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1. Metabolic syndrome and body weight in people living with HIV infection: analysis of differences observed in three different cohort studies over a decade

Author

Taramasso L., Bonfanti P., Ricci E., Maggi P., Orofino G., Squillace N., Menzaghi B., Madeddu G., Molteni C., Vichi F., Riguccini E., Saracino A., Santoro C., Guastavigna M., Francisci D., Di Biagio A., De Socio G. V., Sarchi E., Chichino G., Bolla C., Bellacosa C., Angarano G., Calza L., Farinazzo M., Angioni G., Gussio M., Celesia B. M., Falasca K., Mastroianni A., Guadagnino G., Salomoni E., Martinelli C., Dentone C., Bassetti M., Cenderello G., Pellicano G. F., Nunnari G., Valsecchi L., Cordier L., Parisini S., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G. M., Martini S., Cascio A., Trizzino M., Gulminetti R., Nofri M., Cibelli D., Parruti G., Mameli M. S., Taramasso L., Bonfanti P., Ricci E., Maggi P., Orofino G., Squillace N., Menzaghi B., Madeddu G., Molteni C., Vichi F., Riguccini E., Saracino A., Santoro C., Guastavigna M., Francisci D., Di Biagio A., De Socio G.V., Sarchi E., Chichino G., Bolla C., Bellacosa C., Angarano G., Calza L., Farinazzo M., Angioni G., Gussio M., Celesia B.M., Falasca K., Mastroianni A., Guadagnino G., Salomoni E., Martinelli C., Dentone C., Bassetti M., Cenderello G., Pellicano G.F., Nunnari G., Valsecchi L., Cordier L., Parisini S., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G.M., Martini S., Cascio A., Trizzino M., Gulminetti R., Nofri M., Cibelli D., Parruti G., Mameli M.S., Taramasso, L, Bonfanti, P, Ricci, E, Maggi, P, Orofino, G, Squillace, N, Menzaghi, B, Madeddu, G, Molteni, C, Vichi, F, Riguccini, E, Saracino, A, Santoro, C, Guastavigna, M, Francisci, D, Di Biagio, A, De Socio, G, Taramasso, Lucia, Bonfanti, Paolo, Ricci, Elena, Maggi, Paolo, Orofino, Giancarlo, Squillace, Nicola, Menzaghi, Barbara, Madeddu, Giordano, Molteni, Chiara, Vichi, Francesca, Riguccini, Erika, Saracino, Annalisa, Santoro, Carmen, Guastavigna, Marta, Francisci, Daniela, Di Biagio, Antonio, and De Socio, Giuseppe Vittorio

Subjects
Adult, Male, dyslipidaemia, antiretroviral therapy, HIV Infections, Overweight, Logistic regression, Body Mass Index, Cohort Studies, Prevalence, medicine, overweight, Humans, Pharmacology (medical), Metabolic Syndrome, business.industry, Health Policy, Incidence (epidemiology), Body Weight, HIV, weight gain, Odds ratio, Middle Aged, medicine.disease, Confidence interval, metabolic syndrome, Cross-Sectional Studies, Infectious Diseases, Metabolic syndrome, medicine.symptom, business, Weight gain, Demography, Cohort study
Abstract

Objectives: The aim of this study was to assess the incidence of being overweight and metabolic syndrome (MS) among people living with HIV (PHIV) in three different cross-sectional studies conducted over three different periods: 2005, 2011 and 2015. Methods: This was a multi-centre, nationwide study. Data were collected in three studies from the CISAI group - SIMOne, HIV-HY and STOPSHIV - and included a total of 3014 PHIV. Logistic regression [odds ratio (OR), 95% confidence interval (CI)] was used to account for age and gender difference among three groups when comparing MS prevalence and being overweight; potential confounders were accounted for by including them in the regression equation. Results: Overall, the mean age was 46.9±10.2years, and men comprised 73.3% of participants. Comparing 2005, 2011 and 2015, MS was present in 34.5%, 33.0% and 29.3% of PHIV, respectively. Adjusted OR for MS was 0.64 (95% CI: 0.52-0.78) in 2011 and 0.56 (95% CI: 0.46-0.69) in 2015 compared with 2005, while BMI (kg/m2 ) increased from 23.6 in 2005, 24.5 in 2011 and 24.5 in 2015, with a concomitant increase of being overweight from 29.4% to 39.5% to 39.6% (p&nbsp

Published
2021

2. Positioning of darunavir/cobicistat-containing antiretroviral regimens in real life: results from a large multicentre observational prospective cohort (SCOLTA)

Author

Taramasso L., Ricci E., Cascio A., Valsecchi L., Menzaghi B., Squillace N., Maggi P., De Socio G. V., Dentone C., Madeddu G., Pellicano G. F., Calza L., Angioni G., Bonfanti P., Di Biagio A., Sarchi E., Chichino G., Bellacosa C., Angarano G., Farinazzo M., Gussio M., Celesia B. M., Falasca K., Mastroianni A., Guadagnino G., Vichi F., Salomoni E., Martinelli C., Nicolini L., Cenderello G., Molteni C., Nunnari G., Cordier L., Parisini A., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G. M., Martini S., Trizzino M., Gulminetti R., Cibelli D., Parruti G., Mameli M. S., Orofino G., Guastavigna M., Lucia Taramasso, Elena Ricci, Antonio Cascio, Laura Valsecchi, Barbara Menzaghi, Nicola Squillace, Paolo Maggi, Giuseppe Vittorio De Socio, Chiara Dentone, Giordano Madeddu, Giovanni F. Pellicanò, Leonardo Calza, Goffredo Angioni, Paolo Bonfanti, Antonio Di Biagio, CISAI Study Group, Taramasso, L, Ricci, E, Cascio, A, Valsecchi, L, Menzaghi, B, Squillace, N, Maggi, P, De Socio, Gv, Dentone, C, Madeddu, G, Pellicanò, Gf, Calza, L, Angioni, G, Bonfanti, P, Di Biagio, A, Sarchi, E, Chichino, G, Bellacosa, C, Angarano, G, Farinazzo, M, Gussio, M, Celesia, B, Falasca, K, Mastroianni, A, Guadagnino, G, Vichi, F, Salomoni, E, Martinelli, C, Nicolini, L, Cenderello, G, Molteni, C, Pellicanò, G, Nunnari, G, Cordier, L, Parisini, A, Rizzardini, G, Rusconi, S, Conti, F, Bandiera, A, Gori, A, Motta, D, Puoti, M, Migliorino, G, Martini, S, Trizzino, M, Gulminetti, R, De Socio, G, Cibelli, D, Parruti, G, Mameli, M, Orofino, G, Guastavigna, M, Pellicano, G, Bandera, A, Taramasso L., Ricci E., Cascio A., Valsecchi L., Menzaghi B., Squillace N., Maggi P., De Socio G.V., Dentone C., Madeddu G., Pellicano G.F., Calza L., Angioni G., Bonfanti P., Di Biagio A., Sarchi E., Chichino G., Bellacosa C., Angarano G., Farinazzo M., Gussio M., Celesia B.M., Falasca K., Mastroianni A., Guadagnino G., Vichi F., Salomoni E., Martinelli C., Nicolini L., Cenderello G., Molteni C., Nunnari G., Cordier L., Parisini A., Rizzardini G., Rusconi S., Conti F., Bandera A., Gori A., Motta D., Puoti M., Migliorino G.M., Martini S., Trizzino M., Gulminetti R., Cibelli D., Parruti G., Mameli M.S., Orofino G., and Guastavigna M.

Subjects
0301 basic medicine, Male, HIV Infections, 0302 clinical medicine, Dual, Medicine, HIV Infection, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Darunavir, Cobicistat, Middle Aged, Viral Load, Tolerability, Anti-Retroviral Agents, Cohort, Molecular Medicine, Drug Therapy, Combination, Female, Darunavir/cobicistat, Human, medicine.drug, Adverse event, Adult, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, 030106 microbiology, Context (language use), Durability, 03 medical and health sciences, Darunavir/cobicistat, Dual, Durability, Tolerability, CISAI, Adverse events, Virology, Internal medicine, Humans, business.industry, Research, Hypertriglyceridemia, medicine.disease, CISAI, Discontinuation, Prospective Studie, Adverse events, HIV-1, Anti-Retroviral Agent, business, lcsh:RC581-607
Abstract

Background Study aim was to evaluate the safety and durability of darunavir/cobicistat (DRV/c) in a real life setting. Methods Multicentre prospective cohort study performed in the context of SCOLTA (Surveillance Cohort Long-Term Toxicity Antiretrovirals). Patients were evaluated at baseline, week 24 and 48. Changes were evaluated using the paired t test or signed rank test. The multivariable analysis was performed using a general linear model, after ranking of not normally distributed variables. Results A total of 249 patients were included, 72 (29%) were in DRV/c-based dual therapies (DT). Hypercholesterolemia, HC, (total cholesterol (TC) ≥ 200 mg/dL or low density-C (LDL-C) ≥ 130 or statin use) was present in 121 (48.6%) and hypertriglyceridemia, (triglycerides (TG) ≥ 200 mg/dl or fibrate use) in 41 (16.5%) patients. Blood lipid profile did not change significantly in either the global population or patients with HC. After a median observation of 17 months (IQR 13–20), 59 (25.3%) patients discontinued DRV/c, of which 13 were in DT. The durability DT resulted higher than that of triple therapy (log-rank test p = 0.01). Main reasons for stopping DRV/c were simplification (15 patients), adverse events (13 patients), planned discontinuation for treatment initiation with DAA (4 patients), treatment failure (2 patients); death (2 patients), other causes (10 patients). Twenty-six were lost to follow-up. Conclusions DRV/c was safe and well tolerated. Dual therapies showed a better profile of tolerability and a longer durability compared to triple therapies.

Published
2019

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

Author

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

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

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

Published
2017

4. Referral of type 1 diabetic patients to a nephrology unit: Will pre-emptive transplantation change our life?

Author

Gb, Piccoli, Mezza E, Gino M, Grassi G, Soragna G, Fabrizio Fop, Burdese M, Gai M, Motta D, Malfi B, Rossetti M, Dani F, Jeantet A, and Gp, Segoloni

Subjects
Adult, Male, Diabetes Mellitus, Type 1, Adolescent, Humans, Diabetic Nephropathies, Female, Kidney Diseases, Pancreas Transplantation, Middle Aged, Kidney Transplantation, Referral and Consultation, Aged
Abstract

Type 1 diabetic patients are a small but challenging subset of chronic kidney disease. The new frontiers of pancreas-kidney transplantation may enhance the need for early referral.To analyze the referral pattern of type 1 diabetics to a specialized Nephrology Unit, and to quantify the indications for pancreas or pre-emptive pancreas-kidney transplantation at referral in this population.Setting of study was a Nephrology Outpatient Unit, dedicated to diabetics, active since 1986; period of study 1991--2002. The main biochemical and clinical parameters were analyzed at referral. Indications for transplantation were put at: serum creatinine (sCr)or =2 mg/dL oror =3 mg/dL and/or nephrotic syndrome. Pancreas: lesser degrees of functional impairment without worsening after FK-506 challenge.90 type 1 diabetics were referred: 48 males, 42 females; median age: 38 (18-65) years; median diabetological follow-up 20 (3-37) years; sCr 1.2 (0.6-7) mg/dL, proteinuria 0.9 (0-12.3) g/day; creatinine clearance: 58 (6-234) ml/min; Hbalc: 8.8% (5.9-14), diastolic blood pressure: 80 (55-100) mmHg, systolic blood pressure: 137.5 (70-180) mmHg. 85.6% had signs of end-organ damage due to diabetes. 67% of the patients had diabetic nephropathy, 20.7% hypertensive with or without diabetic nephropathy. According to the chosen criteria, 30.6% had indications for pancreas-kidney graft (sCror = 2 mg/dL), 25.9% considering sCror = 3 mg/dL; 28.2% further patients could be considered for isolated pancreas graft.At referral to the nephrologist, over 50% of type 1 diabetics may have indications for pancreas-kidney or pancreas graft; an earlier multidisciplinary work-up is needed to optimize an early pre-emptive transplant approach.

5. Risk factors for community-acquired bacterial meningitis: men who have sex with men (MSM) as a population at risk for meningococcal nasopharyngeal carriage

Author

Annamaria Pazzi, Marco Merli, Carloandrea Orcese, Davide Motta, Maria Cristina Moioli, Marco Cantone, Beniamino Piero Vigo, Giovanna Travi, Massimo Puoti, Roberto Rossotti, Rossotti, R, Merli, M, Cantone, M, Moioli, M, Motta, D, Orcese, C, Pazzi, A, Travi, G, Vigo, B, and Puoti, M

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Population, MEDLINE, Meningitis, Meningococcal, Neisseria meningitidis, Meningococcal disease, medicine.disease_cause, Men who have sex with men, Risk Factors, Internal medicine, Nasopharynx, medicine, Humans, Homosexuality, Homosexuality, Male, education, media_common, education.field_of_study, Meningitis MSM, General Immunology and Microbiology, business.industry, General Medicine, medicine.disease, Community-Acquired Infections, Infectious Diseases, Carrier State, Bacterial meningitis, business, Meningitis
Abstract

To the Editor,A review recently published in this journal described the risk factors for community acquired bacterial meningitis [1]. Concerning meningococcal disease, people with HIV infection in ...

Published
2019

6. Prospective evaluation of bone markers, parathormone and 1,25-(OH)2 vitamin D in HIV-positive patients after the initiation of tenofovir/emtricitabine with atazanavir/ritonavir or efavirenz

Author

Carlo Torti, Maria Carla Re, Ilaria Izzo, Pasquale Narciso, Laura Albini, Emanuele Focà, Laura Sighinolfi, Alessandra Calabresi, Rita Bellagamba, Davide Gibellini, Bruno Mario Cesana, Nigritella Brianese, Davide Motta, Alberto Clò, Daria Gotti, Eugenia Quiros-Roldan, Marco Borderi, Focà E, Motta D, Borderi M, Gotti D, Albini L, Calabresi A, Izzo I, Bellagamba R, Narciso P, Sighinolfi L, Clò A, Gibellini D, Quiros-Roldan E, Brianese N, Cesana BM, Re MC, and Torti C.

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Efavirenz, Anti-HIV Agents, Osteoporosis, Parathyroid hormone, HIV Infections, Emtricitabine, OSTEOPOROSIS, bone, Bone and Bones, Bone remodeling, lcsh:Infectious and parasitic diseases, chemistry.chemical_compound, ANTIRETROVIRAL THERAPY, Internal medicine, Antiretroviral Therapy, Highly Active, BONE TURNOVER, Vitamin D and neurology, Medicine, Humans, lcsh:RC109-216, Prospective Studies, Vitamin D, Prospective cohort study, business.industry, HIV, Middle Aged, medicine.disease, Ergocalciferol, Infectious Diseases, chemistry, Parathyroid Hormone, Immunology, Ergocalciferols, Female, business, Biomarkers, medicine.drug, Research Article
Abstract

Background Increased risk of fractures and osteoporosis have been associated with the use of antiretroviral drugs. There is a paucity of prospective evaluations of bone markers after the initiation of drugs currently recommended to treat HIV infection and results on the evolution of these markers are conflicting. Lastly, the effect of tenofovir on 1,25-(OH)2 vitamin D is uncertain. Methods We performed a prospective study on the evolution of bone markers, parathormone and 1,25-(OH)2 vitamin D before and after standard antiretroviral regimens. This was a sub-study of a trial conducted in antiretroviral-naïve patients randomized to tenofovir + emtricitabine in combination with either atazanavir/ritonavir (ATV/r) or efavirenz (EFV). Follow-up lasted 48 weeks. The following bone markers were analyzed: C-terminal cross-laps (CTx), osteocalcin (OC), osteoprotegerin (OPG), and receptor activator of nuclear factor κB ligand (RANKL). Mixed-factorial analysis of variance with random-coefficient general linear model was used to compare their trends over time and linear multivariable regression was performed with a backward selection method to assess predictors of their variations from baseline to week 48. Trends of parathormone and 1,25-(OH)2 vitamin D were also evaluated. Results Seventy-five patients were studied: 33 received EFV and 42 ATV/r. Significant increases were found for all markers except for RANKL. There was a significant direct association between CTx and OC increases. Multivariable analysis showed that higher glomerular filtration rate (estimated through cystatin C clearance) predicted greater OPG increase, while older age, higher HIV RNA at baseline and use of ATV/r predicted greater CTx increase. A significant increase of parathormone accompanied the evolution of the study markers. 1,25-(OH)2 vitamin D remained stable, though a seasonality variation was demonstrated. Conclusions These data demonstrate CTx increase (bone resorption marker) corresponding to OC increase (bone formation marker) early upon HAART initiation. Moreover, predictors of bone marker increases have been suggested, possibly indicating that a stricter monitoring of bone health and pro-active interventions are needed in older patients, those with higher HIV RNA, prescribed ATV/r rather than EFV, and with decreased renal function at baseline. Further studies are needed to clarify the mechanisms responsible for up-regulation of bone turnover markers, as well as to understand if and what markers are best correlated or predictive of pathological fractures.

Published
2012

7. A randomized, pilot trial to evaluate glomerular filtration rate by creatinine or cystatin C in naïve HIV-infected patients after tenofovir/emtricitabine in combination with atazanavir/ritonavir or efavirenz

Author

Luigi Manili, Paolo Maggi, Rita Bellagamba, Eugenia Quiros-Roldan, Laura Sighinolfi, Laura Albini, Emanuele Focà, Rita Fezza, Davide Motta, Daria Gotti, Pasquale Narciso, Giovanni Guaraldi, Giuseppe Lapadula, Alessandra Calabresi, Ilaria Izzo, Carlo Torti, Bruno Mario Cesana, Albini, L, Cesana, Bm, Motta, D, Focà, E, Gotti, D, Calabresi, A, Izzo, I, Bellagamba, R, Fezza, R, Narciso, P, Sighinolfi, L, Maggi, P, Quiros-Roldan, E, Manili, L, Guaraldi, G, Lapadula, G, Torti, C, Cesana, B, and Foca, E

Subjects
Cyclopropanes, Male, Pyridines, Pyridine, HIV Infections, Pilot Projects, urologic and male genital diseases, Deoxycytidine, chemistry.chemical_compound, Organophosphonate, Emtricitabine, Pharmacology (medical), HIV Infection, Alkyne, HIV, glomerular filtration rate, HAART, creatinine, cystatin C, biology, Cyclopropane, Middle Aged, female genital diseases and pregnancy complications, Infectious Diseases, Alkynes, Creatinine, Oligopeptide, Female, Oligopeptides, medicine.drug, Human, Glomerular Filtration Rate, Benzoxazine, Adult, medicine.medical_specialty, Efavirenz, Anti-HIV Agents, antiretroviral therapy, Atazanavir Sulfate, Urology, Organophosphonates, Renal function, medicine, Humans, Pilot Project, Cystatin C, Tenofovir, Ritonavir, business.industry, Adenine, Anti-HIV Agent, medicine.disease, Atazanavir, Benzoxazines, chemistry, biology.protein, business, Kidney disease
Abstract

Background: Glomerular filtration rate (GFR) estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation based on creatinine or cystatine C may be more accurate methods especially in patients without chronic kidney disease. There is lack of data on GFR estimated by these methods in patients on highly active antiretroviral therapy. Methods: Antiretroviral-naive HIV-infected patients were randomized to tenofovir/emtricitabine in association with atazanavir/ritonavir (ATV/r) or efavirenz (EFV) Patients had to have an actual creatinine clearance >50 mL/minute (24-hour urine collection) and were followed for 48 weeks. RESULTS: Ninety-one patients (48 ATV/r, 43 EFV) were recruited. Using the CKD-EPI creatinine formula, there was a significant decrease in GFR up to week 48 in patients receiving ATV/r (4.9 mL/minute/m, P = 0.02) compared with a not statistically significant increment in patients prescribed EFV. Using the cystatin C-based equation, we found greater decrease in GFR in both arms, although, in the EFV arm, the decrease was not statistically significant (5.8 mL/minute/m, P = 0.92). At multivariable analysis, ATV/r was a significant predictor of greater decrease in estimated glomerular filtration rate (eGFR) (P = 0.0046) only with CKD-EPI creatinine. Conclusions: ATV/r plus tenofovir caused greater GFR decreases compared with EFV. The evaluation of eGFR by cystatin C confirmed this result, but this method seemed to be more stringent, probably precluding the possibility to detect a significant difference in the pattern of eGFR evolution between the two arms over time. More studies are needed to understand the clinical relevance of these alterations and whether cystatin C is a more appropriate method for monitoring GFR in clinical practice.

Published
2012

8. The disagreement among methods to evaluate glomerular filtration rate in HIV-infected patients naive to antiretroviral therapy

Author

Laura Albini, Carlo Torti, Bruno Mario Cesana, Emanuele Focà, Daria Gotti, Giuseppe Lapadula, Davide Motta, Albini, L, Foca, E, Motta, D, Gotti, D, Lapadula, G, Cesana, B, and Torti, C

Subjects
Male, medicine.medical_specialty, Kidney Disease, Immunology, Renal function, Virology, Internal medicine, medicine, Prevalence, Hiv infected patients, HIV Infection, Cystatin C, Proteinuria, biology, business.industry, Risk Factor, Antiretroviral therapy, Infectious Diseases, biology.protein, Female, medicine.symptom, business, Human, Glomerular Filtration Rate
Published
2012

9. Increase in Standard Cholesterol and Large HDL Particle Subclasses in Antiretroviral-Naïve Patients Prescribed Efavirenz Compared to Atazanavir/Ritonavir

Author

Rita Fezza, Daria Gotti, Emanuele Focà, Laura Albini, Ilaria Izzo, Giovanni Guaraldi, Rita Bellagamba, Bruno Mario Cesana, Pasquale Narciso, Carlo Torti, Paolo Maggi, Nigritella Brianese, Eugenia Quiros-Roldan, Davide Motta, Alessandra Calabresi, Laura Sidhinolfi, Gotti, D, Cesana, Bm, Albini, L, Calabresi, A, Izzo, I, Focà, E, Motta, D, Bellagamba, R, Fezza, R, Narciso, P, Sidhinolfi, L, Maggi, P, Brianese, N, Quiros-Roldan, E, Guaraldi, G, and Torti, C

Subjects
Adult, Cyclopropanes, Male, medicine.medical_specialty, Efavirenz, HDL, Anti-HIV Agents, Pyridines, HIV infection, cholesterol, antiretroviral therapy, Atazanavir Sulfate, Hypercholesterolemia, Pharmacology, Emtricitabine, Gastroenterology, chemistry.chemical_compound, immune system diseases, Internal medicine, medicine, Humans, Pharmacology (medical), HDL particle, Atazanavir/ritonavir, Ritonavir, business.industry, Cholesterol, Cholesterol, HDL, virus diseases, Middle Aged, Confidence interval, Benzoxazines, Atazanavir, Infectious Diseases, chemistry, Alkynes, Drug Therapy, Combination, Female, lipids (amino acids, peptides, and proteins), business, Oligopeptides, medicine.drug
Abstract

Cardiovascular risk in HIV-infected patients is related, at least in part, to serum lipid alterations before and after HAART. Lipoprotein-particle subclasses may also have an effect, but comparative data after standard HAART regimens are limited.This was a substudy of a trial in 91 antiretroviral-naïve patients randomized to tenofovir + emtricitabine + atazanavir/ritonavir (ATV/r) or efavirenz (EFV). Over-time trends from baseline to week 48 in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), HDL particles (HDLp), and TC:HDL-C and TG:HDL-C ratios were analyzed by analysis of covariance (ANCOVA). Furthermore, confidence intervals for differences between the 2 groups at week 48 were calculated. Indications for lipid-lowering interventions and low HDL-C were also studied.ANCOVA showed that, with respect to patients receiving ATV/r, those prescribed efavirenz (EFV) had greater increases reported as mean differences in lipid values at week 48: 14 mg/dL (95% CI, 0.2 to 27) for TC, 14 mg/dL (95% CI, 4 to 25) for LDL-C, 5 mg/dL (95% CI, 2 to 9) for HDL-C, and 2.2 mg/dL (95% CI, 0.4 to 4) for large HDLp. Proportions of subjects with indications for lipid-lowering interventions and with HDL-C40 mg/dL did not differ significantly.Patients prescribed EFV had greater increases in TC, LDL-C, and HDL-C. Although no significant differences were detected between the 2 groups for the TC:HDL ratio and for indications to start lipid-lowering interventions, large HDLp increased more in the EFV group compared to the ATV/r group, suggesting a protective effect associated with EFV use.

Published
2012

10. Spondyloepiphyseal dysplasia tarda: description of one case

Author

DI MOTTA, DANIELE, BERGAMASCHI, ROSALBA, CASTIGLIONI, LAURA, MATTEUCCI, CHIARA, Sudanese A, Di Motta D, Sudanese A, Bergamaschi R, Castiglioni L, and Matteucci C

Subjects
musculoskeletal diseases, Adult, Diagnosis, Differential, Male, Radiography, Foot, Humans, Hip Joint, DYSPLASIA, Osteochondrodysplasias, Spine
Abstract

The authors describe the case of an Italian male aged 19 years who came to their observation for severe limping with reduction in hip movement and spondyloepiphyseal radiographic modifications of an osteochondrodysplastic origin. The studies carried out led to a diagnosis of spondyloepiphyseal dysplasia tarda (SEDT).

Published
2006

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