disease in two ways: 1) by infected women transmitting the illness to healthy children via their milk and 2) by healthy women becoming infected by breast feeding infants born to infected mothers. The belief that transmission is systematic and the fear that the child will contaminate others leads to the widely held view within the population that no care should be taken of children born to women with AIDS and that such children should be abandoned and left to die. These representations have recently developed in the population based on preexisting beliefs relating to the physiology and role of blood in the transmission of diseases and the health information that has been distributed. Health information messages are largely responsible for the representations described above. Indeed, the description of the modes of HIV transmission in such messages has been based on the simplified statement of the triad, sex, blood and mother-child, with no indication of the relative risks of transmission for each. Hence, this incomplete information, interpreted in terms of popular conceptions about contagion, has resulted in maximal probability being attributed to each of the listed modes of transmission. Health information messages are the principal means of communicating scientific information to the general population. The stakes associated with the quality and correctness of the information supplied are therefore very high. The notion of the risk of transmission and statement of the level of risk are essential to any explanation of the modes of transmission of HIV. These ideas cannot be neglected because they are essential to the correct understanding of transmission and to the logical management of individual risk.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[How to manage HIV seropositive or AIDS patients in rural Burkina Faso?].

This article is based on an ethnographical study carried out in 1996. It describes and analyzes the methods of medical and family management of HIV-positive and full-blown AIDS patients in the rural environment of Burkinabé. A number of recommendations are made. Biomedical management of these patients is almost non-existent (currently there is no serology or screening advice available at the dispensary). The patient is never informed of an AIDS diagnosis. The relations between the medical personnel and the patients are dominated by a sense of powerlessness and constant fear of infection. None of the traditional doctors of the region admits to treating AIDS although traditional medicine is used throughout the illness. Family management ranges from complete rejection of the patient to supportive but often misdirected care. It is determined by at least five elements: (1) the composition of the family unit and the nature of relations between the sick individual and the rest of the family, (2) the economic status of the patients, his family group and his parents, (3) the initial uncertainties of the diagnosis of the illness, (4) the fear of contagion and (5) the fear of gossip. Management of these patients would be improved by: (1) real access to counseling and screening, (2) the involvement of health workers in this activity and in the notification of the diagnosis to the peripheral medical organizations, (3) the education of the staff about the risks of contamination and care of the terminally ill, (4) reeducation of the public about the non-contagious nature of the sick by personal counseling given by health care professionals and (5) the material support of families. This is of vital importance but is difficult to achieve in the context of chronic poverty.

Acquired Immunodeficiency Syndrome↗