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Intravenous administration of zidovudine (ZDV) during labour is a key step for vertical HIV transmission (VT) prevention, but there is no evidence of benefit when maternal HIV-RNA at delivery is50 copies/mL. The aim of this study is evaluating the appropriateness of intrapartum ZDV use in Italy.Observational study including mother-infant pairs with perinatal HIV exposure during 2002-2019, enrolled in the Italian Register for HIV Infection in Children. Univariable and multivariable logistic regression were used to evaluate factors associated with VT.A total of 3,861 infants, born from 3,791 pregnancies were included. The frequency of ZDV use was 79.9%, 92.1%, 93.7% and 92.8% when HIV-RNA was not available, ≥400 copies, between 50 and 399 copies, and50 copies/mL. Thirty-three out of 3861 (0.85%) infants were subsequently diagnosed with HIV, 25/3861 (0.6%) of them born to mothers receiving intrapartum ZDV, and 31 (93.9%) to mothers with HIV-RNA ≥50 copies/mL or not available. In women with HIV-RNA50 copies/mL, ART discontinuation during pregnancy was the strongest risk factor for VT (odds ratio, OR, 23.1, 95%CI 2.4-219.3), while a higher gestational age (OR 0.6, 95%CI 0.4-0.8) and PEP administration to the newborn (aOR 0.004, 95%CI0.0001-0.4) were protective factors. Intrapartum ZDV administration did not influence the final outcome in this group.In ART era, more transmission events may occur in utero, limiting value of intrapartum ZDV, particularly for women with suppressed HIV-RNA load. More attention to the HIV-RNA testing of mothers before delivery may avoid unnecessary ZDV use.

Background Vitamin D (vitD) is involved in important regulatory functions of the innate and adaptive immune system. So, it has been hypothesized that vitD might influence the course of atopic dermatitis (AD). Also obesity may have impact on immune system. The aim of our study was to investigate vitamin D status and body mass index (BMI) in urban children with AD. Methods 52 children with AD and 43 healthy children were enrolled. SCORAD, BMI and serum vitD levels were evaluated. Results There was an association between vitamin D and the AD occurrence but neither between vitamin D and the AD severity, nor between vitamin D and BMI. A positive correlation was observed between BMI and the AD severity in males. Conclusions This study highlights the complex inter-relationships among atopic dermatitis severity, vitamin D and body mass index and suggests the need to investigate the role of genetic factors and/or gender-related differences to possibly identify new prevention strategies.

There is some evidence that early colonization of the intestine affects the composition of the intestinal microbiota after weaning. In the present study, the effect of prebiotics administered from the first day of life on fecal counts of bifidobacteria and lactobacilli were studied during and after the administration of the prebiotics. In this double-blind, randomized, placebo-controlled, explorative study, 20 newborns of hepatitis C virus-infected mothers who decided not to breast feed due to their concerns regarding their plasma viral load were randomly assigned to either a formula with 8 g/L of a specific prebiotic mixture (short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides, ratio 9:1) or a formula containing the same amount of maltodextrin (placebo). Clinical examination including anthropometric measurements, microbiological analysis of fecal samples, and blood leukocyte population analysis were performed at birth and 3, 6, and 12 mo age. At the age of 12 mo, hepatitis B vaccine-specific IgG serum titers (Hepatitis B virus surface antibodies) were also measured. Prebiotic supplementation resulted in more fecal bifidobacteria (P < 0.0001) and lactobacilli (P = 0.0044) compared with the placebo group. These differences between the groups were maintained during the second half of the first year without any prebiotic supplementation. There was no influence of the different diets on anthropometric data or the measured immunological variables. The data from this small explorative study indicate that early colonization of the intestine might have long-lasting effects on the composition of the intestinal microbiota.

We designed a food frequency questionnaire [FFQ] for Northern Italian school-children and tested its validity for the assessment of individual nutrient intake. Eighty-eight healthy children (49 females, 39 males — age range 9–12) were investigated. The FFQ we designed consists of 116 food items selected for their common use among our target population (food items found to provide up to 90 % of the following nutrients: energy, total lipids, saturate [SFA], polyunsaturate [PUFA] and monounsaturate [MUFA] fatty acids, carbohydrates, proteins, cholesterol, vitamins A, B1, B2, B6, C, D, E, calcium, iron, soluble and non-soluble fibres). To test the validity of the FFQ we collected data from a seven-day dietary record for comparison at the beginning of the study and six months later. The FFQ was distributed to parents several days before the collection of the second diary. The validity of the FFQ in the categorizing of individual children at the extreme quintiles was evaluated with contingency tables; the validity of the individual evaluations of nutrient intake was assessed by Pearson's correlation coefficient. The estimated energy intake is greater with the use of the FFQ. The intake of most nutrients is comparable, but there is a significant difference for proteins, PUFA, MUFA, cholesterol, vitamins B1, C, B6, E and for fibres. The greatest difference was found for vitamins B1 and C. The degree of correlation for most nutrients was within the 0.30 and 0.58 range. For most nutrients, the calculation of the nutrient density increased the correlation coefficient, while proteins, carbohydrates and MUFA decreased it. For some nutrients (vitamins A and B6) the coefficient of correlation was found to be low. The contingency analysis of absolute nutrient intake shows gross misclassification above all for MUFA and vitamin B1. The use of nutrient density removes the misclassification for MUFA but not for vitamin B1. Proteins are classified with less consistency when expressed as nutrient density. The comparison between a standard measurement methodology and the FFQ yields a higher consistency for individual estimates than for other paediatric populations but lower than that reported in adult populations.

Elena M. Faioni*, Gessica Fontana, Giovanni Carpani, Enza D’Auria, Giuseppe Banderali, Gianalessandro Moroni, Marco Cattaneo DMCO, University of Milano and Hematology and Thrombosis Unit, Ospedale San Paolo, Via A. di Rudini, 8, 20142 Milan, Italy Blood Transfusion Center, Ospedale San Paolo, Milan, Italy Department of Pediatrics and Neonatology, University of Milano, Ospedale San Paolo, Milan, Italy