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2. Go beyond the visible. The City of the Future

Author

Dalzero, S

Subjects
Architecture, Architecture, Project, Real, Urban, Utopia, Urban, Project, Utopia, Real
Abstract

In the desire to go further, to violate the horizon of reality and go in search of other worlds in which the gaze accepts and makes its own a deformed, analytical, complex vision in which ordinary and extraordinary phenomena coexist. Nothing more than an infinite location in which thought becomes unconditional, without borders, attentive to the urban dimension in its most complex form. Thus, fantastic images emerge, extremizations of the present, future perspectives of a "possible necessary" in which a dominant complexity thrives that cannot be governed and to which an answer is offered by interpreting the existing in a surprising form, staging the reasons and values ​​that underlies. We try to go beyond the obvious and see through what reality hides; we want to go beyond the shared rules, to understand the plots of the invisible and recreate others, unexpected but still linked to reality and conquered by the desire to investigate, to seek presumable and only imagined urban perspectives. In this way, unprecedented aspects are understood driven by the fantastic, by dissatisfaction remove the banal, the usual and assume an attitude of insubordination, a different point of view capable of capturing the complexity of reality in its occurrence. The wonder becomes right to be able to investigate and discover otherwise invisible places, using perceptions, signs and colors that in the unexpected become architectural substance, real compositional words and not of worlds extraneous to our life but of a world of which, of our life, the meanings are revealed. Other perspectives of the urban take shape, and other possibilities of the existing, escaped from the present and projected into the future that design thinking reinterprets through the imagination now used as a means of knowledge and without which only a senseless and amorphous mass of elements would be formulated. devoid of any link with the existing. So, starting from the assumption that everything begins with reality, we advance in this study with imaginative features and evaluate the visions of a fantastic, provocative, at times paradoxical architecture, nothing more than extremism of reality as if it were a re-elaboration of the mind that in the critical-objective reflection finds another future, possible architectural form and spatial dimension. From the analysis and knowledge of fantasy places, the transformations of reality and its possible future developments are therefore discussed and, through the imagination, ideal cities of a fantastic and dystopian universe are outlined, whose diversified architectures become material for learning and communicating characteristics of an urban-architectural real as a manifesto of an imaginative world shattered and reassembled through rules that have escaped from common logic and entered the field of architectural design perception and experimentation.

Published
2022
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3. The Destiny of 'Refuse' in a Impure Society

Author

Dalzero S

Subjects
General Medicine
Abstract

We want to be even too angelis: our city wants to get rid of odors, bad or good ones in every way possible…dirty is politics: politics is shame, but the degree of shame varies from culture to culture, from one historical moment to another. An objective condition however, is the existence of the need to dispose waste and this is why I believe it is a reality we need to accept and take advantage of, not to battle against and see as a shame and, therefore, need to “hide”. According to Godard, history today is contained in the history of cinema and the rest exists in the images we have. Our eyes are compelled to see through lenses of those that have already taken the picture, filmed, documented. In effect, I have no choice: form and direction are already embedded in the territory, and my task is only to reveal them, by building little by little the inner structure: the rhythm, the melody and harmony, the out of key places, subjected to my study. I find myself in the conditions of the founders when they had to domesticate an uninhabited place or a place inhabited before. A territory, for those who have just arrived is actually caos, a land that has to be acknowledged for its power, and to work with it by looking for it or avoiding it, strenghtening it or weakening it. Cities are scattered by buidings that do not belong to us, shored up by questionable, ambiguous, insignificant, indifferent architectures.Consider in this case the different incinerators, the fenced in places for waste disposal waiting to be treated to later reach other contexts, other dumps and consider all those spaces that interest the theme, object of this study. The environment is just not a figure. In it there are objective physical conditions and proportions of hygeine, climate, and of pollution. What do we feel in observing the magma of waste invading the earth sometimes in a respectful way, controlled, and sometimes completely free imposing without respect? The landscape continuously modifies to accomodate disposal and collection of waste but how aware are we that it’s a reality that will always accompany our life and how much are we willing to accept it and see it as an opportunity to plan and not as a problem to battle? In particular, this article is part of a more integrated study on the subject of waste, which has now descripted through the eyes of artists who have looked for the material, the feeling… of their works in the waste.

Published
2022
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8. CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Author

Floridia, M., Pinnetti, C., Masuelli, G., Spinillo, A., Savasi, V. M., Liuzzi, G., Degli Antoni, A. M., Sansone, M., Guaraldi, G., Dalzero, S., Maso, G., Francisci, D., Sterrantino, G., Ravizza, M., Tamburrini, E., Di Lorenzo, F., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Portelli, V., Bernardon, M., Bussolaro, S., Della Pieta, I., Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M. A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., De Martino, M., Parazzini, F., Vella, S., Floridia M., Pinnetti C., Masuelli G., Spinillo A., Savasi V.M., Liuzzi G., Degli Antoni A.M., Sansone M., Guaraldi G., Dalzero S., Maso G., Francisci D., Sterrantino G., Ravizza M., Tamburrini E., Di Lorenzo F., Meli M., Campolmi I., Vichi F., Del Pin B., Marocco R., Mastroianni C., Mercurio V.S., Zanaboni D., Nardini G., Stentarelli C., Beghetto B., Molinari A., Crisalli M.P., Donisi A., Ruggieri A., Piepoli M., Cerri V., Zuccotti G., Giacomet V., Paradiso L., Forlanini F., Longoni E., Placido G., Milini P., Savalli F., Sabbatini F., Papalini C., Bernini L., Grossi P., Rizzi L., Portelli V., Bernardon M., Bussolaro S., Della Pieta I., Sorz A., Meloni A., Chiodo A., Dedoni M., Ortu F., Piano P., Citernesi A., Bordoni Vicini I., Luzi K., Roccio M., Vimercati A., Calabretti D., Gigante S., Guerra B., Cervi F., Simonazzi G., Margarito E., Capretti M.G., Marsico C., Faldella G., Martinelli P., Agangi A., Capone A., Maruotti G.M., Tibaldi C., Trentini L., Todros T., Frisina V., Savasi V., Cardellicchio E., Giaquinto C., Fiscon M., Rubino E., Franceschetti L., Badolato R., Forleo M.A., Tassis B., Ruggiero M., Genovese O., Cafforio C., Casadei A.M., Cavaliere A.F., Cellini M., Marconi A.M., Ierardi M., Simonetti S.C., Alfieri N., Agrati S., Polizzi C., Mattei A., Pirillo M.F., Amici R., Galluzzo C.M., Donnini S., Baroncelli S., Cerioli A., De Martino M., Parazzini F., and Vella S.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Multivariate analysis, 030106 microbiology, CD4-CD8 Ratio, Human immunodeficiency virus (HIV), HIV Infections, CD8-Positive T-Lymphocytes, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, CD4/CD8 ratio, Pregnancy, CD4, CD8, HIV suppression, Preterm delivery, Female, Humans, Infant, Newborn, Pregnancy Outcome, Pregnant Women, Viral Load, Pregnancy Complications, Infectious, medicine, 030212 general & internal medicine, business.industry, Obstetrics, Infectious, Infant, General Medicine, Newborn, medicine.disease, Pregnancy Complications, Infectious Diseases, Increased risk, National study, Outcome data, business
Abstract

Purpose: To evaluate associations between CD4/CD8 ratio and pregnancy outcomes in women with HIV. Methods: We evaluated, in a national study of pregnant women with HIV receiving antiretroviral treatment (ART), values of CD4/CD8 ratio at entry in pregnancy, changes between first and third trimester, and possible associations with preterm delivery, low birthweight, and HIV-RNA < 50 copies/ml at third trimester in univariate and multivariate analyses. Results: Among 934 women, 536 (57.4%) were already on ART at conception. CD4/CD8 ratio (baseline value 0.570) increased significantly between the first and third trimesters, particularly in women who started ART in pregnancy (+ 0.163, vs. + 0.036 in women already on treatment). The rate of CD4/CD8 ratio normalization, defined by achieving a ratio ≥ 1 at the third trimester, was 13.2%. In multivariable analyses, women who entered pregnancy with a CD4/CD8 ratio < 0.3, compared to women with ratio ≥ 1, were almost four-times less likely to have third-trimester HIV-RNA < 50 copies/ml (AOR 0.258, 95%CI 0.111–0.601), and more than twice as likely to have preterm delivery (AOR 2.379, 95%CI 1.082–5.232). For preterm delivery, also a baseline CD4/CD8 ratio between 0.3 and 0.45 was significantly associated with an increased risk (AOR: 3.415, 95%CI 1.690–6.900). Conclusion: We described for the first time independent associations of low CD4/CD8 ratio with preterm delivery and HIV-RNA suppression.

Published
2021

10. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, M., Masuelli, G., Tassis, B., Franceschetti, L., Savasi, V. M., Spinillo, A., Tamburrini, E., Guaraldi, G., Dalzero, S., Sansone, M., Chiodo, A., Degli Antoni, A. M., Pinnetti, C., Liuzzi, G., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., della Pieta, I., Sorz, A., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Badolato, R., Forleo, M. A., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., de Martino, M., Parazzini, F., and Vella, S.

Subjects
medicine.medical_specialty, Multivariate analysis, Anti-HIV Agents, Integrase inhibitor, HIV Infections, Overweight, Weight Gain, Cohort Studies, Pregnancy, Internal medicine, medicine, Humans, Pharmacology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Pharmacology, business.industry, Weight change, Odds ratio, medicine.disease, Obesity, Infectious Diseases, Reverse Transcriptase Inhibitors, Female, medicine.symptom, business, Weight gain
Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes. Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses. Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+ T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65). Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2021

11. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. D., Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S. Mercurio V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. D., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordonivicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F. M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., 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., Vella, S., Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. Degli, Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S.Mercurio, V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., BordoniVicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F.M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G.C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., 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
Male, 0301 basic medicine, medicine.medical_treatment, HIV Infections, 0302 clinical medicine, Pregnancy, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Complications, Infectious, Darunavir, medicine.diagnostic_test, Obstetrics, Pregnancy Outcome, virus diseases, Alanine Transaminase, Viral Load, Cholesterol, Treatment Outcome, Infectious Diseases, Premature birth, Gestation, Female, Drugs in pregnancy, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Anti-HIV Agents, Atazanavir Sulfate, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, pharmacology, pharmacology (medical), infectious diseases, medicine, Humans, Caesarean section, Triglycerides, Pharmacology, business.industry, Infant, Newborn, Infant, Bilirubin, medicine.disease, 030112 virology, Atazanavir, azatanavir sulfate, Lipid profile, business
Abstract

Background Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study. Methods Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score). Results Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P

Published
2017
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13. Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol

Author

Tibaldi, C., Masuelli, G., Sansone, M., Tassis, B., Cetin, I., Franceschetti, L., Spinillo, A., Simonazzi, G., Vimercati, A., Dalzero, S., Meloni, A., Bernardon, M., Frisina, V., Polizzi, C., Todros, T., Martinelli, P., Floridia, M., Ravizza, M., Trentini, L., Tiso, G., Brambilla, T., Savasi, V., Personeni, C., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Forleo, M. A., Badolato, R., Roccio, M., Zanaboni, D., Sirico, A., Maruotti, G. M., Capone, A., Guerra, B., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Crupano, F. M., Calabretti, D., Ravizz, M., Marconi, A. M., Galiano, V., Ierardi, S. C. S. M., Chiodo, A., Ortu, F., Piano, P., Dedoni, I. M., Maso, G., Belcaro, C., Rizzante, E., Alberico, S., Citernesi, A., Vicini, I. B., Luzi, K., Tibaldi C, Masuelli G, Sansone M, Tassis B, Cetin I, Franceschetti L, Spinillo A, Simonazzi G, Vimercati A, Dalzero S, Meloni A, Bernardon M, Frisina V, Polizzi C, Todros T, Martinelli P, Floridia M, Ravizza M, and for SIGO-HIV Study Group.

Subjects
0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Young adult, Hiv transmission, Delivery complications, Vaginal delivery, business.industry, Obstetrics, Cesarean Section, HIV, Mode of delivery, Delivery, Obstetric, Female, Italy, Viral Load, Obstetric, General Medicine, medicine.disease, Infectious Diseases, Delivery complication, business, Viral load, Delivery
Abstract

PURPOSE: To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. METHODS: Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). RESULTS: Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p

Published
2019

16. 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
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18. Paesaggi alterati

Author

Dalzero, S

Subjects
rifiuti, città, rifiuti, territorio, città, territorio
Published
2019

21. Abacavir/Lamivudine and Tenofovir/Emtricitabine in Pregnant Women with Hiv: Laboratory and Clinical Outcomes in an Observational National Study

Author

Floridia, M., Pinnetti, C., Ravizza, M., Masuelli, G., Personeni, C., Sansone, M., Antoni, A. D., Guaraldi, G., Spinillo, A., Tassis, B., Dalzero, S., Liuzzi, G., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, B., 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., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., and Baroncelli, S.

Subjects
0301 basic medicine, HIV Infections, Hemoglobins, 0302 clinical medicine, Abacavir, Anemia, Cholesterol, Emtricitabine, HIV-RNA, Lamivudine, Low birthweight, Pregnancy, Preterm delivery, Tenofovir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Outcome, virus diseases, Lipoproteins, LDL, Drug Combinations, Infectious Diseases, Hypertension, RNA, Viral, Female, medicine.drug, Adult, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, 03 medical and health sciences, Internal medicine, medicine, Humans, AIDS-Associated Nephropathy, Cesarean Section, business.industry, Abacavir/Lamivudine, medicine.disease, 030112 virology, Dideoxynucleosides, CD4 Lymphocyte Count, Pregnancy Complications, HIV-1, Observational study, business
Abstract

Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study.Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC.The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P0.001), and had lower CD4 counts (475/mm vs. 533/mm, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030).In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.

Published
2018

23. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

Author

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., 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., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., 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, D., Bernini, L., Grossi, P., Rizzi, L., 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., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, M., Tibaldi, C., Trentini, L., Todros, T., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Cellini, M., Castelli Gattinara, G., Marconi, A. M., 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., Mastroiacovo, P., Parazzini, F., Vella, S., Floridia, M, Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M. [, Faldella G., and ]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, birth weight, HIV, pregnancy, preterm delivery, Health Policy, Infectious Diseases, Pharmacology (medical), Birth weight, Emigrants and Immigrants, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Pregnancy, Preterm delivery, CD4 Lymphocyte Count, Female, HIV-1, Humans, Premature Birth, Viral Load, Infant, Low Birth Weight, 03 medical and health sciences, medicine, Obstetrics, business.industry, Low Birth Weight, Infant, Odds ratio, medicine.disease, 030112 virology, Confidence interval, Pregnancy rate, Low birth weight, Premature birth, medicine.symptom, business, Viral load
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

Published
2016

24. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M, Masuelli, G, Ravizza, M, Tassis, B, Cetin, I, Sansone, M, Degli Antoni, A, Simonazzi, G, Maccabruni, A, Francisci, D, Frisina, V, Liuzzi, G, Dalzero, S, Tamburrini, Enrica, Tamburrini, E (ORCID:0000-0003-4930-426X), Floridia, M, Masuelli, G, Ravizza, M, Tassis, B, Cetin, I, Sansone, M, Degli Antoni, A, Simonazzi, G, Maccabruni, A, Francisci, D, Frisina, V, Liuzzi, G, Dalzero, S, Tamburrini, Enrica, and Tamburrini, E (ORCID:0000-0003-4930-426X)

Abstract

Background: Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study.Methods: Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score).Results: Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P < 0.001).Conclusions: In this observational study, the two main HIV PIs currently recommended by perinatal guidelines showed similar safety and activity in pregnancy, with no evidence of differences between the two drugs in terms of main pregnancy outcomes. Based on the minor differences observed in laboratory measures, prescribing physicians might prefer either drug in some particular situations where the different impacts of treatment on lipid profile and bilirubin may have clinical relevance.

Published
2018

25. Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

Author

Floridia, M., Masuelli, G., Tamburrini, E., Cetin, I., Liuzzi, G., Martinelli, Paolo, Guaraldi, G., Spinillo, A., Vimercati, A., Maso, G., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, Bianca, Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. Degli, Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Angeli, G., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Rizzante, E., Belcaro, C., Meloni, Antonio, Dedoni, M., Ortu, F., Piano, Pierluigi, Citernesi, A., Vicini, I. Bordoni, Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, Filippo, Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Tassis, B., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, Matteo, Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., DE MARTINO, MARIA CRISTINA, Parazzini, F., and Vella, S.

Subjects
Antiretroviral treatment, HIV diagnosis, HIV testing, pregnancy, women's health, medicine.medical_specialty, Pediatrics, Longitudinal study, Adolescent, Epidemiology, Short Report, HIV Infections, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Odds Ratio, Humans, 030212 general & internal medicine, Young adult, 030219 obstetrics & reproductive medicine, business.industry, Odds ratio, medicine.disease, Female, Italy, Infectious Diseases, Confidence interval, Family planning, business, Cohort study
Abstract

SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Published
2017

26. Lo spazio conteso

Author

Dalzero, S

Subjects
globalizations, migrations, boundary
Published
2017

27. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Ravizza, 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, 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, D., 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., Spinillo, A., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Cetin, I., 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, A.M., Cavaliere, A.F., Cellini, M., Castelli Gattinara, G., Marconi, A.M., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., and Degli Antoni, A.

Published
2016
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28. 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

29. Treatment change in pregnancy is a significant risk factor for detectable HIV-1 RNA in plasma at end of pregnancy

Author

Floridia, M, Ravizza, M, Pinnetti, C, Tibaldi, C, Bucceri, A, Anzidei, G, Fiscon, M, Molinari, A, Martinelli, P, Dalzero, S, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy, Anceschi, Maurizio Marco, Massetti, Anna Paola, Mastroianni, Claudio Maria, Floridia M., Ravizza M., Pinnetti C., Tibaldi C., Bucceri A., Anzidei G., Fiscon M., Molinari A., Martinelli P., Dalzero S., Tamburrini E., Faldella G., Guerra B., Floridia, M., Ravizza, M., Pinnetti, C., Tibaldi, C., Bucceri, A., Anzidei, G., Fiscon, M., Molinari, A., Martinelli, Pasquale, Dalzero, S., Tamburrini, E., and Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y.

Subjects
antiretroviral treatment, Adult, medicine.medical_specialty, Multivariate analysis, Time Factors, Pregnancy Trimester, Third, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Drug Administration Schedule, Cohort Studies, Young Adult, Pregnancy, Risk Factors, Medicine, Humans, Pharmacology (medical), Young adult, Pregnancy Complications, Infectious, Univariate analysis, treatment, business.industry, Obstetrics, Confounding, Infant, Newborn, HIV, Odds ratio, Viral Load, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, CD4 Lymphocyte Count, Infectious Diseases, Logistic Models, Anti-Retroviral Agents, Withholding Treatment, HIV-1, RNA, Viral, Female, business, Viral load, Cohort study
Abstract

To investigate the risk factors for an HIV-1 RNA plasma viral load above 400 copies/mL in the third trimester of pregnancy.Data from a large national study were used. The possible determinants were assessed in univariate analyses and in a multivariate logistic regression model in order to adjust for possible confounders.Among 662 pregnancies followed between 2001 and 2008, 131 (19.8%) had an HIV-1 plasma copy number above 400/mL at the third trimester of pregnancy. In the multivariate analysis, the variables significantly associated with this occurrence were earlier calendar year (adjusted odds ratio [AOR] per additional calendar year, 0.70; 95% CI, 0.63-0.77; P.001), lower CD4 count at enrollment (AOR per 100 cells lower, 1.18; 95% CI, 1.09-1.27; P.001), HIV-1 RNA levels above 400 copies per mL at enrollment (AOR, 2.23; 95% CI, 1.50-3.33; P.001), and treatment modification during pregnancy (AOR, 1.66; 95% CI, 1.07-2.57; P=.024).Treatment changes in pregnancy significantly increase the risk of an incomplete viral suppression at the end of pregnancy. In HIV-infected women of childbearing age, proper preconception care, which includes the preferential prescription of regimens with the best safety profile in pregnancy, is likely to prevent an incomplete viral suppression at the end of pregnancy.

Published
2011

31. 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

33. Città alla deriva

Author

Dalzero, S

Subjects
città, macerie, ricostruzione
Published
2015

34. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, Marco, Masuelli, Giulia, Tassis, Beatrice, Franceschetti, Laura, Savasi, Valeria Maria, Spinillo, Arsenio, Tamburrini, Enrica, Guaraldi, Giovanni, Dalzero, Serena, Sansone, Matilde, Chiodo, Antonella, Antoni, Anna Maria Degli, Pinnetti, Carmela, Liuzzi, Giuseppina, Ravizza, Marina, Floridia, M., Ravizza, M., Tamburrini, E., Ravizza, M., Tamburrini, E., Lorenzo, F. Di, Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Pin, B. Del, Marocco, R., Mastroianni, C., Mercurio, V.S., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., Pietà, I. Della, Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. Bordoni, Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M.A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Dalzero, S., Ierardi, M., Simonetti, S.C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Cerioli, A., Martino, M. De, Parazzini, F., Tamburrini, E., Vella, S., Martinelli, P., and Ravizza, M.

Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes.Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses.Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65).Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2020
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35. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: A multicentre case series

Author

Floridia, M, Masuelli, G., Meloni, A., Cetin, I., Tamburrini, Enrica, Cavaliere, Anna Franca, Dalzero, S., Sansone, M., Alberico, S., Guerra, B., Spinillo, A., Chiadò Fiorio Tin, M., Ravizza, M., Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Floridia, M, Masuelli, G., Meloni, A., Cetin, I., Tamburrini, Enrica, Cavaliere, Anna Franca, Dalzero, S., Sansone, M., Alberico, S., Guerra, B., Spinillo, A., Chiadò Fiorio Tin, M., Ravizza, M., and Tamburrini, Enrica (ORCID:0000-0003-4930-426X)

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

36. Rubella susceptibility profile in pregnant women with HIV

Author

Floridia, M., Pinnetti, C., Ravizza, M., Tibaldi, C., Sansone, M., Fiscon, M., Guaraldi, G., Guerra, B., Alberico, S., Spinillo, A., Castelli, P., Dalzero, S., Cavaliere, A. F., Tamburrini, E., Massetti, Anna Paola, Mastroianni, Claudio Maria, Anceschi, Maurizio Marco, The Italian Group On Surveillance On Antiretroviral Treatment In Pregnancy, F. O. R., Floridia M., Pinnetti C., Ravizza M., Tibaldi C., Sansone M., Fiscon M., Guaraldi G., Guerra B., Alberico S., Spinillo A., Castelli P., Dalzero S., Cavaliere A.F., Tamburrini E., Faldella G., and Martinelli, Pasquale

Subjects
Microbiology (medical), medicine.medical_specialty, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Rubella, medicine, Humans, Pregnancy Complications, Infectious, Pregnancy, Obstetrics, business.industry, Infectious, HIV, HIV infection, medicine.disease, Virology, Pregnancy Complications, pregnancy, Rubella Infection, Infectious Diseases, rubella infection, Female, business
Published
2011

37. 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

38. HIV RNA viral load and CD4+ T-cell counts in HIV-infected pregnant women with and without treatment discontinuation in early pregnancy

Author

Tamburini E, Ravizza M, Floridia M, Tibaldi C, Alberico S, Anzidei G, Maccabruni A, Meloni A, Degli Antoni A, Mori F, Dalzero S, Conserva V, Pannetti C, Ferrazzi E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, GUERRA, BRUNELLA, Tamburini E, Ravizza M, Floridia M, Tibaldi C, Alberico S, Anzidei G, Maccabruni A, Meloni A, Degli Antoni A, Mori F, Dalzero S, Conserva V, Pannetti C, Ferrazzi E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, Guerra B, and ]

Published
2008

39. Lipid profile during pregnancy in HIV-infected women

Author

Floridia, M, Tamburrini, E, Ravizza, M, Tibaldi, C, Ravagni Probizer, M F, Anzidei, G, Sansone, M, Mori, F, Rubino, E, Meli, M, Dalzero, S, Guaraldi, G, Italian Grp Surveillance Antiretro, Lanari, M, Guerra, B, Floridia, M, Tamburrini, E, Ravizza, M, Tibaldi, C, Ravagni Probizer, M F, Anzidei, G, Sansone, M, Mori, F, Rubino, E, Meli, M, Dalzero, S, Guaraldi, G, Italian Grp Surveillance Antiretro, Lanari, M, and Guerra, B

Subjects
HIV Infections, Triglyceride, chemistry.chemical_compound, Pregnancy, Hiv infected, Hyperlipidemia, HIV Infection, Pharmacology (medical), Pregnancy Complications, Infectious, triglycerides, medicine.diagnostic_test, Stavudine, Infectious Diseases, Treatment Outcome, Italy, Population Surveillance, Population study, lipids (amino acids, peptides, and proteins), Female, Pregnancy Trimester, Pregnancy Trimesters, pregnancy, Human, medicine.drug, Adult, medicine.medical_specialty, Logistic Model, protease inhibitors, Hyperlipidemias, cholesterol, HIV, protease inhibitor, Internal medicine, medicine, Humans, HIV Protease Inhibitor, Triglycerides, Cholesterol, business.industry, Cholesterol, HDL, Cholesterol, LDL, HIV Protease Inhibitors, medicine.disease, Lipid Metabolism, Endocrinology, Logistic Models, chemistry, Pregnancy Complications, Infectiou, HIV-1, Lipid profile, business
Abstract

Purpose: We investigated the evolution of serum lipid levels in HIV-infected pregnant women and the potential effect of antiretroviral treatment during pregnancy using data from a national surveillance study. Method: Fasting lipid measurements collected during routine care in pregnancy were used, analyzing longitudinal changes and differences in lipid values at each trimester by protease inhibitors (Pls) and stavudine use. Multivariate analyses were used to control for simultaneous factors potentially leading to hyperlipidemia. Study population included 248 women. Results: Lipid values increased progressively and significantly during pregnancy: mean increases between the first and third trimesters were 141.6 mg/dL for triglycerides (p

Published
2006

40. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Floridia, M., primary, Pirillo, M.F., additional, Degli Antoni, A., additional, Molinari, A., additional, Tamburrini, E., additional, Pinnetti, C., additional, Guaraldi, G., additional, Nardini, G., additional, Masuelli, G., additional, Dalzero, S., additional, Cetin, I., additional, Sansone, M., additional, Amici, R., additional, Ravizza, M., additional, Mori, F., additional, Ortolani, P., additional, dalle Nogare, E.R., additional, Di Lorenzo, F., additional, Sterrantino, G., additional, Meli, M., additional, Polemi, S., additional, Nocentini, J., additional, Baldini, M., additional, Montorzi, G., additional, Mazzetti, M., additional, Rogasi, P., additional, Borchi, B., additional, Vichi, F., additional, Del Pin, B., additional, Pinter, E., additional, Anzalone, E., additional, Marocco, R., additional, Mastroianni, C., additional, Mercurio, V.S., additional, Carocci, A., additional, Grilli, E., additional, Maccabruni, A., additional, Zaramella, M., additional, Mariani, B., additional, Natalini Raponi, G., additional, Stentarelli, C., additional, Beghetto, B., additional, Degli Antoni, A.M., additional, Crisalli, M.P., additional, Donisi, A., additional, Piepoli, M., additional, Cerri, V., additional, Zuccotti, G., additional, Giacomet, V., additional, Coletto, S., additional, Di Nello, F., additional, Madia, C., additional, Placido, G., additional, Vivarelli, A., additional, Castelli, P., additional, Savalli, F., additional, Portelli, V., additional, Sabbatini, F., additional, Francisci, D., additional, Bernini, L., additional, Grossi, P., additional, Rizzi, L., additional, Alberico, S., additional, Maso, G., additional, Airoud, M., additional, Soppelsa, G., additional, Meloni, A., additional, Dedoni, M., additional, Cuboni, C., additional, Ortu, F., additional, Piano, P., additional, Citernesi, A., additional, Bordoni Vicini, I., additional, Luzi, K., additional, Spinillo, A., additional, Roccio, M., additional, Vimercati, A., additional, Miccolis, A., additional, De Gennaro, A., additional, Guerra, B., additional, Cervi, F., additional, Simonazzi, G., additional, Margarito, E., additional, Capretti, M.G., additional, Marsico, C., additional, Faldella, G., additional, Martinelli, P., additional, Agangi, A., additional, Capone, A., additional, Maruotti, G.M., additional, Tibaldi, C., additional, Trentini, L., additional, Todros, T., additional, Frisina, V., additional, Brambilla, T., additional, Savasi, V., additional, Personeni, C., additional, Giaquinto, C., additional, Fiscon, M., additional, Rubino, E., additional, Bucceri, A., additional, Matrone, R., additional, Scaravelli, G., additional, Genovese, O., additional, Cafforio, C., additional, Liuzzi, G., additional, Tozzi, V., additional, Massetti, P., additional, Casadei, A.M., additional, Cavaliere, A.F., additional, Cellini, M., additional, Castelli Gattinara, G., additional, Marconi, A.M., additional, Sacchi, V., additional, Ierardi, M., additional, Polizzi, C., additional, Mattei, A., additional, Galluzzo, C.M., additional, Donnini, S., additional, Baroncelli, S., additional, Floridia, M., additional, Villani, P., additional, Cusato, M., additional, Cerioli, A., additional, De Martino, M., additional, Mastroiacovo, P., additional, Parazzini, F., additional, and Vella, S., additional

Published
2016
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41. 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 Dtamburrini, E, 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, 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, Luzi, K, Nardini, G, Stentarelli, C, Degli Antoni Am, Molinari, A, Crisalli, Mp, Donisi, A, Piepoli, M, Cerri, V, Zuccotti, G, Giacomet, V, Fabiano, V, Placido, G, Vivarelli, A, Castelli, P, Savalli, F, Portelli, V, Sabbatini, F, Francisci, D, 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, Mg, 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, Fundarò, C, Genovese, O, Cafforio, C, Liuzzi, G, Tozzi, V, Massetti, P, Anceschi, M, Casadei, Am, Cavaliere, Af, Finelli, V, Cellini, M, Castelli Gattinara, G, Marconi, Am, Sacchi, V, De Pirro, A, Polizzi, C, Mattei, A, Pirillo, Mf, Amici, R, Galluzzo, Cm, Donnini, S, Baroncelli, S, Villani, P, Cusato, M, Cerioli, A, De Martino, Maurizio, Mastroiacovo, P, Moroni, M, Parazzini, F, Tamburrini, E, Vella, S, and Martinelli, P.

Subjects
HIV
Published
2013

43. 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

44. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study.

Author

Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. Degli, Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., and Tamburrini, E.

Subjects
ATAZANAVIR, DARUNAVIR, PREGNANCY complications, HIV-positive women, CHOLESTEROL
Abstract

Background: Atazanavirand darunavir represent the main HIVPIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study. Methods: Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score). Results: Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P < 0.001). Conclusions: In this observational study, the two main HIV PIs currently recommended by perinatal guidelines showed similar safety and activity in pregnancy, with no evidence of differences between the two drugs in terms of main pregnancy outcomes. Based on the minor differences observed in laboratory measures, prescribing physicians might prefer either drug in some particular situations where the different impacts of treatment on lipid profile and bilirubin may have clinical relevance. [ABSTRACT FROM AUTHOR]

Published
2018
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45. Pregnancy outcomes in women with advanced HIV infection in Italy

Author

Fundaro', Carlo, Baroncelli, S, Tamburrini, Enrica, Ravizza, M, Pinnetti, Carmela, Dalzero, S, Crepaldi, A, Liuzzi, G, Molinari, A, Vimercati, and Floridia, M.

Subjects
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, HIV Infection
Published
2011

46. Rubella Susceptibility Profile in Pregnant Women with HIV

Author

Florida, M, Pinnetti, C, Ravizza, M, Tibaldi, C, Sansone, M, Fiscon, M, Guaraldi, G, Guerra, B, Alberico, S, Spinilo, A, Castelli, P, Dalzero, S, Cavaliere, Af, Tamburini, E, for the Italian Group Surveillance Antiretrov, Giaquinto, Carlo, and member of the Study Group

Published
2011

47. HCV–HIV coinfected pregnant women: data from a multicentre study in Italy

Author

Baroncelli, S., primary, Pirillo, M. F., additional, Amici, R., additional, Tamburrini, E., additional, Genovese, O., additional, Ravizza, M., additional, Maccabruni, A., additional, Masuelli, G., additional, Guaraldi, G., additional, Liuzzi, G., additional, Pinnetti, C., additional, Giacomet, V., additional, Degli Antoni, A., additional, Vimercati, A., additional, Dalzero, S., additional, Sacchi, V., additional, and Floridia, Marco, additional

Published
2015
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48. Rate, predictors, and consequences of late antenatal booking in a national cohort study of pregnant women with HIV in Italy

Author

Floridia, M, Pinnetti, C, Ravizza, M, Frisina, V, Cetin, I, Fiscon, M, Sansone, M, Antoni, Ad, Guaraldi, G, Vimercati, A, Guerra, B, Placido, G, Dalzero, S, Tamburrini, Enrica, Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Floridia, M, Pinnetti, C, Ravizza, M, Frisina, V, Cetin, I, Fiscon, M, Sansone, M, Antoni, Ad, Guaraldi, G, Vimercati, A, Guerra, B, Placido, G, Dalzero, S, Tamburrini, Enrica, and Tamburrini, Enrica (ORCID:0000-0003-4930-426X)

Abstract

To evaluate the prevalence and consequences of late antenatal booking (13 or more weeks gestation) in a national observational study of pregnant women with HIV.

Published
2014

49. 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., Nogare, E.R., Di Lorenzo, F., Sterrantino, G., Meli, M., and Polemi, S.

Subjects
AMNIOCENTESIS, CHORIONIC villus sampling, HIV-positive women, PREGNANCY complications, HUMAN abnormalities, HIV infection transmission
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. [ABSTRACT FROM AUTHOR]

Published
2017
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50. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women.

Author

Floridia, M, Tamburrini, E, Masuelli, G, Martinelli, P, Spinillo, A, Liuzzi, G, Vimercati, A, Alberico, S, Maccabruni, A, Pinnetti, C, Frisina, V, Dalzero, S, Ravizza, M, Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., and Polemi, S.

Subjects
LOW birth weight, CONFIDENCE intervals, HIV-positive persons, PREMATURE infants, PREGNANCY, RESEARCH funding, VIRAL load, ACQUISITION of data, DATA analysis software, CD4 lymphocyte count, ODDS ratio
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio ( OR) 1.36; 95% confidence interval ( CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy ( OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy ( OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C ( CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies. [ABSTRACT FROM AUTHOR]

Published
2017
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