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17 results on '"Chemello L."'

1. Profiling the risk of hepatocellular carcinoma after long-term HCV eradication in patients with liver cirrhosis in the PITER cohort

Author

Kondili, L, Quaranta, M, Cavalletto, L, Calvaruso, V, Ferrigno, L, D'Ambrosio, R, Simonelli, I, Brancaccio, G, Raimondo, G, Brunetto, M, Zignego, A, Coppola, C, Iannone, A, Biliotti, E, Verucchi, G, Massari, M, Licata, A, Barbaro, F, Persico, M, Russo, F, Morisco, F, Pompili, M, Vigano, M, Puoti, M, Santantonio, T, Villa, E, Craxi, A, Chemello, L, Panetta, V, Gaeta, G, Filomia, R, Coco, B, Monti, M, Amoruso, D, Madonia, S, Ieluzzi, D, Taliani, G, Badia, L, Migliorino, G, Giorgini, A, Masarone, M, Blanc, P, Cossiga, V, De Siena, M, Tata, X, Rumi, M, Chessa, L, Lampertico, P, Ferrari, C, Gentile, I, Parruti, G, Baiocchi, L, Ciancio, A, Invernizzi, P, Federico, A, Torti, C, Morsica, G, Andreone, P, Aghemo, A, Popoli, P, Vella, S, Kondili L. A., Quaranta M. G., Cavalletto L., Calvaruso V., Ferrigno L., D'Ambrosio R., Simonelli I., Brancaccio G., Raimondo G., Brunetto M. R., Zignego A. L., Coppola C., Iannone A., Biliotti E., Verucchi G., Massari M., Licata A., Barbaro F., Persico M., Russo F. P., Morisco F., Pompili M., Vigano M., Puoti M., Santantonio T., Villa E., Craxi A., Chemello L., Panetta V., Gaeta G. B., Filomia R., Coco B., Monti M., Amoruso D. C., Madonia S., Ieluzzi D., Taliani G., Badia L., Migliorino G. M., Giorgini A., Masarone M., Blanc P., Cossiga V., De Siena M., Tata X., Rumi M. G., Chessa L., Lampertico P., Ferrari C., Gentile I., Parruti G., Baiocchi L., Ciancio A., Invernizzi P., Federico A., Torti C., Morsica G., Andreone P., Aghemo A., Popoli P., Vella S., Kondili, L, Quaranta, M, Cavalletto, L, Calvaruso, V, Ferrigno, L, D'Ambrosio, R, Simonelli, I, Brancaccio, G, Raimondo, G, Brunetto, M, Zignego, A, Coppola, C, Iannone, A, Biliotti, E, Verucchi, G, Massari, M, Licata, A, Barbaro, F, Persico, M, Russo, F, Morisco, F, Pompili, M, Vigano, M, Puoti, M, Santantonio, T, Villa, E, Craxi, A, Chemello, L, Panetta, V, Gaeta, G, Filomia, R, Coco, B, Monti, M, Amoruso, D, Madonia, S, Ieluzzi, D, Taliani, G, Badia, L, Migliorino, G, Giorgini, A, Masarone, M, Blanc, P, Cossiga, V, De Siena, M, Tata, X, Rumi, M, Chessa, L, Lampertico, P, Ferrari, C, Gentile, I, Parruti, G, Baiocchi, L, Ciancio, A, Invernizzi, P, Federico, A, Torti, C, Morsica, G, Andreone, P, Aghemo, A, Popoli, P, Vella, S, Kondili L. A., Quaranta M. G., Cavalletto L., Calvaruso V., Ferrigno L., D'Ambrosio R., Simonelli I., Brancaccio G., Raimondo G., Brunetto M. R., Zignego A. L., Coppola C., Iannone A., Biliotti E., Verucchi G., Massari M., Licata A., Barbaro F., Persico M., Russo F. P., Morisco F., Pompili M., Vigano M., Puoti M., Santantonio T., Villa E., Craxi A., Chemello L., Panetta V., Gaeta G. B., Filomia R., Coco B., Monti M., Amoruso D. C., Madonia S., Ieluzzi D., Taliani G., Badia L., Migliorino G. M., Giorgini A., Masarone M., Blanc P., Cossiga V., De Siena M., Tata X., Rumi M. G., Chessa L., Lampertico P., Ferrari C., Gentile I., Parruti G., Baiocchi L., Ciancio A., Invernizzi P., Federico A., Torti C., Morsica G., Andreone P., Aghemo A., Popoli P., and Vella S.

Abstract

Background and aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis. Methods: HCC occurrence was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the post-treatment variables associated with de-novo HCC; their predictive power was presented in a nomogram. Results: After the end of therapy (median follow-up:28.47 months), among 2064 SVR patients, 119 (5.8%) developed de-novo HCC. The HCC incidence was 1.90%, 4.21%, 6.47% at 12-, 24- and 36-months from end-of-therapy, respectively (incidence rate 2.45/100 person-years). Age, genotype 3, diabetes, platelets (PLT)≤120,000/µl and albumin ≤3.5g/dl levels were identified as pre-treatment HCC independent predictors. Adjusting for age, the post-treatment PLT≤120,000/µl (AdjHR 1.92; 95%CI:1.06-3.45) and albumin≤3.5g/dl (AdjHR 4.38; 95%CI 2.48-7.75) values were independently associated with HCC occurrence. Two different risk profiles were identified by combining long-term post-therapy evaluation of PLT ≤ vs. >120,000/µl and albumin ≤ vs. >3.5g/dl showing a significant different HCC incidence rate of 1.35 vs. 3.77/100 p-y, respectively. Conclusions: The nomogram score based on age, PLT and albumin levels after SVR showed an accurate prediction capability and may support the customizing management for early HCC detection.

Published
2023

2. Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination

Author

Brancaccio, G, Coco, B, Nardi, A, Quaranta, M, Tosti, M, Ferrigno, L, Cacciola, I, Messina, V, Chessa, L, Morisco, F, Milella, M, Barbaro, F, Ciancio, A, Russo, F, Coppola, N, Blanc, P, Claar, E, Verucchi, G, Puoti, M, Zignego, A, Chemello, L, Madonia, S, Fagiuoli, S, Marzano, A, Ferrari, C, Lampertico, P, Di Marco, V, Craxì, A, Santantonio, T, Raimondo, G, Brunetto, M, Gaeta, G, Kondili, L, Pasulo, L, Coppola, C, Pisano, F, Romano, M, Porcu, C, Bottalico, I, Cossiga, V, Tata, X, Sagnelli, C, Pierotti, P, Degasperi, E, Rosato, V, Badia, L, Ieluzzi, D, Monti, M, Bavetta, M, Cavalletto, L, Toniutto, P, Fornasiere, E, Colecchia, A, Ferrarese, A, Nardone, G, Rocco, A, Viganò, M, Foschi, F, Conti, F, Morsica, G, Salpietro, S, Torti, C, Costa, C, Federico, A, Dallio, M, Giorgini, A, Anselmo, M, De Leo, P, Zaltron, S, Cambianica, A, Piscaglia, F, Serio, I, Schivazappa, S, Mastroianni, A, Chidichimo, L, Massari, M, Mazzaro, C, Marrone, A, D'Amore, F, D'Offizi, G, Licata, A, Niro, G, Pollicino, T, Aghemo, A, Brancaccio G., Coco B., Nardi A., Quaranta M. G., Tosti M. E., Ferrigno L., Cacciola I., Messina V., Chessa L., Morisco F., Milella M., Barbaro F., Ciancio A., Russo F. P., Coppola N., Blanc P., Claar E., Verucchi G., Puoti M., Zignego A. L., Chemello L., Madonia S., Fagiuoli S., Marzano A., Ferrari C., Lampertico P., Di Marco V., Craxì A., Santantonio T. A., Raimondo G., Brunetto M. R., Gaeta G. B., Kondili L. A., Pasulo L., Coppola C., Pisano F., Romano M., Porcu C., Bottalico I. F., Cossiga V., Tata X., Sagnelli C., Pierotti P., Degasperi E., Rosato V., Badia L., Ieluzzi D., Monti M., Bavetta M. G., Cavalletto L., Toniutto P., Fornasiere E., Colecchia A., Ferrarese A., Nardone G., Rocco A., Viganò M., Foschi F. G., Conti F., Morsica G., Salpietro S., Torti C., Costa C., Federico A., Dallio M., Giorgini A., Anselmo M., De Leo P., Zaltron S., Cambianica A., Piscaglia F., Serio I., Schivazappa S., Mastroianni A., Chidichimo L., Massari M., Mazzaro C., Marrone A., D'Amore F. M., D'Offizi G., Licata A., Niro G. A., Pollicino T., Aghemo A., Brancaccio, G, Coco, B, Nardi, A, Quaranta, M, Tosti, M, Ferrigno, L, Cacciola, I, Messina, V, Chessa, L, Morisco, F, Milella, M, Barbaro, F, Ciancio, A, Russo, F, Coppola, N, Blanc, P, Claar, E, Verucchi, G, Puoti, M, Zignego, A, Chemello, L, Madonia, S, Fagiuoli, S, Marzano, A, Ferrari, C, Lampertico, P, Di Marco, V, Craxì, A, Santantonio, T, Raimondo, G, Brunetto, M, Gaeta, G, Kondili, L, Pasulo, L, Coppola, C, Pisano, F, Romano, M, Porcu, C, Bottalico, I, Cossiga, V, Tata, X, Sagnelli, C, Pierotti, P, Degasperi, E, Rosato, V, Badia, L, Ieluzzi, D, Monti, M, Bavetta, M, Cavalletto, L, Toniutto, P, Fornasiere, E, Colecchia, A, Ferrarese, A, Nardone, G, Rocco, A, Viganò, M, Foschi, F, Conti, F, Morsica, G, Salpietro, S, Torti, C, Costa, C, Federico, A, Dallio, M, Giorgini, A, Anselmo, M, De Leo, P, Zaltron, S, Cambianica, A, Piscaglia, F, Serio, I, Schivazappa, S, Mastroianni, A, Chidichimo, L, Massari, M, Mazzaro, C, Marrone, A, D'Amore, F, D'Offizi, G, Licata, A, Niro, G, Pollicino, T, Aghemo, A, Brancaccio G., Coco B., Nardi A., Quaranta M. G., Tosti M. E., Ferrigno L., Cacciola I., Messina V., Chessa L., Morisco F., Milella M., Barbaro F., Ciancio A., Russo F. P., Coppola N., Blanc P., Claar E., Verucchi G., Puoti M., Zignego A. L., Chemello L., Madonia S., Fagiuoli S., Marzano A., Ferrari C., Lampertico P., Di Marco V., Craxì A., Santantonio T. A., Raimondo G., Brunetto M. R., Gaeta G. B., Kondili L. A., Pasulo L., Coppola C., Pisano F., Romano M., Porcu C., Bottalico I. F., Cossiga V., Tata X., Sagnelli C., Pierotti P., Degasperi E., Rosato V., Badia L., Ieluzzi D., Monti M., Bavetta M. G., Cavalletto L., Toniutto P., Fornasiere E., Colecchia A., Ferrarese A., Nardone G., Rocco A., Viganò M., Foschi F. G., Conti F., Morsica G., Salpietro S., Torti C., Costa C., Federico A., Dallio M., Giorgini A., Anselmo M., De Leo P., Zaltron S., Cambianica A., Piscaglia F., Serio I., Schivazappa S., Mastroianni A., Chidichimo L., Massari M., Mazzaro C., Marrone A., D'Amore F. M., D'Offizi G., Licata A., Niro G. A., Pollicino T., and Aghemo A.

Abstract

Objectives: The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy. Methods: A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used. Results: The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P <0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P <0.0001) and anti-HDV positive 24.8% vs 17.5% (P <0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P <0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time. Conclusion: Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants.

Published
2023

4. A prospective study of direct-acting antiviral effectiveness and relapse risk in HCV cryoglobulinemic vasculitis by the Italian PITER cohort

Author

Kondili, L, Monti, M, Quaranta, M, Gragnani, L, Panetta, V, Brancaccio, G, Mazzaro, C, Persico, M, Masarone, M, Gentile, I, Andreone, P, Madonia, S, Biliotti, E, Filomia, R, Puoti, M, Fracanzani, A, Laccabue, D, Ieluzzi, D, Coppola, C, Rumi, M, Benedetti, A, Verucchi, G, Coco, B, Chemello, L, Iannone, A, Ciancio, A, Russo, F, Barbaro, F, Morisco, F, Chessa, L, Massari, M, Blanc, P, Zignego, A, Kondili L. A., Monti M., Quaranta M. G., Gragnani L., Panetta V., Brancaccio G., Mazzaro C., Persico M., Masarone M., Gentile I., Andreone P., Madonia S., Biliotti E., Filomia R., Puoti M., Fracanzani A. L., Laccabue D., Ieluzzi D., Coppola C., Rumi M. G., Benedetti A., Verucchi G., Coco B., Chemello L., Iannone A., Ciancio A., Russo F. P., Barbaro F., Morisco F., Chessa L., Massari M., Blanc P., Zignego A. L., Kondili, L, Monti, M, Quaranta, M, Gragnani, L, Panetta, V, Brancaccio, G, Mazzaro, C, Persico, M, Masarone, M, Gentile, I, Andreone, P, Madonia, S, Biliotti, E, Filomia, R, Puoti, M, Fracanzani, A, Laccabue, D, Ieluzzi, D, Coppola, C, Rumi, M, Benedetti, A, Verucchi, G, Coco, B, Chemello, L, Iannone, A, Ciancio, A, Russo, F, Barbaro, F, Morisco, F, Chessa, L, Massari, M, Blanc, P, Zignego, A, Kondili L. A., Monti M., Quaranta M. G., Gragnani L., Panetta V., Brancaccio G., Mazzaro C., Persico M., Masarone M., Gentile I., Andreone P., Madonia S., Biliotti E., Filomia R., Puoti M., Fracanzani A. L., Laccabue D., Ieluzzi D., Coppola C., Rumi M. G., Benedetti A., Verucchi G., Coco B., Chemello L., Iannone A., Ciancio A., Russo F. P., Barbaro F., Morisco F., Chessa L., Massari M., Blanc P., and Zignego A. L.

Abstract

Background and Aims: Mixed cryoglobulinemia is the most common HCV extrahepatic manifestation. We aimed to prospectively evaluate the cryoglobulinemic vasculitis (CV) clinical profile after a sustained virologic response (SVR) over a medium-term to long-term period. Approach and Results: Direct-acting antiviral–treated cryoglobulinemic patients, consecutively enrolled in the multicentric Italian Platform for the Study of Viral Hepatitis Therapy cohort, were prospectively evaluated. Cumulative incidence Kaplan-Meier curves were reported for response, clinical deterioration, relapse and relapse-free survival rates. Cox regression analysis evaluated factors associated with different outcomes. A clinical response was reported in at least one follow-up point for 373 of 423 (88%) patients with CV who achieved SVR. Clinical response increased over time with a 76% improvement rate at month 12 after the end of treatment. A full complete response (FCR) was reached by 164 (38.8%) patients in at least one follow-up point. CV clinical response fluctuated, with some deterioration of the initial response in 49.6% of patients (median time of deterioration, 19 months). In patients who achieved FCR and had an available follow-up (137 patients) a relapse was observed in 13% and it was transient in 66.7% of patients. The rate of patients without any deterioration was 58% and 41% at 12 and 24 months, respectively. After achieving SVR, a clinical nonresponse was associated with older age and renal involvement; a clinical deterioration/relapse was associated with high pretreatment rheumatoid factor values, and FCR was inversely associated with age, neuropathy, and high cryocrit levels. Conclusion: In patients with CV, HCV eradication may not correspond to a persistent clinical improvement, and clinical response may fluctuate. This implies an attentive approach to post-SVR evaluation through prognostic factors and tailored treatment.

Published
2022

5. Epidemiological, virological and clinical profile of HBsAg positive individuals in Italian hospital settings: interim results of the HBV/HDV PITER cohort

Author

Coco, B., primary, Tosti, M.E., additional, Raimondo, G., additional, Coppola, C., additional, Chessa, L., additional, Santantonio, T., additional, Gaeta, G.B., additional, Brancaccio, G., additional, Marzano, A., additional, Milella, M., additional, Messina, V., additional, Russo, F.P., additional, Cattelan, A.M., additional, Lampertico, P., additional, Claar, E., additional, Blanc, P.L., additional, Morisco, F., additional, Verucchi, G., additional, Ieluzzi, D., additional, Madonia, S., additional, Chemello, L., additional, Rumi, M.G., additional, Torti, C., additional, Morsica, G., additional, Federico, A., additional, Giorgini, A., additional, Zignego, A.L., additional, Anselmo, M., additional, Colecchia, A., additional, Toniutto, P., additional, Piscaglia, F., additional, Ciancio, A., additional, Puoti, M., additional, Coppola, N., additional, Foschi, G.F., additional, Nardone, G., additional, D'Offizi, G., additional, Castelli, F., additional, Mazzaro, C., additional, Mastroianni, A., additional, Licata, A., additional, Maida, I., additional, Di Perri, G., additional, Di Marco, V., additional, Quaranta, M.G., additional, and Kondili, L.A., additional

Published
2022
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6. Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination

Author

Giuseppina Brancaccio, Barbara Coco, Alessandra Nardi, Maria Giovanna Quaranta, Maria Elena Tosti, Luigina Ferrigno, Irene Cacciola, Vincenzo Messina, Luchino Chessa, Filomena Morisco, Michele Milella, Francesco Barbaro, Alessia Ciancio, Francesco Paolo Russo, Nicola Coppola, Pierluigi Blanc, Ernesto Claar, Gabriella Verucchi, Massimo Puoti, Anna Linda Zignego, Liliana Chemello, Salvatore Madonia, Stefano Fagiuoli, Alfredo Marzano, Carlo Ferrari, Pietro Lampertico, Vito Di Marco, Antonio Craxì, Teresa Antonia Santantonio, Giovanni Raimondo, Maurizia R. Brunetto, Giovanni Battista Gaeta, Loreta A. Kondili, Luisa Pasulo, Carmine Coppola, Federica Pisano, Mariarosaria Romano, Carmen Porcu, Irene Francesca Bottalico, Valentina Cossiga, Xhimi Tata, Caterina Sagnelli, Piera Pierotti, Elisabetta Degasperi, Valerio Rosato, Lorenzo Badia, Dontella Ieluzzi, Monica Monti, Maria Grazia Bavetta, Luisa Cavalletto, Pierluigi Toniutto, Ezio Fornasiere, Antonio Colecchia, Alberto Ferrarese, Gerardo Nardone, Alba Rocco, Mauro Viganò, Francesco Giuseppe Foschi, Fabio Conti, Giulia Morsica, Stefania Salpietro, Carlo Torti, Chiara Costa, Alessandro Federico, Marcello Dallio, Alessia Giorgini, Marco Anselmo, Pasqualina De Leo, Serena Zaltron, Anna Cambianica, Fabio Piscaglia, Ilaria Serio, Simona Schivazappa, Antonio Mastroianni, Luciana Chidichimo, Marco Massari, Cesare Mazzaro, Aldo Marrone, Francesca Maria D'Amore, Gianpiero D'Offizi, Anna Licata, Grazia Anna Niro, Teresa Pollicino, Alessio Aghemo, Brancaccio, G., Coco, B., Nardi, A., Quaranta, M. G., Tosti, M. E., Ferrigno, L., Cacciola, I., Messina, V., Chessa, L., Morisco, F., Milella, M., Barbaro, F., Ciancio, A., Russo, F. P., Coppola, N., Blanc, P., Claar, E., Verucchi, G., Puoti, M., Zignego, A. L., Chemello, L., Madonia, S., Fagiuoli, S., Marzano, A., Ferrari, C., Lampertico, P., Di Marco, V., Craxi, A., Santantonio, T. A., Raimondo, G., Brunetto, M. R., Gaeta, G. B., Kondili, L. A., Pasulo, L., Coppola, C., Pisano, F., Romano, M., Porcu, C., Bottalico, I. F., Cossiga, V., Tata, X., Sagnelli, C., Pierotti, P., Degasperi, E., Rosato, V., Badia, L., Ieluzzi, D., Monti, M., Bavetta, M. G., Cavalletto, L., Toniutto, P., Fornasiere, E., Colecchia, A., Ferrarese, A., Nardone, G., Rocco, A., Vigano, M., Foschi, F. G., Conti, F., Morsica, G., Salpietro, S., Torti, C., Costa, C., Federico, A., Dallio, M., Giorgini, A., Anselmo, M., De Leo, P., Zaltron, S., Cambianica, A., Piscaglia, F., Serio, I., Schivazappa, S., Mastroianni, A., Chidichimo, L., Massari, M., Mazzaro, C., Marrone, A., D'Amore, F. M., D'Offizi, G., Licata, A., Niro, G. A., Pollicino, T., Aghemo, A., Brancaccio, G, Coco, B, Nardi, A, Quaranta, M, Tosti, M, Ferrigno, L, Cacciola, I, Messina, V, Chessa, L, Morisco, F, Milella, M, Barbaro, F, Ciancio, A, Russo, F, Coppola, N, Blanc, P, Claar, E, Verucchi, G, Puoti, M, Zignego, A, Chemello, L, Madonia, S, Fagiuoli, S, Marzano, A, Ferrari, C, Lampertico, P, Di Marco, V, Craxì, A, Santantonio, T, Raimondo, G, Brunetto, M, Gaeta, G, Kondili, L, Pasulo, L, Coppola, C, Pisano, F, Romano, M, Porcu, C, Bottalico, I, Cossiga, V, Tata, X, Sagnelli, C, Pierotti, P, Degasperi, E, Rosato, V, Badia, L, Ieluzzi, D, Monti, M, Bavetta, M, Cavalletto, L, Toniutto, P, Fornasiere, E, Colecchia, A, Ferrarese, A, Nardone, G, Rocco, A, Viganò, M, Foschi, F, Conti, F, Morsica, G, Salpietro, S, Torti, C, Costa, C, Federico, A, Dallio, M, Giorgini, A, Anselmo, M, De Leo, P, Zaltron, S, Cambianica, A, Piscaglia, F, Serio, I, Schivazappa, S, Mastroianni, A, Chidichimo, L, Massari, M, Mazzaro, C, Marrone, A, D'Amore, F, D'Offizi, G, Licata, A, Niro, G, Pollicino, T, and Aghemo, A

Subjects
Microbiology (medical), Infectious Diseases, Epidemiology, Hepatitis Delta, Migrant, General Medicine, Chronic, Hepatitis B, Migrants, Hepatitis control
Abstract

Objectives: The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy. Methods: A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used. Results: The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P

Published
2023

7. A prospective study of direct-acting antiviral effectiveness and relapse risk in HCV cryoglobulinemic vasculitis by the Italian PITER cohort

Author

Loreta A. Kondili, Monica Monti, Maria Giovanna Quaranta, Laura Gragnani, Valentina Panetta, Giuseppina Brancaccio, Cesare Mazzaro, Marcello Persico, Mario Masarone, Ivan Gentile, Pietro Andreone, Salvatore Madonia, Elisa Biliotti, Roberto Filomia, Massimo Puoti, Anna Ludovica Fracanzani, Diletta Laccabue, Donatella Ieluzzi, Carmine Coppola, Maria Grazia Rumi, Antonio Benedetti, Gabriella Verucchi, Barbara Coco, Liliana Chemello, Andrea Iannone, Alessia Ciancio, Francesco Paolo Russo, Francesco Barbaro, Filomena Morisco, Luchino Chessa, Marco Massari, Pierluigi Blanc, Anna Linda Zignego, Kondili, L, Monti, M, Quaranta, M, Gragnani, L, Panetta, V, Brancaccio, G, Mazzaro, C, Persico, M, Masarone, M, Gentile, I, Andreone, P, Madonia, S, Biliotti, E, Filomia, R, Puoti, M, Fracanzani, A, Laccabue, D, Ieluzzi, D, Coppola, C, Rumi, M, Benedetti, A, Verucchi, G, Coco, B, Chemello, L, Iannone, A, Ciancio, A, Russo, F, Barbaro, F, Morisco, F, Chessa, L, Massari, M, Blanc, P, Zignego, A, Kondili L.A., Monti M., Quaranta M.G., Gragnani L., Panetta V., Brancaccio G., Mazzaro C., Persico M., Masarone M., Gentile I., Andreone P., Madonia S., Biliotti E., Filomia R., Puoti M., Fracanzani A.L., Laccabue D., Ieluzzi D., Coppola C., Rumi M.G., Benedetti A., Verucchi G., Coco B., Chemello L., Iannone A., Ciancio A., Russo F.P., Barbaro F., Morisco F., Chessa L., Massari M., Blanc P., and Zignego A.L.

Subjects
Vasculitis, mixed cryoglobulinemia, Hepatology, Sustained Virologic Response, Clinical Deterioration, Hepatitis C virus, Clinical Response, Cryoglobulinemic Vasculitis, Direct Acting Antivirals, HCV-chronic infection, Mixed Cryoglobulinemia, Hepacivirus, direct acting antivirals, Hepatitis C, Chronic, Antiviral Agents, Hepatitis C, HCV, Mixed cryoglobulinemia, HCV extraepatic manifestation, vasculitis, viral hepatitis, Cryoglobulinemia, Humans, Prospective Studies, Recurrence, HCV Cryoglobulinemia, Chronic
Abstract

Background and Aims: Mixed cryoglobulinemia is the most common HCV extrahepatic manifestation. We aimed to prospectively evaluate the cryoglobulinemic vasculitis (CV) clinical profile after a sustained virologic response (SVR) over a medium-term to long-term period. Approach and Results: Direct-acting antiviral–treated cryoglobulinemic patients, consecutively enrolled in the multicentric Italian Platform for the Study of Viral Hepatitis Therapy cohort, were prospectively evaluated. Cumulative incidence Kaplan-Meier curves were reported for response, clinical deterioration, relapse and relapse-free survival rates. Cox regression analysis evaluated factors associated with different outcomes. A clinical response was reported in at least one follow-up point for 373 of 423 (88%) patients with CV who achieved SVR. Clinical response increased over time with a 76% improvement rate at month 12 after the end of treatment. A full complete response (FCR) was reached by 164 (38.8%) patients in at least one follow-up point. CV clinical response fluctuated, with some deterioration of the initial response in 49.6% of patients (median time of deterioration, 19months). In patients who achieved FCR and had an available follow-up (137 patients) a relapse was observed in 13% and it was transient in 66.7% of patients. The rate of patients without any deterioration was 58% and 41% at 12 and 24months, respectively. After achieving SVR, a clinical nonresponse was associated with older age and renal involvement; a clinical deterioration/relapse was associated with high pretreatment rheumatoid factor values, and FCR was inversely associated with age, neuropathy, and high cryocrit levels. Conclusion: In patients with CV, HCV eradication may not correspond to a persistent clinical improvement, and clinical response may fluctuate. This implies an attentive approach to post-SVR evaluation through prognostic factors and tailored treatment.

Published
2022

8. Profiling the risk of hepatocellular carcinoma after long-term HCV eradication in patients with liver cirrhosis in the PITER cohort

Author

Loreta A. Kondili, Maria Giovanna Quaranta, Luisa Cavalletto, Vincenza Calvaruso, Luigina Ferrigno, Roberta D'Ambrosio, Ilaria Simonelli, Giuseppina Brancaccio, Giovanni Raimondo, Maurizia R. Brunetto, Anna Linda Zignego, Carmine Coppola, Andrea Iannone, Elisa Biliotti, Gabriella Verucchi, Marco Massari, Anna Licata, Francesco Barbaro, Marcello Persico, Francesco Paolo Russo, Filomena Morisco, Maurizio Pompili, Mauro Viganò, Massimo Puoti, Teresa Santantonio, Erica Villa, Antonio Craxì, Liliana Chemello, Valentina Panetta, Giovanni Battista Gaeta, Roberto Filomia, Barbara Coco, Monica Monti, Daniela Caterina Amoruso, Salvatore Madonia, Donatella Ieluzzi, Gloria Taliani, Lorenzo Badia, Guglielmo Marco Migliorino, Alessia Giorgini, Mario Masarone, Pierluigi Blanc, Valentina Cossiga, Martina De Siena, Xhimi Tata, Maria Grazia Rumi, Luchino Chessa, Pietro Lampertico, Carlo Ferrari, Ivan Gentile, Giustino Parruti, Leonardo Baiocchi, Alessia Ciancio, Pietro Invernizzi, Alessandro Federico, Carlo Torti, Giulia Morsica, Pietro Andreone, Alessio Aghemo, Patrizia Popoli, Stefano Vella, Kondili, L. A., Quaranta, M. G., Cavalletto, L., Calvaruso, V., Ferrigno, L., D'Ambrosio, R., Simonelli, I., Brancaccio, G., Raimondo, G., Brunetto, M. R., Zignego, A. L., Coppola, C., Iannone, A., Biliotti, E., Verucchi, G., Massari, M., Licata, A., Barbaro, F., Persico, M., Russo, F. P., Morisco, F., Pompili, M., Vigano, M., Puoti, M., Santantonio, T., Villa, E., Craxi, A., Chemello, L., Panetta, V., Gaeta, G. B., Filomia, R., Coco, B., Monti, M., Amoruso, D. C., Madonia, S., Ieluzzi, D., Taliani, G., Badia, L., Migliorino, G. M., Giorgini, A., Masarone, M., Blanc, P., Cossiga, V., De Siena, M., Tata, X., Rumi, M. G., Chessa, L., Lampertico, P., Ferrari, C., Gentile, I., Parruti, G., Baiocchi, L., Ciancio, A., Invernizzi, P., Federico, A., Torti, C., Morsica, G., Andreone, P., Aghemo, A., Popoli, P., Vella, S., Kondili, Loreta A, Quaranta, Maria Giovanna, Cavalletto, Luisa, Calvaruso, Vincenza, Ferrigno, Luigina, D'Ambrosio, Roberta, Simonelli, Ilaria, Brancaccio, Giuseppina, Raimondo, Giovanni, Brunetto, Maurizia R, Zignego, Anna Linda, Coppola, Carmine, Iannone, Andrea, Biliotti, Elisa, Verucchi, Gabriella, Massari, Marco, Licata, Anna, Barbaro, Francesco, Persico, Marcello, Russo, Francesco Paolo, Morisco, Filomena, Pompili, Maurizio, Viganò, Mauro, Puoti, Massimo, Santantonio, Teresa, Villa, Erica, Craxì, Antonio, and Chemello, Liliana

Subjects
Settore MED/12, Real-life cohort, Hepatology, Direct-acting antiviral, HCC, Long term outcomes, Predictive factors, Gastroenterology, Long term outcome, Predictive factor
Abstract

Background and aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis. Methods: HCC occurrence was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the post-treatment variables associated with de-novo HCC; their predictive power was presented in a nomogram. Results: After the end of therapy (median follow-up:28.47 months), among 2064 SVR patients, 119 (5.8%) developed de-novo HCC. The HCC incidence was 1.90%, 4.21%, 6.47% at 12-, 24- and 36-months from end-of-therapy, respectively (incidence rate 2.45/100 person-years). Age, genotype 3, diabetes, platelets (PLT)≤120,000/µl and albumin ≤3.5g/dl levels were identified as pre-treatment HCC independent predictors. Adjusting for age, the post-treatment PLT≤120,000/µl (AdjHR 1.92; 95%CI:1.06-3.45) and albumin≤3.5g/dl (AdjHR 4.38; 95%CI 2.48-7.75) values were independently associated with HCC occurrence. Two different risk profiles were identified by combining long-term post-therapy evaluation of PLT ≤ vs. >120,000/µl and albumin ≤ vs. >3.5g/dl showing a significant different HCC incidence rate of 1.35 vs. 3.77/100 p-y, respectively. Conclusions: The nomogram score based on age, PLT and albumin levels after SVR showed an accurate prediction capability and may support the customizing management for early HCC detection.

Published
2023

9. A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and delta cohort.

Author

Kondili LA, Brancaccio G, Tosti ME, Coco B, Quaranta MG, Messina V, Ciancio A, Morisco F, Cossiga V, Claar E, Rosato V, Ciarallo M, Cacciola I, Ponziani FR, Cerrito L, Coppola R, Longobardi F, Biliotti E, Rianda A, Barbaro F, Coppola N, Stanzione M, Barchiesi F, Fagiuoli S, Viganò M, Massari M, Russo FP, Ferrarese A, Laccabue D, Di Marco V, Blanc P, Marrone A, Morsica G, Federico A, Ieluzzi D, Rocco A, Foschi FG, Soria A, Maida I, Chessa L, Milella M, Rosselli Del Turco E, Madonia S, Chemello L, Gentile I, Toniutto P, Bassetti M, Surace L, Baiocchi L, Pellicelli A, De Santis A, Puoti M, Degasperi E, Niro GA, Zignego AL, Craxi A, Raimondo G, Santantonio TA, Brunetto MR, and Gaeta GB

Subjects
Humans, Female, Male, Italy epidemiology, Adult, Middle Aged, Cross-Sectional Studies, Cohort Studies, Liver Cirrhosis epidemiology, Liver Cirrhosis virology, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular virology, Comorbidity, Aged, Hepatitis B Surface Antigens blood, Liver Neoplasms epidemiology, Liver Neoplasms virology, Interferons therapeutic use, Antiviral Agents therapeutic use, Hepatitis D, Chronic epidemiology, Hepatitis Delta Virus immunology, Hepatitis Delta Virus genetics
Abstract

Background and Aims: We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility., Methods: This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model., Results: Of 5492 HBsAg-positive enrolled patients, 4152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age ≤ 40 years vs. 2.1%; P < 0.001), more often females (males 43.0% vs. 68.6%; P < 0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care., Conclusions: CHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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10. Reduction of the Risk of Hepatocellular Carcinoma over Time Using Direct-Acting Antivirals: A Propensity Score Analysis of a Real-Life Cohort (PITER HCV).

Author

Quaranta MG, Cavalletto L, Russo FP, Calvaruso V, Ferrigno L, Zanetto A, Mattioli B, D'Ambrosio R, Panetta V, Brancaccio G, Raimondo G, Brunetto MR, Zignego AL, Coppola C, Iannone A, Biliotti E, Rosselli Del Turco E, Massari M, Licata A, Barbaro F, Persico M, Morisco F, Pompili M, Cerini F, Puoti M, Santantonio T, Craxì A, Kondili LA, Chemello L, and On Behalf Of Piter Collaborating Investigators

Subjects
Humans, Male, Female, Middle Aged, Aged, Incidence, Liver Cirrhosis virology, Liver Cirrhosis epidemiology, Prospective Studies, Italy epidemiology, Risk Factors, Cohort Studies, Adult, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular virology, Antiviral Agents therapeutic use, Liver Neoplasms epidemiology, Liver Neoplasms etiology, Liver Neoplasms prevention & control, Liver Neoplasms virology, Propensity Score, Sustained Virologic Response, Hepacivirus drug effects, Hepacivirus genetics, Hepatitis C, Chronic drug therapy, Hepatitis C, Chronic complications
Abstract

The treatment of hepatitis C virus (HCV) with direct-acting antivirals (DAA) leads to high sustained virological response (SVR) rates, but hepatocellular carcinoma (HCC) risk persists in people with advanced liver disease even after SVR. We weighted the HCC risk in people with cirrhosis achieving HCV eradication through DAA treatment and compared it with untreated participants in the multicenter prospective Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. Propensity matching with inverse probability weighting was used to compare DAA-treated and untreated HCV-infected participants with liver cirrhosis. Kaplan-Meier analysis and competing risk regression analysis were performed. Within the first 36 months, 30 de novo HCC cases occurred in the untreated group ( n = 307), with a weighted incidence rate of 0.34% (95%CI: 0.23-0.52%), compared to 63 cases among SVR patients ( n = 1111), with an incidence rate of 0.20% (95%CI: 0.16-0.26%). The 12-, 24-, and 36-month HCC weighted cumulative incidence rates were 6.7%, 8.4%, and 10.0% in untreated cases and 2.3%, 4.5%, and 7.0% in the SVR group. Considering death or liver transplantation as competing events, the untreated group showed a 64% higher risk of HCC incidence compared to SVR patients (SubHR 1.64, 95%CI: 1.02-2.62). Other variables independently associated with the HCC occurrence were male sex, increasing age, current alcohol use, HCV genotype 3, platelet count ≤ 120,000/µL, and albumin ≤ 3.5 g/dL. In real-life practice, the high efficacy of DAA in achieving SVR is translated into high effectiveness in reducing the HCC incidence risk.

Published
2024
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11. Predicting de-novo portal vein thrombosis after HCV eradication: A long-term competing risk analysis in the ongoing PITER cohort.

Author

Kondili LA, Zanetto A, Quaranta MG, Ferrigno L, Panetta V, Calvaruso V, Zignego AL, Brunetto MR, Raimondo G, Biliotti E, Ieluzzi D, Iannone A, Madonia S, Chemello L, Cavalletto L, Coppola C, Morisco F, Barbaro F, Licata A, Federico A, Cerini F, Persico M, Pompili M, Ciancio A, Piscaglia F, Chessa L, Giacometti A, Invernizzi P, Brancaccio G, Benedetti A, Baiocchi L, Gentile I, Coppola N, Nardone G, Craxì A, and Russo FP

Subjects
Humans, Antiviral Agents therapeutic use, Portal Vein, Liver Cirrhosis diagnosis, Liver Cirrhosis epidemiology, Liver Cirrhosis complications, Risk Assessment, Albumins therapeutic use, Bilirubin, Esophageal and Gastric Varices complications, Hepatitis C, Chronic complications, Hepatitis C, Chronic diagnosis, Hepatitis C, Chronic drug therapy, Venous Thrombosis diagnosis, Venous Thrombosis epidemiology, Venous Thrombosis etiology
Abstract

Background & Aims: Sustained virological response (SVR) by direct-acting antivirals (DAAs) may reverse the hypercoagulable state of HCV cirrhosis and the portal vein thrombosis (PVT) risk. We evaluated the incidence and predictive factors of de novo, non-tumoral PVT in patients with cirrhosis after HCV eradication., Methods: Patients with HCV-related cirrhosis, consecutively enrolled in the multi-center ongoing PITER cohort, who achieved the SVR using DAAs, were prospectively evaluated. Kaplan-Meier and competing risk regression analyses were performed., Results: During a median time of 38.3 months (IQR: 25.1-48.7 months) after the end of treatment (EOT), among 1609 SVR patients, 32 (2.0%) developed de novo PVT. A platelet count ≤120,000/μL, albumin levels ≤3.5 mg/dL, bilirubin >1.1 mg/dL, a previous liver decompensation, ALBI, Baveno, FIB-4, and RESIST scores were significantly different (p < 0.001), among patients who developed PVT versus those who did not. Considering death and liver transplantation as competing risk events, esophageal varices (subHR: 10.40; CI 95% 4.33-24.99) and pre-treatment ALBI grade ≥2 (subHR: 4.32; CI 95% 1.36-13.74) were independent predictors of PVT. After HCV eradication, a significant variation in PLT count, albumin, and bilirubin (p < 0.001) versus pre-treatment values was observed in patients who did not develop PVT, whereas no significant differences were observed in those who developed PVT (p > 0.05). After the EOT, esophageal varices and ALBI grade ≥2, remained associated with de novo PVT (subHR: 9.32; CI 95% 3.16-27.53 and subHR: 5.50; CI 95% 1.67-18.13, respectively)., Conclusions: In patients with HCV-related cirrhosis, a more advanced liver disease and significant portal hypertension are independently associated with the de novo PVT risk after SVR., (© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Published
2024
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12. Editorial: Prognostic factors in hepatocellular carcinoma.

Author

Chemello L, Shukla PK, and Dallio M

Abstract

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Published
2023
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14. Profiling the risk of hepatocellular carcinoma after long-term HCV eradication in patients with liver cirrhosis in the PITER cohort.

Author

Kondili LA, Quaranta MG, Cavalletto L, Calvaruso V, Ferrigno L, D'Ambrosio R, Simonelli I, Brancaccio G, Raimondo G, Brunetto MR, Zignego AL, Coppola C, Iannone A, Biliotti E, Verucchi G, Massari M, Licata A, Barbaro F, Persico M, Russo FP, Morisco F, Pompili M, Viganò M, Puoti M, Santantonio T, Villa E, Craxì A, and Chemello L

Subjects
Humans, Antiviral Agents therapeutic use, Risk Factors, Liver Cirrhosis epidemiology, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular etiology, Carcinoma, Hepatocellular diagnosis, Liver Neoplasms epidemiology, Liver Neoplasms etiology, Liver Neoplasms diagnosis, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy
Abstract

Background and Aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis., Methods: HCC occurrence was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the post-treatment variables associated with de-novo HCC; their predictive power was presented in a nomogram., Results: After the end of therapy (median follow-up:28.47 months), among 2064 SVR patients, 119 (5.8%) developed de-novo HCC. The HCC incidence was 1.90%, 4.21%, 6.47% at 12-, 24- and 36-months from end-of-therapy, respectively (incidence rate 2.45/100 person-years). Age, genotype 3, diabetes, platelets (PLT)≤120,000/µl and albumin ≤3.5g/dl levels were identified as pre-treatment HCC independent predictors. Adjusting for age, the post-treatment PLT≤120,000/µl (AdjHR 1.92; 95%CI:1.06-3.45) and albumin≤3.5g/dl (AdjHR 4.38; 95%CI 2.48-7.75) values were independently associated with HCC occurrence. Two different risk profiles were identified by combining long-term post-therapy evaluation of PLT ≤ vs. >120,000/µl and albumin ≤ vs. >3.5g/dl showing a significant different HCC incidence rate of 1.35 vs. 3.77/100 p-y, respectively., Conclusions: The nomogram score based on age, PLT and albumin levels after SVR showed an accurate prediction capability and may support the customizing management for early HCC detection., Competing Interests: Conflict of interest None declared., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2023
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15. Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination.

Author

Brancaccio G, Coco B, Nardi A, Quaranta MG, Tosti ME, Ferrigno L, Cacciola I, Messina V, Chessa L, Morisco F, Milella M, Barbaro F, Ciancio A, Russo FP, Coppola N, Blanc P, Claar E, Verucchi G, Puoti M, Zignego AL, Chemello L, Madonia S, Fagiuoli S, Marzano A, Ferrari C, Lampertico P, Di Marco V, Craxì A, Santantonio TA, Raimondo G, Brunetto MR, Gaeta GB, and Kondili LA

Subjects
Humans, Female, Hepatitis B e Antigens, Cross-Sectional Studies, Italy epidemiology, Liver Cirrhosis complications, Hepatitis B Surface Antigens, Hepatitis Delta Virus, Hepatitis B virus, Hepatitis B, Chronic epidemiology, Hepatitis B, Chronic complications, Hepatitis B epidemiology
Abstract

Objectives: The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy., Methods: A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used., Results: The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P <0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P <0.0001) and anti-HDV positive 24.8% vs 17.5% (P <0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P <0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time., Conclusion: Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2023
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16. A prospective study of direct-acting antiviral effectiveness and relapse risk in HCV cryoglobulinemic vasculitis by the Italian PITER cohort.

Author

Kondili LA, Monti M, Quaranta MG, Gragnani L, Panetta V, Brancaccio G, Mazzaro C, Persico M, Masarone M, Gentile I, Andreone P, Madonia S, Biliotti E, Filomia R, Puoti M, Fracanzani AL, Laccabue D, Ieluzzi D, Coppola C, Rumi MG, Benedetti A, Verucchi G, Coco B, Chemello L, Iannone A, Ciancio A, Russo FP, Barbaro F, Morisco F, Chessa L, Massari M, Blanc P, and Zignego AL

Subjects
Antiviral Agents therapeutic use, Hepacivirus, Humans, Prospective Studies, Recurrence, Sustained Virologic Response, Clinical Deterioration, Cryoglobulinemia drug therapy, Cryoglobulinemia etiology, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy, Vasculitis drug therapy
Abstract

Background and Aims: Mixed cryoglobulinemia is the most common HCV extrahepatic manifestation. We aimed to prospectively evaluate the cryoglobulinemic vasculitis (CV) clinical profile after a sustained virologic response (SVR) over a medium-term to long-term period., Approach and Results: Direct-acting antiviral-treated cryoglobulinemic patients, consecutively enrolled in the multicentric Italian Platform for the Study of Viral Hepatitis Therapy cohort, were prospectively evaluated. Cumulative incidence Kaplan-Meier curves were reported for response, clinical deterioration, relapse and relapse-free survival rates. Cox regression analysis evaluated factors associated with different outcomes. A clinical response was reported in at least one follow-up point for 373 of 423 (88%) patients with CV who achieved SVR. Clinical response increased over time with a 76% improvement rate at month 12 after the end of treatment. A full complete response (FCR) was reached by 164 (38.8%) patients in at least one follow-up point. CV clinical response fluctuated, with some deterioration of the initial response in 49.6% of patients (median time of deterioration, 19 months). In patients who achieved FCR and had an available follow-up (137 patients) a relapse was observed in 13% and it was transient in 66.7% of patients. The rate of patients without any deterioration was 58% and 41% at 12 and 24 months, respectively. After achieving SVR, a clinical nonresponse was associated with older age and renal involvement; a clinical deterioration/relapse was associated with high pretreatment rheumatoid factor values, and FCR was inversely associated with age, neuropathy, and high cryocrit levels., Conclusion: In patients with CV, HCV eradication may not correspond to a persistent clinical improvement, and clinical response may fluctuate. This implies an attentive approach to post-SVR evaluation through prognostic factors and tailored treatment., (© 2022 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)

Published
2022
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17. Surgical management of failing Fontan circulation: results from 30 cases with 285 patient-years follow-up.

Author

Padalino MA, Ponzoni M, Castaldi B, Leoni L, Chemello L, Toscano G, Gerosa G, Di Salvo G, and Vida VL

Subjects
Adult, Follow-Up Studies, Humans, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Reoperation adverse effects, Retrospective Studies, Treatment Outcome, Young Adult, Fontan Procedure methods, Heart Defects, Congenital, Heart Transplantation adverse effects
Abstract

Objectives: Fontan patients are known to suffer from clinical attrition over the years, which has been characterized as Fontan failure. We sought to evaluate the clinical outcomes of such Fontan patients undergoing surgical management in a 25-year, single-centre experience., Methods: A retrospective single-centre analysis of patients undergoing surgical treatment for failing Fontan between 1995 and 2020, including any reoperations when ventricular function was preserved, or a heart transplant (HTx), when ventricular contractility was impaired. We analysed survival, indications for surgery and early and late complication rates., Results: We collected 30 patients (mean age 24.7 years) who required surgery after a mean time of 19.3 years from the original Fontan procedure: Fontan conversion in 21 (70%, extracardiac conduit in 19, lateral tunnel in 2), a HTx in 4 (13.3%) and other reoperations in 5 (16.7%). The most common indications for surgery were tachyarrhythmias (63.3%) and severe right atrial dilatation (63.3%). Overall survival at the 1-, 5-, 10- and 20-year follow-up examinations were 75.9% [95% confidence interval (CI): 91.4-60.4%], 75.9% (95% CI: 91.4-60.4%), 70% (95% CI: 78-52%) and 70% (95% CI: 78-52%), respectively. The most frequent complications were postoperative tachyarrhythmias (50%) and late Fontan-associated liver disease (56.5%). HTx and Fontan conversion provided comparably good outcomes compared to other reoperations (P = 0.022)., Conclusions: Surgery for failing Fontan can be performed effectively with overall good long-term survival. However, early and late morbidities are still a significant burden. Because other reoperations performed when patients presented with contraindications for a HTx have carried high mortality, close clinical follow-up is mandatory, and an earlier indication for Fontan conversion or a HTx is advisable to optimize outcomes., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2022
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