30 results on '"Dusina, Alex"'
Search Results
2. Difference in the neurocognitive functions of WLWH and MLWH in an Italian cohort of people living with HIV
- Author
-
Donne, Valentina Delle, Massaroni, Valentina, Ciccarelli, Nicoletta, Lombardi, Francesca, Borghetti, Alberto, Ciccullo, Arturo, Dusina, Alex, Farinacci, Damiano, Baldin, Ganmaria, Visconti, Elena, Tamburrini, Enrica, and Di Giambenedetto, Simona
- Published
- 2022
- Full Text
- View/download PDF
3. A 67-Year-Old Man with Chronic Lymphocytic Leukemia (CLL) on Maintenance Therapy with Ibrutinib with Persistent SARS-CoV-2 Infection Unresponsive to Antiviral Treatments.
- Author
-
Sanmartin, Flavia, Magrini, Eugenia, Rando, Emanuele, Del Giacomo, Paola, Dusina, Alex, Matteini, Elena, Carbone, Andrea, Puma, Giuseppe, Leanza, Gabriele Maria, Frondizi, Federico, Innocenti, Idanna, Maiuro, Giuseppe, Liotti, Flora Marzia, Santangelo, Rosaria, Laurenti, Luca, and Cingolani, Antonella
- Subjects
CHRONIC lymphocytic leukemia ,SARS-CoV-2 ,BLOOD diseases ,THERAPEUTICS ,COMMON variable immunodeficiency - Abstract
Objective: Unusual clinical course. Background: SARS-CoV-2 infection can persist in immunocompromised patients with hematological malignancies, despite antiviral treatment. This report is of a 67-year-old man with chronic lymphocytic leukemia (CLL), secondary hypogammaglobulinemia, and thrombocytopenia on maintenance therapy with ibrutinib, with persistent SARSCoV- 2 infection unresponsive to antiviral treatment, including remdesivir, nirmatrelvir/ritonavir (Paxlovid), and tixagevimab/cilgavimab (Evusheld). Case Report: The patient was admitted to our hospital 3 times. During his first hospitalization, he was treated with 5-day course of remdesivir and intravenous steroids; however, antigen and molecular nasopharyngeal swabs were persistently positive, and he was discharged home. Due to respiratory worsening, he was rehospitalized, and despite being treated initially with tixagevimab/cilgavimab, and subsequently with a remdesivir course of 5 days, SARS-CoV-2 tests remained persistently positive. During his third hospital stay, our patient was subjected to combined therapy with remdesivir and nirmatrelvir/ritonavir for 5 days, obtaining a significant reduction of viral load at both antigen and molecular testing. As an ultimate attempt to achieve a negative status before discharge, a 10-day course of combined remdesivir and nirmatrelvir/ritonavir was administered, with a temporary reduction of viral load, followed by a sudden increase immediately after the discontinuation of Paxlovid. Due to worsening hematological disease and bacterial over-infections, the patient gradually worsened until death. Conclusions: This is an emblematic case of correlation between persistent SARS-CoV-2 infection and immunosuppression status in hematological hosts. In these patients, the viral load remains high, favoring the evolution of the virus, and the immunodeficiency makes it difficult to identify the appropriate therapeutic approach. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Efficacy of Lamivudine Plus Dolutegravir vs Dolutegravir-Based 3-Drug Regimens in People With HIV Who Are Virologically Suppressed.
- Author
-
Borghetti, Alberto, Ciccullo, Arturo, Lombardi, Francesca, Giannarelli, Diana, Passerotto, Rosa Anna, Lamanna, Francesco, Carcagnì, Antonella, Farinacci, Damiano, Dusina, Alex, Baldin, Gianmaria, Zazzi, Maurizio, and Giambenedetto, Simona Di
- Subjects
LAMIVUDINE ,NUCLEOSIDE reverse transcriptase inhibitors ,HIV-positive persons ,DOLUTEGRAVIR - Abstract
Background Lamivudine + dolutegravir maintenance dual therapy (DT) could be less effective than 3-drug therapy (TT) in the context of resistance-associated mutations to nucleoside reverse transcriptase inhibitors (NRTIs). The ARCA database was queried to test this hypothesis with a trial emulation strategy. Methods People with HIV taking 2 NRTIs plus a protease inhibitor or a non-NRTI who switched to DT or dolutegravir-based TT were followed up from the first HIV RNA <50 copies/mL (baseline) to virologic failure (VF; ie, 2 consecutive HIV RNA ≥50 copies/mL or 1 HIV RNA ≥200 copies/mL). Those switching to DT within 6 months were assigned to the treatment arm and all other patients to the control arm. Each participant was also cloned, assigned to the opposite strategy, and censored at the time of deviation from that strategy. Using inverse probability of censoring weight Cox regression models, we calculated hazard ratios of VF for DT vs TT stratified for the presence of resistance-associated mutations. Results Overall 626 people were analyzed: 204 with DT and 422 with TT (73% men; mean age, 44 years). Ten and 31 VFs occurred with DT and TT, respectively, over a median 5.8 years. When compared with a fully active TT, the DT had similar efficacy (adjusted hazard ratio, 0.88; 95% CI,.29–2.61; P =.812) when full susceptibility was confirmed at historical genotype. When previous M184V/I was present in both groups, the risk of VF was higher for DT vs TT but was not statistically significant (adjusted hazard ratio, 3.06; 95% CI,.45–20.84; P =.252). Conclusions DT was not associated with a significantly higher risk of VF than dolutegravir-based TT. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. The University of California San Diego performance-based skills assessment: a useful tool to detect mild everyday functioning difficulties in HIV-infected patients with very good immunological condition
- Author
-
Delle Donne, Valentina, Ciccarelli, Nicoletta, Massaroni, Valentina, Borghetti, Alberto, Dusina, Alex, Farinacci, Damiano, Visconti, Elena, Tamburrini, Enrica, Fabbiani, Massimiliano, and Di Giambenedetto, Simona
- Published
- 2020
- Full Text
- View/download PDF
6. The association between stigma and wellbeing in an Italian cohort of PLWH: The role of social support and personal factors.
- Author
-
Delle Donne, Valentina, Massaroni, Valentina, Lombardi, Francesca, Dusina, Alex, Salvo, Pierluigi Francesco, Borghetti, Alberto, Ciccullo, Arturo, Visconti, Elena, and Di Giambenedetto, Simona
- Published
- 2024
- Full Text
- View/download PDF
7. SARS-CoV-2 infection in a highly experienced person living with HIV
- Author
-
Di Giambenedetto, Simona, Del Giacomo, Paola, Ciccullo, Arturo, Porfidia, Angelo, De Matteis, Giuseppe, Cianci, Rossella, De Vito, Francesco, Dusina, Alex, Borghetti, Alberto, and Tumbarello, Mario
- Published
- 2020
- Full Text
- View/download PDF
8. No significant changes in body fat mass in virologically suppressed, HIV-positive patients switched to lamivudine--dolutegravir
- Author
-
Ciccullo, Arturo, Dusina, Alex, Lassandro, Anna Pia, Borghetti, Alberto, Baldin, Gianmaria, and Di Giambenedetto, Simona
- Published
- 2020
- Full Text
- View/download PDF
9. Characteristics of mental health interventions in a cohort of Italian PLWH over the last five years: impact of HIV disease and outbreak of COVID-19 pandemic.
- Author
-
Delle Donne, Valentina, Massaroni, Valentina, Borghetti, Alberto, Ciccullo, Arturo, Dusina, Alex, Lombardi, Francesca, Steiner, Rebecca Jo, Iannone, Valentina, Salvo, Pierluigi Francesco, and Di Giambenedetto, Simona
- Subjects
MENTAL illness treatment ,MENTAL illness risk factors ,HIV infections ,PERSONALITY ,SOCIAL support ,TIME ,AGE distribution ,MENTAL health ,HELP-seeking behavior ,PSYCHOLOGISTS ,PATIENTS' attitudes ,COMPARATIVE studies ,SELF-disclosure ,PATHOLOGICAL psychology ,DISEASE duration ,DESCRIPTIVE statistics ,COVID-19 pandemic ,PSYCHOLOGY of HIV-positive persons ,HEALTH promotion ,LONGITUDINAL method ,MENTAL illness ,PSYCHOTHERAPY ,PSYCHOSOCIAL factors - Abstract
Evidence accumulated during past years confirm that people living with HIV (PLWH) still have to deal with comorbidities and chronic complications that can increase physical and psychological issues and can affect daily functioning, quality of life and mental health. Moreover, during the COVID-19 pandemic PLWH proved to be a population at increased risk of psychological distress. We explored the ongoing issues and the characteristics of the mental health interventions for which a cohort of Italian PLWH interacted with a psychologist over the past five years. We analysed a dataset that included 61 PLWH who underwent a psychological intervention between 2018 and 2022. We compared different frequencies in characteristics of mental health interventions according to different demographic and clinical variables, psychopathological symptoms and time of the request for intervention. We showed that psychopathological symptoms most frequently reported by patients were anxiety (55.7%), and depression (49.2%). Furthermore, we reported that most our patients undertook occasional psychological support meetings (31%), sought an intervention after the outbreak of the COVID-19 pandemic (62.3%) and complained about disclosure issues (48.5%). Disclosure issues were mainly reported by younger PLWH (p = 0.002) with a shorter disease (p = 0.031) and treatment history (p = 0.032), and higher interpersonal sensitivity (p = 0.042). It seems fundamental to integrate psychological interventions into the care of PLWH, to give particular attention to PLWH with risky demographic, clinical and mental health factors and to pay special attention to emergency conditions (such as the COVID-19 pandemic) and the most widespread issues to create ad hoc interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
10. Changes in Metabolic Profile in PLWHIV Switching to Doravirine-Based Regimen.
- Author
-
Iannone, Valentina, Passerotto, Rosa Anna, Lamanna, Francesco, Steiner, Rebecca Jo, Lombardi, Francesca, Salvo, Pierluigi Francesco, Dusina, Alex, Farinacci, Damiano, Borghetti, Alberto, Di Giambenedetto, Simona, and Ciccullo, Arturo
- Subjects
LIPID metabolism ,HIV-positive persons ,METABOLIC syndrome - Abstract
Thanks to the modern ARV regimens and the fact that the morbidity and mortality of metabolic syndrome increases with age, clinicians are continuously researching effective and safe antiretroviral regimens with low impact on the lipid profile. Doravirine (DOR) is the latest non-nucleoside reverse-transcriptase inhibitor (NNRTI) that shows long-term safety and tolerability and a favorable lipid profile. The aim of this study is to assess the impact of DOR-based three-drug regimens on the lipid profile in clinical practice. We retrospectively analyzed a cohort of 38 treatment-experienced, virologically suppressed people living with HIV (PLWH) switching to this regimen, following the eligibility criteria. We carried out comparison analysis of immunological and metabolic parameters between baseline and 48 weeks of follow up. In our cohort of treatment-experienced, virologically suppressed PLWH, three-drug regimens with DOR showed good efficacy and a positive profile on lipid metabolism at 48 weeks of follow up. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
11. Differences in the Long-term Impact of the COVID-19 Pandemic on Mental Health and Professional Quality of Life of Resident and Specialist Physicians.
- Author
-
DONNE, VALENTINA DELLE, MASSARONI, VALENTINA, CICCARELLI, NICOLETTA, BORGHETTI, ALBERTO, CICCULLO, ARTURO, BALDIN, GIANMARIA, GIULIANO, GABRIELE, DUSINA, ALEX, VISCONTI, ELENA, TAMBURRINI, ENRICA, and DI GIAMBENEDETTO, SIMONA
- Abstract
Background: The COVID-19 pandemic created a challenging situation for healthcare workers (HCWs) worldwide. We aimed to compare the mental health and professional quality of life of residents and specialist physicians in a cohort of Italian HCWs caring for patients with COVID-19 about two years after the start of the COVID-19 pandemic. Methods: Between November 2021 and November 2022, an online survey investigating the emotional states of depression, anxiety, stress, compassion satisfaction, and compassion fatigue was administered to HCWs (N=78) at the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome. Results: Our findings suggest that from 5 to 20% of our HCWs still showed the effects of the adverse psychological impact of the pandemic, and more than half experienced medium levels of compassion fatigue and a medium level of compassion satisfaction. Our results also show that those with fewer years of clinical practice might be at greater risk of burnout (p=0.021), anxiety, and stress symptoms (both p=0.027). In addition, they might develop a lower level of compassion satisfaction (p=0.018). Moreover, the factors that potentially contribute to poor mental health, compassion fatigue, and compassion satisfaction differ between residents and specialist physicians. Conclusions: This overview presents one of the first pictures of the long-term effects of the pandemic on the mental health and professional quality of life of an Italian sample of HCWs. Moreover, it also helps identify professionals who most need support and emphasizes the importance of improving these individuals' psychological and professional well-being, especially during a pandemic-like crisis with long-lasting effects. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
12. Toxoplasmosis mimicking CMV chorioretinitis in newly diagnosed PLWH: a case report.
- Author
-
Lamanna, Francesco, Passerotto, Rosa Anna, Carbone, Andrea, Steiner, Rebecca Jo, Iannone, Valentina, Salvo, Pierluigi Francesco, Ciccullo, Arturo, Baldin, Gianmaria, Borghetti, Alberto, and Dusina, Alex
- Published
- 2023
- Full Text
- View/download PDF
13. Are we ready for long‐acting? A feasibility evaluation of long‐acting cabotegravir–rilpivirine in clinical practice.
- Author
-
Borghetti, Alberto, Farinacci, Damiano, Ciccullo, Arturo, Dusina, Alex, Moschese, Davide, Iannone, Valentina, D'Angelillo, Anna, Lombardi, Francesca, Donne, Valentina Delle, Massaroni, Valentina, Visconti, Elena, Tamburrini, Enrica, and Di Giambenedetto, Simona
- Subjects
HEPATITIS B virus ,HIV-positive persons ,INTEGRASE inhibitors ,HEPATITIS B ,VIRAL load - Abstract
Cabotegravir and rilpivirine are the first drugs to be approved as injectable therapy to treat individuals with HIV. Despite encouraging results, the guidelines specify strict criteria for eligibility that could limit the feasibility of this strategy. We collected the clinical data of HIV‐positive patients who were being treated at a single, third‐level center in Italy. All patients were on stable therapy and showed suppressed viral load on their most recent analyses. We performed a cross‐sectional analysis of the clinical and viro‐immunological characteristics of this population and excluded patients who had previous virological failures, resistance‐associated mutations (RAMs) to rilpivirine or integrase inhibitors in the historical genotype, hepatitis B infection, absence of previous genotypes, and the coexistence of HIV‐subtype A and obesity. Our aim was to evaluate the proportion of patients who could be eligible for switching to this strategy. one thousand seven hundred fifty‐two patients were eligible. One hundred and forty‐eight were excluded because of a detectable viral load. With regard to the exclusion criteria, 48 patients had coinfection with hepatitis B virus, and 744 had a history of previous virological failures. Of the 896 patients with at least one genotypic resistance test, 161 had one or more RAMs to rilpivirine and 3 had RAMs to cabotegravir. None of the patients presented the combination of obesity and the A viral subtype. Overall, 31.2% of the patients were ineligible for cabotegravir–rilpivirine, and the proportion increased to 47.3% when we considered only patients with all available information concerning resistance tests. Approximately half of our cohort of patients did not fulfill the criteria and even more patients were potentially ineligible for cabotegravir–rilpivirine due to the lack of genotypic resistance tests. Also, fertile women had to be excluded due to the lack of data about this combination during pregnancy and breastfeeding. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
14. COVID-19 and intestinal inflammation: Role of fecal calprotectin
- Author
-
Abbate, Valeria, Acampora, Nicola, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Antonelli, Mariangela, Antonucci, Gabriele, Anzellotti, Gian Marco, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Barone, Fabiana, Bellantone, Rocco Domenico Alfonso, Bellieni, Andrea, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Bibbò, Stefano, Bini, Alessandra, Bisanti, Alessandra, Biscetti, Federico, Bocci, Maria Grazia, Bonadia, Nicola, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Bruni, Teresa, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Burzo, Livia, Calabrese, Angelo, Calvello, Maria Rosaria, Cambieri, Andrea, Cambise, Chiara, Cammà, Giulia, Candelli, Marcello, Canistro, Gennaro, Cantanale, Antonello, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Cardone, Silvia, Carelli, Simone, Carfì, Angelo, Carnicelli, Annamaria, Caruso, Cristiano, Casciaro, Francesco Antonio, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Cesarano, Melania, Chiarito, Annalisa, Cianci, Rossella, Cicchinelli, Sara, Ciccullo, Arturo, Cicetti, Marta, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Maria Ludovica, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Costanzi, Matteo, Covino, Marcello, Crupi, Davide, Cutuli, Salvatore Lucio, D'Addio, Stefano, D'Alessandro, Alessia, D'AlfonsoD'Angelo, Maria ElenaEmanuela, D'Aversa, Francesca, Damiano, Fernando, De Berardinis, Gian Maria, De Cunzo, Tommaso, De Gaetano, Donati Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Santis, Paolo, De Siena, Martina, De Vito, Francesco, Del Gatto, Valeria, Del Giacomo, Paola, Del Zompo, Fabio, Dell'Anna, Antonio Maria, Polla, Davide Della, Di Gialleonardo, Luca, Di Giambenedetto, Simona, Di Luca, Roberta, Di Maurizio, Luca, Di Muro, Mariangela, Dusina, Alex, Eleuteri, Davide, Esperide, Alessandra, Fachechi, Daniele, Faliero, Domenico, Falsiroli, Cinzia, Fantoni, Massimo, Fedele, Annalaura, Feliciani, Daniela, Ferrante, Cristina, Ferrone, Giuliano, Festa, Rossano, Fiore, Maria Chiara, Flex, Andrea, Forte, Evelina, Franceschi, Francesco, Francesconi, Alessandra, Franza, Laura, Funaro, Barbara, Fuorlo, Mariella, Fusco, Domenico, Gabrielli, Maurizio, Gaetani, Eleonora, Galletta, Claudia, Gallo, Antonella, Gambassi, Giovanni, Garcovich, Matteo, Gasbarrini, Antonio, Gasparrini, Irene, Gelli, Silvia, Giampietro, Antonella, Gigante, Laura, Giuliano, Gabriele, Giuliano, Giorgia, Giupponi, Bianca, Gremese, Elisa, Grieco, Domenico Luca, Guerrera, Manuel, Guglielmi, Valeria, Guidone, Caterina, Gullì, Antonio, Iaconelli, Amerigo, Iafrati, Aurora, Ianiro, Gianluca, Iaquinta, Angela, Impagnatiello, Michele, Inchingolo, Riccardo, Intini, Enrica, Iorio, Raffaele, Izzi, Immacolata Maria, Jovanovic, Tamara, Kadhim, Cristina, La Macchia, Rosa, La Milia, Daniele Ignazio, Landi, Francesco, Landi, Giovanni, Landi, Rosario, Landolfi, Raffaele, Leo, Massimo, Leone, Paolo Maria, Levantesi, Laura, Liguori, Antonio, Liperoti, Rosa, Lizzio, Marco Maria, Monaco, Maria Rita Lo, Locantore, Pietro, Lombardi, Francesco, Lombardi, Gianmarco, Lopetuso, Loris, Loria, Valentina, Losito, Angela Raffaella, Lucia, Mothanje Barbara Patricia, Macagno, Francesco, Macerola, Noemi, Maggi, Giampaolo, Maiuro, Giuseppe, Mancarella, Francesco, Mangiola, Francesca, Manno, Alberto, Marchesini, Debora, Maresca, Gian Marco, Marrone, Giuseppe, Martis, Ilaria, Martone, Anna Maria, Marzetti, Emanuele, Mattana, Chiara, Matteo, Maria Valeria, Maviglia, Riccardo, Mazzarella, Ada, Memoli, Carmen, Miele, Luca, Migneco, Alessio, Mignini, Irene, Milani, Alessandro, Milardi, Domenico, Montalto, Massimo, Montemurro, Giuliano, Monti, Flavia, Montini, Luca, Morena, Tony Christian, Morra, Vincenzina, Morretta, Chiara, Moschese, Davide, Murace, Celeste Ambra, Murdolo, Martina, Murri, Rita, Napoli, Marco, Nardella, Elisabetta, Natalello, Gerlando, Natalini, Daniele, Navarra, Simone Maria, Nesci, Antonio, Nicoletti, Alberto, Nicoletti, Rocco, Nicoletti, Tommaso Filippo, Nicolò, Rebecca, Nicolotti, Nicola, Nista, Enrico Celestino, Nuzzo, Eugenia, Oggiano, Marco, Ojetti, Veronica, Pagano, Francesco Cosimo, Paiano, Gianfranco, Pais, Cristina, Pallavicini, Federico, Palombo, Andrea, Paolillo, Federico, Papa, Alfredo, Papanice, Domenico, Papparella, Luigi Giovanni, Paratore, Mattia, Parrinello, Giuseppe, Pasciuto, Giuliana, Pasculli, Pierpaolo, Pecorini, Giovanni, Perniola, Simone, Pero, Erika, Petricca, Luca, Petrucci, Martina, Picarelli, Chiara, Piccioni, Andrea, Piccolo, Annalisa, Piervincenzi, Edoardo, Pignataro, Giulia, Pignataro, Raffaele, Pintaudi, Gabriele, Pisapia, Luca, Pizzoferrato, Marco, Pizzolante, Fabrizio, Pola, Roberto, Policola, Caterina, Pompili, Maurizio, Pontecorvi, Flavia, Pontecorvi, Valerio, Ponziani, Francesca, Popolla, Valentina, Porceddu, Enrica, Porfidia, Angelo, Porro, Lucia Maria, Potenza, Annalisa, Pozzana, Francesca, Privitera, Giuseppe, Pugliese, Daniela, Pulcini, Gabriele, Racco, Simona, Raffaelli, Francesca, Ramunno, Vittoria, Rapaccini, Gian Ludovico, Richeldi, Luca, Rinninella, Emanuele, Rocchi, Sara, Romanò, Bruno, Romano, Stefano, Rosa, Federico, Rossi, Laura, Rossi, Raimondo, Rossini, Enrica, Rota, Elisabetta, Rovedi, Fabiana, Rubino, Carlotta, Rumi, Gabriele, Russo, Andrea, Sabia, Luca, Salerno, Andrea, Salini, Sara, Salvatore, Lucia, Samori, Dehara, Sandroni, Claudio, Sanguinetti, Maurizio, Santarelli, Luca, Santini, Paolo, Santolamazza, Danilo, Santoliquido, Angelo, Santopaolo, Francesco, Santoro, Michele Cosimo, Sardeo, Francesco, Sarnari, Caterina, Saviano, Angela, Saviano, Luisa, Scaldaferri, Franco, Scarascia, Roberta, Schepis, Tommaso, Schiavello, Francesca, Scoppettuolo, Giancarlo, Sedda, Davide, Sessa, Flaminio, Sestito, Luisa, Settanni, Carlo, Siciliano, Matteo, Siciliano, Valentina, Sicuranza, Rossella, Simeoni, Benedetta, Simonetti, Jacopo, Smargiassi, Andrea, Soave, Paolo Maurizio, Sonnino, Chiara, Staiti, Domenico, Stella, Claudia, Stella, Leonardo, Stival, Eleonora, Taddei, Eleonora, Talerico, Rossella, Tamburello, Elio, Tamburrini, Enrica, Tanzarella, Eloisa Sofia, Tarascio, Elena, Tarli, Claudia, Tersali, Alessandra, Tilli, Pietro, Timpano, Jacopo, Torelli, Enrico, Torrini, Flavia, Tosato, Matteo, Tosoni, Alberto, Tricoli, Luca, Tritto, Marcello, Tumbarello, Mario, Tummolo, Anita Maria, Vallecoccia, Maria Sole, Valletta, Federico, Varone, Francesco, Vassalli, Francesco, Ventura, Giulio, Verardi, Lucrezia, Vetrone, Lorenzo, Vetrugno, Giuseppe, Visconti, Elena, Visconti, Felicia, Viviani, Andrea, Zaccaria, Raffaella, Zaccone, Carmelina, Zelano, Lorenzo, Dal Verme, Lorenzo Zileri, Zuccalà, Giuseppe, and Troiani, Eliana
- Published
- 2020
- Full Text
- View/download PDF
15. Cardiovascular Disease Risk in a Cohort of Virologically Suppressed People Living with HIV Switching to Doravirine: Preliminary Data from the Real Life.
- Author
-
Iannone, Valentina, Farinacci, Damiano, D'Angelillo, Anna, Dusina, Alex, Lamanna, Francesco, Passerotto, Rosanna, Baldin, Gianmaria, Visconti, Elena, Tamburrini, Enrica, Borghetti, Alberto, Di Giambenedetto, Simona, and Ciccullo, Arturo
- Abstract
Aim of this study is to assess the impact of doravirine (DOR)-based regimens on cardiovascular risk in treatment-experienced people living with HIV (PLWHIV). We retrospectively analyzed a cohort of 40 treatment-experienced PLWHIV switching to a DOR-based three-drug regimen, evaluating 10-year risk of manifesting clinical cardiovascular diseases (CD) through the Framingham Risk Score at baseline, 12, and 24 weeks of follow-up. At baseline, median predicted 10-year risk of cardiovascular disease (10Y-CD) was 8.0% (interquartile range 4.0–13.0). After 12 weeks, we observed a significant reduction in 10Y-CD (mean decrease −2.21, p = .012); similarly, we observed a nonsignificant reduction at week 24 (p = .336). Regarding metabolic parameters, after 24 weeks we observed a significant reduction in total cholesterol (median change −8.8 mg/dL, p = .018), low-density lipoprotein cholesterol (median −9.5 mg/dL, p = .007), and triglycerides (median −19.8 mg/dL, p < .001). Our results show a favorable metabolic impact of DOR-based regimens along with a promising reduction in 10-year risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
16. Efficacy and durability of two‐ vs. three‐drug integrase inhibitor‐based regimens in virologically suppressed HIV‐infected patients: Data from real‐life ODOACRE cohort.
- Author
-
Fabbiani, Massimiliano, Rossetti, Barbara, Ciccullo, Arturo, Oreni, Letizia, Lagi, Filippo, Celani, Luigi, Colafigli, Manuela, De Vito, Andrea, Mazzitelli, Maria, Dusina, Alex, Durante, Miriam, Montagnani, Francesca, Rusconi, Stefano, Capetti, Amedeo, Sterrantino, Gaetana, D'Ettorre, Gabriella, Di Giambenedetto, Simona, Zanelli, Giacomo, Baldin, Gianmaria, and Borghetti, Alberto
- Subjects
HIV infections ,HIV-positive persons ,HIV integrase inhibitors ,COMBINATION drug therapy ,CLINICAL trials ,RNA ,TREATMENT effectiveness ,COMPARATIVE studies ,SURVIVAL analysis (Biometry) ,DESCRIPTIVE statistics - Abstract
Objectives: The aim of the present study was to compare the efficacy and durability of treatment switch to two‐drug (2DR) vs. three‐drug (3DR) integrase inhibitor (InSTI)‐based regimens in a real‐life setting. Methods: Within the ODOACRE cohort, we selected adult patients with HIV RNA < 50 copies/mL switching to an InSTI‐based 2DR or 3DR. Survival analyses were performed to estimate the probability of virological failure (VF, defined as one HIV RNA > 1000 copies/mL or two consecutive HIV RNA > 50 copies/mL) and treatment discontinuation (TD, defined as any modification, intensification or interruption of the regimen), and to evaluate their predictors. Results: Overall, 1666 patients were included, of whom 1334 (80%) were treated with a 3DR (19.9%, 25.0% and 55.1% elvitegravir‐, raltegravir‐ and dolutegravir‐based, respectively) and 332 (20%) with a 2DR (79.2% dolutegravir + lamivudine and 20.8% dolutegravir + rilpivirine). Over a median (interquartile range) follow‐up of 100 (52–150) weeks, 52 (3.1%) patients experienced VF with an incidence of 1.5/100 person‐year of follow‐up (PYFU). The estimated 96‐week probability of VF was similar for the 2DR and 3DR groups (2.3% vs. 2.8%, P = 0.53), but it was higher for elvitegravir (4.9%) and raltegravir (5.0%) than for dolutegravir (1.5%) (P = 0.04). Four hundred (24%) patients discontinued their InSTI‐based regimen, with an incidence of 11.3/100 PYFU. At 96 weeks, 3DRs showed a higher probability of TD for any reason (20.6% vs. 11.2%, P < 0.001) and TD for toxicity (9.0% vs. 6.6%, P = 0.02) when compared with 2DRs. A higher risk of TD for central nervous system toxicity was observed for dolutegravir than for elvitegravir and raltegravir (4.0% vs. 2.5% vs. 0.6%, P = 0.005). Conclusions: In virologically suppressed HIV‐infected patients, 2DRs showed an efficacy similar to 3DRs but with better tolerability. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
17. Nucleoside Reverse-Transcriptase Inhibitor Resistance Mutations Predict Virological Failure in Human Immunodeficiency Virus-Positive Patients During Lamivudine Plus Dolutegravir Maintenance Therapy in Clinical Practice.
- Author
-
Borghetti, Alberto, Giacomelli, Andrea, Borghi, Vanni, Ciccullo, Arturo, Dusina, Alex, Fabbiani, Massimiliano, Rusconi, Stefano, Zazzi, Maurizio, Mussini, Cristina, and Giambenedetto, Simona Di
- Subjects
LAMIVUDINE ,CHRONIC hepatitis B ,THYMIDINE ,IMMUNODEFICIENCY ,HUMAN beings ,FORECASTING - Abstract
The TANGO trial demonstrated the efficacy of lamivudine plus dolutegravir in virologically suppressed patients without previous virological failures (VFs). In this dataset from clinical practice investigating the impact of past nucleoside reverse-transcriptase inhibitor resistance on this strategy, the combination of M184V/I plus at least 1 thymidine analog-associated mutation significantly increased the risk of VF. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
18. Short Communication: Comparing Lamivudine+Dolutegravir and Bictegravir/Emtricitabine/Tenofovir Alafenamide as Switch Strategies: Preliminary Results from Clinical Practice.
- Author
-
Baldin, Gianmaria, Ciccullo, Arturo, Lombardi, Francesca, D'Angelillo, Anna, Dusina, Alex, Emiliozzi, Arianna, Farinacci, Damiano, Moschese, Davide, Picarelli, Chiara, Borghetti, Alberto, and Di Giambenedetto, Simona
- Abstract
We tried to investigate and compare the safety of a dual therapy (DT) with dolutegravir+lamivudine (DTG +3TC) versus bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). We performed a retrospective analysis in a cohort of virologically suppressed HIV+ pts switching to DT or BIC in our center. Primary endpoint was to evaluate time to treatment discontinuation (TD) for any cause. Survival analysis was employed to determine time to TD and its predictors were analyzed by Cox regression. Moreover, we collected viro-immunological parameters as well as markers of renal function and lipid profile at baseline and after 24 weeks and assessed changes through nonparametric tests. We analyzed 476 patients: 350 starting a DT and 126 starting BIC. Overall, we registered 21 TD: 15 in the DT group during 170 patient-years of follow-up (PYFU) (a rate of 8.8 per 100 PYFU) and 6 in the BIC one during 48 PYFU (12.5 per 100 PYFU). Estimated probabilities of maintaining study regimen after 24 weeks were 95.5% [standard deviation (SD) ±1.1] in the DT group and 94.9% (SD ±2.0) in the BIC group, with no significant differences between them (log-rank p = .639). Concerning metabolic profile, in the DT group, after 24 weeks, triglycerides decreased significantly (median change −14 mg/dL, p < .001), whereas high-density lipoprotein cholesterol increased (+3 mg/dL, p = .031). In the BIC group, meanwhile, we observed a significant decrease in low-density lipoprotein cholesterol after 24 weeks (−13 mg/dL, p = .026). Both optimization strategies showed high tolerability in the short term in experienced pts, with few differences between them. Further studies are needed to properly assess the matter. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
19. Risk of Tumor Onset in HIV+ Patients on Two-Drug Regimens: A Cohort Study in an Italian Hospital.
- Author
-
Borghetti, Alberto, Bellino, Stefania, Lombardi, Francesca, Whalen, Matteo, Belmonti, Simone, Moschese, Davide, Ciccullo, Arturo, Tamburrini, Enrica, Baldin, Gianmaria, Dusina, Alex, Visconti, Elena, Emiliozzi, Arianna, Lamonica, Silvia, Pezzotti, Patrizio, and Di Giambenedetto, Simona
- Abstract
Currently approved 2-drug therapies are as effective as 3-drug regimens but could potentially lead to increased cancer risk due to less efficient immune recovery. We conducted a longitudinal cohort study in a tertiary Italian hospital to investigate HIV+ patients starting a triple therapy (TT) (2 NRTIs +3rd agent) or a dual therapy (DT) (3TC/FTC+boosted-PI, boosted-DRV+RAL, and 3TC/FTC or RPV+DTG) regimen between 2009 and 2018. The effect of DT (vs. TT) on tumor onset was evaluated by the multivariable Cox regression and the marginal structural Cox model, after estimating the inverse probability of treatment weights (IPTW). One thousand one hundred and seven patients who had a median follow-up of 4.2 person-years (py) were evaluated; 69.2% were males, with a median age of 43 years. Overall 2,513 treatments were started during the study period (479 DT, 2,034 TT). Eight tumors occurred over 965 py with DT and 35 over 3,817 py during TT (p = .797). In the Cox regression, DT did not predict an increased risk of tumor compared with TT (HR 1.14; p = .757) after adjusting for potential confounders. A marginal structural model using IPTW (HR 0.68; p = .328) and stabilized IPTW (HR 0.69; p = .361) confirmed this result. Preliminary findings from our cohort do not suggest an increased risk of tumors with DT compared to TT. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
20. Cohort profile: The Observational cohort for the study of DOlutegravir in Antiretroviral Combination REgimens (ODOACRE).
- Author
-
Ciccullo, Arturo, Baldin, Gianmaria, Capetti, Amedeo, Borghi, Vanni, Sterrantino, Gaetana, Latini, Alessandra, Madeddu, Giordano, Celani, Luigi, Vignale, Francesca, Rossetti, Barbara, Dusina, Alex, Cossu, Maria Vittoria, Restelli, Sibilla, Gennari, William, Lagi, Filippo, Giacomelli, Andrea, Colafigli, Manuela, Brescini, Lucia, Borghetti, Alberto, and Mussini, Cristina
- Abstract
Purpose The Observational cohort for the study of DOlutegravir in Antiretroviral Combination REgimens (ODOACRE) cohort was established in Italy in 2016 to evaluate the overall efficacy and tolerability of dolutegravir (DTG)-based antiretroviral (ARV) regimens in clinical practice. Participants The ODOACRE cohort enrols all adult HIV- 1-infected patients, both treatment-naïve and treatment-experienced, starting a DTG-based ARV regimen, in 11 clinical centres in Italy from 2014. Findings to date In recent years, various works by the ODOACRE cohort have been produced, demonstrating the high efficacy and tolerability of DTG-based ARV regimens in clinical practice, both in ART-naïve (in the setting of acute HIV-1 infection and late presenters patient) and experienced patients. We confirmed the virological efficacy of DTG-based regimens and we evaluated predictors of virological failure. We investigated cause of discontinuation and evaluated tolerability and metabolic profile of the regimens. Within these investigations, we explored particularly the use of DTG in simplification in two-drug regimen with either rilpivirine or lamivudine. We also compared DTG-based regimens with other integrase inhibitors in clinical practice. Future plans To continue to study long-term efficacy and tolerability of DTG-based regimens is the purpose of the ODOACRE cohort. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
21. Short Communication: Efficacy and Safety of Dolutegravir Plus Lamivudine as a First-Line Regimen in Clinical Practice.
- Author
-
Ciccullo, Arturo, Baldin, Gianmaria, Dusina, Alex, Cossu, Maria Vittoria, Lombardi, Francesca, Borghetti, Alberto, Capetti, Amedeo, and Di Giambenedetto, Simona
- Abstract
The GEMINI trials have showed that the two drugs regimen of dolutegravir+lamivudine (DTG +3TC) was noninferior to a three-drug regimen as a first line regimen for treatment-naive people living with HIV. The aim of our study was to confirm, in a real-life setting, the efficacy of this regimen. We conducted a retrospective, observational study enrolling treatment-naive patients starting a first-line regimen with lamivudine plus dolutegravir. We evaluated the virological efficacy and the immunological and metabolic profiles. Changes from baseline were evaluated through linear-mixed models for repeated measures. Linear regression analyses were performed to explore variables associated to significant changes in laboratory parameters. We analyzed a total of 20 patients: 15 (75%) were men with a median age of 34.5 years. During a cumulative time of 15.4 patients years of follow up (PYFU), we did not observe any adverse event or treatment discontinuation and all patients achieved virological suppression in the first 6 months from treatment initiation. Increase in CD4
+ cells was significant at both week 24 (p = .003) and week 48 (p = .007) of follow-up. Moreover, CD4/CD8 ratio also significantly improved [median increase of +0.22 (p = .028) after 48 weeks of follow-up]. As to metabolic parameters, we observed no significant changes in total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. In a subgroup of 11 patients, we further investigate HIV-1 DNA variations. Our results are in line with the findings of the GEMINI trials, confirming the efficacy and safety of DTG +3TC in treatment-naive patients. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
22. Changes in bone mineral density in HIV-positive, virologically suppressed patients switching to lamivudine/dolutegravir dual therapy: preliminary results from clinical practice.
- Author
-
Ciccullo, Arturo, D'Avino, Alessandro, Lassandro, Anna Pia, Baldin, Gianmaria, Borghetti, Alberto, Dusina, Alex, Emiliozzi, Arianna, Gagliardini, Roberta, Moschese, Davide, Belmonti, Simone, Lombardi, Francesca, and Di Giambenedetto, Simona
- Published
- 2018
23. EFFICACY OF 3TC+DTG VS 3-DRUG REGIMENS IN VIROLOGICALLYSUPPRESSED PLWH.
- Author
-
Borghetti, Alberto, Ciccullo, Arturo, Lombardi, Francesca, Passerotto, Rosanna, Lamanna, Francesco, Farinacci, Damiano, Dusina, Alex, Baldin, Gianmaria, Zazzi, Maurizio, and Di Giambenedetto, Simona
- Published
- 2023
24. Efficacy and safety of raltegravir in switch strategies in virologically suppressed patients: long-term data from clinical practice.
- Author
-
Emiliozzi, Arianna, Ciccullo, Arturo, Baldin, Gianmaria, Moschese, Davide, Dusina, Alex, Borghetti, Alberto, Giambenedetto, Simona Di, and Di Giambenedetto, Simona
- Subjects
HEPATITIS associated antigen - Published
- 2019
- Full Text
- View/download PDF
25. Cerebrospinal fluid drain infection caused by pandrug-resistant Staphylococcus epidermidis successfully treated with ceftaroline in combination with fosfomycin and vancomycin.
- Author
-
Magrini, Eugenia, Rando, Emanuele, Del Giacomo, Paola, Matteini, Elena, Leanza, Gabriele Maria, Sanmartin, Flavia, Carbone, Andrea, Maiuro, Giuseppe, Dusina, Alex, and Cingolani, Antonella
- Subjects
- *
STAPHYLOCOCCUS epidermidis , *CEREBROSPINAL fluid , *ENTEROCOCCUS , *CEFTAROLINE , *VANCOMYCIN , *CEREBROSPINAL fluid examination ,CENTRAL nervous system infections - Abstract
• Pandrug-resistant S. epidermidis is a challenging cause of infection worldwide • Ceftaroline use for CNS infections caused by Staphylococcus spp. is poorly described • Ceftaroline might represent an effective antimicrobial agent for resistant Staphylococcus spp. CNS infections when used in combination with other agent External ventricular drain-related cerebrospinal fluid infection represents a fearsome complication of neurosurgical interventions. Although vancomycin represents the standard of care for methicillin-resistant CoNS healthcare-associated ventriculitis, resistance phenomena have been described. We reported a case of a persistent external ventricular fluid drain infection after device removal by pandrug-resistant Staphylococcus epidermidis successfully treated with intravenous ceftaroline in combination with fosfomycin and vancomycin. No evidence regarding pandrug-resistant S. epidermidis therapy currently exists to our knowledge. In this case, the S. epidermidis phenotype emerged during the therapy course, possibly due to initial device retention, biofilm formation and the host immune impaired response. Despite being poorly studied in vivo, ceftaroline may be considered an option when other alternatives are unavailable, thanks to its described activity against CoNS in vitro. This case extends the experience with ceftaroline for central nervous system infections suggesting it could also be used in high antimicrobial resistance settings for immunocompromised people. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
26. Prevalence and factors associated with HIV-1 multi-drug resistance over the past two decades in the Italian ARCA database.
- Author
-
Lombardi, Francesca, Giacomelli, Andrea, Armenia, Daniele, Lai, Alessia, Dusina, Alex, Bezenchek, Antonia, Timelli, Laura, Saladini, Francesco, Vichi, Francesca, Corsi, Paola, Colao, Grazia, Bruzzone, Bianca, Gagliardini, Roberta, Callegaro, Annapaola, Castagna, Antonella, and Santoro, Maria Mercedes
- Subjects
- *
MULTIDRUG resistance , *REVERSE transcriptase inhibitors , *HIV , *DRUG resistance , *HEPATITIS C virus - Abstract
• Despite successful antiretroviral therapy, patients with human immunodeficiency virus (HIV) could develop multi-class drug resistance (MDR) • Data about the prevalence of HIV-MDR are scanty and results are unclear • A significant decline in the prevalence of HIV-MDR over between 1998 and 2018 was observed • Nowadays, HIV-MDR still occurs, although at a lower rate • Management of patients infected by MDR viruses is a critical issue in HIV therapy Despite successful antiretroviral therapy (ART), patients infected with human immunodeficiency virus (HIV) can develop multi-class drug resistance (MDR). This retrospective study aimed to explore the prevalence of HIV-1 drug resistance over the past two decades by focusing on HIV-MDR and its predictors. ART-experienced patients with HIV with results from at least one plasma genotypic resistance test (GRT) from 1998 to 2018, from the Antiviral Response Cohort Analysis database, were included in this study. The temporal trend of resistance to any drug class was evaluated by considering all GRTs. Prevalence and predictors of HIV-MDR were analysed by consideration of cumulative GRTs. Among 15 628 isolates from 6802 patients, resistance to at least one drug class decreased sharply from 1998 to 2010 (1998–2001: 78%; 2008–2010: 59%; P <0.001) and then remained relatively constant at approximately 50% from 2011 to 2018, with the proportion of isolates with HIV-MDR also stable (approximately 9%). By evaluating factors associated with cumulative HIV-MDR, the following factors were found to be associated with increased risk of HIV-MDR on multi-variate analysis: male gender; sexual and vertical transmission; number of previous protease inhibitors, nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and non-NRTIs; previous exposure to integrase strand transfer inhibitors, enfuvirtide and maraviroc; and co-infection with hepatitis B virus. In contrast, a nadir CD4 cell count ≥200 cells/mm3, starting first-line ART in 2008 or later and co-infection with hepatitis C virus were associated with lower risk of HIV-MDR. In conclusion, this study revealed that HIV-1 drug resistance has been stable since 2011 despite its dramatic decrease over the past two decades. HIV-MDR is still present, although at a lower rate, suggesting the need for continuous surveillance and accurate management of ART-experienced patients with HIV. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
27. Toxoplasmosis mimicking CMV chorioretinitis in newly diagnosed PLWH: a case report.
- Author
-
Lamanna F, Passerotto RA, Carbone A, Steiner RJ, Iannone V, Salvo PF, Ciccullo A, Baldin G, Borghetti A, and Dusina A
- Abstract
Background: cytomegalovirus (CMV) retinitis, cerebral and ocular toxoplasmosis are common infections in patients with acquired immunodeficiency syndrome (AIDS). Material and methods: this is a case of a 46-year-old female with previous Kaposi's sarcoma, diagnosed with an HIV infection two weeks prior to hospitalization. Blood test at diagnosis showed a CD4+ count of 77 cell/μL and HIV-RNA 3.758.745 copies/mL. Therapy with bictegravir/emtricitabine/tenofovir alafenamide fumarate was started and clinical, viroimmunological and microbiological investigations were performed., Results: the patient went to our hospital for the onset of left occipito-parietal headache and blurred vision. Brain CT and MRI were performed which did not show focal lesions or vascular alterations. Syphilis serology was negative, Toxoplasma gondii serology showed positive IgG and negative IgM, serum CMV-DNA was 31.184 IU/mL. Eye fundus evidenced intraretinal hemorrhages, fluorescein angiography and computed optical tomography documented cottony exudates, retinal hemorrhages and vitreous involvement. Therapy with valganciclovir was initiated for suspicion of CMV retinitis. About a month later, the patient reported blurred vision for which she was re-admitted. Ocular fundus showed a cottony lesion near the macula. Molecular test on vitreous body was positive for Toxoplasma gondii , while on cerebrospinal fluid it was negative; in addition, an MRI of the brain with contrast medium was performed which showed an area of altered hyperintense signal compatible with a diagnosis of Toxoplasma gondii uveitis and neurotoxoplasmosis. Therapy with pyrimethamine and clindamycin (allergy for sulfonamide reported by the patient) was started. Allergy counseling was performed with the execution of allergy tests (patch test) with negative result; therefore the administration of clindamycin was replaced with sulfadiazine. A month following the start of anti-toxoplasma therapy, there was a clinical and radiological improvement., Conclusions: despite progressive developments in the management of PLWH, in this case two different kind of opportunistic infection are found in a late-presenter patient. In particular, two aspects can be highlighted. The first one is that, in the setting of an highly impaired immune system, clinical presentation can be deceptive and more than one opportunistic infection can be observed together in the same patient. The second aspect is that after starting antiretroviral therapy, a rapid improvement of viro-immunologic parameters has been documented, probably leading to an immune reconstitution inflammatory syndrome (IRIS)., Competing Interests: Conflicts of interest A.C. received support for travel to meetings from ViiV Healthcare, A.B. received speakers’ honoraria from ViiV Healthcare, and fees for attending advisory boards from Janssen-Cilag. S.D.G. was a paid consultant or member of advisory boards for Gilead Sciences, ViiV Healthcare, Janssen-Cilag, Merck Sharp & Dohme and Bristol-Myers Squibb. All other authors: none to declare.
- Published
- 2023
- Full Text
- View/download PDF
28. Ventilator-associated pneumonia (VAP) and pleural empyema caused by multidrug-resistant Acinetobacter baumannii in HIV and COVID 19 infected patient: A case report.
- Author
-
Passerotto RA, Lamanna F, Farinacci D, Dusina A, Di Giambenedetto S, Ciccullo A, and Borghetti A
- Abstract
We analyzed the case of a 49-year-old woman with HIV infection off-therapy with poor viro-immunological compensation, not vaccinated for SARS-COV-2, hospitalized for lobar pneumonia and severe COVID19-related respiratory failure in intensive care unit (ICU). The hospitalization was complicated by bacteraemic ventilator-associated pneumonia (VAP) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) isolated on pleural fluid culture, treated with colistin and cefiderocol for about 3 weeks. The molecular research of MDR-AB on transtracheal aspirate was negative following this therapy. The aim is to show the safety, efficacy and tolerability of colistin-based combination therapy with cefiderocol for Acinetobacter baumannii infection in HIV-infected patient., Competing Interests: A.C. received support for travel to meetings from ViiV Healthcare, A.B. received speakers’ honoraria from ViiV Healthcare, and fees for attending advisory boards from Janssen-Cilag. S.D.G. was a paid consultant or member of advisory boards for Gilead Sciences, ViiV Healthcare, Janssen-Cilag, Merck Sharp & Dohme and Bristol-Myers Squibb. All other authors: none to declare., (© 2023 The Authors.)
- Published
- 2023
- Full Text
- View/download PDF
29. Differences in the Long-term Impact of the COVID-19 Pandemic on the Mental Health and Professional Quality of Life of Resident and Specialist Physicians.
- Author
-
Delle Donne V, Massaroni V, Ciccarelli N, Borghetti A, Ciccullo A, Baldin G, Giuliano G, Dusina A, Visconti E, Tamburrini E, and Di Giambendetto S
- Subjects
- Humans, Mental Health, Pandemics, Quality of Life psychology, Burnout, Professional epidemiology, Burnout, Professional psychology, Compassion Fatigue, COVID-19 epidemiology, Physicians
- Abstract
Background: The COVID-19 pandemic created an extremely difficult situation for healthcare workers (HCWs) worldwide. We aimed to compare the mental health and professional quality of life of residents and specialist physicians in a cohort of Italian HCWs caring for patients with COVID-19 about two years after the start of the COVID-19 pandemic., Methods: In November 2021, an online survey investigating the emotional states of depression, anxiety, stress, compassion satisfaction and compassion fatigue was administered to HCWs (N= 78) at the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome., Results: Our findings suggest that from 5 to 20% of our cohort of HCWs still showed the effects of the adverse psychological impact of the pandemic and more than half of them experienced medium levels of compassion fatigue as well as a medium level of compassion satisfaction. Our results also show that those with fewer years of clinical practice might be at greater risk of burnout (p= 0.021), anxiety and stress symptoms (both ps= 0.027) and might develop a lower level of compassion satisfaction (p=0.018). Moreover, the factors that potentially contribute to poor mental health, compassion fatigue and compassion satisfaction seem to differ between residents and specialist physicians., Conclusions: This overview presents one of the first pictures of the long-term effects of the pandemic on the mental health and professional quality of life of an Italian sample of HCWs. Moreover, it also helps identify professionals who are most in need of support and emphasises the importance of improving the psychological and professional wellbeing of these individuals especially during a pandemic-like crisis with long lasting effects.
- Published
- 2023
- Full Text
- View/download PDF
30. Changes in bone mineral density in HIV-positive, virologically suppressed patients switching to lamivudine/dolutegravir dual therapy: preliminary results from clinical practice.
- Author
-
Ciccullo A, D'Avino A, Lassandro AP, Baldin G, Borghetti A, Dusina A, Emiliozzi A, Gagliardini R, Moschese D, Belmonti S, Lombardi F, and Di Giambenedetto S
- Subjects
- Drug Combinations, Drug Substitution, Female, Humans, Male, Middle Aged, Oxazines, Piperazines, Pyridones, Retrospective Studies, Anti-HIV Agents pharmacology, Anti-HIV Agents therapeutic use, Bone Density drug effects, HIV Infections drug therapy, HIV Integrase Inhibitors pharmacology, HIV Integrase Inhibitors therapeutic use, Heterocyclic Compounds, 3-Ring pharmacology, Heterocyclic Compounds, 3-Ring therapeutic use, Lamivudine pharmacology, Lamivudine therapeutic use
- Abstract
Bone toxicity is a well-known side effect of several antiviral agents. In a cohort of virologically suppressed HIV-infected patients, we investigated the effects of a lamivudine/dolutegravir dual therapy on bone mineral density (BMD). We observed a significant improvement in lumbar spine BMD as well as T-score after 12 months of observation with concomitant bisphosphonate therapy independently predicting a greater improvement. These preliminary data show a favorable effect of this 2-drug regimen on bone health.
- Published
- 2018
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.