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1. High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV-infected patients treated in a real-life setting

Author: Fabbiani M., Lombardi A., Colaneri M., Del Poggio P., Perini P., D'Ambrosio R., Degasperi E., Dibenedetto C., Giorgini A., Pasulo L., Maggiolo F., Castelli F., Brambilla P., Spinelli O., Re T., Lleo A., Rumi M., Uberti-Foppa C., Soria A., Aghemo A., Lampertico P., Baiguera C., Schiavini M., Fagiuoli S., Bruno R., Borghi M., Soffredini R., Perbellini R., Gori A., Ferroni V., Colpani M., Manini M., Cologni G., Lazzaroni S., Vinci M., De Nicola S., Mazzarelli C., Angelini Zucchetti T., Picciotto V., Puoti M., Rossotti R., Landonio S., Magni C. F., Rizzardini G., Colella E., Columpsi P., Gambaro A., Spolti A., Magnani C., Vigano P., Mena M., Villa M., Caramma I., Basilico C., Capelli F., Biagiotti S., Mazzone A., Saladino V., Baldacci M. P., Gatti F., Varalli L., Morini L., Menzaghi B., Farinazzo M., Meli R., Plaz Torres M. C., Fanetti I., Orellana D., Zermiani P., Zuin M., De Bona A., D'Arminio Monforte A., Capretti A., Taddei M. T., Soncini M., Spinetti A., Zaltron S., Pigozzi M. G., Rossini A., Pan A., Dal Zoppo S., Zoncada A., Memoli M., Salpietro S., Hamid H., Messina E., Colombo A. E., Giglio O., Bonfanti P., Molteni C., Terreni N., Spinzi G., Conforti S., Clerici E., Menozzi F., Buscarini E., Centenaro R., Corbellini A., Noventa F., Gritti S., Giani P., Fabbiani, Massimiliano, Lombardi, Andrea, Colaneri, Marta, Del Poggio, Paolo, Perini, Paolo, D'Ambrosio, Roberta, Degasperi, Elisabetta, Dibenedetto, Clara, Giorgini, Alessia, Pasulo, Luisa, Maggiolo, Franco, Castelli, Francesco, Brambilla, Paola, Spinelli, Ombretta, Tiziana, Re, Lleo, Ana, Rumi, Mariagrazia, Uberti-Foppa, Caterina, Soria, Alessandro, Aghemo, Alessio, Lampertico, Pietro, Baiguera, Chiara, Schiavini, Monica, Fagiuoli, Stefano, Bruno, Raffaele, Fabbiani, M, Lombardi, A, Colaneri, M, Del Poggio, P, Perini, P, D'Ambrosio, R, Degasperi, E, Dibenedetto, C, Giorgini, A, Pasulo, L, Maggiolo, F, Castelli, F, Brambilla, P, Spinelli, O, Re, T, Lleo, A, Rumi, M, Uberti-Foppa, C, Soria, A, Aghemo, A, Lampertico, P, Baiguera, C, Schiavini, M, Fagiuoli, S, Bruno, R, Borghi, M, Soffredini, R, Perbellini, R, Gori, A, Ferroni, V, Colpani, M, Manini, M, Cologni, G, Lazzaroni, S, Vinci, M, De Nicola, S, Mazzarelli, C, Angelini Zucchetti, T, Picciotto, V, Puoti, M, Rossotti, R, Landonio, S, Magni, C, Rizzardini, G, Colella, E, Columpsi, P, Gambaro, A, Spolti, A, Magnani, C, Vigano, P, Mena, M, Villa, M, Caramma, I, Basilico, C, Capelli, F, Biagiotti, S, Mazzone, A, Saladino, V, Baldacci, M, Gatti, F, Varalli, L, Morini, L, Menzaghi, B, Farinazzo, M, Meli, R, Plaz Torres, M, Fanetti, I, Orellana, D, Zermiani, P, Zuin, M, De Bona, A, D'Arminio Monforte, A, Capretti, A, Taddei, M, Soncini, M, Spinetti, A, Zaltron, S, Pigozzi, M, Rossini, A, Pan, A, Dal Zoppo, S, Zoncada, A, Memoli, M, Salpietro, S, Hamid, H, Messina, E, Colombo, A, Giglio, O, Bonfanti, P, Molteni, C, Terreni, N, Spinzi, G, Conforti, S, Clerici, E, Menozzi, F, Buscarini, E, Centenaro, R, Corbellini, A, Noventa, F, Gritti, S, and Giani, P
Subjects: Simeprevir, Male, medicine.medical_specialty, Cirrhosis, SVR, Sofosbuvir, Sustained Virologic Response, liver cirrhosis, antiviral treatment, Hepacivirus, Antiviral Agents, law.invention, Randomized controlled trial, law, Virology, Internal medicine, Medicine, Humans, chronic hepatitis C, Prospective cohort study, DAA, Retrospective Studies, Hepatology, liver cirrhosi, business.industry, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Discontinuation, Regimen, Infectious Diseases, Treatment Outcome, business, medicine.drug
Abstract: In routine clinical practice, hepatitis C virus-infected patients can prematurely discontinue the prescribed regimen for several reasons. The aim of our study was to investigate sustained virological response (SVR12) rates in patients who prematurely discontinued directly acting antiviral (DAA) regimens and to assess the shortest effective duration of DAA able to lead to SVR12. We retrospectively collected the SVR rates of patients, registered in the NAVIGATORE-Lombardia Network database from January 2015, who discontinued DAAs before the predefined end of treatment. Overall, we included 365 patients, males were the majority (213, 58.4%), mean age was 60.5years, and 53 (14.5%) patients were HIV-co-infected. Liver cirrhosis was observed in 251 (68.8%) subjects, and the most represented genotypes were 1b (n=168, 46%) and 3 (n=59, 16.2%). DAA was discontinued a median of 1 (IQR 1–4) weeks before the predefined EOT, with 164 (44.9%) patients stopping DAAs at least 2weeks before the planned schedule. In patients with F0–F3 liver fibrosis, lower rates of SVR12 were observed in patients treated for
Published: 2021

2. Canakinumab as treatment for COVID-19-related pneumonia: A prospective case-control study

Author: Chiara Costanzi, Daniele Generali, Ilaria Zangrandi, Valeria De Giuli, Fabio Malberti, Maria Rosa Cappelletti, Giancarlo Bosio, Andrea Machiavelli, Marianna Sirico, Antonio Fioravanti, Guglielmo Giannotti, Angelo Pan, Sophie Testa, Ottavia Bernocchi, Fabiola Giudici, Alessia Giossi, Erika Maria Viola, Alfredo Molteni, Marina Foramitti, Alessandro Morandini, Antonio Cuzzoli, Matteo Giorgi-Pierfranceschi, Maurizio Scaltriti, Sergio Venturini, Giulia Chiodelli, Chiara Campana, Alessia Zoncada, Luca Pianta, Laura Romanini, Rosa Angela Tira, Generali, D., Bosio, G., Malberti, F., Cuzzoli, A., Testa, S., Romanini, L., Fioravanti, A., Morandini, A., Pianta, L., Giannotti, G., Viola, E. M., Giorgi-Pierfranceschi, M., Foramitti, M., Tira, R. A., Zangrandi, I., Chiodelli, G., Machiavelli, A., Cappelletti, M. R., Giossi, A., De Giuli, V., Costanzi, C., Campana, C., Bernocchi, O., Sirico, M., Zoncada, A., Molteni, A., Venturini, S., Giudici, F., Scaltriti, M., and Pan, A.
Subjects: 0301 basic medicine, Male, medicine.medical_treatment, Cohort Studies, 0302 clinical medicine, Monoclonal, 80 and over, 030212 general & internal medicine, Viral, Prospective Studies, Prospective cohort study, Humanized, Aged, 80 and over, General Medicine, Middle Aged, Hospitalization, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, Settore SECS-S/01 - STATISTICA, Cohort, Female, Case-Control Studie, medicine.drug, Cohort study, Human, Microbiology (medical), Adult, medicine.medical_specialty, Canakinumab, 030106 microbiology, Pneumonia, Viral, Antibodies, Monoclonal, Humanized, Article, Antibodies, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Internal medicine, medicine, Humans, lcsh:RC109-216, Aged, Mechanical ventilation, Lung, business.industry, SARS-CoV-2, Case-control study, COVID-19, Pneumonia, medicine.disease, Prospective Studie, Case-Control Studies, Cohort Studie, business
Abstract: Highlights • Canakinumab is an IL-1β antibody that neutralizes the activity of IL-1β. • The effects of canakinumab in patients with COVID-19-related pneumonia were studied. • 33 patients received canakinumab and 15 received institutional standard of care. • Treatment with canakinumab rapidly restored normal oxygen status. • Canakinumab was also associated with favorable prognosis versus SoC., Objectives Canakinumab is an IL-1β antibody that neutralizes the activity of IL-1β. We studied the efficacy and safety of canakinumab in patients with moderate COVID-19-related pneumonia. Design The aim of our study was to evaluate the reduction in duration of hospitalization with adequate oxygen status. Forty-eight patients with moderate COVID-19-related pneumonia were asked to participate in the prospective case-control study; 33 patients (Cases) signed informed consent and received canakinumab (Cohort 1); 15 patients (Controls) refused to receive the experimental drug and received institutional standard of care (SoC), (Cohort 2). Results Hospital discharge within 21 days was seen in 63% of patients in Cohort 1 vs. 0% in Cohort 2 (median 14 vs 26 days, respectively; p
Published: 2021

3. Real-life effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients with previous DAA failure

Author: Elisabetta, Degasperi, Angiola, Spinetti, Andrea, Lombardi, Simona, Landonio, Maria Cristina, Rossi, Luisa, Pasulo, Pietro, Pozzoni, Alessia, Giorgini, Paolo, Fabris, Antonietta, Romano, Lorenzo, Lomonaco, Massimo, Puoti, Maria, Vinci, Federico, Gatti, Giada, Carolo, Alessia, Zoncada, Paolo, Bonfanti, Russo, FRANCESCO PAOLO, Alessio, Aghemo, Alessandro, Soria, Riccardo, Centenaro, Franco, Maggiolo, Pierangelo, Rovere, Francesca, Pasin, Veronica, Paon, Giovanni, Faggiano, Alessandro, Vario, Glenda, Grossi, Roberta, Soffredini, Canio, Carriero, Stefania, Paolucci, Franco, Noventa, Alfredo, Alberti, Pietro, Lampertico, Stefano, Fagiuoli, NAVIGATORE-Lombardia and Veneto Study Groups, Degasperi, E, Spinetti, A, Lombardi, A, Landonio, S, Rossi, M, Pasulo, L, Pozzoni, P, Giorgini, A, Fabris, P, Romano, A, Lomonaco, L, Puoti, M, Vinci, M, Gatti, F, Carolo, G, Zoncada, A, Bonfanti, P, Russo, F, Aghemo, A, Soria, A, Centenaro, R, Maggiolo, F, Rovere, P, Pasin, F, Paon, V, Faggiano, G, Vario, A, Grossi, G, Soffredini, R, Carriero, C, Paolucci, S, Noventa, F, Alberti, A, Lampertico, P, and Fagiuoli, S
Subjects: 0301 basic medicine, Liver Cirrhosis, Male, Sofosbuvir, Sustained Virologic Response, Resistance, Hepacivirus, Viral Nonstructural Proteins, medicine.disease_cause, Direct-acting antiviral, Direct-acting antivirals, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Sulfonamides, Liver Neoplasms, Hepatitis C, Middle Aged, Drug Combinations, Treatment Outcome, Italy, Hepatocellular carcinoma, HCV, RAS, Retreatment, RNA, Viral, 030211 gastroenterology & hepatology, Female, medicine.drug, medicine.medical_specialty, Carcinoma, Hepatocellular, Macrocyclic Compounds, Anemia, Voxilaprevir, Hepatitis C virus, Antiviral Agents, Heterocyclic Compounds, 4 or More Rings, 03 medical and health sciences, Internal medicine, Drug Resistance, Viral, medicine, Humans, Intention-to-treat analysis, Hepatology, business.industry, Ribavirin, Hepatitis C, Chronic, medicine.disease, 030104 developmental biology, chemistry, Carbamates, business
Abstract: Background & Aims Sofosbuvir/velpatasivr/voxilaprevir (SOF/VEL/VOX) is approved for retreatment of patients with HCV and a previous failure on direct-acting antivirals (DAAs), however real-life data are limited. The aim of this study was to assess the effectiveness and safety of SOF/VEL/VOX in a real-life setting. Methods All consecutive patients with HCV receiving SOF/VEL/VOX between May-October 2018 in 27 centers in Northern Italy were enrolled. Bridging fibrosis (F3) and cirrhosis (F4) were diagnosed by liver stiffness measurement: >10 and >13 kPa respectively. Sustained virological response (SVR) was defined as undetectable HCV-RNA 4 (SVR4) or 12 (SVR12) weeks after the end-of-treatment. Results A total of 179 patients were included: median age 57 (18–88) years, 74% males, median HCV-RNA 1,081,817 (482–25,590,000) IU/ml. Fibrosis stage was F0-F2 in 32%, F3 in 21%, F4 in 44%. HCV genotype was 1 in 58% (1b 33%, 1a 24%, 1nc 1%), 2 in 10%, 3 in 23% and 4 in 9%; 82% of patients carried resistance-associated substitutions in the NS3, NS5A or NS5B regions. Patients received SOF/VEL/VOX for 12 weeks, ribavirin was added in 22% of treatment schedules. Undetectable HCV-RNA was achieved by 74% of patients at week 4 and by 99% at week 12. Overall, 162/179 (91%) patients by intention to treat analysis and 162/169 (96%) by per protocol analysis achieved SVR12, respectively; treatment failures included 6 relapsers and 1 virological non-responder. Cirrhosis (p = 0.005) and hepatocellular carcinoma (p = 0.02) were the only predictors of treatment failure. Most frequent adverse events included fatigue (6%), hyperbilirubinemia (6%) and anemia (4%). Conclusions SOF/VEL/VOX is an effective and safe retreatment for patients with HCV who have failed on a previous DAA course in a real-life setting. Lay summary This is the largest European real-life study evaluating effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) in a large cohort of consecutive patients with hepatitis C virus infection and a prior direct-acting antiviral failure, who were treated within the NAVIGATORE Lombardia and Veneto Networks, in Italy. This study demonstrated excellent effectiveness (98% and 96% sustained virological response rates at week 4 and 12, respectively) and an optimal safety profile of SOF/VEL/VOX. Cirrhosis and hepatocellular carcinoma onset were the only features associated with treatment failure.
Published: 2019

4. Prevalence of acquired resistance mutations in a large cohort of perinatally infected HIV-1 patients

Author: Ungaro, R., Taramasso, L., Bruzzone, B., Vicenti, I., Galli, L., Borghi, V., Francisci, D., Pecorari, M., Zoncada, A., Callegaro, A. P., Paolini, E., Monno, L., Bonora, S., Di Biagio, A., ARCA Study Group, Giacometti, A., Butini, L., del Gobbo, R., Bagnarelli, P., Tacconi, D., Corbelli, G., Zanussi, S., Punzi, G., Maggiolo, F., Calza, L., Carla Re, M., Pristera, R., Turconi, P., Mandas, A., Tini, S., Amadio, G., Sighinolfi, L., Corsi, P., Di Pietro, M., Colao, G., Tosti, A., Setti, M., Cenderello, G., Trezzi, M., Orani, A., Arcidiacono, I., Degiuli, A., De Gennaro, M., Chiodera, A., Scalzini, A., Palvarini, L., Todaro, G., Rusconi, S., Gismondo, M. R., Micheli, V., Biondi, M. L., Capetti, A., Meraviglia, P., Boeri, E., Mussini, C., Soria, A., Vecchi, L., Santirocchi, M., Brustia, D., Ravanini, P., Dal Bello, F., Romano, N., Mancuso, S., Calzetti, C., Maserati, R., Filice, G., Baldanti, F., Parruti, G., Polilli, E., Sacchini, D., Martinelli, C., Consolini, R., Vatteroni, L., Vivarelli, A., Nerli, A., Lenzi, L., Magnani, G., Ortolani, P., Andreoni, M., Fimiani, C., Palmisano, L., Di Giambenedetto, S., Vullo, V., Turriziani, O., Montano, M., Antinori, A., Zaccarelli, M., Dentone, C., Gonnelli, A., De Luca, A., Palumbo, M., Ghisetti, V., Delle Foglie, P., Rossi, C., Mondino, V., Malena, M., Grossi, P., Seminari, E., Poletti, F., Ungaro R., Taramasso L., Bruzzone B., Vicenti I., Galli L., Borghi V., Francisci D., Pecorari M., Zoncada A., Callegaro A.P., Paolini E., Monno L., Bonora S., Di Biagio A., Giacometti A., Butini L., del Gobbo R., Bagnarelli P., Tacconi D., Corbelli G., Zanussi S., Punzi G., Maggiolo F., Calza L., Carla Re M., Pristera R., Turconi P., Mandas A., Tini S., Amadio G., Sighinolfi L., Corsi P., Di Pietro M., Colao G., Tosti A., Setti M., Cenderello G., Trezzi M., Orani A., Arcidiacono I., Degiuli A., De Gennaro M., Chiodera A., Scalzini A., Palvarini L., Todaro G., Rusconi S., Gismondo M.R., Micheli V., Biondi M.L., Capetti A., Meraviglia P., Boeri E., Mussini C., Soria A., Vecchi L., Santirocchi M., Brustia D., Ravanini P., Dal Bello F., Romano N., Mancuso S., Calzetti C., Maserati R., Filice G., Baldanti F., Parruti G., Polilli E., Sacchini D., Martinelli C., Consolini R., Vatteroni L., Vivarelli A., Nerli A., Lenzi L., Magnani G., Ortolani P., Andreoni M., Fimiani C., Palmisano L., Di Giambenedetto S., Vullo V., Turriziani O., Montano M., Antinori A., Zaccarelli M., Dentone C., Gonnelli A., De Luca A., Palumbo M., Ghisetti V., Delle Foglie P., Rossi C., Mondino V., Malena M., Grossi P., Seminari E., and Poletti F.
Subjects: Male, antiretroviral treatment, Infectious Disease Transmission, genotype, Human immunodeficiency virus (HIV), Drug Resistance, HIV Infections, Drug resistance, medicine.disease_cause, Retrospective Studie, Genotype, pol Gene Products, Human Immunodeficiency Viru, Prevalence, Medicine, Vertical, HIV Infection, Viral, pol Gene Products, Young adult, General Medicine, Infectious Diseases, Italy, Mutation (genetic algorithm), Female, Human Immunodeficiency Virus, Human, Microbiology (medical), Adult, Settore MED/17 - Malattie Infettive, Adolescent, Anti-HIV Agents, Young Adult, Acquired resistance, Drug Resistance, Viral, Humans, vertical HIV transmission, HIV-1, Mutation, Retrospective Studies, pol Gene Products, Human Immunodeficiency Virus, Infectious Disease Transmission, Vertical, HIV perinatally infection, business.industry, Anti-HIV Agent, Retrospective cohort study, Virology, Large cohort, business
Published: 2019

5. Suggestions from Cremona, Italy: 2 months into the pandemic at the frontline of COVID-19 in Europe

Author: S. Testa, A. Zoncada, L. Cammelli, M. Giorgi-Pierfranceschi, G. Bosio, A. Machiavelli, A. Coluccello, A. Pan, L. Romanini, A. Cuzzoli, and R. Canino
Subjects: Microbiology (medical), Coronavirus disease 2019 (COVID-19), business.industry, Health Personnel, COVID-19, General Medicine, Home Care Services, Article, Intensive Care Units, Infectious Diseases, Italy, Pandemic, Humans, Medicine, Education, Medical, Continuing, Health Workforce, Emergency Service, Hospital, business, Socioeconomics, Pandemics
Published: 2020
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6. Pretreatment HIV drug resistance and treatment failure in non-Italian HIV-1-infected patients enrolled in ARCA

Author: Paola Milini, Ilaria Vicenti, Alessia Zoncada, Simona Di Giambenedetto, Monica Pecorari, Paola Meraviglia, Bianca Bruzzone, Laura Monno, Domenico Di Carlo, Barbara Rossetti, Annalisa Saracino, Francesca Lombardi, Vanni Borghi, Emanuele Pontali, and Davide Fiore Bavaro
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, hiv, Drug resistance, 030312 virology, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Treatment failure, 03 medical and health sciences, Risk Factors, Internal medicine, Drug Resistance, Viral, medicine, Humans, Pharmacology (medical), Treatment Failure, Pharmacology, 0303 health sciences, business.industry, resistence, Antiretroviral therapy, Infectious Diseases, Databases as Topic, HIV-1, Female, business, HIV drug resistance
Abstract: Background An increase in pretreatment drug resistance (PDR) to first-line antiretroviral therapy (ART) in low-income countries has been recently described. Herein we analyse the prevalence of PDR and risk of virological failure (VF) over time among migrants to Italy enrolled in ARCA. Methods HIV-1 sequences from ART-naive patients of non-Italian nationality were retrieved from ARCA database from 1998 to 2017. PDR was defined by at least one mutation from the reference 2009 WHO surveillance list. Results Protease/reverse transcriptase sequences from 1,155 patients, mainly migrants from sub-Saharan Africa (SSA; 42%), followed by Latin America (LA; 25%) and Western countries (WE; 21%), were included. PDR was detected in 8.6% of sequences (13.1% versus 5.8% for B and non-B strains, respectively; PConclusions PDR appeared to be stable over the years in migrants to Italy enrolled in ARCA; however, it still remains an important cause of VF together with viral load at diagnosis.
Published: 2020

7. Evolution of transmitted HIV-1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016

Author: Rossetti, B., Giambenedetto, Di, Torti, S, Postorino, C. c., Punzi, M. C., Saladini, G., Gennari, F., Borghi, W. f., Monno, V., Pignataro, L., Polilli, A. R., Colafigli, E., Poggi, M., Tini, A., Zazzi, S., Luca, De, Mellace, A., Capetti, V., Gismondo, A., Biondi, M. R., Mussini, M. L., Pecorari, C., Gianotti, M., Sacchini, N., Parruti, D., Baldelli, F., Zanussi, S., Nerli, A., Lenzi, L., Calzetti, C., Vivarelli, A., Maserati, R., Baldanti, F., Poletti, F., Mondino, V., Malena, M., Cascio, A., Filice, G., Magnani, G., Zerbini, A., Lombardi, F., Gaimbenedetto, Di, Andreoni, S., Montano, M., Vullo, M., Turriziani, V., Gonnelli, O., Boeri, A., Bonora, E., Ghisetti, S., Francisci, D., Grossi, P., Bagnarelli, P., Butini, L., Del, Gobbo, Giacometti, R., Tacconi, A., Callegaro, D., Maggiolo, A., Zoncada, F., Paolini, A., Sighinolfi, E., Colao, L., Corsi, G., Blanc, P., Galli, P., Meraviglia, L., Tosti, P., Bruzzone, A., Setti, B., Penco, M., Biagio, Di, Nencioni, A., Pardelli, C., Arcidiacono, R., Degiuli, I., Gennaro, De, Soria, M., Foc, A., Latella, A., Cosco, S., Malandrin, L., Milini, S., Cicconi, P., Rusconi, P., Micheli, S., the Antiviral Response Cohort Analysis (ARCA) Collaborative Group, Rossetti B., Di Giambenedetto S., Torti C., Postorino M.C., Punzi G., Saladini F., Gennari W., Borghi V., Monno L., Pignataro A.R., Polilli E., Colafigli M., Poggi A., Tini S., Zazzi M., De Luca A., Mellace V., Capetti A., Gismondo M.R., Biondi M.L., Mussini C., Pecorari M., Gianotti N., Sacchini D., Parruti G., Baldelli F., Zanussi S., Nerli A., Lenzi L., Calzetti C., Vivarelli A., Maserati R., Baldanti F., Poletti F., Mondino V., Malena M., Cascio A., Filice G., Magnani G., Zerbini A., Lombardi F., Di Gaimbenedetto S., Andreoni M., Montano M., Vullo V., Turriziani O., Gonnelli A., Boeri E., Bonora S., Ghisetti V., Francisci D., Grossi P., Bagnarelli P., Butini L., del Gobbo R., Giacometti A., Tacconi D., Callegaro A., Maggiolo F., Zoncada A., Paolini E., Sighinolfi L., Colao G., Corsi P., Blanc P., Galli L., Meraviglia P., Tosti A., Bruzzone B., Setti M., Penco G., Di Biagio A., Nencioni C., Pardelli R., Arcidiacono I., Degiuli A., De Gennaro M., Soria A., Foc A., Latella S., Cosco L., Malandrin S., Milini P., Cicconi P., Rusconi S., and Micheli V.
Subjects: 0301 basic medicine, Male, antiretroviral therapy, HIV, recent HIV infection, resistance epidemiology, transmitted HIV drug resistance, Adult, Anti-HIV Agents, CD4 Lymphocyte Count, Female, HIV Infections, HIV-1, Humans, Italy, Middle Aged, Mutation, Odds Ratio, Prevalence, Viral Proteins, Drug Resistance, Viral, Health Policy, Infectious Diseases, Pharmacology (medical), Drug Resistance, Drug resistance, Gastroenterology, Interquartile range, HIV Infection, Viral, biology, Integrase, Viral load, Human, medicine.medical_specialty, 030106 microbiology, Settore MED/17 - MALATTIE INFETTIVE, Virus, 03 medical and health sciences, Internal medicine, medicine, Viral Protein, business.industry, Anti-HIV Agent, Odds ratio, Reverse transcriptase, Confidence interval, biology.protein, business
Abstract: Objectives: The aim was to evaluate the evolution of transmitted HIV-1 drug resistance (TDR) prevalence in antiretroviral therapy (ART)-naïve patients from 2006 to 2016. Methods: HIV-1 sequences were retrieved from the Antiviral Response Cohort Analysis (ARCA) database and TDR was defined as detection of at least one mutation from the World Health Organization (WHO) surveillance list. Results: We included protease/reverse transcriptase sequences from 3573 patients; 455 had also integrase sequences. Overall, 68.1% of the patients were Italian, the median CD4 count was 348 cells/μL [interquartile range (IQR) 169–521 cells/μL], and the median viral load was 4.7 log 10 HIV-1 RNA copies/mL (IQR 4.1–5.3 log 10 copies/mL). TDR was detected in 10.3% of patients: 6% carried mutations to nucleos(t)ide reverse transcriptase inhibitors (NRTIs), 4.4% to nonnucleos(t)ide reverse transcriptase inhibitors (NNRTIs), 2.3% to protease inhibitors (PIs), 0.2% to integrase strand transfer inhibitors (INSTIs) and 2.1% to at least two drug classes. TDR declined from 14.5% in 2006 to 7.3% in 2016 (P=0.003): TDR to NRTIs from 9.9 to 2.9% (P=0.003) and TDR to NNRTIs from 5.1 to 3.7% (P=0.028); PI TDR remained stable. The proportion carrying subtype B virus declined from 76.5 to 50% (P&nbsp
Published: 2018

8. Cohort Profile: Standardized Management of Antiretroviral Therapy Cohort (MASTER Cohort)

Author: Francesco Castelli, Maria Concetta Postorino, Silvia Lorenzotti, Gioacchino Angarano, Giampiero Carosi, Mariarosaria Giralda, Giuseppe Paraninfo, Nicola Mazzini, Fabio Zacchi, Elena Raffetti, Alessia Zoncada, Francesco Mazzotta, Roberto Cauda, Silvia Costarelli, Chiara Fornabaio, Eugenia Quiros-Roldan, Simona Digiambenedetto, Simone Benatti, Alfredo Scalzini, Emanuele Focà, Angelo Pan, Salvatore Casari, Massimo Di Pietro, Franco Maggiolo, Giampietro Gregis, Laura Monno, Filippo Castelnuovo, Paola Nasta, Sergio Lo Caputo, Piera Pierotti, Francesco Donato, Sebastiano Leone, Laura Sighinolfi, Carlo Torti, Massimiliano Fabbiani, Claudio Ble, Nicoletta Ladisa, Chiara Pezzoli, Annalisa Saracino, Andrea Gori, Giuseppe Lapadula, Torti, C, Raffetti, E, Donato, F, Castelli, F, Maggiolo, F, Angarano, G, Mazzotta, F, Gori, A, Sighinolfi, L, Pan, A, Cauda, R, Scalzini, A, Quiros-Roldan, E, Nasta, P, Gregis, G, Benatti, S, Digiambenedetto, S, Ladisa, N, Giralda, M, Saracino, A, Castelnuovo, F, Di Pietro, M, Lo Caputo, S, Lapadula, G, Costarelli, S, Lorenzotti, S, Mazzini, N, Paraninfo, G, Casari, S, Focà, E, Pezzoli, C, Fabbiani, M, Monno, L, Pierotti, P, Ble, C, Leone, S, Postorino, M, Fornabaio, C, Zacchi, F, Zoncada, A, and Carosi, G
Subjects: Adult, Male, medicine.medical_specialty, Sustained Virologic Response, Epidemiology, Alternative medicine, Human immunodeficiency virus (HIV), HIV Infections, hiv, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Drug Prescriptions, Young Adult, Age Distribution, Internal medicine, Antiretroviral Therapy, Highly Active, medicine, Humans, Multicenter Studies as Topic, Prospective Studies, Sex Distribution, Aged, Retrospective Studies, business.industry, Retrospective cohort study, General Medicine, Middle Aged, Antiretroviral therapy, Antiretroviral, Italy, Cohort, Female, Therapy, business
Published: 2015

9. Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

Author: Margherita Busso, Tullio Prestileo, Ermenegildo Francavilla, Marco Anselmo, Francesco Montella, Evangelista Sagnelli, Teresa Santantonio, Massimo Galli, Marcello Saitta, Giuseppe Foti, Cecilia Guariglia, Franco Baldelli, Simona Di Gianbenedetto, Pierluigi Viale, Francesco Castelli, Antonella d'Arminio Monforte, Angelo Pan, Gabriella D’Ettore, Maria Dorrucci, Salvatore Bruno, Tiziana Quirino, Mariangela Raimondo, Alessandro Bartoloni, Vinicio Manfrin, Giovanni Mazzarello, Eugenio Mantia, Raffaele Pempinello, Antonio Traverso, Barbara Suligoi, Fabio Bulla, Pietro Mesina, Alessia Zoncada, Gianfranco Orofino, Oliviero Bosco, Gianmichele Moise, Angelo Salomone Megna, Roberto Ferretto, Mauro Valle, Manuela Colafigli, Claudio Paternoster, S. Artioli, Giovanni Riccio, Stefania Bernardi, Paolo Grossi, Milena Zoppi, Sebastiano Maiuzzo, Giorgio Perboni, Sauro Tini, Giuseppe Ferrea, Nicoletta Ladisa, Enzo M. Farinella, Daniela Francisci, Dino Sgarabotto, Roberto Monarca, Enzo Petrelli, A. Franco, Izzo Cm, Pietro Bellissima, Francesco Ortu, Laura Sighinolfi, Antonio Chirianni, Filippo Bartalesi, Giulio De Stefano, Claudia Colomba, Laura Camoni, Salvatore Galvagna, Benedetto Maurizio Celesia, Andrea Petrucci, Camillo Baretti, Pierluigi Brugnaro, Federica Poletti, Maurilio Chimenti, Camilla Ajassa, Mario Falciano, Rosaria La Sala, Sauro Luchi, V. Portelli, Annamaria Degli Antoni, Francesco Mazzotta, Giuliano Zuccati, Vincenzo Colangeli, Ercole Concia, Giordano Madeddu, Maria Cristina Salfa, Francesca Cattelan, Nicola Acone, Vincenza Regine, Olivia Bargiacchi, Maurizio de Martino, F. Paoletti, Giovanni Cassola, Giuliano Schettino, Carlo De Stefano, Enza Anzalone, D. Aquilini, Giacomo Magnani, Vanni Borghi, Roberta Gastaldi, Alessandra Govoni, Cristina Rossi, Rita Consolini, Gioacchino Angarano, Gloria Taliani, Tommaso Fontana, Sergio Lo Caputo, Davide Vitullo, Pierpaolo Congedo, Emanuela Vaccher, Paolo Viganò, Maria Stella Mura, Claudio Cancellieri, Enrico Girardi, Francesca Savalli, Cecilia Fico, Anna Maria Cattelan, Alessandro Chiodera, Renzo Scaggiante, P. Osimani, Caterina Bramato, Nicola Pietrosillo, Giovanna D'Alessio, Salvatore Bonfante, Vincenzo Vullo, Andrea Gori, Margherita Dalessandro, Domenico Lucchino, Massimo Deseraca, Paolo Tundo, Alfredo Pennica, M. Paoloni, Antonella Castagna, Nicola Serrao, Paolo Costa, Franco Marranconi, Massimo Villa, Pietro Filippini, Maurizio Setti, Eligio Pizzigallo, Marco Tinelli, Mauro Marchili, Domenico Santoro, Cesira Nencioni, Piera Dones, Vincenzo Renda, Alberto Giannetti, Domenico La Rovere, Nicoletta Dorigoni, Guido Palamara, Angelo Iodice, Clara Gabiano, Peter Mian, Luigi Guarnieri, Andrea De Luca, Nicola Tripodi, Giovanni Cristina, Giustino Parruti, Maria Montroni, Loredana Palvarini, Marco Rizzi, Benvenuto Grisorio, Corrado Catalani, Paolo Emilio Manconi, Jacopo Vecchiett, Tiziana Carli, Riccardo Iapoce, Massimo Andreoni, Adriano Lazzarin, Giorgetta Casalino Finocchio, D Sacchini, Mario Gobber, Spartaco Sani, Marco Campus, Rosario La Rosa, Maurizio Mazzeo, Stefano Bonora, Michele Trezzi, Paolo Bassi, Angela La Gala, Alessandro Grimaldi, Dante Di Giammartino, Guido Leo, Gaetano Filice, Antonio Salvo, Paolo Bonfanti, Chiara Pasqualini, Marcello Tavio, Luca Butini, N. Abrescia, Angela Linzalone, Gianpaolo Natalini Ramponi, Pierangelo Rovere, Piero Cortese, Dario Bartolozzi, F. Resta, Miriam Lichtner, Loredana Sarmati, Francesco Cesario, Renato F. Frongillo, Ivano Mezzaroma, Carlo Ferrari, Lorenzo Minoli, Paola Di Stefano, Lucina Titone, Rosa Boncoraglio, Mariana Farenga, Giuliano Rizzardini, Stefano Aviani Barbacci, Andrea Giacometti, Andrea Antinori, Antonio Caterini, Consuelo Geraci, Piergiorgio Chiriacò, Lucio Cosco, Claudio Viscoli, Alfredo Scalzini, Sandro Piga, Massimo Arlotti, Cecilia Occhino, Roberto Luzzati, Paola Sabbatini, Guglielmo Borgia, Umberto Tirelli, Antonio Davi, Letizia Cristiano, Cristina Mussini, Roberto Cauda, Patrizio Vittucci, B. Salassa, Marco Libanore, Maria Pina Sciotti, Isa Picerno, Matteo Bassetti, Benedetto Caroleo, Oswald Moling, Danilo Tacconi, Massimo Puoti, Camoni, Laura, Raimondo, Mariangela, Dorrucci, Maria, Regine V, Salfa MC, CARPHA Study, Group, Lazzarin, Adriano, Castagna, Antonella, Camoni, L, Raimondo, M, Dorrucci, M, Regine, V, Salfa, M, Suligoi, B, Di Giammartino, D, Parruti, G, Di Stefano, P, Paoloni, M, D'Alessandro, M, Grimaldi, A, Sciotti, M, Pizzigallo, E, Vecchiett, J, De Stefano, C, La Gala, A, De Stefano, G, Linzalone, A, Cesario, F, Cosco, L, Caroleo, B, Foti, G, Serrao, N, Lucchino, D, Chirianni, A, Abrescia, N, Pempinello, R, Izzo, C, Borgia, G, Filippini, P, Sagnelli, E, Iodice, A, Megna, A, D'Alessio, G, Acone, N, Mazzeo, M, Sacchini, D, Ferrari, C, Degli Antoni, A, Magnani, G, Mussini, C, Borghi, V, Viale, P, Colangeli, V, Sighinolfi, L, Libanore, M, Govoni, A, Cancellieri, C, Bassi, P, Arlotti, M, Luzzati, R, Bassetti, M, Tirelli, U, Vaccher, E, Moise, G, Palamara, G, Bernardi, S, Falciano, M, Vullo, V, D'Ettore, G, Renda, V, Guariglia, C, Taliani, G, Mezzaroma, I, Paoletti, F, Ajassa, C, Gastaldi, R, Andreoni, M, Sarmati, L, Montella, F, Antinori, A, Giannetti, A, Pietrosillo, N, Girardi, E, Pennica, A, Cauda, R, Colafigli, M, Di Gianbenedetto, S, Caterini, A, Monarca, R, Barbacci, S, Ramponi, G, Marchili, M, Anzalone, E, Lichtner, M, Ferrea, G, Cassola, G, Viscoli, C, Mazzarello, G, Setti, M, Artioli, S, Riccio, G, Finocchio, G, Anselmo, M, Rizzi, M, Scalzini, A, Castelli, F, Quirino, T, Santoro, D, Pan, A, Zoncada, A, Bonfanti, P, Viganò, P, Villa, M, Tinelli, M, Perboni, G, Palvarini, L, Costa, P, Puoti, M, Galli, M, Rizzardini, G, Monforte, A, Lazzarin, A, Castagna, A, Gori, A, Minoli, L, Filice, G, Grossi, P, Giacometti, A, Tavio, M, Montroni, M, Butini, L, Osimani, P, Petrelli, E, Chiodera, A, Vittucci, P, Sabbatini, P, Pasqualini, C, Valle, M, Zoppi, M, Mantia, E, Schettino, G, Deseraca, M, Vitullo, D, Bargiacchi, O, Orofino, G, Bramato, C, Busso, M, Salassa, B, Farenga, M, Bonora, S, Leo, G, Poletti, F, Gobber, M, Cristina, G, Gabiano, C, Mian, P, Moling, O, Paternoster, C, Dorigoni, N, Fontana, T, Angarano, G, Ladisa, N, La Rovere, D, Fico, C, Bulla, F, Santantonio, T, Grisorio, B, Chiriacò, P, Congedo, P, Tundo, P, Resta, F, Cristiano, L, Mura, M, Madeddu, G, Mesina, P, Piga, S, Campus, M, Manconi, P, Ortu, F, Salvo, A, Baretti, C, La Sala, R, Bellissima, P, Bonfante, S, Galvagna, S, Celesia, B, La Rosa, R, Maiuzzo, S, Guarnieri, L, Bruno, S, Picerno, I, Tripodi, N, Farinella, E, Occhino, C, Titone, L, Colomba, C, Prestileo, T, Saitta, M, Dones, P, Boncoraglio, R, Davi, A, Franco, A, Portelli, V, Savalli, F, Geraci, C, Chimenti, M, Luchi, S, Catalani, C, Trezzi, M, Aquilini, D, Sani, S, Nencioni, C, Carli, T, Mazzotta, F, Lo Caputo, S, Zuccati, G, Iapoce, R, Consolini, R, Bartolozzi, D, Bartoloni, A, Bartalesi, F, DE LUCA, A, De Martino, M, Tacconi, D, Tini, S, Baldelli, F, Francisci, D, Frongillo, R, Traverso, A, Francavilla, E, Ferretto, R, Marranconi, F, Manfrin, V, Cortese, P, Rossi, C, Cattelan, F, Petrucci, A, Brugnaro, P, Sgarabotto, D, Scaggiante, R, Cattelan, A, Bosco, O, Concia, E, Rovere, P, Regine, Vincenza, Salfa, Maria Cristina, Suligoi, Barbara, and Luzzati, Roberto
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Immunology, Infectious Diseases, Virology, Settore MED/17 - Malattie Infettive, Epidemiology, Cross-sectional study, Human immunodeficiency virus (HIV), MEDLINE, HIV Infections, medicine.disease_cause, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cross-Sectional Studies, Female, Humans, Italy, Middle Aged, Prevalence, Retrospective Studies, medicine, HIV Infection, HIV, prevalence, Italy, Cross-Sectional Studie, business.industry, Transmission (medicine), HIV, Retrospective cohort study, Hiv prevalence, Northern italy, Anti-Retroviral Agent, business, Viral load, Human, Demography
Abstract: In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/Î¼l, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/Î¼l. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.
Published: 2015

10. Risk of Liver Enzyme Elevation During Treatment With Ritonavir-Boosted Protease Inhibitors Among HIV-Monoinfected and HIV/HCV-Coinfected Patients

Author: Alessia Zoncada, Laura Sighinolfi, Andrea Gori, Giuseppe Lapadula, Francesco Castelli, Nicoletta Ladisa, Eugenia Quiros-Roldan, Silvia Costarelli, Noemi Astuti, Simona Di Giambenedetto, Carlo Torti, Liliane Chatenoud, Massimo Di Pietro, Elisa Di Filippo, Paola Nasta, Lapadula, G, Costarelli, S, Chatenoud, L, Castelli, F, Astuti, N, Di Giambenedetto, S, Quiros Roldan, E, Sighinolfi, L, Ladisa, N, Di Pietro, M, Zoncada, A, Di Filippo, E, Gori, A, Nasta, P, and Torti, C
Subjects: hepatitis C virus, Male, Protease Inhibitor, boosted protease inhibitors, darunavir, HIV Infections, boosted protease inhibitor, Gastroenterology, Cohort Studies, Risk Factors, hepatitis C viru, HIV Infection, Pharmacology (medical), atazanavir, transaminases elevation, Reverse-transcriptase inhibitor, Medicine (all), Hazard ratio, virus diseases, Lopinavir, Hepatitis C, Middle Aged, Hepatitis B, liver toxicity, Infectious Diseases, Italy, Liver, Combination, Coinfection, Drug Therapy, Combination, Female, hepatotoxicity, lopinavir, ritonavir, Adult, Anti-HIV Agents, Humans, Protease Inhibitors, Ritonavir, Human, medicine.drug, medicine.medical_specialty, Infectious Disease, Settore MED/17 - MALATTIE INFETTIVE, Drug Therapy, Internal medicine, medicine, Darunavir, business.industry, Risk Factor, Anti-HIV Agent, medicine.disease, digestive system diseases, Atazanavir, Immunology, Cohort Studie, business
Abstract: Background The risk of liver enzyme elevation (LEE) after different ritonavir-boosted protease inhibitors (PI/r) has not been fully assessed in real-life settings and in populations with high rates of hepatitis C virus (HCV) coinfection. Methods Patients introducing a new PI/r between 1998 and 2012 were included, if transaminases and HCV antibody (Ab) were assessed before treatment initiation. Time to grade 3 and 4 LEE were assessed using univariable and multivariable conditional Cox analyses, stratified by HCV serostatus. Results A total of 6193 HIV-infected patients (3242 HCV-Ab negative and 2951 HCV-Ab positive) were included. Incidence of grade 3 LEE was 1.05, 7.66, and 8.08 per 100 patient-years of follow-up among HCV-Ab negative, HCV-Ab-positive and HCV-RNA-positive patients, respectively. Among HCV-Ab-negative patients, no differences were detected between different PI/r. Use of darunavir/ritonavir was not associated with LEE among HCV-coinfected patients. Atazanavir/ritonavir use was associated with grade 3 LEE but only among HCV-Ab-positive patients (versus LPV/r, hazard ratio: 1.39; 95% confidence interval: 1.1 to 1.75). This risk was not confirmed in a subanalysis restricted to HCV-RNA-positive patients (versus LPV/r, hazard ratio: 1.16; 95% confidence interval: 0.87 to 1.55). Other independent predictors of grade 3 LEE among HCV-Ab-positive patients were older age, male gender, being treatment naive, nonnucleoside reverse transcriptase inhibitor coadministration, increased aspartate aminotransferase at baseline, overweight, positive HCV-RNA, and advanced estimated liver fibrosis. Conclusions Occurrence of hepatotoxicity was a rare finding among HCV-Ab-negative patients and was not influenced by the type of PI/r. In particular, the use of darunavir/ritonavir, previously linked with severe cases of hepatotoxicity, was not associated with a greater risk of LEE, irrespective from HCV serostatus.
Published: 2015

11. Declining Prevalence of HIV-1 Drug Resistance in Antiretroviral Treatment-exposed Individuals in Western Europe

Author: De Luca, A, Dunn, D, Zazzi, M, Camacho, R, Torti, C, Fanti, I, Kaiser, R, Sönnerborg, A, Codoñer, Fm, Van Laethem, K, Vandamme, Am, Bansi, L, Ghisetti, V, van de Vijver DA, Asboe, D, Prosperi, Mc, Di Giambenedetto, S, Collaborators: Giacometti A, SEHERE collaboration in C. h. a. i. n., Butini, L, del Gobbo, R, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Monforte, Ad, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, Rita, De Luca, A, Dunn, D, Zazzi, M, Camacho, R, Torti, C, Fanti, I, Kaiser, R, Sönnerborg, A, Codoñer, F, Van Laethem, K, Vandamme, A, Bansi, L, Ghisetti, V, Van De Vijver, D, Asboe, D, Prosperi, M, Di Giambenedetto, S, Mancuso, S, and Virology
Subjects: Male, Multivariate analysis, Databases, Factual, Drug Resistance, HIV Infections, Drug resistance, 0302 clinical medicine, Retrospective Studie, Risk Factors, Epidemiology, Genotype, pol Gene Products, Human Immunodeficiency Viru, Odds Ratio, Prevalence, Immunology and Allergy, HIV Infection, 030212 general & internal medicine, pol Gene Products, Viral, Multivariate Analysi, media_common, 0303 health sciences, Drug Resistance Prevalence HIV-1, Middle Aged, Resistance mutation, 3. Good health, Reverse Transcriptase Inhibitor, Europe, Infectious Diseases, Reverse Transcriptase Inhibitors, epidemiology, Female, Multiple, Human Immunodeficiency Virus, Human, Drug, Adult, medicine.medical_specialty, Evolution, media_common.quotation_subject, Sexual Behavior, antiretroviral therapy, Infectious Disease, Biology, Settore MED/17 - MALATTIE INFETTIVE, Evolution, Molecular, 03 medical and health sciences, Databases, SDG 3 - Good Health and Well-being, Drug Resistance, Multiple, Viral, medicine, Humans, HIV Protease Inhibitor, Factual, Retrospective Studies, 030306 microbiology, Risk Factor, Molecular, Retrospective cohort study, Odds ratio, HIV Protease Inhibitors, CD4 Lymphocyte Count, drug resistance, genotyping, HIV-1, Multivariate Analysis, Mutation, pol Gene Products, Human Immunodeficiency Virus, Immunology, Demography
Abstract: HIV-1 drug resistance represents a major obstacle to infection and disease control. This retrospective study analyzes trends and determinants of resistance in antiretroviral treatment (ART)-exposed individuals across 7 countries in Europe. Of 20 323 cases, 80% carried at least one resistance mutation: these declined from 81% in 1997 to 71% in 2008. Predicted extensive 3-class resistance was rare (3.2% considering the cumulative genotype) and peaked at 4.5% in 2005, decreasing thereafter. The proportion of cases exhausting available drug options dropped from 32% in 2000 to 1% in 2008. Reduced risk of resistance over calendar years was confirmed by multivariable analysis. © 2013 The Author.
Published: 2013
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12. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

Author: Stewardson, Andrew J., Allignol, A., Beyersmann, J., Graves, N., Schumacher, M., Meyer, R., Tacconelli, E., De Angelis, G., Farina, C., Pezzoli, F., Bertrand, X., Gbaguidi-Haore, H., Edgeworth, J., Tosas, O., Martinez, J. A., Ayala-Blanco, M. P., Pan, A., Zoncada, A., Marwick, C. A., Nathwani, D., Seifert, H., Hos, N., Hagel, S., Pletz, M., Harbarth, S., Masuet-Aumatell, Cristina, Navarro, Marta Banqué, Falcone, Chiara, Freiburg Center for Data Analysis and Modeling (FDM), Albert-Ludwigs-Universität Freiburg, Laboratoire de Biologie Moléculaire et Cellulaire du Cancer [Luxembourg] (LBMCC), Hôpital Kirchberg [Luxembourg], Department of Infectious Diseases, Università cattolica del Sacro Cuore [Milano] (Unicatt), INFN Laboratori Nazionali di Legnaro, Unità di Microbiologia, AO 'Ospedale San Carlo Borromeo', Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Groupe d'histoire et diffusion des sciences d'Orsay (GHDSO), Université Paris-Sud - Paris 11 (UP11), Divisione di Malattie Infettive, Istituti Ospitalieri di Cremona, Feinberg School of Medicine, Northwestern University, Department of Pulmonary Medicine, Hannover Medical School [Hannover] (MHH), and Infection Control Programme and WHO Collaborating Centre on Patient Safety
Subjects: 0301 basic medicine, Male, Epidemiology, medicine.disease_cause, Antimicrobial resistance, MESH: Length of Stay, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH: Staphylococcus aureus, 030212 general & internal medicine, Hospital Mortality, MESH: Enterobacteriaceae Infections, MESH: Treatment Outcome, ddc:616, MESH: Aged, MESH: Middle Aged, Cephalosporin Resistance, Hazard ratio, Enterobacteriaceae Infections, Health Care Costs, Middle Aged, Staphylococcal Infections, Antimicrobial, MESH: Hospitals, Hospitals, 3. Good health, Anti-Bacterial Agents, Europe, Treatment Outcome, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Escherichia coli, Meticillin-resistant Staphylococcus aureus (MRSA) in humans, Staphylococcus aureus, bacterial infections, bloodstream infection, multidrug resistance, Aged, Enterobacteriaceae, Female, Humans, Length of Stay, Methicillin-Resistant Staphylococcus aureus, Proportional Hazards Models, Retrospective Studies, Research Article, medicine.medical_specialty, 030106 microbiology, MESH: Cephalosporin Resistance, MESH: Staphylococcal Infections, MESH: Health Care Costs, MESH: Methicillin-Resistant Staphylococcus aureus, Staphylococcal infections, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, 03 medical and health sciences, MESH: Enterobacteriaceae, Antibiotic resistance, Virology, Internal medicine, MESH: Anti-Bacterial Agents, medicine, MESH: Hospital Mortality, MESH: Humans, Proportional hazards model, business.industry, Public Health, Environmental and Occupational Health, Retrospective cohort study, MESH: Retrospective Studies, medicine.disease, Methicillin-resistant Staphylococcus aureus, Confidence interval, MESH: Male, Surgery, MESH: Europe, business, MESH: Female
Abstract: We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34–2.42, HR = 1.81; 95% CI: 1.49–2.20 and HR = 2.42; 95% CI: 1.66–3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2–9.4, 11.5 days; 95% CI: 11.5–11.6 and 13.3 days; 95% CI: 13.2–13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8–5.9) but not hazard of death (1.16; 95% CI: 0.98–1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13–2.35), excess LOS (4.9 days; 95% CI: 1.1–8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.
Published: 2016
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13. Meticillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis

Author: Enrico Raineri, A. Pan, Nicola Latronico, A. De Silvestri, G. Carnevale, Carmine Tinelli, L. Crema, Nicola Petrosillo, Annamaria Acquarolo, A. Zoncada, and F. Albertario
Subjects: Male, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Meticillin, Micrococcaceae, medicine.drug_class, Antibiotics, medicine.disease_cause, law.invention, Patient Isolation, law, Intensive care, Internal medicine, medicine, Humans, Longitudinal Studies, Aged, Antibacterial agent, Cross Infection, Infection Control, biology, business.industry, Incidence, General Medicine, Middle Aged, Staphylococcal Infections, biology.organism_classification, Intensive care unit, Surgery, Intensive Care Units, Infectious Diseases, Italy, Meticillin resistant, Female, Methicillin Resistance, business, Sentinel Surveillance, medicine.drug
Abstract: Data regarding the efficacy of programmes to control meticillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) are limited. We performed an observational 'before-and-after' study to evaluate the search-and-destroy (SD) strategy as compared with SD and isolation (SDI), to control MRSA in a general ICU. SD included active surveillance, contact precautions and treatment of carriers; in SDI, isolation or cohorting were added. Three phases were identified: period 1 (p1), 1996-1997, before the introduction of programme; period 2 (p2), 1998-2002, with SD programme; period 3 (p3), 2003-2005, with SDI in a new ICU. During the 10 years of the study we observed 3978 patients; 667, 1995 and 1316 patients in p1, p2 and p3 respectively. The numbers of MRSA-infected patients were 19 in p1, 23 in p2, and 6 in p3. The infection rate was 3.5, 1.7 and 0.7 cases per 1000 patient-days in p1, p2 and p3, respectively; a significant reduction was observed between p1 vs p2 (P=0.024) and p2 vs p3 (P=0.048), although the latter was not confirmed by a segmented regression analysis. The proportion of ICU-acquired MRSA cases was 80%, 77% and 52% during p1, p2 and p3, respectively (P=0.0001 for trend). The proportion of S. aureus isolates resistant to meticillin was 51%, 32% and 23% during p1, p2 and p3, respectively (P0.0001 for trend). SD strategy was effective in significantly reducing MRSA infection, transmission rates and proportion of meticillin resistance in an ICU with endemic MRSA. SDI may further enhance SD efficacy.
Published: 2007
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14. Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort

Author: Di Biagio, A, Prinapori, R, Giannarelli, D, Maggiolo, F, Di Giambenedetto, S, Borghi, V, Penco, G, Cicconi, P, Francisci, D, Sterrantino, G, Zoncada, A, Monno, L, Capetti, A, Giacometti, A, Vullo, Vincenzo, ARCA Collaborative Group, Di Biagio, A., Prinapori, R., Giannarelli, D., Maggiolo, F., Di Giambenedetto, S., Borghi, V., Penco, G., Cicconi, P., Francisci, D., Sterrantino, G., Zoncada, A., Monno, L., Capetti, A., Giacometti, A., and Mancuso, S
Subjects: Cyclopropanes, Time Factors, Pyridines, Pyridine, Drug Resistance, Lopinavir/ritonavir, Longitudinal Studie, HIV Infections, Pharmacology, Antiviral therapy, Deoxycytidine, Lopinavir, Cohort Studies, chemistry.chemical_compound, immune system diseases, Retrospective Studie, Organophosphonate, Medicine, Emtricitabine, HIV Infection, Pharmacology (medical), Viral, Longitudinal Studies, Prospective Studies, Prospective cohort study, virus diseases, Infectious Diseases, Anti-Retroviral Agents, Italy, Alkynes, Combination, Oligopeptide, HIV/AIDS, Drug Therapy, Combination, Oligopeptides, medicine.drug, Human, Microbiology (medical), Benzoxazine, medicine.medical_specialty, Efavirenz, Time Factor, antiretroviral therapy, Atazanavir Sulfate, Organophosphonates, first-line therapy tenofovir emtricitabine atazanavir/ritonavir, Settore MED/17 - MALATTIE INFETTIVE, Durability, Drug Therapy, Internal medicine, Drug Resistance, Viral, Drug utilization, Humans, Tenofovir/emtricitabine, Adenine, Benzoxazines, HIV-1, Retrospective Studies, Ritonavir, Tenofovir, business.industry, Atazanavir, Regimen, Prospective Studie, chemistry, Anti-Retroviral Agent, Cohort Studie, business
Abstract: Objectives: To explore the durability of three first-line tenofovir/emtricitabine-based regimens in combination with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in HIV-1-infected patients. Patients and methods: A retrospective, longitudinal, multicentre analysis of adult patients enrolled in the Antiretroviral Resistance Cohort Analysis (ARCA), a national prospective observational cohort of HIV-1-infected patients followed up at more than 100 clinical and laboratory units in Italy. Patients eligible were those starting first-line antiretroviral therapy between 1 June 2004 and 15 April 2011 and who were followed up for at least 6 months. The primary endpoint was durability, defined as the time from antiretroviral therapy initiation to first treatment modification. Time-dependent events were analysed by the Kaplan-Meier approach and the Cox proportional hazard model. Results: There are 26 000 HIV-infected patients in the ARCA database, of whom 1654 met study inclusion criteria. Six hundred and thirty-nine (38.6%) received efavirenz, 321 (19.4%) received atazanavir/ritonavir and 694 (41.9%) received lopinavir/ritonavir as a first-line regimen. Over a total observation period of 88 months, equivalent to more than 2805 person-years of follow-up, 618 patients underwent treatment modification. Lopinavir/ritonavir, given twice daily, was associated with a higher discontinuation rate than efavirenz- and atazanavir-based regimens [hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.56-2.15, P = 0.001]. Comparing the once-daily regimens, the rate of discontinuation of efavirenz was higher than that of atazanavir/ritonavir (HR 1.39, 95% CI 1.06-1.83, P = 0.016). Conclusions: Significant differences in treatment duration were observed among the three studied regimens. Once-daily regimens exhibited greater durability than the twice-daily regimen. Among the specific regimens examined, tenofovir/emtricitabine plus atazanavir/ritonavir showed the greatest durability. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Published: 2013

15. Genotypic resistance profiles associated with virological failure to darunavir-containing regimens: a cross-sectional analysis

Author: Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, MANCUSO, Salvatrice, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, Poletti, F., Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, and Poletti, F
Subjects: Male, Time Factors, Cross-sectional study, Human immunodeficiency virus (HIV), Drug Resistance, HIV Infections, Drug resistance, medicine.disease_cause, Cohort Studies, Antiretroviral Therapy, Highly Active, Ritonavir-boosted darunavir, Genotype, HIV Infection, Treatment Failure, Viral, Genotypic resistance, Darunavir, Sulfonamides, General Medicine, Middle Aged, Virological failure, Infectious Diseases, Female, Human, medicine.drug, Adult, Microbiology (medical), Logistic Model, Time Factor, Antiretroviral Therapy, Settore MED/17 - MALATTIE INFETTIVE, Sulfonamide, Drug Resistance, Viral, medicine, Humans, Highly Active, Protease inhibitors, Cross-Sectional Studies, HIV Protease Inhibitors, HIV-1, Logistic Models, Mutation, HIV Protease Inhibitor, Cross-Sectional Studie, business.industry, Antiretroviral therapy, Virology, Protease inhibitor, Cohort Studie, business
Abstract: Introduction: This study aimed at defining protease (PR) resistance mutations associated with darunavir (DRV) failure and PR resistance evolution at DRV failure in a large database of treatment-experienced human immunodeficiency virus (HIV) patients. Results: Overall, 1,104 patients were included: 118 (10.7%) failed at a median observation time of 16 months. The mean number of PR mutations at baseline was 2.7, but it was higher in patients who subsequently failed DRV. In addition, the number of PR mutations increased at failure. The increase in the mean number of mutations was completely related to mutations considered to be associated with DRV resistance following the indications of the main DRV clinical trials. Discussion The higher statistical difference at baseline between failing versus non-failing patients was observed for the V32I and I84V mutations. At DRV failure, the major increase was still observed for V32I; I54L, V11I, T74P and I50V also increased. Despite the increment in the mean number of mutations per patient between baseline and failure, in 21 patients (17.8%) at baseline and 36 (30.5%) at failure, no PR mutation was detected. Conclusion: The HIV-DB interpretation algorithm identified few patients with full DRV resistance at baseline and few patients developed full resistance at DRV failure, indicating that complete resistance to DRV is uncommon. © Springer-Verlag 2011.
Published: 2012

16. Low Rate of Virological Failure and Maintenance of Susceptibility to HIV-1 Protease Inhibitors with First-Line Lopinavir/Ritonavir-Based Antiretroviral Treatment in Clinical Practice

Author: Prosperi, Mc, Zazzi, M, Punzi, G, Monno, L, Colao, G, Corsi, P, Di Giambenedetto, S, Meini, G, Ghisetti, V, Bonora, S, Pecorari, M, Gismondo, Mr, Bagnarelli, P, Carli, T, De Luca, A, ARCA Collaborative Group, Giacometti, A, Butini, L, del Gobbo, R, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Maggiolo, F, Callegaro, A, Calza, L, Re, Mc, Raffaele, P, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Monforte, A, Cicconi, P, Rusconi, S, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, Rita, Clinic of Infectious Diseases, Università cattolica del Sacro Cuore [Roma] (Unicatt), Molecular Biology, Microbiology and Virology, Bari University Hospital, Clinical Infectious Diseases, Careggi University Hospital, Unit of Infectious Diseases, Catholic Universisty of Sacred Heart, A. Savoia Hospital, infectiuos diseases, Università degli studi di Torino (UNITO), Modena University Hospital, L. Sacco University Hospital, Ancona University Hospital, Grosseto General Hospital, Institute of Infectious Diseases, Sacro Cuore Catholic University, Infectious Diseases Unit, University Hospital of Siena, Prosperi, M, Zazzi, M, Punzi, G, Monno, L, Colao, G, Corsi, P, Di Giambenedetto, S, Meini, G, Ghisetti, V, Bonora, S, Pecorari, M, Gismondo, M, Bagnarelli, P, Carli, T, De Luca, A, Mancuso, S, Prosperi MC, Zazzi M, Punzi G, Monno L, Colao G, Corsi P, Di Giambenedetto S, Meini G, Ghisetti V, Bonora S, Pecorari M, Gismondo MR, Bagnarelli P, Carli T, De Luca A, ARCA Collaborative Group [.., Giacometti A, Butini L, del Gobbo R, Menzo S, Tacconi D, Corbelli G, Zanussi S, Maggiolo F, Callegaro A, Calza L, Re MC, Raffaele P, Turconi P, Mandas A, Tini S, Zoncada A, Paolini E, Amadio G, Sighinolfi L, and ]
Subjects: Male, Lopinavir/ritonavir, HIV Infections, boosted protease inhibitor, Lopinavir, Cohort Studies, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, virologic failure, HIV Infection, Treatment Failure, 030212 general & internal medicine, Pyrimidinone, 0303 health sciences, education.field_of_study, lopinavir/ritonavir, Viral Load, Resistance mutation, first-line antiretroviral therapy, Reverse Transcriptase Inhibitor, 3. Good health, Treatment Outcome, Infectious Diseases, RNA, Viral, Reverse Transcriptase Inhibitors, Medicine, Drug Therapy, Combination, Female, Survival Analysi, Viral load, Human, medicine.drug, Anti-HIV Agents, Population, Pyrimidinones, Settore MED/17 - MALATTIE INFETTIVE, Emtricitabine, human immunodeficiency virus type 1, 03 medical and health sciences, Virology, Drug Resistance, Viral, antiretroviral drug resistance, medicine, Humans, Protease inhibitor (pharmacology), education, HIV Protease Inhibitor, Ritonavir, 030306 microbiology, business.industry, Anti-HIV Agent, HIV Protease Inhibitors, Survival Analysis, HIV-1, Cohort Studie, business
Abstract: Protease inhibitor (PI)-resistant HIV-1 has hardly ever been detected at failed boosted PI-based first-line antiretroviral regimens in clinical trials. However, this phenomenon has not been investigated in clinical practice. To address this gap, data from patients starting a first-line lopinavir/ritonavir (LPV/rtv)-based therapy with available baseline HIV-1 RNA load, a viral genotype and follow-up viral load after 3 and 6 months of treatment were extracted from the Italian Antiretroviral Resistance Cohort Analysis (ARCA) observational database. Based on survival analysis, 39 (7.1%) and 43 (7.8%) of the 548 examined patient cases had an HIV-1 RNA >500 and >50 copies/ml, respectively, after 6 months of treatment. Cox proportional hazard models detected baseline HIV-1 RNA (RH 1.79, 95%CI 1.10-2.92 per 1 - log10 increase, P = 0.02) and resistance to the nucleoside backbone (RH 1.04, 95%CI 1.02-1.06 per 10-point increase using the Stanford HIVdb algorithm, P < 0.001) as independent predictors of HIV-1 RNA at >500 copies/ml, but not at the >50 copies/ml cutoff criteria. Higher baseline viral load, older patient age, heterosexual route of infection and use of tenofovir/emtricitabine were predictors of failure at month 3 using the 50-copy and/or 500-copy threshold. Resistance to LPV/rtv did not occur or increase in any of the available 36 follow-up HIV-1 genotypes. Resistance to the nucleoside backbone (M184V) developed in four cases. Despite the likely differences in patient population and adherence, both the low rate of virological failure and the lack of development of LPV/rtv resistance documented in clinical trials are thus confirmed in clinical practice. J. Med. Virol. 82:1996-2003, 2010. © 2010 Wiley-Liss, Inc.
Published: 2010
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17. Antiretroviral treatment in pregnancy: a six-year perspective on recent trends in prescription patterns, viral load suppression, and pregnancy outcomes

Author: Silvia Baroncelli, Enrica Tamburrini, Marina Ravizza, Serena Dalzero, Cecilia Tibaldi, Enrico Ferrazzi, Gianfranco Anzidei, Marta Fiscon, Salvatore Alberico, Pasquale Martinelli, Giuseppina Placido, Giovanni Guaraldi, Carmela Pinnetti, Marco Floridia for The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [Participants: M. Ravizza, E. Tamburrini, P. Ortolani, F. Mori, C. Monticelli, E. R. dalle Nogare, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, M. Mazzetti, B. Borchi, F. Vichi, E. Pinter, E. Anzalone, V. S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, B. Mariani, A. Moretti, G. Natalini, G. Guaraldi, K. Luzi, G. Nardini, A. Zoncada, A. Degli Antoni, A. Molinari, P. Rogasi, M. P. Crisalli, A. Donisi, V. Cerri, E. Chiesa, A. Lupo, D. Repetto, A. Viganò, V. Giacomet, V. Fabiano, S. Stucchi, C. Cerini, G. Placido, M. Dalessandro, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, S. Alberico, M. Bernardon, A. Meloni, D. Gariel, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Vicini, E. Periti, A. Spinillo, M. Roccio, A. Vimercati, E. Tridapalli, M. Stella, S. Vagnoni, I. Strada, C. Puccetti, M. Sansone, P. Martinelli, C. Tibaldi, L. Trentini, S. Marini, G. Masuelli, L. Di Lenardo, I. Cetin, M. L. Muggiasca, V. Conserva, T. Brambilla, E. Ferrazzi, C. Giaquinto, M. Fiscon, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, G. Anzidei, S. Di Giambenedetto, C. Fundarò, O. Genovese, C. Cafforio, C. Pinnetti, G. Liuzzi, V. Tozzi, P. Massetti, M. Anceschi, A. M. Casadei, F. Montella, A. F. Cavaliere, V. Finelli, C. Riva, L. Lazier, M. Cellini, S. Garetto, G. Castelli Gattinara, A. M. Marconi, M. Ierardi, S. Foina, B. Salerio, S. Dalzero, M. Oneta, C. Polizzi, A. Mattei, M. F. Pirillo, R. Amici, C. M. Galluzzo, S. Donnini, S. Baroncelli, M. F.l.o.r.i.d.i.a. Pharmacokinetics: M. Regazzi, P. Villani, M. Cusato, Advisory Board: A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, S. Vella, SIGO HIV Group National Coordinators: E. Ferrazzi, P. Martinelli], GUERRA, BRUNELLA, FALDELLA, GIACOMO, Baroncelli, S, Tamburrini, E, Ravizza, M, Dalzero, S, Tibaldi, C, Ferrazzi, E, Anzidei, G, Fiscon, M, Alberico, S, Martinelli, Pasquale, Placido, G, Guaraldi, G, Pinnetti, C., Floridia, M., Silvia Baroncelli, Enrica Tamburrini, Marina Ravizza, Serena Dalzero, Cecilia Tibaldi, Enrico Ferrazzi, Gianfranco Anzidei, Marta Fiscon, Salvatore Alberico, Pasquale Martinelli, Giuseppina Placido, Giovanni Guaraldi, Carmela Pinnetti, and Marco Floridia for The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [Participants: M. Ravizza, E. Tamburrini, P. Ortolani, F. Mori, C. Monticelli, E.R. dalle Nogare, G. Sterrantino, M. Meli, S. Polemi, J. Nocentini, M. Baldini, M. Mazzetti, B. Borchi, F. Vichi, E. Pinter, E. Anzalone, V.S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, B. Mariani, A. Moretti, G. Natalini, G. Guaraldi, K. Luzi, G. Nardini, A. Zoncada, A. Degli Antoni, A. Molinari, P. Rogasi, M.P. Crisalli, A. Donisi, V. Cerri, E. Chiesa, A. Lupo, D. Repetto, A. Viganò, V. Giacomet, V. Fabiano, S. Stucchi, C. Cerini, G. Placido, M. Dalessandro, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, S. Alberico, M. Bernardon, A. Meloni, D. Gariel, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Vicini, E. Periti, A. Spinillo, M. Roccio, A. Vimercati, B. Guerra, E. Tridapalli, M. Stella, G. Faldella, S. Vagnoni, I. Strada, C. Puccetti, M. Sansone, P. Martinelli, C. Tibaldi, L. Trentini, S. Marini, G. Masuelli, L. Di Lenardo, I. Cetin, M.L. Muggiasca, V. Conserva, T. Brambilla, E. Ferrazzi, C. Giaquinto, M. Fiscon, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, G. Anzidei, S. Di Giambenedetto, C. Fundarò, O. Genovese, C. Cafforio, C. Pinnetti, G. Liuzzi, V. Tozzi, P. Massetti, M. Anceschi, A.M. Casadei, F. Montella, A.F. Cavaliere, V. Finelli, C. Riva, L. Lazier, M. Cellini, S. Garetto, G. Castelli Gattinara, A.M. Marconi, M. Ierardi, S. Foina, B. Salerio, S. Dalzero, M. Oneta, C. Polizzi, A. Mattei, M.F. Pirillo, R. Amici, C.M. Galluzzo, S. Donnini, S. Baroncelli, M. Floridia. Pharmacokinetics: M. Regazzi, P. Villani, M. Cusato, Advisory Board: A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, S. Vella, SIGO-HIV Group National Coordinators: E. Ferrazzi, and P. Martinelli]
Subjects: Adult, medicine.medical_specialty, Adolescent, Population, antiretroviral therapy, HIV Infections, Antiviral Agents, Drug Prescriptions, Zidovudine, Young Adult, Pregnancy, medicine, Humans, Pregnancy Complications, Infectious, education, HIV, pregnancy, Retrospective Studies, education.field_of_study, business.industry, Obstetrics, Public Health, Environmental and Occupational Health, Pregnancy Outcome, Lamivudine, Lopinavir, Viral Load, medicine.disease, Drug Utilization, Infectious Diseases, Nelfinavir, Italy, Immunology, HIV-1, Ritonavir, Female, business, Viral load, medicine.drug
Abstract: The aim of the study was to describe the recent trends in antiretroviral treatment in late pregnancy and the sociodemographic changes among pregnant women with HIV over the last 6 years. Data from the National Program on Surveillance on Antiretroviral Treatment in Pregnancy in Italy were grouped per calendar year, and changes in antiretroviral treatment, population characteristics, maternal immunovirologic status and newborn clinical parameters were analyzed. A total of 981 HIV-infected mothers who delivered between 2002 and 2008 were evaluated. The proportion of women receiving at least three antiretroviral drugs at delivery increased significantly from 63.0% in 2002 to 95.5% in 2007-2008, paralleled by a similar upward trend in the proportion of women who achieved complete viral suppression at third trimester (from 37.3 in 2002 to 80.9 in 2007-2008; p < 0.001). The co-formulation of zidovudine plus lamivudine remained the most common nucleoside backbone in pregnancy, even if a significant increase in the use of tenofovir plus emtricitabine was observed in more recent years. Starting from 2003, nevirapine prescription declined, paralleled by a significant rise in the use of protease inhibitors (PI), which were present in more than 60% of regimens administered in 2007-2008. Nelfinavir was progressively replaced by ritonavir-boosted PIs, mainly lopinavir. No significant changes in preterm delivery, Apgar score, birth weight, and birth defects were observed during the study period, and the rate of HIV transmission remained below 2%. These data demonstrate a significant evolution in the treatment of HIV in pregnancy. Constant improvements in the rates of HIV suppression were observed, probably driven by the adoption of stronger and more effective regimens and by the increasing options available for combination treatment
Published: 2009

18. The role of baseline HIV-1 RNA, drug resistance, and regimen type as determinants of response to first-line antiretroviral therapy

Author: Di Biagio, Antonio, Rusconi, Stefano, Marzocchetti, Angela, Signori, Alessio, Schiavetti, Irene, Bruzzone, Bianca, Monno, Laura, Punzi, Grazia, Colao, Maria Grazia, Penco, Giovanni, Zazzi, Maurizio, De Luca, Andrea, Giacometti, Andrea, Butini, Luca, Del Gobbo, Romana, Bagnarelli, Patrizia, Tacconi, Danilo, Corbelli, Giovanni, Zanussi, Stefania, Maggiolo, Franco, Callegaro, Annapaola, Calza, Leonardo, Maria Carla, Re, Pristerà, Raffaele, Turconi, Paola, Mandas, Antonella, Pozzo, Alessandra, Simeone, Nuccia, Tini, Sauro, Zoncada, Alessia, Paolini, Elisabetta, Amadio, Giorgio, Sighinolfi, Laura, Zuccati, Giuliano, Morfini, Massimo, Manetti, Roberto, Corsi, Paola, Galli, Luisa, Di Pietro, Massimo, Bartalesi, Filippo, Colao, Grazia, Tosti, Andrea, Setti, Maurizio, Trezzi, Michele, Bonfanti, Paolo, Pardelli, Riccardo, Arcidiacono, Irene, Degiuli, Alberto, De Gennaro, Michele, Chiodera, Alessandro, Scalzini, Alfredo, Palvarini, Loredana, Almi, Paolo, Todaro, Giovanni, Cicconi, Paola, Gismondo, Maria Rita, Micheli, Valeria, Biondi, Maria Luisa, Gianotti, Nicola, Capetti, Amedeo, Meraviglia, Paola, Boeri, Enzo, Mussini, Cristina, Pecorari, Monica, Soria, Alessandro, Malandrin, Sergio, Santirocchi, Maurizio, Brustia, Diego, Ravanini, Paolo, Dal Bello, Federico, Romano, Nino, Mineo, Maurizio, Mancuso, Salvatrice, Calzetti, Carlo, Maserati, Renato, Filice, Gaetano, Baldanti, Fausto, Francisci, Daniela, Parruti, Giustino, Polilli, Ennio, Sacchini, Daria, Martinelli, Chiara, Consolini, Rita, Vatteroni, Linda, Vivarelli, Angela, Nerli, Alessandro, Lenzi, Lucia, Magnani, Giacomo, Ortolani, Patrizia, Andreoni, Massimo, Palamara, Guido, Fimiani, Caterina, Palmisano, Lucia, Di Gaimbenedetto, Simona, Colafigli, Manuela, Vullo, Vincenzo, Turriziani, Ombretta, Montano, Marco, Senatore, Cataldo, Dentone, Chiara, Gonnelli, Angela, Palumbo, Michele, Ghisetti, Valeria, Bonora, Stefano, Foglie, Palma Delle, Rossi, Cristina, Grossi, Paolo, Seminari, Elena, Poletti, Federica, Mondino, Vincenzo, and Malena, Marina
Subjects: Adult, Male, Adolescent, Genotype, Antiretroviral Therapy, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, wGSS, Young Adult, Virology, Antiretroviral Therapy, Highly Active, Drug Resistance, Viral, 80 and over, Humans, Highly Active, HIV-1 RNA, Viral, Longitudinal Studies, CD4, Drug regimen, Drug resistance, N(n)RTI backbone, WGSS, Infectious Diseases, Aged, Aged, 80 and over, Anti-Retroviral Agents, CD4 Lymphocyte Count, Female, HIV-1, Italy, Middle Aged, RNA, Viral, Retrospective Studies, Treatment Outcome, Viral Load, drug regimen, drug resistance, RNA
Abstract: The factors influencing virological response to first-line combined antiretroviral therapy (cART) in an Italian cohort of HIV-1-infected patients were examined. Eligible patients were those enrolled in a national prospective observational cohort (Antiretroviral Resistance Cohort Analysis), starting first-line cART between 2001 and 2011 and who had at least one follow-up of HIV-1 RNA. The primary endpoint was virological success, defined as the first viral load50 copies/ml. Time to events were analyzed by Kaplan-Meier analysis and Cox proportional hazard model. One thousand three hundred five patients met the study inclusion criteria. In a multivariable model adjusting for transmission mode, presence of transmitted drug resistance, baseline CD4(+) cell count, viral subtype, and type of NRTI backbone employed, independent predictors of virological success were higher baseline viral load (≥500,000 vs.100,000 HR 0.52; P 0.001), a weighted genotypic susceptibility score (wGSS)3 (HR 0.58; P = 0.003), male sex (HR 0.76 P = 0.001), and type of initial third drug employed (integrase inhibitor vs. boosted protease inhibitors HR 3.23; P 0.001). In the subset with HIV-1 RNA100,000 copies/ml, virologic success was only associated with the use of integrase inhibitors in the first cART regimen. Independent predictors of immunological success were baseline CD4(+) cell count and wGSS3. High baseline HIV-1 RNA, predicted activity of the first-line regimen based on genotypic resistance testing, gender, and use of new agents were found to predict time to achieve virological success. The type of initial nucleoside analog backbone was not found to predict virological response.
Published: 2014

19. Drug-resistance development differs between HIV-1-infected patients failing first-line antiretroviral therapy containing nonnucleoside reverse transcriptase inhibitors with and without thymidine analogues

Author: Santoro, M, Sabin, C, Forbici, F, Bansi, L, Dunn, D, Fearnhill, E, Boumis, E, Nicastri, E, Antinori, A, Palamara, G, Callegaro, A, Francisci, Daniela, Zoncada, A, Maggiolo, F, Zazzi, M, Perno, C, Ceccherini Silberstein, F, and Mussini, C.
Subjects: Adult, Male, genotypic resistance test, Anti-HIV Agents, Drug Resistance, Organophosphonates, Antiretroviral Therapy, HIV Infections, Deoxycytidine, Antiretroviral Therapy, Highly Active, Drug Resistance, Viral, Emtricitabine, Humans, Highly Active, Viral, Treatment Failure, Tenofovir, virological failure, resistance to reverse transcriptase inhibitors, Adenine, Middle Aged, Viral Load, Settore MED/07 - Microbiologia e Microbiologia Clinica, Dideoxynucleosides, HIV Reverse Transcriptase, CD4 Lymphocyte Count, Drug Combinations, first-line regimen, Female, HIV-1, Lamivudine, Thymidine, Zidovudine
Abstract: We evaluated the emergence of drug resistance in patients failing first-line regimens containing one nonnucleoside reverse transcriptase inhibitor (NNRTI) administered with zidovudine (ZDV) + lamivudine (the ZDV group) or non-thymidine analogues (non-TAs) (tenofovir or abacavir, + lamivudine or emtricitabine; the non-TA group).Three hundred HIV-1-infected patients failing a first-line NNRTI-containing regimen (nevirapine, n = 148; efavirenz, n = 152) were included in the analysis. Virological failure was defined as viraemia ≥ 400 HIV-1 RNA copies/mL for the first time at least 6 months after starting the NNRTI-based regimen. For each patient, a genotypic resistance test at failure was available. The presence of drug-resistance mutations in HIV-1 reverse transcriptase was evaluated by comparing patients treated with NNRTI + zidovudine + lamivudine vs. those treated with NNRTI + non-TA.A total of 208 patients were failing with NNRTI + zidovudine + lamivudine and 92 with NNRTI + non-TA. No significant differences were observed between the non-TA group and the ZDV group regarding the time of virological failure [median (interquartile range): 12 (8-25) vs. 13 (9-32) months, respectively; P = 0.119] and viraemia [median (interquartile range): 4.0 (3.2-4.9) vs. 4.0 (3.3-4.7) log₁₀ copies/mL, respectively; P = 0.894]. Resistance to reverse transcriptase inhibitors (RTIs) occurred at a significant lower frequency in the non-TA group than in the ZDV group (54.3 vs. 75.5%, respectively; P = 0.001). This difference was mainly attributable to a significantly lower prevalence of NNRTI resistance (54.3 vs. 74.0%, respectively; P = 0.002) and of the nucleoside reverse transcriptase inhibitor (NRTI) mutation M184V (23.9 vs. 63.5%, respectively; P 0.001) in the non-TA group compared with the ZDV group. As expected, the mutation K65R was found only in the non-TA group (18.5%; P 0.001).At first-line regimen failure, a lower prevalence of RTI resistance was found in patients treated with NNRTI + non-TA compared with those treated with NNRTI + zidovudine + lamivudine. These results confirm that the choice of backbone may influence the prevalence of drug resistance at virological failure.
Published: 2013

20. HIV-1 subtype F1 epidemiological networks among Italian heterosexual males are associated with introduction events from South America

Author: Gianguglielmo Zehender, Patrizia Bagnarelli, A. Gonnelli, Valeria Micheli, P. Almi, Paola Corsi, Stefania Paolucci, Andrea De Luca, Massimo Ciccozzi, Maurizio Zazzi, Alessia Zoncada, Grazia Colao, Claudia Balotta, Marco Franzetti, Paola Meraviglia, Francesco R. Simonetti, Danilo Tacconi, and Alessia Lai
Subjects: Male, Epidemiology, HIV Infections, Drug resistance, law.invention, 0302 clinical medicine, Risk Factors, law, Cluster Analysis, Europe, Eastern, 030212 general & internal medicine, Young adult, Child, Clade, Phylogeny, Molecular Epidemiology, 0303 health sciences, education.field_of_study, Multidisciplinary, Phylogenetic tree, Middle Aged, 3. Good health, Phylogenetics, Transmission (mechanics), Italy, HIV epidemiology, Infectious diseases, Medicine, Female, Sexuality, Research Article, Adult, medicine.medical_specialty, Adolescent, Clinical Research Design, Science, Population, Retrovirology and HIV immunopathogenesis, Viral diseases, Biology, White People, Infectious Disease Epidemiology, Young Adult, 03 medical and health sciences, medicine, Humans, Evolutionary Systematics, education, Aged, 030304 developmental biology, Evolutionary Biology, Population Biology, HIV, South America, HIV-1, Contact tracing, Demography
Abstract: About 40% of the Italian HIV-1 epidemic due to non-B variants is sustained by F1 clade, which circulates at high prevalence in South America and Eastern Europe. Aim of this study was to define clade F1 origin, population dynamics and epidemiological networks through phylogenetic approaches. We analyzed pol sequences of 343 patients carrying F1 subtype stored in the ARCA database from 1998 to 2009. Citizenship of patients was as follows: 72.6% Italians, 9.3% South Americans and 7.3% Rumanians. Heterosexuals, Homo-bisexuals, Intravenous Drug Users accounted for 58.1%, 24.0% and 8.8% of patients, respectively. Phylogenetic analysis indicated that 70% of sequences clustered in 27 transmission networks. Two distinct groups were identified; the first clade, encompassing 56 sequences, included all Rumanian patients. The second group involved the remaining clusters and included 10 South American Homo-bisexuals in 9 distinct clusters. Heterosexual modality of infection was significantly associated with the probability to be detected in transmission networks. Heterosexuals were prevalent either among Italians (67.2%) or Rumanians (50%); by contrast, Homo-bisexuals accounted for 71.4% of South Americans. Among patients with resistant strains the proportion of clustering sequences was 57.1%, involving 14 clusters (51.8%). Resistance in clusters tended to be higher in South Americans (28.6%) compared to Italian (17.7%) and Rumanian patients (14.3%). A striking proportion of epidemiological networks could be identified in heterosexuals carrying F1 subtype residing in Italy. Italian Heterosexual males predominated within epidemiological clusters while foreign patients were mainly Heterosexual Rumanians, both males and females, and South American Homo-bisexuals. Tree topology suggested that F1 variant from South America gave rise to the Italian F1 epidemic through multiple introduction events. The contact tracing also revealed an unexpected burden of resistance in epidemiological clusters underlying the need of public interventions to limit the spread of non-B subtypes and transmitted drug resistance.
Published: 2012

21. High burden of transmitted HIV-1 drug resistance in Italian patients carrying F1 subtype

Author: P. Almi, Patrizia Bagnarelli, Valeria Micheli, Paola Meraviglia, Alessia Zoncada, Alessia Lai, Marco Franzetti, Giorgio Bozzi, Francesco R. Simonetti, Paola Corsi, Andrea De Luca, and Claudia Balotta
Subjects: Microbiology (medical), Adult, Male, medicine.medical_specialty, transmitted HIV drug resistance, Genotype, Anti-HIV Agents, Population, Mutation, Missense, subtype, HIV Infections, Drug resistance, Biology, Settore MED/17 - MALATTIE INFETTIVE, Men who have sex with men, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Drug Resistance, Viral, medicine, Prevalence, Humans, Pharmacology (medical), education, Pharmacology, education.field_of_study, Middle Aged, medicine.disease, Virology, Reverse transcriptase, Drug-naïve, Infectious Diseases, Italy, pol Gene Products, Human Immunodeficiency Virus, HIV-1, Female, medicine.drug, Cohort study
Abstract: Background Transmitted drug resistance (TDR) is mainly restricted to individuals carrying B subtype, with low prevalence among non-B subtypes when grouped together. Subtype F1 is the most frequent non-B variant found in subjects living in Italy, allowing a specific assessment of TDR associated with this clade. Methods We analysed pol sequences of HIV-1-positive individuals carrying the F1 variant included in the Antiretroviral Resistance Cohort Analysis database in the 1998-2009 period. Mutations were analysed with the Surveillance Drug Resistance Mutation and the International AIDS Society lists for naive and treated patients, respectively. Results Among 343 HIV-1-infected patients carrying an F1 subtype, resistance was evaluated in a subset of 221 patients whose treatment status was known (169 drug naive and 52 drug experienced). The prevalence of TDR was 15.4% (11.8% for nucleoside/nucleotide reverse transcriptase inhibitors, 6.5% for non-nucleoside reverse transcriptase inhibitors and 7.1% for protease inhibitors). Among the 169 naive patients, 75.1%, 10.1% and 7.1% were Italians, South Americans and Romanians, respectively. Heterosexuals were prevalent among Italians and Romanians, while men who have sex with men were predominant among South Americans. The overall frequency of TDR declined from 21.4% to 7.1% in the 1998-2009 period. Although no statistical difference was detected, the frequency of TDR was higher in South Americans (23.5%) compared with Italian and Romanian naive patients (15% and 8.3%, respectively). Discussion Our study shows a remarkable frequency of TDR in the F1 subtype-infected population. The high prevalence of TDR detected in South American subjects is linked to the homosexual route of infection. However, TDR was considerably high also in Italian subjects harbouring the F1 subtype, deserving careful monitoring.
Published: 2012

22. A novel methodology for large-scale phylogeny partition

Author: Prosperi, Mattia C. F., Ciccozzi, Massimo, Fanti, Iuri, Saladini, Francesco, Pecorari, Monica, Borghi, Vanni, Di Giambenedetto, Simona, Bruzzone, Bianca, Capetti, Amedeo, Vivarelli, Angela, Rusconi, Stefano, Maria Carla, Re, Gismondo, Maria Rita, Sighinolfi, Laura, Gray, Rebecca R., Salemi, Marco, Zazzi, Maurizio, De Luca, Andrea, Giacometti, A, Butini, L, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Re, Mc, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Dionisio, D, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, De Luca, A, Fadda, G, Vullo, Vincenzo, Turriziani, Ombretta, Montano, M, Cenderello, G, Gonnelli, A, Palumbo, M, Ghisetti, V, Bonora, S, Delle Foglie, P, Rossi, C, Grossi, P, Seminari, E, Poletti, F, Mondino, V, Malena, M, Lattuada, E., Prosperi MC, Ciccozzi M, Fanti I, Saladini F, Pecorari M, Borghi V, Di Giambenedetto S, Bruzzone B, Capetti A, Vivarelli A, Rusconi S, Re MC, Gismondo MR, Sighinolfi L, Gray RR, Salemi M, Zazzi M, De Luca A, ARCA collaborative group., Prosperi, M, Ciccozzi, M, Fanti, I, Saladini, F, Pecorari, M, Borghi, V, Di Giambenedetto, S, Bruzzone, B, Capetti, A, Vivarelli, A, Rusconi, S, Re, M, Gismondo, M, Sighinolfi, L, Gray, R, Salemi, M, Zazzi, M, De Luca, A, and Mancuso, S
Subjects: Genetics and Molecular Biology (all), Male, pol, Theoretical computer science, Inference, Gene Products, pol, General Physics and Astronomy, HIV Infections, Biology, Network topology, Settore MED/17 - MALATTIE INFETTIVE, Biochemistry, Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Physics and Astronomy (all), 0302 clinical medicine, Search algorithm, phylogenetic analysis, virus transmission, Gene Products, Humans, HIV Infection, 030212 general & internal medicine, Phylogeny, 030304 developmental biology, Algorithms, Classification, Female, HIV-1, Biochemistry, Genetics and Molecular Biology (all), Chemistry (all), Genetics, 0303 health sciences, Multidisciplinary, Phylogenetic tree, Node (networking), HIV, General Chemistry, Partition (database), Algorithm, Identification (information), Transmission (telecommunications), METHODOLOGY, Human
Abstract: Understanding the determinants of virus transmission is a fundamental step for effective design of screening and intervention strategies to control viral epidemics. Phylogenetic analysis can be a valid approach for the identification of transmission chains, and very-large data sets can be analysed through parallel computation. Here we propose and validate a new methodology for the partition of large-scale phylogenies and the inference of transmission clusters. This approach, on the basis of a depth-first search algorithm, conjugates the evaluation of node reliability, tree topology and patristic distance analysis. The method has been applied to identify transmission clusters of a phylogeny of 11,541 human immunodeficiency virus-1 subtype B pol gene sequences from a large Italian cohort. Molecular transmission chains were characterized by means of different clinical/demographic factors, such as the interaction between male homosexuals and male heterosexuals. Our method takes an advantage of a flexible notion of transmission cluster and can become a general framework to analyse other epidemics. © 2011 Macmillan Publishers Limited. All rights reserved.
Published: 2011
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23. Detection of drug resistance mutations at low plasma HIV-1 RNA load in a European multicentre cohort study

Author: Prosperi, Mc1, Mackie, N, Di Giambenedetto, S, Zazzi, M, Camacho, R, Fanti, I, Torti, C, Sönnerborg, A, Kaiser, R, Codoñer, Fm, Van Laethem, K, Bansi, L, van de Vijver DA, Geretti, Am, De Luca, A, Giacometti A, SEHERE c. o. n. s. o. r. t. i. u. m., Butini, L, del Gobbo, R, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Carla Re, M, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, d'Arminio Monforte, A, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Bello, Fd, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Dionisio, D, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, Fadda, G, Vullo, Vincenzo, Turriziani, O, Montano, M, Cenderello, G, Gonnelli, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, Pd, Rossi, C, Grossi, P, Seminari, E, Poletti, F, Mondino, V, Malena, M, Lattuada, E, Lengauer, T, Däumer, M, Hoffmann, D, Schülter, E, Müller, C, Oette, M, Reuter, S, Esser, S, Fätkenheuer, G, Rockstroh, J, Incardona, F, Rosen Zvi, M, Clotet, B, Thalme, A, Svedhem, V, Bratt, G, Gargiulo, F, Lapadula, G, Manca, N, Paraninfo, G, Quiros Roldan, E, Carosi, G, Castelnuovo, F, Vandamme, Am, Van Wijngaerden, E, Ainsworth, J, Anderson, J, Babiker, A, Dunn, D, Easterbrook, P, Fisher, M, Gazzard, B, Garrett, N, Gilson, R, Gompels, M, Hill, T, Johnson, M, Leen, C, Orkin, C, Phillips, A, Pillay, D, Porter, K, Post, F, Sabin, C, Sadiq, T, Schwenk, A, Walsh, J, Delpech, V, Palfreeman, A, Glabay, A, Lynch, J, Hand, J, de Souza, C, Perry, N, Tilbury, S, Churchill, D, Nelson, M, Waxman, M, Mandalia, S, Kall, M, Korat, H, Taylor, C, Ibrahim, F, Campbell, L, James, L, Brima, N, Williams, I, Youle, M, Lampe, F, Smith, C, Grabowska, H, Chaloner, C, Puradiredja, Di, Weber, J, Ramzan, F, Carder, M, Wilson, A, Dooley, D, Asboe, D, Pozniak, A, Cameron, S, Cane, P, Chadwick, D, Clark, D, Collins, S, Lazarus, L, Dolling, D, Fearnhill, E, Castro, H, Coughlin, K, Zuckerman, M, Booth, C, Goldberg, D, Hale, A, Kaye, S, Kellam, P, Leigh Brown, A, Smit, E, Templeton, K, Tilston, P, Tong, W, Zhang, H, Ushiro Lumb, I, Oliver, T, Bibby, D, Mitchell, S, Mbisa, T, Wildfire, A, Tandy, R, Shepherd, J, Maclean, A, Bennett, D, Hopkins, M, Garcia Diaz, A, Kirk, S, Sloot, P. M., Virology, Prosperi, M, Mackie, N, di Giambenedetto, S, Zazzi, M, Camacho, R, Fanti, I, Torti, C, Sönnerborg, A, Kaiser, R, Codoñer, F, van laethem, K, Bansi, L, van de Vijver, D, Geretti, A, de luca, A, and Mancuso, S
Subjects: Male, Drug Resistance, HIV Infections, Drug resistance, Cohort Studies, 0302 clinical medicine, Genotype, HIV Infection, Pharmacology (medical), 030212 general & internal medicine, Viral, 0303 health sciences, Proteolytic enzymes, Genotypic testing, HIV, Viral load, Adult, Anti-HIV Agents, CD4 Lymphocyte Count, Europe, Female, HIV-1, Humans, RNA, Viral, Viral Proteins, Drug Resistance, Viral, Mutation, Missense, Viral Load, Pharmacology, Infectious Diseases, 3. Good health, Cohort, Cohort study, Human, Microbiology (medical), Biology, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Viral Protein, 030306 microbiology, Anti-HIV Agent, Virology, Reverse transcriptase, Regimen, genotypic testing, viral load, Immunology, Mutation, RNA, Missense, Cohort Studie
Abstract: Background and objectives: Guidelines indicate a plasma HIV-1 RNA load of 500-1000 copies/mL as the minimal threshold for antiretroviral drug resistance testing. Resistance testing at lower viral load levels may be useful to guide timely treatment switches, although data on the clinical utility of this remain limited. We report here the influence of viral load levels on the probability of detecting drug resistance mutations (DRMs) and other mutations by routine genotypic testing in a large multicentre European cohort, with a focus on tests performed at a viral load
Published: 2011

24. Treatment of chronic hepatitis B: recommendations from an Italian workshop

Author: Carosi, G., Rizzetto, M., Andreone, P., Angelico, M., Ascione, A., Caporaso, N., Fagiuolim, S., Fattovich, G., Mondelli, M., Niro, G. A., Pontisso, P., Bonino, F., Perno, C. F., Prati, D., Andreoni, M., Angarano, G., Annicchiarico, E., Boncoraglio, R., Brustia, D., Calabrese, N., Carlotto, A., Cavalletto, L., Cavina, M., Chessa, L., Croce, G., De Sanctis, G., Di Candilo, F., Fabris, P., Fracassetti, O., Lanza, A. G., Giuberti, T., Guazzotti, G., Iacovazzi, T., Iovinella, V., Izzi, A., Loperfido, P., Magni, C. F., Marino, N., Messina, V., Michelone, G., Morante, R., Moretti, A., Nasta, P., Nauri, L., Paffetti, A., Pasino, M., Perboni, G., Petrelli, E., Picciotto, A., Pozzi, M., Purificato, F., Re, T., Rinaldi, R., Sani, S., Santoro, R., Schioppa, O., Scotto, G., Siciliano, M., Sorbello, O., Squadrito, G., Taddei, M. T., Traversa, A., Tundo, P., Venezia, G., Vilardo, L., Zignego, A. L., Zoncada, A., and Zuin, M.
Subjects: Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Immune suppressed, Human immunodeficiency virus (HIV), HIV Infections, Disease, Antiviral therapy, medicine.disease_cause, Antiviral Agents, Immunocompromised Host, Hepatitis B, Chronic, Chronic hepatitis, Interferon, HDV, Internal medicine, Drug Resistance, Viral, HBV, medicine, Humans, Hepatitis B Antibodies, Liver histology, Hepatitis B virus, HCV, HIV, Hepatology, business.industry, Gastroenterology, Hepatitis B, medicine.disease, Hepatitis C, Hepatitis D, Italy, Immunology, business, medicine.drug
Abstract: The changing scenario of hepatitis B virus therapy has encouraged the organisation of a workshop, endorsed by three Italian scientific societies, aimed at defining the current recommendations for hepatitis B virus treatment. Liver histology and stage of disease remain fundamental for treatment decisions; interferon and nucleoside/nucleotide analogues-based therapy represent different strategies for different phases of the hepatitis B virus disease. The recommendations defined: new and lower cut-off of hepatitis B virus–DNA for eligibility to therapy according to disease stage, how to optimise the use of nucleoside/nucleotide analogues and to individualise the monitoring of response and what to do with treatment failures. Specific recommendations have also been given for cirrhosis patients, those immune suppressed and co-infected with HIV and other hepatitis viruses. © 2008 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Published: 2008

25. Registered and investigational drugs for the treatment of methicillin-resistant Staphylococcus aureus infection

Author: Angelo Pan, Alessia Zoncada, and Silvia Lorenzotti
Subjects: Penicillin Resistance, Ceftobiprole, Tigecycline, Glycylcycline, medicine.disease_cause, Microbiology, chemistry.chemical_compound, Telavancin, Vancomycin, Drug Discovery, Trimethoprim, Sulfamethoxazole Drug Combination, polycyclic compounds, Medicine, Humans, Pharmacology (medical), business.industry, Clindamycin, Dalbavancin, Tetracycline Resistance, General Medicine, Drugs, Investigational, biochemical phenomena, metabolism, and nutrition, Staphylococcal Infections, bacterial infections and mycoses, Methicillin-resistant Staphylococcus aureus, Infectious Diseases, chemistry, Linezolid, Iclaprim, Drug Therapy, Combination, Methicillin Resistance, Teicoplanin, business, medicine.drug
Abstract: First isolated in the 1960s methicillin-resistant Staphylococcus aureus (MRSA) has become a leading hospital acquired (HA) pathogen, although community acquired isolates (CA-MRSA) are on the rise, particularly in the USA. Treatment of serious MRSA infections has been based for many years upon the use of glycopeptides, i.e. vancomycin and teicoplanin. Other drugs indicated in particular clinical settings, such as prosthetic valve endocarditis or osteomyelitis, are rifampin, gentamycin, fusidic acid, minocycline, co-trimoxazole, clindamycin. Quinolones and doxycycline may be active on some MRSA isolates, and add some this important clinical setting. In the last few years new anti-MRSA drugs have been registered and patented, expanding therapeutic opportunities, i.e. linezolid, the first oxazolidinone, available both as oral and parenteral formulation in being the most widely used new anti-MRSA agent, quinupristin-dalfopristin, daptomycin, a novel lipopeptide, active on germs both in the replicating and in the resting phase, and tigecycline, the first approved glycylcycline. Other drugs from different classes are in the pipeline and will further enhance in the next few years our therapeutic armamentarium: three glycopeptides, i.e. dalbavancin, telavancin, and oritavancin, two broad spectrum cephalosporins, ceftobiprole and ceftaroline, iclaprim, a diaminopyrimidine, as well as a carbapenem, CS- 023/RO-4908463, and adjuvant therapies such as the monoclonal antibody tefibazumab.
Published: 2008

26. Reduction of the risk of cervical intraepithelial neoplasia in HIV-infected women treated with highly active antiretroviral therapy

Author: Emanuele, Soncini, Alessia, Zoncada, Vittorio, Condemi, Anna Degli, Antoni, Elena, Bocchialini, and Paola, Soregotti
Subjects: Adult, Risk Factors, Antiretroviral Therapy, Highly Active, Humans, Uterine Cervical Neoplasms, Female, HIV Infections, Uterine Cervical Dysplasia
Abstract: The purpose of our study was to determine whether highly active antiretroviral therapy (HAART) reduces the onset of cervical intraepithelial neoplasia (CIN) in HIV-positive women.The study was designed to assess CIN incidence in a cohort of 101 HIV-positive women and to evaluate its relationship with ongoing antiretroviral therapy. The patients were screened through a combined Pap smear and colposcopic examination on a yearly basis. If any abnormalities were reported, the patients underwent targeted biopsy with histological confirmation of the diagnosis.During the follow-up period, 38 patients (37.6%) developed histologically verified CIN, including low-grade CIN in seven patients (6.9%) and high-grade CIN in 31 patients (30.4%). Over the study period, 43 patients (42.6%) were treated with HAART for at least 6 months, the average duration of treatment being 37 months. Analysis of HAART efficacy in preventing CIN onset, determined by the Cox regression model with a time-dependent covariate adjusted for the CD4 level at the first visit, showed that HAART significantly reduced the risk of developing CIN (hazard ratio, 0.3; p = 0.004).HIV-positive patients present a high incidence of CIN and of high-grade CIN in particular. HAART exhibits a protective action against the onset of cervical lesions.
Published: 2007

27. [Risk of materno-fetal transmission of the HIV infection with antiretroviral therapy and cesarean section: experience of the Parma group]

Author: G, Magnani, A M, Degli Antoni, G, Cocca, A, Zoncada, E, Cavatorta, A, Grignaffini, C, Verrotti, E, Soncini, A, Pedicelli, S, Fieni, G, Bussolati, L, Gambini, A, Ndongko, G, Bengalia, and I, Dodi
Subjects: Italy, Anti-HIV Agents, Cesarean Section, Pregnancy, Risk Factors, Infant, Newborn, Humans, Female, HIV Infections, Zidovudine, Infectious Disease Transmission, Vertical, Retrospective Studies
Abstract: Vertical transmission of HIV is by far the most important way of infection in pediatric patients. Transmission rate of infection varies between 15-40% in the absence of antiretroviral prophylaxis. Only 2% of infected pregnant women who underwent caesarean section and zidovudine treatment transmitted the infection to their newborns. From January 1995 to September 2000 twenty seropositive pregnant women and their twenty newborns were followed at the Azienda Ospedaliera of Parma. Nine women (45%) were treated with only zidovudine according to the ACTG 076 protocol; eight women (40%) continued the treatment they were assuming before pregnancy with the eventual addition of zidovudine. 3 women (15%) were not treated because HIV infection was only detected after delivery. 15 women underwent caesarean section, in 13 cases in association to antiretroviral prophylaxis: in the remaining 2 cases no intrapartum treatment was started due to the urgency of delivery. The rate of vertical transmission among the 20 women was 5% (1/20), significantly less then that observed (20.5%) among 31 pregnant HIV women followed in Parma from January 1987 to December 1994 and not treated with antiretroviral prophylaxis and/or cesarean section (Magnani G. Personal data). The only infected baby was born by vaginal delivery. No transmission was observed in the group of pregnant women who underwent the combination of antiretroviral prophylaxis and cesarean section.
Published: 2001

28. Chemotherapeutic agents and future fertility

Author: F, Fraschini, F, Zoncada, M, Falchi, G, Gattei, M, Cattaneo, F, Accaria, M, Miraglia, G, Zacharias, and I, Sagome
Subjects: Male, Risk, Fertility, Time Factors, Neoplasms, Antitubercular Agents, Quality of Life, Humans, Antineoplastic Agents, Female, Infertility, Female, Tuberculosis, Pulmonary, Menstrual Cycle
Abstract: The recent progress in antiblastic therapy has achieved significant successes in the treatment of tumors, obtaining in some cases a complete recovery and very frequently a remission of the disease for a considerable number of years. Therefore the clinician has to deal with the problem of long term toxicity which always accompanies these therapies. This aspect was once considered as a secondary feature in respect to the severity of prognosis quod vitam of the subjects affected with cancer, while now, with a significant increase of survival, it is preeminent that there be the possibility to offer these patients an acceptable quality of life under both physical and social profiles. The reintroduction of patients affected with cancer or treated ones into their social and familiar functions must take into account many factors which are bound to the degree of physical integrity, to psychological conditioning and problems of resumption of working activity. Under a strictly social profile it is fundamental to have knowledge of troubles and disturbances that may involve the reproductive sphere.
Published: 1985

29. Distribution of ceftriaxone in the tissues of the female genital system

Author: F, Fraschini, F, Zoncada, F, Scaglione, U, Radaelli, M, Miraglia, P, Valmaggi, M, Falchi, and L, Ripamonti
Subjects: Adult, Adolescent, Ceftriaxone, Humans, Female, Tissue Distribution, Genitalia, Female, Middle Aged, Hysterectomy, Aged
Abstract: Twenty-nine patients, hospitalized in order to undergo gynaecological surgery involving organ removal, were treated with a single intramuscular administration of 1 g ceftriaxone before surgery. The tissue levels of the drug determined in the organs considered: uterus, ovary, fallopian tubes, vagina, proved to be comparable and to guarantee its satisfactory and uniform penetration into the tissues of the female genital system at a slowly decreasing rate. The high levels observed 12 h and 24 h after administration (2.24 +/- 0.74 mcg/g; 3.58 +/- 0.60 mcg/g; 0.70 +/- 0.45 mcg/g; 1.20 +/- 0.57 mcg/g in the ovaries and myometrium respectively) suggest a possible application of ceftriaxone in presurgical prophylaxis also in cases of female genital surgery.
Published: 1987

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1. High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV-infected patients treated in a real-life setting

2. Canakinumab as treatment for COVID-19-related pneumonia: A prospective case-control study

3. Real-life effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients with previous DAA failure

4. Prevalence of acquired resistance mutations in a large cohort of perinatally infected HIV-1 patients

5. Suggestions from Cremona, Italy: 2 months into the pandemic at the frontline of COVID-19 in Europe

6. Pretreatment HIV drug resistance and treatment failure in non-Italian HIV-1-infected patients enrolled in ARCA

7. Evolution of transmitted HIV-1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016

8. Cohort Profile: Standardized Management of Antiretroviral Therapy Cohort (MASTER Cohort)

9. Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

10. Risk of Liver Enzyme Elevation During Treatment With Ritonavir-Boosted Protease Inhibitors Among HIV-Monoinfected and HIV/HCV-Coinfected Patients

11. Declining Prevalence of HIV-1 Drug Resistance in Antiretroviral Treatment-exposed Individuals in Western Europe

12. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

13. Meticillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis

14. Duration of first-line antiretroviral therapy with tenofovir and emtricitabine combined with atazanavir/ritonavir, efavirenz or lopinavir/ritonavir in the Italian ARCA cohort

15. Genotypic resistance profiles associated with virological failure to darunavir-containing regimens: a cross-sectional analysis

16. Low Rate of Virological Failure and Maintenance of Susceptibility to HIV-1 Protease Inhibitors with First-Line Lopinavir/Ritonavir-Based Antiretroviral Treatment in Clinical Practice

17. Antiretroviral treatment in pregnancy: a six-year perspective on recent trends in prescription patterns, viral load suppression, and pregnancy outcomes

18. The role of baseline HIV-1 RNA, drug resistance, and regimen type as determinants of response to first-line antiretroviral therapy

19. Drug-resistance development differs between HIV-1-infected patients failing first-line antiretroviral therapy containing nonnucleoside reverse transcriptase inhibitors with and without thymidine analogues

20. HIV-1 subtype F1 epidemiological networks among Italian heterosexual males are associated with introduction events from South America

21. High burden of transmitted HIV-1 drug resistance in Italian patients carrying F1 subtype

22. A novel methodology for large-scale phylogeny partition

23. Detection of drug resistance mutations at low plasma HIV-1 RNA load in a European multicentre cohort study

24. Treatment of chronic hepatitis B: recommendations from an Italian workshop

25. Registered and investigational drugs for the treatment of methicillin-resistant Staphylococcus aureus infection

26. Reduction of the risk of cervical intraepithelial neoplasia in HIV-infected women treated with highly active antiretroviral therapy

27. [Risk of materno-fetal transmission of the HIV infection with antiretroviral therapy and cesarean section: experience of the Parma group]

28. Chemotherapeutic agents and future fertility

29. Distribution of ceftriaxone in the tissues of the female genital system

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