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15 results on '"Di Biagio, A"'

1. Influence of efavirenz and 8‐hydroxy‐efavirenz plasma levels on cognition and central nervous system side effects.

Author

Ranzani, Alice, Castelli, Francesco, Di Biagio, Antonio, d'Arminio Monforte, Antonella, D'Avolio, Antonio, Soria, Alessandro, Bai, Francesca, Focà, Emanuele, Taramasso, Lucia, Calcagno, Andrea, Bresciani, Elena, Torsello, Antonio, Bonfanti, Paolo, and Lapadula, Giuseppe

Subjects
CROSS-sectional method, DATA analysis, RESEARCH funding, EXECUTIVE function, CENTRAL nervous system, MANN Whitney U Test, DESCRIPTIVE statistics, BLOOD plasma, STATISTICS, EFAVIRENZ, COGNITION
Abstract

Objectives: To investigate whether efavirenz (EFV) or 8‐hydroxy‐EFV (8‐OH‐EFV) plasma levels are associated with neurocognitive impairment and central nervous system (CNS) side effects. Methods: We conducted a cross‐sectional analysis to explore the potential links between EFV/8‐OH‐EFV levels and cognitive performance or CNS‐related side effects in patients screened within a randomized trial involving a switch from EFV to rilpivirine. The Mann–Whitney test was employed to compare drug levels in patients with or without cognitive impairment, depression, anxiety, sleep disorder or CNS symptoms. Additionally, Spearman's test was used to assess correlations between drug levels and test scores. Results: Among 104 patients, neither EFV nor 8‐OH‐EFV levels were linked to cognitive impairment, although trends towards higher EFV levels were observed in those with impaired executive function (p = 0.055) and language performances (p = 0.021). On the other hand, elevated 8‐OH‐EFV levels, but not EFV levels, were associated with more CNS side effects (222 vs. 151 ng/mL, p = 0.027), depressive symptoms (247 vs. 164 ng/mL, p = 0.067) and sleep impairment (247 vs. 164 ng/mL, p = 0.078). Consistently, a trend towards a correlation between EFV levels and lower z‐scores in executive function and motor function was observed, while 8‐OH‐EFV levels, but not EFV levels, were directly correlated with symptom scores. Conclusions: Higher levels of 8‐OH‐EFV were associated with CNS side effects, while EFV levels were only marginally associated with cognitive performance, thus suggesting that EFV and its metabolite may act differently in determining detrimental neurological effects. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Metabolic syndrome and body weight in people living with HIV infection: analysis of differences observed in three different cohort studies over a decade

Author

Taramasso L., Bonfanti P., Ricci E., Maggi P., Orofino G., Squillace N., Menzaghi B., Madeddu G., Molteni C., Vichi F., Riguccini E., Saracino A., Santoro C., Guastavigna M., Francisci D., Di Biagio A., De Socio G. V., Sarchi E., Chichino G., Bolla C., Bellacosa C., Angarano G., Calza L., Farinazzo M., Angioni G., Gussio M., Celesia B. M., Falasca K., Mastroianni A., Guadagnino G., Salomoni E., Martinelli C., Dentone C., Bassetti M., Cenderello G., Pellicano G. F., Nunnari G., Valsecchi L., Cordier L., Parisini S., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G. M., Martini S., Cascio A., Trizzino M., Gulminetti R., Nofri M., Cibelli D., Parruti G., Mameli M. S., Taramasso L., Bonfanti P., Ricci E., Maggi P., Orofino G., Squillace N., Menzaghi B., Madeddu G., Molteni C., Vichi F., Riguccini E., Saracino A., Santoro C., Guastavigna M., Francisci D., Di Biagio A., De Socio G.V., Sarchi E., Chichino G., Bolla C., Bellacosa C., Angarano G., Calza L., Farinazzo M., Angioni G., Gussio M., Celesia B.M., Falasca K., Mastroianni A., Guadagnino G., Salomoni E., Martinelli C., Dentone C., Bassetti M., Cenderello G., Pellicano G.F., Nunnari G., Valsecchi L., Cordier L., Parisini S., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G.M., Martini S., Cascio A., Trizzino M., Gulminetti R., Nofri M., Cibelli D., Parruti G., Mameli M.S., Taramasso, L, Bonfanti, P, Ricci, E, Maggi, P, Orofino, G, Squillace, N, Menzaghi, B, Madeddu, G, Molteni, C, Vichi, F, Riguccini, E, Saracino, A, Santoro, C, Guastavigna, M, Francisci, D, Di Biagio, A, De Socio, G, Taramasso, Lucia, Bonfanti, Paolo, Ricci, Elena, Maggi, Paolo, Orofino, Giancarlo, Squillace, Nicola, Menzaghi, Barbara, Madeddu, Giordano, Molteni, Chiara, Vichi, Francesca, Riguccini, Erika, Saracino, Annalisa, Santoro, Carmen, Guastavigna, Marta, Francisci, Daniela, Di Biagio, Antonio, and De Socio, Giuseppe Vittorio

Subjects
Adult, Male, dyslipidaemia, antiretroviral therapy, HIV Infections, Overweight, Logistic regression, Body Mass Index, Cohort Studies, Prevalence, medicine, overweight, Humans, Pharmacology (medical), Metabolic Syndrome, business.industry, Health Policy, Incidence (epidemiology), Body Weight, HIV, weight gain, Odds ratio, Middle Aged, medicine.disease, Confidence interval, metabolic syndrome, Cross-Sectional Studies, Infectious Diseases, Metabolic syndrome, medicine.symptom, business, Weight gain, Demography, Cohort study
Abstract

Objectives: The aim of this study was to assess the incidence of being overweight and metabolic syndrome (MS) among people living with HIV (PHIV) in three different cross-sectional studies conducted over three different periods: 2005, 2011 and 2015. Methods: This was a multi-centre, nationwide study. Data were collected in three studies from the CISAI group - SIMOne, HIV-HY and STOPSHIV - and included a total of 3014 PHIV. Logistic regression [odds ratio (OR), 95% confidence interval (CI)] was used to account for age and gender difference among three groups when comparing MS prevalence and being overweight; potential confounders were accounted for by including them in the regression equation. Results: Overall, the mean age was 46.9±10.2years, and men comprised 73.3% of participants. Comparing 2005, 2011 and 2015, MS was present in 34.5%, 33.0% and 29.3% of PHIV, respectively. Adjusted OR for MS was 0.64 (95% CI: 0.52-0.78) in 2011 and 0.56 (95% CI: 0.46-0.69) in 2015 compared with 2005, while BMI (kg/m2 ) increased from 23.6 in 2005, 24.5 in 2011 and 24.5 in 2015, with a concomitant increase of being overweight from 29.4% to 39.5% to 39.6% (p&nbsp

Published
2021

3. Trend over time of HIV‐1 drug resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and their drivers: A cohort study from Antiviral Response Cohort Analysis (ARCA)

Author

Rancan, Ilaria, primary, Cassol, Chiara, additional, Graziani, Lucia, additional, Tilli, Marta, additional, Malcontenti, Costanza, additional, Russo, Chiara, additional, Bottanelli, Martina, additional, Bracchitta, Fiorenza, additional, Papaioannu, Rebecka, additional, Labate, Laura, additional, Mora, Sara, additional, Bezenchek, Antonia, additional, Shallvari, Adrian, additional, Di Biagio, Antonio, additional, and Rossetti, Barbara, additional

Published
2023
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4. Prevalence and determinants of resistance mutations in HIV-1-infected patients exposed to integrase inhibitors in a large Italian cohort

Author

Daniela Francisci, Giovanni Penco, Filippo Lagi, Ilaria Vicenti, M Maffeo, Stefania Paolucci, Maurizio Zazzi, Bianca Bruzzone, A. Di Biagio, D Sacchini, A. De Luca, G. Magnani, Sara Modica, Barbara Rossetti, Roberto D'Autilia, Monica Pecorari, and Francesca Lombardi

Subjects
Male, 0301 basic medicine, Integrase inhibitor, HIV Infections, integrase strand transfer inhibitor, HIV Integrase, Quinolones, Piperazines, chemistry.chemical_compound, 0302 clinical medicine, experienced patients, HIV-1, resistance mutations, Interquartile range, Prevalence, Pharmacology (medical), 030212 general & internal medicine, biology, Elvitegravir, Health Policy, Middle Aged, Resistance mutation, Integrase, Infectious Diseases, Italy, Dolutegravir, Female, Heterocyclic Compounds, 3-Ring, medicine.drug, Adult, medicine.medical_specialty, Genotype, Pyridones, 03 medical and health sciences, Raltegravir Potassium, Internal medicine, Drug Resistance, Viral, Oxazines, medicine, Humans, HIV Integrase Inhibitors, business.industry, Raltegravir, 030112 virology, Discontinuation, Logistic Models, chemistry, Mutation, biology.protein, business
Abstract

OBJECTIVES The aim of the study was to analyse the prevalence of integrase resistance mutations in integrase strand transfer inhibitor (INSTI)-experienced HIV-1-infected patients and its predictors. METHODS We selected HIV-1 integrase sequences from the Antiviral Response Cohort Analysis (ARCA) database, derived from INSTI-experienced patients between 2008 and 2017. Differences in the prevalence of resistance to raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG) were assessed by χ2 test and predictors of resistance were analysed by logistic regression. RESULTS We included 462 genotypes from INSTI-exposed individuals: 356 'INSTI-failing' patients and 106 'previously INSTI-exposed' patients (obtained a median of 42 weeks after INSTI discontinuation [interquartile range (IQR) 17-110 weeks]). Overall, at least low-level resistance (LLR) to any INSTI (Stanford 8.5 algorithm) was detected in 198 (42.9%) cases. The most frequent INSTI resistance mutation was N155H, followed by Q148H/K/R, G140A/C/S, E138A/K/T and Y143C/H/R. Y143R and E138A were more prevalent in viral subtype B versus non-B [5.2 versus 1.5%, respectively (P = 0.04), and 3.1 versus 0%, respectively (P = 0.02)]. Overall, the Q148H/K/R plus G140A/C/S and/or E138A/K/T pattern, defining an intermediate level of resistance to DTG, was detected in 70 (15%) cases. Independent predictors of at least LLR to any INSTI were current use versus past use of INSTIs, a lower genotypic sensitivity score (GSS) for contemporary antiretroviral drugs used, and having an integrase sequence obtained in calendar year 2016 as compared to 2008-2009. CONCLUSIONS The results support integrase resistance testing in INSTI-experienced patients. Emergence of INSTI resistance is facilitated by the reduced genetic barrier of the regimen as a consequence of resistance to companion drugs. However, INSTI resistance may become undetectable by standard population sequencing upon INSTI discontinuation.

Published
2018

5. Evolution of major non-HIV-related comorbidities in HIV-infected patients in the Italian Cohort of Individuals, Naïve for Antiretrovirals (ICONA) Foundation Study cohort in the period 2004-2014

Author

d'Arminio Monforte A., Diaz-Cuervo H., De Luca A., Maggiolo F., Cingolani A., Bonora S., Castagna A., Girardi E., Antinori A., Lo Caputo S., Guaraldi G., Cozzi-Lepri A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G. C., Perno C. F., Rezza G., von Schloesser F., Viale P., Ceccherini-Silberstein F., Mussini C., Puoti M., Andreoni M., Ammassari A., Balotta C., Bandera A., Bonfanti P., Borderi M., Calcagno A., Calza L., Capobianchi M. R., Cinque P., Di Biagio A., Gianotti N., Gori A., Lapadula G., Lichtner M., Madeddu G., Marcotullio S., Monno L., Nozza S., Roldan E., Rossotti R., Rusconi S., Santoro M. M., Saracino A., Zaccarelli M., Fanti I., Galli L., Lorenzini P., Rodano' A., Shanyinde M., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petrone F., Prota G., Quartu S., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Santoro C., Suardi C., Donati V., Verucchi G., Castelnuovo F., Minardi C., Menzaghi B., Abeli C., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Mastroianni C., Pozzetto I., Molteni C., Chiodera A., Milini P., Nunnari G., Pellicano G., azzarin A., Rizzardini G., Marchetti G., Moioli M. C., Piolini R., Ridolfo A. L., Salpietro S., Tincati C., Puzzolante C., Chirianni A., Borgia G., Esposito V., Di Martino F., Gentile I., Maddaloni L., Cattelan A. M., Marinello S., Cascio A., Colomba C., Baldelli F., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M. A., Cristaudo A., Vullo V., Acinapura R., Baldin G., Capozzi M., Cicalini S., Capparucia M., Iaiani G., atini A., Mastrorosa I., Plazzi M. M., Savinelli S., Vergori A., Cecchetto M., Viviani F., Bagella P., Rossetti B., Franco A., Vecchio R., Francisci D., Di Giuli C., Caramello P., Orofino G. C., Sciandra M., Bassetti M., ondero A., Pellizzer G., Manfrin V., Starnini G., alungo A., d'Arminio Monforte, A, Diaz-Cuervo, H, De Luca, A, Maggiolo, F, Cingolani, A, Bonora, S, Castagna, A, Girardi, E, Antinori, A, Lo Caputo, S, Guaraldi, G, Cozzi-Lepri, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, G, Perno, C, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Mussini, C, Puoti, M, Andreoni, M, Ammassari, A, Balotta, C, Bandera, A, Bonfanti, P, Borderi, M, Calcagno, A, Calza, L, Capobianchi, M, Cinque, P, Di Biagio, A, Gianotti, N, Gori, A, Lapadula, G, Lichtner, M, Madeddu, G, Marcotullio, S, Monno, L, Nozza, S, Roldan, E, Rossotti, R, Rusconi, S, Santoro, M, Saracino, A, Zaccarelli, M, Fanti, I, Galli, L, Lorenzini, P, Rodano', A, Shanyinde, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Santoro, C, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Mastroianni, C, Pozzetto, I, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicano, G, Azzarin, A, Rizzardini, G, Moioli, M, Piolini, R, Ridolfo, A, Salpietro, S, Tincati, C, Puzzolante, C, Chirianni, A, Borgia, G, Esposito, V, Di Martino, F, Gentile, I, Maddaloni, L, Cattelan, A, Marinello, S, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Baldin, G, Capozzi, M, Cicalini, S, Capparucia, M, Iaiani, G, Atini, A, Mastrorosa, I, Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, Bagella, P, Rossetti, B, Franco, A, Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Ondero, A, Pellizzer, G, Manfrin, V, Starnini, G, Alungo, A, d'Arminio Monforte A., Diaz-Cuervo H., De Luca A., Maggiolo F., Cingolani A., Bonora S., Castagna A., Girardi E., Antinori A., Lo Caputo S., Guaraldi G., Cozzi-Lepri A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G.C., Perno C.F., Rezza G., von Schloesser F., Viale P., Ceccherini-Silberstein F., Mussini C., Puoti M., Andreoni M., Ammassari A., Balotta C., Bandera A., Bonfanti P., Borderi M., Calcagno A., Calza L., Capobianchi M.R., Cinque P., Di Biagio A., Gianotti N., Gori A., Lapadula G., Lichtner M., Madeddu G., Marcotullio S., Monno L., Nozza S., Roldan E., Rossotti R., Rusconi S., Santoro M.M., Saracino A., Zaccarelli M., Fanti I., Galli L., Lorenzini P., Rodano' A., Shanyinde M., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petrone F., Prota G., Quartu S., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Santoro C., Suardi C., Donati V., Verucchi G., Castelnuovo F., Minardi C., Menzaghi B., Abeli C., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Mastroianni C., Pozzetto I., Molteni C., Chiodera A., Milini P., Nunnari G., Pellicano G., azzarin A., Rizzardini G., Marchetti G., Moioli M.C., Piolini R., Ridolfo A.L., Salpietro S., Tincati C., Puzzolante C., Chirianni A., Borgia G., Esposito V., Di Martino F., Gentile I., Maddaloni L., Cattelan A.M., Marinello S., Cascio A., Colomba C., Baldelli F., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M.A., Cristaudo A., Vullo V., Acinapura R., Baldin G., Capozzi M., Cicalini S., Capparucia M., Iaiani G., atini A., Mastrorosa I., Plazzi M.M., Savinelli S., Vergori A., Cecchetto M., Viviani F., Bagella P., Rossetti B., Franco A., Vecchio R., Francisci D., Di Giuli C., Caramello P., Orofino G.C., Sciandra M., Bassetti M., ondero A., Pellizzer G., Manfrin V., Starnini G., alungo A., d'Arminio Monforte, A., Diaz-Cuervo, H., De Luca, A., Maggiolo, F., Cingolani, A., Bonora, S., Castagna, A., Girardi, E., Antinori, A., Lo Caputo, S., Guaraldi, G., Cozzi-Lepri, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Perno, C. F., Rezza, G., von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Mussini, C., Puoti, M., Andreoni, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, P., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cinque, P., Di Biagio, A., Gianotti, N., Gori, A., Lapadula, G., Lichtner, M., Madeddu, G., Marcotullio, S., Monno, L., Nozza, S., Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano', A., Shanyinde, M., Tavelli, A., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petrone, F., Prota, G., Quartu, S., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Santoro, C., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Mastroianni, C., Pozzetto, I., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Azzarin, A., Rizzardini, G., Marchetti, G., Moioli, M. C., Piolini, R., Ridolfo, A. L., Salpietro, S., Tincati, C., Puzzolante, C., Chirianni, A., Borgia, G., Esposito, V., Di Martino, F., Gentile, I., Maddaloni, L., Cattelan, A. M., Marinello, S., Cascio, A., Colomba, C., Baldelli, F., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Baldin, G., Capozzi, M., Cicalini, S., Capparucia, M., Iaiani, G., Atini, A., Mastrorosa, I., Plazzi, M. M., Savinelli, S., Vergori, A., Cecchetto, M., Viviani, F., Bagella, P., Rossetti, B., Franco, A., Vecchio, R., Francisci, D., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Ondero, A., Pellizzer, G., Manfrin, V., Starnini, G., Alungo, A., and on beahlf of he ICONA Foundation Study, Group

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, noncommunicable diseases (NCDs), persons living with HIV (PLWHIV), time trend, Health Policy, Infectious Diseases, Pharmacology (medical), Population, Renal function, Infectious Disease, HIV Infections, Disease, Comorbidity, Settore MED/17 - MALATTIE INFETTIVE, NO, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Prevalence, Medicine, Hiv infected patients, Humans, 030212 general & internal medicine, education, Dyslipidemias, education.field_of_study, Framingham Risk Score, business.industry, Incidence (epidemiology), noncommunicable diseases (NCDs), persons living with HIV (PLWHIV), time trend, Middle Aged, 030112 virology, Italy, Cardiovascular Diseases, Cohort, Hypertension, Female, business
Abstract

Objectives: The management of HIV disease is complicated by the incidence of a new spectrum of comorbid noncommunicable diseases (NCDs). It is important to document changes in the prevalence of NCDs over time. The aim of the study was to describe the impact of ageing on HIV markers and on the prevalence of NCDs in people living with HIV (PLWHIV) in the Italian Cohort of Individuals, Naïve for Antiretrovirals (ICONA) seen for care in 2004–2014. Methods: Analyses were conducted separately for a closed cohort (same people seen at both times) and an open cohort (all people under follow-up). We used the χ2 test for categorical factors and the Wilcoxon test for quantitative factors to compare profiles over time. Results: The closed cohort included 1517 participants and the open cohort 3668 under follow-up in 2004 and 6679 in 2014. The median age of the open cohort was 41 [interquartile range (IQR) 37–46] years in 2004 and 44 (IQR 36–52) years in 2014. Analysis of the closed cohort showed an increase in the prevalence of some NCDs [the prevalence of dyslipidaemia increased from 75% in 2004 to 91% in 2014, that of hypertension from 67 to 84%, and that of cardiovascular disease (CVD) from 18 to 32%] and a decrease in renal function (5% with eGFR < 60 mL/min per 1.73 m2 in 2004 versus 30% in 2014); the percentage of people in the high-risk group for the Framingham CHD score more than tripled (from 13 to 45%). Results in the open cohort were similar. Conclusions: The burden of NCDs in our PLWHIV population markedly worsened over a 10-year time-span, which is likely to be a result of the effects of both ageing and HIV infection as well as their interaction. Special attention must be given to the management and prevention of NCDs.

Published
2018

7. Metabolic syndrome and body weight in people living with HIV infection: analysis of differences observed in three different cohort studies over a decade.

Author

Taramasso, Lucia, Bonfanti, Paolo, Ricci, Elena, Maggi, Paolo, Orofino, Giancarlo, Squillace, Nicola, Menzaghi, Barbara, Madeddu, Giordano, Molteni, Chiara, Vichi, Francesca, Riguccini, Erika, Saracino, Annalisa, Santoro, Carmen, Guastavigna, Marta, Francisci, Daniela, Di Biagio, Antonio, De Socio, Giuseppe Vittorio, Sarchi, E., Chichino, G., and Bolla, C.

Subjects
HIV infections, OBESITY, RESEARCH, HIV-positive persons, CONFIDENCE intervals, MEDICAL cooperation, METABOLIC syndrome, DESCRIPTIVE statistics, LOGISTIC regression analysis, ODDS ratio, BODY mass index
Abstract

Objectives: The aim of this study was to assess the incidence of being overweight and metabolic syndrome (MS) among people living with HIV (PHIV) in three different cross‐sectional studies conducted over three different periods: 2005, 2011 and 2015. Methods: This was a multi‐centre, nationwide study. Data were collected in three studies from the CISAI group – SIMOne, HIV‐HY and STOPSHIV – and included a total of 3014 PHIV. Logistic regression [odds ratio (OR), 95% confidence interval (CI)] was used to account for age and gender difference among three groups when comparing MS prevalence and being overweight; potential confounders were accounted for by including them in the regression equation. Results: Overall, the mean age was 46.9 ± 10.2 years, and men comprised 73.3% of participants. Comparing 2005, 2011 and 2015, MS was present in 34.5%, 33.0% and 29.3% of PHIV, respectively. Adjusted OR for MS was 0.64 (95% CI: 0.52–0.78) in 2011 and 0.56 (95% CI: 0.46–0.69) in 2015 compared with 2005, while BMI (kg/m2) increased from 23.6 in 2005, 24.5 in 2011 and 24.5 in 2015, with a concomitant increase of being overweight from 29.4% to 39.5% to 39.6% (p < 0.0001). Conclusions: In recent years, PHIV have had a significantly improved metabolic profile compared with previously, despite increasing weight and BMI. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Prevalence and determinants of resistance mutations in HIV‐1‐infected patients exposed to integrase inhibitors in a large Italian cohort

Author

Modica, S, primary, Rossetti, B, additional, Lombardi, F, additional, Lagi, F, additional, Maffeo, M, additional, D'Autilia, R, additional, Pecorari, M, additional, Vicenti, I, additional, Bruzzone, B, additional, Magnani, G, additional, Paolucci, S, additional, Francisci, D, additional, Penco, G, additional, Sacchini, D, additional, Zazzi, M, additional, De Luca, A, additional, and Di Biagio, A, additional

Published
2018
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10. Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe

Author

Elizaveta Vdoushkina, Brygida Knysz, Joanna Kozłowska, Anna Schultze, Adrian Curran, Fernando Alcaide, Jens Lundgren, Juan Luis Mosqueda, María Teresa Tórtola Fernández, Alberto Matteelli, Regina Podlasin, Enrico Girardi, Robert Miller, David Dockrell, Viktar M. Mitsura, Daria Podlekareva, Vasily Bondarenko, Alaksandr Skrahin, Anna Grzeszczuk, Vassilenko Anna, EVA CUCHÍ BURGOS, Alicja Wiercińska-Drapało, Antonio Di Biagio, Giuseppe LAPADULA, Małgorzata Inglot, Joan A. Caylà, and Niels Obel

Subjects
Pediatrics, medicine.medical_specialty, Rifabutin, Tuberculosis, business.industry, Cross-sectional study, Health Policy, Human immunodeficiency virus (HIV), medicine.disease, medicine.disease_cause, Infectious Diseases, Epidemiology, Health care, Coinfection, Medicine, Pharmacology (medical), business, Tb treatment, Demography, medicine.drug
Abstract

OBJECTIVES The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE). METHODS Thirty-eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study. RESULTS Respondent centres in EE comprised: Belarus (n = 3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P

Published
2015

11. Predictors of incomplete viral response and virologic failure in patients with acute and early HIV infection. Results of Italian Network of ACuTe HIV InfectiON (INACTION) cohort.

Author

Taramasso, L, Fabbiani, M, Nozza, S, De Benedetto, I, Bruzzesi, E, Mastrangelo, A, Pinnetti, C, Calcagno, A, Ferrara, M, Bozzi, G, Focà, E, Quiros‐Roldan, E, Ripamonti, D, Campus, M, Celesia, BM, Torti, C, Cosco, L, Di Biagio, A, Rusconi, S, and Marchetti, G

Subjects
CENTRAL nervous system, CONFIDENCE intervals, HIV, HIV infections, HIV-positive persons, MEDICAL cooperation, SCIENTIFIC observation, REGRESSION analysis, RESEARCH, RNA, T cells, CD4 antigen, TREATMENT effectiveness, PROPORTIONAL hazards models, RETROSPECTIVE studies, ANTI-HIV agents, DESCRIPTIVE statistics, SYMPTOMS
Abstract

Objectives: The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI). Methods: This was a retrospective, observational study including patients with AEHI (Fiebig stages I–V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51–1000 HIV‐1 RNA copies/mL after achievement of < 50 HIV‐1 RNA copies/mL); (2) virologic failure [> 1000 copies/mL after achievement of < 200 copies/mL, or ≥ 200 copies/mL after 24 weeks on an antiretroviral therapy (ART)]; (3) suboptimal viral response (> 50 copies/mL after 48 weeks on ART or two consecutive HIV‐1 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR. Results: In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30–46) years. During a median follow‐up of 13.0 (5.7–31.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56–14.17), while a higher CD4/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03–0.51 for each point increase) and first‐line ART with three‐drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18–0.91 compared with other regimens including four or five drugs, older drugs or non‐standard backbones) were protective against IVR. Conclusions: Patients with lower CD4/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short‐term viral efficacy in this group of patients. [ABSTRACT FROM AUTHOR]

Published
2020
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12. Missed opportunities to prevent mother‐to‐child transmission of HIV in Italy.

Author

Di Biagio, A, Taramasso, L, Gustinetti, G, Burastero, G, Giacomet, V, La Rovere, D, Genovese, O, Giaquinto, C, Rampon, O, Carloni, I, Hyppolite, TK, Palandri, L, Bernardi, S, Bruzzese, E, Badolato, R, Gabiano, C, Chiappini, E, De Martino, M, Galli, L, and Osimani, Patrizia

Subjects
*HIV infection transmission, *VERTICAL transmission (Communicable diseases), *HIV infections, *HIV-positive persons, *INFANT formulas, *MOTHERS, *ANTIRETROVIRAL agents, *EARLY diagnosis, *PREVENTION
Abstract

Objectives: Vertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother‐to‐child transmission of HIV. Methods: The Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. Results: We found 79 HIV‐1‐infected children newly diagnosed after birth in Italy. Thirty‐two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty‐one newborns received antiretroviral prophylaxis and 39 received infant formula. Conclusions: We found an unacceptable number of missed opportunities to prevent mother‐to‐child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns. [ABSTRACT FROM AUTHOR]

Published
2019
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13. Prevalence and determinants of resistance mutations in HIV‐1‐infected patients exposed to integrase inhibitors in a large Italian cohort.

Author

Rossetti, B, Modica, S, Maffeo, M, De Luca, A, Francisci, D, Penco, G, Sacchini, D, Di Biagio, A, Vicenti, I, Zazzi, M, Lombardi, F, Lagi, F, D'Autilia, R, Pecorari, M, Bruzzone, B, Magnani, G, and Paolucci, S

Subjects
CHI-squared test, DRUG resistance, HIV, HIV infections, HIV-positive persons, GENETIC mutation, LOGISTIC regression analysis, DISEASE prevalence, HIV integrase inhibitors, DESCRIPTIVE statistics, SEQUENCE analysis, GENOTYPES, PHARMACODYNAMICS
Abstract

Objectives: The aim of the study was to analyse the prevalence of integrase resistance mutations in integrase strand transfer inhibitor (INSTI)‐experienced HIV‐1‐infected patients and its predictors. Methods: We selected HIV‐1 integrase sequences from the Antiviral Response Cohort Analysis (ARCA) database, derived from INSTI‐experienced patients between 2008 and 2017. Differences in the prevalence of resistance to raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG) were assessed by χ2 test and predictors of resistance were analysed by logistic regression. Results: We included 462 genotypes from INSTI‐exposed individuals: 356 'INSTI‐failing' patients and 106 'previously INSTI‐exposed' patients (obtained a median of 42 weeks after INSTI discontinuation [interquartile range (IQR) 17–110 weeks]). Overall, at least low‐level resistance (LLR) to any INSTI (Stanford 8.5 algorithm) was detected in 198 (42.9%) cases. The most frequent INSTI resistance mutation was N155H, followed by Q148H/K/R, G140A/C/S, E138A/K/T and Y143C/H/R. Y143R and E138A were more prevalent in viral subtype B versus non‐B [5.2 versus 1.5%, respectively (P = 0.04), and 3.1 versus 0%, respectively (P = 0.02)]. Overall, the Q148H/K/R plus G140A/C/S and/or E138A/K/T pattern, defining an intermediate level of resistance to DTG, was detected in 70 (15%) cases. Independent predictors of at least LLR to any INSTI were current use versus past use of INSTIs, a lower genotypic sensitivity score (GSS) for contemporary antiretroviral drugs used, and having an integrase sequence obtained in calendar year 2016 as compared to 2008–2009. Conclusions: The results support integrase resistance testing in INSTI‐experienced patients. Emergence of INSTI resistance is facilitated by the reduced genetic barrier of the regimen as a consequence of resistance to companion drugs. However, INSTI resistance may become undetectable by standard population sequencing upon INSTI discontinuation. [ABSTRACT FROM AUTHOR]

Published
2019
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14. First‐line antiretroviral therapy with efavirenz plus tenofovir disiproxil fumarate/emtricitabine or rilpivirine plus tenofovir disiproxil fumarate/emtricitabine: a durability comparison.

Author

Taramasso, L., Di Biagio, A., Maggiolo, F., Tavelli, A., Lo Caputo, S., Bonora, S., Zaccarelli, M., Caramello, P., Costantini, A., Viscoli, C., d'Arminio Monforte, A., Cozzi‐Lepri, A., and the Italian Cohort Naive Antiretrovirals (ICONA) Foundation Study Group

Subjects
*HIV prevention, *ANTIRETROVIRAL agents, *EMTRICITABINE-tenofovir, *EFAVIRENZ, *RILPIVIRINE, *CONFIDENCE intervals, *DRUG tolerance, *CLINICAL drug trials, *HIV infections, *LONGITUDINAL method, *MEDICAL cooperation, *SCIENTIFIC observation, *REGRESSION analysis, *RESEARCH, *SURVIVAL analysis (Biometry), *TOXICITY testing, *VIRAL load, *TERMINATION of treatment, *TREATMENT effectiveness, *PROPORTIONAL hazards models, *KAPLAN-Meier estimator, *LOG-rank test, *THERAPEUTICS
Abstract

Objectives: The aim of this study was to compare the durabilities of efavirenz (EFV) and rilpivirine (RPV) in combination with tenofovir/emtricitabine (TDF/FTC) in first‐line regimens. Methods: A multicentre prospective and observational study was carried out. We included all patients participating in the Italian Cohort Naive Antiretrovirals (ICONA) Foundation Study who started first‐line combination antiretroviral therapy (cART) with TDF/FTC in combination with RPV or EFV, with a baseline viral load < 100 000 HIV‐1 RNA copies/mL. Survival analyses using Kaplan–Meier (KM) curves and Cox regression with time‐fixed covariates at baseline were employed. Results: Overall, 1490 ART‐naïve patients were included in the study, of whom 704 were initiating their first cART with EFV and 786 with RPV. Patients treated with EFV, compared with those on RPV, were older [median 36 (interquartile range (IQR) 30–43) years vs. 33 (IQR 27–39) years, respectively; P < 0.001], were more frequently at Centers for Disease Control and Prevention (CDC) stage C (3.1% vs. 1.4%, respectively; P = 0.024), and had a lower median baseline CD4 count [340 (IQR 257–421) cells/μL vs. 447 (IQR 347–580) cells/μL, respectively; P < 0.001] and a higher median viral load [4.38 (IQR 3.92–4.74) log10 copies/mL vs. 4.23 (IQR 3.81–4.59) log10 copies/mL, respectively], (P = 0.004). A total of 343 patients discontinued at least one drug of those included in the first cART regimen, more often EFV (26%) than RPV (13%), by 2 years (P < 0.0001). After adjustment, patients treated with EFV were more likely to discontinue at least one drug for any cause [relative hazard (RH) 4.09; 95% confidence interval (CI) 2.89–5.80], for toxicity (RH 2.23; 95% CI 1.05–4.73) for intolerance (RH 5.17; 95% CI 2.66–10.07) and for proactive switch (RH 10.96; 95% CI 3.17–37.87) than those starting RPV. Conclusions: In our nonrandomized comparison, RPV was better tolerated, less toxic and showed longer durability than EFV, without a significant difference in rates of discontinuation because of failures. [ABSTRACT FROM AUTHOR]

Published
2018
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15. Prevalence and determinants of resistance mutations in HIV-1-infected patients exposed to integrase inhibitors in a large Italian cohort.

Author

Modica S, Rossetti B, Lombardi F, Lagi F, Maffeo M, D'Autilia R, Pecorari M, Vicenti I, Bruzzone B, Magnani G, Paolucci S, Francisci D, Penco G, Sacchini D, Zazzi M, De Luca A, and Di Biagio A

Subjects
Adult, Female, Genotype, HIV Infections virology, HIV Integrase Inhibitors therapeutic use, Heterocyclic Compounds, 3-Ring therapeutic use, Humans, Italy epidemiology, Logistic Models, Male, Middle Aged, Oxazines, Piperazines, Prevalence, Pyridones, Quinolones therapeutic use, Raltegravir Potassium therapeutic use, Drug Resistance, Viral, HIV Infections drug therapy, HIV Integrase genetics, HIV-1 genetics, Mutation
Abstract

Objectives: The aim of the study was to analyse the prevalence of integrase resistance mutations in integrase strand transfer inhibitor (INSTI)-experienced HIV-1-infected patients and its predictors., Methods: We selected HIV-1 integrase sequences from the Antiviral Response Cohort Analysis (ARCA) database, derived from INSTI-experienced patients between 2008 and 2017. Differences in the prevalence of resistance to raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG) were assessed by χ 2 test and predictors of resistance were analysed by logistic regression., Results: We included 462 genotypes from INSTI-exposed individuals: 356 'INSTI-failing' patients and 106 'previously INSTI-exposed' patients (obtained a median of 42 weeks after INSTI discontinuation [interquartile range (IQR) 17-110 weeks]). Overall, at least low-level resistance (LLR) to any INSTI (Stanford 8.5 algorithm) was detected in 198 (42.9%) cases. The most frequent INSTI resistance mutation was N155H, followed by Q148H/K/R, G140A/C/S, E138A/K/T and Y143C/H/R. Y143R and E138A were more prevalent in viral subtype B versus non-B [5.2 versus 1.5%, respectively (P = 0.04), and 3.1 versus 0%, respectively (P = 0.02)]. Overall, the Q148H/K/R plus G140A/C/S and/or E138A/K/T pattern, defining an intermediate level of resistance to DTG, was detected in 70 (15%) cases. Independent predictors of at least LLR to any INSTI were current use versus past use of INSTIs, a lower genotypic sensitivity score (GSS) for contemporary antiretroviral drugs used, and having an integrase sequence obtained in calendar year 2016 as compared to 2008-2009., Conclusions: The results support integrase resistance testing in INSTI-experienced patients. Emergence of INSTI resistance is facilitated by the reduced genetic barrier of the regimen as a consequence of resistance to companion drugs. However, INSTI resistance may become undetectable by standard population sequencing upon INSTI discontinuation., (© 2018 British HIV Association.)

Published
2019
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