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Background and Objectives: HIV epidemics may differ among epidemiological contexts. We aimed at constructing an HIV clinical cohort whose main epidemiological, clinical and therapeutical characteristics are described (the CalabrHIV cohort, Calabria Region, Southern Italy)., Methods: The CalabrHIV Cohort includes all HIV patients on active follow-up in all infectious disease centers in the Calabria Region as at October 2014. All information was recorded in a common electronic database. Not-infectious co-morbidities (such as cardiovascular diseases, bone fractures, diabetes, renal failure and hypertension) were also studied., Results: 548 patients (68% males; 59% aged <50 years) were included in the CalabrHIV cohort. Major risk factors were: sexual transmission (49%) and intravenous drug use (34%). 39% patients had HCV and/or HBV co-infection. Amongst 404 patients who had a complete clinical history, 34% were AIDS presenters and 49.3% had CD4 count ≤350/mm(3) at HIV diagnosis. 83% patients on HAART had undetectable HIV-RNA. Hypertension was the most frequent co-morbidity (21.5%). Multimorbidity was more frequent in >50 years old patients than in <50 years old ones (30% vs. 6%; p<0.0001). Co-morbidity was more frequent in HCV and/or HBV co-infected than in HIV mono-infected patients (46.6% vs. 31.7%: p=0.0006)., Conclusion: This cohort presentation study sheds light, for the first time, on HIV patients' characteristics in the Calabria Region. We showed that HIV-infected patients with chronic hepatitis were affected by concomitant not-infectious co-morbidities more than the HIV mono-infected individuals. New HCV treatments are therefore to be implemented in the co-infected population.

We report herein the first case of a coinfection with Brucella spp., M. bovis, and Enterobacter cloacae in a butcher who moved from Bulgaria to Italy. Molecular typing suggested professional acquisition of M. bovis in Italy. So, surveillance and preventive measures need to be implemented.

The epidemiological profile of HCV infection is evolving in Europe, as well as in Italy. We have previously showed genotype distributions and their dynamics in 2,153 HCV RNA positive patients living in Calabria, Southern Italy, over 11 years. In this study, we extend and update this information by evaluating a hospital-based cohort of 945 HCV RNA positive patients attending five hospitals in the Calabria Region from January 2011 to August 2013. We assessed rates of HCV genotypes according to age and gender and the dynamics of HCV genotype distribution over the 3-year period studied. Data showed that genotype 1b is the most prevalent, followed by subtypes 2a/2c and genotype 3. Genotype 4 exhibited an increase between 2011 and 2013. Also, we found a significant decrease in the median age of subjects infected with HCV genotype 3 and 4 during the period studied. Since HCV genotypes are important in epidemiology, pathogenesis and response to antiviral therapy, a continuous epidemiological surveillance is needed.

The authors valued the incidence and clinical therapeutic aspects of Haemophilus influenzae type b (Hib) meningitis in children. They report a retrospective study, in children, with diagnosis of acute purulent meningitis, from January 1982 to December 1994, aged between 1 month and 14 years. Particular attention was direct to Haemophilus influenzae type b meningitis (20 cases). The incidence rate of Hib meningitis in the overall cases (89) was 22.47% (20), while among children younger than 5 years Hib was the most frequently pathogen isolated (20/58-34.47%). In 1/4 of cases, particularly in children younger than 1 years, exordium was aspecific and unclear. At admission culture and examination of Cerebrospinal Fluid (CFS) have been done. CFS was cultured on blood agar and chocolate plates. A latex agglutination test was used for rapid detection of the bacterial antigens. In some cases we looked for bacterial antigens in urine. 20% of children had complications and 10% had sequelae (1 years of follow-up). We didn't have any dead. Antibiotic treatment was principally with Ampicillin, Cephalosporin and Chloramphenicol. The results of this study confirm the Hib gravity and suggest that the administration of conjugate vaccine against Hib to all living in Italy is justified.

The authors evaluated the incidence of infection by hepatitis A virus (HAV) in a paediatric population through a seroepidemiological investigation in a group of 278 children (0-12 years old), apparently healthy. The determination of anti-HAV antibodies was carried out by ELISA-test. Of the 287 examined sera, 27 cases turned out HAV positive antibodies (9.7%), with the following distribution, according to the groups of age: 0-3 months: 2 of 6 children were positive (mother's antibodies); 3 months-2 years: 6 of 112 (5.35%); 2-6 years: 10 of 93 (10.75%); 6-12 years: 11 of 67 (16.41%). With regard to distribution of anti-HAV antibodies by sex, 23 (15.03%) males of 153 resulted positive, whereas 4 (3.2%) females of 125 resulted positive. The decline of HAV infection in the paediatric age involves a possible shift of the risk to the adult age. It's advisable that the vaccination against hepatitis A in first period should be reserved for the subjects at risk and later both for unweaned and children in order to eradicate the infection.

On the plasma of 20 children from 1 to 6 years old with HIV infection, the following analyses were carried out: vitamin assays (vitamin E and beta-carotene), hematochemical assays, and immunoassays. From the body of our results it emerged that in the seropositive children considered, in addition to the already well-known alterations of the hematic and immune situation, there is a state of hypovitaminosis involving the most important antioxidant vitamins.

We evaluated safety and tolerance of acyclovir ACV per os in immunocompetent children affected by chicken-pox admitted to our department from January 1993 to December 1994. 183 subjects (102 males and 81 females) aged between 0 and 14 years were treated by ACV (80 mg/kg/daily in 4 divided doses): 88 children were treated within 24 hours and 95 subjects within 48 hours from the onset of symptoms. The control group consisted of 83 children (52 males and 31 females) aged between 0 to 14 years. In all patients routine blood-test were performed and in those with respiratory illness Chest-Rx was also done. We evaluated clinical course, degree of eruption, the appearance and kind of complications, duration of hospitalization, the compliance and the potential consequences on specific antibody response. Our results show a faster improvement of clinical symptoms in treated patients with respect to the control group with shortening of the period of the fever, itch and appearance of new vescicles. The percentage of complications was lower in treated than in untreated patients. 16 cases tested for specific antibody response showed protective titers six months after treatment. In conclusion, ACV administered per os within 48 hours from onset of exanthema causes reduction of the period and the degree of general symptoms and exanthema, a lower incidence of complications even if non statistically significant. The drug is safe and well-tolerated.

In this study the authors describe a non-Hodgkin's lymphoma histologically typed "large non-cleaved cell immunophenotype B cell", placed primitively into the liver. It affected a woman twenty seven years old, who contracted HIV infection due to heterosexual intercourse with at risk partner. At the time of diagnosis the woman was already considered AIDS patient on account of a previous Pneumocystis carinii pneumoniae and severe immunodeficiency (DC4 = 13 cells/mm3). The patient received cycles of chemotherapy (adriamycin 40 mg/iv, teniposide 50 mg/iv, cyclophosphamide 500 mg/iv, vincristine 2 mg/iv, bleomycin 15 mg/iv, betamethasone 4 mg/iv). At the 15th day of therapeutic cycle vincristine 2 mg/iv, bleomycin 15 mg/iv and betamethasone 4 mg/iv were given. After one cycle of therapy, hepatic echography showed signs that the lymphoma was reduced significantly. The authors stress the uncommon non-Hodgkin lymphoma localization, which is frequently underestimated in HIV-patients.