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1. HBcAb Positivity Increases the Risk of Severe Hepatic Fibrosis Development in HIV/HCV-Positive Subjects from the ICONA Italian Cohort of HIV-Infected Patients

Author

Malagnino, Vincenzo, Cerva, Carlotta, Cingolani, Antonella, Ceccherini-Silberstein, Francesca, Vergori, Alessandra, Cuomo, Gianluca, Perno, Carlo Federico, Puoti, Massimo, d'Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro, Andreoni, Massimo, Sarmati, Loredana, d’Arminio Monforte (President), Icona Fundation Study Group. Board of Directors: A., Antinori (Vice-President), A., Andreoni, M., Castagna, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., von Schloesser, F., d’Arminio Monforte, P. Viale. Scientific Secretary: A., Antinori, A., Ceccherinisilberstein, F., Cozzi-Lepri, A., Girardi, E., Gori, A., Lo Caputo, S., Maggiolo, F., Mussini, C., Puoti, M., Antinori, C. F. Perno. Steering Committee: A., Bai, F., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capobianchi, M. R., Ceccherini-Silberstein, F., Cicalini, S., Cingolani, A., Cinque, P., d’Arminio Monforte, A., Di Biagio, A., Gagliardini, R., Gianotti, N., Guaraldi, G., Lapadula, G., Lichtner, M., Lai, A., Madeddu, G., Marchetti, G., Merlini, E., Nozza, S., Perno, C. F., Piconi, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Sarmati, L., Spagnuolo, V., Svicher, V., Taramasso, L., Cozzi-Lepri, Statistical and Monitoring Team: A., Fanti, I., Galli, L., Lorenzini, P., Rodanó, A., Macchia, M., Bove, A. Tavelli. Community Advisory Board: A., Camposeragna, A., Errico, M., Manfredini, M., Perziano, A., Carletti, V. Calvino. Biological Bank INMI: F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Giacometti, S. Truffa. Participating Physicians and Centers: Italy: A., Costantini, A., Barocci (Ancona), V., Angarano, G., Monno, L., Milano (Bari), E., F. Maggiolo, C. Suardi (Bergamo), Viale, P., Donati, V., Verucchi (Bologna), G., Castelnuovo, F., Minardi, C., Quiros Roldan (Brescia), E., B. Menzaghi, C. Abeli (Busto Arsizio), L. Chessa, F. Pes (Cagliarti), B. Cacopardo, B. Celesia (Catania), J. Vecchiet, K. Falasca (Chieti), A. Pan, S. Lorenzotti (Cremona), L. Sighinolfi, D. Segala (Ferrara), P. Blanc, F. Vichi (Firenze), Cassola, G., Bassetti, M., Alessandrini, A., Bobbio, N., Mazzarello (Genova), G., M. Lichtner, L. Fondaco (Latina), P. Bonfanti, C. Molteni (Lecco), A. Chiodera, P. Milini (Macerata), G. Nunnari, G. Pellicanò (Messina), Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Poli, A., Tincati (Milano), C., C. Mussini, C. Puzzolante (Modena), C. Migliorino, G. Lapadula (Monza), Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo (Napoli), V., A. M. Cattelan, S. Marinello (Padova), A. Cascio, M. Trizzino (Palermo), D. Francisci, E. Schiaroli (Perugia), G. Parruti, F. Sozio (Pescara), C. Lazzaretti, R. Corsini (Reggio Emilia), Cristaudo, A., Vullo, V., Acinapura, R., Lamonica, S., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Onnelli, G., Plazzi, M. M., De Girolamo, G., Vergori (Roma), A., M. Cecchetto, F. Viviani (Rovigo), G. Madeddu, A. De Vito (Sassari), B. Rossetti, F. Montagnani (Siena), A. Franco, R. Fontana Del Vecchio (Siracusa), Di Giuli (Terni), C., Caramello, P., Orofino, G. C., Sciandra (Torino), M., Londero (Udine), A., V. Manfrin, G. Battagin (Vicenza), G. Starnini, A. Ialungo (Viterbo)., Malagnino, V, Cerva, C, Cingolani, A, Ceccherini-Silberstein, F, Vergori, A, Cuomo, G, Perno, C, Puoti, M, D'Arminio Monforte, A, Cozzi-Lepri, A, Andreoni, M, Sarmati, L, Malagnino, V., Cerva, C., Cingolani, A., Ceccherini-Silberstein, F., Vergori, A., Cuomo, G., Perno, C. F., Puoti, M., D'Arminio Monforte, A., Cozzi-Lepri, A., Andreoni, M., Sarmati, L., ICONA Foundation Study, Group, Castagna, A., Malagnino V., Cerva C., Cingolani A., Ceccherini-Silberstein F., Vergori A., Cuomo G., Perno C.F., Puoti M., D'Arminio Monforte A., Cozzi-Lepri A., Andreoni M., and Sarmati L.A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G C Marchetti, G Rezza, F von Schloesser, E Girardi, A Gori, S Lo Caputo, F Maggiolo, F Bai, A Bandera, S Bonora, M Borderi, A Calcagno, M R Capobianchi, S Cicalini, P Cinque, A Di Biagio, R Gagliardini, N Gianotti, G Guaraldi, G Lapadula, M Lichtner, A Lai, S Lo Caputo, G Madeddu, G Marchetti, E Merlini, C Mussini, S Nozza, S Piconi, C Pinnetti, E Quiros Roldan, R Rossotti, S Rusconi, M M Santoro, A Saracino, V Spagnuolo, V Svicher, L Taramasso, I Fanti, L Galli, P Lorenzini, A Rodanó, M Macchia, A Tavelli, A Bove, A Camposeragna, M Errico, M Manfredini, A Perziano, V Calvino, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, C Suardi, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, L Chessa, F Pes, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, F Vichi, G Cassola, M Bassetti, A Alessandrini, N Bobbio, G Mazzarello, M Lichtner, L Fondaco, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, , G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, A Poli, C Tincati, C Puzzolante, C Migliorino, G Lapadula, V Sangiovanni, G Borgia, V Esposito, G Di Flumeri, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, D Francisci, E Schiaroli, G Parruti, F Sozio, C Lazzaretti, R Corsini, A Antinori, A Cristaudo, V Vullo, R Acinapura, S Lamonica, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, G Onnelli, M M Plazzi, G De Girolamo, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, C Di Giuli, P Caramello, G C Orofino, M Sciandra, A Londero, V Manfrin, G Battagin, G Starnini, A Ialungo

Subjects
HBsAg, medicine.medical_specialty, Hepatitis C virus, Liver fibrosis, Human immunodeficiency virus (HIV), OBI, medicine.disease_cause, anti-HBc, HBV, HIV/HBV coinfection, liver fibrosis, Gastroenterology, Major Articles, NO, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Hiv infected patients, 030212 general & internal medicine, Hepatitis B virus, business.industry, liver fibrosi, virus diseases, Settore MED/17, digestive system diseases, Anti-HBc, HIV-HBV coinfection, HBV, Liver fibrosis, OBI, Infectious Diseases, AcademicSubjects/MED00290, HIV-HBV coinfection, Oncology, Cohort, 030211 gastroenterology & hepatology, business, Hepatic fibrosis
Abstract

Background The aim of this study was to investigate the impact of anti-HBc (HBcAb) positivity on the progression of liver fibrosis (Fibrosis-4 score >3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA). Methods All patients with FIB-4 Results Patients who were HBcAb+/HCV-/HBs antigen (HBsAg)- and HCV+/HBcAb+/HBsAg- or HBsAg+/HBcAb+/HCV- had CD4+ cell counts below the nadir and significantly higher prevalence of AIDS diagnosis at baseline than the other groups (P < .0001). A Cox regression model adjusted for age, HIV transmission mode, country of birth, and alcohol consumption showed a higher relative risk (HR) of progression to FIB-4 >3.25 in HCV+/HBcAb+/HBsAg- patients (HR, 7.2; 95% CI, 3 8–13.64). Conclusions HBcAb+ contributes to liver damage in HIV+/HCV+/HBcAb+/HBsAg- subjects. A careful monitoring for signs of previous HBV infection is needed in this kind of patients.

Published
2021

2. Treatment outcomes of integrase inhibitors, boosted protease inhibitors and nonnucleoside reverse transcriptase inhibitors in antiretroviral-naïve persons starting treatment

Author

J Tiraboschi, B Neesgard, Nikoloz Chkhartishvili, A. Antinori, H Garges, Vincenzo Spagnuolo, Claudine Duvivier, Felipe Rogatto, Andri Rauch, Ferdinand W. N. M. Wit, JC Wasmuth, Kathy Petoumenos, Christoph Stephan, Antonella Castagna, C Mussini, Amanda Mocroft, Armin Rieger, Robert Zangerle, Coca Valentina Necsoi, Vanni Borghi, Fiona C Lampe, Josip Begovac, Veronica Svedhem, Lars Peters, Christian Pradier, S De Wit, Jörg J. Vehreschild, Natalie Bolokadze, Günthard Hf, Mike Youle, Lene Ryom, Infectious diseases, APH - Aging & Later Life, Mocroft, A., Neesgard, B., Zangerle, R., Rieger, A., Castagna, A., Spagnuolo, V., Antinori, A., Lampe, F. C., Youle, M., Vehreschild, J. J., Mussini, C., Borghi, V., Begovac, J., Duvivier, C., Gunthard, H. F., Rauch, A., Tiraboschi, J., Chkhartishvili, N., Bolokadze, N., Wit, F., Wasmuth, J. C., De Wit, S., Necsoi, C., Pradier, C., Svedhem, V., Stephan, C., Petoumenos, K., Garges, H., Rogatto, F., Peters, L., and Ryom, L.

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, International Cooperation, protease inhibitors, Integrase inhibitor, HIV Infections, Logistic regression, law.invention, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Randomized controlled trial, law, Internal medicine, medicine, Humans, Pharmacology (medical), Protease inhibitor (pharmacology), 030212 general & internal medicine, HIV Integrase Inhibitors, antiretroviral naïve, Reverse-transcriptase inhibitor, business.industry, Health Policy, Middle Aged, Viral Load, medicine.disease, nonnucleoside reverse transcriptase inhibitors, 030112 virology, CD4 Lymphocyte Count, Infectious Diseases, Logistic Models, Treatment Outcome, integrase inhibitors, Cohort, HIV-1, RNA, Viral, Reverse Transcriptase Inhibitors, Female, business, Viral load, medicine.drug
Abstract

Objectives: Although outcomes of antiretroviral therapy (ART) have been evaluated in randomized controlled trials, experiences from subpopulations defined by age, CD4 count or viral load (VL) in heterogeneous real-world settings are limited. Methods: The study design was an international multicohort collaboration. Logistic regression was used to compare virological and immunological outcomes at 12±3months after starting ART with an integrase strand transfer inhibitor (INSTI), contemporary nonnucleoside reverse transcriptase inhibitor (NNRTI) or boosted protease inhibitor (PI/b) with two nucleos(t)ides after 1 January 2012. The composite treatment outcome (cTO) defined success as VL'200 HIV-1 RNA copies/mL with no regimen change and no AIDS/death events. Immunological success was defined as a CD4count '750cells/μL or a 33% increase where the baseline CD4 count was ≥500 cells/μL. Poisson regression compared clinical failures (AIDS/death≥14days after starting ART). Interactions between ART class and age, CD4 count, and VL were determined for each endpoint. Results: Of 5198 ART-naïve persons in the International Cohort Consortium of Infectious Diseases (RESPOND), 45.4% started INSTIs, 26.0% PI/b and 28.7% NNRTIs; 880 (17.4%) were aged ' 50years, 2539 (49.4%) had CD4 counts '350 cells/μL and 1891 (36.8%) had VL'100000 copies/mL. Differences in virological and immunological success and clinical failure among ART classes were similar across age groups (≤ 40, 40–50 and '50 years), CD4 count categories (≤ 350 vs. '350 cells/μL) and VL categories at ART initiation (≤ 100000 vs. '100000copies/mL), with all investigated interactions being nonsignificant (P'0.05). Conclusions: Differences among ART classes in virological, immunological and clinical outcomes in ART-naïve participants were consistent irrespective of age, immune suppression or VL at ART initiation. While confounding by indication cannot be excluded, this provides reassuring evidence that such subpopulations will equally benefit from contemporary ART.

Published
2020

3. Update on adherence to a vaccination protocol for invasive bacterial diseases in HIV patients

Author

C Cintori, Z Kahfian, G Casaletti, C Mussini, Sergio Rovesti, Stefano Tancredi, L Berghella, and Annalisa Bargellini

Subjects
Protocol (science), Vaccination, medicine.medical_specialty, business.industry, Internal medicine, Public Health, Environmental and Occupational Health, medicine, Hiv patients, business
Abstract

HIV+ patients present an increased risk of vaccine-preventable invasive bacterial diseases (IBDs), infections characterized by high lethality and frequency of serious complications. Considering that these patients frequently have to face a complex clinical-care pathway, it has been necessary to design a clear vaccination protocol in order to prevent IBDs and to guarantee adequate patient adherence. In 2013 the Local Health Unit Company of Modena's Public Health Department and the University Hospital of Modena developed a shared vaccination protocol to prevent the most common causes of IBDs: Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae type B. The protocol applies to HIV+ patients receiving antiretroviral therapy who have a CD4 + cell count > 200 cells / µL. It provides the following vaccination schedule: administration of PCV13 + MenACWY vaccines; after 15 days administration of MenB + Hib vaccines; after 45 days administration of the MenB vaccine; after at least 60 days, administration of PPSV23 + MenACWY vaccines. The first vaccination counselling is proactively carried out by the Public Health Department healthcare workers and takes place at the Infectious Diseases Division in order to improve patient acceptance and adherence to the protocol. From October 2013 to January 2020, 503 HIV+ patients (378 males and 125 females) were vaccinated. Among these patients, 338 (67.2%) completed the vaccination schedule; 110 (21.9%) interrupted the schedule, 34 (6.7%) have a vaccination schedule currently underway and 21 (4.2%) never started the planned vaccination protocol. Overall, the percentage of patients who have completed the vaccination schedule or have scheduled appointments is 73.9%. The data analysis shows a high adherence to the protocol thanks to the collaboration between public health and infectious disease specialists, which improves the compliance of patients with a complex clinical-care pathway. Key messages HIV patients present an increased risk of IBDs and require a tailor-made vaccination protocol. Collaboration between specialists improves the compliance of patients with a complex clinical-care pathway.

Published
2020

4. HIV-infected children are a special patient group

Author

Latysheva I.B. Latysheva, Mussini C. Mussini, and Voronin E.E. Voronin

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Hiv infected, medicine, Patient group, business
Published
2018

5. Hyalinose segmentaire et focale post-vaccination anti-SARS-CoV-2 : une association fortuite ?

Author

C. Mussini, A. Abdellaoui, P. Housset, D. Viglietti, A.-L. Faucon, and Valérie Caudwell

Subjects
Gynecology, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Nephrology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine, Po-N73, business
Abstract

Introduction Plusieurs cas de syndrome nephrotique secondaire a une nephropathie a lesions glomerulaires minimes (LGM) ont ete rapportes apres vaccination, notamment contre la grippe. Quelques cas commencent a etre rapportes avec les vaccins a ARNm anti SARS-CoV-2. Description Nous rapportons un cas de syndrome nephrotique survenant apres une premiere dose vaccinale anti SARS-CoV-2 (ChAdOx1 nCoV-19, Astra-Zeneca®). Methodes Un homme de 44 ans, sans antecedents medicaux, a ete hospitalise pour un tableau d’anasarque d’installation brutale survenant 3 semaines apres une premiere dose vaccinale. Le bilan biologique montrait un syndrome nephrotique (albumine 12,5 g/l, proteinurie 9,1 g/g) et une insuffisance renale aigue definie par une creatininemie a 187 μmol/l. Le titre d’anticorps anti-proteine Spike etait de 67 U/ml. La serologie anti-nucleocapside etait negative. Resultats La ponction biopsie renale montrait des lesions de hyalinose segmentaire et focale (HSF) avec trois « tip lesions » ( Fig. 1 ). L’evolution clinique et biologique (creatinine 73 μmol/l, albumine 34 g/l, proteinurie 27 mg/mmol) ont ete rapidement favorables sous corticotherapie 1 mg/kg/j. Conclusion La survenue d’un syndrome nephrotique dans les jours qui suivent la vaccination anti-COVID 19 souleve la question de l’imputabilite du vaccin et du mecanisme physiopathologique sous-jacent. La stimulation de l’immunite cellulaire T et une reponse cytokinique mediee par la vaccination pourraient contribuer a la survenue de lesions de LGM/HSF post-vaccination. Les resultats des etudes de pharmacovigilance restent necessaires pour determiner s’il existe un lien causal entre la survenue d’un syndrome nephrotique et la vaccination.

Published
2021

6. Aggravation d’une maladie rénale chronique : la COVID-19, complice ou coupable ?

Author

P. Housset, Valérie Caudwell, C. Mussini, I. Kone, A.-L. Faucon, S. Ferlicot, and R. Boudina

Subjects
Gynecology, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Nephrology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Po-N34, medicine, business
Abstract

Introduction La COVID-19 peut etre associee a une hyalinose segmentaire et focale (HSF) collapsante nommee COVAN de mauvais pronostic. Description Nous rapportons quatre cas de patients ayant presente une aggravation de leur insuffisance renale chronique (IRC) dans les suites d’une infection COVID-19. Methodes Entre novembre 2020 et avril 2021, quatre patients d’origine Africaine âges de 47 a 74 ans, suivis dans notre service, ont ete hospitalises pour une aggravation de leur IRC. Leur nephropathie sous-jacente etait une nephroangiosclerose (n = 2), un diabete (n = 1), une HSF collapsante (n = 1) prouvee par ponction biopsie renale (PBR). Lors du suivi, leur clairance etait en moyenne de 47 mL/min/1,73 m2 avec une proteinurie negative ou Resultats Les patients ont ete hospitalises pour une aggravation majeure de leur IRC. A l’admission, la clairance moyenne etait de 18 mL/min/1,73 m2 associee a une proteinurie de rang nephrotique. Une infection COVID-19 a ete retrouvee dans les deux mois precedents chez deux des quatre patients. Tous avaient une serologie COVID-19 positive, ainsi que les alleles a risque du gene ApoL1 (homozygote G1/G1 ou heterozygote G1/G2). Deux patients ont eu une PBR retrouvant une HSF collapsante. La PBR n’a pas ete realisee chez les autres en raison d’une hypotrophie renale. Durant le suivi, deux patients sont restes stables, un a necessite le recours a l’hemodialyse et le dernier a ete traite par corticoides 0,5 mg/kg/j, permettant une diminution de la proteinurie et une amelioration partielle de la fonction renale. La particularite de notre serie est l’existence d’une IRC sous-jacente regulierement suivie. Il reste a determiner si la presence d’une IRC constitue un facteur favorisant la survenue d’une COVAN ( Tableau 1 ). Conclusion L’aggravation rapide d’une IRC et d’une proteinurie doit maintenant faire rechercher une anteriorite d’infection par la COVID-19. La COVAN est probablement sous-estimee chez ces patients pour lesquels la PBR n’est la plupart du temps pas effectuee.

Published
2021

7. P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center.P211Rheumatic Heart Disease in Uganda - Results from more than 600 echocardiograms in a no-profit hospitalP212Higher ventricular ectopy burden in asymptomatic severe Barlows mitral valve disease compared to similar patients with mitral valve prolapseP213Surgical mitral valve repair for severe secondary mitral regurgitation: prognostic implications of left ventricular forward flowP214Multicentre trial results of a transfemoral annuloplasty system for mitral valve reconstruction -P215Comparative assessment of paravalvular leaks with 3D-transesophageal echocardiography and cardiac computed tomographyP216Failing surgical aortic bioprosthetic valves: redo aortic valve surgery versus percutaneous valve-in-valve replacementP217Mitral annular calcification and infective endocarditisP218Infective endocarditis - a changing diseaseP219Staphilococcus aureus bacteremia: application of the ESC proposed diagnostic echocardiographic algorithm in clinical practiceP220ESC proposed diagnostic echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis and negative blood cultures: diagnostic yield and prognostic implicationsP221Three-dimensional transesophageal echocardiography versus multidetector computed tomography for aortic annulus sizing in TAVI: a worthy alternativeP222Early and mid-term improvement in left ventricular function after transcatheter aortic valve replacement as assessed by myocardial strain imagingP223Dynamic of aortic root as predictor of paravalvular regurgitation after transcatheter aortic valve implantationP224Short term effect of heart rate reduction by Ivabradine on left ventricular function and remodeling in systolic heart failure patientsP225Global longitudinal strain and regional longitudinal strain in patients with hypertrophic cardiomyopathy: are they associated with the presence of myocardial fibrosis?P226Investigation of mitral leaflet elongation in patients with non-obstructive versus latent-obstructive hypertrophic cardiomyopathyP227Hypertrophic cardiomyopathy: to what degree have the new ESC guidelines been implemented in routine clinical practice? A retrospective audit assessing current practice in a large general UK hospitalP228New genotype-phenotype associations in hypertrophic cardiomyopathy patients studied with cardiac magnetic resonance with feature-trackingP229How many are too many - frequent premature ventricular contractions and left ventricular functionP230Two-dimensional global longitudinal strain and strain rate for evaluation of inflammatory cardiomyopathy as proven by endomyocardial biopsyP231The echocardiographic features of young asymptomatic screening population with left ventricular hypertrabeculationP232Use of amlodipine to decrease myocardial iron in thalassemia major (AMIT trial): comparison of T2* CMR and echocardiography for assessment of cardiac volumes and functionP233Echocardiographic comparison of Fabry cardiomyopathy and light-chain amyloid heart diseaseP234Early detection of left atrial enlargement using 3D echocardiography in patients undergoing breast cancer treatment

Author

R. Rascon Sabido, J. Marek, N. Alvi, HC. Tang, AS. Aleksandrov, OH. Lie, AC. Gomes, J. Basu, L. Zuo, JF. Carvalho, JW. Son, I. Boretti, VC. Lozano-Granero, C. Gillebert, Y. Bartolacelli, M. Coutinho Cruz, G. Pressman, A. Mameri, M. Alonso Fernandez De Gatta, H. Treede, V. Kamperidis, K. Johnson, M. Mapelli, V. Mecarocci, F. Mori, L. Fusini, P. Zagni, M. Muratori, P. Agostoni, P. Gripari, S. Ghulam Ali, G. Tamborini, M. Pepi, C. Fiorentini, ST. Abdel-Rahman, L. Dobson, A. Kidambi, K. Gatenby, D. Schlosshan, SE. Van Wijngaarden, PJ. Van Rosendael, W. Kong Kok Fai, M. Leung, G. Sianos, N. Ajmone Marsan, JJ. Bax, V. Delgado, G. Nickenig, KH. Kuck, S. Baldus, A. Vahanian, A. Colombo, O. Alfieri, Y. Topilsky, P. Grayburn, F. Maisano, M. Barreiro Perez, A. Arribas Jimenez, A. Martin Garcia, E. Diaz Pelaez, J. Rodriguez Collado, I. Cruz Gonzalez, PL. Sanchez Fernandez, M. Urena Alcazar, C. Cimadevilla, D. Himbert, R. Raffoul, C. Verdonk, P. Nataf, D. Messika-Zeitoun, CH. Gartman, E. Obasare, E. Melendres, M. Malik, L. Slipczuk, V. Figueredo, R. Ilhao Moreira, L. Moura Branco, A. Galrinho, L. Coutinho Miranda, AT. Timoteo, J. Abreu, P. Pinto Teixeira, J. Fragata, R. Cruz Ferreira, A. Barbieri, F. Bursi, F. Mantovani, R. Lugli, M. Fabbri, C. Mussini, G. Boriani, R. Perry, T. Hecker, M. Szpytma, M. Joseph, S. Fernandez-Santos, M. Plaza-Martin, T. Lopez-Fernandez, JM. De La Hera, A. Martinez-Monzonis, G. La Canna, D. Mesa, M. Swaans, R. Murzilli, T. Echevarria, G. Habib, JL. Zamorano, C. Fernandez-Golfin Loban, L. Salido, A. Gonzalez Gomez, A. Garcia Martin, R. Hinojar Baides, A. Pardo, JL. Moya Mur, S. Ruiz Leria, R. Hernandez Antolin, JJ. Jimenez Nacher, JL. Zamorano Gomez, HJ. Kim, BJ. Kim, KW. Choi, CH. Lee, W. Kim, JS. Park, DG. Shin, YJ. Kim, JH. Choi, K. Congo, D. Neves, J. Pais, R. Guerreiro, B. Picarra, AR. Santos, A. Bento, J. Aguiar, J. Wang, SJ. Ta, N. Kang, MY. Zhou, RQ. Guo, L. Liu, L. Thorsen, K. Thomas, A. Shabbir, K. Balkhausen, S. Bull, LR. Lopes, I. Cruz, AR. Almeida, H. Pereira, J. Saberniak, LA. Dejgaard, OG. Anfinsen, F. Hegbom, T. Edvardsen, KH. Haugaa, M. Kasner, C. Tschoepe, JS. Ho, LK. Goh, ZP. Ding, FA. Tipoo, D. Chowdhury, S. Colan, A. Imran, U. Raza, S. Ashiqali, BS. Hasan, D. Mohty, T. Palecek, L. Golan, A. Jaccard, A. Lenhart, RGM Garcia Mendez Rosalba, MHC Martinez Hernandez Carlos, DIQ Ibarra Quevedo David, and EAG Almeida Gutierrez Eduardo

Subjects
education.field_of_study, Mitral regurgitation, medicine.medical_specialty, Ejection fraction, business.industry, Population, valvular heart disease, Atrial fibrillation, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, Sudden death, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiology, Mitral valve prolapse, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, education
Abstract

Background Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease. Methods We reviewed our MVP database; patients with at least 2 cardiologic evaluations inclusive of echocardiographic examination and at least 6 months follow up were enrolled. A total of 250 patients (126 F) were selected. Their mean age was 52.1 years (ranging from 13 to 88 yo). The average follow-up time was 100 months (8,33 yrs). Results At the first medical and echocardiographic examination 8 patients (3,2%) had no mitral regurgitation (MR), 104 (41.6%) have a trace/mild MR, 93 (37,2%) a moderate MR and 46 (18,4%) a severe MR. They were widely asymptomatic (NYHA I 205-82%, NYHA II 44-17.60%, NYHA III 1- 0.40%). Most of theme presented a bileaflet (140-55.8%) or a posterior MVP (94 - 37.6%); an isolated anterior MVP was rare (16 - 6,4%). Flail leaflet was present in 8 (3,2%) and 25 (10%) had a chordal rupture. Respectively 165 (65,6%) and 115 (46,1%) patients had thick and redundant leaflets. Mean antero-posterior mitral annulus diameter was 37 mm. During the follow up 7 patients died of non-cardiac cause and 5 (2%) of suspected cardiac cause (2 because of acute coronary syndrome and 3 died suddenly). MR progresses in 43 (17,2%) patients and finally we observed 81 (32,4%) moderate/severe and severe MR. 12 new chordal rupture occurred during the follow up in most cases concerning mitral chordae linked to posterior mitral leaflet (10 cases-83,3%). The worsening of MR provoked an evolution of the clinical condition of 48 patients (19.2%) which developed Dyspnea On Excertion (DOE) with 42 new NYHA II and 6 new NYHA III. At the end of the follow up the amount of patients symptomatic for DOE was 93 (37.2% vs 18% at the initial evaluation). A total of 45 patients (18%) underwent mitral valve surgery. 40 needed in-hospital treatment in most cases due to the development of atrial fibrillation (19 -7.6%) or heart failure ( 8- 3,2%). Endocarditis occurred in 4 patients (1.6%) and cerebrovascular accidents/cardioembolic event in 6 (2.4%). The overall cardiovascular event rate was 4,33/100 patients-year, significantly higher than reported in community based studies. Conclusions The prognosis of a MVP population referred to a tertiary cardiovascular center is not benign. The most frequent complications are progression of MR and MV surgery. Sudden death is also more frequent than in general population. More studies are needed to identify what patients with MVP are at risk for it.

Published
2016

8. European survey on principles of prudent antibiotic prescribing teaching in undergraduate students

Author

C. Pulcini, F. Wencker, N. Frimodt-Møller, W.V. Kern, D. Nathwani, J. Rodríguez-Baño, G.S. Simonsen, V. Vlahović-Palčevski, I.C. Gyssens, F. Jacobs, W. Peetermans, I. Francetić, N. Frimodt-Mǿller, N. Høiby, M. Kilian, F. Ader, C. Cazorla, M. Etienne, G. Fätkenheuer, M.W. Pletz, B. Salzberger, B. Cacopardo, M. Mikulska, C. Mussini, G. Orlando, S. Stefani, S.H. Lowe, J.L. Nouwen, J.E. Afset, K. Bergh, F. Müller, B. Carevic, O. Horvat, S. Jankovic, B. Beović, J.R. Gorisek, R. Canton, M.C. Fariñas, F. Gudiol, J.R. Paño Pardo, J. Rodríguez Baño, S. Harbarth, G. Zanetti, G. Barlow, N. Brown, B. Healy, Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Radboud University Medical Center [Nijmegen], Canisius-Wilhelmina Hospital, Rigshospitalet [Copenhagen], Center for Infectious Diseases and Travel Medicine, University Hospital Freiburg, Ninewells Hospital and Medical School [Dundee], Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Universidad de Sevilla, UNN, University Hospital of North Norway, Tromsoe, Norvège, The Arctic University of Norway ( UiT ), University Hospital Rijeka, University of Rijeka, Hasselt University, Gyssens I, Jacobs F, Peetermans W, Francetić I, Vlahović-Palčevski V, Frimodt-Mǿller N, Høiby N, Kilian M, Ader F, Cazorla C, Etienne M, Pulcini C, Fätkenheuer G, Kern W, Pletz M, Salzberger B, Cacopardo B, Mikulska M, Mussini C, Orlando G, Stefani S, Gyssens I, Lowe S, Nouwen J, Afset J, Bergh K, Müller F, Simonsen G, Carevic B, Horvat O, Jankovic S, Beović B, Gorisek J, Canton R, Fariñas M, Gudiol F, Pardo J, Baño J, Harbarth S, Zanetti G, Barlow G, Brown N, Healy B, Nathwani D., Medical Microbiology & Infectious Diseases, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Paris Diderot - Paris 7 (UPD7), The Arctic University of Norway (UiT), Copenhagen University Hospital, and Hasselt University (UHasselt)

Subjects
Pediatrics, Cross-sectional study, MESH : Drug Prescriptions, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], curriculum, MESH : Drug Utilization, law.invention, 0302 clinical medicine, MESH : Cross-Sectional Studies, MESH: Drug Prescriptions, law, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, Duration (project management), MESH: Drug Utilization, MESH : Anti-Bacterial Agents, Schools, Medical, Antibiotic stewardship, 0303 health sciences, education, Clinical pharmacology, Schools, Education, Medical, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, BIOMEDICINA I ZDRAVSTVO. Temeljne medicinske znanosti. Farmakologija, antibiotic stewardship, medical student, medical school, questionnaire, 3. Good health, Anti-Bacterial Agents, Europe, Infectious Diseases, ntibiotic stewardship, MESH: Communicable Diseases, MESH : Surveys and Questionnaires, Microbiology (medical), medicine.medical_specialty, MESH : Schools, Medical, MESH: Education, Medical, MESH : Europe, BIOMEDICINE AND HEALTHCARE. Basic Medical Sciences. Pharmacology, Communicable Diseases, Drug Prescriptions, Antibiotic prescribing, 03 medical and health sciences, MESH: Cross-Sectional Studies, SDG 3 - Good Health and Well-being, Antibiotic therapy, Medical, MESH: Anti-Bacterial Agents, Curriculum, Education, Medical school, Medical student, Questionnaire, Cross-Sectional Studies, Drug Utilization, Antibiotic use, medical schoo, MESH: Surveys and Questionnaires, MESH : Education, Medical, ntibiotic stewardship, curriculum, education, medical school, medical student, questionnaire, Medical education, MESH: Schools, Medical, 030306 microbiology, business.industry, MESH : Communicable Diseases, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business
Abstract

We surveyed European medical schools regarding teaching of prudent antibiotic prescribing in the undergraduate curriculum. We performed a cross-sectional survey in 13 European countries (Belgium, Croatia, Denmark, France, Germany, Italy, Netherlands, Norway, Serbia, Slovenia, Spain, Switzerland, United Kingdom) in 2013. Proportional sampling was used, resulting in the selection of two to four medical schools per country. A standardized questionnaire based on literature review and validated by a panel of experts was sent to lecturers in infectious diseases, medical microbiology and clinical pharmacology. In-depth interviews were conducted with four lecturers. Thirty-five of 37 medical schools were included in the study. Prudent antibiotic use principles were taught in all but one medical school, but only four of 13 countries had a national programme. Interactive teaching formats were used less frequently than passive formats. The teaching was mandatory for 53% of the courses and started before clinical training in 71%. We observed wide variations in exposure of students to important principles of prudent antibiotic use among countries and within the same country. Some major principles were poorly covered (e.g. reassessment and duration of antibiotic therapy, communication skills). Whereas 77% of the respondents fully agreed that the teaching of these principles should be prioritized, lack of time, mainly due to rigid curriculum policies, was the main reported barrier to implementation. Given the study design, these are probably optimistic results. Teaching of prudent antibiotic prescribing principles should be improved. National and European programmes for development of specific learning outcomes or competencies are urgently needed. Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved

Published
2015

9. Correlates of frailty phenotype and frailty index and their associations with clinical outcomes

Author

G Guaraldi, A Malagoli, O Theou, TD Brothers, LMK Wallace, R Torelli, C Mussini, S Sartini, SA Kirkland, and K Rockwood

Subjects
0301 basic medicine, Gerontology, Adult, Male, Activities of daily living, HIV, age-related conditions, disability, falls, frailty, multimorbidity, Psychological intervention, Frailty Index, HIV Infections, Comorbidity, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Pharmacology (medical), In patient, 030212 general & internal medicine, Aged, Frailty, business.industry, Health Policy, Middle Aged, 030112 virology, Antiretroviral therapy, Frailty phenotype, Infectious Diseases, Cross-Sectional Studies, Italy, Life course approach, Observational study, Accidental Falls, Female, business
Abstract

OBJECTIVES Frailty is a predictor of adverse health outcomes and can be measured across the life course, including among people living with HIV. The purpose of this study was to examine two commonly used measures of frailty - the frailty index (FI) and frailty phenotype - to assess common characteristics and to describe associations with multimorbidity, falls, and disability in people aging with HIV. METHODS This was a cross-sectional observational study including 482 consecutive HIV-infected patients (mean age 53.9 ± SD 6.9 years; 75% male) attending the multidisciplinary metabolic clinic at the University of Modena, Italy. Frailty was measured with the frailty phenotype and a 37-item FI. RESULTS The mean FI score was 0.28±0.1 and frailty phenotype categories were: 3.1% frail, 51.9% pre-frail, and 45% robust. The duration of antiretroviral therapy was significantly different across levels of frailty as measured by both frailty tools (P < 0.01), but the nadir CD4 count was only significant for the FI (P = 0.01); current CD4 count was not significantly different across frailty levels using either tool. Both frailty measures were associated with multimorbidity; the FI was associated with Instrumental Activities of Daily Living impairment and falls history, whereas the frailty phenotype was not. CONCLUSIONS The frailty phenotype and the FI demonstrated similar characteristics in patients at a tertiary-level HIV clinic. The FI had a stronger association with age, nadir CD4 count, comorbidities, falls, and disability. Integrating frailty assessments in clinical practice will be crucial for the development of interventions in age-related conditions, including disability and falls, in older persons living with HIV.

Published
2017

10. The importance of collaboration between urologists and infectious disease specialist in the reduction of antibiotics resistance rate

Author

Ahmed Eissa, G. Bianchi, S. Toso, Bernardo Rocco, S. Ciarlariello, B. Filippi, L. Sarti, C. Mussini, G. Orlando, Salvatore Micali, and M. C. Sighinolfi

Subjects
Infectious disease specialist, medicine.medical_specialty, Antibiotic resistance, business.industry, Urology, medicine.medical_treatment, Medicine, business, Intensive care medicine, Reduction (orthopedic surgery)
Published
2019

11. PS1274 EPIDEMIOLOGY AND MANAGEMENT OF LATENT TUBERCULOSIS INFECTION IN ADULT PATIENTS WITH ACUTE LEUKEMIA OR APLASTIC ANEMIA: A RETROSPECTIVE MONOCENTER STUDY

Author

P. Barozzi, M. Luppi, F. Forghieri, M. Celli, A. Messerotti, C. Mussini, Ivana Lagreca, E. Colaci, L. Potenza, A. Gilioli, S. Iotti, F. Narni, D. Giusti, M. Codeluppi, D. Vallerini, L. Arletti, H. Catellani, Erica Franceschini, V. pioli, V. Nasillo, Monica Morselli, Rossana Maffei, F. Bettelli, Giovanni Riva, A. Paolini, C. Colasante, L. Galassi, R. Marasca, and F. Donatelli

Subjects
Pediatrics, medicine.medical_specialty, Acute leukemia, Adult patients, Latent tuberculosis, business.industry, Epidemiology, medicine, Hematology, Aplastic anemia, medicine.disease, business
Published
2019

12. Changing Incidence and Risk Factors for Kaposi Sarcoma by Time Since Starting Antiretroviral Therapy: Collaborative Analysis of 21 European Cohort Studies

Author

Matthias Egger, Vincenzo Spagnuolo, Robert Zangerle, Andrea Antinori, Gary M. Clifford, Vassilios Paparizos, Fernando Dronda, Stéphane De Wit, Firouzé Bani-Sadr, José M. Miró, Vincent Le Moing, Annelies Verbon, Maria Campbell, Niels Obel, Eugenia Quiros-Roldan, Geneviève Chêne, Janne Vehreschild, Maria Prins, Laurence Meyer, Marcel Zwahlen, Fabrice Bonnet, Bernardino Roca, Caroline A. Sabin, Barbara Hasse, C Mussini, Natascha Wyss, Amanda Mocroft, François Boué, Norbert H. Brockmeyer, Rana Chakraborty, Julia Bohlius, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Infectious diseases, Cancer Project Working Group for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in, Eurocoord, Spagnuolo, V, and Internal Medicine

Subjects
Male, adults, antiretroviral therapy, HIV, Kaposi sarcoma, risk factors, Adolescent, Adult, Anti-Retroviral Agents, Cohort Studies, Europe, Female, HIV Infections, Humans, Incidence, Middle Aged, Risk Factors, Sarcoma, Kaposi, Young Adult, 0302 clinical medicine, immune system diseases, Medicine, 030212 general & internal medicine, Immunodeficiency, Factors de risc en les malalties, adult, Incidence (epidemiology), virus diseases, Antiretrovirals, Sarcoma, 3. Good health, Infectious Diseases, risk factor, 030220 oncology & carcinogenesis, HIV/AIDS, Viral load, Cohort study, Microbiology (medical), Cart, medicine.medical_specialty, Risk factors in diseases, 610 Medicine & health, 03 medical and health sciences, 360 Social problems & social services, Internal medicine, mental disorders, VIH (Virus), Risk factor, business.industry, Proportional hazards model, HIV (Viruses), medicine.disease, Antiretroviral agents, Surgery, Regimen, nervous system, business
Abstract

BACKGROUND: Kaposi sarcoma (KS) remains a frequent cancer in human immunodeficiency virus (HIV)-positive patients starting combination antiretroviral therapy (cART). We examined incidence rates and risk factors for developing KS in different periods after starting cART in patients from European observational HIV cohorts. METHODS: We included HIV-positive adults starting cART after 1 January 1996. We analyzed incidence rates and risk factors for developing KS up to 90 and 180 days and 1, 2, 5, and 8 years after cART start and fitted univariable and multivariable Cox regression models. RESULTS: We included 109 461 patients from 21 prospective clinical cohorts in Europe with 916 incident KS cases. The incidence rate per 100 000 person-years was highest 6 months after starting cART, at 953 (95% confidence interval, 866-1048), declining to 82 (68-100) after 5-8 years. In multivariable analyses adjusted for exposure group, origin, age, type of first-line regimen, and calendar year, low current CD4 cell counts increased the risk of developing KS throughout all observation periods after cART initiation. Lack of viral control was not associated with the hazard of developing KS in the first year after cART initiation, but was over time since starting cART increasingly positively associated (P < .001 for interaction). CONCLUSION: In patients initiating cART, both incidence and risk factors for KS change with time since starting cART. Whereas soon after starting cART low CD4 cell count is the dominant risk factor, detectable HIV-1 RNA viral load becomes an increasingly important risk factor in patients who started cART several years earlier, independently of immunodeficiency.

Published
2016

13. Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013

Author

Anne M Johnson, Geneviève Chêne, Frank A. Post, Jordi Casabona, Dorthe Raben, Hansjakob Furrer, Mario Lazanas, Linda Wittkop, Catherine Leport, Dominique Costagliola, Peter Reiss, Caroline A. Sabin, Antonella Castagna, C Mussini, Stéphane De Wit, Andrea Antinori, Corinne Jadand, Gerd Fätkenheuer, Robert Zangerle, Adriane Skaletz-Rorowski, Norbert H. Brockmeyer, Ole Kirk, Johanna Brännström, Niels Obel, Josiane Warszawski, Amanda Mocroft, Fabrice Bonnet, Carlo Torti, Antonella d'Arminio Monforte, Ignacio Suarez-Loano, Santiago Moreno, Jens D Lundgren, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Global Health, Infectious diseases, The late presenters working group in COHERE in, Eurocoord, and Castagna, Antonella

Subjects
Male, Delayed Diagnosis, Time Factors, Epidemiology, HIV Infections, Substance Abuse, Intravenou, Cohort Studies, Risk Factors, Interquartile range, HIV Seropositivity, Prevalence, HIV Infection, Cooperative Behavior, Substance Abuse, Intravenous, Pathologie maladies infectieuses, Multivariate Analysi, Incidence, Incidence (epidemiology), AIDS Serodiagnosi, Delayed Diagnosi, AIDS Serodiagnosis, Middle Aged, Sciences bio-médicales et agricoles, Europe, Cohort, Disease Progression, Female, epidemiology, Human, human immunodeficiency virus - HIV, Cohort study, Adult, medicine.medical_specialty, Logistic Model, Time Factor, Acquired immunodeficiency syndrome (AIDS), Virology, medicine, Humans, late presentation, business.industry, Risk Factor, Public Health, Environmental and Occupational Health, Odds ratio, medicine.disease, Confidence interval, CD4 Lymphocyte Count, Logistic Models, Multivariate Analysis, Immunology, Cohort Studie, business, Demography
Abstract

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrolment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count, 0, The late presenters working group in COHERE in EuroCoord, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2015

14. O4 Early start of antiretroviral therapy (ART) during primary HIV infection (PHI) is associated with faster optimal immunological recovery: results of Italian Network of ACuTe HIV InfectiON (INACTION) retrospective study

Author

Antonio Muscatello, Giulia Marchetti, A. Di Biagio, I. De Benedetto, Roberto Gulminetti, Giuseppe Tambussi, Gabriella d'Ettorre, Adriana Ammassari, A. Antinori, Giordano Madeddu, Diego Ripamonti, G. Orofino, Emanuele Focà, A. Cingolani, Enrico Girardi, Silvia Nozza, Benedetto Maurizio Celesia, Alessandra Bandera, Andrea Gori, Stefano Rusconi, Massimiliano Fabbiani, Andrea Calcagno, and C Mussini

Subjects
0301 basic medicine, Acute HIV infection, Pediatrics, medicine.medical_specialty, Epidemiology, business.industry, Immunology, Public Health, Environmental and Occupational Health, Retrospective cohort study, Antiretroviral therapy, Primary HIV infection, Microbiology, QR1-502, 03 medical and health sciences, 030104 developmental biology, Infectious Diseases, Virology, Early start, Medicine, Public aspects of medicine, RA1-1270, business
Published
2017

15. Prevalence and predictors of sarcopenia in an HIV cohort characterized by nutrition and physical activity parameters

Author

A. Malagoli, Carla M. Prado, M. Mancini, C. Mussini, G. Guaraldi, J. Falutz, A. Caselgrandi, V. Masi, and Jordan E. Lake

Subjects
medicine.medical_specialty, Nutrition and Dietetics, business.industry, Endocrinology, Diabetes and Metabolism, Internal medicine, Sarcopenia, Cohort, medicine, Physical activity, Human immunodeficiency virus (HIV), business, medicine.disease, medicine.disease_cause
Published
2018

16. Non HCV-related mixed cryoglobulinemia

Author

D. Campioli, Clodoveo Ferri, C. Mussini, Maria Teresa Mascia, D Ferrari, and Gilda Sandri

Subjects
Hepatitis C virus, Lymphoproliferative disorders, lymphoma, Disease, medicine.disease_cause, cryoglobulinemia, Cryoglobulins, Autoimmunity, Neoplasms, medicine, Humans, Connective Tissue Diseases, HCV, hepatitis C, autoimmunity, connective tissue diseases, Hepatology, business.industry, Gastroenterology, Hepatitis C, Hepatitis C, Chronic, medicine.disease, Cryoglobulinemia, Lymphoma, Immunology, business
Abstract

A striking association (>90%) between mixed cryoglobulinemia (MC) and hepatitis C virus (HCV) infection has been established by means of clinico-epidemiological and laboratory studies. However, little information is available as regards the etiopathogenesis and the actual percentage of HCV-negative MC. This latter seems to be more frequent in the same geographical areas where the overall prevalence of MC is low. In 195 Italian patients with serum mixed cryoglobulins consecutively analyzed at the laboratory of our hospital, during one year, the prevalence of HCV-negative MC was 15.9%. Moreover, we evaluated the clinico-serological characteristics of our whole series of 65 HCV-negative MC patients: “essential” MC was present in only 25%, while the majority of cases showed different connective tissue diseases or neoplastic disorders. Interestingly, patients with Sjogren's syndrome or lymphoma had higher levels of cryocrit with cryoglobulinemic syndrome comparable to that found in HCV-positive MC patients. MC is a multifactorial disorder; considering possible etiological factors and clinical associations the disease may present different subsets: the prevalent group of HCV-positive MC; HCV-positive MC associated with different autoimmune lymphoproliferative disorders; two MC subsets without any apparent causative agent: those with well-known autoimmune lymphoproliferative disorders and the rare cases of “essential” MC; and finally MC associated with other infectious agents.

Published
2007

17. Impact of antiretroviral dosing frequency and daily pill burden on virological success rates in patients of the ICoNA cohort starting their first ART

Author

Andrea Gori, Patrizia Lorenzini, Giovanni Cassola, A Cozzi-Lepri, Adriana Ammassari, Adriano Lazzarin, Tozzi, A. Antinori, A d'Arminio Monforte, Franco Baldelli, G. Di Perri, C Mussini, M. Andreoni, and Tiziana Quirino

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Proportional hazards model, Population, Public Health, Environmental and Occupational Health, medicine.disease, Regimen, Infectious Diseases, Pharmacotherapy, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Pill, Cohort, Medicine, Dosing, business, education
Abstract

Complexity of antiretroviral treatment (ART) is a reason for non-adherence and may impact treatment outcome. The association between daily dosing and pill burden and chance of virological success (VS) of first ART has been rarely assessed. 3,674 naive patients who started treatment after January 2000 were identified from the ICoNA cohort. Number of daily doses and pills were estimated on the basis of the drugs used to rank first ART complexity: 1-2 daily pills once a day (low-pills QD [lpQD]); 3-6 daily pills QD (high-pills QD [hpQD]); 2-5 daily pills BID (low-pills BID [lpBID]); >6 daily pills BID (high-pills BID [hpBID]). VS was the date of first HIV RNA

Published
2012

18. Timing of cART initiation after a first AIDS-defining event (ADE): temporal changes in clinical attitudes in a large cohort of HIV-infected patients

Author

C Mussini, E. Girardi, A. Cingolani, Pietro Caramello, G. Angarano, A d'Arminio Monforte, Paolo Bonfanti, Adriana Ammassari, A. Antinori, A. De Luca, A Cozzi-Lepri, G. Magnani, and Maria Stella Mura

Subjects
Cervical cancer, Cart, medicine.medical_specialty, business.industry, Proportional hazards model, Public Health, Environmental and Occupational Health, Bacterial pneumonia, medicine.disease, Group B, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, business, Survival analysis, Immunodeficiency
Abstract

Introduction : Criteria of cART initiation after a first ADE have been modified over time based on evidence suggesting that treatment should be initiated earlier. The impact of these changes on clinical practice is unknown. Objective of this analysis was to evaluate temporal changes of time of starting cART after a first diagnosis of ADE in ART-naive patients (pts). Methods : All HIV+ enrolled in ICONA Foundation Study who presented with a diagnosis of ADE while cART-naive regardless of CD4 cell count were included. Pts were grouped according to have ADE for which additional medications that may have interactions with cART are required (Tb, atypical mycobacteriosis, non-Hodgkin lymphoma) [group A], ADE treatable only by cART (PML, isosporidiasis/cryptosporidiasis, KS, wasting syndrome) [group B] and ADE treatable with specific drugs (PCP, toxoplasmic encephalitis, CMV disease, esoph candidiasis, bacterial pneumonia, cervical cancer, cryptococcosis) [group C]. Standard survival analysis by KM was used to estimate the cumulative percentage of pts starting cART, overall and after stratification for calendar period of diagnosis (1996-2000, 2001-2008, 2009-2011) and type of ADE (groups A, B, C). Multivariable Cox regression was used to investigate association between calendar year of ADE and time to cART initiation after controlling for demographics. Summary of results : A total of 715 pts with a first ADE were observed over 1996-2011 (group A, n=187; B, n=123; C, n=405). 519 (73%) male, median age 38 (IQR:33-45), median CD4+ 64 (23-187)/mm 3 and HIV/RNA 5.25 (4.57-5.70) log 10 cps/mL, with no differences by calendar period. By 30 days from ADE, 23% (95% CI: 19-27) of those diagnosed in 1996-2000 have started cART vs. 32% (95% CI: 25-39) in 2001-2008 and 36% (28-44) after 2009 (log-rank p=0.001). After stratifying by CD4 at ADE, 45% of pts with CD4 201/mm 3 had started cART by 30 days (p

Published
2012

19. Late presenters: what can we do?

Author

C Mussini

Subjects
medicine.medical_specialty, education.field_of_study, Pediatrics, business.industry, Public health, Population, Public Health, Environmental and Occupational Health, Stigma (botany), Eleventh, Treatment as prevention, medicine.disease, Oral Abstract – O114, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Family medicine, Epidemiology, medicine, education, business, Serostatus
Abstract

Late presentation represents a major problem for patients with HIV infection. Actually, it should be made a distinction between late testers and late presenters, since the strategies to reduce the percentage of these two group of subjects could be different. Indeed, the first population is represented by individuals unaware of their serological status, while in the second case the problem is related to engagement and retention in care. Concerning the first population, it has been shown that most of the patients had been seen by their family doctor or admitted to hospital during the year before HIV diagnosis. Indeed, this is a relevant problem and new strategies to increase the level of suspect of HIV infection among doctors non-HIV specialist, as testing in presence of indicator diseases, should be applied. Concerning the population of late presenters, American data showed a percentage of engagement in care ranging between 50 and 59%. These low percentages could be due to the American Health System, while in a public health system setting, the percentage of patients not engaged in care or lost to follow-up could be lower, even if still relevant. Another important factor that should be considered in both populations is stigma. Indeed, many patients that present late, either late testers or late presenters, are immigrants and have important cultural barriers to disclose their HIV serostatus to family members and friends. Obviously, all subjects unaware or refusing their HIV infection could potentially infect their partners. In conclusion, all efforts should be made to reduce the phenomenon of late presentation since these two populations represent not only an epidemiological problem for the prognosis of the single patient, but also for the treatment as prevention strategy. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Mussini C. Journal of the International AIDS Society 2012, 15 (Suppl 4):18072 http://www.jiasociety.org/index.php/jias/article/view/18072 | http://dx.doi.org/10.7448/IAS.15.6.18072

Published
2012

20. Dasabuvir and Ombitasvir/Paritaprevir/Ritonavir with or without Ribavirin in Patients with HIV-HCV Coinfection: Real Life Interim Analysis of an Italian Multicentre Compassionate Use Program

Author

G. Di Perri, L. Sighinolgi, A. De Luca, Caterina Pasquazzi, Alfredo Pennica, M. Andreoni, Giustino Parruti, E. Gentilotti, Elisabetta Teti, L. Sarmati, A. Ricciardi, Andrea Gori, G. Angarano, Nicola Boffa, Raffaele Bruno, A. Di Biagio, A d'Arminio Monforte, C Mussini, Adriano Lazzarin, Antonio Chirianni, Massimo Galli, Bruno Cacopardo, Claudio Maria Mastroianni, Andrea Giacometti, A. Antinori, Vincenzo Vullo, M. Puoti, Giuliano Rizzardini, Francesco Castelli, Gloria Taliani, A Cattelan, and F. Maggiolo

Subjects
Pediatrics, medicine.medical_specialty, Dasabuvir, Hepatology, business.industry, Ribavirin, Compassionate Use, Interim analysis, HIV/HCV coinfection, Virology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, chemistry, Hiv hcv coinfection, anti-HCV therapy, 030220 oncology & carcinogenesis, Ombitasvir/paritaprevir/ritonavir, antiviral therapy, medicine, 030211 gastroenterology & hepatology, In patient, business
Published
2016

22. 61 A panel of pediatric liver cancer patient-derived xenografts to improve stratification of children with hepatoblastoma

Author

E. Fadel, Louise Galmiche-Rolland, A. Gorse, Carolina Armengol, O. Déas, Laurence Brugières, Stefano Cairo, Sophie Branchereau, Jean-Gabriel Judde, C. Mussini, Christophe Chardot, M.R. Ghigna, D. Nicolle, and Monique Fabre

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Hepatoblastoma, business.industry, Internal medicine, Medicine, business, medicine.disease, Pediatric liver cancer, Stratification (mathematics)
Published
2014

23. Effect of a fixed-dose combination of emtricitabine, tenofovir and efavirenz on adherence and treatment acceptability (ADONE study)

Author

P Sette, G. Orofino, F. Maggiolo, Teresa Bini, C Mussini, Andrea Gori, Michele Trotta, Luca Bisi, Francesca Bai, and M Airoldi

Subjects
medicine.medical_specialty, Efavirenz, Visual analogue scale, business.industry, Fixed-dose combination, Public Health, Environmental and Occupational Health, Pharmacology, Emtricitabine/Tenofovir, Preliminary analysis, chemistry.chemical_compound, Infectious Diseases, Multicenter study, chemistry, Internal medicine, medicine, In patient, ADONE, business, medicine.drug
Abstract

Methods ADONE is a prospective, multicenter study in patients chronically treated with FTC+TDF+EFV or 3TC+TDF+EFV, showing a stable viremia

Published
2008

24. Treatment of cryoglobulinemic neuropathy with alpha-interferon

Author

Massimo Gentilini, Maria Teresa Mascia, M Ghini, and C. Mussini

Subjects
medicine.medical_specialty, business.industry, hemic and lymphatic diseases, Internal medicine, medicine, Alpha interferon, Context (language use), Essential mixed cryoglobulinemia, Neurology (clinical), medicine.disease, business, Cryoglobulinemia, Large sample
Abstract

To the Editor: We read with interest the article by Khella et al on the treatment of cryoglobulinemic neuropathy with alpha-interferon (alpha-IFN). [1] Our group has been studying the relationship between HCV and essential mixed cryoglobulinemia (EMC) since 1990. We are a collaborating center of the Italian Group for the Study of Cryoglobulinemias (GISC), and have recently published the results obtained from a large sample (654 patients with EMC). [2] In this context, we have also studied the occurrence …

Published
1996

25. Monoclonal gammopathies and hepatitis C virus infection [letter] [see comments]

Author

C. Mussini, M Ghini, I Lattuada, Giuseppe Torelli, Mg Ferrari, Maria Teresa Mascia, Giuseppe Longo, S. Moreali, P Giovanardi, and G Zanni

Subjects
business.industry, Hepatitis C virus, Immunology, Monoclonal, medicine, Cell Biology, Hematology, medicine.disease_cause, medicine.disease, business, Biochemistry, Cryoglobulinemia, Virology
Published
1995

26. Mixed connective tissue disease (Sharp syndrome): Description of two cases

Author

E. Rucco, C. Mussini, P. Bortolotti, G. Gilioli, M. Gibertoni, A. Colombo, and R. Schoenhuber

Subjects
Adult, medicine.medical_specialty, Pathology, Neurology, Biopsy, Dermatology, Diagnosis, Differential, Mixed connective tissue disease, medicine, Humans, Myositis, Mixed Connective Tissue Disease, Neuroradiology, business.industry, Muscles, General Neuroscience, General Medicine, Middle Aged, medicine.disease, Psychiatry and Mental health, Immunohistochemistry, Female, Neurology (clinical), Neurosurgery, business
Abstract

Clinical, neurophysiological, histopathological and immunohistochemical features of two cases of mixed connective tissue disease (Sharp syndrome) are reported.

Published
1983

27. Impact of antiretroviral dosing and daily pill burden on viral rebound rates in naive patients receiving a tenofovir-based regimen

Author

Carlo Federico Perno, C Mussini, A. Antinori, Adriana Ammassari, Antonio Chirianni, F. Maggiolo, N Abrescia, Giuliano Rizzardini, Patrizia Lorenzini, Nicola Gianotti, Gaetana Sterrantino, Massimo Andreoni, M Foggia, and A Corpolongo

Subjects
Viral rebound, medicine.medical_specialty, Multivariate analysis, business.industry, Public Health, Environmental and Occupational Health, Pharmacology, Rate ratio, Regimen, symbols.namesake, Infectious Diseases, Internal medicine, Pill, Cohort, medicine, symbols, Dosing, Poisson regression, business
Abstract

Methods A total of 480 ART-naive patients were selected from the GNOMO cohort. Incidence rate of viral rebound (VR = first of two consecutive VL>50 cp/ml) was calculated as number of events over PYFU and expressed at univariate and multivariate analysis as incidence rate ratio (IRR). Number of both pills and doses per day were used to define three different types of regimens: twice-a-day regimens (BID regimens); once-a-day regimens with 3 pills (high-pill QD [hp-QD]). Adjusted rates of viral rebound were estimated by Poisson regression using date of first HIV-RNA

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28. Fostemsavir in Adults with Multidrug-Resistant HIV-1 Infection

Author

Michael, Kozal, Judith, Aberg, Gilles, Pialoux, Pedro, Cahn, Melanie, Thompson, Jean-Michel, Molina, Beatriz, Grinsztejn, Ricardo, Diaz, Antonella, Castagna, Princy, Kumar, Gulam, Latiff, Edwin, DeJesus, Mark, Gummel, Margaret, Gartland, Amy, Pierce, Peter, Ackerman, Cyril, Llamoso, Max, Lataillade, A, Wurcel, Yale School of Medicine [New Haven, Connecticut] (YSM), Icahn School of Medicine at Mount Sinai [New York] (MSSM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Fundación Huésped [Buenos Aires], Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP), Federal University of Sao Paulo (Unifesp), IRCCS San Raffaele Scientific Institute [Milan, Italie], Georgetown University [Washington] (GU), Orlando Immunology Center, GlaxoSmithKline, Glaxo Smith Kline, GlaxoSmithKline [Research Triangle Park] (GSK ), ViiV Healthcare US, ViiV Healthcare [Brentford, UK], BRIGHTE Trial Team: P Cahn, L Cassetti, D O David, E Loiza, D Cecchini, S Lupo, M Martins, C Zala, A Carr, J McMahon, S De Wit, E Florence, C R Alves, J Andrade Neto, M Della Negra, R Diaz, B Grinsztejn, J Madruga, K Morejon, F Ribeiro, E Sprinz, M Murray, J Szabo, S Trottier, S Walmsley, J Ballesteros, F Zamora, C Beltran, C Chahin Anania, C Perez, M Wolff Reyes, J Velez, P M Girard, C Katlama, J-M Molina, D Neau, G Pialoux, I Poizot-Martin, F Raffi, D Salmon-Ceron, K Arastéh, A Baumgarten, J Bogner, M Hower, W Kern, D Schürmann, C Stephan, S Metallidis, V Paparizos, P Mallon, A Antinori, R Cauda, A Lazzarin, G Migliorino, C Mussini, G Orofino, G Rizzardini, P F Belaunzaran, R Cabello, J Duque Rodríguez, M Santoscoy-Gómez, S C Treviño, I Hoepelman, F Mendo, Y Pinedo Ramirez, M Parczewski, B Knysz, N Janeiro, F Maltez, L Preotescu, A Streinu-Cercel, G Latiff, I Mitha, J M Libre Codina, S Moreno Guillén, J Pineda, S M Hsieh, A Pozniak, J Aberg, J Bartczak, M Berhe, T Campbell, C Creticos, E DeJesus, V Drelichman, C Durand, J Eron, C Fichtenbaum, R Grossberg, S Gupta, F Haas, D Hagins, M Jain, M Kozal, P Kumar, J Lalezari, J Lennox, R Loftus, R Lubelchek, J McGowan, M McKellar, A Mills, J Morales-Ramirez, O Osiyemi, N Ramgopal, S Schrader, J Slim, P Tebas, M Thompson, W Towner, T Wilkin, A Wurcel, Malbec, Odile, Kozal, M., Aberg, J., Pialoux, G., Cahn, P., Thompson, M., Molina, J. -M., Grinsztejn, B., Diaz, R., Castagna, A., Kumar, P., Latiff, G., Dejesus, E., Gummel, M., Gartland, M., Pierce, A., Ackerman, P., Llamoso, C., Lataillade, M., Yale University School of Medicine, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Adult, Male, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), HIV Infections, Drug resistance, 030204 cardiovascular system & hematology, medicine.disease_cause, Piperazines, law.invention, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Drug Resistance, Multiple, Viral, Randomized controlled trial, law, Humans, Medicine, Prodrugs, 030212 general & internal medicine, Aged, business.industry, General Medicine, Middle Aged, Viral Load, Virology, Organophosphates, CD4 Lymphocyte Count, 3. Good health, [SDV] Life Sciences [q-bio], Clinical trial, Multiple drug resistance, Fostemsavir, Anti-Retroviral Agents, Multicenter study, HIV-1, RNA, Viral, Drug Therapy, Combination, Female, business
Abstract

International audience; Background: Among some patients with human immunodeficiency virus type 1 (HIV-1) infection who have undergone multiple antiretroviral therapies and have limited options for treatment, new classes of antiretroviral drugs with novel mechanisms of action are needed. Fostemsavir is the prodrug of temsavir, a first-in-class investigational HIV-1 attachment inhibitor.Methods: In this ongoing phase 3 trial in 23 countries, we enrolled patients with multidrug-resistant HIV-1 infection in two cohorts, according to their remaining treatment options. In the first cohort, we assigned (in a 3:1 ratio) patients who had the option of using at least one fully active, approved antiretroviral drug in at least one but no more than two antiretroviral classes to add either fostemsavir (at a dose of 600 mg twice daily) or placebo to their failing regimen for 8 days, followed by open-label fostemsavir plus optimized background therapy (randomized cohort). In the second cohort, patients who had no remaining antiretroviral options were started on open-label fostemsavir plus optimized background therapy on day 1 (nonrandomized cohort). The primary end point was the mean change in the HIV-1 RNA level from day 1 through day 8 in the randomized cohort.Results: A total of 371 patients were treated, including 272 in the randomized cohort and 99 in the nonrandomized cohort. At day 8, the mean decrease in the HIV-1 RNA level was 0.79 log10 copies per milliliter in the fostemsavir group and 0.17 log10 copies in the placebo group (P

Published
2020

29. Virological response and retention in care according to time of starting ART in Italy: data from the Icona Foundation Study cohort

Author

D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, D., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, D., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., A d'Arminio Monforte, A Antinori, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G C Marchetti, G Rezza, F von Schloesser, F Ceccherini-Silberstein, A Cozzi-Lepri, E Girardi, S Lo Caputo, C Mussini, M Puoti, C F Perno, F Bai, C Balotta, A Bandera, S Bonora, M Borderi, A Calcagno, A Capetti, M R Capobianchi, S Cicalini, A Cingolani, P Cinque, , A Di Biagio, N Gianotti, A Gori, G Guaraldi, G Lapadula, M Lichtner, G Madeddu, F Maggiolo, L Monno, S Nozza, C Pinnetti, E Quiros Roldan, R Rossotti, S Rusconi, M M Santoro, A Saracino, L Sarmati, I Fanti, L Galli, P Lorenzini, A Rodano', M Macchia, A Tavelli, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, E Milano, C Suardi, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, F Vichi, G Cassola, C Viscoli, A Alessandrini, N Bobbio, G Mazzarello, L Fondaco, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, S Salpietro, C Tincati, C Puzzolante, C Migliorino, V Sangiovanni, G Borgia, V Esposito, G Di Flumeri, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, D Francisci, E Schiaroli, G Parruti, F Sozio, G Magnani, M A Ursitti, A Cristaudo, V Vullo, R Acinapura, D Moschese, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, R Gagliardini, M M Plazzi, G De Girolamo, A Vergori, M Cecchetto, F Viviani, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, C Di Giuli, P Caramello, G C Orofino, M Sciandra, M Bassetti, A Londero, V Manfrin, G Battagin, G Starnini, A Ialungo, D'Arminio Monforte, A, Tavelli, A, Cozzi-Lepri, A, Castagna, A, Passerini, S, Francisci, D, Saracino, A, Maggiolo, F, Lapadula, G, Girardi, E, Perno, C, Antinori, A, Andreoni, M, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, G, Rezza, G, Von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Lo Caputo, S, Mussini, C, Puoti, M, Bai, F, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Gori, A, Guaraldi, G, Lichtner, M, Madeddu, G, Monno, L, Nozza, S, Pinnetti, C, Quiros Roldan, E, Rossotti, R, Rusconi, S, Santoro, M, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodano, A, Macchia, M, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Fondaco, L, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicano, G, Rizzardini, G, Cannizzo, E, Moioli, M, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, Di Flumeri, G, Gentile, I, Rizzo, V, Cattelan, A, Marinello, S, Cascio, A, Trizzino, M, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, Rivano Capparuccia, M, Iaiani, G, Latini, A, Gagliardini, R, Plazzi, M, De Girolamo, G, Vergori, A, Cecchetto, M, Viviani, F, De Vito, A, Rossetti, B, Montagnani, F, Franco, A, Fontana Del Vecchio, R, Di Giuli, C, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Manfrin, V, Battagin, G, Starnini, G, Ialungo, A, D'Arminio Monforte A., Tavelli A., Cozzi-Lepri A., Castagna A., Passerini S., Francisci D., Saracino A., Maggiolo F., Lapadula G., Girardi E., Perno C.F., Antinori A., Andreoni M., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G.C., Rezza G., Von Schloesser F., Viale P., Ceccherini-Silberstein F., Lo Caputo S., Mussini C., Puoti M., Bai F., Balotta C., Bandera A., Bonora S., Borderi M., Calcagno A., Capetti A., Capobianchi M.R., Cicalini S., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Gori A., Guaraldi G., Lichtner M., Madeddu G., Marchetti G., Monno L., Nozza S., Pinnetti C., Quiros Roldan E., Rossotti R., Rusconi S., Santoro M.M., Sarmati L., Fanti I., Galli L., Lorenzini P., Rodano A., MacChia M., Carletti F., Carrara S., Di Caro A., Graziano S., Petroni F., Prota G., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Milano E., Suardi C., Donati V., Verucchi G., Castelnuovo F., Minardi C., Menzaghi B., Abeli C., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Pan A., Lorenzotti S., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Fondaco L., Bonfanti P., Molteni C., Chiodera A., Milini P., Nunnari G., Pellicano G., Rizzardini G., Cannizzo E.S., Moioli M.C., Piolini R., Bernacchia D., Salpietro S., Tincati C., Puzzolante C., Migliorino C., Sangiovanni V., Borgia G., Esposito V., Di Flumeri G., Gentile I., Rizzo V., Cattelan A.M., Marinello S., Cascio A., Trizzino M., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M.A., Cristaudo A., Vullo V., Acinapura R., Moschese D., Capozzi M., Mondi A., Rivano Capparuccia M., Iaiani G., Latini A., Gagliardini R., Plazzi M.M., De Girolamo G., Vergori A., Cecchetto M., Viviani F., De Vito A., Rossetti B., Montagnani F., Franco A., Fontana Del Vecchio R., Di Giuli C., Caramello P., Orofino G.C., Sciandra M., Bassetti M., Londero A., Manfrin V., Battagin G., Starnini G., and Ialungo A.

Subjects
0301 basic medicine, diagnosis, hiv, communicable diseases, HIV Infections, Logistic regression, Virological response, Cohort Studies, 0302 clinical medicine, Retention in Care, Medicine, Pharmacology (medical), HIV Infection, 030212 general & internal medicine, Prospective cohort study, cd4 count determination procedure, drug, suppression, Viral Load, CD4 Lymphocyte Count, Humans, Italy, Anti-HIV Agents, virology, Infectious Diseases, blood hiv rna, Cohort, hiv, cd4 count determination procedure, communicable diseases, incomeitaly, diagnosis, virology, blood hiv rna, retention in care, incomeitaly, Viral load, HIV, ART, Cohort study, Human, Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, Settore MED/17 - MALATTIE INFETTIVE, NO, 03 medical and health sciences, HIV viral load, Internal medicine, HIV, CD4, ART, Pharmacology, business.industry, double blind, Anti-HIV Agent, HIV viral load, antiretroviral therapy, double blind, initiation, suppression, infection, Retention in care, 030112 virology, infection, initiation, Observational study, Cohort Studie, business
Abstract

Objectives To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year from ART initiation according to timing of start in a real-life setting. Methods All individuals in the Icona cohort diagnosed with HIV in 2016–17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, ≤7 days; Group 2, 8–14 days; Group 3, 15–30 days; Group 4, 31–120 days; and Group 5, >120 days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12 week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1 year (on ART with HIV-RNA Results A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1 year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1 year. Conclusions In our high-income observational setting, we did not observe differences in the 1 year rate of virological response and retention in care according to timing of ART initiation.

Published
2020

30. Incidence and risk factors for liver enzyme elevation among naive HIV-1-infected patients receiving ART in the ICONA cohort

Author

Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., ICONA Foundation Study Group:, A d'Arminio Monforte, Antinori, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, G Di Perri, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, C Marchetti, G, Rezza, G, F von Schloesser, Viale, P, A d'Arminio Monforte, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Girardi, E, S Lo Caputo, Mussini, C, Puoti, M, F Perno, C, Bai, F, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, R Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, A De Luca, A Di Biagio, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Monno, L, Nozza, S, Pinnetti, C, QUIROS ROLDAN, Maria Eugenia, Rossotti, R, Rusconi, S, M Santoro, M, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, A Di Caro, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, S Cannizzo, E, C Moioli, M, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, F Di Martino, Gentile, I, Rizzo, V, M Cattelan, A, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, A Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, M Rivano Capparuccia, Iaiani, G, Latini, A, Gagliardini, R, M Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, A De Vito, Rossetti, B, Montagnani, F, Franco, A, R Fontana Del Vecchio, Francisci, D, C Di Giuli, Caramello, P, C Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Taramasso, L, Lorenzini, P, Di Biagio, A, Lichtner, M, Marchetti, G, Rossotti, R, Lapadula, G, Cozzi-Lepri, A, Vichi, F, Antinori, A, Bonora, S, D'Arminio Monforte, A, d'Arminio Monforte, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, Gc, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Mussini, C, Puoti, M, Perno, Cf, Bai, F, Balotta, C, Bandera, A, Borderi, M, Calcagno, A, Capetti, A, Capobianchi, Mr, Cicalini, S, Cingolani, A, Cinque, P, De Luca, A, Gianotti, N, Gori, A, Guaraldi, G, Madeddu, G, Maggiolo, F, Monno, L, Nozza, S, Pinnetti, C, Quiros Roldan, E, Rusconi, S, Santoro, Mm, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, Cannizzo, E, Moioli, Mc, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, Di Martino, F, Gentile, I, Rizzo, V, Cattelan, Am, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, Ma, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, Capparuccia, Mr, Iaiani, G, Latini, A, Gagliardini, R, Plazzi, Mm, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, De Vito, A, Rossetti, B, Montagnani, F, Franco, A, Fontana Del Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, Gc, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Taramasso L., Lorenzini P., Di Biagio A., Lichtner M., Marchetti G., Rossotti R., Lapadula G., Cozzi-Lepri A., Vichi F., Antinori A., Bonora S., Cascio A., D'Arminio Monforte A., Cascio A. in ICONA Foundation Study Group., Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., Castagna, A., and A d'Arminio Monforte,i, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G Rezza, F von Schloesser, F Ceccherini-Silberstein, E Girardi, S Lo Caputo, C Mussini, M Puoti, C F Perno, F Bai, C Balotta, A Bandera, M Borderi, A Calcagno, A Capetti, M R Capobianchi, S Cicalini, A Cingolani, P Cinque, A De Luca, E Girardi, N Gianotti, A Gori, G Guaraldi, G Madeddu, F Maggiolo, L Monno, S Nozza, C Pinnetti, E Quiros Roldan, S Rusconi, M M Santoro, A Saracino, L Sarmati, I Fanti, A Rodano', M Macchia, A Tavelli, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, F Maggiolo, C Suardi, P Viale, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, G Cassola, C Viscoli, A Alessandrini, N Bobbio, G Mazzarello, S Vita, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, S Salpietro, C Tincati, C Puzzolante, C Migliorino, V Sangiovanni, G Borgia, V Esposito, F Di Martino, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, F Baldelli, E Schiaroli, G Parruti, F Sozio, G Magnani, M A Ursitti, A Cristaudo, V Vullo, R Acinapura, D Moschese, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, R Gagliardini, M M Plazzi, S Savinelli, A Vergori, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, D Francisci, C Di Giuli, P Caramello, G C Orofino, M Sciandra, M Bassetti, A Londero, G Pellizzer, V Manfrin, G Starnini, A Ialungo

Subjects
0301 basic medicine, Male, Integrase inhibitor, Hepatitis B Surface Antigen, HIV Infections, 0302 clinical medicine, Risk Factors, hivh epatitis c rna surface antigens follow-up homosexuality integrase inhibitors hepatitis b virus hepatitis b virus measurement hiv infections hepatotoxicity hepatitis c virus coinfection nucleoside reverse transcriptase inhibitors non-nucleoside reverse transcriptase inhibitors cox proportional hazards models baseline value liver enzyme raltegravir, Pharmacology (medical), HIV Infection, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Coinfection, Incidence (epidemiology), Liver Disease, Incidence, Liver Diseases, virus diseases, Hepatitis C, Middle Aged, Reverse Transcriptase Inhibitor, Infectious Diseases, Cohort, Population study, Regression Analysis, Reverse Transcriptase Inhibitors, Female, medicine.drug, Human, Microbiology (medical), Adult, medicine.medical_specialty, Anti-HIV Agents, Regression Analysi, NO, 03 medical and health sciences, Internal medicine, medicine, Humans, HIV Integrase Inhibitors, HIV Protease Inhibitor, Pharmacology, Hepatitis B Surface Antigens, business.industry, Anti-HIV Agent, HIV, ART, HIV Protease Inhibitors, medicine.disease, Raltegravir, 030112 virology, HIV Integrase Inhibitor, Prospective Studie, HIV-1, business, Adult, Anti-HIV Agents, Coinfection, Female, Hepatitis B Surface Antigens, Hepatitis C, HIV Infections, HIV Integrase Inhibitors, HIV Protease Inhibitors, HIV-1, Humans, Incidence, Liver Diseases, Male, Middle Aged, Prospective Studies, Regression Analysis, Reverse Transcriptase Inhibitors, Risk Factors
Abstract

ObjectivesTo evaluate the incidence and risk factors for liver enzyme elevations (LEE) in patients initiating first-line ART in the ICONA prospective observational cohort, between June 2009 and December 2017.Patients and methodsIn total, 6575 ART-naive patients were selected, initiating two NRTIs with the third drug being a boosted PI (n=2436; 37.0%), an NNRTI (n=2384; 36.3%) or an integrase strand transfer inhibitor (INSTI) (n=1755; 26.7%). HBV surface antigen and HCV RNA were detected in 3.9% and 5.8% of the study population. Inverse probability weighted Cox regression analysis was used to calculate the HRs, according to first-line regimen, for LEE, defined as ALT or AST increases of ≥2.5× upper limit of normal (ULN) for patients with normal baseline values or ≥2.5× baseline for patients with higher baseline values.ResultsOne hundred and eighty-three LEE occurred over 20722 patient-years of follow-up. After adjusting for the main confounders, the risk of LEE halved with INSTIs compared with NNRTIs (HR 0.46, 95% CI 0.25–0.86), with a significant reduction in the raltegravir group (HR 0.11, 95% CI 0.02–0.84 using the NNRTI class as reference). HRs for LEE were significantly higher in subjects with HBV or HCV coinfection, in patients with poorly controlled HIV infection and in those who acquired HIV through homosexual transmission.ConclusionsIn our study, INSTI use almost halved the risk of LEE compared with other regimens. This finding could be particularly important for choosing ART in patients with risk factors for liver toxicity such as HCV and HBV coinfections.

Published
2019

31. Week 48 Resistance Analyses of the Once-Daily, Single-Tablet Regimen Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide (D/C/F/TAF) in Adults Living with HIV-1 from the Phase III Randomized AMBER and EMERALD Trials

Author

Lathouwers, Erkki, Wong, Eric Y, Brown, Kimberley, Baugh, Bryan, Ghys, Anne, Jezorwski, John, Mohsine, El Ghazi, Van Landuyt, Erika, Opsomer, Magda, De Meyer, Sandra, De Wit, S, Florence, E, Vandekerckhove, L, Vandercam, B, Brunetta, J, Klein, M, Murphy, D, Rachlis, A, Walmsley, S, Ajana, F, Cotte, L, Girard, P-M, Katlama, C, Molina, J-M, Poizot-Martin, I, Raffi, F, Rey, D, Reynes, J, Teicher, E, Yazdanpanah, Y, Arasteh, K, Bickel, M, Bogner, J, Esser, S, Faetkenheuer, G, Jessen, H, Kern, W, Rockstroh, J, Spinner, C, Stellbrink, H-J, Stoehr, A, Antinori, A, Castelli, F, Chirianni, A, De Luca, A, Di Biagio, A, Galli, M, Lazzarin, A, Maggiolo, F, Maserati, R, Mussini, C, Garlicki, A, Gasiorowski, J, Halota, W, Horban, A, Parczewski, M, Piekarska, A, Belonosova, E, Chernova, O, Dushkina, N, Kulagin, V, Ryamova, E, Shuldyakov, A, Sizova, N, Tsybakova, O, Voronin, E, Yakovlev, A, Antela, A, Arribas, JR, Berenguer, J, Casado, J, Estrada, V, Galindo, MJ, Garcia Del Toro, M, Gatell, JM, Gorgolas, M, Gutierrez, F, Gutierrez, MDM, Negredo, E, Pineda, JA, Podzamczer, D, Portilla Sogorb, J, Rivero, A, Rubio, R, Viciana, P, De Los Santos, I, Clarke, A, Gazzard, BG, Johnson, MA, Orkin, C, Reeves, I, Waters, L, Benson, P, Bhatti, L, Bredeek, F, Crofoot, G, Cunningham, D, DeJesus, E, Eron, J, Felizarta, F, Franco, R, Gallant, J, Hagins, D, Henry, K, Jayaweera, D, Lucasti, C, Martorell, C, McDonald, C, McGowan, J, Mills, A, Morales-Ramirez, J, Prelutsky, D, Ramgopal, M, Rashbaum, B, Ruane, P, Slim, J, Wilkin, A, deVente, J, Moutschen, M, Van Wijngaerden, E, Vekerckhove, L, Vercam, B, Conway, B, Shafran, S, Janssen Pharmaceutica [Beerse], Janssen Pharmaceutical Research and Development Titusville, AMBER and EMERALD Study Groups: S De Wit, E Florence, L Vandekerckhove, B Vandercam, J Brunetta, M Klein, D Murphy, A Rachlis, S Walmsley, F Ajana, L Cotte, P-M Girard, C Katlama, J-M Molina, I Poizot-Martin, F Raffi, D Rey, J Reynes, E Teicher, Y Yazdanpanah, K Arastéh, M Bickel, J Bogner, S Esser, G Faetkenheuer, H Jessen, W Kern, J Rockstroh, C Spinner, H-J Stellbrink, A Stoehr, A Antinori, F Castelli, A Chirianni, A De Luca, A Di Biagio, M Galli, A Lazzarin, F Maggiolo, R Maserati, C Mussini, A Garlicki, J Gasiorowski, W Halota, A Horban, M Parczewski, A Piekarska, E Belonosova, O Chernova, N Dushkina, V Kulagin, E Ryamova, A Shuldyakov, N Sizova, O Tsybakova, E Voronin, A Yakovlev, A Antela, J R Arribas, J Berenguer, J Casado, V Estrada, M J Galindo, M Garcia Del Toro, J M Gatell, M Gorgolas, F Gutierrez, Mdm Gutierrez, E Negredo, J A Pineda, D Podzamczer, J Portilla Sogorb, A Rivero, R Rubio, P Viciana, I De Los Santos, A Clarke, B G Gazzard, M A Johnson, C Orkin, I Reeves, L Waters, P Benson, L Bhatti, F Bredeek, G Crofoot, D Cunningham, E DeJesus, J Eron, F Felizarta, R Franco, J Gallant, D Hagins, K Henry, D Jayaweera, C Lucasti, C Martorell, C McDonald, J McGowan, A Mills, J Morales-Ramirez, D Prelutsky, M Ramgopal, B Rashbaum, P Ruane, J Slim, A Wilkin, J deVente, S De Wit, E Florence, M Moutschen, E Van Wijngaerden, L Vandekerckhove, B Vandercam, J Brunetta, B Conway, M Klein, D Murphy, A Rachlis, S Shafran, S Walmsley, F Ajana, L Cotte, P-M Girard, C Katlama, J-M Molina, I Poizot-Martin, F Raffi, D Rey, J Reynes, E Teicher, Y Yazdanpanah, J Gasiorowski, W Halota, A Horban, A Piekarska, A Witor, J R Arribas, I Perez-Valero, J Berenguer, J Casado, J M Gatell, F Gutierrez, M J Galindo, Mdm Gutierrez, J A Iribarren, H Knobel, E Negredo, J A Pineda, D Podzamczer, J Portilla Sogorb, F Pulido, C Ricart, A Rivero, I Santos Gil, A Blaxhult, L Flamholc, M Gisslèn, A Thalme, J Fehr, A Rauch, M Stoeckle, A Clarke, B G Gazzard, M A Johnson, C Orkin, F Post, A Ustianowski, L Waters, J Bailey, P Benson, L Bhatti, I Brar, U F Bredeek, C Brinson, G Crofoot, D Cunningham, E DeJesus, C Dietz, R Dretler, J Eron, F Felizarta, C Fichtenbaum, J Gallant, J Gathe, D Hagins, S Henn, K W Henry, G Huhn, M Jain, C Lucasti, C Martorell, C McDonald, A Mills, J Morales-Ramirez, K Mounzer, R Nahass, H Olivet, O Osiyemi, D Prelutsky, M Ramgopal, B Rashbaum, G Richmond, P Ruane, A Scarsella, A Scribner, P Shalit, D Shamblaw, J Slim, K Tashima, G Voskuhl, D Ward, A Wilkin, J de Vente, and Malbec, Odile

Subjects
0301 basic medicine, [SDV]Life Sciences [q-bio], efficacy, Human immunodeficiency virus (HIV), HIV Infections, darunavir, medicine.disease_cause, VIRALLY SUPPRESSED ADULTS, PLUS LAMIVUDINE, DOUBLE-BLIND, 0302 clinical medicine, INFECTION, Medicine and Health Sciences, Emtricitabine, 030212 general & internal medicine, Darunavir, Emtricitabine tenofovir alafenamide, Alanine, Cobicistat, Single tablet regimen, virus diseases, Viral Load, OPEN-LABEL, 3. Good health, [SDV] Life Sciences [q-bio], Drug Combinations, Infectious Diseases, NON-INFERIORITY, INITIAL TREATMENT, Reverse Transcriptase Inhibitors, Life Sciences & Biomedicine, Tablets, medicine.drug, Adult, TENOFOVIR DISOPROXIL FUMARATE, Anti-HIV Agents, Darunavir/Cobicistat, Immunology, archived RAMs, Tenofovir alafenamide, Drug Administration Schedule, single-tablet regimen, resistance, 03 medical and health sciences, deep sequencing, Virology, Drug Resistance, Viral, medicine, darunavir/cobicistat/emtricitabine/TAF, Humans, Clinical Trials/Clinical Studies, Tenofovir, emtricitabine, DRUG-RESISTANCE, Science & Technology, TREATMENT-NAIVE PATIENTS, business.industry, Adenine, cobicistat, 030104 developmental biology, TAF, HIV-1, business
Abstract

Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg is being investigated in two Phase III trials, AMBER (NCT02431247; treatment-naive adults) and EMERALD (NCT02269917; treatment-experienced, virologically suppressed adults). Week 48 AMBER and EMERALD resistance analyses are presented. Postbaseline samples for genotyping/phenotyping were analyzed from protocol-defined virologic failures (PDVFs) with viral load (VL) ≥400 copies/mL at failure/later time points. Post hoc analyses were deep sequencing in AMBER, and HIV-1 proviral DNA from baseline samples (VL

Published
2019

32. A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren’s syndrome

Author

Stanislas Faguer, H. François, Alain Le Quellec, Guillaume Moulis, Laurent Chiche, Alexandre Karras, Philippe Remy, Xavier Mariette, Aurélie Hummel, Evguenia Krastinova, Perrine Jullien, Anne-Laure Fauchais, J.B. Fraison, Véronique Le Guern, Estibaliz Lazaro, R. Mesbah, Magali Jasiek, Noémie Jourde-Chiche, Emmanuelle Dernis, Benjamin Terrier, Sophie Ferlicot, Carole Cordonnier, Philippe Vanhille, Pierre Ronco, Eric Thervet, Raphaèle Seror, Nathalie Costedoat-Chalumeau, Eric Hachulla, Vannary Meas-Yedid, Laurent Daniel, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre National de Référence Maladies Systémiques et Autoimmunes Rares, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CH Boulogne sur Mer, Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU Dupuytren, Hôpital Européen [Fondation Ambroise Paré - Marseille], Centre Hospitalier Le Mans (CH Le Mans), Hôpital Purpan [Toulouse], CH Béziers, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], CHU Saint-Etienne, Hôpital Claude Huriez [Lille], CHU Lille, CHU Saint-Eloi, CHU Henri Mondor, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CH Valenciennes, Analyse d'images biologiques - Biological Image Analysis (BIA), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), CHU Amiens-Picardie, Hôpital Bicêtre, No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this manuscript., The authors thank all the clinicians and pathologists who participated in the REINSS study: C. Agard, A. Audemard, S. Bally, J.J. Boffa, D. Le Thi Huong-Boutin, P. Cacoub, P. Cathebras, G. Choukroun, E. Daugas, J.G. Fuzibet, C. Garrouste, M. Hamidou, P.Y. Hatron, D. Joly, J.E. Kahn, B. Knebelmann, T. Kofman, B. Laurent-Pilonchery, C. Lavigne, G. Le Guenno, T. Lobbedez, J. Schmidt, C. Sordet, A. Barbier-Dupas, A. Guillaudeau, A. Moreau, B. Ambrosetti, B. Mougenot, B. Mac-Gregor, C. Deminiere, C. Guilbeau-Frugier, C. Mussini, D. Droz, D. Desvaux-Belghiti, F. Comoz, H. Perrochia, H. Beaufils, J. Verine, L.H. Noel, J.P. Duong Van Huyen, A. Modesto, L. Marcellin, M. Mignon-Conte, D. Nochy, N. Patey-Mariaud De Serre, P. Rouvier, S. Lepreux, V. Algagnac-Oskman, M.-C. Copin, B. Gosselin, B. Delisle, F. Paraf, I. Brocheriou, J.-P. Saint-Are, J.-L. Kermeny, P. Callard., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Henri Mondor [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, Biopsy, T-Lymphocytes, Kidney Glomerulus, Plasma cell, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, Adrenal Cortex Hormones, Medicine, Pharmacology (medical), tubulointerstitial nephritis, 030212 general & internal medicine, Renal Insufficiency, Cryoglobulins, Aged, 80 and over, B-Lymphocytes, medicine.diagnostic_test, biology, Middle Aged, 3. Good health, medicine.anatomical_structure, Sjogren's Syndrome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antibodies, Antinuclear, Rituximab, Female, Renal biopsy, France, Antibody, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Plasma Cells, primary Sjögren’s syndrome, Renal function, cryoglobulinaemia, Nephropathy, 03 medical and health sciences, Young Adult, Rheumatology, Internal medicine, Humans, Aged, Retrospective Studies, 030203 arthritis & rheumatology, business.industry, Plasmacytosis, medicine.disease, biology.protein, Nephritis, Interstitial, business
Abstract

International audience; Objective. Renal involvement is a rare event during primary SS (pSS). We aimed to describe the clinico-biological and histopathological characteristics of pSS-related nephropathy and its response to treatment. Methods. We conducted a French nationwide, retrospective, multicentre study including pSS patients fulfilling American–European Consensus Group criteria or enlarged American–European Consensus Group criteria, and with biopsy-proven renal involvement. Results. A total of 95 patients were included (median age 49 years). An estimated glomerular filtration rate (eGFR) of

Published
2017

33. Prognostic Value of the Fibrosis-4 Index in Human Immunodeficiency Virus Type-1 Infected Patients Initiating Antiretroviral Therapy with or without Hepatitis C Virus

Author

Mussini C., Lorenzini P., Puoti M., Lichtner M., Lapadula G., Di Giambenedetto S., Antinori A., Madeddu G., Cozzi-Lepri A., D'Arminio Monforte A., De Luca A., Moroni M., Andreoni M., Angarano G., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Perno C. F., von Schloesser F., Viale P., Castagna A., Ceccherini-Silber-Stein F., Girardi E., Lo Caputo S., Ammassari A., Balotta C., Bandera A., Bonfanti P., Bonora S., Borderi M., Calcagno A., Calza L., Capobianchi M. R., Ceccherini-Silberstein F., Cingolani A., Cinque P., Di Biagio A., Gianotti N., Gori A., Guaraldi G., Maggiolo F., Marchetti G., Marcotullio S., Monno L., Nozza S., Roldan E. Q., Rossotti R., Rusconi S., Santoro M. M., Saracino A., Zaccarelli M., Fanti I., Galli L., Rodano A., Shanyinde M., Tavelli A., Giacometti A., Costantini A., Mazzoccato S., Santoro C., Suardi C., Vanino E., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P. E., Piano P., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Mazzotta F., Cassola G., Viscoli C., Alessandrini A., Piscopo R., Mazzarello G., Mastroianni C., Belvisi V., Caramma I., Chiodera A., Castelli A. P., Rizzardini G., Ridolfo A. L., Piolini R., Salpietro S., Carenzi L., Moioli M. C., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Di Martino F., Maddaloni L., Gentile I., Orlando R., Baldelli F., Francisci D., Parruti G., Ursini T., Magnani G., Ursitti M. A., Vullo V., Baldin G., Gallo L., Nicastri E., Acinapura R., Capozzi M., Libertone R., Savinelli S., Cecchetto M., Viviani F., Mura M. S., Rossetti B., Caramello P., Oro-Fino G. C., Sciandra M., Bassetti M., Londero A., Pellizzer G., Manfrin V., Mussini, C, Lorenzini, P, Puoti, M, Lichtner, M, Lapadula, G, Di Giambenedetto, S, Antinori, A, Madeddu, G, Cozzi-Lepri, A, D'Arminio Monforte, A, De Luca, A, Moroni, M, Andreoni, M, Angarano, G, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, von Schloesser, F, Viale, P, Castagna, A, Ceccherini-Silber-Stein, F, Girardi, E, Lo Caputo, S, Ammassari, A, Balotta, C, Bandera, A, Bonfanti, P, Bonora, S, Borderi, M, Calcagno, A, Calza, L, Capobianchi, M, Ceccherini-Silberstein, F, Cingolani, A, Cinque, P, Di Biagio, A, Gianotti, N, Gori, A, Guaraldi, G, Maggiolo, F, Marchetti, G, Marcotullio, S, Monno, L, Nozza, S, Roldan, E, Rossotti, R, Rusconi, S, Santoro, M, Saracino, A, Zaccarelli, M, Fanti, I, Galli, L, Rodano, A, Shanyinde, M, Tavelli, A, Giacometti, A, Costantini, A, Mazzoccato, S, Santoro, C, Suardi, C, Vanino, E, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Mazzotta, F, Cassola, G, Viscoli, C, Alessandrini, A, Piscopo, R, Mazzarello, G, Mastroianni, C, Belvisi, V, Caramma, I, Chiodera, A, Castelli, A, Rizzardini, G, Ridolfo, A, Piolini, R, Salpietro, S, Carenzi, L, Moioli, M, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Di Martino, F, Maddaloni, L, Gentile, I, Orlando, R, Baldelli, F, Francisci, D, Parruti, G, Ursini, T, Magnani, G, Ursitti, M, Vullo, V, Baldin, G, Gallo, L, Nicastri, E, Acinapura, R, Capozzi, M, Libertone, R, Savinelli, S, Cecchetto, M, Viviani, F, Mura, M, Rossetti, B, Caramello, P, Oro-Fino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Mussini, Cristina, Lorenzini, Patrizia, Puoti, Massimo, Lichtner, Miriam, Lapadula, Giuseppe, Di Giambenedetto, Simona, Antinori, Andrea, Madeddu, Giordano, Cozzi Lepri, Alessandro, D'Arminio Monforte, Antonella, De Luca, Andrea, Moroni, M., Andreoni, ALESSANDRA MARIA, Angarano, G., Antinori, A., D'Arminio Monforte, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Perno, C. F., Von Schloesser, F., Viale, P., Castagna, A., Ceccherini Silberstein, F., Cozzi Lepri, A., Girardi, E., Gentile, Ivan, Borgia, Guglielmo, Lo Caputo, S., Mussini, C., Puoti, M., Andreoni, M., Ammassari, A., Balotta, C., Bandera, A., Bonfanti, Patrizia, Bonora, S., Borderi, M., Calcagno, A., Calza, L., Capobianchi, M. R., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lapadula, G., Lichtner, M., Madeddu, G., Maggiolo, F., Marchetti, G., Marcotullio, S., Monno, L., Nozza, S., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Zaccarelli, M., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Shanyinde, M., Tavelli, A., C, Mussini, P. Lorenzini, M. Puoti, M. Lichtner, G. Lapadula, S. Di Giambenedetto, A. Antinori, G. Madeddu, A. Cozzi-Lepri, A. d’Arminio Monforte, A. De Luca, ICONA Foundation study group […, P Viale, E Vanino, G Verucchi, …], Cozzi-Lepri, Alessandro, D'arminio Monforte, Antonella, on behalf the ICONA Foundation Study, Grp, and Castagna, Antonella

Subjects
CD4-Positive T-Lymphocytes, Liver Cirrhosis, Male, Genetics and Molecular Biology (all), lcsh:Medicine, HIV Infections, hiv, Hepacivirus, medicine.disease_cause, Biochemistry, MED/17 Malattie infettive, Retrospective Studie, Risk Factors, HIV Infection, Prospective Studies, Viral, Chronic, lcsh:Science, Prospective cohort study, Multidisciplinary, Medicine (all), Adult, Anti-Retroviral Agents, Carcinoma, Hepatocellular, Female, HIV-1, Hepatitis C, Chronic, Humans, Liver, Liver Neoplasms, Middle Aged, Prognosis, RNA, Viral, Retrospective Studies, Viral Load, Agricultural and Biological Sciences (all), Biochemistry, Genetics and Molecular Biology (all), agricultural and biological sciences (all), biochemistry, genetics and molecular biology (all), medicine (all), virus diseases, Hepatitis C, Not available, CD4-Positive T-Lymphocyte, Liver Neoplasm, Hepatocellular carcinoma, Cohort, Viral load, Human, Research Article, Cart, medicine.medical_specialty, Prognosi, Hepatitis C virus, Liver Cirrhosi, Settore MED/17 - MALATTIE INFETTIVE, NO, Internal medicine, medicine, fibrosis, Hepaciviru, business.industry, Proportional hazards model, Risk Factor, lcsh:R, Carcinoma, Retrospective cohort study, Hepatocellular, medicine.disease, Prospective Studie, Immunology, RNA, lcsh:Q, Anti-Retroviral Agent, business
Abstract

Objective: To evaluate the Fibrosis (FIB)-4 index as a predictor of major liver-related events (LRE) and liver-related death (LRD) in human immunodeficiency virus (HIV) type-1 patients initiating combination antiretroviral therapy (cART). Design: Retrospective analysis of a prospective cohort study. Setting: Italian HIV care centers participating to the ICONA Foundation cohort. Participants: Treatment-naive patients enrolled in ICONA were selected who: initiated cART, had hepatitis C virus (HCV) serology results, were HBsAg negative, had an available FIB-4 index at cART start and during follow up. Methods: Cox regression models were used to determine the association of FIB4 with the risk of major LRE (gastrointestinal bleeding, ascites, hepatic encephalopathy, hepato-renal syndrome or hepatocellular carcinoma) or LRD. Results: Three-thousand four-hundred seventy-five patients were enrolled: 73.3% were males, 27.2% HCV seropositive. At baseline (time of cART initiation) their median age was 39 years, had a median CD4+ T cell count of 260 cells/uL, and median HIV RNA 4.9 log copies/mL, 65.9% had a FIB-4 3.25. Over a follow up of 18,662 person-years, 41 events were observed: 25 major LRE and 16 LRD (incidence rate, IR, 2.2 per 1,000 PYFU [95% confidence interval, CI 1.6–3.0]). IR was higher in HCV seropositives as compared to negatives (5.9 vs 0.5 per 1,000 PYFU). Higher baseline FIB-4 category as compared to 3.25: HR 4.25, 1.21–14.92) and time-updated FIB-4 (FIB-4 1.45–3.25: HR 3.40, 1.02–11.40; FIB-4 >3.25: HR 21.24, 6.75–66.84) were independently predictive of major LRE/LRD, after adjusting for HIV- and HCV-related variables, alcohol consumption and type of cART. Conclusions: The FIB-4 index at cART initiation, and its modification over time are risk factors for major LRE or LRD, independently of infection with HCV and could be used to monitor patients on cART.

Published
2015

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