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1. Late presentation of HIV infection: predictors of delayed diagnosis and survival in Eastern Sicily.

Author

Celesia BM, Castronuovo D, Pinzone MR, Bellissimo F, Mughini MT, Lupo G, Scarpino MR, Gussio M, Palermo F, Cosentino S, Cacopardo B, and Nunnari G

Subjects
Adult, Age Factors, CD4 Lymphocyte Count, Disease Progression, Female, Follow-Up Studies, HIV Infections diagnosis, HIV Infections drug therapy, Heterosexuality statistics & numerical data, Homosexuality statistics & numerical data, Humans, Male, Middle Aged, Multivariate Analysis, Prevalence, Risk Factors, Sex Factors, Sicily epidemiology, Survival Analysis, Time Factors, Antiretroviral Therapy, Highly Active methods, Delayed Diagnosis, HIV Infections epidemiology
Abstract

Objectives: Across Europe, more than one third of patients are diagnosed with HIV infection late. Late presentation for care has been associated with higher risk of clinical progression and mortality. In the present study, we evaluated the prevalence, epidemiological characteristics and survival probability of patients with late and very late presentation, newly diagnosed with HIV infection in Catania, Italy, from 1985 to 2010., Patients and Methods: According to the European Consensus definition, Late Presenters (LP) were defined as subjects presenting for care with a CD4+ T-cell count below 350 cells/µl or with an AIDS-defining event, regardless of CD4+ T-cell count; patients with advanced HIV disease (Very Late Presenters) (VLP) were those presenting with a CD4+ T-cell count below 200 cells/µl or with an AIDS-defining event, regardless of CD4+ T-cell count., Results: 620 patients were included in the study. 345 (55.6%) subjects were LP, 35% of them were asymptomatic; 246 (39.7%) were VLP. In univariate analysis, late presentation was related to age (p < 0.001), to heterosexual exposure to HIV infection (70% of heterosexual subjects were LP) (p < 0.005) and to being diagnosed during the calendar period from 1991 to 2000 (p < 0.001). Very late presentation was related to age (p < 0.001), male sex (p < 0.01), heterosexual risk (p < 0.001) and to being diagnosed during the calendar period from 1991 to 2000 (p < 0.001). In multivariate analysis, age (p < 0.0001), being older than 50 years old (p = 0.02), years of diagnosis 1991-1995 (p < 0.005) and 1996-2000 (p < 0.05) in the subgroup of late presenters and age (p < 0.0001), being older than 50 years old (p < 0.005), male sex (p < 0.0001), years of diagnosis 1991-1995 (p < 0.05) and 1996-2000 (p < 0.005) in the subgroup of very late presenters maintained statistical significance. The survival probability within LP and VLP group was statistically lower than no LP/VLP (log rank test p < 0.0005 and p < 0.0001, respectively). For both LP (p < 0.002) and VLP (p < 0.0001), survival probability was significantly lower in the pre-HAART era, in comparison with the period of mono/dual therapy and the HAART era., Conclusions: More than fifty percent of patients in our setting were diagnosed late with HIV infection and, consequently, treated late. Late and very late presentation were associated with lower survival probability. The implementation of strategies focused on targeted prevention efforts and HIV testing programs appears fundamental to diagnose and treat HIV infection as early as possible.

Published
2013

2. High prevalence of undiagnosed anxiety symptoms among HIV-positive individuals on cART: a cross-sectional study.

Author

Celesia BM, Nigro L, Pinzone MR, Coco C, La Rosa R, Bisicchia F, Mavilla S, Gussio M, Pellicanò G, Milioni V, Palermo F, Russo R, Mughini MT, Martellotta F, Taibi R, Cacopardo B, and Nunnari G

Subjects
Adult, Ambulatory Care Facilities, Cross-Sectional Studies, Drug Therapy, Combination, Female, HIV Seroprevalence, Humans, Male, Middle Aged, Prevalence, Sicily epidemiology, Surveys and Questionnaires, Anti-HIV Agents therapeutic use, Anxiety drug therapy, Anxiety epidemiology, Anxiety psychology, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections psychology
Abstract

Introduction: Anxiety disorders are frequent in HIV-infected individuals, can pre-exist or occur during HIV infection. We evaluated with a self-reported questionnaire whether anxiety is related to HIV clinical status and therapeutic success in a cohort of HIV-positive subjects in Sicily., Patients and Methods: We enrolled 251 patients on combination antiretroviral therapy (cART) for at least six months; Self Rating Anxiety State SAS 054 was used to diagnose anxiety and a Z score ≥ 45 points was considered diagnostic., Results: 47% of patients were diagnosed with anxiety. Patients showing symptoms related to anxiety had experienced a high number of therapeutic switches (fourth line or more)., Conclusions: These data confirm a high prevalence of anxiety symptoms among subjects with HIV infection in Eastern Sicily. Physicians should be aware of the extent of the problem and should be able to adequately manage anxiety in the setting of HIV infection.

Published
2013

3. HCV and HIV infection among intravenous drug abusers in eastern Sicily.

Author

Cacopardo B, Fatuzzo F, Cosentino S, Celesia BM, Mughini MT, La Rosa R, Bruno S, Lupo G, Zipper F, and La Medica G

Subjects
Female, HIV Infections complications, Hepatitis C complications, Humans, Male, Sicily epidemiology, HIV Infections epidemiology, Hepatitis C epidemiology, Substance Abuse, Intravenous complications
Abstract

In a study of 175 intravenous drug addicts from Eastern Sicily, 58.3% were found to be anti-HCV positive. In this population, the presence of anti-HCV was independent of HIV infection, age, duration of drug use and the practice of needle sharing. This may indicate that HCV is more readily transmitted (or spread earlier in this population) among drug addicts than is HIV.

Published
1992
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4. Treatment simplification to atazanavir/ritonavir+lamivudine versus maintenance of atazanavir/ritonavir+two NRTIs in virologically suppressed HIV-1-infected patients: 48 week results from a randomized trial (ATLAS-M)

Author

Di Giambenedetto, S., Fabbiani, M., Quiros Roldan, E., Latini, A., D'Ettorre, G., Antinori, A., Castagna, A., Orofino, G., Francisci, D., Chinello, P., Madeddu, G., Grima, P., Rusconi, S., Di Pietro, M., Mondi, A., Ciccarelli, N., Borghetti, A., Focà, E., Colafigli, M., De Luca, A., Cauda, R., Baldonero, E., Belmonti, S., D'Avino, A., Gagliardini, R., Lamonica, S., Lombardi, F., Sidella, L., Tamburrini, E., Visconti, E., Giacometti, A., Barchiesi, F., Castelli, P., Cirioni, O., Mazzocato, S., Blanc, P., Degli Esposti, A., Del Pin, B., Mariabelli, E., Marini, S., Poggi, A., Amadasi, S., Apostoli, A., Biasi, L., Bonito, A., Brianese, N., Compostella, S., Ferraresi, A., Motta, D., Mughini, M. T., Celesia, B. M., Gussio, M., Sofia, S., Tana, M., Tundo, P., Viscoli, C., De Hoffer, L., Di Biagio, A., Grignolo, S., Parisini, A., Schenone, E., Taramasso, L., Manconi, P. E., Boccone, A., Ortu, F., Piano, P., Serusi, L., Puoti, M., Moioli, M. C., Rossotti, R., Travi, G., Ventura, F., Galli, M., Di Nardo Stuppino, S., Di Cristo, V., Giacomelli, A., Vimercati, V., Viale, P., Gori, A., Rizzardini, G., Capetti, A., Carenzi, L., Mazza, F., Meraviglia, P., Rosa, S., Zucchi, P., Mineo, M., Giuliani, M., Pacifici, A., Pimpinelli, F., Solivetti, F., Stivali, F., Angelici, F., Bellagamba, R., Delle Rose, D., Fezza, R., Libertone, R., Mosti, S., Narciso, P., Nicastri, E., Ottou, S., Tomassi, C., Vlassi, C., Zaccarelli, M., Zoppè, F., Vullo, V., Altavilla, F., Ceccarelli, G., Fantauzzi, A., Gebremeskel, S., Lo Menzo, S., Mezzaroma, I., Tierno, F., Petrosillo, N., Boumis, E., Cicalini, S., Grilli, E., Musso, M., Stella, C., Mura, M. S., Bagella, P., Mannazzu, M., Soddu, V., Caramello, P., Carcieri, C., Carosella, S., Farenga, M., Scotton, P. G., Rossi, M. C., Concia, E., Corsini, F., Gricolo, C., Lanzafame, M., Lattuada, E., Leonardi, S., Rigo, F., Lazzarin, A., Bigoloni, A., Carini, E., Nozza, S., Spagnuolo, V., Belfiori, B., Malincarne, L., Schiaroli, E., Sfara, C., Tosti, A., Sacchini, D., Ruggieri, A., Valdatta, C., Di Giambenedetto, S, Fabbiani, M, Quiros Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Di Pietro, M, Mondi, A, Ciccarelli, N, Borghetti, A, Foca, E, Colafigli, M, De Luca, A, Cauda, R, Baldonero, E, Belmonti, S, D'Avino, A, Gagliardini, R, Lamonica, S, Lombardi, F, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Blanc, P, Degli Esposti, A, Del Pin, B, Mariabelli, E, Marini, S, Poggi, A, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Roldan, Eq, Focà, E, and on behalf of the Atlas-M Study, Group

Subjects
Male, 0301 basic medicine, HIV Infections, ART HIV, Gastroenterology, law.invention, 0302 clinical medicine, Randomized controlled trial, immune system diseases, law, Antiretroviral Therapy, Highly Active, HIV Infection, Pharmacology (medical), Viral, 030212 general & internal medicine, Adult, Atazanavir Sulfate, Coinfection, Drug Therapy, Combination, Female, HIV-1, Humans, Lamivudine, Middle Aged, RNA, Viral, Ritonavir, Viral Load, Young Adult, Pharmacology, Infectious Diseases, virus diseases, dual therapy, Combination, Viral load, Human, medicine.drug, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Antiretroviral Therapy, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Drug Therapy, Internal medicine, medicine, Highly Active, Adverse effect, business.industry, Surgery, Atazanavir, Regimen, RNA, business
Abstract

Background: Combination ART (cART)-related toxicities and costs have prompted the need for treatment simplification. The ATLAS-M trial explored 48 week non-inferior efficacy of simplification to atazanavir/ritonavir + lamivudine versus maintaining three-drug atazanavir/ritonavir-based cART in virologically suppressed patients. Methods: We performed an open-label, multicentre, randomized, non-inferiority study, enrolling HIV-infected adults on atazanavir/ritonavir+two NRTIs, with stable HIV-RNA 200 cells/mm3. Main exclusion criteria were hepatitis B virus coinfection, past virological failure on or resistance to study drugs, recent AIDS and pregnancy. Patients were randomly assigned 1:1 to either switch to 300mg of atazanavir/ 100mg of ritonavir once daily and 300mg of lamivudine once daily (atazanavir/ritonavir+lamivudine arm) or to continue the previous regimen (atazanavir/ritonavir+two NRTIs arm). The primary study outcome was the maintenance of HIV-RNA

Published
2017

5. Late presentation of HIV infection: Predictors of delayed diagnosis and survival in Eastern Sicily

Author

benedetto maurizio celesia, Castronuovo, D., Pinzone, M. R., Bellissimo, F., Mughini, M. T., Lupo, G., Scarpino, M. R., Gussio, M., Palermo, F., Cosentino, S., Cacopardo, B., and Nunnari, G.

Subjects
Adult, Male, HAART, Delayed Diagnosis, Time Factors, HIV Infections, HIV, HAART, Late presentation, Late presenter, Sex Factors, Late presenter, Risk Factors, Antiretroviral Therapy, Highly Active, Prevalence, Humans, Heterosexuality, Sicily, Age Factors, HIV, Homosexuality, Middle Aged, Survival Analysis, CD4 Lymphocyte Count, Late presentation, Multivariate Analysis, Disease Progression, Female, Follow-Up Studies
Abstract

Across Europe, more than one third of patients are diagnosed with HIV infection late. Late presentation for care has been associated with higher risk of clinical progression and mortality. In the present study, we evaluated the prevalence, epidemiological characteristics and survival probability of patients with late and very late presentation, newly diagnosed with HIV infection in Catania, Italy, from 1985 to 2010.According to the European Consensus definition, Late Presenters (LP) were defined as subjects presenting for care with a CD4+ T-cell count below 350 cells/µl or with an AIDS-defining event, regardless of CD4+ T-cell count; patients with advanced HIV disease (Very Late Presenters) (VLP) were those presenting with a CD4+ T-cell count below 200 cells/µl or with an AIDS-defining event, regardless of CD4+ T-cell count.620 patients were included in the study. 345 (55.6%) subjects were LP, 35% of them were asymptomatic; 246 (39.7%) were VLP. In univariate analysis, late presentation was related to age (p0.001), to heterosexual exposure to HIV infection (70% of heterosexual subjects were LP) (p0.005) and to being diagnosed during the calendar period from 1991 to 2000 (p0.001). Very late presentation was related to age (p0.001), male sex (p0.01), heterosexual risk (p0.001) and to being diagnosed during the calendar period from 1991 to 2000 (p0.001). In multivariate analysis, age (p0.0001), being older than 50 years old (p = 0.02), years of diagnosis 1991-1995 (p0.005) and 1996-2000 (p0.05) in the subgroup of late presenters and age (p0.0001), being older than 50 years old (p0.005), male sex (p0.0001), years of diagnosis 1991-1995 (p0.05) and 1996-2000 (p0.005) in the subgroup of very late presenters maintained statistical significance. The survival probability within LP and VLP group was statistically lower than no LP/VLP (log rank test p0.0005 and p0.0001, respectively). For both LP (p0.002) and VLP (p0.0001), survival probability was significantly lower in the pre-HAART era, in comparison with the period of mono/dual therapy and the HAART era.More than fifty percent of patients in our setting were diagnosed late with HIV infection and, consequently, treated late. Late and very late presentation were associated with lower survival probability. The implementation of strategies focused on targeted prevention efforts and HIV testing programs appears fundamental to diagnose and treat HIV infection as early as possible.

6. High prevalence of undiagnosed anxiety symptoms among HIV-positive individuals on cART: A cross-sectional study

Author

Celesia, B. M., Nigro, L., Pinzone, M. R., Coco, C., La Rosa, R., Bisicchia, F., Mavilla, S., Gussio, M., Pellicanò, G., Milioni, V., Palermo, F., Russo, R., Mughini, M. T., Martellotta, F., Taibi, R., bruno cacopardo, and Nunnari, G.

Subjects
Adult, Male, Anti-HIV Agents, HIV, HIV Infections, Middle Aged, Anxiety, Ambulatory Care Facilities, Cross-Sectional Studies, HIV Seroprevalence, Surveys and Questionnaires, Prevalence, Humans, CART, Drug Therapy, Combination, Female, Sicily
Abstract

Anxiety disorders are frequent in HIV-infected individuals, can pre-exist or occur during HIV infection. We evaluated with a self-reported questionnaire whether anxiety is related to HIV clinical status and therapeutic success in a cohort of HIV-positive subjects in Sicily.We enrolled 251 patients on combination antiretroviral therapy (cART) for at least six months; Self Rating Anxiety State SAS 054 was used to diagnose anxiety and a Z score ≥ 45 points was considered diagnostic.47% of patients were diagnosed with anxiety. Patients showing symptoms related to anxiety had experienced a high number of therapeutic switches (fourth line or more).These data confirm a high prevalence of anxiety symptoms among subjects with HIV infection in Eastern Sicily. Physicians should be aware of the extent of the problem and should be able to adequately manage anxiety in the setting of HIV infection.

7. Evolution of blood-associated HIV-1 DNA levels after 48 weeks of switching to atazanavir/ritonavir+lamivudine dual therapy versus continuing triple therapy in the randomized AtLaS-M trial

Author

Lombardi, Francesca, Belmonti, Simone, Quiros-Roldan, Eugenia, Latini, Alessandra, Castagna, Antonella, D'Ettorre, Gabriella, Gagliardini, Roberta, Fabbiani, Massimiliano, Cauda, Roberto, De Luca, Andrea, Di Giambenedetto, Simona, Giacometti, Andrea, Di Pietro, Massimo, Mughini, Maria Teresa, Grima, Pierfrancesco, Viscoli, Claudio, Manconi, Paolo Emilio, Puoti, Massimo, Galli, Massimo, Viale, Pierluigi, Gori, Andrea, Rizzardini, Giuliano, Mineo, Maurizio, Antinori, Andrea, Petrosillo, Nicola, Vullo, Vincenzo, Mura, Maria Stella, Caramello, Pietro, Scotton, Pier Giorgio, Concia, Ercole, Lazzarin, Adriano, Francisci, Daniela, Sacchini, Daria, Lombardi, F, Belmonti, S, Quiros-Roldan, E, Latini, A, Castagna, A, D'Ettorre, G, Gagliardini, R, Fabbiani, M, Cauda, R, De Luca, A, Di Giambenedetto, S, Giacometti, A, Di Pietro, M, Mughini, M, Grima, P, Viscoli, C, Manconi, P, Puoti, M, Galli, M, Viale, P, Gori, A, Rizzardini, G, Mineo, M, Antinori, A, Petrosillo, N, Vullo, V, Mura, M, Caramello, P, Scotton, P, Concia, E, Lazzarin, A, Francisci, D, Sacchini, D, and on behalf of the AtLaS-M Study, Group

Subjects
0301 basic medicine, Male, hiv, HIV Infections, Gastroenterology, HIV HIV-1-DNA, law.invention, Randomized controlled trial, law, Antiretroviral Therapy, Highly Active, Pharmacology (medical), Whole blood, virus diseases, Lamivudine, Middle Aged, Viral Load, antiretroviral agents, Infectious Diseases, RNA, Viral, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, dna level, Viral load, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, Anti-HIV Agents, 030106 microbiology, Atazanavir Sulfate, Viremia, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Internal medicine, medicine, Humans, Pharmacology, Ritonavir, business.industry, dual therapy, HIV Protease Inhibitors, medicine.disease, Atazanavir, CD4 Lymphocyte Count, Immunology, DNA, Viral, HIV-1, business
Abstract

Objectives The AtLaS-M randomized trial showed that in patients with HIV-1 RNA

Published
2016

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