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Background: Resilience is defined as an individual's positive adaptation to stressors. The COVID-19 pandemic represents a generalized stressor which may affect differently people living with HIV (PLWH). The objective of this study was to characterize resilience in PLWH with particular regarding the identification of frailty-resilience phenotypes, which may differently affect health-related quality of life (HR-QoL)., Methods: This was an observational study of PLWH attending Modena HIV Metabolic Clinic. Frailty was assessed in 2019, before the onset of the COVID-19 pandemic by using 37-Item frailty index ranging from 0 to 1. The frailty index score was categorized as fit (<0.25) or frail (>0.25). In January 2021, PLWH were offered to complete a set of electronic questionnaires including the CD-RISC-25 for resilience and EQ-5D5L and SF-36 for HR-QoL. Resilience was defined as CD-RISC-25 score >75.7 (ranging from 0 to 100)., Results: Of 800 PLWH reached by mail, 575 (72%) completed the questionnaires. The median age and HIV duration were 54.5 and 24.3 years, respectively. Impaired resilience was associated with loneliness [odds ratio (OR = 2.39; 1.20 to 4.76, P < 0.001)]. Predictors for EQ-5D5L <89.7% were the phenotypes "frail/nonresilient" [OR = 5.21, 95% confidence interval (CI): 2.62 to 10.33] and "fit/nonresilient" (OR = 5.48, 95% CI: 2.8 to 10.74). Predictors for SF-36 <64.40 were the phenotypes "frail/nonresilient" (OR = 7.43, 95% CI: 2.57 to 21.22) and "fit/nonresilient" (OR = 6.27, 95% CI: 2.17 to 18.16). Both models were corrected for age, sex, HIV duration, and nadir CD4., Conclusions: Resilience characterizes the well-being of PLWH during the COVID-19 crisis. This construct is complementary to frailty in the identification of clinical phenotypes with different impacts on HR-QoL., Competing Interests: G.G. and C.M. received research grant and speaker honorarium from Gilead, ViiV, MERCK, and Jansen. G.G. and C.M. attended advisory boards of Gilead, ViiV, and MERCK. The other authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: A proposal has recently been advanced to change the traditional definition of nonalcoholic fatty liver disease to metabolic-associated fatty liver disease (MAFLD), to reflect the cluster of metabolic abnormalities that may be more closely associated with cardiovascular risk. Long coronavirus disease 2019 (COVID-19) is a smoldering inflammatory condition, characterized by several symptom clusters. This study aims to determine the prevalence of MAFLD in patients with postacute COVID syndrome (PACS) and its association with other PACS-cluster phenotypes., Methods: We included 235 patients observed at a single university outpatient clinic. The diagnosis of PACS was based on ≥1 cluster of symptoms: respiratory, neurocognitive, musculoskeletal, psychological, sensory, and dermatological. The outcome was prevalence of MAFLD detected by transient elastography during the first postdischarge follow-up outpatient visit. The prevalence of MAFLD at the time of hospital admission was calculated retrospectively using the hepatic steatosis index., Results: Of 235 patients, 162 (69%) were men (median age 61). The prevalence of MAFLD was 55.3% at follow-up and 37.3% on admission ( P  < .001). Insulin resistance (odds ratio [OR] = 1.5; 95% confidence interval [CI], 1.14-1.96), body mass index (OR = 1.14; 95% CI, 1.04-1.24), and the metabolic syndrome (OR = 2.54; 95% CI, 1.13-5.68) were independent predictors of MAFLD. The number of PACS clusters was inversely associated with MAFLD (OR = 0.86; 95% CI, .76-0.97). Thirty-one patients (13.2%) had MAFLD with no other associated PACS clusters. All correlations between MAFLD and other PACS clusters were weak., Conclusions: Metabolic-associated fatty liver disease was highly prevalent after hospital discharge and may represent a specific PACS-cluster phenotype, with potential long-term metabolic and cardiovascular health implications., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Objectives: This research aims to study the relationship between personality traits and periodontal clinical outcomes by taking into account the level of anxiety and depression, periodontal health and oral hygiene behaviour of patients affected with gingivitis or moderate periodontitis requiring periodontal therapy., Material and Methods: The periodontal data of 40 systemically healthy patients affected by gingivitis or moderate periodontitis were collected at baseline and 18 months later. The psychological variables, dental awareness and adherence intent of the patients were assessed through questionnaires, and only those patients that exhibited a higher degree of compliance were included in the study. The personality traits (cluster A: paranoid, schizoid, schizotypal; cluster B: borderline, antisocial, narcissistic, and histrionic; cluster C: avoidant, dependent, and obsessive-compulsive) and the level of anxiety and depression of the patients were assessed. Patients were instructed with oral hygiene measures and were treated with periodontal therapy., Results: Clusters A and B showed a consistent tendency for reduced levels of oral hygiene (increased full-mouth plaque score - FMPS). The results from cluster B were found to be significantly related to deep periodontal pockets at baseline. On the contrary, cluster C seemed to be linked to clinically better indices, particularly in terms of full-mouth-bleeding-score and pocket depth, both at baseline and 18 months later. The results collected from clusters B and C were directly correlated with anxiety, depression and FMPS. Moreover, anxiety was directly correlated with the patient's need for professional oral-care., Conclusions: Personality traits appear to play a significant role in determining the therapeutic outcomes of periodontal therapy in themselves. Thus, it is ideal for several important psychological, affective or behavioural factors to be associated with various personality traits so as to orient the outcome of periodontal therapy.