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HIV Seropositivity: HELP
Articles from Italy
Based on 128 articles published since 2008
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These are the 128 published articles about HIV Seropositivity that originated from Italy during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Editorial Autologous stem cell transplantation in HIV-positive patients affected by relapsed/partially responding lymphoma: let it be. 2016

Zanet, Ernesto / Michieli, Mariagrazia / Tirelli, Umberto. ·a Unit of Cell Therapy and High Dose Chemotherapy , CRO National Cancer Institute , Aviano , Italy. · b Division of Medical Oncology A , CRO National Cancer Institute , Aviano , Italy. ·Expert Rev Hematol · Pubmed #27269371.

ABSTRACT: -- No abstract --

2 Review Evidence-based renewal of the Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. 2018

Antinori, Andrea / Di Biagio, Antonio / Marcotullio, Simone / Sarmati, Loredana / Andreoni, Massimo / Angarano, Gioacchino / Chirianni, Antonio / d'Arminio Monforte, Antonella / Di Perri, Giovanni / Galli, Massimo / Gianotti, Nicola / Girardi, Enrico / Gori, Andrea / Mussini, Cristina / Perno, Carlo-Federico / Lazzarin, Adriano. ·National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy. · Policlinico San Martino Hospital, IRCCS for Cancer Research Genova, Italy. · Nadir Onlus, Rome, Italy. · University of Tor Vergata, Rome, Italy. · University of Bari, Italy. · P.O. Cotugno, AORN Ospedali dei Colli, Naples, Italy. · San Paolo Hospital, University of Milan, Italy. · University of Turin, Italy. · University of Milan, Italy. · Division of Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy. · Policlinico Ca Granda Hospital, University of Milan; Italy. · University of Modena and Reggio Emilia, Modena, Italy. · University of Milan - ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. · San Raffaele Scientific Institute, Milan, Italy. ·New Microbiol · Pubmed #30604833.

ABSTRACT: The Italian Society for Infectious and Tropical Diseases (SIMIT) in collaboration with the Technical Health Committee (Sections L and M) of the Italian Ministry of Health have supported the renewal of the recommendations for the Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. This publication summarizes the latest updates to the 2017 version of the Italian Guidelines for the management of HIV-1 infected patients and the use of antiretroviral drugs. New recommendations were released framing the clinical questions the use of antiretrovirals according to the Patient Intervention Comparator Outcome (PICO) methodology and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Diagnostic tools for immunological and virological monitoring, when to start, what to start, optimization and therapeutic failure were updated in order to include the recommendation obtained with these newly developed methods. For a complete review of clinical and therapeutic relevant topics we refer the reader to the extended version of the Guidelines.

3 Review Radiotherapy in patients with HIV: current issues and review of the literature. 2017

Alongi, Filippo / Giaj-Levra, Niccolò / Sciascia, Savino / Fozza, Alessandra / Fersino, Sergio / Fiorentino, Alba / Mazzola, Rosario / Ricchetti, Francesco / Buglione, Michela / Buonfrate, Dora / Roccatello, Dario / Ricardi, Umberto / Bisoffi, Zeno. ·Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy; University of Brescia, Brescia, Italy. · Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy; Department of Oncology, University of Turin, Torino, Italy. Electronic address: niccolo.giajlevra@sacrocuore.it. · Department of Clinical and Biological Sciences, Centre of Research of Immunopathology and Rare Diseases-Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Disease, Torino, Italy. · Radiation Oncology, Department of Oncology, Ospedale dell'Angelo, Mestre-Venezia, Italy. · Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy. · Radiation Oncology, University and Spedali Civili, Brescia, Italy. · Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. · Department of Oncology, University of Turin, Torino, Italy. ·Lancet Oncol · Pubmed #28677574.

ABSTRACT: Although the introduction of highly active antiretroviral therapy has radically improved the life expectancy of patients with HIV, HIV positivity is still considered a major barrier to oncological treatment for patients with cancer because of their worse prognosis and increased susceptibility to toxic effects compared with patients who are immunocompetent. The use of radiotherapy with or without chemotherapy, immunotherapy, or molecular targeted therapy is the standard of care for several cancers. These new drugs and substantial improvements in radiotherapy techniques, including intensity-modulated radiotherapy, image-guided radiotherapy, and stereotactic ablative radiotherapy, are optimising the feasibility of such anticancer treatments and are providing new opportunities for patients with cancer and HIV. In this Review, we discuss the role of radiotherapy, with or without chemotherapy or new drugs, in the treatment of cancer in patients with HIV, with a focus on the efficacy and tolerability of this approach on the basis of available evidence. Moreover, we analyse and discuss the biological basis of interactions between HIV and radiotherapy, evidence from preclinical studies, and immunomodulation by radiotherapy in the HIV setting.

4 Review Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis. 2016

Zafer, Maryam / Horvath, Hacsi / Mmeje, Okeoma / van der Poel, Sheryl / Semprini, Augusto E / Rutherford, George / Brown, Joelle. ·Global Health Sciences, University of California, San Francisco, California. · Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan. · Division of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. · Department of Clinical Sciences "L. Sacco", University of Milan School of Medicine, Milan, Italy. · Global Health Sciences, University of California, San Francisco, California; Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Epidemiology and Biostatistics and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California. Electronic address: joelle.brown@ucsf.edu. ·Fertil Steril · Pubmed #26688556.

ABSTRACT: OBJECTIVE: To evaluate the effectiveness of semen washing in human immunodeficiency virus (HIV)-discordant couples in which the male partner is infected. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Forty single-arm open-label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen. INTERVENTION(S): Semen washing followed by IUI, IVF, or IVF/ICSI. PRIMARY OUTCOME: HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy. RESULT(S): No HIV transmission occurred in 11,585 cycles of assisted reproduction with the use of washed semen among 3,994 women. Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women after 2,863 cycles of assisted reproduction with the use of washed semen. Studies that measured HIV transmission to infants reported no cases of vertical transmission. Overall, 56.3% of couples (2,357/4,184) achieved a clinical pregnancy with the use of washed semen. CONCLUSION(S): Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help to further reduce the spread of HIV.

5 Review The impact of antiretroviral therapy on mortality in HIV positive people during tuberculosis treatment: a systematic review and meta-analysis. 2014

Odone, Anna / Amadasi, Silvia / White, Richard G / Cohen, Theodore / Grant, Alison D / Houben, Rein M G J. ·TB Modelling Group, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America; University of Parma, School of Medicine, Parma, Italy. · University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy. · TB Modelling Group, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom. · Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America; Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America. · TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom. ·PLoS One · Pubmed #25391135.

ABSTRACT: OBJECTIVE: To quantify the impact of antiretroviral therapy (ART) on mortality in HIV-positive people during tuberculosis (TB) treatment. DESIGN: We conducted a systematic literature review and meta-analysis. Studies published from 1996 through February 15, 2013, were identified by searching electronic resources (Pubmed and Embase) and conference books, manual searches of references, and expert consultation. Pooled estimates for the outcome of interest were acquired using random effects meta-analysis. SUBJECTS: The study population included individuals receiving ART before or during TB treatment. MAIN OUTCOME MEASURES: Main outcome measures were: (i) TB-case fatality ratio (CFR), defined as the proportion of individuals dying during TB treatment and, if mortality in HIV-positive people not on ART was also reported, (ii) the relative risk of death during TB treatment by ART status. RESULTS: Twenty-one studies were included in the systematic review. Random effects pooled meta-analysis estimated the CFR between 8% and 14% (pooled estimate 11%). Among HIV-positive TB cases, those receiving ART had a reduction in mortality during TB treatment of between 44% and 71% (RR = 0.42, 95%CI: 0.29-0.56). CONCLUSION: Starting ART before or during TB therapy reduces the risk of death during TB treatment by around three-fifths in clinical settings. National programmes should continue to expand coverage of ART for HIV positive in order to control the dual epidemic.

6 Review Influenza vaccination in HIV-positive subjects: latest evidence and future perspective. 2013

Ceravolo, A / Orsi, A / Parodi, V / Ansaldi, F. ·Department of Health Sciences, University of Genoa, Italy. s2098054@studenti.unige.it · Department of Health Sciences, University of Genoa, Italy. · Local Health Unit of Genoa (LHA 3), Italy. ·J Prev Med Hyg · Pubmed #24396998.

ABSTRACT: Annual influenza vaccination is recommended for persons with human immunodeficiency virus (HIV) infection. Recent reports indicate that immunizations may increase IIeplication in infected individuals. Generally, vaccination against influenza is well tolerated in both children and adult individuals with HNIVand does not induce significant changes in viral load and CD4+ cell counts. The observed increase in viral replication is usually transient and a clear, measurable progression of the underlying HIV disease is hard to be determined. Several studies reported immunogenicity data in HIV+ population, by comparing diferfent influenza vaccines, adjuvanted or not, and different administration routes. Data are encouraging because an adequate immune response is shown, although split/subunit vaccines do not elicite an efficient immune response in these subjects. New strategies have been evaluated to increase the immune response in immunocompromised patients.The aim of this review is to evaluate tolerability, safety, immunogenicity and efficacy of vaccines actually approved for human use and to consider latest evidence and future perspective in HIV positive subjects.

7 Review Reproductive assistance in HIV serodiscordant couples. 2013

Savasi, V / Mandia, L / Laoreti, A / Cetin, I. ·Unit of Obstetrics and Gynecology, Department of Clinical Sciences, Hospital L. Sacco, University of Milan, Via G. B. Grassi, 74, 20157 Milan, Italy. valeria.savasi@unimi.it ·Hum Reprod Update · Pubmed #23146867.

ABSTRACT: BACKGROUND: Three quarters of individuals infected with human immunodeficiency virus (HIV) are in their reproductive years and may consider pregnancy planning. Techniques have been developed which can minimize the risk of HIV transmission in these couples, and the current literature on this topic is reviewed here. METHODS: We reviewed the literature for the following topics: risk of HIV transmission, effects of HIV infection on fertility, reproductive assistance in industrialized and low-income countries, pre-exposure chemoprophylaxis (PrEP) and timed intercourse in HIV-discordant couples for both male and female positivity. Relevant publications were identified through searches of the EMBASE Medline and PubMed databases, the Google-indexed scientific literature and periodic specialized magazines from the on-line Library Service of the University of Milan, Italy. RESULTS: In serodiscordant couples in which the man is positive, the primary method used to prevent HIV transmission is 'sperm washing', followed by IUI or IVF. Data show that sperm washing in HIV-positive men has not produced seroconversion in women or their offspring; however, the evidence is limited. Recently, increasing evidence describing PrEP for HIV prevention has been published and PrEP could be an alternative to ART for fertile couples. Usually HIV-infected women undergo self-insemination around the time of ovulation. Few studies have been published on IVF outcome in HIV-infected women. CONCLUSIONS: Assisted reproduction programmes should be integrated into global public health services against HIV. For HIV serodiscordant couples with infected men, sperm washing should be the first choice. However, timed intercourse and PrEP for HIV prevention has been reported. Recent data highlight the possible impairment of fertility in HIV-infected women. Efforts to design a multicentric study should be strengthened.

8 Review Hepatocellular carcinoma in HIV positive patients. 2012

Nunnari, G / Berretta, M / Pinzone, M R / Di Rosa, M / Berretta, S / Cunsolo, G / Malaguarnera, M / Cosentino, S / De Paoli, P / Schnell, J M / Cacopardo, B. ·Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy. gnunnari@hotmail.com ·Eur Rev Med Pharmacol Sci · Pubmed #23047511.

ABSTRACT: Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV-1-infected patients leading to increased survival and a better quality of life. Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are common among HIV-1-infected subjects and represent the most important risk factors for hepatocellular carcinoma (HCC). Whether HIV plays a direct role in hepatocellular carcinoma (HCC) pathogenesis remains to be established.HCC clinical course depends on stage of cancer disease, performance status and comorbidities. Therapeutic options include liver transplantation, local antiblastic chemotherapy and biological drugs. In the HIV setting few data are available about treatment options. The increased longevity of patients with HIV imposes new strategies for prevention and therapeutic management of patients. The aim of this article is to provide an up-to-date review of HIV-related HCC in the HAART era.

9 Review Positioning of HIV-protease inhibitors in clinical practice. 2012

Andreoni, M / Perno, C F. ·Department of Public Health and Cell Biology, School of Medicine, University of Rome Tor Vergata, Rome, Italy. andreoni@uniroma2.it ·Eur Rev Med Pharmacol Sci · Pubmed #22338543.

ABSTRACT: The availability of more than 20 drugs for the treatment of HIV infection, and the success of the current antiretroviral regimens, should not overlook the difficulty of long-term maintaining the control of viral replication. The therapy needs to be continued for decades, if not for lifetime, and there are clear evidences that, even in patients fully suppressed for many years, HIV starts again its replication cycles in case antiviral pressure is removed. The development of resistance is a natural event at the time of virological failure, that needs to be taken into account in the global strategy against HIV in each particular patient. Taking all together, therapeutic regiments must be embedded, since the beginning, in a long-term strategy whose main task is the stable control of the replication of HIV. To do so, the choice of the first antiviral regimen has to be highly appropriate to keep the virus in check, and at the same time maintain future therapeutic options. Change of therapy at the time of failure has to be also appropriate, in term of timing, diagnostic strategy, and selection of drugs. Under these circumstances, the use of protease inhibitors in the first line acquires a strong rationale, that balances the greater pure potency of non-nucleoside reverse transcriptase inhibitors (NNRTI), and makes them a valuable options for many patients that need to start antiviral therapy.

10 Clinical Trial Probiotic supplementation promotes a reduction in T-cell activation, an increase in Th17 frequencies, and a recovery of intestinal epithelium integrity and mitochondrial morphology in ART-treated HIV-1-positive patients. 2017

d'Ettorre, Gabriella / Rossi, Giacomo / Scagnolari, Carolina / Andreotti, Mauro / Giustini, Noemi / Serafino, Sara / Schietroma, Ivan / Scheri, Giuseppe Corano / Fard, Saeid Najafi / Trinchieri, Vito / Mastromarino, Paola / Selvaggi, Carla / Scarpona, Silvia / Fanello, Gianfranco / Fiocca, Fausto / Ceccarelli, Giancarlo / Antonelli, Guido / Brenchley, Jason M / Vullo, Vincenzo. ·Department of Public Health and Infectious Diseases, Azienda Policlinico Umberto I of Rome, Rome, Italy. · School of Biosciences, Veterinary Medicine University of Camerino, Matelica, Italy. · Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy. · Department of Therapeutic Research and Medicines Evaluation, Italian Institute of Health, Rome, Italy. · Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. · Section of Microbiology, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. · Department of Emergency Surgery-Emergency Endoscopic Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. · Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA. ·Immun Inflamm Dis · Pubmed #28474815.

ABSTRACT: INTRODUCTION: HIV infection is characterized by a persistent immune activation associated to a compromised gut barrier immunity and alterations in the profile of the fecal flora linked with the progression of inflammatory symptoms. The effects of high concentration multistrain probiotic (Vivomixx®, Viale del Policlinico 155, Rome, Italy in EU; Visbiome®, Dupont, Madison, Wisconsin in USA) on several aspects of intestinal immunity in ART-experienced HIV-1 patients was evaluated. METHODS: A sub-study of a longitudinal pilot study was performed in HIV-1 patients who received the probiotic supplement twice a day for 6 months (T6). T-cell activation and CD4+ and CD8+ T-cell subsets expressing IFNγ (Th1, Tc1) or IL-17A (Th17, Tc17) were stained by cytoflorimetric analysis. Histological and immunohistochemical analyses were performed on intestinal biopsies while enterocytes apoptosis index was determined by TUNEL assay. RESULTS: A reduction in the frequencies of CD4 CONCLUSIONS: These findings highlight the potential beneficial effects of probiotic supplementation for the reconstitution of physical and immunological integrity of the mucosal intestinal barrier in ART-treated HIV-1-positive patients.

11 Article The impact of homocysteine, B 2019

Falasca, Katia / Di Nicola, Marta / Di Martino, Giuseppe / Ucciferri, Claudio / Vignale, Francesca / Occhionero, Alessandro / Vecchiet, Jacopo. ·Clinic of Infectious Diseases - Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Pescara, Italy. k.falasca@unich.it. · Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti- Pescara, Pescara, Italy. · School of Hygiene and Preventive Medicine - Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Pescara, Italy. · Clinic of Infectious Diseases - Department of Medicine and Science of Aging, University "G. d'Annunzio" Chieti-Pescara, Pescara, Italy. · Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. ·BMC Infect Dis · Pubmed #30717694.

ABSTRACT: BACKGROUND: The correlation among high levels of total homocysteine, low levels of B METHODS: 57 HIV infected were enrolled and underwent the serum measurement of homocysteine, B CONCLUSIONS: In this study serum homocysteine, B

12 Article Efficacy and tolerability of lamivudine plus dolutegravir compared with lamivudine plus boosted PIs in HIV-1 positive individuals with virologic suppression: a retrospective study from the clinical practice. 2019

Borghetti, Alberto / Lombardi, Francesca / Gagliardini, Roberta / Baldin, Gianmaria / Ciccullo, Arturo / Moschese, Davide / Emiliozzi, Arianna / Belmonti, Simone / Lamonica, Silvia / Montagnani, Francesca / Visconti, Elena / De Luca, Andrea / Di Giambenedetto, Simona. ·Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Policlinico Gemelli, Rome, Italy. · Infectious Diseases Unit, Siena University Hospital, Viale Mario Bracci, 53100, Siena, Italy. · Infectious Diseases Unit, Siena University Hospital, Viale Mario Bracci, 53100, Siena, Italy. andrea.deluca@unisi.it. ·BMC Infect Dis · Pubmed #30654739.

ABSTRACT: BACKGROUND: Direct comparisons between lamivudine plus bPIs and lamivudine plus dolutegravir as maintenance strategies in virologically-suppressed HIV positive patients are lacking. METHODS: Time to treatment discontinuation (TD) and virological failure (VF) were compared in a cohort of HIV+ patients on a virologically-effective ART starting lamivudine with either darunavir/r, atazanavir/r or dolutegravir. Changes in laboratory parameters were also evaluated. RESULTS: Four-hundred-ninety-four patients were analyzed (170 switching to darunavir/r, 141 to atazanavir/r, 183 to dolutegravir): median age was 49 years, with 8 years since ART start. Groups differed for age, HIV-risk factor, time since HIV-diagnosis and on ART, previous therapy and reasons for switching. Estimated proportions free from TD at week 48 and 96 were 79.8 and 48.3% of patients with darunavir/r, 87.0 and 70.9% with atazanavir/r, and 88.2 and 82.6% with dolutegravir, respectively (p < 0.001). Calendar years, HIV-risk factor, higher baseline cholesterol and an InSTI-based previous regimen predicted TD, whereas lamivudine+dolutegravir therapy and previous tenofovir use were protective. VF was the cause of TD in 6/123 cases with darunavir/r, 4/97 with atazanavir/r and 3/21 with dolutegravir. Other main reasons for TD were: toxicity (43.1% with darunavir/r, 39.2% with atazanavir/r, 52.4% with dolutegravir), further simplification (36.6% with darunavir/r, 30.9% with atazanavir/r, 14.3% with dolutegravir). Incidence of VF did not differ among study groups (p = 0.747). No factor could predict VF. Lipid profile improved in the dolutegravir group, whereas renal function improved in the bPIs groups. CONCLUSIONS: In real practice, a switch to lamivudine+dolutegravir showed similar efficacy but longer durability than a switch to lamivudine+bPIs.

13 Article Evolution of HIV-1 transmitted drug resistance in Italy in the 2007-2014 period: A weighted analysis. 2018

Franzetti, M / De Luca, A / Ceccherini-Silberstein, F / Spagnuolo, V / Nicastri, E / Mussini, C / Antinori, A / Monno, L / Vecchiet, J / Fanti, I / d'Arminio Monforte, A / Balotta, C / Anonymous2541082. ·Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy. Electronic address: franzetti.marco@gmail.com. · Siena University Hospital, Infectious Diseases Unit, Siena, Italy. · University of Rome Tor Vergata, Department of Experimental Medicine and Surgery, Rome, Italy. · San Raffaele Scientific Institute, Infectious Diseases, Milan, Italy. · National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy. · Clinic of Infectious Disease, University Hospital, Modena, Italy. · University of Bari, Department of Biomedical Science and Oncology, Bari, Italy. · University of Chieti, Infectious Diseases Clinic, Italy. · Catholic University of Sacred Heart, Clinical Infectious Diseases, Rome, Italy. · San Paolo University Hospital Milan, Clinic of Infectious and Tropical Diseases, Milan, Italy. · Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy. ·J Clin Virol · Pubmed #30075459.

ABSTRACT: BACKGROUND: Recent studies suggest that transmitted drug resistance (TDR) may be decreasing in latest years, likely because of the reduced frequency of acquired resistance. However, specific risk factors, geographical areas and special HIV-infected populations may be disproportionally affected by TDR. OBJECTIVES: Correlates of TDR and time trends were evaluated from 2007 to 2014. STUDY DESIGN: We evaluated the genotypic results of 2155 naïve patients enrolled in the I.Co.N.A cohort at 23 clinical Centers in Italy between 2007 and 2014. A weighted analysis was performed to account for the patients enrolled in the cohort in each clinical Centre at each biennium (total number of patients: 3737). RESULTS: Overall prevalence of TDR was 10.7%. Independent predictors of TDR were sexual risk factor (OR 2.315, p = 0.020) and non-Italian geographical origin (OR 1.57, p = 0.038). The weighted prevalence of TDR was 10.5% with a stable proportion over calendar years. Generally, TDR prevalence was numerically higher, although not significantly, in clinical Centers of metropolitan areas with more than 3 millions of residents as compared to others (11.3% vs. 9.2%). The difference in TDR prevalence between these Centers decreased in more recent years. CONCLUSIONS: A stable frequency of TDR was observed during the most recent years in Italy, with opposite and converging trends in large metropolitan areas as compared to the rest of the country, suggesting a more homogeneous spread of TDR across the country in latest years. Concerns remain for sexual route of infection and non-Italian origin, reinforcing the need for specific prevention strategies prioritizing specific populations.

14 Article Clearance of human papillomavirus related anal condylomas after oral and endorectal multistrain probiotic supplementation in an HIV positive male: A case report. 2018

Ceccarelli, Giancarlo / Cavallari, Eugenio Nelson / Savinelli, Stefano / Bianchi, Luigi / Pierangeli, Alessandra / Vullo, Francesco / Ciardi, Antonio / D'ettorre, Gabriella. ·Department of Public Health and Infectious Diseases. · Department of Molecular Medicine, Laboratory of Virology. · Department of Radiological, Oncological and Pathology Sciences, "Sapienza" University of Rome, Italy. ·Medicine (Baltimore) · Pubmed #29668581.

ABSTRACT: INTRODUCTION: Here we present the case of a 56-year-old human immunodeficiency virus (HIV)-infected man with multiple anal condylomas and positivity for human papilloma virus (HPV) 18 on anal brushing. Biopsies of the anal mucosa led to the diagnosis of Bowen's disease and a subsequent pelvic magnetic resonance imaging (MRI) scan evidenced multiple reactive lymphoadenopathies and large intra-anal condylomas. The patient was treated with a complete excision of Bowen's lesion and with a 4 months course of supplementation with a high concentration multistrain probiotic formulation administered orally and by rectal instillation with the purpose to reduce local inflammation and to enhance local mucosal immunity. CONCLUSION: An MRI performed at the end of the supplementation period evidenced the clearance of the anal condylomas previously described and no evidence of residual lymphadenopathies. Trials are therefore required to confirm this therapeutic possibility and for a better understanding of the mechanisms by which this specific probiotic formulation interacts with local epithelium when administered by the anal route.

15 Article HIV serostatus knowledge and serostatus disclosure with the most recent anal intercourse partner in a European MSM sample recruited in 13 cities: results from the Sialon-II study. 2017

Marcus, Ulrich / Schink, Susanne Barbara / Sherriff, Nigel / Jones, Anna-Marie / Gios, Lorenzo / Folch, Cinta / Berglund, Torsten / Nöstlinger, Christiana / Niedźwiedzka-Stadnik, Marta / Dias, Sonia F / Gama, Ana F / Naseva, Emilia / Alexiev, Ivailo / Staneková, Danica / Toskin, Igor / Pitigoi, Daniela / Rafila, Alexandru / Klavs, Irena / Mirandola, Massimo / Anonymous3220928. ·Department of Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany. MarcusU@rki.de. · Department of Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany. · University of Brighton, Health Sciences, Brighton, UK. · Mill View Hospital, Sussex Education Centre, Research & Development, Brighton, UK. · Department of Health, Verona University Hospital, CReMPE - Regional Coordination Centre for European Project Management, Verona, Veneto Region, Italy. · Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain. · CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. · Department of Monitoring & Evaluation, Public Health Agency of Sweden, Solna, Sweden. · Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. · Department of Epidemiology, National Institute of Public Health, Warsaw, Poland. · Universidade Nova de Lisboa, Instituto de Higiene e Medicina Tropical, Global Health and Tropical Medicine, Lisbon, Portugal. · Ministry of Health, Program "Prevention and Control of HIV/AIDS", Sofia, Bulgaria. · National Centre of Infectious and Parasitic Diseases, National Reference Laboratory of HIV, Sofia, Bulgaria. · Slovak Medical University, National Reference Centre for HIV/AIDS, Bratislava, Slovakia. · Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. · University of Medicine and Pharmacy Carol Davila, Department Clinic 2, Epidemiology, Bucharest, Romania. · National Institute for Infectious Diseases "Prof Dr Matei Bals", Bucharest, Romania. · Department of Microbiology, National Institute of Infectious Diseases "Prof Dr Matei Bals", Bucharest, Romania. · National Institute of Public Health, Communicable Diseases Centre, Ljubljana, Slovenia. · Department of Health, Infectious Disease Section, Verona University Hospital, CReMPE - Regional Coordination Centre for European Project Management, Verona, Veneto Region, Italy. ·BMC Infect Dis · Pubmed #29178847.

ABSTRACT: BACKGROUND: Knowledge of HIV status can be important in reducing the risk of HIV exposure. In a European sample of men-who-have-sex-with-men (MSM), we aimed to identify factors associated with HIV serostatus disclosure to the most recent anal intercourse (AI) partner. We also aimed to describe the impact of HIV serostatus disclosure on HIV exposure risks. METHODS: During 2013 and 2014, 4901 participants were recruited for the bio-behavioural Sialon-II study in 13 European cities. Behavioural data were collected with a self-administered paper questionnaire. Biological specimens were tested for HIV antibodies. Factors associated with HIV serostatus disclosure with the most recent AI partner were examined using bivariate and multilevel multivariate logistic regression analysis. We also describe the role of serostatus disclosure for HIV exposure of the most recent AI partner. RESULTS: Thirty-five percent (n = 1450) of the study participants reported mutual serostatus disclosure with their most recent AI partner or disclosed having HIV to their partner. Most of these disclosures occurred between steady partners (74%, n = 1077). In addition to the type of partner and HIV diagnosis status, other factors positively associated with HIV serostatus disclosure in the multilevel multivariate logistic regression model were recent testing, no condom use, and outness regarding sexual orientation. Disclosure rates were lowest in three south-eastern European cities. Following condom use (51%, n = 2099), HIV serostatus disclosure (20%, n = 807) was the second most common prevention approach with the most recent AI partner, usually resulting in serosorting. A potential HIV exposure risk for the partner was reported by 26% (111/432) of HIV antibody positive study participants. In 18% (20/111) of exposure episodes, an incorrect HIV serostatus was unknowingly communicated. Partner exposures were equally distributed between steady and non-steady partners. CONCLUSIONS: The probability of HIV exposure through condomless AI is substantially lower after serostatus disclosure compared to non-disclosure. Incorrect knowledge of one's HIV status contributes to a large proportion of HIV exposures amongst European MSM. Maintaining or improving condom use for anal intercourse with non-steady partners, frequent testing to update HIV serostatus awareness, and increased serostatus disclosure particularly between steady partners are confirmed as key aspects for reducing HIV exposures amongst European MSM.

16 Article Cardiovascular disease (CVD) and chronic kidney disease (CKD) event rates in HIV-positive persons at high predicted CVD and CKD risk: A prospective analysis of the D:A:D observational study. 2017

Boyd, Mark A / Mocroft, Amanda / Ryom, Lene / Monforte, Antonella d'Arminio / Sabin, Caroline / El-Sadr, Wafaa M / Hatleberg, Camilla Ingrid / De Wit, Stephane / Weber, Rainer / Fontas, Eric / Phillips, Andrew / Bonnet, Fabrice / Reiss, Peter / Lundgren, Jens / Law, Matthew. ·Kirby Institute, University of New South Wales, Sydney, Australia. · Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia. · Department of Infection and Population Health, University College London, London, United Kingdom. · Centre of Excellence for Health, Immunity and Infections, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. · Dipartimento di Scienze della Salute, Clinica di Malattie Infettive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy. · ICAP at Columbia University, New York, New York, United States of America. · Division of Infectious Diseases, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium. · Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. · Department of Public Health, Nice University Hospital, Nice, France. · Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France. · Bordeaux Population Health, INSERM U1219, Université de Bordeaux, Bordeaux, France. · Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · HIV Monitoring Foundation, Amsterdam, The Netherlands. ·PLoS Med · Pubmed #29112958.

ABSTRACT: BACKGROUND: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study has developed predictive risk scores for cardiovascular disease (CVD) and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] ≤ 60 ml/min/1.73 m2) events in HIV-positive people. We hypothesized that participants in D:A:D at high (>5%) predicted risk for both CVD and CKD would be at even greater risk for CVD and CKD events. METHODS AND FINDINGS: We included all participants with complete risk factor (covariate) data, baseline eGFR > 60 ml/min/1.73 m2, and a confirmed (>3 months apart) eGFR < 60 ml/min/1.73 m2 thereafter to calculate CVD and CKD risk scores. We calculated CVD and CKD event rates by predicted 5-year CVD and CKD risk groups (≤1%, >1%-5%, >5%) and fitted Poisson models to assess whether CVD and CKD risk group effects were multiplicative. A total of 27,215 participants contributed 202,034 person-years of follow-up: 74% male, median (IQR) age 42 (36, 49) years, median (IQR) baseline year of follow-up 2005 (2004, 2008). D:A:D risk equations predicted 3,560 (13.1%) participants at high CVD risk, 4,996 (18.4%) participants at high CKD risk, and 1,585 (5.8%) participants at both high CKD and high CVD risk. CVD and CKD event rates by predicted risk group were multiplicative. Participants at high CVD risk had a 5.63-fold (95% CI 4.47, 7.09, p < 0.001) increase in CKD events compared to those at low risk; participants at high CKD risk had a 1.31-fold (95% CI 1.09, 1.56, p = 0.005) increase in CVD events compared to those at low risk. Participants' CVD and CKD risk groups had multiplicative predictive effects, with no evidence of an interaction (p = 0.329 and p = 0.291 for CKD and CVD, respectively). The main study limitation is the difference in the ascertainment of the clinically defined CVD endpoints and the laboratory-defined CKD endpoints. CONCLUSIONS: We found that people at high predicted risk for both CVD and CKD have substantially greater risks for both CVD and CKD events compared with those at low predicted risk for both outcomes, and compared to those at high predicted risk for only CVD or CKD events. This suggests that CVD and CKD risk in HIV-positive persons should be assessed together. The results further encourage clinicians to prioritise addressing modifiable risks for CVD and CKD in HIV-positive people.

17 Article CD4 T cell decline following HIV seroconversion in individuals with and without CXCR4-tropic virus. 2017

Ghosn, Jade / Bayan, Tatiana / Meixenberger, Karolin / Tran, Laurent / Frange, Pierre / d'Arminio Monforte, Antonella / Zangerle, Robert / de Mendoza, Carmen / Krastinova, Evguenia / Porter, Kholoud / Meyer, Laurence / Chaix, Marie-Laure / Anonymous4530925. ·Université Paris Descartes, Sorbonne Paris Cité, Paris, France. · Inserm UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Université Pierre et Marie Curie, Paris, France. · Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, HIV Epidemiology, Le Kremlin-Bicêtre, F-94276, France. · Univ Paris-Sud, UMRS 1018, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, F-94276, France. · Robert Koch Institute, HIV and other Retroviruses, Berlin, Germany. · AP-HP, Hopital Bicêtre, Epidemiology and Public Health Service, Le Kremlin Bicêtre, F-94276, France. · AP-HP, Laboratoire de Microbiologie Clinique, Hôpital Universitaire Necker-Enfants Malades, Paris, France. · Infectious Diseases, University of Milan, San Paolo Hospital, Milano, Italy and Health Sciences, University of Milan, San Paolo Hospital, Milano, Italy. · Medical University Innsbruck, Innsbruck, Austria. · Research Institute and University Hospital Puerta de Hierro, Majahonda, Madrid, Spain. · Medical Research Council Clinical Trials Unit, University College London, London, UK. · INSERM U941, Université Paris Diderot, Paris, France. · APHP, Laboratoire de Virologie, Hôpital Saint Louis, Paris, France. ·J Antimicrob Chemother · Pubmed #29091208.

ABSTRACT: Background: The natural clinical and immunological courses following HIV seroconversion with CXCR4-tropic or dual-mixed (X4/DM) viruses are controversial. We compared spontaneous immunological outcome in patients harbouring an X4/DM virus at the time of seroconversion with those harbouring a CCR5-tropic (R5) virus. Methods: Data were included from patients participating in CASCADE, a large cohort collaboration of HIV seroconverters, with ≥2 years of follow-up since seroconversion. The HIV envelope gene was sequenced from frozen plasma samples collected at enrolment, and HIV tropism was determined using Geno2Pheno (false-positive rate 10%). The spontaneous CD4 T cell evolution was compared by modelling CD4 kinetics using linear mixed-effects models with random intercept and random slope. Results: A total of 1387 patients were eligible. Median time between seroconversion and enrolment was 1 month (range 0-3). At enrolment, 202 of 1387 (15%) harboured an X4/DM-tropic virus. CD4 decrease slopes were not significantly different according to HIV-1 tropism during the first 30 months after seroconversion. No marked change in these results was found after adjusting for age, year of seroconversion and baseline HIV viral load. Time to antiretroviral treatment initiation was not statistically different between patients harbouring an R5 (20.76 months) and those harbouring an X4/DM-tropic virus (22.86 months, logrank test P = 0.32). Conclusions: In this large cohort collaboration, 15% of the patients harboured an X4/DM virus close to HIV seroconversion. Patients harbouring X4/DM-tropic viruses close to seroconversion did not have an increased risk of disease progression, estimated by the decline in CD4 T cell count or time to combined ART initiation.

18 Article Tuberculosis Case Finding With Combined Rapid Point-of-Care Assays (Xpert MTB/RIF and Determine TB LAM) in HIV-Positive Individuals Starting Antiretroviral Therapy in Mozambique. 2017

Floridia, Marco / Ciccacci, Fausto / Andreotti, Mauro / Hassane, Archa / Sidumo, Zita / Magid, Nurja A / Sotomane, Horacio / David, Muhlavasse / Mutemba, Elsa / Cebola, Junia / Mugunhe, Remigio Josè / Riccardi, Fabio / Marazzi, Maria Cristina / Giuliano, Marina / Palombi, Leonardo / Mancinelli, Sandro. ·National Center for Global Health, Istituto Superiore di Sanità. · DREAM Program, Community of S. Egidio, Rome, Italy. · DREAM Program, Community of S. Egidio, Maputo. · DREAM Program, Community of S. Egidio, Machava. · DREAM Program, Community of S. Egidio, Beira, Mozambique. · Department of Biomedicine and Prevention, University of Rome Tor Vergata. · LUMSA University, Rome, Italy. ·Clin Infect Dis · Pubmed #29020319.

ABSTRACT: Background: Tuberculosis is a major health concern in several countries, and effective diagnostic algorithms for use in human immunodeficiency virus (HIV)-positive patients are urgently needed. Methods: At prescription of antiretroviral therapy, all patients in 3 Mozambican health centers were screened for tuberculosis, with a combined approach: World Health Organization (WHO) 4-symptom screening (fever, cough, night sweats, and weight loss), a rapid test detecting mycobacterial lipoarabinomannan in urine (Determine TB LAM), and a molecular assay performed on a sputum sample (Xpert MTB/RIF; repeated if first result was negative). Patients with positive LAM or Xpert MTB/RIF results were referred for tuberculosis treatment. Results: Among 972 patients with a complete diagnostic algorithm (58.5% female; median CD4 cell count, 278/μL; WHO HIV stage I, 66.8%), 98 (10.1%) tested positive with Xpert (90, 9.3%) or LAM (34, 3.5%) assays. Compared with a single-test Xpert strategy, dual Xpert tests improved case finding by 21.6%, LAM testing alone improved it by 13.5%, and dual Xpert tests plus LAM testing improved it by 32.4%. Rifampicin resistance in Xpert-positive patients was infrequent (2.5%). Among patients with positive results, 22 of 98 (22.4%) had no symptoms at WHO 4-symptom screening. Patients with tuberculosis diagnosed had significantly lower CD4 cell counts and hemoglobin levels, more advanced WHO stage, and higher HIV RNA levels. Fifteen (15.3%) did not start tuberculosis treatment, mostly owing to rapidly deteriorating clinical conditions or logistical constraints. The median interval between start of the diagnostic algorithm and start of tuberculosis treatment was 7 days. Conclusions: The prevalence of tuberculosis among Mozambican HIV-positive patients starting antiretroviral therapy was 10%, with limited rifampicin resistance. Use of combined point-of-care tests increased case finding, with a short time to treatment. Interventions are needed to remove logistical barriers and prevent presentation in very advanced HIV/tuberculosis disease.

19 Article Immune response to hepatitis B vaccination in HIV-positive individuals with isolated antibodies against hepatitis B core antigen: Results of a prospective Italian study. 2017

Morsica, Giulia / Bagaglio, Sabrina / Spagnuolo, Vincenzo / Castagna, Antonella / Di Serio, Clelia / Galli, Andrea / Della Torre, Liviana / Andolina, Andrea / Pramov, Alexander / Uberti-Foppa, Caterina. ·Division of Infectious Diseases, IRCCS, Ospedale San Raffaele, Milan, Italy. · Vita-Salute San Raffaele University, Milan, Italy. · Vita-Salute San Raffaele University, CUSSB (University Centre for Statistics in the Biomedical Sciences), Milan, Italy. ·PLoS One · Pubmed #28863182.

ABSTRACT: BACKGROUND AND AIM: Antibodies against hepatitis B core antigen (anti-HBc) are found in 14-44% of patients with HIV infection, but it is still unclear whether hepatitis B virus (HBV) vaccination should be recommended for HIV-positive subjects with isolated anti-HBc (IAHBc). We examined the rate of anamnestic and primary responses (ARs and PRs) and associated factors in a group of HIV-infected patients with an IAHBc profile. METHODS: This prospective study recruited 25 HIV-positive patients with anti-HBc alone who were vaccinated against HBV infection. Those without an AR (anti-hepatitis B envelope antigen [anti-HBs] levels of <10 U/L) or who were hypo-responsiveness (anti-HBs levels of >10 but <100 U/L) four weeks after the first dose of vaccine underwent a full course of vaccinations. Their clinical and virological data, including the presence of occult hepatitis B infection (OBI), were evaluated in accordance with the vaccination schedule. RESULTS: Six of the 25 patients (24%) showed an AR, four of whom had anti-HBs levels of <100 U/L. Ten of 19 (52.6%) remaining patients became seroprotected after the third dose. OBI was detected in four of the six patients with an AR, two of the 10 patients with a PR, and none of the nine patients who did not respond. Multivariate analysis showed that an AR was associated with the presence of OBI (P = 0.0162), and a PR was associated with HCV antibody status. (P = 0.0191). CONCLUSIONS: Our data suggest that testing for anti-HBc alone may not be a reliable means of assessing protection from HBV infection in HIV-positive patients. OBI-positive patients may benefit from a single vaccine dose. Anti-HCV serostatus may affect PRs.

20 Article Terminal differentiation of T cells is strongly associated with CMV infection and increased in HIV-positive individuals on ART and lifestyle matched controls. 2017

Booiman, Thijs / Wit, Ferdinand W / Girigorie, Arginell F / Maurer, Irma / De Francesco, Davide / Sabin, Caroline A / Harskamp, Agnes M / Prins, Maria / Franceschi, Claudio / Deeks, Steven G / Winston, Alan / Reiss, Peter / Kootstra, Neeltje A / Anonymous1540916. ·Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. · Department of Global Health & Division of Infectious Disease, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · HIV Monitoring Foundation, Amsterdam, The Netherlands. · Department of Infection and Population Health, University College London, London, United Kingdom. · Public health service, Amsterdam, The Netherlands. · Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum Universita di Bologna, Bologna, Italy. · Department of Medicine, University of California, San Francisco, California, United States of America. · Imperial College of Science, Technology and Medicine, London, United Kingdom. ·PLoS One · Pubmed #28806406.

ABSTRACT: HIV-1-positive individuals on successful antiretroviral therapy (ART) are reported to have higher rates of age-associated non-communicable comorbidities (AANCCs). HIV-associated immune dysfunction has been suggested to contribute to increased AANCC risk. Here we performed a cross-sectional immune phenotype analysis of T cells in ART-treated HIV-1-positive individuals with undetectable vireamia (HIV-positives) and HIV-1-negative individuals (HIV-negatives) over 45 years of age. In addition, two control groups were studied: HIV negative adults selected based on lifestyle and demographic factors (Co-morBidity in Relation to AIDS, or COBRA) and unselected age-matched donors from a blood bank. Despite long-term ART (median of 12.2 years), HIV-infected adults had lower CD4+ T-cell counts and higher CD8+ T-cell counts compared to well-matched HIV-negative COBRA participants. The proportion of CD38+HLA-DR+ and PD-1+ CD4+ T-cells was higher in HIV-positive cohort compared to the two HIV-negative cohorts. The proportion CD57+ and CD27-CD28- cells of both CD4+ and CD8+ T-cells in HIV-positives was higher compared to unselected adults (blood bank) as reported before but this difference was not apparent in comparison with well-matched HIV-negative COBRA participants. Multiple regression analysis showed that the presence of an increased proportion of terminally differentiated T cells was strongly associated with CMV infection. Compared to appropriately selected HIV-negative controls, HIV-positive individuals on ART with long-term suppressed viraemia exhibited incomplete immune recovery and increased immune activation/exhaustion. CMV infection rather than treated HIV infection appears to have more consistent effects on measures of terminal differentiation of T cells.

21 Article High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy? 2017

Girometti, Nicolò / Gutierrez, Angela / Nwokolo, Nneka / McOwan, Alan / Whitlock, Gary. ·Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. · Chelsea & Westminster Hospital NHS Foundation Trust, London, UK. ·Sex Transm Infect · Pubmed #28729516.

ABSTRACT: OBJECTIVES: HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for HIV prevention. Understanding the impact of risk factors for HIV transmission to identify those at highest risk would favour the implementation of PrEP, currently limited by costs. In this service evaluation, we estimated the incidence of bacterial STIs in men who have sex with men (MSM) diagnosed with early syphilis attending a London sexual health clinic according to their HIV status. In addition, we estimated the incidence of HIV infection in HIV-negative MSM, following a diagnosis of early syphilis. METHODS: We undertook a retrospective case note review of all MSM patients diagnosed with early syphilis between January and June 2014. A number of sexual health screens and diagnoses of chlamydia, gonorrhoea and HIV were prospectively analysed following the syphilis diagnosis. RESULTS: 206 MSM were diagnosed with early syphilis. 110 (53%) were HIV-negative at baseline, 96 (47%) were HIV-positive. Only age (37 vs 32 years, p=0.0005) was significantly different according to HIV status of MSM at baseline. In HIV-negative versus HIV-positive MSM, incidence of rectal chlamydia infection at follow-up was 27 cases vs 50/100 person-years of follow-up (PYFU) (p=0.0039), 33 vs 66/100 PYFU (p=0.0044) for rectal gonorrhoea and 10 vs 26/100 PYFU (p=0.0044) for syphilis reinfection, respectively. Total follow-up for 110 HIV-negative MSM was 144 person-years. HIV incidence was 8.3/100 PYFU (CI 4.2 to 14). CONCLUSIONS: A diagnosis of early syphilis carries a high risk of consequent HIV seroconversion and should warrant prioritised access to prevention measures such as PrEP and regular STI screening to prevent HIV transmission.

22 Article Head and neck diffuse large B cell lymphomas (HN-DLBCL) in human immunodeficiency virus (HIV) positive patients: long-term results in the highly active antiretroviral therapy (HAART) era. 2017

De Felice, Francesca / Di Mino, Andrea / Grapulin, Lavinia / Mistrulli, Maria Lusia / Musio, Daniela / Tombolini, Vincenzo. ·Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 326, 00161, Rome, Italy. fradefelice@hotmail.it. · Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 326, 00161, Rome, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #28702826.

ABSTRACT: To report long-term outcomes and toxicity rates after chemotherapy (CHT) followed by radiotherapy (RT) in the highly active antiretroviral therapy (HAART) era in human immunodeficiency virus (HIV) positive patients with head and neck diffuse large B cell lymphomas (HN-DLBCL). Clinical data concerning consecutive HIV patients treated for DLBCL located in head and neck region with CHT and RT were retrospectively reviewed. Systemic treatment consisted of combination CHT agents given with concomitant HAART and regimen was left to oncologists' discretion. Involved field RT was delivered at a total dose of 30-36 Gy (2 Gy per fraction). Survival rates were estimated using the Kaplan-Meier method. Toxicity was evaluated using National Cancer Institute's Common Terminology Criteria for Adverse Events. Overall, 13 patients were included. There were no missing data. Eight patients had advanced disease (stage III-IV = 8; 61.5%). The most common primary tumor location was oral cavity (n = 7) with large mass at presentation. All patients completed the programmed treatment. Severe acute toxicity was observed in one patient, only. Overall, three patients had died and no treatment-related deaths occurred. After a median follow-up of 152 months, the 20-year overall survival and disease-free survival rates were 65.9 and 41.5%, respectively. Globally, there were no RT-related late complications. This data analysis suggested that CHT followed by RT can be safety proposed in the management of patients with HIV-related HN-DLBCL in the HAART era. Further investigations are necessary to validate our results.

23 Article Hospital admissions for HIV-infected prisoners in Italy. 2017

Pontali, Emanuele / Ranieri, Roberto / Rastrelli, Elena / Iannece, Maria Donata / Ialungo, Anna Maria / Dell'Isola, Serena / Liberti, Alfonso / Rosario, Pietro / Casati, Rodolfo / Starnini, Giulio / Babudieri, Sergio. ·Department of Infectious Diseases, Galliera Hospital, Genoa, Italy. · Department of Internal Medicine, Santi Paolo e Carlo Hospital, Milan, Italy. · Medicina Protetta-malattie Infettive, Ospedale di Belcolle, Viterbo, Italy. · Cotugno Hospital, Naples, Italy. · Ospedale di Belcolle, Viterbo, Italy. · Belcolle Hospital, Viterbo, Italy. · V Division, AORN Ospedali dei Colli, Napoli, Italy. · AORN Ospedali dei Colli, Napoli, Italy. · Santi Paolo e Carlo Hospital, Milan, Italy. · Unit Medicina Protetta-Malattie Infettive, Ospedale di Belcolle, Viterbo, Italy. · Facolta di Medicina e Chirurgia, Universita degli Studi di Sassari , Sassari, Italy. ·Int J Prison Health · Pubmed #28581372.

ABSTRACT: Purpose The purpose of this paper is to give a description of the clinical conditions and patient demographics of inpatient admissions of human immunodeficiency virus (HIV)-infected inmates in three hospital wards that provide hospital care for inmates in Italy. Design/methodology/approach This is a retrospective review of hospital medical admissions of patients living with HIV from January 1 to December 31, 2014, in three Italian referral centers for hospitalization of inmates. Findings A total of 85 admissions for 85 different HIV-infected inmates occurred in 2014 in the three centers participating to the study. Most patients (54.1 percent) were co-infected with hepatitis C. Discharge diagnosis largely varied ranging from common HIV-related co-morbidities to completely independent diagnosis. The most commonly observed discharge diagnoses were chronic hepatitis C, liver cirrhosis, opiate dependence and thrombocytopenia. Originality/value Discharge diagnosis between HIV-infected inmates and HIV-infected patients in freedom are strikingly and significantly different. A large number of hospitalized HIV-infected inmates were affected by chronic viral hepatitis and liver cirrhosis; this is probably a direct consequence of the high prevalence of HCV and/or HBV co-infections in the inmate population in Italy. In addition, a significantly lower proportion of cancer diagnosis was observed among inmates; this is possibly justified by the fact that in our Italian settings when HIV infection is at advanced stages or if cancer treatment is started those affected are released from prison and can continue their diagnostic and treatment follow-up in freedom.

24 Article Infectious disease ward admission positively influences P. jiroveci pneumonia (PjP) outcome: A retrospective analysis of 116 HIV-positive and HIV-negative immunocompromised patients. 2017

Ricciardi, Alessandra / Gentilotti, Elisa / Coppola, Luigi / Maffongelli, Gaetano / Cerva, Carlotta / Malagnino, Vincenzo / Mari, Alessia / Di Veroli, Ambra / Berrilli, Federica / Apice, Fabiana / Toschi, Nicola / Di Cave, David / Parisi, Saverio Giuseppe / Andreoni, Massimo / Sarmati, Loredana. ·Infectious Diseases, Tor Vergata University, Rome, Italy. · Respiratory Diseases Unit, Tor Vergata University, Rome, Italy. · Department of Haematology, Tor Vergata University, Rome, Italy. · Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy. · Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy. · Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, United States of America. · Department of Molecular Medicine, University of Padua, Padua, Italy, Clinical Microbiology and Virology Unit, Padua University Hospital, Padua, Italy. ·PLoS One · Pubmed #28505159.

ABSTRACT: P. jiroveci (Pj) causes a potentially fatal pneumonia in immunocompromised patients and the factors associated with a bad outcome are poorly understood. A retrospective analysis on Pj pneumonia (PjP) cases occurring in Tor Vergata University Hospital, Italy, during the period 2011-2015. The patients' demographic, clinical and radiological characteristics and the Pj genotypes were considered. The study population included 116 patients, 37.9% of whom had haematological malignancy or underwent haematological stem cell transplantation (HSCT), 22.4% had HIV infection, 16.4% had chronic lung diseases (CLD), 7.8% had a solid cancer, and 3.4% underwent a solid organ transplant (SOT). The remaining 12.1% had a miscellaneous other condition. At univariate analysis, being older than 60 years was significantly correlated with a severe PjP (OR [95%CI] 2.52 [0.10-5.76]; p = 0.031) and death (OR [95%CI] 2.44 [1.05-5.70]; p = 0.036), while a previous trimethoprim/sulfamethoxazole (TMP/SMX) prophylaxis were significantly associated with a less severe pneumonia (OR[95%CI] 0.35 [0.15-0.84], p = 0.023); moreover, death due to PjP was significantly more frequent in patients with CLD (OR[95%CI] 3.26 [1.17-9.05]; p = 0.019) while, admission to the Infectious Diseases Unit was significantly associated with fewer deaths (OR[95%CI] 0.10 [0.03-0.36], p = 0.002). At multivariate analysis, a better PjP outcome was observed in patients taking TMP/SMX prophylaxis and that were admitted to the Infectious Diseases Unit (OR[95%CI] 0.27 [0.07-1.03], p = 0.055, OR[95%CI] 0.16 [0.05-0.55]; p = 0.004, respectively). In conclusion, in our study population, TMP/SMX prophylaxis and infectious disease specialist approach were variables correlated with a better PjP outcome.

25 Article Attitudes of Heterosexual Men and Women Toward HIV Negative and Positive Gay Men. 2017

Norcini Pala, Andrea / Villano, Paola / Clinton, Lauren. ·a HIV center New York State Psychiatric Institute (NYSPI)/Columbia University , New York , New York , USA. · b School of Psychology and Education , University of Bologna , Bologna , Italy. · c Teachers College, Columbia University , New York , New York , USA. ·J Homosex · Pubmed #27892803.

ABSTRACT: Attitudes of Italian heterosexual men and women toward gay men, both HIV positive and negative, are poorly investigated. Italian culture is still extremely conservative and provides limited support to the gay community (e.g., lack of same-sex marriage recognition). Consequently, gay men experience social exclusion and disparities. The present study explores the association between homophobia and closeness with sexual orientation and HIV status. 261 heterosexual Italian men and women were assessed for feelings of closeness and homophobia after reading a vignette where the character was C1: heterosexual and HIV negative; C2: gay and HIV negative; or C3: gay and HIV positive. Experiences of homophobia and closeness varied depending on gender of participant and condition assigned, and higher levels of homophobia were correlated with lower levels of closeness regardless of HIV status. Implications and future directions are discussed.

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