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1. Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL

Author

Bruno Cacopardo, M. A. Ursitti, Claudio Maria Mastroianni, Emanuele Nicastri, R. Piolini, A. Antinori, Giustino Parruti, S. Truffa, Ivan Gentile, Giovanni Cassola, E. Girardi, I. Caramma, Andrea Calcagno, Laura Monno, A d'Arminio Monforte, R. Acinapura, Francesca Ceccherini-Silberstein, A. Di Biagio, Gabriella Verucchi, Alessandra Latini, Simone Marcotullio, Nicola Gianotti, C. Balotta, Camilla Tincati, M. C. Moioli, Alessandro Tavelli, Pietro Caramello, Carmen Rita Santoro, C. Abeli, A. Londero, F. Di Martino, R. Iardino, Stefano Bonora, M. Andreoni, A. Costantini, Raffaella Libertone, F. von Schloesser, G. Prota, Annalisa Saracino, Maria Grazia Cecchetto, Antonio Cristaudo, Mauro Zaccarelli, Carmela Pinnetti, Fabrizio Carletti, N. Abrescia, Andrea Giacometti, L. Gallo, Paolo Bonfanti, G. Angarano, E. Quiros Roldan, G. Pellizzer, F. Petrone, Giovanni Mazzarello, Silvia Nozza, R. Orlando, Franco Baldelli, Giovanni Guaraldi, Paola Meraviglia, Laura Sighinolfi, S. Carrara, D. Segala, Giuliano Rizzardini, C. Suardi, P. Piano, Mauro Sciandra, Daniela Francisci, A. De Luca, Patrizia Lorenzini, Paola Cinque, Tiziana Quirino, S. Graziano, Cristina Mussini, Massimo Galli, Giuseppe Ippolito, S. Lo Caputo, Benedetto Maurizio Celesia, C. Valeriani, Matteo Bassetti, Maria Rosaria Capobianchi, Claudio Viscoli, Vinicio Manfrin, Alessandro Chiodera, Alessandra Bandera, Guglielmo Borgia, Cinzia Puzzolante, Stefano Rusconi, Leonardo Calza, Valeria Belvisi, Francesca Vichi, Serena Quartu, Roberto Cauda, J. Vecchiet, Antonio Chirianni, A. Di Caro, P.E. Manconi, Stefania Cicalini, G. Magnani, M. Lichtner, Milensu Shanyinde, Stefano Savinelli, M. Puoti, Giulia Marchetti, Laura Carenzi, Carlo Federico Perno, Annalisa Ridolfo, G. Di Perri, F. Maggiolo, A Castagna, G. Orofino, Roberto Rossotti, Francesco Mazzotta, Gianmaria Baldin, Giovanni Lapadula, A. Rodano, V. Donati, Barbara Rossetti, F. Viviani, Adriana Ammassari, N. Bobbio, Adriano Lazzarin, C. Minardi, A. Alessandrini, Katia Falasca, Maria Stella Mura, Tamara Ursini, Andrea Gori, A. Cingolani, L. Maddaloni, Alessandro Cozzi-Lepri, Francesco Castelli, Iuri Fanti, Giordano Madeddu, E. Quiros, P. Viale, Marco Borderi, M. Capozzi, and Vincenzo Vullo

Subjects
Adult, Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Anti-HIV Agents, Hepatitis C virus, Renal function, Integrase inhibitor, HIV Infections, medicine.disease_cause, Rate ratio, 03 medical and health sciences, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Internal medicine, Clinical endpoint, Humans, Medicine, Pharmacology (medical), Treatment Failure, 030212 general & internal medicine, Retrospective Studies, Pharmacology, AIDS-Related Opportunistic Infections, Coinfection, business.industry, Retrospective cohort study, Middle Aged, Viral Load, 030112 virology, CD4 Lymphocyte Count, Discontinuation, Treatment Outcome, Infectious Diseases, Cohort, Female, business
Abstract

ObjectivesOur aim was to investigate the durability of different initial regimens in patients starting ART with CD4+ counts 5 log10 copies/mL.MethodsThis was a retrospective study of HIV-infected patients prospectively followed in the ICONA cohort. Those who started ART with boosted protease inhibitors (bPIs), NNRTIs or integrase strand transfer inhibitors (InSTIs), with CD4+ 5 log10 copies/mL, were included. The primary endpoint was treatment failure (TF), a composite endpoint defined as virological failure (VF, first of two consecutive HIV-RNA >50 copies/mL after 6 months of treatment), discontinuation of class of the anchor drug or death. Independent associations were investigated by Poisson regression analysis in a model including age, gender, mode of HIV transmission, CDC stage, HCV and HBV co-infection, pre-treatment HIV-RNA, CD4+ count and CD4+/CD8+ ratio, ongoing opportunistic disease, fibrosis FIB-4 index, estimated glomerular filtration rate, haemoglobin, platelets, neutrophils, calendar year of ART initiation, anchor drug class (treatment group) and nucleos(t)ide backbone.ResultsA total of 1195 patients fulfilled the inclusion criteria: 696 started ART with a bPI, 315 with an InSTI and 184 with an NNRTI. During 2759 person-years of follow up, 642 patients experienced TF. Starting ART with bPIs [adjusted incidence rate ratio (aIRR) (95% CI) 1.62 (1.29–2.03) versus starting with NNRTIs; P ConclusionsIn patients starting ART with 5 log10 HIV-RNA copies/mL, the durability of regimens based on InSTIs was longer than that of NNRTI- and bPI-based regimens.

Published
2019

2. Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort

Author

Maria Giovanna Quaranta, Luigina Ferrigno, Xhimi Tata, Franca D'Angelo, Marco Massari, Carmine Coppola, Elisa Biliotti, Alessia Giorgini, Diletta Laccabue, Alessia Ciancio, Pier Luigi Blanc, Marzia Margotti, Donatella Ieluzzi, Maurizia Rossana Brunetto, Francesco Barbaro, Francesco Paolo Russo, Ilaria Beretta, Giulia Morsica, Gabriella Verucchi, Annalisa Saracino, Massimo Galli, Loeta A. Kondili, Cesare Mazzaro, Manuela Bertola, Ornella Schioppa, Antonio Benedetti, Laura Schiadà, Monica Cucco, Andrea Giacometti, Laura Brescini, Sefora Castelletti, Alessandro Fiorentini, Gioacchino Angarano, Michele Milella, Alfredo Di Leo, Maria Rendina, Fulvio Salvatore D'abramo, Chiara Lillo, Andrea Iannone, Mariano Piazzolla, Lorenzo Badia, Fabio Piscaglia, Francesca Benevento, Ilaria Serio, Francesco Castelli, Serena Zaltron, Angiola Spinetti, Silvia Odolini, Raffaele Bruno, Mario Mondelli, Luchino Chessa, Martina Loi, Carlo Torti, Chiara Costa, Maria Mazzitelli, Vincenzo Pisani, Vincenzo Scaglione, Enrico Maria Trecarichi, Anna Linda Zignego, Monica Monti, Francesco Madia, Letizia Attala, Piera Pierotti, Elena Salomoni, Elisa Mariabelli, Teresa Antonia Santantonio, Serena Rita Bruno, Ester Marina Cela, Matteo Bassetti, Giovanni Mazzarello, Anna Ida Alessandrini, Antonio Di Biagio, Laura Ambra Nicolini, Giovanni Raimondo, Roberto Filomia, Alessio Aghemo, Rossella Meli, Adriano Lazzarin, Stefania Salpietro, Anna Ludovica Fracanzani, Erika Fatta, Rosa Lombardi, Pietro Lampertico, Marta Borghi, Roberta D'ambrosio, Elisabetta Degasperi, Massimo Puoti, Chiara Baiguera, Federico D'amico, Maria Vinci, Maria Grazia Rumi, Massimo Zuin, Paola Zermiani, Pietro Andreone, Paolo Caraceni, Valeria Guarneri, Erica Villa, Veronica Bernabucci, Laura Bristot, Maria Luisa Paradiso, Guglielmo Migliorino, Alessandra Gambaro, Giuseppe Lapadula, Anna Spolti, Alessandro Soria, Pietro Invernizzi, Antonio Ciaccio, Martina LucÀ, Federica Malinverno, Laura Ratti, Daniela Caterina Amoruso, Federica Pisano, Ferdinando Scarano, Laura Staiano, Filomena Morisco, Valentina Cossiga, Ivan Gentile, Antonio Riccardo Buonomo, Maria Foggia, Emanuela Zappulo, Alessandro Federico, Marcello Dallio, Nicola Coppola, Caterina Sagnelli, Salvatore Martini, Caterina Monari, Gerardo Nardone, Costantino Sgamato, Liliana Chemello, Luisa Cavalletto, Daniela Sterrantino, Alberto Zanetto, Paola Zanaga, Giuseppina Brancaccio, Antonio Craxì, Salvatore Petta, Vincenza Calvaruso, Luciano Crapanzano, Salvatore Madonia, Marco Cannizzaro, Erica Maria Bruno, Anna Licata, Simona Amodeo, Adele Rosaria Capitano, Carlo Ferrari, Elisa Negri, Alessandra Orlandini, Marco Pesci, Roberto Gulminetti, Layla Pagnucco, Giustino Parruti, Paola Di Stefano, Barbara Coco, Romina Corsini, Elisa Garlassi, Massimo Andreoni, Elisabetta Teti, Carlotta Cerva, Lorenzo Baiocchi, Giuseppe Grassi, Antonio Gasbarrini, Maurizio Pompili, Martina De Siena, Gloria Taliani, Martina Spaziante, Marcello Persico, Mario Masarone, Andrea Aglitti, Gemma Calvanese, Marco Anselmo, Pasqualina De Leo, Monica Marturano, Giorgio Maria Saracco, Quaranta M.G., Ferrigno L., Tata X., D'Angelo F., Massari M., Coppola C., Biliotti E., Giorgini A., Laccabue D., Ciancio A., Blanc P.L., Margotti M., Ieluzzi D., Brunetto M.R., Barbaro F., Russo F.P., Beretta I., Morsica G., Verucchi G., Saracino A., Galli M., Kondili L.A., Mazzaro C., Bertola M., Benedetti A., Schiada L., Cucco M., Giacometti A., Brescini L., Castelletti S., Fiorentini A., Angarano G., Milella M., Leo A.D., Rendina M., Salvatore D'ABRAMO F., Lillo C., Iannone A., Piazzolla M., Badia L., Piscaglia F., Benevento F., Serio I., Castelli F., Zaltron S., Spinetti A., Odolini S., Bruno R., Mondelli M., Chessa L., Loi M., Torti C., Costa C., Mazzitelli M., Pisani V., Scaglione V., Trecarichi E.M., Zignego A.L., Monti M., Madia F., Attala L., Pierotti P., Salomoni E., Mariabelli E., Santantonio T.A., Bruno S.R., Cela E.M., Bassetti M., Mazzarello G., Alessandrini A.I., Biagio A.D., Nicolini L.A., Raimondo G., Filomia R., Aghemo A., Meli R., Lazzarin A., Salpietro S., Fracanzani A.L., Fatta E., Lombardi R., Lampertico P., Borghi M., D'ambrosio R., Degasperi E., Puoti M., Baiguera C., D'AMICO F., Vinci M., Rumi M.G., Zuin M., Zermiani P., Andreone P., Caraceni P., Guarneri V., Villa E., Bernabucci V., Bristot L., Paradiso M.L., Migliorino G., Gambaro A., Lapadula G., Spolti A., Soria A., Invernizzi P., Ciaccio A., LucA M., Malinverno F., Ratti L., Amoruso D.C., Pisano F., Scarano F., Staiano L., Morisco F., Cossiga V., Gentile I., Buonomo A.R., Foggia M., Zappulo E., Federico A., Dallio M., Coppola N., Sagnelli C., Martini S., Monari C., Nardone G., Sgamato C., Chemello L., Cavalletto L., Sterrantino D., Zanetto A., Zanaga P., Brancaccio G., Craxi A., Petta S., Calvaruso V., Crapanzano L., Madonia S., Cannizzaro M., Bruno E.M., Licata A., Amodeo S., Capitano A.R., Ferrari C., Negri E., Orlandini A., Pesci M., Gulminetti R., Pagnucco L., Parruti G., Stefano P.D., Coco B., Corsini R., Garlassi E., Andreoni M., Teti E., Cerva C., Baiocchi L., Grassi G., Gasbarrini A., Pompili M., Siena M.D., Taliani G., Spaziante M., Persico M., Masarone M., Aglitti A., Calvanese G., Anselmo M., Leo P.D., Marturano M., Saracco G.M., Quaranta, M, Ferrigno, L, Tata, X, D'Angelo, F, Massari, M, Coppola, C, Biliotti, E, Giorgini, A, Laccabue, D, Ciancio, A, Blanc, P, Margotti, M, Ieluzzi, D, Brunetto, M, Barbaro, F, Russo, F, Beretta, I, Morsica, G, Verucchi, G, Saracino, A, Galli, M, Kondili, L, Mazzaro, C, Bertola, M, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Fiorentini, A, Angarano, G, Milella, M, Leo, A, Rendina, M, Salvatore D'ABRAMO, F, Lillo, C, Iannone, A, Piazzolla, M, Badia, L, Piscaglia, F, Benevento, F, Serio, I, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Bruno, R, Mondelli, M, Chessa, L, Loi, M, Torti, C, Costa, C, Mazzitelli, M, Pisani, V, Scaglione, V, Trecarichi, E, Zignego, A, Monti, M, Madia, F, Attala, L, Pierotti, P, Salomoni, E, Mariabelli, E, Santantonio, T, Bruno, S, Cela, E, Bassetti, M, Mazzarello, G, Alessandrini, A, Biagio, A, Nicolini, L, Raimondo, G, Filomia, R, Aghemo, A, Meli, R, Lazzarin, A, Salpietro, S, Fracanzani, A, Fatta, E, Lombardi, R, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Puoti, M, Baiguera, C, D'Amico, F, Vinci, M, Rumi, M, Zuin, M, Zermiani, P, Andreone, P, Caraceni, P, Guarneri, V, Villa, E, Bernabucci, V, Bristot, L, Paradiso, M, Migliorino, G, Gambaro, A, Lapadula, G, Spolti, A, Soria, A, Invernizzi, P, Ciaccio, A, Luca, M, Malinverno, F, Ratti, L, Amoruso, D, Pisano, F, Scarano, F, Staiano, L, Morisco, F, Cossiga, V, Gentile, I, Buonomo, A, Foggia, M, Zappulo, E, Federico, A, Dallio, M, Coppola, N, Sagnelli, C, Martini, S, Monari, C, Nardone, G, Sgamato, C, Chemello, L, Cavalletto, L, Sterrantino, D, Zanetto, A, Zanaga, P, Brancaccio, G, Craxi, A, Petta, S, Calvaruso, V, Crapanzano, L, Madonia, S, Cannizzaro, M, Bruno, E, Licata, A, Amodeo, S, Capitano, A, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Gulminetti, R, Pagnucco, L, Parruti, G, Stefano, P, Coco, B, Corsini, R, Garlassi, E, Andreoni, M, Teti, E, Cerva, C, Baiocchi, L, Grassi, G, Gasbarrini, A, Pompili, M, Siena, M, Taliani, G, Spaziante, M, Persico, M, Masarone, M, Aglitti, A, Calvanese, G, Anselmo, M, Leo, P, Marturano, M, Saracco, G, Quaranta, M. G., Ferrigno, L., Tata, X., D'Angelo, F., Massari, M., Coppola, C., Biliotti, E., Giorgini, A., Laccabue, D., Ciancio, A., Blanc, P. L., Margotti, M., Ieluzzi, D., Brunetto, M. R., Barbaro, F., Russo, F. P., Beretta, I., Morsica, G., Verucchi, G., Saracino, A., Galli, M., Kondili, L. A., Mazzaro, C., Bertola, M., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Fiorentini, A., Angarano, G., Milella, M., Leo, A. D., Rendina, M., Salvatore D'ABRAMO, F., Lillo, C., Iannone, A., Piazzolla, M., Badia, L., Piscaglia, F., Benevento, F., Serio, I., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Bruno, R., Mondelli, M., Chessa, L., Loi, M., Torti, C., Costa, C., Mazzitelli, M., Pisani, V., Scaglione, V., Trecarichi, E. M., Zignego, A. L., Monti, M., Madia, F., Attala, L., Pierotti, P., Salomoni, E., Mariabelli, E., Santantonio, T. A., Bruno, S. R., Cela, E. M., Bassetti, M., Mazzarello, G., Alessandrini, A. I., Biagio, A. D., Nicolini, L. A., Raimondo, G., Filomia, R., Aghemo, A., Meli, R., Lazzarin, A., Salpietro, S., Fracanzani, A. L., Fatta, E., Lombardi, R., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Puoti, M., Baiguera, C., D'Amico, F., Vinci, M., Rumi, M. G., Zuin, M., Zermiani, P., Andreone, P., Caraceni, P., Guarneri, V., Villa, E., Bernabucci, V., Bristot, L., Paradiso, M. L., Migliorino, G., Gambaro, A., Lapadula, G., Spolti, A., Soria, A., Invernizzi, P., Ciaccio, A., Luca, M., Malinverno, F., Ratti, L., Amoruso, D. C., Pisano, F., Scarano, F., Staiano, L., Morisco, F., Cossiga, V., Gentile, I., Buonomo, A. R., Foggia, M., Zappulo, E., Federico, A., Dallio, M., Coppola, N., Sagnelli, C., Martini, S., Monari, C., Nardone, G., Sgamato, C., Chemello, L., Cavalletto, L., Sterrantino, D., Zanetto, A., Zanaga, P., Brancaccio, G., Craxi, A., Petta, S., Calvaruso, V., Crapanzano, L., Madonia, S., Cannizzaro, M., Bruno, E. M., Licata, A., Amodeo, S., Capitano, A. R., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Gulminetti, R., Pagnucco, L., Parruti, G., Stefano, P. D., Coco, B., Corsini, R., Garlassi, E., Andreoni, M., Teti, E., Cerva, C., Baiocchi, L., Grassi, G., Gasbarrini, A., Pompili, M., Siena, M. D., Taliani, G., Spaziante, M., Persico, M., Masarone, M., Aglitti, A., Calvanese, G., Anselmo, M., Leo, P. D., Marturano, M., and Saracco, G. M.

Subjects
Male, HCV genotypes, Ethnic group, Linked-to-care patient, Comorbidity, Hepacivirus, Logistic regression, medicine.disease_cause, Comorbidities, Direct acting antivirals, HCV Cohort, Linked-to-care patients, Aged, Antiviral Agents, Coinfection, Female, Hepatitis C, Chronic, Humans, Italy, Middle Aged, Transients and Migrants, 0302 clinical medicine, Medicine, Chronic, Gastroenterology, virus diseases, Hepatitis C, Life evaluation, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Comorbiditie, Human, Hepatitis C virus, Settore MED/12 - GASTROENTEROLOGIA, 03 medical and health sciences, Disease severity, Antiviral Agent, Hepaciviru, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, medicine.disease, digestive system diseases, Direct acting antiviral, business, Demography
Abstract

Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively. Conclusion: Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted.

Published
2021

3. Tocilizumab and steroid treatment in patients with COVID-19 pneumonia

Author

Ferdinando Dodi, Marco Camera, Chiara Dentone, Silvia Dettori, Angelo Gratarola, Andrea De Maria, Chiara Russo, Antonio Ferrazin, Federico Baldi, Giorgio Da Rin, Stefania Tutino, A. Alessandrini, Daniele Roberto Giacobbe, Federica Portunato, Emanuela Barisione, Rachele Pincino, Sara Mora, Laura Labate, Maria Pia Sormani, Michele Mirabella, Giancarlo Icardi, Mauro Giacomini, Marco Berruti, Elisabetta Sasso, Malgorzata Mikulska, Lucia Taramasso, Paolo Pelosi, Laura Magnasco, Elisa Balletto, Emanuele Delfino, Federica Briano, Laura Ambra Nicolini, Bianca Bruzzone, Nirmala Rosseti, Antonio Di Biagio, Giovanni Mazzarello, Federica Toscanini, Antonio Vena, Alessio Signori, Chiara Sepulcri, Eva Schenone, Andrea Orsi, Matteo Bassetti, and Sabrina Beltramini

Subjects
Male, 0301 basic medicine, Viral Diseases, Pulmonology, Cancer Treatment, Anti-Inflammatory Agents, Biochemistry, COVID-19, C-reactive proteins, Ferritin, Hospitals, Steroids, Cytokine therapy, Pneumonia, Oxygen, chemistry.chemical_compound, Medical Conditions, 0302 clinical medicine, Medicine and Health Sciences, Clinical endpoint, 030212 general & internal medicine, Darunavir, Aged, 80 and over, Multidisciplinary, Organic Compounds, Hazard ratio, Middle Aged, C-Reactive Proteins, Chemistry, Infectious Diseases, Treatment Outcome, Oncology, Methylprednisolone, Physical Sciences, Medicine, Female, Coronavirus Infections, Research Article, Chemical Elements, Hydroxychloroquine, medicine.drug, Adult, medicine.medical_specialty, Science, Pneumonia, Viral, 030106 microbiology, Cytokine Therapy, Antibodies, Monoclonal, Humanized, Antimalarials, Betacoronavirus, 03 medical and health sciences, Tocilizumab, Internal medicine, medicine, Humans, Pandemics, Aged, Ritonavir, SARS-CoV-2, business.industry, Organic Chemistry, Chemical Compounds, Biology and Life Sciences, Proteins, Protein Complexes, Covid 19, HIV Protease Inhibitors, medicine.disease, COVID-19 Drug Treatment, Health Care, chemistry, Respiratory failure, Health Care Facilities, Adjunctive treatment, business, Follow-Up Studies
Abstract

IntroductionCoronavirus disease 2019 (COVID-19) can lead to respiratory failure due to severe immune response. Treatment targeting this immune response might be beneficial but there is limited evidence on its efficacy.The aim of this study was to determine if early treatment of patients with COVID-19 pneumonia with tocilizumab and/or steroids was associated with better outcome.MethodsThis observational single-center study included patients with COVID-19 pneumonia who were not intubated and received either standard of care (SOC, controls) or SOC plus early (within 3 days from hospital admission) anti-inflammatory treatment. SOC consisted of hydroxychloroquine 400mg bid plus, in those admitted before March 24th, also darunavir/ritonavir. Anti-inflammatory treatment consisted of either tocilizumab (8mg/kg intravenously or 162mg subcutaneously) or methylprednisolone 1 mg/kg for 5 days or both. Failure was defined as intubation or death, and the endpoints were failure-free survival (primary endpoint) and overall survival (secondary) at day 30. Difference between the groups was estimated as Hazard Ratio by a propensity score weighted Cox regression analysis (HROW).ResultsOverall, 196 adults were included in the analyses. They were mainly male (67.4%), with comorbidities (78.1%) and severe COVID-19 pneumonia (83.7%). Median age was 67.9 years (range, 30-100) and median PaO2/FiO2200 mmHg (IQR 133-289). Among them, 130 received early anti-inflammatory treatment with: tocilizumab (n=29, 22.3%), methylprednisolone (n=45, 34.6%), or both (n=56, 43.1%). The adjusted failure-free survival among tocilizumab/methylprednisolone/SOC treated patients vs. SOC was 80.8% (95%CI, 72.8-86.7) vs. 64.1% (95%CI, 51.3-74.0), HROW0.48, 95%CI, 0.23-0.99; p=0.049. The overall survival among tocilizumab/methylprednisolone/SOC patients vs. SOC was 85.9% (95%CI, 80.7-92.6) vs. 71.9% (95%CI, 46-73), HROW0.41, 95%CI: 0.19-0.89, p=0.025.ConclusionEarly adjunctive treatment with tocilizumab, methylprednisolone or both may improve outcomes in non-intubated patients with COVID-19 pneumonia.

Published
2020

4. Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy

Author

Antonio Vena, Daniele Roberto Giacobbe, Antonio Di Biagio, Malgorzata Mikulska, Lucia Taramasso, Andrea De Maria, Lorenzo Ball, Iole Brunetti, Maurizio Loconte, Nicolò A. Patroniti, Chiara Robba, Emanuele Delfino, Chiara Dentone, Laura Magnasco, Laura Nicolini, Federica Toscanini, Martina Bavastro, Matteo Cerchiaro, Emanuela Barisione, Mauro Giacomini, Sara Mora, Federico Baldi, Elisa Balletto, Marco Berruti, Federica Briano, Chiara Sepulcri, Silvia Dettori, Laura Labate, Michele Mirabella, Federica Portunato, Rachele Pincino, Chiara Russo, Stefania Tutino, Paolo Pelosi, Matteo Bassetti, Anna Alessandrini, Marco Camera, Ferdinando Dodi, Antonio Ferrazin, Giovanni Mazzarello, Daniele R. Giacobbe, Eva Schenone, Nirmala Rosseti, Chiara russo, Giovanni Sarteschi, Chiara sepulcri, Roberto Pontremoli, Valentina Beccati, Salvatore Casciaro, Massimo Casu, Francesco Gavaudan, Maria Ghinatti, Elisa Gualco, Giovanna Leoncini, Paola pitto, Kassem salam, Angelo Gratarola, Mattia Bixio, Annalisa Amelia, Andrea Balestra, Paola Ballarino, Nicholas Bardi, Roberto Boccafogli, Francesca Caserza, Elisa Calzolari, Marta Castelli, Elisabetta Cenni, Paolo Cortese, Giuseppe Cuttone, Sara Feltrin, Stefano Giovinazzo, Patrizia Giuntini, Letizia Natale, Davide Orsi, Matteo Pastorino, Tommaso Perazzo, Fabio Pescetelli, Federico Schenone, Maria G. Serra, Marco Sottano, Roberto Tallone, Massimo Amelotti, Marie J. Majabò, Massimo Merlini, Federica Perazzo, Nidal Ahamd, Paolo Barbera, Marta Bovio, Paola Campodonico, Andrea Collidà, Ombretta Cutuli, Agnese Lomeo, Francesca Fezza, Nicola Gentilucci, Nadia Hussein, Emanuele Malvezzi, Laura Massobrio, Giula Motta, Laura Pastorino, Nicoletta Pollicardo, Stefano Sartini, Paola Vacca, Valentina Virga, Italo Porto, Giampaolo Bezante, Roberta Della Bona, Giovanni La Malfa, Alberto Valbusa, Vered G. Ad, Michele Bellotti, Aloe’ Teresita, Alessandro Blanco, Marco Grosso, Maria Grazia Piroddi, Paolo Moscatelli, Matteo Caiti, Ottavia Magnani, Samir Sukkar, Ludovica Cogorno, Raffaella Gradaschi, Erica Guiddo, Eleonora Martino, Livia Pisciotta, Bruno Cavagliere, Rossi Cristina, Farina Francesca, Giacomo Garibotto, Pasquale Esposito, Carmen Bellezza, Emirjona Harusha, Francesca Rossi, Eleonora Arboscello, Laura Arzani, Laura De Mattei, Marzia Spadaro, Giovanni Passalacqua, Diego Bagnasco, Fulvio Braido, Annamaria Riccio, Elena Tagliabue, Claudio Gustavino, Antonella Ferraiolo, Fiammetta Monacelli, Mona Mahmoud, Luca Tagliafico, Armando Napolitano, Maria Fiorio, Monica Pizzonia, Chiara Giannotti, Alessio Nencioni, Salvatore Giuffrida, Nicola Rosso, Alessandra Morando, Riccardo Papalia, Donata Passerini, Gabriella Tiberio, Giovanni Orengo, Alberto Battaglini, Silvano Ruffoni, and Sergio Caglieris

Subjects
0301 basic medicine, Male, ARDS, medicine.medical_treatment, Disease, law.invention, 0302 clinical medicine, COVID-19 Testing, law, Risk Factors, Cause of Death, 80 and over, Severe acute respiratory syndrome coronavirus 2, 030212 general & internal medicine, Hospital Mortality, Viral, Cause of death, Acute respiratory distress syndrome, Coronavirus disease 2019, General Medicine, Middle Aged, Intensive care unit, Hospitalization, Infectious Diseases, Italy, Vomiting, Female, medicine.symptom, Coronavirus Infections, Interleukin-6, Mortality, Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Clinical Laboratory Techniques, Humans, Pandemics, Pneumonia, Viral, Retrospective Studies, SARS-CoV-2, Microbiology (medical), medicine.medical_specialty, Nausea, 030106 microbiology, 03 medical and health sciences, Internal medicine, medicine, Mechanical ventilation, business.industry, Retrospective cohort study, Pneumonia, medicine.disease, business
Abstract

Objectives To describe clinical characteristics, management and outcome of individuals with coronavirus disease 2019 (COVID-19); and to evaluate risk factors for all-cause in-hospital mortality. Methods This retrospective study from a University tertiary care hospital in northern Italy, included hospitalized adult patients with a diagnosis of COVID-19 between 25 February 2020 and 25 March 2020. Results Overall, 317 individuals were enrolled. Their median age was 71 years and 67.2% were male (213/317). The most common underlying diseases were hypertension (149/317; 47.0%), cardiovascular disease (63/317; 19.9%) and diabetes (49/317; 15.5%). Common symptoms at the time of COVID-19 diagnosis included fever (285/317; 89.9%), shortness of breath (167/317; 52.7%) and dry cough (156/317; 49.2%). An ‘atypical' presentation including at least one among mental confusion, diarrhoea or nausea and vomiting was observed in 53/317 patients (16.7%). Hypokalaemia occurred in 25.8% (78/302) and 18.5% (56/303) had acute kidney injury. During hospitalization, 111/317 patients (35.0%) received non-invasive respiratory support, 65/317 (20.5%) were admitted to the intensive care unit (ICU) and 60/317 (18.5%) required invasive mechanical ventilation. All-cause in-hospital mortality, assessed in 275 patients, was 43.6% (120/275). On multivariable analysis, age (per-year increase OR 1.07; 95% CI 1.04–1.10; p Conclusions COVID-19 mainly affected elderly patients with predisposing conditions and caused severe illness, frequently requiring non-invasive respiratory support or ICU admission. Despite supportive care, COVID-19 remains associated with a substantial risk of all-cause in-hospital mortality.

Published
2020

5. Second outbreak of Trichinella pseudospiralis in Europe: clinical patterns, epidemiological investigation and identification of the etiological agent based on the western blot patterns of the patients' serum

Author

Giovanni Orefice, Maria Cristina Bisso, Laura Arenare, Maria Angeles Gómez-Morales, Patrizio Pezzotti, Federica Magnè, Giovanni Mazzarello, Marco Amati, Edoardo Pozio, Alessandra Ludovisi, Claudio Viscoli, Elisabetta Bondi, and Elio Castagnola

Subjects
0301 basic medicine, Male, Veterinary medicine, Anti-Inflammatory Agents, Trichinella, Trichinella pseudospiralis, Disease Outbreaks, 0302 clinical medicine, Trichinella britovi, Food Parasitology, Zoonoses, Epidemiology, Cooking, Child, Anthelmintics, medicine.diagnostic_test, biology, Middle Aged, Infectious Diseases, Italy, Child, Preschool, Female, Original Article, epidemiology, wild boar, Adult, trichinellosis, medicine.medical_specialty, Adolescent, Prednisolone, 030106 microbiology, 030231 tropical medicine, Trichinella spiralis, Blotting, Western, Albendazole, 03 medical and health sciences, Western blot, Wild boar, biology.animal, parasitic diseases, medicine, Animals, Humans, western blot, General Veterinary, General Immunology and Microbiology, outbreak, Public Health, Environmental and Occupational Health, Outbreak, Infant, Original Articles, biology.organism_classification, Red Meat, Etiology
Abstract

Trichinellosis is a zoonotic disease due to the ingestion of raw or undercooked meat from animals infected with the larvae of nematodes belonging to the genus Trichinella. In January–February 2015, an outbreak of trichinellosis occurred in Genoa, Northern Italy. The epidemiological link was traced back to a dinner served at an agritourism farm on 31 December 2014, where a majority of the 52 guests had consumed the ‘beef’ steak tartare. The source of infection was not traced; however, it was noted that the amount of beef purchased officially for providing at the dinner did not correspond with that served, suggesting that meat of a different origin had been added to the beef to prepare the steak tartare. Clinical and laboratory data of 30 individuals out of the 52 (57.7%), of which four were hospitalized, were consistent with that of the case definition of trichinellosis. Western blot patterns of the sera from patients with confirmed trichinellosis were similar to the diagnostic pattern identified for the reference sera of Trichinella pseudospiralis but different from those of the control sera tested for patients infected with Trichinella spiralis and Trichinella britovi. Identification of T. pseudospiralis as the aetiological agent responsible for the outbreak of trichinellosis using an indirect tool represents an advancement in the epidemiological investigation of this zoonotic disease.

Published
2019

6. Durability of first-line regimens including integrase strand transfer inhibitors (INSTIs): data from a real-life setting

Author

Antonella d'Arminio Monforte, Alessandro, Cozzi-Lepri, DI BIAGIO, Antonio, Giulia, Marchetti, Sergio Lo Caputo, Stefano, Rusconi, Nicola, Gianotti, Valentina, Mazzotta, Giovanni, Mazzarello, Andrea, Costantini, Antonella, Castagna, Andrea, Antinori, A d'Arminio Monforte, Antinori, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, G Di Perri, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, C Marchetti, G, Rezza, G, F von Schloesser, Viale, P, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Girardi, E, S Lo Caputo, Mussini, C, Puoti, M, F Perno, C, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, R Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, A De Luca, A Di Biagio, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Monno, L, Nozza, S, Pinnetti, C, E Quiros Roldan, Rossotti, R, Rusconi, S, M Santoro, M, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodan(`(o))', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, A Di Caro, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Fabrizio, C, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Pozzetto, I, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellican(`(o)), G, Rizzardini, G, Bai, F, C Moioli, M, Piolini, R, L Ridolfo, A, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, F Di Martino, Gentile, I, Maddaloni, L, M Cattelan, A, Marinello, S, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, A Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Baldin, G, Capozzi, M, Mondi, A, M Rivano Capparucia, Iaiani, G, Latini, A, Gagliardini, R, M Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, Bagella, P, Rossetti, B, Franco, A, R Fontana Del Vecchio, Francisci, D, C Di Giuli, Caramello, P, C Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, A Ialungo and, d'Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro, Di Biagio, Antonio, Marchetti, Giulia, Lo Caputo, Sergio, Rusconi, Stefano, Gianotti, Nicola, Mazzotta, Valentina, Mazzarello, Giovanni, Costantini, Andrea, Castagna, Antonella, and Antinori, Andrea

Subjects
0301 basic medicine, Male, Integrase inhibitor, hiv, HIV Infections, Quinolones, Piperazines, Settore MED/07, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, HIV Seropositivity, Pharmacology (medical), 030212 general & internal medicine, Treatment Failure, risk reduction, cd4 count, toxic effect, Elvitegravir, cox proportional hazards models, Cobicistat, hiv, cd4 count, determination procedure, hiv seropositivity, integrase inhibitors, plasma, treatment failure, virology, toxic effect, risk reduction, cox proportional hazards models, elvitegravir, raltegravir, surrogate endpoints, cobicistat, dolutegravir, time-to-treatment, Middle Aged, virology, dolutegravir, Infectious Diseases, integrase inhibitors, Italy, Dolutegravir, hiv,cd4 count determination procedure, hiv seropositivity, integrase inhibitors, plasma, treatment failure, virology, toxic effect, risk reduction, cox proportional hazards models, elvitegravir, raltegravir, surrogate endpoints, cobicistat, dolutegravir, time-to-treatment, elvitegravir, Regression Analysis, Female, raltegravir, Heterocyclic Compounds, 3-Ring, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, Pyridones, 030106 microbiology, time-to-treatment, Lower risk, 03 medical and health sciences, Internal medicine, Raltegravir Potassium, Oxazines, medicine, Humans, HIV Integrase Inhibitors, plasma, Pharmacology, business.industry, Surrogate endpoint, Raltegravir, Survival Analysis, Discontinuation, CD4 Lymphocyte Count, chemistry, determination procedure, surrogate endpoints, business
Abstract

Objectives To evaluate the durability of three integrase strand transfer inhibitors (INSTIs) and two NRTIs in ART-naive individuals. Methods The study design was observational. Patients were HIV-positive, ART-naive subjects starting raltegravir, elvitegravir/cobicistat or dolutegravir with two NRTIs. The primary endpoint was time to treatment failure, i.e. occurrence of virological failure (first of two consecutive plasma HIV RNAs ≥200 copies/mL after 24 weeks) or INSTI discontinuation for any reason apart from simplification. Secondary endpoints were INSTI discontinuation due to toxicity/intolerance and CD4 count response. Survival analysis was done using Kaplan-Meier and Cox regression. Results Two thousand and sixteen patients were included: 310 (15.4%) started raltegravir-based regimens, 994 (49.3%) started dolutegravir-based regimens and 712 (35.3%) started elvitegravir/cobicistat-based regimens. Over a median of 11 months, 167 patients experienced treatment failure; the 1 year probability of treatment failure was 6.5% for raltegravir, 5.4% for dolutegravir and 6.7% for elvitegravir/cobicistat (P = 0.001). Sixty-eight patients (3.4%) discontinued INSTIs owing to toxicity/intolerance. By multivariable analysis, patients starting raltegravir had a 2.03-fold (95% CI = 1.2-3.2) higher risk and patients on elvitegravir/cobicistat a 1.88-fold (95% CI = 1.2-2.9) higher risk of treatment failure versus dolutegravir; there was no difference in risk of discontinuation due to toxicity/intolerance when comparing dolutegravir and raltegravir and marginal evidence for a difference when comparing elvitegravir/cobicistat and dolutegravir (adjusted relative hazard = 1.94 for elvitegravir/cobicistat versus dolutegravir, 95% CI = 1.00-3.76, P = 0.05). Conclusions In our real-life setting, INSTI-based regimens showed high potency and durability. Among regimens currently recommended in Europe, those including dolutegravir are associated with a lower risk of treatment failure.

Published
2018

7. Quality of life in an Italian cohort of people living with HIV in the era of combined antiretroviral therapy (Evidence from I.A.N.U.A. study-investigation on antiretroviral therapy)

Author

Marcello Montefiori, Maurizio Setti, Barbara Giannini, Giovanni Cassola, C. Merlano, Giovanni Cenderello, Mauro Giacomini, Claudio Viscoli, Patrizia Orcamo, A. Di Biagio, Giovanni Mazzarello, Alberto Venturini, and Marta Ameri

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Health (social science), Social Psychology, Human immunodeficiency virus (HIV), HIV Infections, coinfection HIV-HCV, HIV, Quality of life, CD4+, coinfection HIV-HCV, HIV-RNA, medicine.disease_cause, CD4+, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Quality of life, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Aged, Aged, 80 and over, Multivariable linear regression, business.industry, Public Health, Environmental and Occupational Health, HIV, Middle Aged, Viral Load, medicine.disease, 030112 virology, Antiretroviral therapy, humanities, HIV-RNA, Cross-Sectional Studies, Anti-Retroviral Agents, Italy, Family medicine, Cohort, Immunology, Coinfection, Quality of Life, Female, business, Viral load
Abstract

The aims of this study were to assess the Health Related Quality of Life (HRQoL) of People Living with HIV/AIDS (PLWHA) who attend outpatient services in Genoa, Italy, and to evaluate the relationship between HRQoL and clinical factors, primarily: CD4+ cell count, viral load and HIV-Hepatitis C Virus (HCV) coinfection. A cross-sectional study was performed involving a sample of 943 consecutive patients. Firstly the EuroQol-Five Dimensions-Three Level (EQ-5D-3L) self-reported questionnaire was used to evaluate HRQoL, while socio-demographic information was collected using a separate self-administered questionnaire. Descriptive statistical analysis was then used to show the socio-demographic and clinical characteristics of the sample. Having characterized the sample, Pearson's correlation technique was used to assess the relationship between HRQoL and socio-demographic and clinical characteristics. Finally, multivariable linear regression was used to determine factors associated with HRQOL. The median EQ-Visual analogue scale (EQ-VAS) score was 75.4 (SD 18.4). We found statistically significant associations between the EQ-VAS score and age, coinfection with HCV+, education, other drugs taken over cART, hospitalization due to HIV and a CD4+ cell count200 mm

Published
2017

8. Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

Author

Margherita Busso, Tullio Prestileo, Ermenegildo Francavilla, Marco Anselmo, Francesco Montella, Evangelista Sagnelli, Teresa Santantonio, Massimo Galli, Marcello Saitta, Giuseppe Foti, Cecilia Guariglia, Franco Baldelli, Simona Di Gianbenedetto, Pierluigi Viale, Francesco Castelli, Antonella d'Arminio Monforte, Angelo Pan, Gabriella D’Ettore, Maria Dorrucci, Salvatore Bruno, Tiziana Quirino, Mariangela Raimondo, Alessandro Bartoloni, Vinicio Manfrin, Giovanni Mazzarello, Eugenio Mantia, Raffaele Pempinello, Antonio Traverso, Barbara Suligoi, Fabio Bulla, Pietro Mesina, Alessia Zoncada, Gianfranco Orofino, Oliviero Bosco, Gianmichele Moise, Angelo Salomone Megna, Roberto Ferretto, Mauro Valle, Manuela Colafigli, Claudio Paternoster, S. Artioli, Giovanni Riccio, Stefania Bernardi, Paolo Grossi, Milena Zoppi, Sebastiano Maiuzzo, Giorgio Perboni, Sauro Tini, Giuseppe Ferrea, Nicoletta Ladisa, Enzo M. Farinella, Daniela Francisci, Dino Sgarabotto, Roberto Monarca, Enzo Petrelli, A. Franco, Izzo Cm, Pietro Bellissima, Francesco Ortu, Laura Sighinolfi, Antonio Chirianni, Filippo Bartalesi, Giulio De Stefano, Claudia Colomba, Laura Camoni, Salvatore Galvagna, Benedetto Maurizio Celesia, Andrea Petrucci, Camillo Baretti, Pierluigi Brugnaro, Federica Poletti, Maurilio Chimenti, Camilla Ajassa, Mario Falciano, Rosaria La Sala, Sauro Luchi, V. Portelli, Annamaria Degli Antoni, Francesco Mazzotta, Giuliano Zuccati, Vincenzo Colangeli, Ercole Concia, Giordano Madeddu, Maria Cristina Salfa, Francesca Cattelan, Nicola Acone, Vincenza Regine, Olivia Bargiacchi, Maurizio de Martino, F. Paoletti, Giovanni Cassola, Giuliano Schettino, Carlo De Stefano, Enza Anzalone, D. Aquilini, Giacomo Magnani, Vanni Borghi, Roberta Gastaldi, Alessandra Govoni, Cristina Rossi, Rita Consolini, Gioacchino Angarano, Gloria Taliani, Tommaso Fontana, Sergio Lo Caputo, Davide Vitullo, Pierpaolo Congedo, Emanuela Vaccher, Paolo Viganò, Maria Stella Mura, Claudio Cancellieri, Enrico Girardi, Francesca Savalli, Cecilia Fico, Anna Maria Cattelan, Alessandro Chiodera, Renzo Scaggiante, P. Osimani, Caterina Bramato, Nicola Pietrosillo, Giovanna D'Alessio, Salvatore Bonfante, Vincenzo Vullo, Andrea Gori, Margherita Dalessandro, Domenico Lucchino, Massimo Deseraca, Paolo Tundo, Alfredo Pennica, M. Paoloni, Antonella Castagna, Nicola Serrao, Paolo Costa, Franco Marranconi, Massimo Villa, Pietro Filippini, Maurizio Setti, Eligio Pizzigallo, Marco Tinelli, Mauro Marchili, Domenico Santoro, Cesira Nencioni, Piera Dones, Vincenzo Renda, Alberto Giannetti, Domenico La Rovere, Nicoletta Dorigoni, Guido Palamara, Angelo Iodice, Clara Gabiano, Peter Mian, Luigi Guarnieri, Andrea De Luca, Nicola Tripodi, Giovanni Cristina, Giustino Parruti, Maria Montroni, Loredana Palvarini, Marco Rizzi, Benvenuto Grisorio, Corrado Catalani, Paolo Emilio Manconi, Jacopo Vecchiett, Tiziana Carli, Riccardo Iapoce, Massimo Andreoni, Adriano Lazzarin, Giorgetta Casalino Finocchio, D Sacchini, Mario Gobber, Spartaco Sani, Marco Campus, Rosario La Rosa, Maurizio Mazzeo, Stefano Bonora, Michele Trezzi, Paolo Bassi, Angela La Gala, Alessandro Grimaldi, Dante Di Giammartino, Guido Leo, Gaetano Filice, Antonio Salvo, Paolo Bonfanti, Chiara Pasqualini, Marcello Tavio, Luca Butini, N. Abrescia, Angela Linzalone, Gianpaolo Natalini Ramponi, Pierangelo Rovere, Piero Cortese, Dario Bartolozzi, F. Resta, Miriam Lichtner, Loredana Sarmati, Francesco Cesario, Renato F. Frongillo, Ivano Mezzaroma, Carlo Ferrari, Lorenzo Minoli, Paola Di Stefano, Lucina Titone, Rosa Boncoraglio, Mariana Farenga, Giuliano Rizzardini, Stefano Aviani Barbacci, Andrea Giacometti, Andrea Antinori, Antonio Caterini, Consuelo Geraci, Piergiorgio Chiriacò, Lucio Cosco, Claudio Viscoli, Alfredo Scalzini, Sandro Piga, Massimo Arlotti, Cecilia Occhino, Roberto Luzzati, Paola Sabbatini, Guglielmo Borgia, Umberto Tirelli, Antonio Davi, Letizia Cristiano, Cristina Mussini, Roberto Cauda, Patrizio Vittucci, B. Salassa, Marco Libanore, Maria Pina Sciotti, Isa Picerno, Matteo Bassetti, Benedetto Caroleo, Oswald Moling, Danilo Tacconi, Massimo Puoti, Camoni, Laura, Raimondo, Mariangela, Dorrucci, Maria, Regine V, Salfa MC, CARPHA Study, Group, Lazzarin, Adriano, Castagna, Antonella, Camoni, L, Raimondo, M, Dorrucci, M, Regine, V, Salfa, M, Suligoi, B, Di Giammartino, D, Parruti, G, Di Stefano, P, Paoloni, M, D'Alessandro, M, Grimaldi, A, Sciotti, M, Pizzigallo, E, Vecchiett, J, De Stefano, C, La Gala, A, De Stefano, G, Linzalone, A, Cesario, F, Cosco, L, Caroleo, B, Foti, G, Serrao, N, Lucchino, D, Chirianni, A, Abrescia, N, Pempinello, R, Izzo, C, Borgia, G, Filippini, P, Sagnelli, E, Iodice, A, Megna, A, D'Alessio, G, Acone, N, Mazzeo, M, Sacchini, D, Ferrari, C, Degli Antoni, A, Magnani, G, Mussini, C, Borghi, V, Viale, P, Colangeli, V, Sighinolfi, L, Libanore, M, Govoni, A, Cancellieri, C, Bassi, P, Arlotti, M, Luzzati, R, Bassetti, M, Tirelli, U, Vaccher, E, Moise, G, Palamara, G, Bernardi, S, Falciano, M, Vullo, V, D'Ettore, G, Renda, V, Guariglia, C, Taliani, G, Mezzaroma, I, Paoletti, F, Ajassa, C, Gastaldi, R, Andreoni, M, Sarmati, L, Montella, F, Antinori, A, Giannetti, A, Pietrosillo, N, Girardi, E, Pennica, A, Cauda, R, Colafigli, M, Di Gianbenedetto, S, Caterini, A, Monarca, R, Barbacci, S, Ramponi, G, Marchili, M, Anzalone, E, Lichtner, M, Ferrea, G, Cassola, G, Viscoli, C, Mazzarello, G, Setti, M, Artioli, S, Riccio, G, Finocchio, G, Anselmo, M, Rizzi, M, Scalzini, A, Castelli, F, Quirino, T, Santoro, D, Pan, A, Zoncada, A, Bonfanti, P, Viganò, P, Villa, M, Tinelli, M, Perboni, G, Palvarini, L, Costa, P, Puoti, M, Galli, M, Rizzardini, G, Monforte, A, Lazzarin, A, Castagna, A, Gori, A, Minoli, L, Filice, G, Grossi, P, Giacometti, A, Tavio, M, Montroni, M, Butini, L, Osimani, P, Petrelli, E, Chiodera, A, Vittucci, P, Sabbatini, P, Pasqualini, C, Valle, M, Zoppi, M, Mantia, E, Schettino, G, Deseraca, M, Vitullo, D, Bargiacchi, O, Orofino, G, Bramato, C, Busso, M, Salassa, B, Farenga, M, Bonora, S, Leo, G, Poletti, F, Gobber, M, Cristina, G, Gabiano, C, Mian, P, Moling, O, Paternoster, C, Dorigoni, N, Fontana, T, Angarano, G, Ladisa, N, La Rovere, D, Fico, C, Bulla, F, Santantonio, T, Grisorio, B, Chiriacò, P, Congedo, P, Tundo, P, Resta, F, Cristiano, L, Mura, M, Madeddu, G, Mesina, P, Piga, S, Campus, M, Manconi, P, Ortu, F, Salvo, A, Baretti, C, La Sala, R, Bellissima, P, Bonfante, S, Galvagna, S, Celesia, B, La Rosa, R, Maiuzzo, S, Guarnieri, L, Bruno, S, Picerno, I, Tripodi, N, Farinella, E, Occhino, C, Titone, L, Colomba, C, Prestileo, T, Saitta, M, Dones, P, Boncoraglio, R, Davi, A, Franco, A, Portelli, V, Savalli, F, Geraci, C, Chimenti, M, Luchi, S, Catalani, C, Trezzi, M, Aquilini, D, Sani, S, Nencioni, C, Carli, T, Mazzotta, F, Lo Caputo, S, Zuccati, G, Iapoce, R, Consolini, R, Bartolozzi, D, Bartoloni, A, Bartalesi, F, DE LUCA, A, De Martino, M, Tacconi, D, Tini, S, Baldelli, F, Francisci, D, Frongillo, R, Traverso, A, Francavilla, E, Ferretto, R, Marranconi, F, Manfrin, V, Cortese, P, Rossi, C, Cattelan, F, Petrucci, A, Brugnaro, P, Sgarabotto, D, Scaggiante, R, Cattelan, A, Bosco, O, Concia, E, Rovere, P, Regine, Vincenza, Salfa, Maria Cristina, Suligoi, Barbara, and Luzzati, Roberto

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Immunology, Infectious Diseases, Virology, Settore MED/17 - Malattie Infettive, Epidemiology, Cross-sectional study, Human immunodeficiency virus (HIV), MEDLINE, HIV Infections, medicine.disease_cause, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cross-Sectional Studies, Female, Humans, Italy, Middle Aged, Prevalence, Retrospective Studies, medicine, HIV Infection, HIV, prevalence, Italy, Cross-Sectional Studie, business.industry, Transmission (medicine), HIV, Retrospective cohort study, Hiv prevalence, Northern italy, Anti-Retroviral Agent, business, Viral load, Human, Demography
Abstract

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.

Published
2015

9. Highly Active Antiretroviral Therapy Reduces the Age-Associated Risk of Dementia in a Cohort of Older HIV-1-Infected Patients

Author

Antonella d'Arminio Monforte, Giovanni Mazzarello, Carlo Federico Perno, Paola Cinque, Rosa Pedale, Susanna Grisetti, Adriana Ammassari, Sergio Foresti, Simona Bossolasco, Dora Larussa, Italian Registry Investigative Neuro Aids, Andrea Antinori, Paolo Zannoni, Patrizia Lorenzini, Valerio Tozzi, Marco Bongiovanni, Antonella Cingolani, Francesca Moretti, Ilaria Uccella, and Maria Irene Arcidiacono

Subjects
Adult, Male, Aging, medicine.medical_specialty, Longitudinal study, Odds Ratio, AIDS Dementia Complex, Humans, HIV-1, HIV Infections, Risk Factors, Cohort Studies, Antiretroviral Therapy, Highly Active, Confidence Intervals, Middle Aged, Female, Immunology, Population, Antiretroviral Therapy, Acquired immunodeficiency syndrome (AIDS), Virology, Internal medicine, medicine, Dementia, Highly Active, education, education.field_of_study, Proportional hazards model, business.industry, Odds ratio, Settore MED/07 - Microbiologia e Microbiologia Clinica, medicine.disease, Infectious Diseases, Cohort, business, Cohort study
Abstract

Historically, older patients have shown a higher risk of HIV-1-associated dementia (HIVD). The objective of this study was to evaluate the association of aging with HIVD and minor cognitive motor disorders (MCMDs) during the late-highly active antiretroviral therapy (HAART) era and to analyze characteristics, predictive factors, and survival of older HIV-1-infected individuals affected by these disorders. A nested longitudinal study was designed for a cohort of HIV-1-infected individuals with neurological diseases. Multiple logistic regression and Cox regression for survival were employed. From 2000 to 2003, 195 patients with HIVD (53%) or MCMD (47%) were enrolled. The cumulative prevalence of these two disorders was 21%, with an increasing rate for calendar year (p0.001). Previous antiretroviral exposure occurred in 46% of patients. Mean CD4(+) cell count and plasma HIV-1 RNA were 144 cells/microl and 4.5 log10 copies/ml, respectively. The mean age was 44 years (SD, 9.9), with 35% of patients aged 20-39 years (I), 45% aged 40-49 years (II), and 20% aged/=50 years (III). Among drug-naive patients, the prevalence of HIVD progressively increased in older subjects: 7.2% (I), 15.3% (II), and 27.3% (III) (p0.001), whereas no significant increase in HIVD with older age was observed in drug-treated subjects. Older age was independently associated with an increased risk of HIVD (odds ratio, 6.44; 95% confidence interval, 2.82-14.69) in naive but not in experienced individuals, but had no significant effect on survival. No significant effect of age was observed for MCMD. We conclude that in our cohort, HAART seems to alter the relationship between aging and HIVD, conferring a neuroprotective effect to older patients. These results may have significant implications for the clinical management of the older HIV population.

Published
2006

10. Role of HCV-RNA decay and IP-10 levels after 48 hours of standard HCV therapy as predictors of rapid virological response

Author

Bianca Bruzzone, Giancarlo Icardi, Giovanni Mazzarello, Roberta Prinapori, A. Alessandrini, Laura Sticchi, Cristiano Alicino, Antonio Di Biagio, Filippo Del Puente, Alessio Signori, and Claudio Viscoli

Subjects
Male, medicine.medical_specialty, Time Factors, Hepacivirus, RNA Stability, Logistic regression, Gastroenterology, Antiviral Agents, Virological response, chemistry.chemical_compound, Predictive Value of Tests, Internal medicine, Ribavirin, Medicine, Humans, Viral, Prospective Studies, Chronic, Prospective cohort study, Hepatology, biology, business.industry, Area under the curve, virus diseases, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, biology.organism_classification, digestive system diseases, Chemokine CXCL10, Treatment Outcome, chemistry, Predictive value of tests, Immunology, RNA, RNA, Viral, Female, Interferons, business
Abstract

Summary Background and objectives Rapid virological response (RVR) is a critical end-point in the era of the new direct-acting antiviral agents (DAA). The aim of this study was to evaluate the predictive value in achieving RVR of HCV-RNA load and IP10 after 48 hours of standard anti HCV therapy. Methods HCV mono-infected and HIV/HCV co-infected patients naives to interferon were included. Demographic data, immune-virological HIV-related condition and HCV disease status were recorded before starting treatment. HCV-RNA and IP10 concentrations were also measured 48 hours after first interferon dose. Univariate model, logistic regression and ROC curve were performed for statistical analysis. Results Thirty-two patients were enrolled (mean age 49.2 ± 5.6 years): all were treated with pegylated-interferon and ribavirin. Nineteen (59.3%) were HIV/HCV co-infected patients. RVR was reached in 10 patients (31.2%). A decline of more than two log of HCV-RNA after 48 hours of therapy was associated with RVR ( P = 0.004). A trend was observed between increased IP10 levels at 48 hours and RVR ( P = 0.08). In a multivariable model only HCV-RNA at 48 hours was associated with RVR ( P = 0.011). ROC curve analysis for both HCV-RNA at 48 hours and IP-10 at 48 hours showed an area under the curve of 0.87 (95%CI: 0.74–1; P = 0.001) with specificity of 72.2% and sensibility of 90%. Conclusion In HCV treatment-naive patients HCV-RNA and IP10 determination after 48 hours of interferon and ribavirin may be a worthwhile endpoint to predict RVR and select patients that may not require DAA addition.

Published
2014

11. Determinants of access to experimental antiretroviral drugs in an Italian cohort of patients with HIV: A multilevel analysis

Author

Antonella Castagna, Enrico Girardi, Claudio Angeletti, Paola Scognamiglio, Andrea Gori, Giuseppe Ippolito, Massimo Andreoni, Antonella d'Arminio Monforte, Giovanni Mazzarello, Massimo Arlotti, Dora Buonfrate, Andrea Antinori, Girardi, E, Scognamiglio, P, Angeletti, C, Gori, A, Buonfrate, D, Arlotti, M, Mazzarello, G, Castagna, A, Andreoni, M, D'Arminio Monforte, A, Antinori, A, Ippolito, G, Girardi, Enrico, Scognamiglio, Paola, Angeletti, Claudio, Gori, Andrea, Buonfrate, Dora, Arlotti, Massimo, Mazzarello, Giovanni, Castagna, Antonella, Andreoni, Massimo, Monforte A., D'Arminio, Antinori, Andrea, and Ippolito, Giuseppe

Subjects
Compassionate Use Trials, Adult, Male, medicine.medical_specialty, Adolescent, Logistic Model, Anti-HIV Agents, antiretroviral therapy, HIV Infections, Comorbidity, Logistic regression, Health Services Accessibility, Young Adult, Internal medicine, medicine, cohort study, Compassionate Use Trial, Humans, HIV Infection, Young adult, Clinical Trials as Topic, experimental drug, multilevel analysi, business.industry, lcsh:Public aspects of medicine, Liver Diseases, Liver Disease, Health Policy, HIV, Anti-HIV Agent, lcsh:RA1-1270, clinical trial, Odds ratio, Drugs, Investigational, Middle Aged, Surgery, Clinical trial, Clinical research, Logistic Models, expanded access program, Italy, Expanded access, Cohort, Multilevel Analysis, Female, business, Cohort study, Research Article, Human
Abstract

Background Identification of the determinants of access to investigational drugs is important to promote equity and scientific validity in clinical research. We aimed to analyze factors associated with the use of experimental antiretrovirals in Italy. Methods We studied participants in the Italian Cohort of Antiretroviral-Naive Patients (ICoNA). All patients 18 years or older who had started cART (≥ 3 drugs including at least two NRTI) after their enrolment and during 1997-2007 were included in this analysis. We performed a random effect logistic regression analysis to take into account clustering observations within clinical units. The outcome variable was the use of an experimental antiretroviral, defined as an antiretroviral started before commercial availability, in any episode of therapy initiation/change. Use of an experimental antiretroviral obtained through a clinical trial or an expanded access program (EAP) was also analyzed separately. Results A total of 9,441 episodes of therapy initiation/change were analyzed in 3,752 patients. 392 episodes (360 patients) involved an experimental antiretroviral. In multivariable analysis, factors associated with the overall use of experimental antiretrovirals were: number of experienced drugs (≥ 8 drugs versus "naive": adjusted odds ratio [AOR] = 3.71) or failed antiretrovirals(3-4 drugs and ≥ 5 drugs versus 0-2 drugs: AOR = 1.42 and 2.38 respectively); calendar year (AOR = 0.80 per year) and plasma HIV-RNA copies/ml at therapy change (≥ 4 log versus < 2 log: AOR = 1.55). The probability of taking an experimental antiretroviral through a trial was significantly lower for patients suffering from liver co-morbidity(AOR = 0.65) and for those who experienced 3-4 drugs (vs naive) (AOR = 0.55), while it increased for multi-treated patients(AOR = 2.60). The probability to start an experimental antiretroviral trough an EAP progressively increased with the increasing number of experienced and of failed drugs and also increased for patients with liver co-morbidity (AOR = 1.44; p = 0.053). and for male homosexuals (vs heterosexuals: AOR = 1.67). Variability of the random effect associated to clinical units was statistically significant (p < 0.001) although no association was found with specific characteristics of clinical unit examined. Conclusions Among patients with HIV infection in Italy, access to experimental antiretrovirals seems to be influenced mainly by exhaustion of treatment options and not by socio-demographic factors.

Published
2012

12. A case of secondary syphilis presenting as optic neuritis

Author

Giovanni Mazzarello, Alberto Primavera, Claudio Viscoli, Elisabetta Capello, Angelo Schenone, Monica Bandettini di Poggio, and Fabio Bandini

Subjects
Male, medicine.medical_specialty, Pediatrics, Visual acuity, Neurology, Optic Neuritis, Time Factors, genetic structures, Optic Disk, Dermatology, Neurosyphilis, Diagnosis, Differential, medicine, Humans, Optic neuritis, Homosexuality, Male, Neuroradiology, business.industry, Penicillin G, General Medicine, Middle Aged, medicine.disease, eye diseases, Surgery, Anti-Bacterial Agents, Psychiatry and Mental health, Treatment Outcome, Disease Progression, Syphilis, Neurology (clinical), Neurosurgery, medicine.symptom, business, Meningitis
Abstract

Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.

Published
2009

13. Therapeutical aspects and outcome of HIV/HCV coinfected patients treated with pegylated interferon plus ribavirin in an Italian cohort

Author

A. Di Biagio, Giovanni Mazzarello, Sandra Ratto, V. Lindstrom, Matteo Bassetti, Claudio Viscoli, Elda Righi, Chiara Dentone, and Andrea Beltrame

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Population, HIV Infections, Interferon alpha-2, Gastroenterology, Antiviral Agents, Polyethylene Glycols, Cohort Studies, chemistry.chemical_compound, Pegylated interferon, Internal medicine, Antiretroviral Therapy, Highly Active, Ribavirin, Medicine, Humans, Risk factor, education, Demography, Retrospective Studies, education.field_of_study, business.industry, virus diseases, Interferon-alpha, General Medicine, Middle Aged, medicine.disease, Hepatitis C, digestive system diseases, Recombinant Proteins, Discontinuation, Surgery, Infectious Diseases, Treatment Outcome, chemistry, Italy, Cohort, Coinfection, Drug Therapy, Combination, Female, business, Viral load, medicine.drug
Abstract

One-third of HIV-infected individuals suffer from chronic hepatitis C virus infection (HCV) in Europe. Recommendations from HCV-HIV International Panel advise current treatment with pegylated interferon plus ribavirin. We assessed the impact of interferon and ribavirin combination in 43 patients between 2002 and 2006.All coinfected patients treated for HCV during the 5-year period were included in retrospective data collection. CD4+ T-lymphocyte count, HAART discontinuation, reasons for treatment interruption and factors correlated to sustained virological response (SVR) were monitored.The mean age was 41 +/- 6.7 years; the risk factor for coinfection was intravenous drug abuse in 32/43 (74%). The baseline CD4+ T-lymphocytes cell count was500 in 51% (22/43). Genotype 3a represented 51% (22/43); 37% were on HAART at baseline (16/43) and half of patients showed high HCV RNA levels (800,000 IU/ml). High rates of treatment discontinuation were observed (27/43, 63%), caused by voluntary interruptions in 52% (14/27) and virological failure in 26% (7/27). The overall population had an SVR of 30%; genotypes 3a and 1 had SVR of 38% and 24%, respectively. The SVR was significantly lower in three groups: high HCV RNA viral load (chi2 = 6, p0.0025), CD4+ T-lymphocyte historical nadir350 cells/mm3 (chi2 = 3.26, p0.01) and genotype 1 with high viral load (chi2 = 4.8, p0.005).Although factors such as HCV viral load rates and genotype 1 have been confirmed to threaten the response to therapy, we observed a significant response rate when patients had a history of CD4+ T-lymphocyte nadir350 per mm3. The high dropout rates due to voluntary discontinuations complicated the patients' case management.

Published
2007

14. [HIV and related infections in Italian penal institutions: epidemiological and health organization note]

Author

Sergio, Babudieri, Giulio, Starnini, Bruna, Brunetti, Sergio, Carbonara, Gian Piero, D'Offizi, Roberto, Monarca, Giovanni, Mazzarello, Stefano, Novati, Aldo, Casti, Grazia, Florenzano, Giulio, Quercia, Enzo, Iovinella, Celestino, Sardu, Anacleto, Romano, Marinella, Dierna, Serafino, Vullo, Antonio, Pintus, Ivana, Maida, Luca, Dori, Sebastiano, Ardita, Maria Stella, Mura, Massimo, Andreoni, Giovanni, Rezza, Babudieri, Sergio, Starnini, Giulio, Brunetti, Bruna, Carbonara, Sergio, D'Offizi, Gian Piero, Monarca, Roberto, Mazzarello, Giovanni, Novati, Stefano, Casti, Aldo, Florenzano, Grazia, Quercia, Giulio, Iovinella, Enzo, Sardu, Celestino, Romano, Anacleto, Dierna, Marinella, Vullo, Serafino, Pintus, Antonio, Maida, Ivana, Dori, Luca, Ardita, Sebastiano, Mura, Maria Stella, Andreoni, Massimo, and Rezza, Giovanni

Subjects
Adult, Male, AIDS-Related Opportunistic Infections, Hepatitis, Viral, Human, Prisoners, Prison, Sexually Transmitted Diseases, HIV Infections, Prisoner, Health Survey, Middle Aged, Substance Abuse, Intravenou, Health Surveys, AIDS-Related Opportunistic Infection, Italy, HIV Seroprevalence, Prisons, Antiretroviral Therapy, Highly Active, Humans, Tuberculosis, Female, HIV Infection, Substance Abuse, Intravenous, Human, Sexually Transmitted Disease
Abstract

HIV and other infections represent an important health problem in Italian jails. In particular, HIV prevalence is high, due to the characteristics of the prison population, which is constituted by a large proportion of injecting drug users and foreigners. In addition, data from other countries suggest that risky behaviour are not uncommon during imprisonment, and transmission of HIV and other infection in this setting may also occur. Data from surveys conducted by the Penitentiary Authority in Italian jails show a decline of HIV seroprevalence from 9.7% in 1990 to 2.6% in 2001. However, these data are largely incomplete and do not account for possible biases due to self-selection of inmates toward HIV serological testing or to variations in the access to screening activities. More accurate data, possibly obtained through anonymous unlinked surveys, are needed in order to better plan health services and preventive measures.

Published
2003

15. Papular-purpuric gloves and socks syndrome in HIV-positive patients

Author

Giovanni Mazzarello, Roberto De Marchi, Flavio Fusco, Valerio Del Bono, A. Nigro, and G. Ghigliotti

Subjects
Adult, medicine.medical_specialty, Anemia, viruses, AIDS-Related Opportunistic Infections, Papular purpuric gloves and socks syndrome, Dermatology, Disease, Hand Dermatoses, Parvoviridae Infections, Acquired immunodeficiency syndrome (AIDS), hemic and lymphatic diseases, Immunopathology, HIV Seropositivity, Parvovirus B19, Human, Medicine, Humans, Foot Dermatoses, biology, business.industry, Parvovirus, virus diseases, Middle Aged, biology.organism_classification, medicine.disease, Immunology, Skin Diseases, Viral, Female, Viral disease, business
Abstract

Three HIV-positive women showed clinical signs of papular-purpuric gloves and socks syndrome and serologic evidence of acute Parvovirus B19 infection. The course of the disease was complicated by anemia and persistent skin lesions, probably related to inadequate immune response. Because anemia in AIDS patients may be due to many causes, the history of recent Parvovirus B19 infection is helpful in suggesting the etiologic diagnosis.

Published
2000

16. Possible malignant transformation of benign lymphoepithelial parotid lesions in human immunodeficiency virus-infected patients: report of three cases

Author

F. Pretolesi, V. Del Bono, Maurizio Chiaramondia, Lorenzo E. Derchi, Dante Bassetti, Emanuele Pontali, Matteo Bassetti, Carlo Martinoli, and Giovanni Mazzarello

Subjects
Microbiology (medical), Adult, Male, Pathology, medicine.medical_specialty, Lymphoma, Lymphoid Tissue, HIV Infections, Benign lymphoepithelial lesion, Cell Transformation, Virus, Malignant transformation, Immunopathology, medicine, Humans, Parotid Gland, Pathological, AIDS-Related, B cell, Lymphoma, AIDS-Related, Neoplastic, business.industry, pathology/virology, Middle Aged, medicine.disease, Parotid gland, Cell Transformation, Neoplastic, Infectious Diseases, medicine.anatomical_structure, Female, pathology, Viral disease, Parotid Diseases, business, Adult, Cell Transformation, Neoplastic, Female, HIV Infections, pathology, Humans, Lymphoid Tissue, pathology/virology, Lymphoma, pathology, Male, Middle Aged, Parotid Diseases, pathology/virology, Parotid Gland
Abstract

Benign lymphoepithelial parotid lesions (BLL) are intraparotid pathological changes that are commonly thought to be an early manifestation of human immunodeficiency virus (HIV) infection. It is not well known whether BLL may undergo malignant transformation into B cell lymphoma and may therefore be a sort of precancerous lesion. We report 3 cases of possible malignant transformation of BLL in HIV-infected patients.

Published
2000

17. Anti-V3 loop spectrotype in HIV-infected individuals during zidovudine therapy

Author

R. D'amelio, Andrea Canessa, Marco Anselmo, R. Biselli, Dante Bassetti, Giovanni Mazzarello, and V. Del Bono

Subjects
Microbiology (medical), Adult, Male, HIV Antigens, HIV Core Protein p24, HIV Infections, V3 loop, HIV Antibodies, HIV Envelope Protein gp120, Zidovudine, Immune system, Immunopathology, medicine, Humans, Sida, biology, virus diseases, General Medicine, Middle Aged, biology.organism_classification, Virology, Peptide Fragments, Exact test, Infectious Diseases, Immunology, biology.protein, Female, Viral disease, Antibody, Isoelectric Focusing, medicine.drug, Densitometry
Abstract

In order to investigate the role played by zidovudine (ZDV) as immune modulator, particularly on B-cell response, the anti-V3 loop spectrotype in 115 sera from 26 HIV-infected individuals was evaluated, prior to and during treatment with ZDV, by isoelectric focusing and reverse blotting (IEF-RB), a technique useful for indirectly measuring the activity and the number of B-cell clones. All 18 patients showing seroreactivity by IEFRB displayed a clear oligoclonal banding pattern, with no change in the spectrotype (i.e. new bands), in sequential analysis over the course of therapy. Only minor changes in band intensity were found, without any correlation with ZDV treatment or CD4+ cell count. In addition, among the sera reactive in spectrotypic analysis, the percentage of those with p24 antigen positivity was significantly lower than those with no detectable p24 antigen (19.8% vs 80.2%, respectively, p=

Published
1996

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