50 results on '"Ortolani, P."'
Search Results
2. Prevalence of acquired resistance mutations in a large cohort of perinatally infected HIV-1 patients
- Author
-
Ungaro, R., Taramasso, L., Bruzzone, B., Vicenti, I., Galli, L., Borghi, V., Francisci, D., Pecorari, M., Zoncada, A., Callegaro, A. P., Paolini, E., Monno, L., Bonora, S., Di Biagio, A., ARCA Study Group, Giacometti, A., Butini, L., del Gobbo, R., Bagnarelli, P., Tacconi, D., Corbelli, G., Zanussi, S., Punzi, G., Maggiolo, F., Calza, L., Carla Re, M., Pristera, R., Turconi, P., Mandas, A., Tini, S., Amadio, G., Sighinolfi, L., Corsi, P., Di Pietro, M., Colao, G., Tosti, A., Setti, M., Cenderello, G., Trezzi, M., Orani, A., Arcidiacono, I., Degiuli, A., De Gennaro, M., Chiodera, A., Scalzini, A., Palvarini, L., Todaro, G., Rusconi, S., Gismondo, M. R., Micheli, V., Biondi, M. L., Capetti, A., Meraviglia, P., Boeri, E., Mussini, C., Soria, A., Vecchi, L., Santirocchi, M., Brustia, D., Ravanini, P., Dal Bello, F., Romano, N., Mancuso, S., Calzetti, C., Maserati, R., Filice, G., Baldanti, F., Parruti, G., Polilli, E., Sacchini, D., Martinelli, C., Consolini, R., Vatteroni, L., Vivarelli, A., Nerli, A., Lenzi, L., Magnani, G., Ortolani, P., Andreoni, M., Fimiani, C., Palmisano, L., Di Giambenedetto, S., Vullo, V., Turriziani, O., Montano, M., Antinori, A., Zaccarelli, M., Dentone, C., Gonnelli, A., De Luca, A., Palumbo, M., Ghisetti, V., Delle Foglie, P., Rossi, C., Mondino, V., Malena, M., Grossi, P., Seminari, E., Poletti, F., Ungaro R., Taramasso L., Bruzzone B., Vicenti I., Galli L., Borghi V., Francisci D., Pecorari M., Zoncada A., Callegaro A.P., Paolini E., Monno L., Bonora S., Di Biagio A., Giacometti A., Butini L., del Gobbo R., Bagnarelli P., Tacconi D., Corbelli G., Zanussi S., Punzi G., Maggiolo F., Calza L., Carla Re M., Pristera R., Turconi P., Mandas A., Tini S., Amadio G., Sighinolfi L., Corsi P., Di Pietro M., Colao G., Tosti A., Setti M., Cenderello G., Trezzi M., Orani A., Arcidiacono I., Degiuli A., De Gennaro M., Chiodera A., Scalzini A., Palvarini L., Todaro G., Rusconi S., Gismondo M.R., Micheli V., Biondi M.L., Capetti A., Meraviglia P., Boeri E., Mussini C., Soria A., Vecchi L., Santirocchi M., Brustia D., Ravanini P., Dal Bello F., Romano N., Mancuso S., Calzetti C., Maserati R., Filice G., Baldanti F., Parruti G., Polilli E., Sacchini D., Martinelli C., Consolini R., Vatteroni L., Vivarelli A., Nerli A., Lenzi L., Magnani G., Ortolani P., Andreoni M., Fimiani C., Palmisano L., Di Giambenedetto S., Vullo V., Turriziani O., Montano M., Antinori A., Zaccarelli M., Dentone C., Gonnelli A., De Luca A., Palumbo M., Ghisetti V., Delle Foglie P., Rossi C., Mondino V., Malena M., Grossi P., Seminari E., and Poletti F.
- Subjects
Male ,antiretroviral treatment ,Infectious Disease Transmission ,genotype ,Human immunodeficiency virus (HIV) ,Drug Resistance ,HIV Infections ,Drug resistance ,medicine.disease_cause ,Retrospective Studie ,Genotype ,pol Gene Products, Human Immunodeficiency Viru ,Prevalence ,Medicine ,Vertical ,HIV Infection ,Viral ,pol Gene Products ,Young adult ,General Medicine ,Infectious Diseases ,Italy ,Mutation (genetic algorithm) ,Female ,Human Immunodeficiency Virus ,Human ,Microbiology (medical) ,Adult ,Settore MED/17 - Malattie Infettive ,Adolescent ,Anti-HIV Agents ,Young Adult ,Acquired resistance ,Drug Resistance, Viral ,Humans ,vertical HIV transmission ,HIV-1 ,Mutation ,Retrospective Studies ,pol Gene Products, Human Immunodeficiency Virus ,Infectious Disease Transmission, Vertical ,HIV perinatally infection ,business.industry ,Anti-HIV Agent ,Retrospective cohort study ,Virology ,Large cohort ,business - Published
- 2019
3. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series
- Author
-
Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S., Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, and Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S.
- Subjects
Infectious Disease Transmission ,Prenatal diagnosis ,HIV Infections ,0302 clinical medicine ,Birth defect ,Pregnancy ,Odds Ratio ,Vertical ,Medicine ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,education.field_of_study ,Amniocentesi ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Obstetrics ,Infectious ,Obstetrics and Gynecology ,Amniocentesis ,birth defects ,chorionic villus sampling ,HIV ,invasive testing ,mother-to child HIV transmission ,pregnancy ,prenatal diagnosis ,Birth defects ,Chorionic villus sampling ,Invasive testing ,Mother-to child HIV transmission ,Anti-Retroviral Agents ,Chorionic Villi Sampling ,Female ,Adult ,medicine.medical_specialty ,Prenatal diagnosi ,Population ,Settore MED/17 - MALATTIE INFETTIVE ,03 medical and health sciences ,Humans ,education ,Fetal Death ,Analysis of Variance ,Chi-Square Distribution ,business.industry ,Infectious Disease Transmission, Vertical ,Odds ratio ,medicine.disease ,Confidence interval ,Pregnancy Complications ,business ,Chi-squared distribution - Abstract
Objectives To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting University and hospital clinics. Population Pregnant women with HIV. Methods Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures Rate of invasive testing, intrauterine death, HIV transmission. Results Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011–2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.
- Published
- 2016
4. Incidence of Malignancies in HIV‐Infected Patients and Prognostic Role of Current CD4 Cell Count: Evidence from a Large Italian Cohort Study
- Author
-
Prosperi M.C., Cozzi Lepri A., Castagna A., Mussini C., Murri R., Giacometti A., Torti C., Costantini A., Narciso P., Ghinelli F., Antinori A., d'Arminio Monforte A., Moroni M, Carosi G, Galli M, Iardino R, Ippolito G, Lazzarin A, Panebianco R, Pastore G, Perno CF, Ammassari A, Arici C, Balotta C, Bonfanti P, Capobianchi MR, Ceccherini Silberstein F, De Luca A, Gervasoni C, Girardi E, Lo Caputo S, Puoti M, Fanti I, Formenti T, Montroni M, Riva A, Tirelli U, Martellotta F, Ladisa N, Pierri A, Suter F, Maggiolo F, Cristini G, Minardi C, Bertelli D, Quirino D, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Pagano G, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Soscia F, Tacconi L, Orani A, Rossotti R, Tommasi D, Congedo P, Chiodera A, Castelli P, Rizzardini G, Schlacht I, Ridolfo AL, Foschi A, Salpietro S, Merli S, Melzi S, Moioli MC, Cicconi P, Esposito R, Gori A, Fiorino M, Abrescia N, Chirianni A, Izzo CM, De Marco M, Viglietti R, Manzillo E, Ferrari C, Pizzaferri P, Baldelli F, Belfiori B, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Cauda R, Andreoni M, Antonucci G, Tozzi V, Vullo V, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Calbi M, Gallo L, Miccoli A, Carletti F, Mura MS, Madeddu G, Caramello P, Di Perri G, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., BORDERI, MARCO, VERUCCHI, GABRIELLA, PIERGENTILI, BENEDETTA, Prosperi MC., Cozzi-Lepri A., Castagna A., Mussini C., Murri R., Giacometti A., Torti C., Costantini A., Narciso P., Ghinelli F., Antinori A., d'Arminio Monforte A., Moroni M, Carosi G, Galli M, Iardino R, Ippolito G, Lazzarin A, Panebianco R, Pastore G, Perno CF, Ammassari A, Arici C, Balotta C, Bonfanti P, Capobianchi MR, Ceccherini-Silberstein F, De Luca A, Gervasoni C, Girardi E, Lo Caputo S, Puoti M, Fanti I, Formenti T, Montroni M, Riva A, Tirelli U, Martellotta F, Ladisa N, Pierri A, Suter F, Maggiolo F, Borderi M, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino D, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Pagano G, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Soscia F, Tacconi L, Orani A, Rossotti R, Tommasi D, Congedo P, Chiodera A, Castelli P, Rizzardini G, Schlacht I, Ridolfo AL, Foschi A, Salpietro S, Merli S, Melzi S, Moioli MC, Cicconi P, Esposito R, Gori A, Fiorino M, Abrescia N, Chirianni A, Izzo CM, De Marco M, Viglietti R, Manzillo E, Ferrari C, Pizzaferri P, Baldelli F, Belfiori B, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Cauda R, Andreoni M, Antonucci G, Tozzi V, Vullo V, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Calbi M, Gallo L, Miccoli A, Carletti F, Mura MS, Madeddu G, Caramello P, Di Perri G, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., Prosperi, M. C. F., Cozzi lepri, A., Castagna, Antonella, Mussini, C., Murri, R., Giacometti, A., Torti, C., Costantini, A., Narciso, P., Ghinelli, F., Antinori, A., and D'arminio Monforte, A.
- Subjects
Adult ,Male ,Microbiology (medical) ,tumor ,medicine.medical_specialty ,Prognosi ,Prognosis ,male ,cohort studies ,CD4 lymphocyte count ,HIV infections ,female ,neoplasms ,Italy ,incidence ,adult ,humans ,HIV Infections ,Cohort Studies ,MALIGNANCIES ,HIV ,AIDS ,CD4 ,Neoplasms ,Immunopathology ,Internal medicine ,Epidemiology ,medicine ,Humans ,HIV Infection ,Sida ,biology ,business.industry ,Incidence ,Incidence (epidemiology) ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,biology.organism_classification ,Confidence interval ,CD4 Lymphocyte Count ,Surgery ,Infectious Diseases ,Cohort ,Neoplasm ,Female ,Viral disease ,Cohort Studie ,business ,Human ,Cohort study - Abstract
The incidence of and predictors of acquired immunodeficiency syndrome-defining malignancies (ADMs) and nonADM (NADMs) were evaluated in a large Italian cohort. The incidence of ADM and NADM was 5.0 cases per 1000 personyears of follow-up (95% confidence interval, 4.3-5.8 cases per 1000 person-years of follow-up) and 2.4 cases per 1000 person-years of follow-up (95% confidence interval, 1.9-3.1 cases per 1000 person-years of follow-up), respectively. Lower current CD4 cell count was an independent predictor of developing malignancies, with the association being stronger for ADM than for NADM. © 2010 by the Infectious Diseases Society of America. All rights reserved.
- Published
- 2010
5. Immune activation and microbial translocation in liver disease progression in HIV/hepatitis co-infected patients: results from the Icona Foundation study
- Author
-
Marchetti, Giulia, Cozzi Lepri, Alessandro, Tincati, Camilla, Calcagno, Andrea, Ceccherini Silberstein, Francesca, De Luca, Andrea, Antinori, Andrea, Castagna, Antonella, Puoti, Massimo, Monforte, Antonella d'Arminio, for the Icona Foundation Study Group […, Moroni M, Angarano G, Antinori A, Carosi G, Cauda R, Monforte A, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Monforte Ad, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi MR, Castagna A, Ceccherini Silberstein F, Cozzi Lepri A, De Luca A, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Maggiolo F, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Antonucci G, Narciso P, Tozzi V, Vullo V, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D, VERUCCHI, GABRIELLA, Marchetti, G, Cozzi Lepri, A, Tincati, C, Calcagno, A, Ceccherini Silberstein, F, DE LUCA, A, Antinori, A, Castagna, A, Puoti, M, Monforte, A, Marchetti, Giulia, Cozzi Lepri, Alessandro, Tincati, Camilla, Calcagno, Andrea, Ceccherini Silberstein, Francesca, De Luca, Andrea, Antinori, Andrea, Castagna, Antonella, Puoti, Massimo, Monforte Antonella, D'Arminio, Cozzi-Lepri, Alessandro, Ceccherini-Silberstein, Francesca, Monforte, Antonella d'Arminio, and for the Icona Foundation Study Group […, Moroni M, Angarano G, Antinori A, Carosi G, Cauda R, Monforte A, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Monforte Ad, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Cozzi-Lepri A, De Luca A, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Maggiolo F, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Antonucci G, Narciso P, Tozzi V, Vullo V, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D, …], DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, and AREA MIN. 06 - Scienze mediche
- Subjects
microbial ,Male ,Fibrosi ,Lipopolysaccharide Receptors ,HIV Infections ,Kaplan-Meier Estimate ,Liver disease ,Medical microbiology ,Risk Factors ,HIV Infection ,Fib-4 ,Coinfection ,Liver Disease ,Medicine (all) ,Liver Diseases ,virus diseases ,Hepatitis A ,Hepatitis C ,Hepatitis B ,Middle Aged ,sCD14 ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,Infectious Diseases ,Treatment Outcome ,HIV/hepatitis co-infection ,traslocation ,HCV ,HIV ,liver ,Disease Progression ,Biological Markers ,Female ,medicine.symptom ,Adult ,Antigens, CD14 ,CD4 Lymphocyte Count ,Enzyme-Linked Immunosorbent Assay ,Fibrosis ,Humans ,Inflammation ,CD14 ,Microbial translocation ,Research Article ,Human ,medicine.medical_specialty ,Infectious Disease ,Settore MED/17 - MALATTIE INFETTIVE ,Biomarkers ,medicine ,Antigens ,Hepatitis ,business.industry ,Risk Factor ,Biomarker ,medicine.disease ,Virology ,digestive system diseases ,Immunology ,business - Abstract
none 157 no Abstract BACKGROUND: We evaluated whether immune activation (IA) and microbial translocation (MT) might play a role in accelerating liver disease progression in HIV-HBV/HCV co-infected patients. METHODS: ART-naïve HIV/viral hepatitis co-infected patients from Icona with a CD4 cell count >200/μl and with a known date of prior HIV neg/pos tests and ≥1 plasma sample stored were included in the study. Plasma MT (LPS, sCD14) and IA (IL-6,TNFα) were measured using ELISA while activated CD8 + CD38 + HLA-DR + were measured by flow cytometry, with one measurement being performed for all patients and two measurements for a smaller group of subjects. The association between these biomarkers and the time to i) a single ALT >200 IU/l and ii) a Fib-4 >1.45 was also investigated. A standard survival analysis with robust standard errors was used for all evaluations. Follow-up was censored at patients' last clinical follow-up. RESULTS: We studied 127 HIV-infected hepatitis viruses co-infected patients (118 HCV, 9 HBV). Overall median (IQR) CD4, VL, age were 596/μl (208-1303), 3.8 log10cp/mL (3-4.3), 34 years (22-56). While heightened TNF-α was associated with a 13-fold increased risk of Fib-4 > 1.45 (RH 13.05, 95% CI 2.43-70; p = 0.003), markers of MT did not show an association with liver illness. Interestingly, higher sCD14 was associated with a decreased risk of Fib-4 > 1.45, independently of other biomarkers considered (RH 0.20, 95% CI 0.04-0,9; p = 0.04). CONCLUSIONS: In HIV/hepatitis virus co-infected ART-naive patients, higher TNF-α plasma levels were associated with a 13-fold increase in the risk of progression to a Fib-4 >1.45, suggesting that the pro-inflammatory status in HIV infection might hasten the course of HCV. In view of the fact that sCD14 may hinder the interaction between LPS and the phagocyte membrane CD14, we herewith propose a model which aims to demonstrate that high sCD14 levels might contribute to shelter liver function through the down-regulation of the inflammatory cascade. Marchetti, Giulia; Cozzi-Lepri, Alessandro; Tincati, Camilla; Calcagno, Andrea; Ceccherini-Silberstein, Francesca; De Luca, Andrea; Antinori, Andrea; Castagna, Antonella; Puoti, Massimo; Monforte, Antonella d'Arminio; and for the Icona Foundation Study Group […; Moroni M; Angarano G; Antinori A; Carosi G; Cauda R; Monforte A; Di Perri G; Galli M; Iardino R; Ippolito G; Lazzarin A; Perno CF; Viale PL; Von Schlosser F; Monforte Ad; Ammassari A; Andreoni M; Antinori A; Balotta C; Bonfanti P; Bonora S; Borderi M; Capobianchi MR; Castagna A; Ceccherini-Silberstein F; Cozzi-Lepri A; Monforte A; De Luca A; Gargiulo M; Gervasoni C; Girardi E; Lichtner M; Lo Caputo S; Madeddu G; Maggiolo F; Marcotullio S; Monno L; Murri R; Mussini C; Puoti M; Torti C; Cozzi-Lepri A; Fanti I; Formenti T; Montroni M; Giacometti A; Costantini A; Riva A; Tirelli U; Martellotta F; Angarano G; Monno L; Ladisa N; Suter F; Maggiolo F; Viale PL; Verucchi G; Piergentili B; Carosi G; Cristini G; Torti C; Minardi C; Bertelli D; Quirino T; Abeli C; Manconi PE; Piano P; Vecchiet J; Falasca K; Carnevale G; Lorenzotti S; Sighinolfi L; Leoncini F; Mazzotta F; Pozzi M; Lo Caputo S; Cassola G; Viscoli G; Alessandrini A; Piscopo R; Mazzarello G; Mastroianni C; Belvisi V; Bonfanti P; Molteni C; Chiodera A; Castelli P; Galli M; Lazzarin A; Rizzardini G; Puoti M; Monforte A; Ridolfo AL; Foschi A; Castagna A; Salpietro S; Merli S; Carenzi L; Moioli MC; Cicconi P; Formenti T; Esposito R; Mussini C; Gori A; Pastore V; Abrescia N; Chirianni A; De Marco M; Ferrari C; Borghi R; Baldelli F; Belfiori B; Parruti G; Sozio F; Magnani G; Ursitti MA; Arlotti M; Ortolani P; Cauda R; Andreoni M; Antinori A; Antonucci G; Narciso P; Tozzi V; Vullo V; De Luca A; Zaccarelli M; Gallo L; Acinapura R; De Longis P; Ceccarelli L; Libertone R; Trotta MP; Miccoli A; Cattelan AM; Mura MS; Madeddu G; Caramello P; Di Perri G; Orofino GC; Sciandra M; Raise E; Ebo F; Pellizzer G; Buonfrate D; …] Marchetti, Giulia; Cozzi-Lepri, Alessandro; Tincati, Camilla; Calcagno, Andrea; Ceccherini-Silberstein, Francesca; De Luca, Andrea; Antinori, Andrea; Castagna, Antonella; Puoti, Massimo; Monforte, Antonella d'Arminio; and for the Icona Foundation Study Group […; Moroni M; Angarano G; Antinori A; Carosi G; Cauda R; Monforte A; Di Perri G; Galli M; Iardino R; Ippolito G; Lazzarin A; Perno CF; Viale PL; Von Schlosser F; Monforte Ad; Ammassari A; Andreoni M; Antinori A; Balotta C; Bonfanti P; Bonora S; Borderi M; Capobianchi MR; Castagna A; Ceccherini-Silberstein F; Cozzi-Lepri A; Monforte A; De Luca A; Gargiulo M; Gervasoni C; Girardi E; Lichtner M; Lo Caputo S; Madeddu G; Maggiolo F; Marcotullio S; Monno L; Murri R; Mussini C; Puoti M; Torti C; Cozzi-Lepri A; Fanti I; Formenti T; Montroni M; Giacometti A; Costantini A; Riva A; Tirelli U; Martellotta F; Angarano G; Monno L; Ladisa N; Suter F; Maggiolo F; Viale PL; Verucchi G; Piergentili B; Carosi G; Cristini G; Torti C; Minardi C; Bertelli D; Quirino T; Abeli C; Manconi PE; Piano P; Vecchiet J; Falasca K; Carnevale G; Lorenzotti S; Sighinolfi L; Leoncini F; Mazzotta F; Pozzi M; Lo Caputo S; Cassola G; Viscoli G; Alessandrini A; Piscopo R; Mazzarello G; Mastroianni C; Belvisi V; Bonfanti P; Molteni C; Chiodera A; Castelli P; Galli M; Lazzarin A; Rizzardini G; Puoti M; Monforte A; Ridolfo AL; Foschi A; Castagna A; Salpietro S; Merli S; Carenzi L; Moioli MC; Cicconi P; Formenti T; Esposito R; Mussini C; Gori A; Pastore V; Abrescia N; Chirianni A; De Marco M; Ferrari C; Borghi R; Baldelli F; Belfiori B; Parruti G; Sozio F; Magnani G; Ursitti MA; Arlotti M; Ortolani P; Cauda R; Andreoni M; Antinori A; Antonucci G; Narciso P; Tozzi V; Vullo V; De Luca A; Zaccarelli M; Gallo L; Acinapura R; De Longis P; Ceccarelli L; Libertone R; Trotta MP; Miccoli A; Cattelan AM; Mura MS; Madeddu G; Caramello P; Di Perri G; Orofino GC; Sciandra M; Raise E; Ebo F; Pellizzer G; Buonfrate D; …]
- Published
- 2014
6. Clinical Features of Bacterial Meningitis in Italy: a Multicenter Prospective Observational Study
- Author
-
Lazzarini, L., Toti, M., Fabris, P., Conti, E., Magni, G., Mazzotta, F., Lalla, F., Acone, N., Aquila, G., Pastore, G., Buongiorno, R., Francavilla, E., Granata, C., Maio, G., Sangiuolo, A., Andreoni, M., Bellissima, P., Russo, R., Tosto, S., Stagno, A., Beltrami, C., Brighi, S., Guaglianone, L., Luciani, F., Carnevale, G., Viganò, P., Re, T., Fiore, M., Ciao, V., Padovani, P., Ghinelli, F., Bicocchi, R., Leoncini, F., Pozzi, M., Gioacchino ANGARANO, Scotto, G., Palumbo, E., Cancellieri, C., Pagano, G., Camera, M., Cassola, G., Giomi, S., Iannessi, A., Cellini, A., Soscia, F., Salone, G., Rovere, P., Scasso, A., Chiodera, A., Todaro, G., Orifici, G., Moroni, M., Negri, C., Cargnel, A., Gubertini, G., Bisoffi, Z., Marocco, S., Sapienza, M., Benenati, P., Colucci, M., Giordano, G., Baldelli, F., Di Candilo, F., Alberici, F., Ratti, G., Zauli, T., Foti, G., Magnani, G., Rossi, G., Arlotti, M., Ortolani, P., Petrosillo, N., Renda, V., Iaiani, G., Narciso, P., Ghirga, P., Paffetti, A., Mannozzi, P., Vullo, V., Massetti, A. P., Carretta, M., Viviani, F., Frongillo, R. F., Palumbo, M., Caramello, P., Gaiottino, F., Viale, P., Crapis, M., Grossi, P., Dinatale, Poggio, A., and Mondino, V.
- Subjects
Male ,Time Factors ,Neisseria meningitidis ,medicine.disease_cause ,Severity of Illness Index ,Ampicillin ,80 and over ,Pharmacology (medical) ,Prospective Studies ,Antibacterial agent ,Aged, 80 and over ,ampicillin ,ceftriaxone ,italy ,meningitis ,steroids ,Respiration ,Ceftriaxone ,Bacterial ,Middle Aged ,Anti-Bacterial Agents ,Streptococcus pneumoniae ,Infectious Diseases ,Italy ,Oncology ,Combination ,Artificial ,Meningitis ,Steroids ,Adolescent ,Adult ,Aged ,Drug Therapy, Combination ,Female ,Glucocorticoids ,Humans ,Length of Stay ,Meningitis, Bacterial ,Respiration, Artificial ,Young Adult ,Pharmacology ,medicine.drug ,Meningitides ,medicine.medical_specialty ,Drug Therapy ,Internal medicine ,medicine ,business.industry ,medicine.disease ,Surgery ,Adjunctive treatment ,business - Abstract
We carried out a prospective observational study on clinical features of bacterial meningitis. Between October 2002 and June 2005, 322 adult bacterial meningitis cases in 49 infectious disease wards in Italy (MENTORE study group) were enrolled in the study. 133 cases were due to Streptococcus pneumoniae, 44 to Neisseria meningitidis and 145 to other microorganisms. A high SAPS score and coma on admission, as well as need for mechanical ventilation, were more frequent in the pneumococcal meningitis group. Neurological impairment was present in 151 out of 311 patients, and was more frequent in pneumococcal meningitis. A single antibiotic was employed in only 90 of 315 cases; a combination of ceftriaxone and ampicillin was the most frequently administered treatment. Ceftriaxone was also the single most used drug. Adjunctive treatment with steroids was administered in 210 out of 303 patients for a median duration of 7 days. Median duration of fever was 4 days, and median hospital stay was 16 days; hospitalization was significantly longer in the pneumococcal meningitis group. At discharge, neurological impairment was still present in 59 (21%) of 277 patients. Twenty (6.9%) out of 289 patients died during hospitalization. Distribution of adverse outcome (death and neurological impairment) in patients treated with or without steroids and within different time zones between onset of symptoms and commencement of antibiotics was studied; a trend toward a worse prognosis was seen in patients treated more than 24 hours after onset of the disease.In our study, infectious disease clinicians made extensive use of steroids as adjuvant therapy for bacterial meningitis, even in absence of detailed national and local guidelines. Mortality seemed to be lower in comparison with the literature.
- Published
- 2008
7. Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy
- Author
-
Floridia, M, Mastroiacovo, P., Ravizza, M., Todros, T., Chiadò Fiorio Tin, M., Marconi, A. M., Cetin, I., Maruotti, G. M., Liuzzi, G., Pinnetti, C., Degli Antoni, A., Spinillo, A., Guerra, B., Tamburrini, E., Floridia, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, Daniela, Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Tibaldi, C., Trentini, L., Masuelli, G., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., and Vella, S.
- Subjects
Adult ,Infectious ,Obstetrics and Gynecology ,HIV Infections ,Congenital Abnormalities ,Pregnancy Complications ,Italy ,Pregnancy ,Humans ,Female ,Pregnancy Complications, Infectious ,Genetics (clinical) - Published
- 2015
8. Genotypic resistance profiles associated with virological failure to darunavir-containing regimens: a cross-sectional analysis
- Author
-
Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, MANCUSO, Salvatrice, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, Poletti, F., Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, and Poletti, F
- Subjects
Male ,Time Factors ,Cross-sectional study ,Human immunodeficiency virus (HIV) ,Drug Resistance ,HIV Infections ,Drug resistance ,medicine.disease_cause ,Cohort Studies ,Antiretroviral Therapy, Highly Active ,Ritonavir-boosted darunavir ,Genotype ,HIV Infection ,Treatment Failure ,Viral ,Genotypic resistance ,Darunavir ,Sulfonamides ,General Medicine ,Middle Aged ,Virological failure ,Infectious Diseases ,Female ,Human ,medicine.drug ,Adult ,Microbiology (medical) ,Logistic Model ,Time Factor ,Antiretroviral Therapy ,Settore MED/17 - MALATTIE INFETTIVE ,Sulfonamide ,Drug Resistance, Viral ,medicine ,Humans ,Highly Active ,Protease inhibitors ,Cross-Sectional Studies ,HIV Protease Inhibitors ,HIV-1 ,Logistic Models ,Mutation ,HIV Protease Inhibitor ,Cross-Sectional Studie ,business.industry ,Antiretroviral therapy ,Virology ,Protease inhibitor ,Cohort Studie ,business - Abstract
Introduction: This study aimed at defining protease (PR) resistance mutations associated with darunavir (DRV) failure and PR resistance evolution at DRV failure in a large database of treatment-experienced human immunodeficiency virus (HIV) patients. Results: Overall, 1,104 patients were included: 118 (10.7%) failed at a median observation time of 16 months. The mean number of PR mutations at baseline was 2.7, but it was higher in patients who subsequently failed DRV. In addition, the number of PR mutations increased at failure. The increase in the mean number of mutations was completely related to mutations considered to be associated with DRV resistance following the indications of the main DRV clinical trials. Discussion The higher statistical difference at baseline between failing versus non-failing patients was observed for the V32I and I84V mutations. At DRV failure, the major increase was still observed for V32I; I54L, V11I, T74P and I50V also increased. Despite the increment in the mean number of mutations per patient between baseline and failure, in 21 patients (17.8%) at baseline and 36 (30.5%) at failure, no PR mutation was detected. Conclusion: The HIV-DB interpretation algorithm identified few patients with full DRV resistance at baseline and few patients developed full resistance at DRV failure, indicating that complete resistance to DRV is uncommon. © Springer-Verlag 2011.
- Published
- 2012
9. Prevalence of hypovitaminosis D and factors associated with vitamin D deficiency and morbidity among HIV-infected patients enrolled in a large Italian cohort
- Author
-
Vescini F, Cozzi Lepri A, Maggiolo F, De Luca A, Cassola G, Vullo V, Carosi G, Antinori A, Tozzi V, Monforte AD, Icona Foundation Study G.r.o.u.p. Moroni M, Angarano G, Cauda R, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Von Schlosser F, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Capobianchi MR, Castagna A, Ceccherini Silberstein F, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Emilia R, Arlotti M, Ortolani P, Antonucci G, Narciso P, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., BORDERI, MARCO, RE, MARIA CARLA, VIALE, PIERLUIGI, VERUCCHI, GABRIELLA, PIERGENTILI, BENEDETTA, Vescini F, Cozzi-Lepri A, Borderi M, Re MC, Maggiolo F, De Luca A, Cassola G, Vullo V, Carosi G, Antinori A, Tozzi V, Monforte AD, Icona Foundation Study Group.Moroni M, Angarano G, Cauda R, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno CF, Viale PL, Von Schlosser F, Ammassari A, Andreoni M, Balotta C, Bonfanti P, Bonora S, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Gargiulo M, Gervasoni C, Girardi E, Lichtner M, Lo Caputo S, Madeddu G, Marcotullio S, Monno L, Murri R, Mussini C, Puoti M, Torti C, Fanti I, Formenti T, Montroni M, Giacometti A, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Suter F, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Molteni C, Chiodera A, Castelli P, Rizzardini G, Ridolfo AL, Foschi A, Salpietro S, Merli S, Carenzi L, Moioli MC, Cicconi P, Esposito R, Gori A, Pastore V, Abrescia N, Chirianni A, De Marco M, Ferrari C, Borghi R, Baldelli F, Belfiori B, Parruti G, Sozio F, Magnani G, Ursitti MA, Emilia R, Arlotti M, Ortolani P, Antonucci G, Narciso P, Zaccarelli M, Gallo L, Acinapura R, De Longis P, Ceccarelli L, Libertone R, Trotta MP, Miccoli A, Cattelan AM, Mura MS, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., Vescini, F, Cozzi Lepri, A, Borderi, M, Re, M, Maggiolo, F, De Luca, A, Cassola, G, Vullo, V, Carosi, G, Antinori, A, Tozzi, V, Monforte, A, Gori, A, Vescini, Fabio, Cozzi lepri, Alessandro, Borderi, Marco, Re, Maria Carla, Maggiolo, Franco, De Luca, Andrea, Cassola, Giovanni, Vullo, Vincenzo, Carosi, Giampiero, Antinori, Andrea, Tozzi, Valerio, Monforte, Antonella D'arminio, Icona Foundation Study, Group, and Castagna, Antonella
- Subjects
Male ,HIV Infections ,vitamin D ,Logistic regression ,Risk Factors ,Cardiovascular Disease ,Prevalence ,HIV Infection ,Pharmacology (medical) ,Renal Insufficiency ,Chronic ,Vitamin D ,Young adult ,education.field_of_study ,hiv infection ,prognosis ,vitamin d deficiency and insufficiency ,Diabetes Mellitu ,Middle Aged ,Prognosis ,Infectious Diseases ,Anti-Retroviral Agents ,Italy ,Cardiovascular Diseases ,Combination ,Cohort ,Linear Model ,Drug Therapy, Combination ,Female ,Seasons ,prognosi ,Adult ,Africa ,Aged ,Central America ,Diabetes Mellitus ,Drug Therapy ,Humans ,Linear Models ,South America ,Vitamin D Deficiency ,Young Adult ,Human ,medicine.medical_specialty ,Population ,Infectious Disease ,Settore MED/17 - MALATTIE INFETTIVE ,vitamin D deficiency ,Internal medicine ,medicine ,Vitamin D and neurology ,Renal Insufficiency, Chronic ,education ,Survival analysis ,business.industry ,Risk Factor ,Hypovitaminosis D ,HIV ,Odds ratio ,medicine.disease ,vitamin D deficiency and insufficiency ,Immunology ,Anti-Retroviral Agent ,Season ,business - Abstract
Background: A high prevalence of hypovitaminosis D (hypD) in HIV-infected patients has been reported, but reasons are unclear. Methods: The 25 hydroxy vitamin D (vitD) concentration was measured in a sample of HIV-positive patients from Italy enrolled in the Icona Foundation Study. The change in absolute levels of vitD pre/post combination antiretroviral treatment was modelled by linear regression controlling for confounders and seasonality. Factors associated with hypD were identified using logistic regression analysis, and survival analysis was employed to evaluate the prognostic value of vitD concentration to predict severe diseases (diabetes, cardiovascular, renal), AIDS, and death. RESULTS:: We studied 810 patients contributing 1408 vitD measures. Median age was 36 years (range: 20-69). VitD insufficiency (30-75 nmol/L) and deficiency (
- Published
- 2011
10. Favourable evolution of virological and immunological profiles in treated and untreated patients in Italy in the period 1998-2008
- Author
-
Prosperi, Mc1, Cozzi Lepri, A, Antinori, A, Cassola, G, Torti, C, Ursitti, Ma, Pellizzer, Gp, Giacometti, A, d'Arminio Monforte, A, De Luca, A, Collaborators Moroni M, Icona Foundation Study G. r. o. u. p., Carosi, G, Cauda, R, Di Perri, G, Galli, M, Ghinelli, F, Iardino, R, Ippolito, G, Lazzarin, A, Mazzotta, F, Panebianco, R, Pastore, G, Perno, Cf, Ammassari, A, Arici, C, Balotta, C, Bonfanti, P, Capobianchi, Mr, Castagna, A, Ceccherini Silberstein, F, Gervasoni, C, Girardi, E, Lo Caputo, S, Maggiolo, F, Murri, R, Mussini, C, Puoti, M, Fanti, I, Formenti, T, Prosperi, Cf, Montroni, M, Costantini, A, Riva, A, Tirelli, U, Martellotta, F, Ladisa, N, Pierri, A, Suter, F, Borderi, M, Verucchi, G, Piergentili, B, Cristini, G, Minardi, C, Bertelli, D, Quirino, T, Abeli, C, Manconi, Pe, Piano, P, Vecchiet, J, Falasca, K, Carnevale, G, Lorenzotti, S, Sighinolfi, L, Leoncini, F, Pozzi, M, Pagano, G, Viscoli, G, Alessandrini, A, Piscopo, R, Mazzarello, G, Soscia, F, Tacconi, L, Orani, A, Rossotto, R, Tommasi, D, Congedo, P, Chiodera, A, Castelli, P, Rizzardini, G, Schlacht, I, Ridolfo, Al, Foschi, A, Salpietro, S, Merli, S, Melzi, S, Moioli, Mc, Cicconi, P, Esposito, R, Gori, A, Fiorino, M, Abrescia, N, Chirianni, A, Izzo, Cm, De Marco, M, Viglietti, R, Manzillo, E, Ferrari, C, Pizzaferri, P, Baldelli, F, Belfiori, B, Magnani, G, Arlotti, M, Ortolani, P, Andreoni, M, Antonucci, G, Narciso, P, Tozzi, V, Vullo, Vincenzo, Zaccarelli, M, Acinapura, R, De Longis, P, Trotta, Mp, Calbi, M, Gallo, L, Carletti, F, Mura, Ms, Madeddu, G, Caramello, P, Orofino, Gc, Sciandra, M, Raise, E, Ebo, F, Pellizzer, G, Buonfrate, D., Prosperi, M. C. F., Cozzi lepri, A., Antinori, A., Cassola, G., Torti, C., Ursitti, M. A., Pellizzer, G. P., Giacometti, A., D'arminio Monforte, A., De Luca, A, Icona Foundation Study, Group, Castagna, Antonella, Prosperi MC, Cozzi-Lepri A, Antinori A, Cassola G, Torti C, Ursitti MA, Pellizzer GP, Giacometti A, d'Arminio Monforte A, De Luca A, Icona, Moroni M, Carosi G, Cauda R, Di Perri G, Galli M, Ghinelli F, Iardino R, Ippolito G, Lazzarin A, Mazzotta F, Panebianco R, Pastore G, Perno CF, Ammassari A, Arici C, Balotta C, Bonfanti P, Capobianchi MR, Castagna A, Ceccherini-Silberstein F, Gervasoni C, Girardi E, Lo Caputo S, Maggiolo F, Murri R, Mussini C, Puoti M, Fanti I, Formenti T, Prosperi CF, Montroni M, Costantini A, Riva A, Tirelli U, Martellotta F, Ladisa N, Pierri A, Suter F, Borderi M, Verucchi G, Piergentili B, Cristini G, Minardi C, Bertelli D, Quirino T, Abeli C, Manconi PE, Piano P, Vecchiet J, Falasca K, Carnevale G, Lorenzotti S, Sighinolfi L, Leoncini F, Pozzi M, Pagano G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Soscia F, Tacconi L, Orani A, Rossotto R, Tommasi D, Congedo P, Chiodera A, Castelli P, Rizzardini G, Schlacht I, Ridolfo AL, Foschi A, Salpietro S, Merli S, Melzi S, Moioli MC, Cicconi P, Esposito R, Gori A, Fiorino M, Abrescia N, Chirianni A, Izzo CM, De Marco M, Viglietti R, Manzillo E, Ferrari C, Pizzaferri P, Baldelli F, Belfiori B, Magnani G, Arlotti M, Ortolani P, Andreoni M, Antonucci G, Narciso P, Tozzi V, Vullo V, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Calbi M, Gallo L, Carletti F, Mura MS, Madeddu G, Caramello P, Orofino GC, Sciandra M, Raise E, Ebo F, Pellizzer G, Buonfrate D., Prosperi, M, Cozzi Lepri, A, Antinori, A, Cassola, G, Torti, C, Ursitti, M, Pellizzer, G, Giacometti, A, D'Arminio Monforte, A, and Gori, A
- Subjects
Adult ,Male ,HAART ,Sexual Behavior ,HIV Infections ,Infectious Disease ,HUMAN-IMMUNODEFICIENCY-VIRUS ,Settore MED/17 - MALATTIE INFETTIVE ,Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA ,Virological response rate ,immunological response rates ,Poisson regression ,Antiretroviral Therapy, Highly Active ,Prevalence ,Humans ,HIV Infection ,Pharmacology (medical) ,Poisson Distribution ,Health Policy ,HIV ,HEPATITIS C VIRUS ,HIV–infected patients ,Viral Load ,CD4 Lymphocyte Count ,Treatment Outcome ,Italy ,HIV-1 ,Female ,Immunological response rate ,Human - Abstract
Background: This study provides an estimate of the proportion of HIV-positive patients in Italian clinics showing an 'adverse prognosis' (defined as a CD4 count â¤200cells/μL or an HIV RNA >50 HIV-1 RNA copies/mL) over time, and investigates whether this proportion varied according to patients' characteristics. Methods: We estimated the annual proportion of patients with a CD4 count â¤200cells/μL or HIV RNA >50copies/mL out of the total number of patients in the Icona Foundation cohort seen in any given year, both overall and after stratifying by demographical and treatment status groups. Generalized estimating equation models for Poisson regression were applied. Results: In 1998-2008, the prevalence of patients with a CD4 count â¤200cells/μL decreased from 14 to 6% [adjusted relative risk (RR) 0.86/year; 95% confidence interval (CI) 0.84-0.88; P50copies/mL decreased from 66 to 40% (adjusted RR 0.95/year; 95% CI 0.95-0.96; P
- Published
- 2011
11. No pol mutation is associated independently with the lack of immune recovery in patients infected with HIV and failing antiretroviral therapy
- Author
-
Gianotti, N1, Galli, L, Zazzi, M, Ghisetti, V, Bonora, S, Micheli, V, Meraviglia, P, Corsi, P, Bruzzone, B, Menzo, S, Di Giambenedetto, S, De Luca, A, Filice, G, Penco, G, Castagna, A, Collaborators Giacometti A, ARCA database i. n. i. t. i. a. t. i. v. e., Butini, L, del Gobbo, R, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Re, Mc, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Carnevale, G, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Gianotti, N, Cicconi, P, Rusconi, S, Gismondo, Mr, Biondi, Ml, Capetti, A, Boeri, E, Pecorari, M, Mussini, C, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, Antinori, A, Vullo, Vincenzo, Turriziani, O, Perno, Cf, Montano, M, Cenderello, G, Gonnelli, A, Romano, L, Palumbo, M, Delle Foglie, P, Rossi, C, Poletti, F, Mondino, V, Malena, M, Lattuada, E., Gianotti, N, Galli, L, Zazzi, M, Ghisetti, V, Bonora, S, Micheli, V, Meraviglia, P, Corsi, P, Bruzzone, B, Menzo, S, Di Giambenedetto, S, De Luca, A, Filice, G, Penco, G, Castagna, A, Mancuso, S, Gianotti N, Galli L, Zazzi M, Ghisetti V, Bonora S, Micheli V, Meraviglia P, Corsi P, Bruzzone B, Menzo S, Di Giambenedetto S, De Luca A, Filice G, Penco G, Castagna A, Giacometti A, Butini L, del Gobbo R, Tacconi D, Corbelli G, Zanussi S, Monno L, Punzi G, Maggiolo F, Callegaro A, Calza L, Re MC, Pristerà R, Turconi P, Mandas A, Tini S, Carnevale G, Paolini E, Amadio G, Sighinolfi L, Zuccati G, Morfini M, Manetti R, Di Pietro M, Bartalesi F, Colao G, Tosti A, Di Biagio A, Setti M, Trezzi M, Orani A, Pardelli R, De Gennaro M, Chiodera A, Scalzini A, Palvarini L, Almi P, Todaro G, Cicconi P, Rusconi S, Gismondo MR, Biondi ML, Capetti A, Boeri E, Pecorari M, Mussini C, Santirocchi M, Brustia D, Ravanini P, Dal Bello F, Romano N, Mancuso S, Calzetti C, Maserati R, Baldanti F, Francisci D, Parruti G, Polilli E, Sacchini D, Martinelli C, Consolini R, Vatteroni L, Vivarelli A, Nerli A, Lenzi L, Magnani G, Ortolani P, Andreoni M, Palamara G, Fimiani C, Palmisano L, Antinori A, Vullo V, Turriziani O, Perno CF, Montano M, Cenderello G, Gonnelli A, Romano L, Palumbo M, Delle Foglie P, Rossi C, Poletti F, Mondino V, Malena M, Lattuada E., Gianotti, Nicola, Galli, Laura, Zazzi, Maurizio, Ghisetti, Valeria, Bonora, Stefano, Micheli, Valeria, Meraviglia, Paola, Corsi, Paola, Bruzzone, Bianca, Menzo, Stefano, Di Giambenedetto, Simona, De Luca, Andrea, Filice, Gaetano, Penco, Giovanni, and Castagna, Antonella
- Subjects
Male ,HIV Infections ,Drug resistance ,Logistic regression ,Resistance to nucleoside reverse transcriptase inhibitor ,CD4+ T-lymphocyte ,Retrospective Studie ,Immunopathology ,Antiretroviral Therapy, Highly Active ,Resistance to non-nucleoside reverse transcriptase inhibitor ,genetics ,Resistance to protease inhibitor ,HIV Infection ,resistance to nucleoside reverse transcriptase inhibitors ,Viral ,Sida ,resistance to protease inhibitors ,biology ,Reverse-transcriptase inhibitor ,Viral Load ,Genes, pol ,drug therapy/immunology/virology ,Reverse Transcriptase Inhibitor ,Infectious Diseases ,Treatment Outcome ,resistance to non-nucleoside reverse transcriptase inhibitors ,Reverse Transcriptase Inhibitors ,Female ,Viral load ,medicine.drug ,Human ,pol ,Anti-HIV Agents ,Antiretroviral Therapy ,Viremia ,Infectious Disease ,Settore MED/17 - MALATTIE INFETTIVE ,pharmacology/therapeutic use ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Drug Resistance, Viral ,medicine ,Humans ,Highly Active ,Retrospective Studies ,pharmacology/therapeutic use, Antiretroviral Therapy ,Highly Active, CD4 Lymphocyte Count, Drug Resistance ,genetics, Female, Genes ,pol, HIV Infections ,drug therapy/immunology/virology, HIV-1 ,drug effects/enzymology/genetics, Humans, Male, Mutation, Retrospective Studies, Reverse Transcriptase Inhibitors ,therapeutic use, Treatment Outcome, Viral Load ,drug resistance ,Anti-HIV Agent ,biology.organism_classification ,medicine.disease ,CD4 Lymphocyte Count ,Genes ,drug effects/enzymology/genetics ,therapeutic use ,Mutation ,CD4+ T-lymphocytes ,HIV-1 - Abstract
An investigation was undertaken to determine whether specific pol mutations hinder long-term immune recovery regardless of virological response. In total, 826 patients with >50 HIV RNA copies/ml, who underwent genotypic resistance testing between 1 January 2000 and 31 December 2003 after >3 years of antiretroviral treatment, and were followed up for >3 years after genotypic resistance testing, were analyzed retrospectively. The outcome of the study was the lack of immune recovery after >3 years of follow-up, defined as a slope by linear regression 50 copies/ml divided by the number of HIV RNA measurements during follow-up. Logistic regression was used for univariable and multivariable analysis. Median (Q1, Q3) values at baseline were the following: age 40 (37, 45) years, years on antiretroviral therapy 4.45 (3.65, 5.47), HIV RNA 3.91 (3.39, 4.53) log 10 copies/ml, CD4+ T-cell 358 (211, 524)/μl. After 3.13 years of follow-up, 375 patients (45.4%) showed a lack of immune recovery. The risk of lack of immune recovery increased independently with increasing baseline CD4+ counts (OR=1.104 per 50-cell increase, 95% CI=1.069-1.142, P
- Published
- 2011
12. Clinical presentation and outcome of colorectal cancer in HIV-positive patients: a clinical case-control study
- Author
-
Berretta, M, Cappellani, A, Di Benedetto, F, Lleshi, A, Talamini, R, Canzonieri, V, Zanet, E, Bearz, A, Nasti, G, Lacchin, T, Berretta, S, Fisichella, R, Balestreri, L, Torresin, A, Izzi, I, Ortolani, P, M lanzafame, Tirelli U., Guaraldi, G, Giacomazzi, D, Malincarne, L, Nunnari, G, Berretta, M, Cappellani, A, Di Benedetto, F, Lleshi, A, Talamini, R, Canzonieri, V, Zanet, E, Bearz, A, Nasti, G, Lacchin, T, Berretta, S, Fisichella, R, Balestreri, L, Torresin, A, Izzi, I, Ortolani, P, and Tirelli, U
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,Adult, Case-Control Studies, Colorectal Neoplasms ,mortality, Comorbidity, Female, HIV Infections ,mortality, Humans, Italy ,epidemiology, Male, Middle Aged, Outcome Assessment (Health Care), Prevalence, Risk Assessment, Risk Factors, Survival Analysis, Survival Rate ,folinic acid ,MEDLINE ,HIV Infections ,Comorbidity ,Risk Assessment ,fluorouracil ,Outcome Assessment (Health Care) ,Risk Factors ,Internal medicine ,Outcome Assessment, Health Care ,Prevalence ,irinotecan ,medicine ,Humans ,Survival rate ,Survival analysis ,business.industry ,Case-control study ,virus diseases ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,mortality ,Survival Analysis ,Survival Rate ,Italy ,Case-Control Studies ,Female ,epidemiology ,Presentation (obstetrics) ,Colorectal Neoplasms ,Risk assessment ,business - Abstract
Background: Data on colorectal cancer (CRC) in HIV-positive patients are limited. The study objective was to investigate and compare clinical presentation and outcome between HIV-positive and HIV-negative CRC patients. Patients and Methods: Between September 1985 and November 2003 we identified 27 cases of HIV-positive CRC patients from the cancer registry database-Italian Cooperative Group AIDS and Tumours (GICAT); the clinical presentation/outcome information was retrieved. Each HIV-positive patient from our institution was randomly matched (ratio 1: 2) with HIV-negative patients (54 controls) based on age, sex, and year of diagnosis in the same time period. Differences in clinical presentation, treatment, and overall survival were assessed. Results: Of 1130 HIV-negative CRC patients, 54 were identified and matched with 27 HIV-positive patients. Compared with the HIV-negative patients, the HIV-positive patients had a higher risk of lower performance status (PS: >= 2) (odds ratio (OR) = 14.4; 95% confidence interval (CI): 3.6-57.7), a higher risk of unfavorable Dukes' stage (D) (OR = 4.9; 95% CI: 1.8-13.5), and a higher risk of poor grading (G3-G4) (OR = 5.0; 95% CI: 1.9-13.4). Median overall follow-up was 27 months (range: 2-212). At multivariate analysis, the only characteristics that significantly reduced the survival of the CRC patients were: HIV-positive status (hazard ratio (HR): 2.4; 95% CI: 1.1-5.2) and Dukes' stage D (HR: 3.7; 95% CI: 1.9-7.1). Conclusion: Our data show that HIV-positive CRC patients compared to HIV-negative patients have a poorer PS, an unfavorable Dukes' stage, higher grading and shorter survival.
- Published
- 2009
13. Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy : not all AIDS-defining conditions are created equal
- Author
-
Antiretroviral Therapy Cohort Collaboration Mocroft A, Sterne JA, Egger M, May M, Grabar S, Furrer H, Sabin C, Fatkenheuer G, Justice A, Reiss P, d'Arminio Monforte A, Gill J, Hogg R, Bonnet F, Kitahata M, Staszewski S, Casabona J, Harris R, Saag M, Chêne G, Costagliola D, Dabis F, D'Arminio Monforte A, de Wolf F, Ledergerber B, Mocroft A, Phillips A, Weller I, Sterne J, Abgrall S, Barin F, Bentata M, Billaud E, Boué F, Burty C, Cabié A, Cotte L, De Truchis P, Duval X, Duvivier C, Enel P, Fredouille Heripret L, Gasnault J, Gaud C, Gilquin J, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorgé F, Poizot Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot Dupont H, Viard JP, Viget N, Pariente Khayat A, Salomon V, Jacquemet N, Rivet A, Guiguet M, Kousignian I, Lanoy E, Lièvre L, Potard V, Selinger Leneman H, Bouvet E, Crickx B, Ecobichon JL, Leport C, Picard Dahan C, Yeni P, Tisne Dessus D, Weiss L, Salmon D, Sicard D, Auperin I, Roudière L, Fior R, Delfraissy JF, Goujard C, Jung C, Lesprit P, Desplanque N, Meyohas MC, Picard O, Cadranel J, Mayaud C, Bricaire F, Herson S, Clauvel JP, Decazes JM, Gerard L, Molina JM, Diemer M, Sellier P, Berthé H, Dupont C, Chandemerle C, Mortier E, Honoré P, Jeantils V, Tassi S, Mechali D, Taverne B, Gourdon F, Laurichesse H, Fresard A, Lucht F, Eglinger P, Faller JP, Bazin C, Verdon R, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Trepo C, Ravaux I, Delmont JP, Moreau J, Gastaut JA, Retornaz F, Soubeyrand J, Allegre T, Blanc PA, Galinier A, Ruiz JM, Lepeu G, Granet Brunello P, Esterni JP, Pelissier L, Cohen Valensi R, Nezri M, Chadapaud S, Laffeuillade A, May T, Rabaud C, Raffi F, Arvieux C, Michelet C, Borsa Lebas F, Caron F, Fraisse P, Rey D, Arlet Suau E, Cuzin L, Massip P, Thiercelin Legrand MF, Yasdanpanah Y, Pradinaud R, Sobesky M, Contant M, Montroni M, Scalise G, Braschi MC, Riva A, Tirelli U, Martellotta F, Pastore G, Ladisa N, Suter F, Arici C, Chiodo F, Colangeli V, Fiorini C, Carosi G, Cristini G, Torti C, Minardi C, Bertelli D, Quirino T, Manconi PE, Piano P, Cosco L, Scerbo A, Vecchiet J, D'Alessandro M, Santoro D, Pusterla L, Carnevale G, Lorenzotti S, Viganò P, Mena M, Ghinelli F, Sighinolfi L, Leoncini F, Mazzotta F, Pozzi M, Lo Caputo S, Grisorio B, Ferrara S, Grima P, Grima PF, Pagano G, Cassola G, Alessandrini A, Piscopo R, Toti M, Trezzi M, Soscia F, Tacconi L, Orani A, Perini P, Scasso A, Vincenti A, Chiodera F, Castelli P, Scalzini A, Palvarini L, Moroni M, Lazzarin A, Rizzardini G, Caggese L, Cicconi P, Galli A, Merli S, Pastecchia C, Moioli MC, Esposito R, Mussini C, Abrescia N, Chirianni A, Izzo CM, Piazza M, De Marco M, Viglietti R, Manzillo E, Colomba A, Abbadessa V, Prestileo T, Mancuso S, Ferrari C, Pizzaferri P, Filice G, Minoli L, Bruno R, Novati S, Baldelli F, Camanni G, Petrelli E, Cioppi A, Alberici F, Ruggieri A, Menichetti F, Martinelli C, De Stefano C, La Gala A, Ballardini G, Rizzo E, Magnani G, Ursitti MA, Arlotti M, Ortolani P, Cauda R, Dianzani F, Ippolito G, Antinori A, Antonucci G, Ciardi M, Narciso P, Petrosillo N, Vullo V, De Luca A, Zaccarelli M, Acinapura R, De Longis P, Trotta MP, Noto P, Lichtner M, Capobianchi MR, Carletti F, Girardi E, Pezzotti P, Rezza G, Mura MS, Mannazzu M, Caramello P, Di Perri G, Orofino GC, Sciandra M, Grossi PA, Basilico C, Poggio A, Bottari G, Raise E, Ebo F, Pellizzer G, Buonfrate D, Resta F, Loso K, Cozzi Lepri A, Battegay M, Bernasconi E, Böni J, Bucher H, Bürgisser P, Cattacin S, Cavassini M, Dubs R, Elzi L, Erb P, Fischer M, Flepp M, Fontana A, Francioli P, Gorgievski M, Günthard H, Hirsch H, Hirschel B, Hösli I, Kahlert C, Kaiser L, Karrer U, Kind C, Klimkait T, Martinetti G, Martinez B, Müller N, Nadal D, Opravil M, Paccaud F, Pantaleo G, Rickenbach M, Rudin C, Schmid P, Schultze D, Schüpbach J, Speck R, Taffé P, Tarr P, Telenti A, Trkola A, Vernazza P, Weber R, Yerly S, Gras LA, van Sighem AI, Smit C, Bronsveld W, Hillebrand Haverkort ME, Prins JM, Branger J, Eeftinck Schattenkerk JK, Gisolf J, Godfried MH, Lange JM, Lettinga KD, van der Meer JT, Nellen FJ, van der Poll T, Ruys TA, Steingrover R, Vermeulen JN, Vrouenraets SM, van Vugt M, Wit FW, Kuijpers TW, Pajkrt D, Scherpbier HJ, van Eeden A, Brinkman K, van den Berk GE, Blok WL, Frissen PH, Roos JC, Schouten WE, Mulder JW, van Gorp EC, Wagenaar J, Veenstra J, Danner SA, Van Agtmael MA, Claessen FA, Perenboom RM, Rijkeboer A, van Vonderen MG, Richter C, van der Berg J, Vriesendorp R, Jeurissen FJ, Kauffmann RH, Pogány K, Bravenboer B, ten Napel CH, Kootstra GJ, Sprenger HG, van Assen S, van Leeuwen JT, Doedens R, Scholvinck EH, ten Kate RW, Soetekouw R, van Houte D, Polée MB, Kroon FP, van den Broek PJ, van Dissel JT, Schippers EF, Schreij G, van der Geest S, Lowe S, Verbon A, Koopmans PP, Van Crevel R, de Groot R, Keuter M, Post F, van der Ven AJ, Warris A, van der Ende ME, Gyssens IC, van der Feltz M, Nouwen JL, Rijnders BJ, de Vries TE, Driessen G, van der Flier M, Hartwig NG, Juttman JR, van Kasteren ME, Van de Heul C, Hoepelman IM, Schneider MM, Bonten MJ, Borleffs JC, Ellerbroek PM, Jaspers CA, Mudrikove T, Schurink CA, Gisolf EH, Geelen SP, Wolfs TF, Faber T, Tanis AA, Groeneveld PH, den Hollander JG, Duits AJ, Winkel K, Back NK, Bakker ME, Berkhout B, Jurriaans S, Zaaijer HL, Cuijpers T, Rietra PJ, Roozendaal KJ, Pauw W, van Zanten AP, Smits PH, von Blomberg BM, Savelkoul P, Pettersson A, Swanink CM, Franck PF, Lampe AS, Jansen CL, Hendriks R, Benne CA, Veenendaal D, Storm H, Weel J, van Zeijl JH, Kroes AC, Claas HC, Bruggeman CA, Goossens VJ, Galama JM, Melchers WJ, Poort YA, Doornum GJ, Niesters MG, Osterhaus AD, Schutten M, Buiting AG, Swaans CA, Boucher CA, Schuurman R, Boel E, Jansz AF, Veldkamp A, Beijnen JH, Huitema AD, Burger DM, Hugen PW, van Kan HJ, Losso M, Duran A, Vetter N, Karpov I, Vassilenko A, Mitsura VM, Suetnov O, Clumeck N, De Wit S, Poll B, Colebunders R, Kostov K, Begovac J, Machala L, Rozsypal H, Sedlacek D, Nielsen J, Lundgren J, Benfield T, Kirk O, Gerstoft J, Katzenstein T, Hansen AB, Skinhøj P, Pedersen C, Oestergaard L, Zilmer K, Ristola M, Girard PM, Vanhems P, Rockstroh J, Schmidt R, van Lunzen J, Degen O, Stellbrink HJ, Bogner J, Kosmidis J, Gargalianos P, Xylomenos G, Perdios J, Panos G, Filandras A, Karabatsaki E, Sambattakou H, Banhegyi D, Mulcahy F, Yust I, Turner D, Burke M, Pollack S, Hassoun G, Maayan S, Chiesi A, Mazeu I, Pristera R, Gabbuti A, Montesarchio E, Gargiulo M, Iacomi F, Vlassi C, Finazzi R, Galli M, Ridolfo A, Rozentale B, Aldins P, Chaplinskas S, Hemmer R, Staub T, Bruun J, Maeland A, Ormaasen V, Knysz B, Gasiorowski J, Horban A, Prokopowicz D, Wiercinska Drapalo A, Boron Kaczmarska A, Pynka M, Beniowski M, Mularska E, Trocha H, Antunes F, Valadas E, Mansinho K, Maltez F, Duiculescu D, Rakhmanova A, Vinogradova E, Buzunova S, Jevtovic D, Mokrás M, Staneková D, González Lahoz J, Soriano V, Martin Carbonero L, Labarga P, Clotet B, Jou A, Conejero J, Tural C, Gatell JM, Miró JM, Domingo P, Gutierrez M, Mateo G, Sambeat MA, Karlsson A, Persson PO, Flamholc L, Boffi E, Kravchenko E, Chentsova N, Barton S, Johnson AM, Mercey D, Johnson MA, Murphy M, Weber J, Scullard G, Fisher M, Brettle R, Gatell J, Gazzard B, Friis Møller N, Bannister W, Ellefson M, Borch A, Podlekareva D, Holkmann Olsen C, Kjaer J, Peters L, Reekie J, Raffanti S, Dieterch D, Becker S, Scarsella A, Fusco G, Most B, Balu R, Rana R, Beckerman R, Ising T, Fusco J, Irek R, Johnson B, Hirani A, DeJesus E, Pierone G, Lackey P, Irek C, Johnson A, Burdick J, Leon S, Arch J, Helm EB, Carlebach A, Müller A, Haberl A, Nisius G, Lennemann T, Stephan C, Bickel M, Mösch M, Gute P, Locher L, Lutz T, Klauke S, Knecht G, Khaykin P, Doerr HW, Stürmer M, Babacan E, von Hentig N, Beylot J, Dupon M, Longy Boursier M, Pellegrin JL, Ragnaud JM, Salamon R, Thiébaut R, Lewden C, Lawson Ayayi S, Mercié P, Moreau JF, Morlat P, Bernard N, Lacoste D, Malvy D, Neau D, Blaizeau MJ, Decoin M, Delveaux S, Hannapier C, Labarrère S, Lavignolle Aurillac V, Uwamaliya Nziyumvira B, Palmer G, Touchard D, Balestre E, Alioum A, Jacqmin Gadda H, Bonarek M, Coadou B, Gellie P, Nouts C, Bocquentin F, Dutronc H, Lafarie S, Aslan A, Pistonne T, Thibaut P, Vatan R, Chambon D, De La Taille C, Cazorla C, Ocho A, Viallard JF, Caubet O, Cipriano C, Lazaro E, Couzigou P, Castera L, Fleury H, Lafon ME, Masquelier B, Pellegrin I, Breilh D, Blanco P, Loste P, Caunègre L, Bonnal F, Farbos S, Ferrand M, Ceccaldi J, Tchamgoué S, De Witte S, Buy E, Alexander C, Barrios R, Braitstein P, Brumme Z, Chan K, Cote H, Gataric N, Geller J, Guillemi S, Harrigan PR, Harris M, Joy R, Levy A, Montaner J, Montessori V, Palepu A, Phillips E, Phillips P, Press N, Tyndall M, Wood E, Yip B, Bhagani S, Breen R, Byrne P, Carroll A, Cuthbertson Z, Dunleavy A, Geretti AM, Heelan B, Johnson M, Kinloch de Loes S, Lipman M, Madge S, Marshall N, Nair D, Nebbia G, Prinz B, Shah S, Swader L, Tyrer M, Youle M, Chaloner C, Grabowska H, Holloway J, Puradiredja J, Ransom D, Tsintas R, Bansi L, Fox Z, Harris E, Hill T, Lampe F, Lodwick R, Smith C, Amoah E, Booth C, Clewley G, Garcia Diaz A, Gregory B, Janossy G, Labbett W, Thomas M, Read R, Krentz H, Beckthold B, Schmeisser N, Alquézar A, Esteve A, Podzamczer D, Murillas J, Romero A, Agustí C, Agüero F, Ferrer E, Riera M, Segura F, Navarro G, Force L, Vilaró J, Masabeu A, García I, Guadarrama M, Montoliu A, Ortega N, Lazzari E, Puchol E, Sanchez M, Blanco JL, Garcia Alcaide F, Martinez E, Mallolas J, López Dieguez M, García Goez JF, Sirera G, Romeu J, Negredo E, Miranda C, Capitan MC, Olmo M, Barragan P, Saumoy M, Bolao F, Cabellos C, Peña C, Sala M, Cervantes M, Jose Amengual M, Navarro M, Penelo E, Barrufet P, Raper JL, Mugavero MJ, Willig JH, Schumacher J, Chang PW, Westfall AO, Cloud G, Lin HY, Acosta EP, Colette Kempf M, Allison JJ, Pisu M., NAPPA, SALVATORE, Mocroft, A, Mancuso, S, Antiretroviral Therapy Cohort Collaboration Mocroft, A, Sterne, Ja, Egger, M, May, M, Grabar, S, Furrer, H, Sabin, C, Fatkenheuer, G, Justice, A, Reiss, P, d'Arminio Monforte, A, Gill, J, Hogg, R, Bonnet, F, Kitahata, M, Staszewski, S, Casabona, J, Harris, R, Saag, M, Chêne, G, Costagliola, D, Dabis, F, D'Arminio Monforte, A, de Wolf, F, Ledergerber, B, Phillips, A, Weller, I, Sterne, J, Abgrall, S, Barin, F, Bentata, M, Billaud, E, Boué, F, Burty, C, Cabié, A, Cotte, L, De Truchis, P, Duval, X, Duvivier, C, Enel, P, Fredouille Heripret, L, Gasnault, J, Gaud, C, Gilquin, J, Katlama, C, Khuong, Ma, Lang, Jm, Lascaux, A, Launay, O, Mahamat, A, Mary Krause, M, Matheron, S, Meynard, Jl, Pavie, J, Pialoux, G, Pilorgé, F, Poizot Martin, I, Pradier, C, Reynes, J, Rouveix, E, Simon, A, Tattevin, P, Tissot Dupont, H, Viard, Jp, Viget, N, Pariente Khayat, A, Salomon, V, Jacquemet, N, Rivet, A, Guiguet, M, Kousignian, I, Lanoy, E, Lièvre, L, Potard, V, Selinger Leneman, H, Bouvet, E, Crickx, B, Ecobichon, Jl, Leport, C, Picard Dahan, C, Yeni, P, Tisne Dessus, D, Weiss, L, Salmon, D, Sicard, D, Auperin, I, Roudière, L, Fior, R, Delfraissy, Jf, Goujard, C, Jung, C, Lesprit, P, Desplanque, N, Meyohas, Mc, Picard, O, Cadranel, J, Mayaud, C, Bricaire, F, Herson, S, Clauvel, Jp, Decazes, Jm, Gerard, L, Molina, Jm, Diemer, M, Sellier, P, Berthé, H, Dupont, C, Chandemerle, C, Mortier, E, Honoré, P, Jeantils, V, Tassi, S, Mechali, D, Taverne, B, Gourdon, F, Laurichesse, H, Fresard, A, Lucht, F, Eglinger, P, Faller, Jp, Bazin, C, Verdon, R, Boibieux, A, Peyramond, D, Livrozet, Jm, Touraine, Jl, Trepo, C, Ravaux, I, Delmont, Jp, Moreau, J, Gastaut, Ja, Retornaz, F, Soubeyrand, J, Allegre, T, Blanc, Pa, Galinier, A, Ruiz, Jm, Lepeu, G, Granet Brunello, P, Esterni, Jp, Pelissier, L, Cohen Valensi, R, Nezri, M, Chadapaud, S, Laffeuillade, A, May, T, Rabaud, C, Raffi, F, Arvieux, C, Michelet, C, Borsa Lebas, F, Caron, F, Fraisse, P, Rey, D, Arlet Suau, E, Cuzin, L, Massip, P, Thiercelin Legrand, Mf, Yasdanpanah, Y, Pradinaud, R, Sobesky, M, Contant, M, Montroni, M, Scalise, G, Braschi, Mc, Riva, A, Tirelli, U, Martellotta, F, Pastore, G, Ladisa, N, Suter, F, Arici, C, Chiodo, F, Colangeli, V, Fiorini, C, Carosi, G, Cristini, G, Torti, C, Minardi, C, Bertelli, D, Quirino, T, Manconi, Pe, Piano, P, Cosco, L, Scerbo, A, Vecchiet, J, D'Alessandro, M, Santoro, D, Pusterla, L, Carnevale, G, Lorenzotti, S, Viganò, P, Mena, M, Ghinelli, F, Sighinolfi, L, Leoncini, F, Mazzotta, F, Pozzi, M, Lo Caputo, S, Grisorio, B, Ferrara, S, Grima, P, Grima, Pf, Pagano, G, Cassola, G, Alessandrini, A, Piscopo, R, Toti, M, Trezzi, M, Soscia, F, Tacconi, L, Orani, A, Perini, P, Scasso, A, Vincenti, A, Chiodera, F, Castelli, P, Scalzini, A, Palvarini, L, Moroni, M, Lazzarin, A, Rizzardini, G, Caggese, L, Cicconi, P, Galli, A, Merli, S, Pastecchia, C, Moioli, Mc, Esposito, R, Mussini, C, Abrescia, N, Chirianni, A, Izzo, Cm, Piazza, M, De Marco, M, Viglietti, R, Manzillo, E, Nappa, Salvatore, Colomba, A, Abbadessa, V, Prestileo, T, Ferrari, C, Pizzaferri, P, Filice, G, Minoli, L, Bruno, R, Novati, S, Baldelli, F, Camanni, G, Petrelli, E, Cioppi, A, Alberici, F, Ruggieri, A, Menichetti, F, Martinelli, C, De Stefano, C, La Gala, A, Ballardini, G, Rizzo, E, Magnani, G, Ursitti, Ma, Arlotti, M, Ortolani, P, Cauda, R, Dianzani, F, Ippolito, G, Antinori, A, Antonucci, G, Ciardi, M, Narciso, P, Petrosillo, N, Vullo, V, De Luca, A, Zaccarelli, M, Acinapura, R, De Longis, P, Trotta, Mp, Noto, P, Lichtner, M, Capobianchi, Mr, Carletti, F, Girardi, E, Pezzotti, P, Rezza, G, Mura, M, Mannazzu, M, Caramello, P, Di Perri, G, Orofino, Gc, Sciandra, M, Grossi, Pa, Basilico, C, Poggio, A, Bottari, G, Raise, E, Ebo, F, Pellizzer, G, Buonfrate, D, Resta, F, Loso, K, Cozzi Lepri, A, Battegay, M, Bernasconi, E, Böni, J, Bucher, H, Bürgisser, P, Cattacin, S, Cavassini, M, Dubs, R, Elzi, L, Erb, P, Fischer, M, Flepp, M, Fontana, A, Francioli, P, Gorgievski, M, Günthard, H, Hirsch, H, Hirschel, B, Hösli, I, Kahlert, C, Kaiser, L, Karrer, U, Kind, C, Klimkait, T, Martinetti, G, Martinez, B, Müller, N, Nadal, D, Opravil, M, Paccaud, F, Pantaleo, G, Rickenbach, M, Rudin, C, Schmid, P, Schultze, D, Schüpbach, J, Speck, R, Taffé, P, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Yerly, S, Gras, La, van Sighem, Ai, Smit, C, Bronsveld, W, Hillebrand Haverkort, Me, Prins, Jm, Branger, J, Eeftinck Schattenkerk, Jk, Gisolf, J, Godfried, Mh, Lange, Jm, Lettinga, Kd, van der Meer, Jt, Nellen, Fj, van der Poll, T, Ruys, Ta, Steingrover, R, Vermeulen, Jn, Vrouenraets, Sm, van Vugt, M, Wit, Fw, Kuijpers, Tw, Pajkrt, D, Scherpbier, Hj, van Eeden, A, Brinkman, K, van den Berk, Ge, Blok, Wl, Frissen, Ph, Roos, Jc, Schouten, We, Mulder, Jw, van Gorp, Ec, Wagenaar, J, Veenstra, J, Danner, Sa, Van Agtmael, Ma, Claessen, Fa, Perenboom, Rm, Rijkeboer, A, van Vonderen, Mg, Richter, C, van der Berg, J, Vriesendorp, R, Jeurissen, Fj, Kauffmann, Rh, Pogány, K, Bravenboer, B, ten Napel, Ch, Kootstra, Gj, Sprenger, Hg, van Assen, S, van Leeuwen, Jt, Doedens, R, Scholvinck, Eh, ten Kate, Rw, Soetekouw, R, van Houte, D, Polée, Mb, Kroon, Fp, van den Broek, Pj, van Dissel, Jt, Schippers, Ef, Schreij, G, van der Geest, S, Lowe, S, Verbon, A, Koopmans, Pp, Van Crevel, R, de Groot, R, Keuter, M, Post, F, van der Ven, Aj, Warris, A, van der Ende, Me, Gyssens, Ic, van der Feltz, M, Nouwen, Jl, Rijnders, Bj, de Vries, Te, Driessen, G, van der Flier, M, Hartwig, Ng, Juttman, Jr, van Kasteren, Me, Van de Heul, C, Hoepelman, Im, Schneider, Mm, Bonten, Mj, Borleffs, Jc, Ellerbroek, Pm, Jaspers, Ca, Mudrikove, T, Schurink, Ca, Gisolf, Eh, Geelen, Sp, Wolfs, Tf, Faber, T, Tanis, Aa, Groeneveld, Ph, den Hollander, Jg, Duits, Aj, Winkel, K, Back, Nk, Bakker, Me, Berkhout, B, Jurriaans, S, Zaaijer, Hl, Cuijpers, T, Rietra, Pj, Roozendaal, Kj, Pauw, W, van Zanten, Ap, Smits, Ph, von Blomberg, Bm, Savelkoul, P, Pettersson, A, Swanink, Cm, Franck, Pf, Lampe, A, Jansen, Cl, Hendriks, R, Benne, Ca, Veenendaal, D, Storm, H, Weel, J, van Zeijl, Jh, Kroes, Ac, Claas, Hc, Bruggeman, Ca, Goossens, Vj, Galama, Jm, Melchers, Wj, Poort, Ya, Doornum, Gj, Niesters, Mg, Osterhaus, Ad, Schutten, M, Buiting, Ag, Swaans, Ca, Boucher, Ca, Schuurman, R, Boel, E, Jansz, Af, Veldkamp, A, Beijnen, Jh, Huitema, Ad, Burger, Dm, Hugen, Pw, van Kan, Hj, Losso, M, Duran, A, Vetter, N, Karpov, I, Vassilenko, A, Mitsura, Vm, Suetnov, O, Clumeck, N, De Wit, S, Poll, B, Colebunders, R, Kostov, K, Begovac, J, Machala, L, Rozsypal, H, Sedlacek, D, Nielsen, J, Lundgren, J, Benfield, T, Kirk, O, Gerstoft, J, Katzenstein, T, Hansen, Ab, Skinhøj, P, Pedersen, C, Oestergaard, L, Zilmer, K, Ristola, M, Girard, Pm, Vanhems, P, Rockstroh, J, Schmidt, R, van Lunzen, J, Degen, O, Stellbrink, Hj, Bogner, J, Kosmidis, J, Gargalianos, P, Xylomenos, G, Perdios, J, Panos, G, Filandras, A, Karabatsaki, E, Sambattakou, H, Banhegyi, D, Mulcahy, F, Yust, I, Turner, D, Burke, M, Pollack, S, Hassoun, G, Maayan, S, Chiesi, A, Mazeu, I, Pristera, R, Gabbuti, A, Montesarchio, E, Gargiulo, M, Iacomi, F, Vlassi, C, Finazzi, R, Galli, M, Ridolfo, A, Rozentale, B, Aldins, P, Chaplinskas, S, Hemmer, R, Staub, T, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Prokopowicz, D, Wiercinska Drapalo, A, Boron Kaczmarska, A, Pynka, M, Beniowski, M, Mularska, E, Trocha, H, Antunes, F, Valadas, E, Mansinho, K, Maltez, F, Duiculescu, D, Rakhmanova, A, Vinogradova, E, Buzunova, S, Jevtovic, D, Mokrás, M, Staneková, D, González Lahoz, J, Soriano, V, Martin Carbonero, L, Labarga, P, Clotet, B, Jou, A, Conejero, J, Tural, C, Gatell, Jm, Miró, Jm, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, Ma, Karlsson, A, Persson, Po, Flamholc, L, Boffi, E, Kravchenko, E, Chentsova, N, Barton, S, Johnson, Am, Mercey, D, Johnson, Ma, Murphy, M, Weber, J, Scullard, G, Fisher, M, Brettle, R, Gatell, J, Gazzard, B, Friis Møller, N, Bannister, W, Ellefson, M, Borch, A, Podlekareva, D, Holkmann Olsen, C, Kjaer, J, Peters, L, Reekie, J, Raffanti, S, Dieterch, D, Becker, S, Scarsella, A, Fusco, G, Most, B, Balu, R, Rana, R, Beckerman, R, Ising, T, Fusco, J, Irek, R, Johnson, B, Hirani, A, Dejesus, E, Pierone, G, Lackey, P, Irek, C, Johnson, A, Burdick, J, Leon, S, Arch, J, Helm, Eb, Carlebach, A, Müller, A, Haberl, A, Nisius, G, Lennemann, T, Stephan, C, Bickel, M, Mösch, M, Gute, P, Locher, L, Lutz, T, Klauke, S, Knecht, G, Khaykin, P, Doerr, Hw, Stürmer, M, Babacan, E, von Hentig, N, Beylot, J, Dupon, M, Longy Boursier, M, Pellegrin, Jl, Ragnaud, Jm, Salamon, R, Thiébaut, R, Lewden, C, Lawson Ayayi, S, Mercié, P, Moreau, Jf, Morlat, P, Bernard, N, Lacoste, D, Malvy, D, Neau, D, Blaizeau, Mj, Decoin, M, Delveaux, S, Hannapier, C, Labarrère, S, Lavignolle Aurillac, V, Uwamaliya Nziyumvira, B, Palmer, G, Touchard, D, Balestre, E, Alioum, A, Jacqmin Gadda, H, Bonarek, M, Coadou, B, Gellie, P, Nouts, C, Bocquentin, F, Dutronc, H, Lafarie, S, Aslan, A, Pistonne, T, Thibaut, P, Vatan, R, Chambon, D, De La Taille, C, Cazorla, C, Ocho, A, Viallard, Jf, Caubet, O, Cipriano, C, Lazaro, E, Couzigou, P, Castera, L, Fleury, H, Lafon, Me, Masquelier, B, Pellegrin, I, Breilh, D, Blanco, P, Loste, P, Caunègre, L, Bonnal, F, Farbos, S, Ferrand, M, Ceccaldi, J, Tchamgoué, S, De Witte, S, Buy, E, Alexander, C, Barrios, R, Braitstein, P, Brumme, Z, Chan, K, Cote, H, Gataric, N, Geller, J, Guillemi, S, Harrigan, Pr, Harris, M, Joy, R, Levy, A, Montaner, J, Montessori, V, Palepu, A, Phillips, E, Phillips, P, Press, N, Tyndall, M, Wood, E, Yip, B, Bhagani, S, Breen, R, Byrne, P, Carroll, A, Cuthbertson, Z, Dunleavy, A, Geretti, Am, Heelan, B, Johnson, M, Kinloch de Loes, S, Lipman, M, Madge, S, Marshall, N, Nair, D, Nebbia, G, Prinz, B, Shah, S, Swader, L, Tyrer, M, Youle, M, Chaloner, C, Grabowska, H, Holloway, J, Puradiredja, J, Ransom, D, Tsintas, R, Bansi, L, Fox, Z, Harris, E, Hill, T, Lampe, F, Lodwick, R, Smith, C, Amoah, E, Booth, C, Clewley, G, Garcia Diaz, A, Gregory, B, Janossy, G, Labbett, W, Thomas, M, Read, R, Krentz, H, Beckthold, B, Schmeisser, N, Alquézar, A, Esteve, A, Podzamczer, D, Murillas, J, Romero, A, Agustí, C, Agüero, F, Ferrer, E, Riera, M, Segura, F, Navarro, G, Force, L, Vilaró, J, Masabeu, A, García, I, Guadarrama, M, Montoliu, A, Ortega, N, Lazzari, E, Puchol, E, Sanchez, M, Blanco, Jl, Garcia Alcaide, F, Martinez, E, Mallolas, J, López Dieguez, M, García Goez, Jf, Sirera, G, Romeu, J, Negredo, E, Miranda, C, Capitan, Mc, Olmo, M, Barragan, P, Saumoy, M, Bolao, F, Cabellos, C, Peña, C, Sala, M, Cervantes, M, Jose Amengual, M, Navarro, M, Penelo, E, Barrufet, P, Raper, Jl, Mugavero, Mj, Willig, Jh, Schumacher, J, Chang, Pw, Westfall, Ao, Cloud, G, Lin, Hy, Acosta, Ep, Colette Kempf, M, Allison, Jj, Pisu, M., Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Infectious diseases, Other departments, General Internal Medicine, Graduate School, Global Health, Paediatric Infectious Diseases / Rheumatology / Immunology, and Medical Microbiology and Infection Prevention
- Subjects
Male ,Infectious diseases and international health [NCEBP 13] ,Lymphoma ,030312 virology ,Esophageal candidiasis ,Cohort Studies ,0302 clinical medicine ,Interquartile range ,030212 general & internal medicine ,AIDS-Related ,Lymphoma, AIDS-Related ,0303 health sciences ,Mortality rate ,Progressive multifocal leukoencephalopathy ,Hazard ratio ,Prognosis ,3. Good health ,Pathogenesis and modulation of inflammation [N4i 1] ,Infectious Diseases ,Combination ,Drug Therapy, Combination ,Female ,Infection and autoimmunity [NCMLS 1] ,Human ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Prognosi ,Anti-HIV Agents ,antiretroviral therapy ,Infectious Disease ,Article ,AIDS-Related Opportunistic Infection ,03 medical and health sciences ,Acquired immunodeficiency syndrome (AIDS) ,Drug Therapy ,Internal medicine ,medicine ,Humans ,AIDS-defining event ,Proportional Hazards Models ,AIDS-Related Opportunistic Infections/diagnosis/ mortality ,Acquired Immunodeficiency Syndrome/complications/diagnosis/drug ,therapy/ mortality ,Anti-HIV Agents/ therapeutic use ,AIDS-Related/diagnosis/mortality ,Acquired Immunodeficiency Syndrome ,AIDS-Related Opportunistic Infections ,business.industry ,Proportional hazards model ,Poverty-related infectious diseases [N4i 3] ,Anti-HIV Agent ,medicine.disease ,mortality ,Confidence interval ,Immunology ,Proportional Hazards Model ,Cohort Studie ,business - Abstract
Contains fulltext : 80963.pdf (Publisher’s version ) (Open Access) BACKGROUND: The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. METHODS: We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in
- Published
- 2009
14. Atazanavir and lopinavir profile in pregnant women with HIV: tolerability, activity and pregnancy outcomes in an observational national study
- Author
-
Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Degli Antoni, A., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, Giovanni, Nardini, Giulia, Stentarelli, Chiara, Beghetto, Barbara, Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Giacomet, V, Martinelli, Pasquale, Degli Antoni, A, Spinillo, A, Fiscon, M, Francisci, D, Liuzzi, G, Pinnetti, C, Marconi, Am, Tamburrini, E, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Floridia, M1, Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y., Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [.., Capretti, M.G., Marsico, C., Faldella, G., and ].
- Subjects
Pyridines ,Pyridine ,HIV Infections ,Triglyceride ,Lopinavir ,Liver Function Tests ,Pregnancy ,HIV Infection ,Pharmacology (medical) ,Viral ,Pregnancy Complications, Infectious ,triglycerides ,pre-term delivery ,medicine.diagnostic_test ,Liver Function Test ,Obstetrics ,Medicine (all) ,Pregnancy Outcome ,Infectious ,virus diseases ,HIV ,pregnancy ,RNA ,Lipid ,Viral Load ,Lipids ,Infectious Diseases ,Tolerability ,Oligopeptide ,Population study ,RNA, Viral ,Female ,medicine.symptom ,bilirubin ,Viral load ,Oligopeptides ,Human ,medicine.drug ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,HIV RNA ,Anti-HIV Agents ,Atazanavir Sulfate ,Infectious Disease ,Bilirubin ,Cholesterol ,Pre-term delivery ,Triglycerides ,Pharmacology ,cholesterol ,Settore MED/17 - MALATTIE INFETTIVE ,medicine ,Humans ,business.industry ,Anti-HIV Agent ,medicine.disease ,Atazanavir ,CD4 Lymphocyte Count ,Pregnancy Complications ,Immunology ,Pregnancy Complications, Infectiou ,business ,Liver function tests ,Weight gain - Abstract
BACKGROUND: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. METHODS: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. RESULTS: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P = 0.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P < 0.001 for both comparisons) and bilirubin levels were significantly higher in the atazanavir group (1.53 versus 0.46 mg/dL, P < 0.001). CONCLUSIONS: In this observational study atazanavir and lopinavir showed similar safety and activity in pregnancy, with no differences in the main pregnancy outcomes. Atazanavir use was associated with a better lipid profile and with higher bilirubin levels. Overall, the study findings confirm that these two HIV protease inhibitors represent equally valid alternative options.
- Published
- 2014
15. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy
- Author
-
Floridia, M., Ravizza, M., Masuelli, G., Dalzero, S., Pinnetti, C., Cetin, I., Meloni, A., Spinillo, A., Rubino, E., Francisci, D., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, Claudio Maria, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Alberico, S., Maso, G., Tropea, M., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Garetto, S., Brambilla, T., Savasi, V., Crepaldi, A., Giaquinto, C., Fiscon, M., Rinaldi, R., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Liuzzi, G., Tozzi, V., Massetti, Anna Paola, Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci, D, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Martinelli, Pasquale, Floridia M, Ravizza M, Masuelli G, Dalzero S, Pinnetti C, Cetin I, Meloni A, Spinillo A, Rubino E, Francisci D, Tamburrini E, Faldella G, Guerra B, and for the Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,antiretroviral therapy ,MEDLINE ,Human immunodeficiency virus (HIV) ,HIV Infections ,body mass index ,medicine.disease_cause ,Settore MED/17 - MALATTIE INFETTIVE ,Body Mass Index ,BMI ,weight gain ,HIV-1 ,Pregnancy ,Medicine ,Humans ,HIV infection ,pregnancy ,Pregnancy Complications, Infectious ,business.industry ,Obstetrics ,Cesarean Section ,Infectious ,Pregnancy Outcome ,HIV ,medicine.disease ,Pregnancy Complications ,Infectious Diseases ,Italy ,National study ,Female ,medicine.symptom ,business ,Weight gain ,Body mass index - Abstract
Although most of the women (69.4%) had a normal BMI at start of pregnancy, only 37% had an adequate weight gain during pregnancy. Inadequate body weight gain was more common (44.8%) than excessive weight gain (18.2%), but 40% of overweight women and 50% of obese women had an excessive weight gain in pregnancy, with about 9% of the women in these categories gaining >18 kg during pregnancy (Table 1). Only 1.9% of the women had a vaginal delivery; elective and nonelective cesarean deliveries accounted for 81.3% and 16.7% of deliveries, respectively. Compared to underweight/normal women, overweight/obese women had similar occurrences of preterm delivery (23.4% vs 22.7%, P = .871), significantly lower rates of low birthweight (14.2% vs 24.2%, P = .007) and nonelective cesarean deliveries (11.7% vs 18.3%, P = .042), and a significantly higher occurrence of fasting plasma glucose >92 mg/dL at 20–28 weeks (12.1% vs 6.6%, P = .027), hypertension during pregnancy (6.4% vs 2.7%, P = .019), and gestational age–adjusted birthweight >90th percentile (15.5% vs 5.0%, P < .001). Complications of delivery, major birth defects, and HIV transmission were similar between the 2 groups (7.3% vs 7.6%, P = .881; 2.6% vs 3.5%, P = .589; and 0.8% vs 0.5%, P = .661, respectively). An inadequate weight gain during pregnancy was associated with an increased risk of nonelective cesarean delivery (OR, 1.589 [95% CI, 1.077–2.346], P = .020). Excessive weight gain during pregnancy was not associated with either hypertension (OR, 1.364 [95% CI, .537–3.465], P = .514) or 20–28 week glucose level of >92 mg/dL (OR, 0.841 [95% CI, .399–1.772], P = .648), but was significantly associated with birthweight >90th percentile (OR, 2.271 [95% CI, 1.229–4.195], P = .009), and appeared to be protective against low birthweight (OR, 0.544 [95% CI, .323–.918], P = .023) and birthweight
- Published
- 2013
16. Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011
- Author
-
Floridia, M., Mastroiacovo, P., Tamburrini, E., Tibaldi, C., Todros, T., Crepaldi, A., Sansone, M., Fiscon, M., Liuzzi, G., Guerra, B., Vimercati, A., Vichi, F., Vicini, I., Pinnetti, C., Marconi, A. M., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Alberico, S., Maso, G., Tropea, M., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Spinillo, A., Roccio, M., Miccolis, A., Bassi, E., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Trentini, L., Masuelli, G., Garetto, S., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Mastroiacovo, P, Tamburrini, E, Tibaldi, C, Todros, T, Crepaldi, A, Sansone, M, Fiscon, M, Liuzzi, G, Guerra, B, Vimercati, A, Vichi, F, Vicini, I, Pinnetti, C, Marconi, A, Ravizza, M, Martinelli, Pasquale, and The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy
- Subjects
Male ,HIV Infections ,transcriptase inhibitors ,Cohort Studies ,chemistry.chemical_compound ,Pregnancy ,Prevalence ,Birth Weight ,Young adult ,Pregnancy Complications, Infectious ,education.field_of_study ,Obstetrics ,Coinfection ,Antiretroviral therapy ,birth defects ,efavirenz ,HIV ,non-nucleoside reverse transcriptase inhibitors ,nucleoside reverse transcriptase inhibitors ,pregnancy ,protease inhibitors ,women ,Obstetrics and Gynecology ,Abnormalities, Drug-Induced ,Middle Aged ,Italy ,Maternal Exposure ,Reverse Transcriptase Inhibitors ,Female ,Cohort study ,Adult ,medicine.medical_specialty ,Efavirenz ,Adolescent ,Anti-HIV Agents ,Birth weight ,Population ,Antiretroviral Therapy ,Birth defects ,HIV-1 ,Young Adult ,Hepatitis B, Chronic ,medicine ,Humans ,education ,business.industry ,Infant, Newborn ,Odds ratio ,Hepatitis C, Chronic ,medicine.disease ,Infectious Disease Transmission, Vertical ,Surgery ,Pregnancy Trimester, First ,chemistry ,business - Abstract
Objective We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design Observational study. Setting University and hospital clinics. Population Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.
- Published
- 2013
17. A novel methodology for large-scale phylogeny partition
- Author
-
Prosperi, Mattia C. F., Ciccozzi, Massimo, Fanti, Iuri, Saladini, Francesco, Pecorari, Monica, Borghi, Vanni, Di Giambenedetto, Simona, Bruzzone, Bianca, Capetti, Amedeo, Vivarelli, Angela, Rusconi, Stefano, Maria Carla, Re, Gismondo, Maria Rita, Sighinolfi, Laura, Gray, Rebecca R., Salemi, Marco, Zazzi, Maurizio, De Luca, Andrea, Giacometti, A, Butini, L, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Re, Mc, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Dionisio, D, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, De Luca, A, Fadda, G, Vullo, Vincenzo, Turriziani, Ombretta, Montano, M, Cenderello, G, Gonnelli, A, Palumbo, M, Ghisetti, V, Bonora, S, Delle Foglie, P, Rossi, C, Grossi, P, Seminari, E, Poletti, F, Mondino, V, Malena, M, Lattuada, E., Prosperi MC, Ciccozzi M, Fanti I, Saladini F, Pecorari M, Borghi V, Di Giambenedetto S, Bruzzone B, Capetti A, Vivarelli A, Rusconi S, Re MC, Gismondo MR, Sighinolfi L, Gray RR, Salemi M, Zazzi M, De Luca A, ARCA collaborative group., Prosperi, M, Ciccozzi, M, Fanti, I, Saladini, F, Pecorari, M, Borghi, V, Di Giambenedetto, S, Bruzzone, B, Capetti, A, Vivarelli, A, Rusconi, S, Re, M, Gismondo, M, Sighinolfi, L, Gray, R, Salemi, M, Zazzi, M, De Luca, A, and Mancuso, S
- Subjects
Genetics and Molecular Biology (all) ,Male ,pol ,Theoretical computer science ,Inference ,Gene Products, pol ,General Physics and Astronomy ,HIV Infections ,Biology ,Network topology ,Settore MED/17 - MALATTIE INFETTIVE ,Biochemistry ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Physics and Astronomy (all) ,0302 clinical medicine ,Search algorithm ,phylogenetic analysis ,virus transmission ,Gene Products ,Humans ,HIV Infection ,030212 general & internal medicine ,Phylogeny ,030304 developmental biology ,Algorithms ,Classification ,Female ,HIV-1 ,Biochemistry, Genetics and Molecular Biology (all) ,Chemistry (all) ,Genetics ,0303 health sciences ,Multidisciplinary ,Phylogenetic tree ,Node (networking) ,HIV ,General Chemistry ,Partition (database) ,Algorithm ,Identification (information) ,Transmission (telecommunications) ,METHODOLOGY ,Human - Abstract
Understanding the determinants of virus transmission is a fundamental step for effective design of screening and intervention strategies to control viral epidemics. Phylogenetic analysis can be a valid approach for the identification of transmission chains, and very-large data sets can be analysed through parallel computation. Here we propose and validate a new methodology for the partition of large-scale phylogenies and the inference of transmission clusters. This approach, on the basis of a depth-first search algorithm, conjugates the evaluation of node reliability, tree topology and patristic distance analysis. The method has been applied to identify transmission clusters of a phylogeny of 11,541 human immunodeficiency virus-1 subtype B pol gene sequences from a large Italian cohort. Molecular transmission chains were characterized by means of different clinical/demographic factors, such as the interaction between male homosexuals and male heterosexuals. Our method takes an advantage of a flexible notion of transmission cluster and can become a general framework to analyse other epidemics. © 2011 Macmillan Publishers Limited. All rights reserved.
- Published
- 2011
- Full Text
- View/download PDF
18. Detection of drug resistance mutations at low plasma HIV-1 RNA load in a European multicentre cohort study
- Author
-
Prosperi, Mc1, Mackie, N, Di Giambenedetto, S, Zazzi, M, Camacho, R, Fanti, I, Torti, C, Sönnerborg, A, Kaiser, R, Codoñer, Fm, Van Laethem, K, Bansi, L, van de Vijver DA, Geretti, Am, De Luca, A, Giacometti A, SEHERE c. o. n. s. o. r. t. i. u. m., Butini, L, del Gobbo, R, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Carla Re, M, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, d'Arminio Monforte, A, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Bello, Fd, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Dionisio, D, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, Fadda, G, Vullo, Vincenzo, Turriziani, O, Montano, M, Cenderello, G, Gonnelli, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, Pd, Rossi, C, Grossi, P, Seminari, E, Poletti, F, Mondino, V, Malena, M, Lattuada, E, Lengauer, T, Däumer, M, Hoffmann, D, Schülter, E, Müller, C, Oette, M, Reuter, S, Esser, S, Fätkenheuer, G, Rockstroh, J, Incardona, F, Rosen Zvi, M, Clotet, B, Thalme, A, Svedhem, V, Bratt, G, Gargiulo, F, Lapadula, G, Manca, N, Paraninfo, G, Quiros Roldan, E, Carosi, G, Castelnuovo, F, Vandamme, Am, Van Wijngaerden, E, Ainsworth, J, Anderson, J, Babiker, A, Dunn, D, Easterbrook, P, Fisher, M, Gazzard, B, Garrett, N, Gilson, R, Gompels, M, Hill, T, Johnson, M, Leen, C, Orkin, C, Phillips, A, Pillay, D, Porter, K, Post, F, Sabin, C, Sadiq, T, Schwenk, A, Walsh, J, Delpech, V, Palfreeman, A, Glabay, A, Lynch, J, Hand, J, de Souza, C, Perry, N, Tilbury, S, Churchill, D, Nelson, M, Waxman, M, Mandalia, S, Kall, M, Korat, H, Taylor, C, Ibrahim, F, Campbell, L, James, L, Brima, N, Williams, I, Youle, M, Lampe, F, Smith, C, Grabowska, H, Chaloner, C, Puradiredja, Di, Weber, J, Ramzan, F, Carder, M, Wilson, A, Dooley, D, Asboe, D, Pozniak, A, Cameron, S, Cane, P, Chadwick, D, Clark, D, Collins, S, Lazarus, L, Dolling, D, Fearnhill, E, Castro, H, Coughlin, K, Zuckerman, M, Booth, C, Goldberg, D, Hale, A, Kaye, S, Kellam, P, Leigh Brown, A, Smit, E, Templeton, K, Tilston, P, Tong, W, Zhang, H, Ushiro Lumb, I, Oliver, T, Bibby, D, Mitchell, S, Mbisa, T, Wildfire, A, Tandy, R, Shepherd, J, Maclean, A, Bennett, D, Hopkins, M, Garcia Diaz, A, Kirk, S, Sloot, P. M., Virology, Prosperi, M, Mackie, N, di Giambenedetto, S, Zazzi, M, Camacho, R, Fanti, I, Torti, C, Sönnerborg, A, Kaiser, R, Codoñer, F, van laethem, K, Bansi, L, van de Vijver, D, Geretti, A, de luca, A, and Mancuso, S
- Subjects
Male ,Drug Resistance ,HIV Infections ,Drug resistance ,Cohort Studies ,0302 clinical medicine ,Genotype ,HIV Infection ,Pharmacology (medical) ,030212 general & internal medicine ,Viral ,0303 health sciences ,Proteolytic enzymes ,Genotypic testing ,HIV ,Viral load ,Adult ,Anti-HIV Agents ,CD4 Lymphocyte Count ,Europe ,Female ,HIV-1 ,Humans ,RNA, Viral ,Viral Proteins ,Drug Resistance, Viral ,Mutation, Missense ,Viral Load ,Pharmacology ,Infectious Diseases ,3. Good health ,Cohort ,Cohort study ,Human ,Microbiology (medical) ,Biology ,Settore MED/17 - MALATTIE INFETTIVE ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Viral Protein ,030306 microbiology ,Anti-HIV Agent ,Virology ,Reverse transcriptase ,Regimen ,genotypic testing ,viral load ,Immunology ,Mutation ,RNA ,Missense ,Cohort Studie - Abstract
Background and objectives: Guidelines indicate a plasma HIV-1 RNA load of 500-1000 copies/mL as the minimal threshold for antiretroviral drug resistance testing. Resistance testing at lower viral load levels may be useful to guide timely treatment switches, although data on the clinical utility of this remain limited. We report here the influence of viral load levels on the probability of detecting drug resistance mutations (DRMs) and other mutations by routine genotypic testing in a large multicentre European cohort, with a focus on tests performed at a viral load
- Published
- 2011
19. Importance of baseline prognostic factors with increasing time since initiation of highly active antiretroviral therapy: collaborative analysis of cohorts of HIV-1-infected patients
- Author
-
Sterne, Jonathan A. C., May, Margaret, Sabin, Caroline, Phillips, Andrew, Costagliola, Dominique, Chêne, Geneviève, Justice, Amy C., De Wolf, Frank, Hogg, Robert, Battegay, Manuel, Monforte, Antonella D'Arminio, Gerdtkenheuer, Fa, Staszewski, Schlomo, Gill, John, Egger, Matthias, Casabona, Jordi, Dabis, Francxois, Kitahata, Mari, Leport, Catherine, Lundgren, Jens, Reiss, Peter, Saag, Michael, Weller, Ian, Beckthold, Brenda, Yip, Benita, Dauer, Brenda, Fusco, Jenifer, Lanoy, Emilie, Rickenbach, Martin, Lavignolle, Valerie, Van Sighem, Ard, Pereira, Edwige, Pezzotti, Patrizio, Schmeisser, Norbert, Billaud, E., Boué, F., Costagliola, D., Duval, X., Duvivier, C., Enel, P., Fournier, S., Gasnault, J., Gaud, C., Gilquin, J., Grabar, S., Khuong, M. A., Lang, J. M., Mary Krause, M., Matheron, S., Meyohas, M. C., Pialoux, G., Poizot Martin, I., Pradier, C., Rouveix, E., Salmon Ceron, D., Sobel, A., Tattevin, P., Tissot Dupont, H., Yasdanpanah, Y., Aronica, E, Tirard Fleury, V., Tortay, I., Abgrall, S., Guiguet, M., Lanoy, E., Leneman, H., Lièvre, L., Potard, V., Saidi, S., Vildé, J. L., Leport, C., Yeni, P., Bouvet, E., Gaudebout, C., Crickx, B., Picard Dahan, C., Weiss, L., Tisne Dessus, D., Sicard, D., Salmon, D., Auperin, I., Viard, J. P., Roudière, L., Fior, R., Delfraissy, J. F., Goujard, C., Lesprit, P. h., Jung, C., Meynard, J. L., Picard, O., Desplanque, N., Cadranel, J., Mayaud, C., Rozenbaum, W., Bricaire, F., Katlama, C., Herson, S., Simon, A., Decazes, J. M., Molina, J. M., Clauvel, J. P., Gerard, L., Sellier, P., Diemer, M., Dupont, C., Berthé, H., Saïag, P., Mortier, E., Chandemerle, C., De Truchis, P., Bentata, M., Honoré, P., Tassi, S., Jeantils, V., Mechali, D., Taverne, B., Laurichesse, H., Gourdon, F., Lucht, F., Fresard, A., Faller, J. P., Eglinger, P., Bazin, C., Verdon, R., Peyramond, D., Boibieux, A., Touraine, J. L., Livrozet, J. M., Trepo, C., Cotte, L., Ravaux, I., Delmont, J. P., Moreau, J., Gastaut, J. A., Soubeyrand, J., Retornaz, F., Blanc, P. A., Allegre, T., Galinier, A., Ruiz, J. M., Lepeu, G., Granet Brunello, P., Pelissier, L., Esterni, J. P., Nezri, M., Cohen Valensi, R., Laffeuillade, A., Chadapaud, S., Reynes, J., May, T., Rabaud, C., Raffi, F., Pugliese, P., Michelet, C., Arvieux, C., Caron, F., Borsa Lebas, F., Rey, D., Fraisse, P., Massip, P., Cuzin, L., Arlet Suau, E., Thiercelin Legrand, M. F., Sobesky, M., Pradinaud, R., Contant, M., Montroni, M., Scalise, G., Braschi, M. C., Riva, A., Tirelli, U., Cinelli, R., Pastore, G., Ladisa, N., Minafra, G., Suter, F., Arici, C., Pristera, R., Chiodo, F., Colangeli, V., Fiorini, C., Coronado, O., Carosi, G., Cadeo, G. P., Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Melzi, S., Manconi, P. E., Piano, P., Cosco, L., Scerbo, A., Vecchiet, J., D'Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Citterio, P., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Vullo, Vincenzo, Lichtner, Miriam, Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Palvarini, L., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., d'Arminio Monforte, A., Repetto, D., Galli, A., Merli, S., Pastecchia, C., Moioli, M. C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, C. M., Piazza, M., De Marco, M., Viglietti, R., Manzillo, E., Nappa, S., Antonucci, G., Iacomi, F., Narciso, P., Zaccarelli, M., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., De Stefano, C., La Gala, A., Ballardini, G., Rizzo, E., Magnani, G., Ursitti, M. A., Arlotti, M., Ortolani, P., Cauda, R., Dianzani, F., Ippolito, G., Antinori, A., D'Elia, S., Petrosillo, N., De Luca, A., Bacarelli, A., Acinapura, R., De Longis, P., Brandi, A., Trotta, M. P., Noto, P., Capobianchi, M. R., Carletti, F., Girardi, E., Pezzotti, P., Rezza, G., Mura, M. S., Mannazzu, M., Caramello, P., Di Perri, G., Soranzo, M. L., Orofino, G. C., Arnaudo, I., Bonasso, M., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Ebo, F., De Lalla, F., Tositti, G., Resta, F., Loso, K., Cozzi Lepri, A., Johnson, A. M., Mercey, D., Phillips, A., Johnson, M. A., Mocroft, A., Murphy, M., Weber, J., Scullard, G., Fisher, M., Battegay, M., Bernasconi, E., Böni, J., Bucher, H., Bürgisser, P. h., Cattacin, S., Cavassini, M., Dubs, R., Egger, M., Elzi, L., Erb, P., Fantelli, K., Fischer, M., Flepp, M., Fontana, A., Francioli, P., Hirschel, B., Soravia Dunand, V., Furrer, H., Gorgievski, M., Günthard, H., Kaiser, L., Kind, C., Klimkait, T. h., Lauper, U., Ledergerber, B., Opravil, M., Paccaud, F., Pantaleo, G., Perrin, L., Piffaretti, J. C., Rickenbach, M., Rudin, C., Schmid, P., Schüpbach, J., Speck, R., Telenti, A., Trkola, A., Vernazza, P., Buy, E., Bronsveld, W., Hillebrand Haverkort, M. E., Reiss, P., Back, N. K. T., Bakker, M. E. G., Berkhout, B., Jurriaans, S., Cuijpers, T. h., Rietra, P. J. G. M., Roozendaal, K. J., Pauw, W., Van Zanten, A. P., Smits, P. H. M., Von Blomberg, B. M. E., Savelkoul, P., Danner, S. A., Van Agtmael, M. A., Claessen, F. A. P., Perenboom, R. M., Rijkeboer, A., Van Vonderen, M., Kuijpers, T. W., Pajkrt, D., Scherpbier, H. J., Prins, J. M., Bos, J. C., Eeftinck Schattenkerk, J. K. M., Geerlings, S. E., Godfried, M. H., Lange, J. M. A., Van Leth, F. C., Lowe, S. H., Van Der Meer, J. T. M., Nellen, F. J. B., Pogány, K., Van Der Poll, T., Ruys, T. h. A., Sankatsing, S., Steingrover, R., Van Twillert, G., Van Der Valk, M., Van Vonderen, M. G. A., Vrouenraets, S. M. E., Van Vugt, M., Wit, F. W. M. N., Veenstra, J., Van Eeden, A., Veen, J. H., Van Dam, P. S., Roos, J. C., Brinkman, K., Frissen, P. H. J., Weigel, H. M., Mulder, J. W., Van Gorp, E. C. M., Meenhorst, P. L., Mairuhu, A. T. A., Richter, C., Van Der Berg, J., Van Leusen, R., Swanink, C. M. A., Vriesendorp, R., Jeurissen, F. J. F., Franck, P. F. H., Lampe, A. S., Kauffmann, R. H., Koger, E. L. W., Bravenboer, B., Ten Napel, C. H. H., Kootstra, G. J., Schirm, J., Bennw, C. A., Sprenger, H. G., Miesen, W. M. A. J., Doedens, R., Scholvinck, E. H., Ten Kate, R. W., Van Houte, D. P. F., Polee, M., Kroes, A. C. M., Claas, H. C. J., Kroon, F. P., Van Den, Broek, Van Dissel, J. T., Schippers, E. F., Bruggeman, C. A. M. V. A., Goossens, V. J., Schreij, G., Van De Geest, S., Verbon, A., Galama, J. M. D., Melchers, W. J. G., Poort, Y. A. G., Koopmans, P. P., Keuter, M., Post, F., Van Der Ven, A. J. A. M., Doornum, G. J. J., Niesters, M. G., Osterhaus, A. D. M. E., Schutten, M., Driessen, G., De Groot, R., Hartwig, N., Van Der Ende, M. E., Gyssens, I. C., Van Der Feltz, M., Den Hollander, J. G., De Marie, S., L. Nouwen, J., Rijnders, B. J. A., De Vries, T. E. M. S., Juttmann, J. R., Van De Heul, C., Van Kasteren, M. E. E., Boucher, C. A. B., Schuurman, R., Geelen, S. P. M., Wolfs, T. F. W., Schneider, M. M. E., Bonten, M. J. M., Borleffs, J. C. C., Ellerbroek, P. M., Hoepelman, I. M., Jaspers, C. A. J. J., Schouten, I., Schurink, C. A. M., Blok, W. L., Tanis, A. A., Groeneveld, P. H. P., Jansen, C. L., Hendriks, R., Veenendaal, D., Storm, H., Weel, J., Van Zeijl, J. H., Buiting, A. G. M., Swaans, C. A. M., Boel, E., Jansz, A. F., Losso, M., Duran, A., Vetter, N., Karpov, I., Vassilenko, A., Clumeck, N., Dewit, S., Poll, B., Colebunders, R., Machala, L., Rozsypal, H., Sedlacek, D., Gerstoft, J., Katzenstein, T., Hansen, A. B. E., Skinhøj, P., Nielsen, J., Lundgren, J., Benfield, T., Kirk, O., Pedersen, C., Zilmer, K., Girard, P. M., Saint Marc, T., Vanhems, P., Dabis, F., Dietrich, M., Manegold, C., Van Lunzen, J., Stellbrink, H. J., Staszewski, S., Bickel, M., Goebel, F. D., Fätkenheuer, G., Rockstroh, J., Schmidt, R., Kosmidis, J., Gargalianos, P., Sambatakou, H., Perdios, J., Panos, G., Filandras, A., Karabatsaki, E., Banhegyi, D., Mulcahy, F., Yust, I., Turner, D., Burke, M., Pollack, S., Hassoun, G., Sthoeger, Z., Maayan, S., Borghi, R., Cotugno, A. D., Gabbuti, A., Chiesi, A., Montesarchio, E., Finazzi, R., D'Arminio Monforte, A., Viksna, L., Chaplinskas, S., Hemmer, R., Staub, T., Bruun, J., Maeland, A., Ormaasen, V., Knysz, B., Gasiorowski, J., Horban, A., Prokopowicz, D., Wiercinska Drapalo, A., Boron Kaczmarska, A., Pynka, M., Beniowski, M., Mularska, E., Trocha, H., Antunes, F., Valadas, E., Mansinho, K., Matez, F., Duiculescu, D., Babes, Victor, Streinu Cercel, A., Vinogradova, E., Rakhmanova, A., Jevtovic, D., Mokráš, M., Staneková, D., González Lahoz, J., Sánchez Conde, M., García Benayas, T., Martin Carbonero, L., Soriano, V., Clotet, B., Jou, A., Conejero, J., Tural, C., Gatell, J. M., Miró, J. M., Blaxhult, A., Karlsson, A., Pehrson, P., Weber, R., Kravchenko, E., Chentsova, N., Barton, S., Brettle, R., Loveday, C., Antunes, Francisco, Blaxhult, Anders, Clumeck, Nathan, Gatell, Jose, Horban, Andrzej, Johnson, Anne, Katlama, Christine, Ledergerber, Bruno, Loveday, Clive, Vella, Stefano, Gjørup, I., Friis Moeller, N., Bannister, W., Mollerup, D., Podlevkareva, D., Holkmann Olsen, C., Kjær, J., Raffanti, Stephen, Dieterch, Douglas, Becker, Stephen, Scarsella, Anthony, Fusco, Gregory, Most, Bernard, Balu, Rukmini, Rana, Rashida, Beckerman, Robin, Ising, Theodore, Fusco, Jennifer, Irek, Renae, Johnson, Bernadette, Hirani, Ashwin, Edwinjesus, De, Pierone, Gerald, Lackey, Philip, Irek, Chip, Johnson, Alison, Burdick, John, Leon, Saul, Arch, Joseph, Helm, Eilke B., Carlebach, Amina, Axelller, Mu, Haberl, Annette, Nisius, Gabi, Lennemann, Tessa, Rottmann, Carsten, Wolf, Timo, Stephan, Christoph, Bickel, Markus, Manfredsch, Mo, Gute, Peter, Locher, Leo, Lutz, Thomas, Klauke, Stephan, Knecht, Gabi, Doerr, Hans W., Stu, Martinrmer, Von Hentig, Nils, Jennings, Beverly, Beylot, J., Chêne, G., Dupon, M., Longy Boursier, M., Pellegrin, J. L., Ragnaud, J. M., Salamon, R., Thiébaut, R., Lewden, C., Lawson Ayayi, S., Mercié, P., Moreau, J. F., Morlat, P., Bernard, N., Lacoste, D., Malvy, D., Neau, D., Blaizeau, M. J., Decoin, M., Delveaux, S., Hannapier, C., Labarrère, S., Lavignolle Aurillac, V., Uwamaliya Nziyumvira, B., Palmer, G., Touchard, D., Balestre, E., Alioum, A., Jacqmin Gadda, H., Bonarek, M., Bonnet, F., Coadou, B., Gellie, P., Nouts, C., Bocquentin, F., Dutronc, H., Lafarie, S., Aslan, A., Pistonne, T., Thibaut, P., Vatan, R., Chambon, D., De La Taille, C., Cazorla, C., Ocho, A., Viallard, J. F., Caubet, O., Cipriano, C., Lazaro, E., Couzigou, P., Castera, L., Fleury, H., Lafon, M. E., Masquelier, B., Pellegrin, I., Breilh, D., Blanco, P., Loste, P., Caunègre, L., Bonnal, F., Farbos, S., Ferrand, M., Ceccaldi, J., Tchamgoué, S., De Witte, S., Alexander, Chris, Barrios, Rolando, Braitstein, Paula, Brumme, Zabrina, Chan, Keith, Cote, Helen, Gataric, Nada, Geller, Josie, Guillemi, Silvia, Richard Harrigan, P., Harris, Marrianne, Joy, Ruth, Levy, Adrian, Montaner, Julio, Montessori, Val, Palepu, Anita, Phillips, Elizabeth, Phillips, Peter, Press, Natasha, Tyndall, Mark, Wood, Evan, Bhagani, S., Byrne, P., Carroll, A., Cuthbertson, Z., Dunleavy, A., Geretti, A. M., Heelan, B., Johnson, M., Kinloch de Loes, S., Lipman, M., Madge, S., Marshall, N., Nair, D., Nebbia, G., Prinz, B., Swaden, L., Tyrer, M., Youle, M., Chaloner, C., Grabowska, H., Holloway, J., Puradiredja, J., Ransom, D., Tsintas, R., Bansi, L., Fox, Z., Harris, E., Hill, T., Lampe, F., Lodwick, R., Reekie, J., Sabin, C., Smith, C., Amoah, E., Booth, C., Clewley, G., Garcia Diaz, A., Gregory, B., Labbett, W., Tahami, F., Thomas, M., Read, Ron, Fatkenheuer, G., Schmeisser, N., Voigt, K., Wasmuth, J. C., Wohrmann, A., Infectious diseases, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Medical Microbiology and Infection Prevention, Paediatric Infectious Diseases / Rheumatology / Immunology, Landsteiner Laboratory, ARD - Amsterdam Reproduction and Development, Graduate School, Cardiology, APH - Global Health, APH - Quality of Care, AII - Infectious diseases, AII - Inflammatory diseases, and Global Health
- Subjects
Adult ,medicine.medical_specialty ,AIDS ,CD4 counts ,Highly active antiretroviral therapy ,HIV ,Prognosis ,Substance abuse (intravenous) ,Adolescent ,Anti-HIV Agents ,Antiretroviral Therapy, Highly Active ,CD4 Lymphocyte Count ,Europe ,HIV Infections ,HIV-1 ,Humans ,Middle Aged ,North America ,Risk Factors ,Substance Abuse, Intravenous ,Survival Analysis ,Pharmacology (medical) ,Infectious Diseases ,Cost effectiveness ,Antiretroviral Therapy ,Article ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,medicine ,Highly Active ,Survival analysis ,Immunodeficiency ,business.industry ,Transmission (medicine) ,Hazard ratio ,Substance Abuse ,medicine.disease ,Confidence interval ,Physical therapy ,Intravenous ,business ,Cohort study - Abstract
Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.
- Published
- 2007
20. Determinants of virologic and immunologic outcomes in chronically HIV-infected subjects undergoing repeated treatment interruptions: The Istituto Superiore di Sanità-Pulsed Antiretroviral Therapy (ISS-PART) study
- Author
-
Palmisano, L., Giuliano, M., Bucciardini, R., Fragola, V., Andreotti, M., Galluzzo, C. M., Pirillo, M. F., Weimer, L. E., Arcieri, R., Germinario, E. A. P., Amici, R., Mancini, M. G., D'Arminio Monforte, A., Castelli, F., Caramello, P., Vella, S., Abrescia, N., Figoni, M., Viglietti, R., Angarano, G., Saracino, A., Anselmo, M., Antinori, A., Sette, P., Zaccarelli, M., Liuzzi, G., Arlotti, M., Martelli, L. T., Ortolani, P., Bassetti, D., Di Biagio, A., Bisio, F., Bellissima, P., Branz, F., Dorigoni, N., Cadeo, G., Vangi, D., Bertelli, D., Bergamasco, A., Caggese, L., Volonterio, A., Orofino, G. C., Carosella, S., Gennero, L., Caremani, M., Tacconi, D., Carosi, G., Tomasoni, L., Patroni, A., Chiodo, F., Borderi, M., Calza, L., Gritti, F., Fasulo, G., Chirianni, A., Gargiulo, M., Colomba, A., Dalle Nogare, E. R., Di Lorenzo, F., Prestileo, T., Bini, T., Cicconi, P., De Lalla, F., Giordani, M. T., De Stefano, C., De Stefano, G., Delia, S., Ciardi, M., Di Perri, G., Sinicco, A., Sales, P., Dini, M., Simeone, M., Esposito, R., Guaraldi, G., Beghetto, B., Fatuzzo, F., La Rosa, R., Ferrari, C., Calzetti, C., Ferraro, T., Cosco, L., Ghinelli, F., Sighinolfi, L., Guadagnino, V., Caroleo, B., Izzi, A., Izzo, C., Franco, A., Lazzarin, A., Castagna, A., Fusetti, G., Leoncini, F., Pozzi, M., Sbaragli, S., Marzetti, M., Magnani, G., Bonazzi, L., Barchi, E., Zoboli, G., Pintus, A., Mandas, A., Soddu, M. L., Zucca, F., Mannucci, P. M., Gringeri, A., Marani Toro, G., Graziani, R. V., Consorti, A., Mazzotta, F., Di Pietro, M., Ble, C., Meneghetti, F., Sasset, L., Cattelan, A. M., Menichetti, F., Savalli, E., Mian, P., Pristera, R., Mignani, E., Artioli, S., Mura, M. S., Mannazzu, M., Narciso, P., Bellagamba, R., Orani, A., Perini, P., Ortona, L., De Luca, A., Murri, R., Pagano, G., Alessandrini, A., Paladini, A., Vinattieri, M. A., Carbonai, S., Pastore, G., Ladina, N., Tateo, M., Piersantelli, N., Penco, G., Petrelli, E., Balducci, M., Pippi, L., Gonnelli, A., Puppo, F., Murdaca, G., Raise, E., Pasquirucci, A., Riccio, G., Bartolacci, V., Carrega, G., Rizzardini, G., Migliorino, G., Russo, R., Casentino, S., Celesia, M., Soranzo, M. L., Macor, A., Salassa, B., Soscia, F., Roberti, L., Di Toro, M. T., Stagno, A., Beltrami, C., Suter, F., Maggiolo, F., Ripamonti, D., Tantimonaco, G., Grisorio, B., Tassara, A., Rossi, P., Tinelli, M., Regazzetti, A., Tirelli, U., Voltaggio, G., Cinelli, R., Toti, M., Baldari, M., Carli, T., Ricciardi, B., Trezzi, M., Vigevani, G. M., Capetti, A., Landonio, S., Vullo, V., Massetti, P., Zauli, T., and Casolari, S.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Anti-HIV Agents ,medicine.medical_treatment ,HIV Infections ,Drug resistance ,Drug Administration Schedule ,law.invention ,Randomized controlled trial ,Drug Resistance, Multiple, Viral ,law ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Protease inhibitor (pharmacology) ,Structured treatment interruptions ,Chemotherapy ,Reverse-transcriptase inhibitor ,biology ,business.industry ,HIV ,Middle Aged ,biology.organism_classification ,CD4 Lymphocyte Count ,Clinical trial ,Chronic infection ,Regimen ,Infectious Diseases ,Immunology ,Lentivirus ,RNA, Viral ,Female ,business ,medicine.drug - Abstract
Background: Factors influencing the outcome of structured treatment interruptions (STIs) in HIV chronic infection are not fully elucidated. Methods: In ISS-PART, 273 subjects were randomly assigned to arm A (137 assigned to continuous highly active antiretroviral therapy [HAART]) and arm B (136 assigned to 5 STIs of 1, 1, 2, 2, and 3 months'duration, each followed by 3 months of therapy). Main outcome measures were the proportion of subjects with a CD4 count >500 cells/mm 3 , the rate of virologic failure, and the emergence of resistance at 24 months. Results: The proportion of subjects with a CD4 count >500 cells/mm 3 was higher in arm A than in arm B (86.5% vs. 69.1%; P = 0.0075). Pre-HAART CD4 cell count and male gender were independent predictors of a CD4 count >500 cells/mm 3 in arm B. The overall risk of virologic failure was not increased in arm B; however, it was higher in the 38 subjects who had resistance mutations in the rebounding virus. Archived mutations at baseline and the use of a regimen that included an unboosted protease inhibitor (PI), compared with nonnucleoside reverse transcriptase inhibitor-based HAART, independently predicted the emergence of plasma mutations during STI (P = 0.002 for DNA mutations and P = 0.048 for PI-based HAART). Conclusions: Our results suggest that patients with preexisting mutations and treated with unboosted PI-based HAART should not be enrolled in studies of time-fixed treatment interruptions, being at higher risk of developing plasma mutations during STI and virologic failure at therapy reinstitution.
- Published
- 2007
21. Economic evaluation of HIV treatments: The I.CO.N.A. cohort study
- Author
-
Merito, Monica, Bonaccorsi, Andrea, Pammolli, Fabio, Riccaboni, Massimo, Baio, Gianluca, Arici, Claudio, D'Arminio Monforte, Antonella, Pezzotti, Patrizio, Corsini, Dario, Tramarin, Andrea, Cauda, Roberto, Colangeli, Vincenzo, Pastore, Giuseppe, Montroni, M., Scalise, G., Braschi, M. C., Del Prete, M. S., Tirelli, U., Cinelli, R., Ladisa, N., Minafra, G., Suter, F., Chiodo, F., Fiorini, C., Coronado, O., Carosi, G., Cadeo, G. P., Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Migliorino, G., Manconi, P. E., Piano, P., Ferraro, T., Scerbo, A., Pizzigallo, E., D'Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Galloni, D., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Fibbia, G., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., Repetto, D., Novati, R., Galli, A., Merli, S., Pastecchia, C., Moioli, M. C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, C. M., Piazza, M., De Marco, M., Viglietti, R., Manzillo, E., Graf, M., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., De Stefano, C., La Gala, A., Ballardini, G., Briganti, E., Magnani, G., Ursitti, M. A., Arlotti, M., Ortolani, P., Dianzani, F., Ippolito, G., Antinori, A., Antonucci, G., D'Elia, S., Narciso, P., Petrosillo, N., Vullo, Vincenzo, De Luca, A., Di Giambenedetti, S., Zaccarelli, M., Acinapura, R., De Longis, P., Ciardi, Maria Rosa, D'Offizi, G., Trotta, M. P., Noto, P., Lichtner, Miriam, Capobianchi, M. R., Girardi, E., Rezza, G., Mura, M. S., Mannazzu, M., Resta, F., Loso, K., Caramello, P., Sinicco, A., Soranzo, M. L., Orofino, G., Sciandra, M., Bonasso, M., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Pasquinucci, S., De Lalla, F., Tositti, G., and Lepri, A. Cozzi
- Subjects
Pediatrics ,medicine.medical_specialty ,HAART ,Settore MED/17 - Malattie Infettive ,National Health Programs ,Costs per person-year ,Health resources ,HIV infection ,Antiretroviral Therapy, Highly Active ,Cohort Studies ,Costs and Cost Analysis ,HIV Infections ,Health Care Costs ,Humans ,Italy ,Health Policy ,Antiretroviral Therapy ,Indirect costs ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Highly Active ,Seroconversion ,Health policy ,health care economics and organizations ,business.industry ,Medicine (all) ,medicine.disease ,Antiretroviral therapy ,Cohort ,Economic evaluation ,business ,Cohort study - Abstract
Objective: To describe the changes in costs of care for HIV-positive patients in Italy after the spread of antiretroviral combination therapies (HAART).Methods: Five thousand four hundred and twenty-two patients from the I.CO.N.A. (Italian Cohort Naive Antiretrovirals) study were followed between 1997 and 2002. Costs included antiretroviral therapies (ART), hospital admissions, prophylaxis, and main laboratory examinations. The perspective was that of the National Health Service.Results: Admission costs per person-year decreased from 2148 euro in 1997 to 256 in 2002, while the average annual costs of ART increased from 2145 to 3149 euro (1997 prices). From 1997 to]999, ART costs increased from 42.3 to 85.9% of the total, while admission costs decreased from 42.3 to 7.0% and prophylaxis from 7.3 to 1.7%. The breakdown of ART costs shows how dual therapies decreased over time in favor of HAART, falling from 26.8% in 1997 to 5.9% in 2002. Patients with fewer than five treatment switches had the lowest costs distributions over the entire observation period.Conclusions: From 1997 to 2002 inpatient costs progressively decreased in favor of antiretroviral therapy. Annual average costs per patient decreased, while total direct costs increased over time: health resources, initially concentrated on hospitalized patients were then distributed over a growing number of subjects. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
- Published
- 2005
22. A Prognostic Model for Estimating the Time to Virologic Failure in HIV-1 Infected Patients Undergoing a New Combination Antiretroviral Therapy Regimen
- Author
-
PProsperi MC, Di Giambenedetto S, Fanti I, Meini G, Bruzzone B, Callegaro A, Penco G, Bagnarelli P, Micheli V, Paolini E, Di Biagio A, Ghisetti V, Di Pietro M, Zazzi M, De Luca A, Giacometti A, Butini L, del Gobbo R, Menzo S, Tacconi D, Corbelli G, Zanussi S, Monno L, Punzi G, Maggiolo F, CALZA, LEONARDO, RE, MARIA CARLA, Pristerà R, Turconi P, Mandas A, Tini S, Carnevale G, Amadio G, Sighinolfi L, Zuccati G, Morfini M, Manetti R, Galli L, Bartalesi F, Colao G, Tosti A, Setti M, Trezzi M, Orani A, Pardelli R, De Gennaro M, Chiodera A, Scalzini A, Palvarini L, Almi P, Todaro G, Gianotti N, Cicconi P, Rusconi S, Gismondo MR, Biondi ML, Capetti A, Meraviglia P, Boeri E, Pecorari M, Mussini C, Santirocchi M, Brustia D, Ravanini P, Dal Bello F, Romano N, Mancuso S, Calzetti C, Maserati R, Baldanti F, Francisci D, Parruti G, Polilli E, Sacchini D, Martinelli C, Consolini R, Vatteroni L, Vivarelli A, Nerli A, Lenzi L, Magnani G, Ortolani P, Andreoni M, Palamara G, Fimiani C, Palmisano L, Antinori A, Vullo V, Turriziani O, Perno CF, Montano M, Cenderello G, Gonnelli A, Romano L, Palumbo M, Bonora S, Delle Foglie P, Rossi C, Poletti F, Mondino V, Malena M, Lattuada E., PProsperi MC, Di Giambenedetto S, Fanti I, Meini G, Bruzzone B, Callegaro A, Penco G, Bagnarelli P, Micheli V, Paolini E, Di Biagio A, Ghisetti V, Di Pietro M, Zazzi M, De Luca A, Giacometti A, Butini L, del Gobbo R, Menzo S, Tacconi D, Corbelli G, Zanussi S, Monno L, Punzi G, Maggiolo F, Calza L, Re MC, Pristerà R, Turconi P, Mandas A, Tini S, Carnevale G, Amadio G, Sighinolfi L, Zuccati G, Morfini M, Manetti R, Galli L, Bartalesi F, Colao G, Tosti A, Setti M, Trezzi M, Orani A, Pardelli R, De Gennaro M, Chiodera A, Scalzini A, Palvarini L, Almi P, Todaro G, Gianotti N, Cicconi P, Rusconi S, Gismondo MR, Biondi ML, Capetti A, Meraviglia P, Boeri E, Pecorari M, Mussini C, Santirocchi M, Brustia D, Ravanini P, Dal Bello F, Romano N, Mancuso S, Calzetti C, Maserati R, Baldanti F, Francisci D, Parruti G, Polilli E, Sacchini D, Martinelli C, Consolini R, Vatteroni L, Vivarelli A, Nerli A, Lenzi L, Magnani G, Ortolani P, Andreoni M, Palamara G, Fimiani C, Palmisano L, Antinori A, Vullo V, Turriziani O, Perno CF, Montano M, Cenderello G, Gonnelli A, Romano L, Palumbo M, Bonora S, Delle Foglie P, Rossi C, Poletti F, Mondino V, Malena M, Lattuada E., Prosperi, M, Di Giambenedetto, S, Fanti, I, Meini, G, Bruzzone, B, Callegaro, A, Penco, G, Bagnarelli, P, Micheli, V, Paolini, E, Di Biagio, A, Ghisetti, V, Di Pietro, M, Zazzi, M, De Luca, A, and Mancuso, S
- Subjects
Oncology ,Male ,Adult ,Anti-HIV Agents ,Cohort Studies ,Drug Therapy, Combination ,Female ,HIV Infections ,HIV-1 ,Humans ,Middle Aged ,Proportional Hazards Models ,Treatment Failure ,Viral Load ,0302 clinical medicine ,ANTIRETROVIRAL THERAPY ,Medicine ,HIV Infection ,030212 general & internal medicine ,0303 health sciences ,Health Policy ,3. Good health ,Computer Science Applications ,Censoring (clinical trials) ,Cohort ,Combination ,lcsh:R858-859.7 ,Viral load ,Human ,Research Article ,Cart ,medicine.medical_specialty ,antiretroviral therapy ,Health Informatics ,Settore MED/17 - MALATTIE INFETTIVE ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,Drug Therapy ,Internal medicine ,Survival analysis ,030306 microbiology ,business.industry ,Proportional hazards model ,ANTIRETROVIRAL DRUGS ,Anti-HIV Agent ,HIV ,GENOTYPES ,Discontinuation ,Regimen ,Immunology ,Proportional Hazards Model ,Cohort Studie ,business - Abstract
Background HIV-1 genotypic susceptibility scores (GSSs) were proven to be significant prognostic factors of fixed time-point virologic outcomes after combination antiretroviral therapy (cART) switch/initiation. However, their relative-hazard for the time to virologic failure has not been thoroughly investigated, and an expert system that is able to predict how long a new cART regimen will remain effective has never been designed. Methods We analyzed patients of the Italian ARCA cohort starting a new cART from 1999 onwards either after virologic failure or as treatment-naïve. The time to virologic failure was the endpoint, from the 90th day after treatment start, defined as the first HIV-1 RNA > 400 copies/ml, censoring at last available HIV-1 RNA before treatment discontinuation. We assessed the relative hazard/importance of GSSs according to distinct interpretation systems (Rega, ANRS and HIVdb) and other covariates by means of Cox regression and random survival forests (RSF). Prediction models were validated via the bootstrap and c-index measure. Results The dataset included 2337 regimens from 2182 patients, of which 733 were previously treatment-naïve. We observed 1067 virologic failures over 2820 persons-years. Multivariable analysis revealed that low GSSs of cART were independently associated with the hazard of a virologic failure, along with several other covariates. Evaluation of predictive performance yielded a modest ability of the Cox regression to predict the virologic endpoint (c-index≈0.70), while RSF showed a better performance (c-index≈0.73, p < 0.0001 vs. Cox regression). Variable importance according to RSF was concordant with the Cox hazards. Conclusions GSSs of cART and several other covariates were investigated using linear and non-linear survival analysis. RSF models are a promising approach for the development of a reliable system that predicts time to virologic failure better than Cox regression. Such models might represent a significant improvement over the current methods for monitoring and optimization of cART.
- Published
- 2011
- Full Text
- View/download PDF
23. Virologic and immunologic response to regimens containing nevirapine or efavirenz in combination with 2 nucleoside analogues in the Italian Cohort Naive Antiretrovirals (I.Co.N.A.) study
- Author
-
Cozzi-Lepri, Alessandro, Phillips, Andrew N., D'Arminio Monforte, Antonella, Piersantelli, Nicoloò, Orani, Anna, Petrosillo, Nicola, Leoncini, Francesco, Scerbo, Antonio, Tundo, Paolo, Abrescia, Nicola, Montroni, M., Scalise, G., Costantini, Alessia, Del Prete, M. S., Tirelli, U., Nasti, G., Pastore, G., Ladisa, N., Perulli, L. M., Suter, F., Arici, C., Chiodo, F., Gritti, F. M., Colangeli, V., Fiorini, C., Guerra, L., Carosi, G., Cadeo, G. P., Castelli, F., Minardi, C., Vangi, D., Rizzardini, G., Migliorino, G., Manconi, P. E., Piano, P., Ferraro, T., Scerbo, A., Pizzigallo, E., Ricci, Fiammetta, Rinaldi, E., Pusterla, L., Carnevale, G., Galloni, D., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Ambu, S., Lo Caputo, S., Angarano, G., Grisorio, B., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Piersantelli, N., Alessandrini, A., Piscopo, R., Toti, M., Chigiott, S., Soscia, F., Tacconi, L., Orani, A., Castaldo, G., Scasso, A., Vincenti, A., Scalzini, A., Alessi, F., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., d’Arminio Monforte, A., Bongiovanni, M., Novati, R., Delfanti, F., Merli, S., Pastecchia, C., Moioli, C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, OMAR CARLO ENRICO, Piazza, M., De Marco, M., Montesarchio, V., Manzillo, E., Nappa, S., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Filice, G., Minoli, L., Bruno, R., Maserati, R., Pauluzzi, S., Tosti, A., Alberici, F., Sisti, M., Menichetti, F., Smorfa, A., De Stefano, C., Lagala, A., Zauli, T., Ballardini, G., Bonazzi, L., Ursitti, M. A., Ciammarughi, R., Ortolani, P., Ortona, L., Dianzani, F., Antinori, A., Antonucci, G., D’Elia, S., Ippolito, G., Narciso, P., Petrosillo, N., Rezza, G., Vullo, V., De Luca, A., Del Forno, A., Capobianchi, M. R., Zaccarelli, M., De Longis, P., Ciardi, M., Girardi, E., D’Offizi, G., Noto, P., Pezzotti, P., Bugarini, R., Lichter, M., Mura, M. S., Mannazzu, M., Caramello, P., Caramello, A., Soranzo, M. L., Gennero, L., Sciandra, M., Salassa, B., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Pasquinucci, S., De Lalla, F., Tositti, G., Resta, F., and Chimienti, A.
- Subjects
Cyclopropanes ,Adult ,Male ,medicine.medical_specialty ,Efavirenz ,Nevirapine ,Settore MED/17 - Malattie Infettive ,Adolescent ,Antiretroviral Therapy ,Pharmacology ,Efficacy ,Cohort Studies ,chemistry.chemical_compound ,Drug Therapy ,Antiretroviral Therapy, Highly Active ,Internal medicine ,Oxazines ,medicine ,Humans ,Immunology and Allergy ,Highly Active ,Viral ,Sida ,Aged ,Acquired Immunodeficiency Syndrome ,biology ,Reverse-transcriptase inhibitor ,business.industry ,Middle Aged ,biology.organism_classification ,Confidence interval ,Benzoxazines ,CD4 Lymphocyte Count ,Infectious Diseases ,chemistry ,Alkynes ,Cohort ,Combination ,RNA, Viral ,RNA ,Drug Therapy, Combination ,Female ,business ,Cohort study ,medicine.drug - Abstract
This nonrandomized study compared the virologic and immunologic responses to potent regimens containing either efavirenz or nevirapine after considering potential systematic differences between patients receiving these drugs. Virologic failure was defined as the first of 2 consecutive measurements of virus load >500 human immunodeficiency virus RNA copies/mL. Of the 694 patients included in the analysis, 460 (66.3%) started nevirapine and 234 (33.7%) started efavirenz. The adjusted relative hazard of virologic failure for patients who started nevirapine, compared with those who started efavirenz, was 2.08 (95% confidence interval, 1.37-3.15; P=.0006). In addition, patients receiving efavirenz tended to recover 5 CD4 cells/microL more per quarter (P=.05). Although comparisons of drug efficacy in nonrandomized studies should be viewed with caution, no results from randomized controlled comparisons of these drugs are thought to be available. The findings of this study are in agreement with those of other observational studies.
- Published
- 2002
24. [Role of transesophageal echography in the diagnosis of aortic dissection and in therapy programming]
- Author
-
Rapezzi C, Assirelli C, Ortolani P, Ferlito M, Turinetto B, Fattori R, Nazzareno Galie, Castelli G, Branzi A, and Pierangeli A
- Subjects
Adult ,Aged, 80 and over ,Male ,Aortic Aneurysm, Thoracic ,Middle Aged ,Sensitivity and Specificity ,Aortic Dissection ,Acute Disease ,Chronic Disease ,Humans ,Female ,False Negative Reactions ,Echocardiography, Transesophageal ,Aged ,Follow-Up Studies - Abstract
The diagnostic accuracy of transesophageal echocardiography and its relevance on the decision making process were evaluated in 80 patients with suspected aortic dissection during a 37-month period. The diagnosis was proven by aortography and/or magnetic resonance and/or computerized tomography and/or surgery and/or autopsy in each case. Transesophageal echocardiography had no serious complication. A correct diagnosis of aortic dissection was made in 39 of 40 patients (sensitivity, 97.5%; specificity, 100%) and the type of dissection was correctly demonstrated in each case. Thrombi in the false lumen were detected in 16 patients. The primary entry site was correctly identified in 33 patients (85%). Aortic regurgitation was detected in 25 cases (severe in 9) and pericardial effusion in 14 (with tamponade in 2). Transesophageal echocardiography was more accurate than aortography in the diagnosis of noncommunicating intramural dissection (2 cases) and identified more precisely the retrograde extension of the dissection in DeBakey type III patients (4 cases). In 9 cases surgical indication was based on clinical data and transesophageal echocardiography alone. We conclude that transesophageal echocardiography allows a bedside, safe and accurate diagnosis of aortic dissection. In the majority of the patients it provides the minimal diagnostic information necessary to the therapeutical decision making.
- Published
- 1993
25. Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina
- Author
-
Ortolani, P., Marzocchi, A., Marrozzini, C., Palmerini, T., Aquilina, M., Corlianò, L., Francesco Saia, Taglieri, N., Sbarzaglia, P., Reggiani, M. L. B., Branzi, A., ORTOLANI P, MARZOCCHI A, MARROZZINI C, PALMERINI T, AQUILINA M, CORLIANO L, SAIA F, TAGLIERI N, SBARZAGLIA P, BACCHI REGGIANI ML, and BRANZI A.
- Subjects
Aged, 80 and over ,Male ,Reoperation ,Coronary Stenosis ,Stroke Volume ,Middle Aged ,Coronary Angiography ,Survival Analysis ,Blood Vessel Prosthesis Implantation ,C-Reactive Protein ,Treatment Outcome ,Italy ,Predictive Value of Tests ,Multivariate Analysis ,Humans ,Female ,Stents ,Angina, Unstable ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Coronary Artery Bypass ,Homocysteine ,Biomarkers ,Aged ,Follow-Up Studies - Abstract
We prospectively investigated whether plasma homocysteine (HCY) concentrations are related to target lesion revascularization (TLR) rates in patients with unstable angina undergoing stenting.We enrolled 196 consecutive patients with at least one successful coronary stent implantation for unstable angina.The mean vessel diameter was 3.1 +/- 0.5 mm. At follow-up (17.8 +/- 7.5 months), patients with higher HCY levels (17 micromol/l, 4th quartile) had similar TLR rates to the rest of the sample (11.1 vs 13.2%, p = 0.90). On the other hand, high HCY levels did seem to be associated with higher total (13.3 vs 0.7%, p = 0.001) and cardiac (6.7 vs 0%, p = 0.01) mortality rates. At multivariate analysis, only target vessel diameter independently predicted TLR, while both HCY levels and target vessel size predicted late total mortality.At least in patients with a mean vessel diameter3 mm, HCY levels cannot be taken as a prognostic indicator of in-stent restenosis for patients with unstable angina. However, in spite of successful percutaneous revascularization, HCY values do seem to strongly influence late mortality.
26. Genetic and Functional Characterization of Toll-Like Receptor Responses in Immunocompetent Patients With CMV Mononucleosis
- Author
-
Giada Frascaroli, Giada Rossini, Virginia Maltoni, Michele Bartoletti, Patrizia Ortolani, Sara Gredmark-Russ, Francesco Gelsomino, Alessandra Moroni, Silvia Silenzi, Gastone Castellani, Vittorio Sambri, Antonio Mastroianni, Wolfram Brune, Stefania Varani, Frascaroli G., Rossini G., Maltoni V., Bartoletti M., Ortolani P., Gredmark-Russ S., Gelsomino F., Moroni A., Silenzi S., Castellani G., Sambri V., Mastroianni A., Brune W., and Varani S.
- Subjects
0301 basic medicine ,Microbiology (medical) ,Human cytomegalovirus ,Adult ,Mononucleosis ,cytomegaloviru ,mononucleosis ,medicine.medical_treatment ,030106 microbiology ,Immunology ,lcsh:QR1-502 ,pro-inflammatory cytokines ,Microbiology ,lcsh:Microbiology ,Proinflammatory cytokine ,polymorphism ,03 medical and health sciences ,Cellular and Infection Microbiology ,Immune system ,medicine ,Humans ,cytomegalovirus ,Toll-like receptor ,Innate immune system ,business.industry ,virus diseases ,Brief Research Report ,medicine.disease ,Immunity, Innate ,TLR2 ,030104 developmental biology ,Infectious Diseases ,Cytokine ,toll-like receptors ,pro-inflammatory cytokine ,Toll-Like Receptor 9 ,Cytomegalovirus Infections ,Cytokines ,mononucleosi ,business - Abstract
Background: Human cytomegalovirus (CMV) modulates both innate and adaptive immune responses. However, limited data are available on the role of receptors of innate immunity, such as toll-like receptors (TLRs) in contributing to antiviral responses and inflammation. Objectives: The aim of this translational study was to characterize TLR responses in immunocompetent patients with primary and symptomatic CMV infection. Study Design: The study population consisted of 40 patients suffering from CMV mononucleosis and 124 blood donors included as controls. We evaluated the association between TLR2, 3, 4, 7 and 9 gene single nucleotide polymorphism (SNP) and susceptibility to symptomatic CMV infection in immunocompetent adults. Additionally, functional TLR-mediated cytokine responses in supernatants of short-term cultures of whole blood from patients with CMV mononucleosis and blood donors were evaluated. Results: TLR2 and TLR7/8 responses were altered in CMV infected patients as compared to healthy donors and were associated with the release of higher levels of the pro-inflammatory cytokines IL-6 and TNF-α, but not of the anti-inflammatory mediator IL-10. The analysis on the TLR SNPs indicated no difference between patients with CMV infection and the control group. Conclusions: No variation in the TLR2,3,4,7 and 9 genes was associated to the development of symptomatic CMV infection in immunocompetent adults. Nevertheless, TLR-mediated responses in CMV-infected patients appeared to be skewed toward a pro-inflammatory profile, which may contribute to the development of inflammatory symptoms during the CMV mononucleotic syndrome.
- Published
- 2020
27. Reactive follicular lymphoid infiltrate: A new condition to exclude in patients with PET positivity inside the heart
- Author
-
Mariano Cefarelli, Ornella Leone, Pier Luigi Zinzani, Cristina Nanni, Marco Di Eusanio, Roberto Di Bartolomeo, Paolo Ortolani, Sebastiano Castrovinci, Claudio Rapezzi, Luigi Lovato, Francesco Bacci, Di Eusanio M, Nanni C, Zinzani P, Bacci F, Leone O, Lovato L, Castrovinci S, Cefarelli M, Ortolani P, Rapezzi C, and Di Bartolomeo R
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Treatment outcome ,Heart failure ,Coronary Artery Disease ,NO ,Diagnosis, Differential ,Heart Neoplasms ,Heart neoplasms ,Fluorodeoxyglucose F18 ,Follicular phase ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Lymphoma, Follicular ,business.industry ,medicine.disease ,Lymphoma ,Treatment Outcome ,Positron-Emission Tomography ,Radiopharmaceuticals ,Differential diagnosis ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
28. How many patients with severe symptomatic aortic stenosis excluded for cardiac surgery are eligible for transcatheter heart valve implantation?
- Author
-
Antonio Marzocchi, Vincenzo Russo, Barbara Bordoni, Roberto Di Bartolomeo, Francesco Saia, Paolo Ortolani, Carlo Savini, Tullio Palmerini, Sofia Martin-Suarez, Cinzia Marrozzini, Nevio Taglieri, Angelo Branzi, Gianni DallʼAra, Emanuele Pilato, Saia F, Marrozzini C, Dall'Ara G, Russo V, Martìn-Suàrez S, Savini C, Ortolani P, Palmerini T, Taglieri N, Bordoni B, Pilato E, Di Bartolomeo R, Branzi A, and Marzocchi A.
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Percutaneous ,Eligibility Determination ,Prosthesis Design ,Risk Assessment ,Severity of Illness Index ,Catheterization ,Aortic valve replacement ,Risk Factors ,Internal medicine ,medicine.artery ,medicine ,Humans ,Thoracic aorta ,Hospital Mortality ,Heart valve ,Aged ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Mitral regurgitation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Patient Selection ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,Italy ,Heart Valve Prosthesis ,Practice Guidelines as Topic ,Angiography ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective We sought to assess what proportion of patients with severe symptomatic aortic stenosis who are excluded from cardiac surgery are eligible for transcatheter aortic valve implantation (TAVI). Methods Between July 2007 and December 2008, 98 patients with severe symptomatic aortic stenosis judged inoperable were referred to our institution for percutaneous aortic balloon valvuloplasty (PABV). They entered a screening for TAVI with the CoreValve Revalving System or the Edwards-Sapien valve, comprising general clinical evaluation, echocardiogram, coronary angiography, angiography and angio-CT scan of thoracic aorta and ilio-femoral axes. Results Mean patients' age was 82 +/- 7 years; the vast majority presented relevant comorbidities. Mortality risk predicted by the logistic European System for Cardiac Operative Risk Evaluation was on average 25.3 +/- 14.5%. Overall, 45 (45.9%) patients met the criteria for TAVI: 29.6% for percutaneous transfemoral access, 6.1% for trans-subclavian and 10.2% for transapical approaches. Reason for exclusion was severe noncardiac comorbidity in around half of the cases. PABV allowed re-classification of several patients with very poor left ejection fraction and severe mitral regurgitation. Among the 39 patients undergoing TAVI after the screening, in-hospital mortality was 3.7% for transfemoral and 0 for trans-subclavian and transapical approaches. Conclusions TAVI represents a viable therapeutic option for elderly patients with severe symptomatic aortic stenosis who are not candidates for surgical aortic valve replacement. However, presently less than half of them actually fulfil the criteria for these procedures.
- Published
- 2010
29. Long-term effectiveness of early administration of glycoprotein IIb/IIIa agents to real-world patients undergoing primary percutaneous interventions: results of a registry study in an ST-elevation myocardial infarction network
- Author
-
Roberto Grilli, Gianni Dall'Ara, Cinzia Marrozzini, Paolo Guastaroba, Antonio Marzocchi, Francesco Saia, Paolo Ortolani, Tullio Palmerini, Silvia Gianstefani, Federica Baldazzi, Nevio Taglieri, Angelo Branzi, Paola Nardini, Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Taglieri N, Baldazzi F, Dall'ara G, Nardini P, Gianstefani S, Guastaroba P, Grilli R, and Branzi A.
- Subjects
Male ,medicine.medical_specialty ,Databases, Factual ,medicine.medical_treatment ,Population ,Myocardial Infarction ,Infarction ,Kaplan-Meier Estimate ,Platelet Glycoprotein GPIIb-IIIa Complex ,Coronary Angiography ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,education ,Aged ,Retrospective Studies ,Killip class ,education.field_of_study ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Glycoprotein IIb/IIIa inhibitors ,Female ,Emergencies ,Cardiology and Cardiovascular Medicine ,Glycoprotein IIb/IIIa ,business ,TIMI ,Follow-Up Studies ,medicine.drug - Abstract
Aims To evaluate the clinical impact of early administration of glycoprotein IIb/IIIa agents (IIb/IIIa agents) in the context of a dedicated hub and spoke network allowing very prompt pharmacological/mechanical interventions. Methods and results Using a prospective database, we conducted a cohort study of ST-elevation myocardial infarction (STEMI) patients ( n = 1124) undergoing primary percutaneous coronary interventions (PPCIs) and IIb/IIIa agents administration (period, 2003–2006). Comparisons were planned between patients receiving early IIb/IIIa agents administration (in hub/spoke centre emergency departments or during ambulance transfer; early group, n = 380) or delayed administration (in the catheterization laboratory; late group, n = 744). The primary outcome measure was long-term overall mortality/re-infarction. Baseline characteristics of the two groups were largely comparable. Angiographically, early group patients more often achieved pre-PPCI TIMI Grade 2–3 and TIMI Grade 3 flow. Clinically, the early administration group experienced lower 2-year risk of unadjusted mortality/re-infarction (17 vs. 23%; P = 0.01). After adjustment for potential confounders, early administration was associated with favourable outcome in the overall population (HR = 0.71, P = 0.03) and in high-risk subgroups (TIMI risk index >25, HR = 0.64, P = 0.02; Killip class >1, HR = 0.54, P = 0.01). Conclusion In patients treated by PPCI within a STEMI network setting, early administration of IIb/IIIa agents may provide long-term clinical benefits. Notably, these results appeared magnified in high-risk patients.
- Published
- 2008
30. Comparison Between Coronary Angioplasty and Coronary Artery Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Stenosis (the Bologna Registry)
- Author
-
Letizia Bacchi-Reggiani, Paolo Ortolani, Tullio Palmerini, Silvia Gianstefani, Francesca Manara, Santo Virzi, Roberto Di Bartolomeo, Antonio Marzocchi, Francesco Saia, Carlo Savini, Giuseppe Marinelli, Cinzia Marrozzini, Meron Kiros Weldeab, Angelo Branzi, Palmerini T, Marzocchi A, Marrozzini C, Ortolani P, Saia F, Savini C, Bacchi-Reggiani L, Gianstefani S, Virzi S, Manara F, Kiros Weldeab M, Marinelli G, Di Bartolomeo R, and Branzi
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,Left Main Coronary Artery Stenosis ,Coronary artery bypass surgery ,Internal medicine ,Angioplasty ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Coronary Artery Bypass ,Aged ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,Stent ,medicine.disease ,Surgery ,Carotid Arteries ,Treatment Outcome ,surgical procedures, operative ,medicine.anatomical_structure ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Artery - Abstract
Although great interest exists in the relative efficacy of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) for the treatment of unprotected left main coronary artery stenosis, data comparing the 2 strategies are scant. Furthermore, no comparison has ever been performed between CABG and drug-eluting stents in this setting. From January 2002 to June 2005, 154 patients with unprotected left main coronary artery stenosis underwent CABG and 157 underwent PCI. Ninety-four patients received a drug-eluting stent in the left main artery. After a median follow-up of 430 days, the rate of mortality, acute myocardial infarction, and target lesion revascularization was 12.3%, 4.5%, and 2.6%, respectively, in the CABG group and 13.4%, 8.3%, and 25.5%, respectively, in the PCI group (death and myocardial infarction p = NS, target lesion revascularization p = 0.0001). Although patients treated with drug-eluting stents had a 25% relative risk reduction in the rate of death, myocardial infarction, and target lesion revascularization compared with patients treated with bare stents, event-free survival was still better for patients treated with CABG. In the multivariate analysis, age >/=70 years, New York Heart Association classes III and IV, acute coronary syndromes, and peripheral vascular disease were the only independent predictors of mortality. In conclusion, our results have indicated that at long-term follow-up no difference exists in the rate of mortality and myocardial infarction between PCI and CABG for the treatment of unprotected left main coronary artery stenosis. However, the rate of target lesion revascularization was higher in the PCI group.
- Published
- 2006
31. Clinical impact of direct referral to primary percutaneous coronary intervention following pre-hospital diagnosis of ST-elevation myocardial infarction
- Author
-
Robin M. T. Cooke, Angelo Branzi, Matteo Aquilina, Maria Letizia Bacchi-Reggiani, Nevio Taglieri, Federica Baldazzi, Simona Silenzi, Paolo Ortolani, Carlo Serantoni, Antonio Marzocchi, Tullio Palmerini, Cinzia Marrozzini, Daniele Grosseto, Francesco Saia, Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Serantoni C, Aquilina M, Silenzi S, Baldazzi F, Grosseto D, Taglieri N, Cooke RM, Bacchi-Reggiani ML, and Branzi A.
- Subjects
Male ,Emergency Medical Services ,medicine.medical_specialty ,Referral ,medicine.medical_treatment ,Myocardial Infarction ,Internal medicine ,Humans ,Medicine ,Hospital Mortality ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Referral and Consultation ,Aged ,business.industry ,ST elevation ,Cardiogenic shock ,Percutaneous coronary intervention ,Emergency department ,Middle Aged ,medicine.disease ,Early Diagnosis ,Treatment Outcome ,surgical procedures, operative ,Emergency medicine ,Conventional PCI ,Cardiology ,Female ,Myocardial infarction diagnosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Treatment delay is a powerful predictor of survival in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated effectiveness of pre-hospital diagnosis of STEMI with direct referral to PCI, alongside more conventional referral strategies. Methods and results From January 2003 to December 2004, 658 STEMI patients were referred for primary PCI at our intervention laboratory. Three predefined referral routes were compared: (1) for patients within 90 min drive of the PCI centre, pre-hospital diagnosis and direct transportation ( n =166), (2) diagnosis at the interventional hospital emergency department ( n =316), (3) diagnosis at local hospitals before transportation ( n =176). Pre-hospital diagnosis was associated with more than 45 min reduction in treatment delay ( P =0.001). No significant difference in in-hospital mortality was apparent in the overall study population. In the cardiogenic shock subgroup ( n =80), pre-hospital diagnosis was associated with a two-thirds reduction in in-hospital mortality ( P =0.019); mortality was only 6.2% in shock patients who underwent PCI in
- Published
- 2006
32. Clinical imaging of the vulnerable plaque in the coronary arteries: new intracoronary diagnostic methods
- Author
-
Paolo Ortolani, Evelyn Regar, Tullio Palmerini, Johannes A. Schaar, Patrick W. Serruys, Cinzia Marrozzini, Angelo Branzi, Frits Mastik, Antonio Marzocchi, Francesco Saia, Pim J. de Feyter, Gaston A. Rodriguez, Antonius F.W. van der Steen, Cardiology, Saia F, Schaar J, Regar E, Rodriguez G, De Feyter PJ, Mastik F, Marzocchi A, Marrozzini C, Ortolani P, Palmerini T, Branzi A, van der Steen AF, and Serruys PW.
- Subjects
Coronary angiography ,Diagnostic Imaging ,medicine.medical_specialty ,Diagnostic methods ,Coronary Artery Disease ,medicine.disease_cause ,Coronary Angiography ,Coronary artery disease ,User-Computer Interface ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Clinical imaging ,Ultrasonography, Interventional ,business.industry ,General Medicine ,medicine.disease ,Angioscopy ,Vulnerable plaque ,Elasticity ,Coronary arteries ,medicine.anatomical_structure ,Treatment modality ,Thermography ,Cardiology ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Tomography, Optical Coherence - Abstract
Rupture of a vulnerable plaque is the main cause of acute coronary syndromes and myocardial infarction. The features of rupture-prone atherosclerotic plaques have been previously described by pathologists. However, identification of vulnerable plaques in vivo is essential to study their natural history and to evaluate potential treatment modalities. Coronary angiography is the gold standard for the diagnosis of coronary artery disease, but it is unable to distinguish between stable and unstable plaques and to accurately predict future cardiac events. This current perspective describes the recently developed invasive imaging techniques to detect atherosclerotic vulnerable plaques in the coronary tree.
- Published
- 2006
33. Recent temporal trends for first-time hospitalization for acute myocardial infarction. Treatment patterns and clinical outcome in a large cohort study
- Author
-
Elena Berti, Massimiliano Marino, Paolo Guastaroba, Alessandro Corzani, Paolo Ortolani, Claudio Rapezzi, Rossana De Palma, Giovanni Melandri, Angelo Branzi, Ortolani P, Marino M, Melandri G, Guastaroba P, Corzani A, Berti E, Rapezzi C, De Palma R, and Branzi A
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Myocardial Infarction ,NO ,Cohort Studies ,Angioplasty ,Internal medicine ,Case fatality rate ,Medicine ,Humans ,In patient ,Myocardial infarction ,Intensive care medicine ,education ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,Evidence-Based Medicine ,LONG-TERM MORTALITY ,business.industry ,ACUTE CORONARY SYNDROMES ,Incidence (epidemiology) ,Incidence ,HEART-FAILURE ,medicine.disease ,Large cohort ,Hospitalization ,Survival Rate ,Treatment Outcome ,Italy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
BACKGROUND: The objective was to report recent trends in the incidence, adoption of evidence-based treatment, and clinical outcomes for first-time hospitalization for acute myocardial infarction. METHODS: This is a large retrospective population-based cohort study using medical administrative data (International Classification of Diseases, Ninth Revision, Clinical Modification, codes) performed in the Emilia-Romagna Region of Italy (approximately 4.5 million inhabitants). We identified 60,673 patients with a first hospitalization for acute myocardial infarction from 2002 through 2009. RESULTS: The standardized incidence rate per 100,000 person-years of acute myocardial infarction increased from 173 cases in 2002 to a peak of 197 cases in 2004 and then decreased each year thereafter to 167 cases in 2009. The proportion of patients who underwent coronary angiography and angioplasty in the acute phase increased over time, respectively, from 45.4% and 27.1% to 72.3% and 57.2% (P < .001). Medication use within 12 months of discharge increased for aspirin, β-blockers, and statins. A reduction in crude and adjusted in-hospital all-cause (16.1% in 2002 vs 12.8% in 2009, P < .001) and cardiovascular mortality (13.6% in 2002 vs 9.5% in 2009, P < .001) was observed over time. At 1 year after hospital discharge, no significant variations occurred in adjusted risk for all-cause mortality or cardiovascular mortality. Notably, crude and adjusted risk for in-hospital and postdischarge bleeding showed a significant increment. CONCLUSIONS: The utilization of evidence-based treatments in patients with myocardial infarction increased between 2002 and 2009. These changes in practice over time favored a reduction in early case fatality at the cost of a significant increase in bleeding.
- Published
- 2013
34. What is the acceptable rate of false positives for STEMI within a primary PCI network? Insights from a metropolitan system with direct ambulance-based access
- Author
-
Nevio Taglieri, Antonio Marzocchi, Enrica Perugini, Massimiliano Lorenzini, Paolo Ortolani, Angelo Branzi, Gianni Casella, Lara Di Diodoro, Giuseppe Di Pasquale, Claudio Rapezzi, M. Letizia Bacchi Reggiani, Perugini, E, Di Pasquale, G, Di Diodoro, L, Ortolani, P, Casella, G, Taglieri, N, Reggiani, M L, Marzocchi, A, Lorenzini, M, Branzi, A, and Rapezzi, C
- Subjects
Male ,medicine.medical_treatment ,Ambulances ,ANGIOPLASTY ,DIAGNOSIS ,ELECTROCARDIOGRAPHY ,MYOCARDIAL INFARCTION ,NO ,Angioplasty ,medicine ,False positive paradox ,Humans ,False Positive Reactions ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Aged ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Metropolitan area ,Conventional PCI ,Female ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography - Abstract
No abstract available]
- Published
- 2012
35. One-year clinical outcome in patients with acute coronary syndrome treated with concomitant use of clopidogrel and proton pump inhibitors: results from a regional cohort study
- Author
-
Rossana De Palma, Antonio Marzocchi, Angelo Branzi, Massimiliano Marino, Paolo Ortolani, Ortolani P., Marino M., Marzocchi A., De Palma R., and Branzi A.
- Subjects
Male ,medicine.medical_specialty ,Gastrointestinal bleeding ,Acute coronary syndrome ,Ticlopidine ,Time Factors ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Revascularization ,Patient Readmission ,Risk Assessment ,Risk Factors ,PROTON PUMP INHIBITORS ,Internal medicine ,medicine ,Humans ,Drug Interactions ,Acute Coronary Syndrome ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,clopidogrel ,Chi-Square Distribution ,business.industry ,ACUTE CORONARY SYNDROMES ,Hazard ratio ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Clopidogrel ,Treatment Outcome ,Italy ,Concomitant ,Multivariate Analysis ,Cardiology ,Female ,Gastrointestinal Hemorrhage ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,Cohort study ,medicine.drug - Abstract
OBJECTIVES We sought to compare the 1-year risk of re-hospitalization for acute coronary syndrome (ACS) between patients taking clopidogrel with proton pump inhibitors (PPIs) vs. clopidogrel without PPIs. MATERIALS AND METHODS We conducted a retrospective cohort study among 3896 patients with ACS, at low risk for gastrointestinal bleeding, discharged from all hospitals of the Emilia-Romagna region of Italy during the period January-August 2008. Patients' consumption of clopidogrel and PPIs at hospital discharge and follow-up was based on pharmacy refill data. Of these 3896 patients, 90% (n = 3519) were prescribed PPIs at hospital discharge and/or at some time during follow-up. RESULTS At 1-year follow-up, hospitalization for ACS occurred in 15% of patients taking clopidogrel with PPIs vs. 3.4% of those taking clopidogrel without PPIs (P
- Published
- 2012
36. Impact of a territorial ST-segment elevation myocardial infarction network on prognosis of patients with out-of-hospital cardiac arrest
- Author
-
Paolo Ortolani, Antonio Marzocchi, Roberto Faccioli, Pamela Gallo, Valerio Lanzillotti, Bruno Iarussi, Nevio Taglieri, Pietro Cortesi, Marrozzini, Angelo Branzi, Francesco Saia, Giovanni Gordini, Tullio Palmerini, Taglieri N., Saia F., Lanzillotti V., Marrozzini, Faccioli R., Iarussi B., Ortolani P., Palmerini T., Cortesi P., Gordini G., Gallo P., Branzi A., and Marzocchi A.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Resuscitation ,Emergency Medical Services ,Myocardial Infarction ,Return of spontaneous circulation ,Regional Medical Programs ,Out of hospital cardiac arrest ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,ST segment ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Myocardial infarction ,Aged ,Entire population ,business.industry ,Network on ,Territorial system of care ,Middle Aged ,medicine.disease ,Cardiac arrest ,Prognosis ,Cardiopulmonary Resuscitation ,Survival Rate ,Italy ,Emergency Medicine ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Introduction: We sought to assess the effect of a territorial system of care for ST-elevation myocardial infarction (STEMI) on the outcome of out-of-hospital cardiac arrest (OOHCA). Materials and Methods: We enrolled 720 patients who experienced a witnessed OOHCA of presumed cardiac origin during a four-year period in an area with a STEMI network and for whom resuscitation was attempted. Results: Overall, 242 (33.6%) patients had return of spontaneous circulation (ROSC), 645 (90%) died before discharge. We observed a trend toward decreased overall mortality for OOHCA between the years 2004 and 2007, both in the entire population and in patients with ROSC (2004=94%; 2005=89%; 2006=85%; 2007=89%; P=0.064; 2004=81%; 2005=69%; 2006=65%; 2007=60%; P=0.076, respectively). On multivariable analysis, age, crew-witnessed arrest and presence of shockable rhythm were independent predictors of mortality. Patients who experienced OOHCA in the year 2006 (OR=0.47; 95% CI: 0.21-1.05; P=0.07) and 2007 (OR=0.51; 95% CI: 0.23-1.12; P=0.09) showed a strong trend toward decreased risk of mortality compared to year 2004. In patients with ROSC, the year 2007 was associated with a significant lower risk of mortality compared to year 2004 (OR=0.38; 95% CI: 0.15-0.96; P=0.04). Conclusions: Implementation of a territorial network of care for STEMI appears to be associated with reduced mortality OOHCA patient
- Published
- 2011
37. Short- and long-term prognostic significance of ST-segment elevation in lead aVR in patients with non-ST-segment elevation acute coronary syndrome
- Author
-
Paolo Ortolani, Laura Cinti, Giuseppe Scaramuzzino, Tullio Palmerini, Cinzia Marrozzini, Antonio Marzocchi, Claudio Rapezzi, Ilaria Gallelli, Laura Alessi, Francesco Saia, Caterina Villani, Giovanni Melandri, Angelo Branzi, Fabio Vagnarelli, Nevio Taglieri, Stefania Rosmini, Taglieri N., Marzocchi A., Saia F., Marrozzini C., Palmerini T., Ortolani P., Cinti L., Rosmini S., Vagnarelli F., Alessi L., Villani C., Scaramuzzino G., Gallelli I., Melandri G., Branzi A., and Rapezzi C.
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,Time Factors ,ELECTROCARDIOGRAM ,Coronary Angiography ,Culprit ,Severity of Illness Index ,NO ,Diagnosis, Differential ,Electrocardiography ,Internal medicine ,Cause of Death ,medicine ,ST segment ,Humans ,Hospital Mortality ,Acute Coronary Syndrome ,Aged ,Retrospective Studies ,ST depression ,medicine.diagnostic_test ,business.industry ,ST elevation ,ACUTE CORONARY SYNDROMES ,CARDIOVASCULAR RISK ,Hazard ratio ,non ST segment elevation ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Survival Rate ,Early Diagnosis ,Italy ,Cardiology ,Disease Progression ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
We sought to evaluate the prognostic significance of ST-segment elevation (STE) in lead aVR in unselected patients with non-STE acute coronary syndrome (NSTE-ACS). We enrolled 1,042 consecutive patients with NSTE-ACS. Patients were divided into 5 groups according to the following electrocardiographic (ECG) patterns on admission: (1) normal electrocardiogram or no significant ST-T changes, (2) inverted T waves, (3) isolated ST deviation (ST depression [STD] without STE in lead aVR or transient STE), (4) STD plus STE in lead aVR, and (5) ECG confounders (pacing, right or left bundle branch block). The main angiographic end point was left main coronary artery (LM) disease as the culprit artery. Clinical end points were in-hospital and 1-year cardiovascular death defined as the composite of cardiac death, fatal stroke, and fatal bleeding. Prevalence of STD plus STE in lead aVR was 13.4%. Rates of culprit LM disease and in-hospital cardiovascular death were 8.1% and 3.8%, respectively. On multivariable analysis, patients with STD plus STE in lead aVR (group 4) showed an increased risk of culprit LM disease (odds ratio 4.72, 95% confidence interval [CI] 2.31 to 9.64, p
- Published
- 2011
38. Safety and efficacy of early aggressive versus cholesterol-driven lipid-lowering strategies in heart transplantation: A pilot, randomized, intravascular ultrasound study
- Author
-
Angelo Branzi, Antonio Russo, Marco Masetti, Gaia Magnani, Fabio Coccolo, Paolo Ortolani, Francesco Saia, F. Fabbri, Francesco Fallani, Teresa Ionico, Francesco Grigioni, Luciano Potena, Claudio Rapezzi, Potena L., Grigioni F., Ortolani P., Magnani G., Fabbri F., Masetti M., Coccolo F., Fallani F., Russo A., Ionico T., Saia F., Rapezzi C., and Branzi A.
- Subjects
Male ,Indoles ,medicine.medical_treatment ,Pilot Projects ,law.invention ,Fatty Acids, Monounsaturated ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Intravascular ultrasound ,Creatine Kinase ,Heart transplantation ,medicine.diagnostic_test ,Anticholesteremic Agents ,CHOLESTEROL ,Middle Aged ,Coronary Vessels ,Lipoproteins, LDL ,Dose–response relationship ,Treatment Outcome ,Female ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Urology ,Hyperlipidemias ,NO ,intravascular ultrasound ,statins ,medicine ,Humans ,Vascular Diseases ,Dosing ,Fluvastatin ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,Transplantation ,Dose-Response Relationship, Drug ,Cholesterol ,business.industry ,Retrospective cohort study ,Surgery ,HEART TRANSPLANTATION ,chemistry ,business ,Follow-Up Studies - Abstract
Background: Statins are recommended in heart transplantation regardless of lipid levels. However, it remains unknown whether dosing should be maximized or adjusted toward a pre-defined cholesterol threshold. Methods: This pilot, randomized, open-label study compares an early maximal dose of fluvastatin (80 mg/day) with a strategy based on 20 mg/day subsequently titrated to target low-density lipoproteins (LDL) 0.5 mm, with numerical prevalence in the titrated-dosing arm (3 [12.5%] vs 1 [5%]; p = 0.3). Intimal volume increased in the titrated-dosing (p < 0.01) but not in the maximal-dosing arm (p = 0.1), which accordingly showed a higher prevalence of negative remodeling (p = 0.02). Conclusions: Despite being as effective as the titrated-dosing approach in achieving LDL
- Published
- 2011
39. Prognostic significance of mean platelet volume on admission in an unselected cohort of patients with non ST-segment elevation acute coronary syndrome
- Author
-
Fabio Vagnarelli, Nevio Taglieri, Giovanni Melandri, Cinzia Marrozzini, Stefania Rosmini, Paolo Ortolani, Tullio Palmerini, Laura Cinti, Francesco Saia, Claudio Rapezzi, Bacchi Reggiani Ml, Laura Alessi, Antonio Marzocchi, Caterina Villani, Angelo Branzi, Taglieri N., Saia F., Rapezzi C., Marrozzini C., Bacchi Reggiani M.L., Palmerini T., Ortolani P., Melandri G., Rosmini S., Cinti L., Alessi L., Vagnarelli F., Villani C., Branzi A., and Marzocchi A.
- Subjects
Erythrocyte Indices ,Male ,Risk ,Acute coronary syndrome ,medicine.medical_specialty ,Myocardial Infarction ,030204 cardiovascular system & hematology ,ACUTE MYOCARDIAL INFARCTION ,Platelet physiology ,RISK FACTORS ,NO ,Cohort Studies ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Mean platelet volume ,Risk factor ,Acute Coronary Syndrome ,Prospective cohort study ,Killip class ,Aged ,Aged, 80 and over ,business.industry ,Diagnostic Tests, Routine ,Platelet Count ,ST elevation ,Hematology ,Middle Aged ,medicine.disease ,Prognosis ,Survival Analysis ,Surgery ,Italy ,Acute Disease ,Cardiology ,Female ,business ,Biomarkers - Abstract
SummaryMean platelet volume (MPV) has been proposed as a marker of platelet reactivity and cardiovascular risk. Its prognostic significance has not been thoroughly investigated in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). We included 1,041 consecutive patients with NSTE-ACS. Patients were divided in quartiles according to the MPV value on admission (fl) i.e. Q1
- Published
- 2011
40. Lower long-term mortality within a regional system of care for ST-elevation myocardial infarction
- Author
-
Leonardo G. Pancaldi, Angelo Branzi, Cinzia Marrozzini, Paolo Guastaroba, Nevio Taglieri, Giuseppe Di Pasquale, Paolo Ortolani, Tullio Palmerini, Rossana De Palma, Antonio Marzocchi, Francesco Saia, Giovanni Gordini, Pier Camillo Pavesi, Saia F, Marrozzini C, Guastaroba P, Ortolani P, Palmerini T, Pavesi PC, Gordini G, Pancaldi LG, Taglieri N, Palma R, Pasquale G, Branzi A, and Marzocchi A.
- Subjects
Male ,medicine.medical_specialty ,Emergency Medical Services ,medicine.medical_treatment ,Myocardial Infarction ,Regional Medical Programs ,Electrocardiography ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Thrombolytic Therapy ,cardiovascular diseases ,Chromatin structure remodeling (RSC) complex ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Survival rate ,Stroke ,Aged ,Aged, 80 and over ,biology ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Triage ,Survival Rate ,Treatment Outcome ,ST-elevation myocardial infarction ,Italy ,Conventional PCI ,Emergency Medicine ,biology.protein ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
INTRODUCTION: Organization of regional systems of care (RSC) with an emphasis on pre-hospital triage and primary percutaneous coronary intervention (PCI) has been recommended to implement guidelines and improve clinical outcome in ST-segment elevation myocardial infarction (STEMI). PATIENTS AND METHODS: All STEMI patients (n = 1,823) admitted to any of the 13 hospitals of the province of Bologna, Italy, before (pre-RSC, n = 858) and after (RSC, n = 965) the implementation of a RSC were enrolled in the study. Primary evaluation was mortality. Secondary outcomes included death, myocardial infarction, stroke, and coronary revascularization procedures up to three-year follow-up. RESULTS: Among patients admitted
- Published
- 2010
41. A randomised study comparing the antiplatelet and antiinflammatory effect of clopidogrel 150 mg/day versus 75 mg/day in patients with ST-segment elevation acute myocardial infarction and poor responsiveness to clopidogrel: results from the DOUBLE study
- Author
-
Letizia Bacchi Reggiani, Giulia Lauria, Mirna Bassi, Chiara Barozzi, Luciana Tomasi, Stefano De Servi, Laura Alessi, Diego Sangiorgi, Angelo Branzi, Antonio Marzocchi, Paolo Ortolani, Tullio Palmerini, Palmerini T, Barozzi C, Tomasi L, Sangiorgi D, Marzocchi A, De Servi S, Ortolani P, Bacchi Reggiani L, Alessi L, Lauria G, Bassi M, and Branzi A.
- Subjects
medicine.medical_specialty ,Ticlopidine ,Platelet Aggregation ,medicine.medical_treatment ,Anti-Inflammatory Agents ,Myocardial Infarction ,Internal medicine ,medicine ,ST segment ,Humans ,cardiovascular diseases ,Myocardial infarction ,Anterior Wall Myocardial Infarction ,Maintenance dose ,business.industry ,ST elevation ,Microfilament Proteins ,Percutaneous coronary intervention ,Hematology ,medicine.disease ,Clopidogrel ,Phosphoproteins ,Thromboelastometry ,C-Reactive Protein ,Conventional PCI ,Cardiology ,business ,Cell Adhesion Molecules ,medicine.drug - Abstract
Introduction The antiplatelet effect of standard or increased clopidogrel doses in patients with ST- segment elevation acute myocardial infarction (STEMI) has never been studied. In this study we compared the antiplatelet effect of a 75 mg daily maintenance dose of clopidogrel with 150 mg in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Materials and methods Fifty-four patients with STEMI undergoing PCI were randomly allocated to receive either 75 mg/day clopidogrel (group 1) or 150 mg/day (group 2) for 1 month. Platelet function, measured by 5 different assays, was determined at 3 time points: 38 ± 8 hours after the procedure, 1 week and 1 month after randomization. Results In group 1, mean ± SD platelet reactivity index (PRI) measured with the VASP assay was 57.7 ± 15.7% and 46.9 ± 15.7% at 1 week and 1 month, respectively, compared to 38.8 ± 15.7% and 34.9 ± 12.6% in group 2 (p = 0.0001). Same results were observed for light transmittance aggregometry, whole blood aggregometry and VerifyNow, but not for thromboelastometry. In contrast to what may be expected, the 75 mg daily maintenance dose took longer than 1-week to provide the full clopidogrel antiplatelet effect. Furthermore, patients in group 2 had a nearly 50% reduction in C-reactive protein levels both at 1 week and 1 month. Conclusion In patients with STEMI and poor responsiveness to clopidogrel a 150 mg daily maintenance dose of clopidogrel is associated with a significant reduction of platelet aggregation and a trend towards reduced inflammation.
- Published
- 2009
42. Optimisation of therapeutic strategies for ST-segment elevation acute myocardial infarction: the impact of a territorial network on reperfusion therapy and mortality
- Author
-
Paolo Ortolani, Pancaldi Lg, Paolo Guastaroba, Tullio Palmerini, Pietro Cortesi, Nevio Taglieri, G. Di Pasquale, Cinzia Marrozzini, Antonio Marzocchi, Angelo Branzi, Giovanni Gordini, Pier Camillo Pavesi, Francesco Saia, Saia F, Marrozzini C, Ortolani P, Palmerini T, Guastaroba P, Cortesi P, Pavesi PC, Gordini G, Pancaldi LG, Taglieri N, di Pasquale G, Branzi A, and Marzocchi A.
- Subjects
Male ,medicine.medical_specialty ,Emergency Medical Services ,Time Factors ,Myocardial Infarction ,Coronary Angiography ,Reperfusion therapy ,Internal medicine ,Epidemiology ,medicine ,ST segment ,Humans ,Thrombolytic Therapy ,cardiovascular diseases ,Myocardial infarction ,Hospital Mortality ,Angioplasty, Balloon, Coronary ,Stroke ,Aged ,Interventional cardiology ,business.industry ,Incidence (epidemiology) ,ST elevation ,Coronary Care Units ,medicine.disease ,Treatment Outcome ,Italy ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective: To assess the clinical impact of a regional network for the treatment of ST-segment elevation myocardial infarction (STEMI). Methods: All patients with STEMI (n = 1823) admitted to any of the hospitals of an area with one million inhabitants during the year 2002 (n = 858) - that is, before the network was implemented, and in 2004 (n = 965), the year of full implementation of the network, were enrolled in this study. The primary evaluation was inhospital mortality. Secondary outcomes included the incidence of major adverse cardiac and cerebrovascular events (MACCE), defined as death, myocardial infarction, stroke and coronary revascularisation procedures over 1-year follow-up. Results: Between 2002 and 2004, there was a major change in reperfusion strategy: primary angioplasty increased from 20.2% to 65.6% (p
- Published
- 2009
43. Prophylaxis versus preemptive anti-cytomegalovirus approach for prevention of allograft vasculopathy in heart transplant recipients
- Author
-
Gaia Magnani, Fabio Coccolo, Antonio Russo, Anna Chiara Musuraca, Angelo Branzi, Francesco Fallani, Paolo Ortolani, Tiziana Lazzarotto, Francesco Grigioni, Luciano Potena, Potena L, Grigioni F, Magnani G, Lazzarotto T, Musuraca AC, Ortolani P, Coccolo F, Fallani F, Russo A, and Branzi A
- Subjects
Pulmonary and Respiratory Medicine ,Human cytomegalovirus ,Adult ,Male ,medicine.medical_specialty ,Opportunistic infection ,medicine.medical_treatment ,Coronary Artery Disease ,Kaplan-Meier Estimate ,Lower risk ,Gastroenterology ,Antiviral Agents ,Drug Administration Schedule ,Cohort Studies ,Viral Matrix Proteins ,Postoperative Complications ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Infusions, Intravenous ,Ganciclovir ,Ultrasonography, Interventional ,Aged ,Heart transplantation ,Transplantation ,business.industry ,Coronary Stenosis ,Valganciclovir ,Odds ratio ,Middle Aged ,Viral Load ,medicine.disease ,Phosphoproteins ,Survival Analysis ,Surgery ,Cytomegalovirus Infections ,Heart Transplantation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Viral load ,Immunosuppressive Agents ,medicine.drug ,Follow-Up Studies - Abstract
Background Cytomegalovirus (CMV) infection may influence the development of cardiac allograft vasculopathy (CAV). Prophylactic or preemptive administration of anti-CMV agents effectively prevents acute CMV manifestations. However, studies comparing allograft-related outcomes between these anti-CMV approaches are lacking. Herein we report a longitudinal observational study comparing CAV development between prophylactic and preemptive approaches. Methods The 1-year change in maximal intimal thickening (MIT) assessed by intravascular ultrasound at 1 and 12 months after heart transplantation (the major surrogate for late survival) was compared in groups of patients routinely assigned to a preemptive strategy (from November 2004 to October 2005; n = 21) or receiving valganciclovir prophylaxis (from November 2005 to October 2006; n = 19). CMV infection was monitored with pp65 antigenemia. Results The 1-year increase in MIT was significantly lower in patients receiving prophylaxis compared with those managed preemptively (0.15 ± 0.17 vs 0.31 ± 0.20 mm; p = 0.01). Prophylaxed recipients presented less frequently with MIT change ≥0.3 mm ( p = 0.03) and ≥0.5 mm ( p = 0.10) than those managed preemptively. Prophylaxis was also associated with later onset of CMV infection ( p = 0.01), lower peak CMV detection ( p p = 0.04). After adjusting for metabolic risk factors and other possible confounders, prophylaxis remained independently associated with lower risk for MIT change ≥0.3 mm (odds ratio=0.09, 95% confidence interval 0.01 to 0.93; p = 0.04). Conclusions Universal prophylaxis was associated with delayed onset of CMV infection, lower viral burden, reduced CMV disease/syndrome and less intimal thickening, as compared with a preemptive anti-CMV approach. Randomized studies are required to confirm the potential benefits of prophylaxis vs a preemptive approach in heart transplant recipients.
- Published
- 2008
44. Usefulness of prehospital triage in patients with cardiogenic shock complicating ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
- Author
-
Simona Silenzi, Roberto Grilli, Antonio Marzocchi, Maria Letizia Bacchi-Reggiani, Nevio Taglieri, Paolo Guastaroba, Francesco Saia, Cinzia Marrozzini, Giovanni Gordini, Angelo Branzi, Federica Baldazzi, Paolo Ortolani, Tullio Palmerini, Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Baldazzi F, Silenzi S, Taglieri N, Bacchi-Reggiani ML, Gordini G, Guastaroba P, Grilli R, and Branzi A
- Subjects
Male ,medicine.medical_specialty ,Emergency Medical Services ,Time Factors ,medicine.medical_treatment ,Ambulances ,Myocardial Infarction ,Myocardial Ischemia ,Shock, Cardiogenic ,Electrocardiography ,Ventricular Dysfunction, Left ,Internal medicine ,Cause of Death ,medicine ,Humans ,Myocardial infarction ,Hospital Mortality ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Prospective cohort study ,Survival rate ,Aged ,business.industry ,ST elevation ,Cardiogenic shock ,Percutaneous coronary intervention ,medicine.disease ,Triage ,Telemedicine ,Survival Rate ,Cardiology ,Myocardial infarction complications ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
We investigated the impact of ambulance-based prehospital triage on treatment delay and all-cause mortality (in hospital and long term) in patients with ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock referred for primary percutaneous coronary intervention in a prospectively collected registry. During the study period (January 2003 to December 2005), a total of 121 patients was referred for primary percutaneous coronary intervention at our intervention laboratory through 2 main triage groups: (1) after prehospital, ambulance-telemedicine-based triage (42 patients) and (2) by more conventional routes (79 patients) represented by the institutional S. Orsola-Malpighi hospital emergency department triage (44 patients) and spoke hospital triage (35 patients). Total ischemic time was shorter in the prehospital triage (142 minutes, range 106 to 187, vs 212 minutes, range 150 to 366, p = 0.003). Patients with prehospital triage showed a lower rate (29% vs 54%, p = 0.01) of severely depressed (
- Published
- 2007
45. Randomized comparative trial of a thin-strut bare metal cobalt-chromium stent versus a sirolimus-eluting stent for coronary revascularization
- Author
-
Francesco Saia, Paolo Ortolani, Antonio Marzocchi, Angelo Branzi, Simona Silenzi, Nevio Taglieri, Maria Letizia Bacchi Reggiani, Tullio Palmerini, Cinzia Marrozzini, Matteo Aquilina, Robin M. T. Cooke, Federica Baldazzi, Ortolani P., Marzocchi A., Marrozzini C., Palmerini T., Saia F., Taglieri N., Aquilina M., Baldazzi F., Silenzi S., Cooke RM., Reggiani ML., and Branzi A.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Coronary Angiography ,Prosthesis Design ,Balloon ,law.invention ,Coronary Restenosis ,Coronary artery disease ,Restenosis ,Randomized controlled trial ,Risk Factors ,law ,Angioplasty ,Internal medicine ,Humans ,Medicine ,Single-Blind Method ,Radiology, Nuclear Medicine and imaging ,Angioplasty, Balloon, Coronary ,Aged ,Sirolimus ,business.industry ,fungi ,Coronary Stenosis ,Stent ,Cardiovascular Agents ,General Medicine ,Middle Aged ,Comparative trial ,medicine.disease ,Coronary Vessels ,Surgery ,Treatment Outcome ,Research Design ,Cardiology ,Female ,Stents ,Chromium Alloys ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
OBJECTIVES: To see whether use of a sirolimus-eluting stent (SES) is superior to a third-generation thin-strut, cobalt-chromium stent (CCS) in terms of in-segment late loss at 9 months in patients with symptomatic coronary artery disease. BACKGROUND: Stent-strut thickness has been shown to be strictly related with risk of in-stent restenosis, but available demonstrations of the angiographic efficacy of SES have been based on comparisons with thick-strut bare metal control stents. METHODS: The primary outcome measure of this single-center, single-blind randomized comparative trial was 9-month in-segment late loss. Eligibility criteria were symptomatic coronary artery disease and target vessel diameter appropriate for implantation a 3-mm stent. Based on a power calculation, 104 patients were randomly assigned to receive a SES (Cypher™) or a CCS (Vision™). RESULTS: In-segment late loss was significantly lower in the SES group (0.18 ± 0.40 mm vs 0.58 ± 0.51 mm, P < 0.001). Regarding subsidiary outcome measures, in-segment restenosis (at 9 months) was recorded in 10% (5/50) patients treated with SES and 23% (11/48) receiving CCS (P = 0.14). No clinical difference between the two groups was apparent at 12 months. Freedom from target vessel failure at 12 months was 72% for SES patients and 68% for CCS patients (P = 0.65). CONCLUSIONS: In patients with de-novo coronary lesions at medium risk of restenosis the anti-proliferative effect of SES is greater than that of a thin-strut CCS. Nevertheless, the angiographic results of the CCS were rather good. It remains to be seen whether the angiographic superiority of SES can translate into clinical superiority. © 2007 Wiley-Liss, Inc.
- Published
- 2007
46. Clinical comparison of 'normal-hours' vs 'off-hours' percutaneous coronary interventions for ST-elevation myocardial infarction
- Author
-
Nevio Taglieri, Paolo Ortolani, Tullio Palmerini, Daniele Grosseto, Simona Silenzi, Paolo Guastaroba, Matteo Aquilina, Antonio Marzocchi, Federica Baldazzi, Maria Letizia Bacchi-Reggiani, Angelo Branzi, Francesco Saia, Cinzia Marrozzini, Roberto Grilli, Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Aquilina M, Baldazzi F, Silenzi S, Taglieri N, Grosseto D, Bacchi-Reggiani ML, Guastaroba P, Grilli R, and Branzi A.
- Subjects
Male ,medicine.medical_specialty ,Percutaneous ,Time Factors ,medicine.medical_treatment ,Population ,Myocardial Infarction ,Platelet Glycoprotein GPIIb-IIIa Complex ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,education ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,Ejection fraction ,business.industry ,ST elevation ,Mortality rate ,Thrombolysis ,Middle Aged ,medicine.disease ,Survival Analysis ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors - Abstract
Background High mortality rates were reported in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary interventions (PPCI) "off-hours." The objective of this study was to evaluate this issue in a more recent population of patients with STEMI treated with PPCI in a high-volume tertiary center specifically dedicated to STEMI treatment. Methods and Results We analyzed in-hospital/1-year mortality among 985 consecutive patients with STEMI treated with PPCI between January 2003 and December 2005 in a high-volume (>1400 PCI/year) hub center in a STEMI provincial network organization during "normal-hours" (weekdays 08:00 am to 07:29 pm) and "off-hours" (weekdays 07:30 pm to 07:59 am and weekends). Most (61.2%) patients were treated during "off-hours". Clinical and angiographic characteristics of the "normal-hours" and "off-hours" groups were comparable (in both groups, glycoprotein IIb/IIIa were administered to ∼80% patients). The off-hours group tended toward higher median (25th-75th percentiles) total ischemic time (199 [135-312] minutes vs 179 [126-285] minutes; P = .052). Median electrocardiogram-to-balloon time was less than 90 minutes in both groups. Despite 20 minutes longer median total ischemic time, patients who underwent PPCI during "off-hours" showed similar post-PPCI Thrombolysis In Myocardial Infarction 3 flow grade and mean left ventricular ejection fraction. No difference could be observed between the 2 groups in terms of in-hospital and 1-year mortality rates. Conclusion This study provides evidence that the clinical effectiveness of "normal" and "off-hours" PPCI can be equivalent, at least when performed at a center specifically dedicated to STEMI treatment with frequent use of glycoprotein IIb/IIIa agents.
- Published
- 2007
47. 32P brachytherapy in the treatment of complex Cypher in-stent restenosis
- Author
-
Stefano Neri, Nevio Taglieri, Paolo Ortolani, Angelo Branzi, William Gaiba, Antonio Marzocchi, Cinzia Marrozzini, Tullio Palmerini, Matteo Aquilina, Ortolani P, Marzocchi A, Aquilina M, Gaiba W, Neri S, Marrozzini C, Palmerini T, Taglieri N, and Branzi A.
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Myocardial Infarction ,Coronary Angiography ,Coronary Restenosis ,Blood Vessel Prosthesis Implantation ,Restenosis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Aged ,business.industry ,Stent ,equipment and supplies ,medicine.disease ,Coronary Vessels ,Prosthesis Failure ,Radiation therapy ,surgical procedures, operative ,Stents ,Radiology ,Diabetic patient ,In stent restenosis ,Cardiology and Cardiovascular Medicine ,business ,Phosphorus Radioisotopes ,Follow-Up Studies - Abstract
Treatment of in-stent restenosis after implantation of a drug-eluting stent is a critical issue. We provide the first report of the use of intravascular radiation therapy for this purpose in a 73-year-old diabetic patient stented for small-vessel bifurcation; treatment of Cypher diffuse in-stent restenosis with (32)P brachytherapy proved successful at clinical and angiographic follow-up at 7 months. This finding should encourage systematic studies on the safety and efficacy of IRT in this problematic setting.
- Published
- 2005
48. Preprocedural Levels of C-Reactive Protein and Leukocyte Counts Predict 9-Month Mortality After Coronary Angioplasty for the Treatment of Unprotected Left Main Coronary Artery Stenosis
- Author
-
Cinzia Marrozzini, Antonio Marzocchi, Santo Virzi, Francesco Saia, Silvia Gianstefani, Angelo Branzi, Letizia Bacchi-Reggiani, Paolo Ortolani, Tullio Palmerini, Palmerini T, Marzocchi A, Marrozzini C, Ortolani P, Saia F, Bacchi-Reggiani L, Virzi S, Gianstefani S, and Branzi A.
- Subjects
Bare-metal stent ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Left Main Coronary Artery Stenosis ,Coronary Angiography ,Leukocyte Count ,Left coronary artery ,Physiology (medical) ,Internal medicine ,medicine.artery ,Angioplasty ,medicine ,Myocardial Revascularization ,Humans ,Myocardial infarction ,ANGIOPLASTY ,Aged ,biology ,business.industry ,C-reactive protein ,Coronary Stenosis ,Stent ,Middle Aged ,STENTS ,medicine.disease ,Survival Analysis ,LEUKOCYTES ,Stenosis ,C-Reactive Protein ,Cardiology ,biology.protein ,Female ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Biomarkers ,Follow-Up Studies - Abstract
Background— An accurate preprocedural risk stratification scheme for patients with unprotected left main coronary artery (ULMCA) stenosis who are undergoing coronary stenting is lacking. We examined the predictive value of preprocedural levels of C-reactive protein (CRP), fibrinogen, and leukocyte counts with respect to 9-month clinical outcomes after stenting of the ULMCA stenosis. Methods and Results— Levels of CRP, fibrinogen, and leukocyte count were prospectively measured in 83 patients undergoing stenting of the ULMCA. A drug-eluting stent was used in 42 patients, and a bare metal stent was used in 41. The end point of the study was death and the combination of death and myocardial infarction (MI). By the 9-month follow-up, there were 11 deaths (13%), 7 MIs (8%), and 16 target lesion revascularizations (19%). Death and death/MI occurred in 19% and 31%, respectively, of 59 patients with high serum levels of CRP (>3 mg/L) but in none of 24 patients with normal CRP levels (for death, P =0.02; for death/MI, P =0.006). In multivariate analysis, the highest tertiles of CRP level ( P =0.028) and leukocyte count ( P =0.002) were the only independent predictors of death. The highest tertiles of CRP level ( P =0.002) and leukocyte count ( P =0.002) and acute coronary syndromes ( P =0.05) were the only independent predictors of the combined end point death/MI. Conclusions— Elevated preprocedural levels of CRP indicate an increased risk of death and death/MI after ULMCA stenting. Inflammatory risk assessment in patients with ULMCA stenosis may be useful for selecting patients for percutaneous coronary interventions with very low risk.
- Published
- 2005
49. Long-term clinical and angiographic outcome of patients with occlusive in-stent restenosis treated with (32P) beta-brachytherapy
- Author
-
Stefano Neri, Matteo Aquilina, Enza Barbieri, Cinzia Marrozzini, Maria Letizia Bacchi Reggiani, Nevio Taglieri, Stefania Pini, Antonio Marzocchi, Feisal Bunkheila, Angelo Branzi, Paolo Ortolani, Tullio Palmerini, Paolo Sbarzaglia, Enzo Lombardo, William Gaiba, ORTOLANI P., MARZOCCHI A., AQUILINA M., GAIBA W., NERI S., BUNKHEILA F., LOMBARDO E., PINI S., MARROZZINI C., PALMERINI T., TAGLIERI N., SBARZAGLIA P., REGGIANI M.L., BARBIERI E., and BRANZI A.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Population ,Brachytherapy ,Revascularization ,Coronary Angiography ,Coronary Restenosis ,Blood Vessel Prosthesis Implantation ,Restenosis ,Internal medicine ,Angioplasty ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,education ,Aged ,education.field_of_study ,business.industry ,Stent ,General Medicine ,Middle Aged ,medicine.disease ,Beta Particles ,Catheter ,Treatment Outcome ,Multivariate Analysis ,Cardiology ,Female ,Stents ,Radiology ,Radiopharmaceuticals ,Cardiology and Cardiovascular Medicine ,business ,Phosphorus Radioisotopes ,Mace ,Follow-Up Studies - Abstract
The objective of this study was to determine the safety and efficacy of 32P β-brachytherapy in totally occlusive in-stent restenosis (ISR). Patients with occlusive ISR were generally excluded from the randomized clinical trials on intracoronary brachytherapy (utilizing either γ- or β-sources) that have shown reductions in restenosis rate and need for revascularization procedures. We analyzed short- and long-term effects of 32P β-brachytherapy (20 Gy) in 27 patients (28 lesions) with occlusive ISR and 84 (99 lesions) patients with nonocclusive high-risk ISR. The primary outcome measure was frequency of in-lesion angiographic binary restenosis at 7 months. Secondary endpoints were rates of major adverse cardiac events (MACE), target vessel revascularization (TVR), clinically driven TVR, and target lesion revascularization (TLR). 32P β-brachytherapy was feasible and safe and provided similar postprocedural angiographic results in the two clinically comparable groups. However, the 7-month binary restenosis rate was higher in the occlusive group, as were the MACE and late total occlusion rates. Multivariate logistic analysis of the overall population indicated occlusive pattern to be the only independent predictor of angiographic restenosis. In both groups, recurrent lesions most often showed a focal pattern with significant reduction of length. Although safe and effective in high-risk ISR, 32P brachytherapy at 20 Gy does not appear to be sufficient to avoid long-term restenosis in patients with occlusive lesions. Further studies should determine the most suitable source and dosage of brachytherapy for patients with occlusive ISR. Catheter Cardiovasc Interv 2004;63:433–438. © 2004 Wiley-Liss, Inc.
- Published
- 2004
50. Predictors of trend in CD4-positive T-cell count and mortality among HIV-1 infected individuals with virological failure to all three antiretroviral-drug classes
- Author
-
Ledergerber, B, Lundgren, Jd, Walker, As, Sabin, C, Justice, A, Reiss, P, Mussini, C, Wit, F, d'Arminio Monforte, A, Weber, R, Fusco, G, Staszewski, S, Law, M, Hogg, R, Lampe, F, Gill, Mj, Castelli, Francesco, Phillips, An, Rooney, P. q, Taylor, S. q, Couldwell, D. r, Austin, D. s, Block, M. s, Clemons, J. s, Finlayson, R. s, Petoumenos, K. s, Quan, D. s, Smith, D. s, O'Connor, C. t, Gorton, C. t, Allen, D. u, Mulhall, B. u, Mutimer, K. v, Keeffe, N. v, Cooper, D. w, Carr, A. w, Miller, J. w, Pell, C. w, Ellis, D. x, Baker, D. y, Kidd, J. y, Mcfarlane, R. y, Liang, M. T. z, Brown, Aa, K., Huffam, Ab, S., Savage, Ab, J., Morgan, Knibbs, Ab, P., Sowden, Ac, D., Walker, Ac, A., Orth, Ad, D., Lister, Ad, G., Chuah, Ae, J., Fankhauser, Ae, W., Dickson, Ae, B., Bradford, Af, D., Wilson, Af, C., Ree, Ag, H., Magon, Anderson, Ah, J., Moore, Ah, R., Russell, Ah, D., Mcgovern, Ah, G., Mcnair, Bal, Fairley, Ah, K., Roth, Ai, N., Ai, B., Strecker, Ai, S., Ai, D., Wood, Ai, H., Mijch, Aj, A., Hoy, Aj, J., Pierce, Mccormack, Aj, C., Watson, Aj, K., Medland, Ak, N., Daye, Al, J., Mallal, Am, S., French, Am, M., Skett, Am, J., Maxwel, Am, D., Cain, Am, A., Montroni, An, M., Scalise, An, G., Costantini, An, A., Giacometti, Tirelli, Ao, U., Nasti, Ao, G., Pastore, Ap, G., Ladisa, Ap, N., Perulli, M. L., Ap, Suter, Aq, F., Arici, Aq, C., Maggiolo, Chiodo, Ar, F., Gritti, F. M., Ar, Colangeli, Ar, V., Fiorini, Ar, C., Guerra, Ar, L., Carosi, As, G., Cadeo, G. P., As, Minardi, As, C., Vangi, As, D., Paraninfo, Casari, As, S., Pan, As, A., Patroni, Torti, Quiros, Roldan, As, E., Tomasoni, As, L., Moretti, As, F., Nasta, As, P., Uccelli, M. C., As, Bertelli, Rizzardini, At, G., Migliorino, At, M., Abeli, At, C., Manconi, P. E., Au, Piano, Au, P., Ferraro, Av, T., Scerbo, Av, A., Pizzigallo, Aw, E., Ricci, Aw, F., Santoro, Ax, D., Pusterla, Ax, L., Carnevale, Ay, G., Galloni, Ay, D., Viganò, Az, P., Mena, Az, M., Ghinelli, Ba, F., Sighinolfi, Ba, L., Leoncini, Bb, F., Mazzotta, Pozzi, Bb, M., Caputo, Lo, Bb, S., Angarano, Bc, G., Grisorio, Bc, B., Ferrara, Bc, S., Grima, Bd, P., Tundo, Pagano, Be, G., Piersantelli, Be, N., Alessandrini, Be, A., Piscopo, Be, R., Toti, Bf, M., Chigiotti, Bf, S., Soscia, Bg, F., Tacconi, Bg, L., Orani, Bh, A., Perini, Bh, P., Nigro, Bh, M., Scasso, Bi, A., Vincenti, Scalzini, Bj, A., Fibbia, Bj, G., Moroni, Bk, M., Lazzarin, Bk, A., Cargnel, Vigevani, G. M., Bk, Caggese, Bk, L., Tordato, Bk, F., Novati, Bk, R., Galli, Merli, Bk, S., Pastecchia, Bk, C., Moioli, Esposito, Bl, R., Abrescia, Bm, N., Chirianni, Bm, A., Izzo, Bm, C., Piazza, Bm, M., Marco, De, Montesarchio, Bm, V., Manzillo, Bm, E., Nappa, Bm, S., Colomba, Bn, A., Abbadessa, Bn, V., Prestileo, Bn, T., Mancuso, Bn, S., Ferrari, Bo, C., Pzzaferri, Bo, P., Filice, Bp, G., Minoli, Bp, L., Bruno, Bp, R., Maserati, Bp, S., Tinelli, Bp, C., Pauluzzi, Bq, S., Baldelli, Bq, F., Petrelli, Br, E., Cioppi, Br, A., Alberici, Bs, F., Ruggieri, Bs, A., Menichetti, Bt, F., Martinelli, Bt, C., Stefano, De, Bu, C., Gala, La, Bu, A., Zauli, Bv, T., Ballardini, Bv, G., Magnani, Bw, G., Ursitti, M. A., Bw, Arlotti, Bx, M., Ortolani, Bx, P., Ortona, By, L., Dianzani, By, F., Ippolito, By, G., Antinori, Bz, A., Antonucci, Bz, G., D'Elia, Bz, S., Narciso, Bz, P., Petrosillo, Bz, N., Vullo, Bz, V., Luca, De, Del, Forno, Bz, L., Zaccarelli, Bz, M., Longis, De, Ciardi, D'Offizi, Noto, Lichtner, Capobianchi, M. R., Bz, Girardi, Bz, E., Pezzotti, Rezza, Mura, M. S., Ca, Mannazzu, Ca, M., Caramello, Cb, P., Sinicco, Cb, A., Soranzo, M. L., Cb, Gennero, Cb, L., Sciandra, Cb, M., Salassa, Cb, B., Grossi, P. A., Cc, Basilico, Cc, C., Poggio, Cd, A., Bottari, Cd, G., Raise, Ce, E., Pasquinucci, Ce, S., Lalla, De, Cf, F., Tositti, Cf, G., Resta, Cg, F., Chimienti, Cg, A., Lepri, Cozzi, Ch, A., Bachmann, Fb, S., Battegay, Fb, M., Bernasconi, Fb, E., Bucher, Fb, H., Bürgisser, Fb, P., Cattacin, Egger, Erb, Fierz, Fb, W., Fischer, Flepp, Fontana, Fb, A., Francioli, Furrer, H. J., Fb, Gorgievski, Günthard, Hirschel, Fb, B., Kaiser, Fb, L., Kind, Fb, C., Klimkait, Fb, T., Lauper, Fb, U., Opravil, Paccaud, Fb, F., Pantaleo, Fb, G., Perrin, Piffaretti, J. C., Fb, Rickenbach, Rudin, Schüpbach, Fb, J., Speck, Fb, R., Tarr, Telenti, Trkola, Vernazza, Yerly, Wolf, De, Ci, F., Van, Sighem, A. I., Ci, Van, Valkengoed, Ci, I., Gras, Ci, L., Bronsveld, Ci, W., Veldkamp, Ci, A., Prins, J. M., Cj, Bos, J. C., Cj, Schattenkerk, Eeftinck, J. K. M., Cj, Godfried, M. H., Cj, Lange, J. M. A., Cj, Lowe, S. H., Cj, van der Meer, J. T. M., Cj, Nellen, F. J. B., Cj, Pogany, Cj, K., van der Poll, Cj, T., Ruys, T. A., Cj, Sankatsing, Cj, S., van der Valk, Cj, M., Van, Vonderen, M. G. A., Cj, Wit, F. W. M. N., Cj, Van, Eeden, Cj, A., Ten, Veen, J. H., Cj, Van, Dam, P. S., Cj, Hillebrand, Haverkort, M. E., Cj, Brinkman, Frissen, P. H. J., Cj, Weigel, H. M., Cj, Mulder, J. W., Cj, Van, Gorp, E. C. M., Cj, Meenhorst, P. L., Cj, Mairuhu, A. T. A., Cj, Veenstra, Cj, J., Danner, S. A., Cj, Van, Agtmael, M. A., Cj, Claessen, F. A. P., Cj, Geerlings, S. E., Cj, Perenboom, R. M., Cj, Jurriaans, Back, N. K. T., Cj, Cuijpers, Rietra, P. J. G. M., Cj, Roozendaal, K. J., Cj, Pauw, Cj, W., Van, Zanten, A. P., Cj, Smits, P. H. M., Cj, Von, Blomberg, B. M. E., Cj, Savelkoul, Cj, P., Zaaijer, Cj, H., Beijnen, Crommentuyn, K. M. L., Cj, Huitema, A. D. R., Cj, Kappelhoff, Cj, B., Maat, De, M. M. R., Cj, Richter, Ck, C., van der Berg, Ck, J., Van, Leusen, Ck, R., Swanink, Vriesendorp, Cl, R., Jeurissen, F. J. F., Cl, Kauffmann, R. H., Cm, Koger, E. L. W., Cm, Franck, P. F. H., Cm, Lampe, A. S., Cm, Jansen, C. L., Cm, Bravenboer, Cn, B., Ten, Napel, C. H. H., Co, Mudrikova, Co, T., Hendriks, Co, R., Sprenger, H. G., Cp, Miesen, W. M. A. J., Cp, Schirm, Cp, J., Benne, Cp, D., Ten, Kate, R. W., Cq, Veenendaal, Cq, D., Van, Houte, D. P. F., Cr, Leemhuis, M. P., Cr, Pole, Cr, M., Storm, Cr, H., Van, Zeijl, J. H., Cr, Kroon, F. P., Cs, Schippers, E. F., Cs, Kroes, A. C. M., Cs, Claas, H. C. J., Cs, Schreij, Ct, G., van de Geest, Ct, S., Verbon, Ct, A., Bruggeman, C. A. M. V. A., Ct, Goossens, V. J., Ct, Koopmans, P. P., Cu, Telgt, Cu, M., van der Ven, A. J. A. M., Cu, Burger, D. M., Cu, Hugen, P. W. H., Cu, Galama, J. M. D., Cu, Poort, Y. A. G. M., Cu, van der Ende, M. E., Cv, Gyssens, I. C., Cv, Marie, De, Cv, S., Nouwen, J. L., Cv, Niesters, M. G., Cv, Osterhaus, A. D. M. E., Cv, Schutten, Cv, M., Juttmann, J. R., Cw, Buiting, A. G. M., Cw, Swaans, C. A. M., Cw, Schneider, M. M. E., Cx, Bonten, M. J. M., Cx, Borleffs, J. C. C., Cx, Hoepelman, I. M., Cx, Jaspers, C. A. J. J., Cx, Schouten, Cx, I., Schurink, C. A. M., Cx, Boucher, C. A. B., Cx, Schuurman, Cx, R., Blok, W. L., Cy, Groeneveld, P. H. P., Cz, Boel, Da, E., Jansz, A. F., Da, Dabis, Db, F., Thiebaut, Db, R., Chêne, Db, G., Lawson, Ayayi, Db, S., Meyer, Dc, L., Boufassa, Dc, F., Hamouda, Dd, O., De, P., De, G., Touloumi, Df, G., Hatzakis, Df, A., Karafoulidou, Katsarou, Df, O., Brettle, Dg, R., Del, Amo, Dh, J., Del, Romero, Van, Asten, Di, L., Van, Benthem, Di, B., Di, M., Coutinho, Di, R., Kirk, Dj, O., Pedersen, Dj, C., Hernández, Aguado, Dk, I., Pérez, Hoyos, Dk, S., Eskild, Dl, A., Bruun, J. N., Dl, Sannes, Dl, M., Lee, Dm, C., Johnson, A. M., Dn, Babiker, Dn, A., Darbyshire, Dn, J., Gill, Dn, N., Porter, Dn, K., Do, P., Vanhems, Do, M., Cooper, Dp, D., Kaldor, Dpdq, J., Ashton, Dp, L., Dq, D., Dq, L., Vizzard, Dq, J., Muga, Dr, R., Ds, P., Dt, J., Cayla, Du, J., Garcia de Olalla, Du, P., Day, N. E., Dv, Angelis, De, Dv, D., Fb, K., Dw, A., Dw, S., Dw, J., Tyrer, Dw, F., Beral, Fb, V., Fb, N., Raffanti, Becker, Scarsella, Braun, Most, Balu, Gilbert, Fleenor, Ising, Dieterich, Fb, D., Fusco, Losso, Dx, M., Duran, Dx, A., Vetter, Dy, N., Clumeck, Dz, N., Wit, De, Dz, S., Kabeya, Dz, K., Poll, Dz, B., Colebunders, Dz, R., Machala, Ea, L., Rozsypal, Ea, H., Nielsen, Eb, J., Lundgren, Eb, O., Olsen, C. H., Eb, Gerstoft, Katzenstein, Eb, T., Hansen, A. B. E., Eb, Skinhøj, Eb, P., Eb, C., Zilmer, Ec, K., Rauka, Ec, M., Katlama, Ed, C., De, Sa, Ed, M., Viard, J. P., Ed, Saint, Marc, Ed, T., Ed, P., Pradier, Dietrich, Ee, M., Manegold, Ee, C., Van, Lunzen, Ee, J., Stellbrink, H. J., Ee, Miller, Ee, V., Goebel, F. D., Ee, Salzberger, Ee, B., Rockstroh, Kosmidis, Ef, J., Gargalianos, Ef, P., Sambatakou, Ef, H., Perdios, Panos, Ef, G., Filandras, Ef, A., Banhegyi, Eg, D., Mulcahy, Eh, F., Yust, Ei, I., Burke, Ei, M., Pollack, Ei, S., Hassoun, Ei, J., Sthoeger, Ei, Z., Maayan, Vella, Ej, S., Chiesi, Ej, A., Ej, C., Pristerá, Ej, R., Ej, F., Gabbuti, Bedini, Ej, E., Ej, V., Santopadre, Ej, P., Franci, Ej, M., Castagna, Viksna, Ek, L., Rozentale, Ek, B., Chaplinskas, El, S., Hemmer, Em, R., Staub, Em, T., En, J., Maeland, En, A., Ormaasen, En, V., Knysz, Eo, B., Gasiorowski, Eo, J., Horban, Eo, A., Prokopowicz, Eo, D., Wiercinska, Drapalo, Boron, Kaczmarska, Pynka, Eo, M., Beniowski, Trocha, Eo, H., Smiatacz, Eo, T., Antunes, Ep, F., Mansinho, Ep, K., Maltez, Duiculescu, Eq, D., Streinu, Cercel, Eq, A., Mokrás, Er, M., Staneková, Er, D., González, Lahoz, Es, J., Diaz, Es, B., García, Benayas, Es, T., Martin, Carbonero, Es, L., Soriano, Es, V., Clotet, Jou, Es, A., Conejero, Tural, Es, C., Gatell, J. M., Es, Miró, Zamora, Blaxhult, Et, A., Karlsson, Pehrson, Et, P., Eu, P., Eu, B., Schiffer, Eu, V., Eu, H., Chentsova, Ev, N., Barton, Ew, S., A. M., Ew, Mercey, Ew, D., Phillips, Ew, A., Youle, Ew, M., M. A., Ew, Mocroft, Murphy, Weber, Ew, J., Scullard, Ew, G., Fisher, Ew, R., Loveday, Ew, C., Ex, B., Ruiz, Ex, L., Helm, E. B., Fb, Carlebach, Mösch, Müller, Haberl, Korn, Stephan, Bickel, Gute, Locher, Lutz, Klauke, Doerr, H. W., Fb, Stürmer, Dauer, Jennings, Alexander, Braitstein, Chan, Cote, Gataric, Harrigan, P. R., Fb, Harris, Bonner, Montaner, O'Shaughnessy, Yip, Chaloner, Gumley, Ransom, Sabin, C. A., Fb, Lipman, Ey, J., Read, Ey, R., Ez, F., Riccio, Fa, G., Borghi, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases, Global Health, Other departments, Public and occupational health, General Internal Medicine, Center of Experimental and Molecular Medicine, Ledergerber, B, Lundgren, Jd, Walker, A, Sabin, C, Justice, A, Reiss, P, Mussini, C, Wit, F, Monforte, Ad, Weber, R, Fusco, G, Staszewski, S, Law, M, Hogg, R, Lampe, F, Gill, Mj, Castelli, F, Phillips, An, Fusco, Gp, Rooney, P, Taylor, S, Couldwell, D, Austin, D, Block, M, Clemons, J, Finlayson, R, Petoumenos, K, Quan, D, Smith, D, O'Connor, C, Gorton, C, Allen, D, Mulhall, B, Mutimer, K, Keeffe, N, Cooper, D, Carr, A, Miller, J, Pell, C, Ellis, D, Baker, D, Kidd, J, Mcfarlane, R, Liang, Mt, Brown, K, Huffam, S, Savage, J, Morgan, S, Knibbs, P, Sowden, D, Orth, D, Lister, G, Chuah, J, Fankhauser, W, Dickson, B, Bradford, D, Wilson, C, Ree, H, Magon, H, Anderson, J, Moore, R, Russell, D, Mcgovern, G, Mcnair, R, Bal, J, Fairley, K, Roth, N, Eu, B, Strecker, S, Wood, H, Mijch, A, Hoy, J, Pierce, A, Mccormack, C, Watson, K, Medland, N, Daye, J, Mallal, S, French, M, Skett, J, Maxwel, D, Cain, A, Montroni, M, Scalise, G, Costantini, A, Giacometti, A, Tirelli, U, Nasti, G, Pastore, G, Ladisa, N, Perulli, Ml, Suter, F, Arici, C, Chiodo, F, Gritti, Fm, Colangeli, V, Fiorini, C, Guerra, L, Carosi, G, Cadeo, Gp, Minardi, C, Vangi, D, Rizzardini, G, Migliorino, G, Manconi, Pe, Piano, P, Ferraro, T, Scerbo, A, Pizzigallo, E, Ricci, F, Santoro, D, Pusterla, L, Carnevale, G, Galloni, D, Vigano, P, Mena, M, Ghinelli, F, Sighinolfi, L, Leoncini, F, Mazzotta, F, Pozzi, M, Lo Caputo, S, Angarano, G, Grisorio, B, Ferrara, S, Grima, P, Tundo, P, Pagano, G, Piersantelli, N, Alessandrini, A, Piscopo, R, Toti, M, Chigiotti, S, Soscia, F, Taccooni, L, Orani, A, Perini, P, Scasso, A, Vincenti, A, Scalzini, A, Fibbia, G, Moroni, M, Lazzarin, A, Cargnel, A, Vigevani, Gm, Caggese, L, Tordato, F, Novati, R, Galli, A, Merli, S, Pastecchia, C, Moioli, C, Esposito, R, Abrescia, N, Chirianni, A, Izzo, C, Piazza, M, De Marco, M, Montesarchio, V, Manzillo, E, Nappa, S, Colomba, A, Abbadessa, V, Prestileo, T, Mancuso, S, Ferrari, C, Pzzaferri, P, Filice, G, Minoli, L, Bruno, R, Maserati, R, Pauluzzi, S, Baldelli, F, Petrelli, E, Cioppi, A, Alberici, F, Ruggieri, A, Menichetti, F, Martinelli, C, De Stefano, C, La Gala, A, Zauli, T, Ballardini, G, Magnani, G, Ursitti, Ma, Arlotti, M, Ortolani, P, Ortona, L, Dianzani, F, Ippolito, G, Antinori, A, Antonucci, G, D'Elia, S, Narciso, P, Petrosillo, N, Vullo, V, De Luca, A, Del Forno, L, Zaccarelli, M, De Longis, P, Ciardi, M, D'Offizi, G, Noto, P, Lichtner, M, Capobianchi, Mr, Girardi, E, Pezzotti, P, Rezza, G, Mura, M, Mannazzu, M, Caramello, P, Sinicco, A, Soranzo, Ml, Gennero, L, Sciandra, M, Salassa, B, Grossi, Pa, Basilico, C, Poggio, A, Bottari, G, Raise, E, Pasquinucci, S, De Lalla, F, Tositti, G, Resta, F, Chimienti, A, Lepri, Ac, Bachmann, S, Battegay, M, Bernasconi, E, Bucher, H, Burgisser, P, Cattacin, S, Egger, M, Erb, P, Fierz, W, Fischer, M, Flepp, M, Fontana, A, Francioli, P, Furrer, Hj, Gorgievski, M, Hirschel, B, Kaiser, L, Kind, C, Klimkait, T, Lauper, U, Opravil, M, Paccaud, F, Pantaleo, G, Perrin, L, Piffaretti, Jc, Rickenbach, M, Rudin, C, Schupbach, J, Speck, R, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Yerly, S, de Wolf, F, van Sighem, Ai, van Valkengoed, I, Gras, L, Bronsveld, W, Prins, Jm, Bos, Jc, Schattenkerk, Jkme, Godfried, Mh, Lange, Jma, Lowe, Sh, van der Meer, Jtm, Nellen, Fjb, Pogany, K, van der Poll, T, Ruys, Ta, Sankatsing, S, van der Valk, M, van Vonderen, Mga, Wit, Fwmn, van Eeden, A, ten Veen, Jh, van Dam, P, Hillebrand Haverkort, Me, Brinkman, K, Frissen, Phj, Weigel, Hm, Mulder, Jw, van Gorp, Ecm, Meenhorst, Pl, Mairuhu, Ata, Veenstra, J, Danner, Sa, Van Agtmael, Ma, Claessen, Fap, Geerlings, Se, Perenboom, Rm, Richter, C, van der Berg, J, van Leusen, R, Vriesendorp, R, Jeurissen, Fjf, Kauffmann, Rh, Koger, Elw, Bravenboer, B, ten Napel, Chh, Mudrikova, T, Sprenger, Hg, Miesen, Wmaj, ten Kate, Rw, van Houte, Dpf, Leemhuis, Mp, Pole, M, Kroon, Fp, Schippers, Ef, Schreij, G, van de Geest, S, Verbon, A, Koopmans, Pp, Telgt, M, van der Ven, Ajam, van der Ende, Me, Gyssens, Ic, de Marie, S, Nouwen, Jl, Juttmann, Jr, Schneider, Mme, Bonten, Mjm, Borleffs, Jcc, Hoepelman, Im, Jaspers, Cajj, Schouten, I, Schurink, Cam, Blok, Wl, Groenveld, Php, Jurriaans, S, Back, Nkt, Cuijpers, T, Rietra, Pjgm, Roozendaal, Kj, Pauw, W, van Zanten, Ap, Smits, Phm, von Blomberg, Bme, Savelkoul, P, Zaaijer, H, Swanink, C, Franck, Pfh, Lampe, A, Jansen, Cl, Hendriks, R, Schirm, J, Benne, D, Veenendaal, D, Storm, H, van Zeijl, Jh, Kroes, Acm, Claas, Hcj, Bruggeman, Camva, Goossens, Vj, Galama, Jmd, Poort, Yagm, Niesters, Mg, Osterhaus, Adme, Schutten, M, Buiting, Agm, Swaans, Cam, Boucher, Cab, Schuurman, R, Boel, E, Jansz, Af, Veldkamp, A, Beijnen, Jh, Crommentuyn, Kml, Huitema, Adr, Kappelhoff, B, de Maat, Mmr, Burger, Dm, Hugen, Pwh, Dabis, F, Thiebaut, R, Chene, G, Lawson Ayayi, S, Meyer, L, Boufassa, F, Hamouda, O, Touloumi, G, Hatzakis, A, Karafoulidou, A, Katsarou, O, Brettle, R, Del Amo, J, del Romero, J, van Asten, L, van Benthem, B, Prins, M, Coutinho, R, Kirk, O, Pedersen, C, Aguado, Ih, Perez Hoyos, S, Eskild, A, Bruun, Jn, Sannes, M, Lee, C, Johnson, Am, Babiker, A, Darbyshire, J, Gill, N, Porter, K, Vanhems, P, Kaldor, J, Ashton, L, Vizzard, J, Muga, R, Gill, J, Cayla, J, de Olalla, Pg, Day, Ne, De Angelis, D, Walker, S, Tyrer, F, Beral, V, Raffanti, S, Becker, S, Scarsella, A, Braun, J, Most, B, Balu, R, Gilbert, L, Fleenor, R, Ising, T, Dieterich, D, Fusco, J, Losso, M, Duran, A, Vetter, N, Clumeck, N, De Wit, S, Kabeya, K, Poll, B, Colebunders, R, Machala, L, Rozsypal, H, Nielsen, J, Lundgren, J, Olsen, Ch, Gerstoft, J, Katzenstein, T, Hansen, Abe, Skinhoj, P, Zilmer, K, Rauka, M, Katlama, C, De Sa, M, Viard, Jp, Saint Marc, T, Pradier, C, Dietrich, M, Manegold, C, van Lunzen, J, Stellbrink, Hj, Miller, V, Goebel, Fd, Salzberger, B, Rockstroh, J, Kosmidis, J, Gargalianos, P, Sambatakou, H, Perdios, J, Panos, G, Filandras, A, Banhegyi, D, Mulcahy, F, Yust, I, Burke, M, Pollack, S, Hassoun, J, Sthoeger, Z, Maayan, S, Vella, S, Chiesi, A, Pristera, R, Gabbuti, A, Bedini, A, Montesarchio, E, Santopadre, P, Franci, P, Castagna, Antonella, Viksna, L, Rozentale, B, Chaplinskas, S, Hemmer, R, Staub, T, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Prokopowicz, D, Wiercinska Drapalo, A, Boron Kaczmarska, A, Pynka, M, Beniowski, M, Trocha, H, Smiatacz, T, Antunes, F, Mansinho, K, Maltez, F, Duiculescu, D, Streinu Cercel, A, Mokras, M, Stanekova, D, Gonzalez Lahoz, J, Diaz, B, Garcia Benayas, T, Martin Carbonero, L, Soriano, V, Clotet, B, Jou, A, Conejero, J, Tural, C, Gatell, Jm, Miro, Jm, Zamora, L, Blaxhult, A, Karlsson, A, Pehrson, P, Schiffer, V, Furrer, H, Chentsova, N, Barton, S, Mercey, D, Phillips, A, Youle, M, Johnson, Ma, Mocroft, A, Murphy, M, Weber, J, Scullard, G, Fisher, M, Loveday, C, Ruiz, L, Helm, Eb, Carlebach, A, Mosch, M, Muller, A, Haberl, A, Korn, S, Stephan, C, Bickel, M, Gute, P, Locher, L, Lutz, T, Klauke, S, Doerr, Hw, Sturmer, M, Dauer, B, Jennings, B, Alexander, C, Braitstein, P, Chan, K, Cote, H, Gataric, N, Harrigan, Pr, Harris, M, Bonner, S, Montaner, J, O'Shaughnessy, M, Wood, E, Yip, B, Chaloner, C, Gumley, H, Ransom, D, Sabin, Ca, Lipman, M, Johnson, M, Read, R, Paraninfo, G, Casari, S, Pan, A, Patroni, A, Torti, C, Quiros Roldan, E, Tomasoni, L, Moretti, F, Nasta, P, Uccelli, Mc, Bertelli, D, Nigro, M, Migliorino, M, Abeli, C, Maggiolo, F, Novati, S, Tinelli, C, Riccio, G, Borghi, V, and Esposito, R.
- Subjects
Male ,HAART ,Human immunodeficiency virus (HIV) ,CD4 cell count ,HIV Infections ,CLINICAL PROGRESSION ,medicine.disease_cause ,THERAPY ,HAART REGIMEN ,Cohort Studies ,Risk Factors ,Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cohort Studies, Female, Follow-Up Studies, HIV Infections, HIV Protease Inhibitors, HIV-1, Humans, Male, Middle Aged, Proportional Hazards Models, Reverse Transcriptase Inhibitors, Risk Factors, Treatment Failure, Viral Load ,Medicine ,Treatment Failure ,Mortality rate ,Medicine (all) ,INHIBITOR ,General Medicine ,Middle Aged ,HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1) ,BLIND CONTROLLED-TRIAL ,medicine.anatomical_structure ,Anti-Retroviral Agents ,Cohort ,HUMAN-IMMUNODEFICIENCY-VIRUS ,Reverse Transcriptase Inhibitors ,Female ,Off Treatment ,Viral load ,Cohort study ,Adult ,medicine.medical_specialty ,Settore MED/17 - Malattie Infettive ,T cell ,Internal medicine ,Humans ,COHORT ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,DISEASE PROGRESSION ,HIV Protease Inhibitors ,HIV-INFECTED INDIVIDUALS ,CD4 Lymphocyte Count ,VIRAL LOAD ,Immunology ,HIV-1 ,business ,Follow-Up Studies - Abstract
Background Treatment strategies for patients in whom HIV replication is not suppressed after exposure to several drug classes remain unclear. We aimed to assess the inter-relations between viral load, CD4-cell count, and clinical outcome in patients who had experienced three-class virological failure.Methods We undertook collaborative joint analysis of 13 HIV cohorts from Europe, North America, and Australia, involving patients who had had three-class virological failure (viral load >1000 copies per mL for >4 months). Regression analyses were used to quantify the associations between CD4-cell-count slope, HIV-1 RNA concentration, treatment information, and demographic characteristics. Predictors of death were analysed by Cox's proportional-hazards models.Findings 2488 patients were included. 2118 (85%) had started antiretroviral therapy with single or dual therapy. During 5015 person-years of follow-up, 276 patients died (mortality rate 5.5 per 100 person-years; 3-year mortality risk 15.3% (95% Cl 13.5-17.3). Risk of death was strongly influenced by the latest CD4-cell count with a relative hazard of 15.8 (95% CI 9.28-27.0) for counts below 50 cells per muL versus above 200 cells per muL. The latest viral load did not independently predict death. For any given viral load, patients on treatment had more favourable CD4-cell-count slopes than those off treatment. For patients on treatment and with stable viral load, CD4-cell counts tended to be increasing at times when the current viral load was below 10 000 copies per mL or 1.5 log(10) copies per mL below off-treatment values.Interpretation In patients for whom viral-load suppression to below the level of detection is not possible, achievement and maintenance of a CD4-cell count above 200 per muL becomes the primary aim. Treatment regimens that maintain the viral load below 10 000 copies per mL or at least provide 1.5 log(10) copies per mL suppression below the off-treatment value do not seem to be associated with appreciable CD4-cell-count decline.
- Published
- 2004
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.