6 results on '"Perno, Carlo F."'
Search Results
2. Improving the Prediction of Virological Response to Tipranavir: The Development and Validation of a Tipranavir-Weighted Mutation Score
- Author
-
Schapiro, Jonathan M, primary, Scherer, Joseph, additional, Boucher, Charles A, additional, Baxter, John D, additional, Tilke, Clemens, additional, Perno, Carlo F, additional, Maggiolo, Franco, additional, Santoro, Maria M, additional, and Hall, David B, additional
- Published
- 2010
- Full Text
- View/download PDF
3. Very high pre-therapy viral load is a predictor of virological rebound in HIV-1-infected patients starting a modern first-line regimen.
- Author
-
Armenia D, Di Carlo D, Cozzi-Lepri A, Calcagno A, Borghi V, Gori C, Bertoli A, Gennari W, Bellagamba R, Castagna A, Latini A, Pinnetti C, Cicalini S, Saracino A, Lapadula G, Rusconi S, Castelli F, Di Giambenedetto S, Andreoni M, Di Perri G, Antinori A, Mussini C, Ceccherini-Silberstein F, Monforte AD, Perno CF, and Santoro MM
- Subjects
- Adult, Anti-HIV Agents pharmacology, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Drug Resistance, Viral, Female, HIV Infections drug therapy, HIV Infections mortality, HIV-1 drug effects, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Recurrence, Risk Factors, Treatment Outcome, HIV Infections diagnosis, HIV Infections virology, HIV-1 physiology, Viral Load
- Abstract
Background: Pre-cART (combined antiretroviral therapy) plasma viral load >500,000 copies/ml has been associated with a lower probability of achieving virological suppression, while few data about its role on maintenance of virological suppression are available. In this study we aimed to clarify whether high levels of pre-cART viraemia are associated with virological rebound (VR) after virological suppression., Methods: HIV-infected individuals who achieved virological suppression after first-line cART were included. VR was defined as the first of two consecutive viraemia >50 copies/ml (VR50) or, in an alternative analysis, >200 copies/ml (VR200). The impact of pre-cART viraemia on the risk of VR was evaluated by survival analyses., Results: Among 5,766 patients included, 59.2%, 31.4%, 5.2% and 4.2% had pre-cART viraemia ≤100,000, 100,001-500,000, 500,001-1,000,000 and >1,000,000 copies/ml, respectively. Patients with pre-cART viraemia levels >1,000,000 copies/ml had the highest probability of VR (>1,000,000; 500,000-1,000,000; 100,000-500,000; <100,000 copies/ml; VR50: 28.4%; 24.3%; 17.6%; 13.8%, P<0.0001; VR200: 14.4%; 11.1%; 7.2%; 7.6%; P=0.009). By Cox multivariable analyses, patients with pre-cART viraemia >500,000 and >1,000,000 copies/ml showed a significantly higher risk of VR regardless of the VR end point used. No difference in the risk of VR was found between patients with pre-cART viraemia ranging 500,000-1,000,000 copies/ml and those with pre-cART viraemia >1,000,000 copies/ml, regardless of the VR end point used., Conclusions: Pre-cART plasma viral load levels >500,000 copies/ml can identify fragile patients with poorer chance of maintaining virological control after an initial response. An effort in defining effective treatment strategies is mandatory for these patients that remain difficult to treat.
- Published
- 2019
- Full Text
- View/download PDF
4. Implications of HIV drug resistance on first- and second-line therapies in resource-limited settings: report from a workshop organized by the Collaborative HIV and Anti-HIV Drug Resistance Network.
- Author
-
Pillay D, Albert J, Bertagnolio S, Boucher C, Brun-Vezinet F, Clotet B, Giaquinto C, and Perno CF
- Subjects
- Developing Countries, HIV Infections prevention & control, HIV Infections transmission, Humans, Anti-HIV Agents therapeutic use, Drug Resistance, Viral, HIV Infections drug therapy, Health Resources
- Abstract
Here, we summarize the discussions and conclusions from an expert workshop held in October 2012 to consider the implications of HIV drug resistance in the context of scale-up of access to antiretroviral therapy and prophylaxis in resource-limited settings. Topics considered during the workshop included the implications of drug resistance for the selection of first-line regimens and sequencing of treatments, optimal surveillance strategies and prevention of mother-to-child transmission.
- Published
- 2013
- Full Text
- View/download PDF
5. Interpretation of genotypic HIV-1 resistance to darunavir and virological response: validation of available systems and of a new score.
- Author
-
De Luca A, Di Giambenedetto S, Maserati R, Gianotti N, Narciso P, Antinori A, Di Perri G, Prosperi MC, Baldanti F, Micheli V, Zazzi M, Perno CF, and Santoro MM
- Subjects
- Algorithms, Anti-HIV Agents therapeutic use, Darunavir, Drug Therapy, Combination, Genotype, HIV Infections drug therapy, HIV Infections virology, HIV Protease Inhibitors therapeutic use, HIV-1 genetics, Humans, Microbial Sensitivity Tests methods, Predictive Value of Tests, Ritonavir pharmacology, Ritonavir therapeutic use, Sulfonamides therapeutic use, Treatment Outcome, Anti-HIV Agents pharmacology, Drug Resistance, Viral genetics, HIV Protease Inhibitors pharmacology, HIV-1 drug effects, Sulfonamides pharmacology
- Abstract
Background: There is not yet consensus on interpretation of genotypic HIV-1 resistance to darunavir (DRV). We validated existing rules and a newly derived score., Methods: Protease inhibitor (PI)-failing patients starting a DRV/ritonavir-based regimen, with available baseline resistance genotypes, were extracted from three Italian databases. Virological response (VR) was analysed between 4 and 32 follow-up weeks, defined as a drop from baseline HIV RNA of ≥2 log(10) or a value <50 copies/ml if the last measurement had been obtained at ≤12 weeks and as HIV RNA<50 copies/ml if it had been obtained at >12 weeks of follow-up. DRV/ritonavir resistance was interpreted by seven algorithms. A new weighted score (DRV-2009) was derived and validated, analysing associations of protease mutations with VR., Results: A total of 217 patients were analysed, with a mean (±sd) follow-up time of 17 (±9) weeks. At baseline, median HIV RNA was 4.26 log(10) copies/ml (IQR 3.11-5.03); VR was achieved in 135/217 (62%) patients. Adjusting for use of a new drug class, number of previous PIs experienced, CD4(+) T-cell count and HIV RNA, only the Rega DRV/ritonavir interpretation was significantly associated with VR (per increase in susceptibility category, OR 1.94, 95% CI 1.32-2.86; P<0.001). The DRV-2009 score V11I+L33F+R41K+I47V+2*I50V+2*I54M+K55R+D60E+L74P+L76V+N88D+2*L89V-L10I/V-I13V-G16E-G48V-F53I/L-I62V-I66F-V77I (<0 indicating susceptibility, 0-1 intermediate resistance and ≥2 resistance) correlated with VR in the derivation set (n=132, R=0.395; P<0.001). In the validation set (n=85), after adjusting for mutual interpretation and new use of enfuvirtide, DRV-2009 (P=0.017) and Rega (P=0.013) were both independently associated with VR., Conclusions: In contrast to the other algorithms, both the DRV-2009 score and Rega interpretation showed a robust predictive capacity of VR to DRV/ritonavir-containing regimens.
- Published
- 2011
- Full Text
- View/download PDF
6. Historical resistance profile helps to predict salvage failure.
- Author
-
Zaccarelli M, Lorenzini P, Ceccherini-Silberstein F, Tozzi V, Forbici F, Gori C, Trotta MP, Boumis E, Narciso P, Perno CF, and Antinori A
- Subjects
- Drug Therapy, Combination, Female, Genetic Variation, HIV drug effects, HIV genetics, Humans, Male, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Treatment Failure, Antiviral Agents therapeutic use, Drug Resistance, Multiple, Viral, HIV Infections drug therapy, HIV Infections epidemiology, Salvage Therapy
- Abstract
Background: This study compared the predictive value for treatment failure of extended resistance detected in the current genotype resistance test (GRT) versus those from GRT history in patients with multiple combination antiretroviral therapy (cART) failures., Methods: Patients who underwent three GRT between 1999 and 2007 were included. Extended resistance at genotypic sensitivity score (GSS) using the Rega 7.1 interpretation system compared with a non-standard definition (defined as class-wide resistance [CWR] on the basis of International AIDS Society-USA mutations) was assessed both for current and historical GRTs (a combination of mutations was detected in all three tests). The predictive role of extended resistance for treatment failure was evaluated with an adjusted Cox proportional hazard model., Results: Overall, 177 patients were included. The historical GRT increased the number of patients with extended resistance to all three major drug classes by 25% in comparison with the current GRT. Using the GSS method, the absence of detection of any active drug in any drug class was predictive of failure with both the current and historical GRTs. Similarly, the number of active drugs in the cART regimen after the third resistance test, used as continuous variable, was also predictive of failure. Using both GSS approaches, current genotype had a higher effect than historical genotype on risk of treatment failure. Using the non-standard definition (CWR), historical resistance predicted failure better than current resistance., Conclusions: Our results provide an epidemiological demonstration that analysis of a combined latest and historical GRT, which also considers archived mutations, might better identify of the more virologically impaired patients in order to assess the best salvage treatment.
- Published
- 2009
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.