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3. Respiratory Syndrome and Respiratory Tract Infections in Foreign-Born and National Travelers Hospitalized with Fever in Italy

Author

Matteelli, A., anna beltrame, Saleri, N., Bisoffi, Z., Allegri, R., Volonterio, A., Giola, M., Perini, P., Galimberti, L., Visonà, R., Donisi, A., Giani, G., Scalzini, A., Gaiera, G., Ravasio, L., Carvalho, A. C. C., Gulletta, M., Caligaris, S., Pizzocolo, C., Marocco, S., Cadeo, G. P., Grossi, P., Orani, A., Moroni, M., Rizzardini, G., Alberici, F., Vigevani, M., Perboni, G., and Lazzarin, A.

Subjects
Adult, Male, medicine.medical_specialty, Tuberculosis, Fever, Physical examination, Diagnostic Tests, Predictive Value of Tests, Internal medicine, Epidemiology, medicine, Humans, Routine, Blood Cell Count, Diagnostic Tests, Routine, Female, Hospitalization, Italy, Middle Aged, Prospective Studies, Respiratory Tract Infections, Syndrome, Tuberculosis, Pulmonary, Travel, Intensive care medicine, Respiratory tract infections, medicine.diagnostic_test, business.industry, Respiratory disease, Pulmonary, General Medicine, medicine.disease, Pneumonia, n.a, Predictive value of tests, Erythrocyte sedimentation rate, business, human activities
Abstract

BACKGROUND:We measured frequency and epidemiologic, clinical, and hematochemical variables associated with respiratory tract infections (RTIs) in foreign-born and national patients hospitalized with fever with a history of international travel, and compared the final diagnosis of RTI with the presence of a respiratory syndrome (RS) at presentation. METHODS:A prospective, multicenter, observational study was conducted at tertiary care hospitals in Northern Italy from September 1998 to December 2000. RESULTS:A final diagnosis of RTI was obtained in 40 cases (7.8%), 27 (67.5%) with lower RTI and 13 (32.5%) with upper RTI. The most common RTIs were pneumonia (35%) and pulmonary tuberculosis (15%). A white blood cell count > or = 10,000 and an erythrocyte sedimentation rate > or = 20 mm/h were independently associated with a final diagnosis of RTI; onset of symptoms at > or = 16 days and > or = 75% neutrophils were independently associated with lower RTI. An RS was identified in 51 (9.9%) of 515 travelers. Sensitivity, specificity, and positive and negative predictive values of a diagnosis of RS for a final diagnosis of RTI were 67.5%, 94.9%, 52.9%, and 97.2%, respectively. CONCLUSIONS:Pneumonia and pulmonary tuberculosis were frequent among foreign-born and national travelers with fever admitted to a tertiary care hospital. Half of the pneumonia cases did not present with an RS at first clinical examination.

Published
2006
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4. Simit Epidemiological Multicentric Study on Hospitalized Immigrants in Italy During 2002

Author

Scotto, G., Saracino, A., Pempinello, R., El Hamad, I., Geraci, S., Panunzio, M., Palumbo, Ernesto, Cibelli, D. C., Angarano, G., Quirino, T., Vigevani, G. M., Balducci, M., Petrelli, E., Bergamasco, A., Cadeo, G., Elhamad, I., Carosi, G., Vitucci, N., Gobbi, M., Allegri, M. P., Toti, M., Piretti, B., De Stefano, C., Mannozzi, P., Mastropietro, C., Paffetti, A., Losappio, R., Fontana, T., Sfara, C., Stagni, G., Salome, G., Soscia, F., Maggi, P., Pastore, G., Miccolis, S., Scalzini, A., Brogi, A., Renda, V., Lancella, L., Ticca, F., Gabbati, A., Mazzotta, A., Villa, M., Viganò, P., Salatino, A., Andreoni, M., Drenaggi, D., Scalise, G., Ciardi, M., D'Elia, S., Limodio, M., Gallo, A. I., Delia, S., Caltabiano, E., Cosentino, G., Raspaglieli, M., Di Gregorio, P., Mariani, R., Paolini, M., Sabbatani, S., Chiodo, F., Casabianca, A., Biglino, A., Galloni, D., Carnevale, G., Pantaleoni, M., Ghinelli, F., Purificato, F., Pompei, A. G., Portelli, V., Chasseur, R., Tassara, A., Benenat, B., Sapienza, M., Sabatini, P., Sabusco, G., Bellardini, G., Zauli, T., Valencic, A., Luzzati, R., Milini, P., Chiodera, A., Sebbia, F., Davi', A., Pizzigallo, E., Scerbo, P., Ferraro, T., Consorte, A., Mariani Toro, G., Gioia, M., Grossi, P., Coviello, G., Sagnelli, E., Azzimi, A., Concia, A., Allegra, M., and Todaro, Gianmarco

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Tuberculosis, Adolescent, Epidemiology, HIV Infections, infectious diseases, Communicable Diseases, Article, Hepatitis, HIV, Hospitalization, Immigration, Infectious diseases, Female, Humans, Italy, Middle Aged, Multicenter Studies as Topic, Poverty, Surveys and Questionnaires, Emigration and Immigration, Public Health, Environmental and Occupational Health, medicine, business.industry, Public health, Environmental and Occupational Health, medicine.disease, Country of origin, tuberculosis, Infectious disease (medical specialty), Immunology, Public Health, business, Viral hepatitis, Malaria, immigration
Abstract

The aim of this article is to retrospectively evaluate the patient characteristics and the most common infectious diseases in immigrant patients hospitalized in 46 Italian infectious disease clinics during 2002. The main Italian infectious disease clinics were invited to fill in a questionnaire that regarded the number and type of hospital admissions, the country of origin, and demographic features (age, sex, and resident state) of immigrants. A total of 46 clinics including 2255 patients participated in the study. Most patients were men (63%) with an age between 16 and 40 years (63.4%) covered by the National Health Service (71%) and coming from Africa (44.3%). The main infectious diseases observed were: 378 (16.76%) cases of HIV infection, 303 (13.43%) cases of tuberculosis diseases, 282 (12.5%) cases of various forms of viral hepatitis, 177 (7.84%) cases of respiratory diseases, and 196 (8.69%) gastrointestinal diseases. Tropical diseases found were 134 (5.94%) including 95 cases of malaria (70.9%). In conclusion, a broad range of diseases was noted in immigrants which were directly correlated with conditions of poverty. Only a few tropical diseases were diagnosed and therefore the immigrant should not be considered as an infectious disease carrier.

Published
2005
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5. Importance of baseline prognostic factors with increasing time since initiation of highly active antiretroviral therapy: collaborative analysis of cohorts of HIV-1-infected patients

Author

Sterne, Jonathan A. C., May, Margaret, Sabin, Caroline, Phillips, Andrew, Costagliola, Dominique, Chêne, Geneviève, Justice, Amy C., De Wolf, Frank, Hogg, Robert, Battegay, Manuel, Monforte, Antonella D'Arminio, Gerdtkenheuer, Fa, Staszewski, Schlomo, Gill, John, Egger, Matthias, Casabona, Jordi, Dabis, Francxois, Kitahata, Mari, Leport, Catherine, Lundgren, Jens, Reiss, Peter, Saag, Michael, Weller, Ian, Beckthold, Brenda, Yip, Benita, Dauer, Brenda, Fusco, Jenifer, Lanoy, Emilie, Rickenbach, Martin, Lavignolle, Valerie, Van Sighem, Ard, Pereira, Edwige, Pezzotti, Patrizio, Schmeisser, Norbert, Billaud, E., Boué, F., Costagliola, D., Duval, X., Duvivier, C., Enel, P., Fournier, S., Gasnault, J., Gaud, C., Gilquin, J., Grabar, S., Khuong, M. A., Lang, J. M., Mary Krause, M., Matheron, S., Meyohas, M. C., Pialoux, G., Poizot Martin, I., Pradier, C., Rouveix, E., Salmon Ceron, D., Sobel, A., Tattevin, P., Tissot Dupont, H., Yasdanpanah, Y., Aronica, E, Tirard Fleury, V., Tortay, I., Abgrall, S., Guiguet, M., Lanoy, E., Leneman, H., Lièvre, L., Potard, V., Saidi, S., Vildé, J. L., Leport, C., Yeni, P., Bouvet, E., Gaudebout, C., Crickx, B., Picard Dahan, C., Weiss, L., Tisne Dessus, D., Sicard, D., Salmon, D., Auperin, I., Viard, J. P., Roudière, L., Fior, R., Delfraissy, J. F., Goujard, C., Lesprit, P. h., Jung, C., Meynard, J. L., Picard, O., Desplanque, N., Cadranel, J., Mayaud, C., Rozenbaum, W., Bricaire, F., Katlama, C., Herson, S., Simon, A., Decazes, J. M., Molina, J. M., Clauvel, J. P., Gerard, L., Sellier, P., Diemer, M., Dupont, C., Berthé, H., Saïag, P., Mortier, E., Chandemerle, C., De Truchis, P., Bentata, M., Honoré, P., Tassi, S., Jeantils, V., Mechali, D., Taverne, B., Laurichesse, H., Gourdon, F., Lucht, F., Fresard, A., Faller, J. P., Eglinger, P., Bazin, C., Verdon, R., Peyramond, D., Boibieux, A., Touraine, J. L., Livrozet, J. M., Trepo, C., Cotte, L., Ravaux, I., Delmont, J. P., Moreau, J., Gastaut, J. A., Soubeyrand, J., Retornaz, F., Blanc, P. A., Allegre, T., Galinier, A., Ruiz, J. M., Lepeu, G., Granet Brunello, P., Pelissier, L., Esterni, J. P., Nezri, M., Cohen Valensi, R., Laffeuillade, A., Chadapaud, S., Reynes, J., May, T., Rabaud, C., Raffi, F., Pugliese, P., Michelet, C., Arvieux, C., Caron, F., Borsa Lebas, F., Rey, D., Fraisse, P., Massip, P., Cuzin, L., Arlet Suau, E., Thiercelin Legrand, M. F., Sobesky, M., Pradinaud, R., Contant, M., Montroni, M., Scalise, G., Braschi, M. C., Riva, A., Tirelli, U., Cinelli, R., Pastore, G., Ladisa, N., Minafra, G., Suter, F., Arici, C., Pristera, R., Chiodo, F., Colangeli, V., Fiorini, C., Coronado, O., Carosi, G., Cadeo, G. P., Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Melzi, S., Manconi, P. E., Piano, P., Cosco, L., Scerbo, A., Vecchiet, J., D'Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Citterio, P., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Vullo, Vincenzo, Lichtner, Miriam, Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Palvarini, L., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., d'Arminio Monforte, A., Repetto, D., Galli, A., Merli, S., Pastecchia, C., Moioli, M. C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, C. M., Piazza, M., De Marco, M., Viglietti, R., Manzillo, E., Nappa, S., Antonucci, G., Iacomi, F., Narciso, P., Zaccarelli, M., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., De Stefano, C., La Gala, A., Ballardini, G., Rizzo, E., Magnani, G., Ursitti, M. A., Arlotti, M., Ortolani, P., Cauda, R., Dianzani, F., Ippolito, G., Antinori, A., D'Elia, S., Petrosillo, N., De Luca, A., Bacarelli, A., Acinapura, R., De Longis, P., Brandi, A., Trotta, M. P., Noto, P., Capobianchi, M. R., Carletti, F., Girardi, E., Pezzotti, P., Rezza, G., Mura, M. S., Mannazzu, M., Caramello, P., Di Perri, G., Soranzo, M. L., Orofino, G. C., Arnaudo, I., Bonasso, M., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Ebo, F., De Lalla, F., Tositti, G., Resta, F., Loso, K., Cozzi Lepri, A., Johnson, A. M., Mercey, D., Phillips, A., Johnson, M. A., Mocroft, A., Murphy, M., Weber, J., Scullard, G., Fisher, M., Battegay, M., Bernasconi, E., Böni, J., Bucher, H., Bürgisser, P. h., Cattacin, S., Cavassini, M., Dubs, R., Egger, M., Elzi, L., Erb, P., Fantelli, K., Fischer, M., Flepp, M., Fontana, A., Francioli, P., Hirschel, B., Soravia Dunand, V., Furrer, H., Gorgievski, M., Günthard, H., Kaiser, L., Kind, C., Klimkait, T. h., Lauper, U., Ledergerber, B., Opravil, M., Paccaud, F., Pantaleo, G., Perrin, L., Piffaretti, J. C., Rickenbach, M., Rudin, C., Schmid, P., Schüpbach, J., Speck, R., Telenti, A., Trkola, A., Vernazza, P., Buy, E., Bronsveld, W., Hillebrand Haverkort, M. E., Reiss, P., Back, N. K. T., Bakker, M. E. G., Berkhout, B., Jurriaans, S., Cuijpers, T. h., Rietra, P. J. G. M., Roozendaal, K. J., Pauw, W., Van Zanten, A. P., Smits, P. H. M., Von Blomberg, B. M. E., Savelkoul, P., Danner, S. A., Van Agtmael, M. A., Claessen, F. A. P., Perenboom, R. M., Rijkeboer, A., Van Vonderen, M., Kuijpers, T. W., Pajkrt, D., Scherpbier, H. J., Prins, J. M., Bos, J. C., Eeftinck Schattenkerk, J. K. M., Geerlings, S. E., Godfried, M. H., Lange, J. M. A., Van Leth, F. C., Lowe, S. H., Van Der Meer, J. T. M., Nellen, F. J. B., Pogány, K., Van Der Poll, T., Ruys, T. h. A., Sankatsing, S., Steingrover, R., Van Twillert, G., Van Der Valk, M., Van Vonderen, M. G. A., Vrouenraets, S. M. E., Van Vugt, M., Wit, F. W. M. N., Veenstra, J., Van Eeden, A., Veen, J. H., Van Dam, P. S., Roos, J. C., Brinkman, K., Frissen, P. H. J., Weigel, H. M., Mulder, J. W., Van Gorp, E. C. M., Meenhorst, P. L., Mairuhu, A. T. A., Richter, C., Van Der Berg, J., Van Leusen, R., Swanink, C. M. A., Vriesendorp, R., Jeurissen, F. J. F., Franck, P. F. H., Lampe, A. S., Kauffmann, R. H., Koger, E. L. W., Bravenboer, B., Ten Napel, C. H. H., Kootstra, G. J., Schirm, J., Bennw, C. A., Sprenger, H. G., Miesen, W. M. A. J., Doedens, R., Scholvinck, E. H., Ten Kate, R. W., Van Houte, D. P. F., Polee, M., Kroes, A. C. M., Claas, H. C. J., Kroon, F. P., Van Den, Broek, Van Dissel, J. T., Schippers, E. F., Bruggeman, C. A. M. V. A., Goossens, V. J., Schreij, G., Van De Geest, S., Verbon, A., Galama, J. M. D., Melchers, W. J. G., Poort, Y. A. G., Koopmans, P. P., Keuter, M., Post, F., Van Der Ven, A. J. A. M., Doornum, G. J. J., Niesters, M. G., Osterhaus, A. D. M. E., Schutten, M., Driessen, G., De Groot, R., Hartwig, N., Van Der Ende, M. E., Gyssens, I. C., Van Der Feltz, M., Den Hollander, J. G., De Marie, S., L. Nouwen, J., Rijnders, B. J. A., De Vries, T. E. M. S., Juttmann, J. R., Van De Heul, C., Van Kasteren, M. E. E., Boucher, C. A. B., Schuurman, R., Geelen, S. P. M., Wolfs, T. F. W., Schneider, M. M. E., Bonten, M. J. M., Borleffs, J. C. C., Ellerbroek, P. M., Hoepelman, I. M., Jaspers, C. A. J. J., Schouten, I., Schurink, C. A. M., Blok, W. L., Tanis, A. A., Groeneveld, P. H. P., Jansen, C. L., Hendriks, R., Veenendaal, D., Storm, H., Weel, J., Van Zeijl, J. H., Buiting, A. G. M., Swaans, C. A. M., Boel, E., Jansz, A. F., Losso, M., Duran, A., Vetter, N., Karpov, I., Vassilenko, A., Clumeck, N., Dewit, S., Poll, B., Colebunders, R., Machala, L., Rozsypal, H., Sedlacek, D., Gerstoft, J., Katzenstein, T., Hansen, A. B. E., Skinhøj, P., Nielsen, J., Lundgren, J., Benfield, T., Kirk, O., Pedersen, C., Zilmer, K., Girard, P. M., Saint Marc, T., Vanhems, P., Dabis, F., Dietrich, M., Manegold, C., Van Lunzen, J., Stellbrink, H. J., Staszewski, S., Bickel, M., Goebel, F. D., Fätkenheuer, G., Rockstroh, J., Schmidt, R., Kosmidis, J., Gargalianos, P., Sambatakou, H., Perdios, J., Panos, G., Filandras, A., Karabatsaki, E., Banhegyi, D., Mulcahy, F., Yust, I., Turner, D., Burke, M., Pollack, S., Hassoun, G., Sthoeger, Z., Maayan, S., Borghi, R., Cotugno, A. D., Gabbuti, A., Chiesi, A., Montesarchio, E., Finazzi, R., D'Arminio Monforte, A., Viksna, L., Chaplinskas, S., Hemmer, R., Staub, T., Bruun, J., Maeland, A., Ormaasen, V., Knysz, B., Gasiorowski, J., Horban, A., Prokopowicz, D., Wiercinska Drapalo, A., Boron Kaczmarska, A., Pynka, M., Beniowski, M., Mularska, E., Trocha, H., Antunes, F., Valadas, E., Mansinho, K., Matez, F., Duiculescu, D., Babes, Victor, Streinu Cercel, A., Vinogradova, E., Rakhmanova, A., Jevtovic, D., Mokráš, M., Staneková, D., González Lahoz, J., Sánchez Conde, M., García Benayas, T., Martin Carbonero, L., Soriano, V., Clotet, B., Jou, A., Conejero, J., Tural, C., Gatell, J. M., Miró, J. M., Blaxhult, A., Karlsson, A., Pehrson, P., Weber, R., Kravchenko, E., Chentsova, N., Barton, S., Brettle, R., Loveday, C., Antunes, Francisco, Blaxhult, Anders, Clumeck, Nathan, Gatell, Jose, Horban, Andrzej, Johnson, Anne, Katlama, Christine, Ledergerber, Bruno, Loveday, Clive, Vella, Stefano, Gjørup, I., Friis Moeller, N., Bannister, W., Mollerup, D., Podlevkareva, D., Holkmann Olsen, C., Kjær, J., Raffanti, Stephen, Dieterch, Douglas, Becker, Stephen, Scarsella, Anthony, Fusco, Gregory, Most, Bernard, Balu, Rukmini, Rana, Rashida, Beckerman, Robin, Ising, Theodore, Fusco, Jennifer, Irek, Renae, Johnson, Bernadette, Hirani, Ashwin, Edwinjesus, De, Pierone, Gerald, Lackey, Philip, Irek, Chip, Johnson, Alison, Burdick, John, Leon, Saul, Arch, Joseph, Helm, Eilke B., Carlebach, Amina, Axelller, Mu, Haberl, Annette, Nisius, Gabi, Lennemann, Tessa, Rottmann, Carsten, Wolf, Timo, Stephan, Christoph, Bickel, Markus, Manfredsch, Mo, Gute, Peter, Locher, Leo, Lutz, Thomas, Klauke, Stephan, Knecht, Gabi, Doerr, Hans W., Stu, Martinrmer, Von Hentig, Nils, Jennings, Beverly, Beylot, J., Chêne, G., Dupon, M., Longy Boursier, M., Pellegrin, J. L., Ragnaud, J. M., Salamon, R., Thiébaut, R., Lewden, C., Lawson Ayayi, S., Mercié, P., Moreau, J. F., Morlat, P., Bernard, N., Lacoste, D., Malvy, D., Neau, D., Blaizeau, M. J., Decoin, M., Delveaux, S., Hannapier, C., Labarrère, S., Lavignolle Aurillac, V., Uwamaliya Nziyumvira, B., Palmer, G., Touchard, D., Balestre, E., Alioum, A., Jacqmin Gadda, H., Bonarek, M., Bonnet, F., Coadou, B., Gellie, P., Nouts, C., Bocquentin, F., Dutronc, H., Lafarie, S., Aslan, A., Pistonne, T., Thibaut, P., Vatan, R., Chambon, D., De La Taille, C., Cazorla, C., Ocho, A., Viallard, J. F., Caubet, O., Cipriano, C., Lazaro, E., Couzigou, P., Castera, L., Fleury, H., Lafon, M. E., Masquelier, B., Pellegrin, I., Breilh, D., Blanco, P., Loste, P., Caunègre, L., Bonnal, F., Farbos, S., Ferrand, M., Ceccaldi, J., Tchamgoué, S., De Witte, S., Alexander, Chris, Barrios, Rolando, Braitstein, Paula, Brumme, Zabrina, Chan, Keith, Cote, Helen, Gataric, Nada, Geller, Josie, Guillemi, Silvia, Richard Harrigan, P., Harris, Marrianne, Joy, Ruth, Levy, Adrian, Montaner, Julio, Montessori, Val, Palepu, Anita, Phillips, Elizabeth, Phillips, Peter, Press, Natasha, Tyndall, Mark, Wood, Evan, Bhagani, S., Byrne, P., Carroll, A., Cuthbertson, Z., Dunleavy, A., Geretti, A. M., Heelan, B., Johnson, M., Kinloch de Loes, S., Lipman, M., Madge, S., Marshall, N., Nair, D., Nebbia, G., Prinz, B., Swaden, L., Tyrer, M., Youle, M., Chaloner, C., Grabowska, H., Holloway, J., Puradiredja, J., Ransom, D., Tsintas, R., Bansi, L., Fox, Z., Harris, E., Hill, T., Lampe, F., Lodwick, R., Reekie, J., Sabin, C., Smith, C., Amoah, E., Booth, C., Clewley, G., Garcia Diaz, A., Gregory, B., Labbett, W., Tahami, F., Thomas, M., Read, Ron, Fatkenheuer, G., Schmeisser, N., Voigt, K., Wasmuth, J. C., Wohrmann, A., Infectious diseases, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Medical Microbiology and Infection Prevention, Paediatric Infectious Diseases / Rheumatology / Immunology, Landsteiner Laboratory, ARD - Amsterdam Reproduction and Development, Graduate School, Cardiology, APH - Global Health, APH - Quality of Care, AII - Infectious diseases, AII - Inflammatory diseases, and Global Health

Subjects
Adult, medicine.medical_specialty, AIDS, CD4 counts, Highly active antiretroviral therapy, HIV, Prognosis, Substance abuse (intravenous), Adolescent, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Europe, HIV Infections, HIV-1, Humans, Middle Aged, North America, Risk Factors, Substance Abuse, Intravenous, Survival Analysis, Pharmacology (medical), Infectious Diseases, Cost effectiveness, Antiretroviral Therapy, Article, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Highly Active, Survival analysis, Immunodeficiency, business.industry, Transmission (medicine), Hazard ratio, Substance Abuse, medicine.disease, Confidence interval, Physical therapy, Intravenous, business, Cohort study
Abstract

Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.

Published
2007

6. Determinants of virologic and immunologic outcomes in chronically HIV-infected subjects undergoing repeated treatment interruptions: The Istituto Superiore di Sanità-Pulsed Antiretroviral Therapy (ISS-PART) study

Author

Palmisano, L., Giuliano, M., Bucciardini, R., Fragola, V., Andreotti, M., Galluzzo, C. M., Pirillo, M. F., Weimer, L. E., Arcieri, R., Germinario, E. A. P., Amici, R., Mancini, M. G., D'Arminio Monforte, A., Castelli, F., Caramello, P., Vella, S., Abrescia, N., Figoni, M., Viglietti, R., Angarano, G., Saracino, A., Anselmo, M., Antinori, A., Sette, P., Zaccarelli, M., Liuzzi, G., Arlotti, M., Martelli, L. T., Ortolani, P., Bassetti, D., Di Biagio, A., Bisio, F., Bellissima, P., Branz, F., Dorigoni, N., Cadeo, G., Vangi, D., Bertelli, D., Bergamasco, A., Caggese, L., Volonterio, A., Orofino, G. C., Carosella, S., Gennero, L., Caremani, M., Tacconi, D., Carosi, G., Tomasoni, L., Patroni, A., Chiodo, F., Borderi, M., Calza, L., Gritti, F., Fasulo, G., Chirianni, A., Gargiulo, M., Colomba, A., Dalle Nogare, E. R., Di Lorenzo, F., Prestileo, T., Bini, T., Cicconi, P., De Lalla, F., Giordani, M. T., De Stefano, C., De Stefano, G., Delia, S., Ciardi, M., Di Perri, G., Sinicco, A., Sales, P., Dini, M., Simeone, M., Esposito, R., Guaraldi, G., Beghetto, B., Fatuzzo, F., La Rosa, R., Ferrari, C., Calzetti, C., Ferraro, T., Cosco, L., Ghinelli, F., Sighinolfi, L., Guadagnino, V., Caroleo, B., Izzi, A., Izzo, C., Franco, A., Lazzarin, A., Castagna, A., Fusetti, G., Leoncini, F., Pozzi, M., Sbaragli, S., Marzetti, M., Magnani, G., Bonazzi, L., Barchi, E., Zoboli, G., Pintus, A., Mandas, A., Soddu, M. L., Zucca, F., Mannucci, P. M., Gringeri, A., Marani Toro, G., Graziani, R. V., Consorti, A., Mazzotta, F., Di Pietro, M., Ble, C., Meneghetti, F., Sasset, L., Cattelan, A. M., Menichetti, F., Savalli, E., Mian, P., Pristera, R., Mignani, E., Artioli, S., Mura, M. S., Mannazzu, M., Narciso, P., Bellagamba, R., Orani, A., Perini, P., Ortona, L., De Luca, A., Murri, R., Pagano, G., Alessandrini, A., Paladini, A., Vinattieri, M. A., Carbonai, S., Pastore, G., Ladina, N., Tateo, M., Piersantelli, N., Penco, G., Petrelli, E., Balducci, M., Pippi, L., Gonnelli, A., Puppo, F., Murdaca, G., Raise, E., Pasquirucci, A., Riccio, G., Bartolacci, V., Carrega, G., Rizzardini, G., Migliorino, G., Russo, R., Casentino, S., Celesia, M., Soranzo, M. L., Macor, A., Salassa, B., Soscia, F., Roberti, L., Di Toro, M. T., Stagno, A., Beltrami, C., Suter, F., Maggiolo, F., Ripamonti, D., Tantimonaco, G., Grisorio, B., Tassara, A., Rossi, P., Tinelli, M., Regazzetti, A., Tirelli, U., Voltaggio, G., Cinelli, R., Toti, M., Baldari, M., Carli, T., Ricciardi, B., Trezzi, M., Vigevani, G. M., Capetti, A., Landonio, S., Vullo, V., Massetti, P., Zauli, T., and Casolari, S.

Subjects
Adult, Male, medicine.medical_specialty, Anti-HIV Agents, medicine.medical_treatment, HIV Infections, Drug resistance, Drug Administration Schedule, law.invention, Randomized controlled trial, Drug Resistance, Multiple, Viral, law, Internal medicine, medicine, Humans, Pharmacology (medical), Protease inhibitor (pharmacology), Structured treatment interruptions, Chemotherapy, Reverse-transcriptase inhibitor, biology, business.industry, HIV, Middle Aged, biology.organism_classification, CD4 Lymphocyte Count, Clinical trial, Chronic infection, Regimen, Infectious Diseases, Immunology, Lentivirus, RNA, Viral, Female, business, medicine.drug
Abstract

Background: Factors influencing the outcome of structured treatment interruptions (STIs) in HIV chronic infection are not fully elucidated. Methods: In ISS-PART, 273 subjects were randomly assigned to arm A (137 assigned to continuous highly active antiretroviral therapy [HAART]) and arm B (136 assigned to 5 STIs of 1, 1, 2, 2, and 3 months'duration, each followed by 3 months of therapy). Main outcome measures were the proportion of subjects with a CD4 count >500 cells/mm 3 , the rate of virologic failure, and the emergence of resistance at 24 months. Results: The proportion of subjects with a CD4 count >500 cells/mm 3 was higher in arm A than in arm B (86.5% vs. 69.1%; P = 0.0075). Pre-HAART CD4 cell count and male gender were independent predictors of a CD4 count >500 cells/mm 3 in arm B. The overall risk of virologic failure was not increased in arm B; however, it was higher in the 38 subjects who had resistance mutations in the rebounding virus. Archived mutations at baseline and the use of a regimen that included an unboosted protease inhibitor (PI), compared with nonnucleoside reverse transcriptase inhibitor-based HAART, independently predicted the emergence of plasma mutations during STI (P = 0.002 for DNA mutations and P = 0.048 for PI-based HAART). Conclusions: Our results suggest that patients with preexisting mutations and treated with unboosted PI-based HAART should not be enrolled in studies of time-fixed treatment interruptions, being at higher risk of developing plasma mutations during STI and virologic failure at therapy reinstitution.

Published
2007

7. Economic evaluation of HIV treatments: The I.CO.N.A. cohort study

Author

Merito, Monica, Bonaccorsi, Andrea, Pammolli, Fabio, Riccaboni, Massimo, Baio, Gianluca, Arici, Claudio, D'Arminio Monforte, Antonella, Pezzotti, Patrizio, Corsini, Dario, Tramarin, Andrea, Cauda, Roberto, Colangeli, Vincenzo, Pastore, Giuseppe, Montroni, M., Scalise, G., Braschi, M. C., Del Prete, M. S., Tirelli, U., Cinelli, R., Ladisa, N., Minafra, G., Suter, F., Chiodo, F., Fiorini, C., Coronado, O., Carosi, G., Cadeo, G. P., Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Migliorino, G., Manconi, P. E., Piano, P., Ferraro, T., Scerbo, A., Pizzigallo, E., D'Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Galloni, D., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Fibbia, G., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., Repetto, D., Novati, R., Galli, A., Merli, S., Pastecchia, C., Moioli, M. C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, C. M., Piazza, M., De Marco, M., Viglietti, R., Manzillo, E., Graf, M., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., De Stefano, C., La Gala, A., Ballardini, G., Briganti, E., Magnani, G., Ursitti, M. A., Arlotti, M., Ortolani, P., Dianzani, F., Ippolito, G., Antinori, A., Antonucci, G., D'Elia, S., Narciso, P., Petrosillo, N., Vullo, Vincenzo, De Luca, A., Di Giambenedetti, S., Zaccarelli, M., Acinapura, R., De Longis, P., Ciardi, Maria Rosa, D'Offizi, G., Trotta, M. P., Noto, P., Lichtner, Miriam, Capobianchi, M. R., Girardi, E., Rezza, G., Mura, M. S., Mannazzu, M., Resta, F., Loso, K., Caramello, P., Sinicco, A., Soranzo, M. L., Orofino, G., Sciandra, M., Bonasso, M., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Pasquinucci, S., De Lalla, F., Tositti, G., and Lepri, A. Cozzi

Subjects
Pediatrics, medicine.medical_specialty, HAART, Settore MED/17 - Malattie Infettive, National Health Programs, Costs per person-year, Health resources, HIV infection, Antiretroviral Therapy, Highly Active, Cohort Studies, Costs and Cost Analysis, HIV Infections, Health Care Costs, Humans, Italy, Health Policy, Antiretroviral Therapy, Indirect costs, Acquired immunodeficiency syndrome (AIDS), medicine, Highly Active, Seroconversion, Health policy, health care economics and organizations, business.industry, Medicine (all), medicine.disease, Antiretroviral therapy, Cohort, Economic evaluation, business, Cohort study
Abstract

Objective: To describe the changes in costs of care for HIV-positive patients in Italy after the spread of antiretroviral combination therapies (HAART).Methods: Five thousand four hundred and twenty-two patients from the I.CO.N.A. (Italian Cohort Naive Antiretrovirals) study were followed between 1997 and 2002. Costs included antiretroviral therapies (ART), hospital admissions, prophylaxis, and main laboratory examinations. The perspective was that of the National Health Service.Results: Admission costs per person-year decreased from 2148 euro in 1997 to 256 in 2002, while the average annual costs of ART increased from 2145 to 3149 euro (1997 prices). From 1997 to]999, ART costs increased from 42.3 to 85.9% of the total, while admission costs decreased from 42.3 to 7.0% and prophylaxis from 7.3 to 1.7%. The breakdown of ART costs shows how dual therapies decreased over time in favor of HAART, falling from 26.8% in 1997 to 5.9% in 2002. Patients with fewer than five treatment switches had the lowest costs distributions over the entire observation period.Conclusions: From 1997 to 2002 inpatient costs progressively decreased in favor of antiretroviral therapy. Annual average costs per patient decreased, while total direct costs increased over time: health resources, initially concentrated on hospitalized patients were then distributed over a growing number of subjects. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Published
2005

9. Virologic and immunologic response to regimens containing nevirapine or efavirenz in combination with 2 nucleoside analogues in the Italian Cohort Naive Antiretrovirals (I.Co.N.A.) study

Author

Cozzi-Lepri, Alessandro, Phillips, Andrew N., D'Arminio Monforte, Antonella, Piersantelli, Nicoloò, Orani, Anna, Petrosillo, Nicola, Leoncini, Francesco, Scerbo, Antonio, Tundo, Paolo, Abrescia, Nicola, Montroni, M., Scalise, G., Costantini, Alessia, Del Prete, M. S., Tirelli, U., Nasti, G., Pastore, G., Ladisa, N., Perulli, L. M., Suter, F., Arici, C., Chiodo, F., Gritti, F. M., Colangeli, V., Fiorini, C., Guerra, L., Carosi, G., Cadeo, G. P., Castelli, F., Minardi, C., Vangi, D., Rizzardini, G., Migliorino, G., Manconi, P. E., Piano, P., Ferraro, T., Scerbo, A., Pizzigallo, E., Ricci, Fiammetta, Rinaldi, E., Pusterla, L., Carnevale, G., Galloni, D., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Ambu, S., Lo Caputo, S., Angarano, G., Grisorio, B., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Piersantelli, N., Alessandrini, A., Piscopo, R., Toti, M., Chigiott, S., Soscia, F., Tacconi, L., Orani, A., Castaldo, G., Scasso, A., Vincenti, A., Scalzini, A., Alessi, F., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., d’Arminio Monforte, A., Bongiovanni, M., Novati, R., Delfanti, F., Merli, S., Pastecchia, C., Moioli, C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, OMAR CARLO ENRICO, Piazza, M., De Marco, M., Montesarchio, V., Manzillo, E., Nappa, S., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Filice, G., Minoli, L., Bruno, R., Maserati, R., Pauluzzi, S., Tosti, A., Alberici, F., Sisti, M., Menichetti, F., Smorfa, A., De Stefano, C., Lagala, A., Zauli, T., Ballardini, G., Bonazzi, L., Ursitti, M. A., Ciammarughi, R., Ortolani, P., Ortona, L., Dianzani, F., Antinori, A., Antonucci, G., D’Elia, S., Ippolito, G., Narciso, P., Petrosillo, N., Rezza, G., Vullo, V., De Luca, A., Del Forno, A., Capobianchi, M. R., Zaccarelli, M., De Longis, P., Ciardi, M., Girardi, E., D’Offizi, G., Noto, P., Pezzotti, P., Bugarini, R., Lichter, M., Mura, M. S., Mannazzu, M., Caramello, P., Caramello, A., Soranzo, M. L., Gennero, L., Sciandra, M., Salassa, B., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Pasquinucci, S., De Lalla, F., Tositti, G., Resta, F., and Chimienti, A.

Subjects
Cyclopropanes, Adult, Male, medicine.medical_specialty, Efavirenz, Nevirapine, Settore MED/17 - Malattie Infettive, Adolescent, Antiretroviral Therapy, Pharmacology, Efficacy, Cohort Studies, chemistry.chemical_compound, Drug Therapy, Antiretroviral Therapy, Highly Active, Internal medicine, Oxazines, medicine, Humans, Immunology and Allergy, Highly Active, Viral, Sida, Aged, Acquired Immunodeficiency Syndrome, biology, Reverse-transcriptase inhibitor, business.industry, Middle Aged, biology.organism_classification, Confidence interval, Benzoxazines, CD4 Lymphocyte Count, Infectious Diseases, chemistry, Alkynes, Cohort, Combination, RNA, Viral, RNA, Drug Therapy, Combination, Female, business, Cohort study, medicine.drug
Abstract

This nonrandomized study compared the virologic and immunologic responses to potent regimens containing either efavirenz or nevirapine after considering potential systematic differences between patients receiving these drugs. Virologic failure was defined as the first of 2 consecutive measurements of virus load >500 human immunodeficiency virus RNA copies/mL. Of the 694 patients included in the analysis, 460 (66.3%) started nevirapine and 234 (33.7%) started efavirenz. The adjusted relative hazard of virologic failure for patients who started nevirapine, compared with those who started efavirenz, was 2.08 (95% confidence interval, 1.37-3.15; P=.0006). In addition, patients receiving efavirenz tended to recover 5 CD4 cells/microL more per quarter (P=.05). Although comparisons of drug efficacy in nonrandomized studies should be viewed with caution, no results from randomized controlled comparisons of these drugs are thought to be available. The findings of this study are in agreement with those of other observational studies.

Published
2002

10. Transmission of HIV-associated tuberculosis to healthcare workers

Author

Perri, G. D., Cadeo, G. P., Castelli, F., Micciolo, R., Bassetti, S., Rubini, F., Cazzadori, Angelo Antonio, Marocco, S., Carlotto, A., and Adami, T.

Subjects
Infection Control, complications, HIV Infections, Pulmonary, statistics /&/ numerical data, Hospitalization, Occupational Diseases, Hospital, Italy, Risk Factors, Occupational Exposure, HIV Seropositivity, epidemiology/etiology, Personnel, Humans, Tuberculosis, epidemiology, epidemiology/microbiology/transmission, complications, HIV Seropositivity, Hospitalization, Humans, Infection Control, Italy, epidemiology, Occupational Diseases, epidemiology/etiology, Occupational Exposure, statistics /&/ numerical data, Personnel, statistics /&/ numerical data, Retrospective Studies, Risk Factors, Tuberculosis, Retrospective Studies
Published
1993

14. gammadelta T lymphocytes in the peripheral blood of patients with tuberculosis with and without HIV co-infection.

Author

Carvalho, A C C, Matteelli, A, Airò, P, Tedoldi, S, Casalini, C, Imberti, L, Cadeo, G P, Beltrame, A, and Carosi, G

Abstract

Background: Several recent studies suggest that gammadelta T lymphocytes play an important role in immunity against Mycobacterium tuberculosis. However, the dynamics of these cells in the peripheral blood of patients with tuberculosis (TB) with and without HIV infection is not fully understood. A study was undertaken to evaluate the profile of the gammadelta T cell population in patients at the time the diagnosis of TB was established.Methods: A cross sectional study was performed in consecutive TB patients from the Department of Infectious Diseases, Spedali Civili, Brescia. CD4+, CD8+ and Vdelta1 and Vdelta2 T cell counts were analysed. Lymphocyte surface membrane expression was evaluated with the FITC-TCRgammadelta, -Vdelta1, -Vdelta2 and PE-Vdelta1 monoclonal antibodies. Blood donors and HIV seropositive asymptomatic individuals acted as controls.Results: Seventy four TB patients were evaluated, 20 of whom (27%) were co-infected with HIV. HIV seronegative TB patients (n=54) had total gammadelta T cells and Vdelta1 subsets comparable to those in blood donors (n=39). However, the percentage with the Vdelta2 subset was significantly lower in patients with TB than in controls (median 1.5 v 2.1; p=0.05). Responsiveness to PPD was not associated with predominance of a specific gammadelta T cell subset. HIV seropositive individuals had a decreased percentage of circulating Vdelta2 cells at a level similar to that in HIV seronegative TB patients, regardless of the presence of active TB.Conclusions: HIV seronegative TB patients and HIV infected individuals (with or without active TB) have a reduced number of circulating Vdelta2 T cells compared with healthy individuals. Whether TB and HIV infection share a common mechanism causing Vdelta2 T cell depletion still needs to be established. [ABSTRACT FROM AUTHOR]

Published
2002
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15. Yδ T lymphocytes in the peripheral blood of patients with tuberculosis with and without HIV co-infection.

Author

Carvlho, A. C. C., Matteelli, A., Airà, P., Tedoldi, S., Casalini, C., Imberti, L., Cadeo, G. P., Beltrame, A., and Carosi, G.

Subjects
TUBERCULOSIS, HIV infections, BLOOD donors, PATIENTS, T cells, MYCOBACTERIUM tuberculosis, IMMUNITY, CELLS, MONOCLONAL antibodies
Abstract

Background: Several recent studies suggest that yδ T lymphocytes play an important role in immunity against Mycobacterium tuberculosis. However, the dynamics of these cells in the peripheral blood of patients with tuberculosis (TB) with and without HIV infection is not fully understood. A study was undertaken to evaluate the profile of the yδ T cell population in patients at the time the diagnosis of TB was established. Methods: A cross sectional study was performed in consecutive TB patients from the Department of Infectious Diseases, Spedali Civili, Brescia. CD4+, CD8+ and Vδ1 and Vδ2 cell counts were analysed. Lymphocyte surface membrane expression was evaluated with the FITC-TCRγδ, -Vδ1, Vδ2 and PE-Vδ1 monoclonal antibodies. Blood donors and HIV seropositive asymptomatic individuals acted as controls. Results: Seventy four TB patients were evaluated, 20 of whom (27%) were co-infected with HIV. HIV seronegative TB patients (n=54) had total γδ T cells and Vδ2 subsets comparable to those in blood donors (n=39). However, the percentage with the Vδ2 subset was significantly lower in patients with TB than in controls (median 1 .5 v 2.1; p=0.05). Responsiveness to PPD was not associated with predominance of a specific γδ cell subset. HIV seropositive individuals had a decreased percentage of circulating Vδ2 cells at a level similar to that in HIY seronegative TB patients, regardless of the presence of active TB. Conclusions: HIV seronegative TB patients and HIV infected individuals (with or without active TB) have a reduced number of circulating Vδ2 T cells compared with healthy individuals. Whether TB and HIV infection share a common mechanism causing Vδ2 T cell depletion still needs to be established. [ABSTRACT FROM AUTHOR]

Published
2002

17. Incidence and clinicopathological heterogeneity of HIV-related non-Hodgkin's lymphoma

Author

Giuseppe Rossi, Cadeo G, Stellini R, Zorzi F, Favret M, Sueri L, Carosi G, Mariano M, and Marinone G

Subjects
Adult, Male, Incidence, Lymphoma, Non-Hodgkin, HIV Seropositivity, Humans, Female
Abstract

The characteristics of 14 HIV-seropositive patients with NHL consecutively observed between 1984 and 1988 at our Institution are described. Patients belonged to a known population of 1242 HIV-seropositive individuals in whom the incidence of NHL was 1.13%, significantly higher than in age-matched controls (P less than .0001). Within this population, a previous diagnosis of ARC or AIDS, but not of LAS, was the only significant risk factor for the development of NHL (P less than .0001). According to the status of HIV infection at the time of NHL diagnosis, two groups of patients could be clearly identified with different clinicopathological features and prognosis. In fact, NHL developing in 7 patients previously affected by ARC or AIDS, presented as localized, extranodal disease, predominantly in the CNS; large cell histology, peripheral blood cytopenia, severe immunodeficiency and poor prognosis further distinguished this subgroup. Conversely, NHL developing in 7 patients with either asymptomatic HIV-seropositivity or LAS, more often presented as disseminated disease both in nodal and extranodal sites, with Burkitt's-type histology. Cytopenia was uncommon and immunodeficiency was significantly less severe. In this subgroup complete remission (CR) was achieved with aggressive treatment in 6 of 7 patients. No relapses occurred but two opportunistic infection-related deaths were observed. Four patients are alive 6-34 months after CR, two of whom show newly developed opportunistic infections.

18. Effects of recombinant granulocyte colony-stimulating factor (G-CSF) in patients treated with ProMACE-CytaBOM for HIV-related non-Hodgkin's lymphoma (NHL)

Author

Rossi, G., Donisi, A., Casari, S., Alessandro Re, Stellini, R., Cadeo, G., and Carosi, G.

Subjects
Adult, Male, Lymphoma, Non-Hodgkin, Cytarabine, HIV, Middle Aged, Recombinant Proteins, Cohort Studies, Bleomycin, Methotrexate, Treatment Outcome, Doxorubicin, Vincristine, Antineoplastic Combined Chemotherapy Protocols, Granulocyte Colony-Stimulating Factor, Humans, Prednisone, Female, Cyclophosphamide, Etoposide, Lymphoma, AIDS-Related, Retrospective Studies
Abstract

The use of hematopoietic growth factors in association with chemotherapy in human immunodeficiency virus (HIV)-related non-Hodgkin's lymphoma (NHL) has been recommended, but few studies have evaluated its cost-effectiveness.The effects of recombinant granulocyte colony-stimulating factor (G-CSF) were analyzed in 33 consecutive patients with HIV-related NHL treated at a single institution with the same chemotherapy program, ProMACE-CytaBOM, with G-CSF, in 21 cases diagnosed after December 31, 1991, or without G-CSF, in 12 cases diagnosed earlier. Pearson's chi-square analysis and the two-sided Student's t-test were used for statistical comparisons. The method of Kaplan-Meyer and the log-rank-test were used for survival analyses.G-CSF support significantly reduced the frequency of day-1 drug dose reductions (p0.001) and of chemotherapy delays (p0.001), and improved the actual delivered doses of adriamycin, cyclophosphamide and etoposide (p0.02). In patients with a CD4+ count0.01 x 10(9)/L, chemotherapy could be given at full doses in 90% of cycles with G-CSF compared to only 20% without it. G-CSF affected neither the frequency and duration of fever and hospitalization nor the complete remission and survival rates after stratification according to the CD4+ count.G-CSF support significantly improved dose-intensity in patients with HIV-related NHL treated with aggressive chemotherapy, particularly in the subgroup with a CD4+ count0.1 x 10(9)/L, but it did not improve their clinical outcome.

19. Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor antiretroviral regimens failed.

Author

Perno CF, Cozzi-Lepri A, Forbici F, Bertoli A, Violin M, Stella Mura M, Cadeo G, Orani A, Chirianni A, De Stefano C, Balotta C, and d'Arminio Monforte A

Subjects
Cohort Studies, Drug Resistance, Viral genetics, Female, HIV genetics, HIV Infections virology, HIV Protease metabolism, HIV Protease Inhibitors therapeutic use, Humans, Logistic Models, Male, Multivariate Analysis, Point Mutation, RNA, Viral chemistry, RNA, Viral genetics, Reverse Transcriptase Inhibitors therapeutic use, Reverse Transcriptase Polymerase Chain Reaction, Sequence Analysis, DNA, Antiretroviral Therapy, Highly Active, HIV enzymology, HIV Infections drug therapy, HIV Protease genetics, HIV Protease Inhibitors pharmacology, Reverse Transcriptase Inhibitors pharmacology
Abstract

The association between minor mutations in human immunodeficiency virus (HIV) protease at baseline and development of common primary mutation 90M at virological failure (conferring some resistance to all protease inhibitors [PIs]) was evaluated in 93 previously drug-naive patients experiencing failure of their first PI-based antiretroviral regimens. In logistic regression analysis, the probability of accumulating a new 90M mutation at virological failure was associated with the presence at baseline of minor mutation 36I (naturally occurring in approximately 25% of HIV clade B and in >80% of HIV non-clade-B viruses) (adjusted odds ratio, 13.5 [95% confidence interval, 1.89-95.6]; P=.009) and, possibly, of 10I/V. This suggests a potential role for the presence of 36I at baseline in predicting the appearance of 90M at virological failure.

Published
2004
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20. Secondary mutations in the protease region of human immunodeficiency virus and virologic failure in drug-naive patients treated with protease inhibitor-based therapy.

Author

Perno CF, Cozzi-Lepri A, Balotta C, Forbici F, Violin M, Bertoli A, Facchi G, Pezzotti P, Cadeo G, Tositti G, Pasquinucci S, Pauluzzi S, Scalzini A, Salassa B, Vincenti A, Phillips AN, Dianzani F, Appice A, Angarano G, Monno L, Ippolito G, Moroni M, and d' Arminio Monforte A

Subjects
Acute Disease, Antiretroviral Therapy, Highly Active, Antiviral Agents therapeutic use, Chronic Disease, Cohort Studies, Databases as Topic, Genotype, HIV Infections transmission, Humans, Odds Ratio, Treatment Failure, HIV Infections drug therapy, HIV Protease genetics, Mutation
Abstract

The role of mutations in protease (PR) and reverse-transcriptase (RT) of human immunodeficiency virus (HIV) in predicting virologic failure was assessed in 248 antiretroviral-naive HIV-positive patients who began a PR inhibitor-containing antiretroviral regimen. Genotypic testing was performed on plasma samples stored before the start of therapy. Twenty-seven patients (10.9%) had mutations in the RT, 5 (2%) carried primary mutations in the PR, and 131 (52.8%) showed only secondary PR mutations. Virologic failure at week 24 occurred in 62 (25.0%) of 248 patients. There was a statistically significant correlation between virologic failure and the number of PR mutations (P= .04, chi(2) test). Mutations at codons 10 and 36 of PR (present in 39.3% and 40.0% of patients in whom treatment failed, respectively) were identified by stepwise logistic regression as the strongest predictors of virologic failure (odds ratio, 2.20; 95% confidence interval, 1.30-3.75; P= .004). If confirmed in independent studies, this result may justify the increased use of HIV genotyping in drug-naive patients requiring antiretroviral therapy.

Published
2001
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21. Effects of recombinant granulocyte colony-stimulating factor (G-CSF) in patients treated with ProMACE-CytaBOM for HIV-related non-Hodgkin's lymphoma (NHL).

Author

Rossi G, Donisi A, Casari S, Re A, Stellini R, Cadeo G, and Carosi G

Subjects
Adult, Bleomycin administration & dosage, Cohort Studies, Cyclophosphamide administration & dosage, Cytarabine administration & dosage, Doxorubicin administration & dosage, Etoposide administration & dosage, Female, HIV, Humans, Male, Methotrexate administration & dosage, Middle Aged, Prednisone administration & dosage, Recombinant Proteins therapeutic use, Retrospective Studies, Treatment Outcome, Vincristine administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Granulocyte Colony-Stimulating Factor therapeutic use, Lymphoma, AIDS-Related drug therapy, Lymphoma, Non-Hodgkin drug therapy
Abstract

Background and Objective: The use of hematopoietic growth factors in association with chemotherapy in human immunodeficiency virus (HIV)-related non-Hodgkin's lymphoma (NHL) has been recommended, but few studies have evaluated its cost-effectiveness., Design and Methods: The effects of recombinant granulocyte colony-stimulating factor (G-CSF) were analyzed in 33 consecutive patients with HIV-related NHL treated at a single institution with the same chemotherapy program, ProMACE-CytaBOM, with G-CSF, in 21 cases diagnosed after December 31, 1991, or without G-CSF, in 12 cases diagnosed earlier. Pearson's chi-square analysis and the two-sided Student's t-test were used for statistical comparisons. The method of Kaplan-Meyer and the log-rank-test were used for survival analyses., Results: G-CSF support significantly reduced the frequency of day-1 drug dose reductions (p < 0.001) and of chemotherapy delays (p < 0.001), and improved the actual delivered doses of adriamycin, cyclophosphamide and etoposide (p < 0.02). In patients with a CD4+ count < 0.01 x 10(9)/L, chemotherapy could be given at full doses in 90% of cycles with G-CSF compared to only 20% without it. G-CSF affected neither the frequency and duration of fever and hospitalization nor the complete remission and survival rates after stratification according to the CD4+ count., Interpretation and Conclusions: G-CSF support significantly improved dose-intensity in patients with HIV-related NHL treated with aggressive chemotherapy, particularly in the subgroup with a CD4+ count < 0.1 x 10(9)/L, but it did not improve their clinical outcome.

Published
1998

22. Transmission of HIV-associated tuberculosis to healthcare workers.

Author

Di Perri G, Cadeo GP, Castelli F, Micciolo R, Bassetti S, Rubini F, Cazzadori A, Marocco S, Carlotto A, and Adami T

Subjects
HIV Seropositivity, Hospitalization, Humans, Infection Control, Italy epidemiology, Occupational Diseases epidemiology, Occupational Diseases etiology, Retrospective Studies, Risk Factors, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary microbiology, HIV Infections complications, Occupational Exposure statistics & numerical data, Personnel, Hospital statistics & numerical data, Tuberculosis, Pulmonary transmission
Abstract

Objective: A retrospective investigation was made to compare the occupational risk of tuberculosis in personnel assisting human immunodeficiency virus (HIV)-infected and uninfected subjects with active tuberculosis., Design: We retrospectively reviewed 6 years of hospital activity in 3 units where HIV-infected patients with tuberculosis are hospitalized and in 2 units where non-HIV-infected tuberculosis patients are hospitalized. The risk of occupational tuberculosis in healthcare workers who assisted HIV-infected and non-HIV-infected patients with tuberculosis was investigated., Participants: The risk of occupational tuberculosis in healthcare workers was studied by considering the numbers of potential source cases (hospitalized patients with tuberculosis) in the two conditions investigated (HIV-positive and HIV-negative). Both potential source cases and cases of tuberculosis in healthcare workers had to be microbiologically proven in order to be considered., Results: Seven cases of tuberculosis occurred in persons who cared for 85 HIV-infected subjects with tuberculosis, while only 2 cases occurred in staff members who took care of 1,079 HIV-negative tuberculosis patients over the same period (relative risk = 44.4; 95% confidence interval = 8.5-438)., Conclusions: Tuberculosis seems no longer to be a neglectable risk in healthcare workers assisting patients with HIV infection. Further study is urgently needed to see whether such unexpectedly high dissemination of tuberculosis also is demonstrable in the community.

Published
1993

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