69 results on '"Alessandro Soria"'
Search Results
2. The high volume of patients admitted during the SARS-CoV-2 pandemic has an independent harmful impact on in-hospital mortality from COVID-19.
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Alessandro Soria, Stefania Galimberti, Giuseppe Lapadula, Francesca Visco, Agata Ardini, Maria Grazia Valsecchi, and Paolo Bonfanti
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Medicine ,Science - Abstract
BackgroundDuring the Coronavirus disease 2019 (COVID-19) pandemic, advanced health systems have come under pressure by the unprecedented high volume of patients needing urgent care. The impact on mortality of this "patients' burden" has not been determined.Methods and findingsThrough retrieval of administrative data from a large referral hospital of Northern Italy, we determined Aalen-Johansen cumulative incidence curves to describe the in-hospital mortality, stratified by fixed covariates. Age- and sex-adjusted Cox models were used to quantify the effect on mortality of variables deemed to reflect the stress on the hospital system, namely the time-dependent number of daily admissions and of total hospitalized patients, and the calendar period. Of the 1225 subjects hospitalized for COVID-19 between February 20 and May 13, 283 died (30-day mortality rate 24%) after a median follow-up of 14 days (interquartile range 5-19). Hospitalizations increased progressively until a peak of 465 subjects on March 26, then declined. The risk of death, adjusted for age and sex, increased for a higher number of daily admissions (adjusted hazard ratio [AHR] per an incremental daily admission of 10 patients: 1.13, 95% Confidence Intervals [CI] 1.05-1.22, p = 0.0014), and for a higher total number of hospitalized patients (AHR per an increase of 50 patients in the total number of hospitalized subjects: 1.11, 95%CI 1.04-1.17, p = 0.0004), while was lower for the calendar period after the peak (AHR 0.56, 95%CI 0.43-0.72, pConclusionsThe pressure of a high volume of severely ill patients suffering from COVID-19 has a measurable independent impact on in-hospital mortality.
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- 2021
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3. Correction: Real-life data on potential drug-drug interactions in patients with chronic hepatitis C viral infection undergoing antiviral therapy with interferon-free DAAs in the PITER Cohort Study.
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Loreta A Kondili, Giovanni Battista Gaeta, Donatella Ieluzzi, Anna Linda Zignego, Monica Monti, Andrea Gori, Alessandro Soria, Giovanni Raimondo, Roberto Filomia, Alfredo Di Leo, Andrea Iannone, Marco Massari, Romina Corsini, Roberto Gulminetti, Alberto Gatti Comini, Pierluigi Toniutto, Denis Dissegna, Francesco Paolo Russo, Alberto Zanetto, Maria Grazia Rumi, Giuseppina Brancaccio, Elena Danieli, Maurizia Rossana Brunetto, Liliana Elena Weimer, Maria Giovanna Quaranta, Stefano Vella, and Massimo Puoti
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0172159.].
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- 2018
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4. Real-life data on potential drug-drug interactions in patients with chronic hepatitis C viral infection undergoing antiviral therapy with interferon-free DAAs in the PITER Cohort Study.
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Loreta A Kondili, Giovanni Battista Gaeta, Donatella Ieluzzi, Anna Linda Zignego, Monica Monti, Andrea Gori, Alessandro Soria, Giovanni Raimondo, Roberto Filomia, Alfredo Di Leo, Andrea Iannone, Marco Massari, Romina Corsini, Roberto Gulminetti, Alberto Gatti Comini, Pierluigi Toniutto, Denis Dissegna, Francesco Paolo Russo, Alberto Zanetto, Maria Grazia Rumi, Giuseppina Brancaccio, Elena Danieli, Maurizia Rossana Brunetto, Liliana Elena Weimer, Maria Giovanna Quaranta, Stefano Vella, and Massimo Puoti
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Medicine ,Science - Abstract
BACKGROUND:There are few real-life data on the potential drug-drug interactions (DDIs) between anti-HCV direct-acting antivirals (DAAs) and the comedications used. AIM:To assess the potential DDIs of DAAs in HCV-infected outpatients, according to the severity of liver disease and comedication used in a prospective multicentric study. METHODS:Data from patients in 15 clinical centers who had started a DAA regimen and were receiving comedications during March 2015 to March 2016 were prospectively evaluated. The DDIs for each regimen and comedication were assigned according to HepC Drug Interactions (www.hep-druginteractions.org). RESULTS:Of the 449 patients evaluated, 86 had mild liver disease and 363 had moderate-to-severe disease. The use of a single comedication was more frequent among patients with mild liver disease (p = 0.03), whereas utilization of more than three drugs among those with moderate-to-severe disease (p = 0.05). Of the 142 comedications used in 86 patients with mild disease, 27 (20%) may require dose adjustment/closer monitoring, none was contraindicated. Of the 322 comedications used in 363 patients with moderate-to-severe liver disease, 82 (25%) were classified with potential DDIs that required only monitoring and dose adjustments; 10 (3%) were contraindicated in severe liver disease. In patients with mild liver disease 30% (26/86) used at least one drug with a potential DDI whereas of the 363 patients with moderate-to-severe liver disease, 161 (44%) were at risk for one or more DDI. CONCLUSIONS:Based on these results, we can estimate that 30-44% of patients undergoing DAA and taking comedications are at risk of a clinically significant DDI. This data indicates the need for increased awareness of potential DDI during DAA therapy, especially in patients with moderate-to-severe liver disease. For several drugs, the recommendation related to the DDI changes from "dose adjustment/closer monitoring", in mild to moderate liver disease, to "the use is contraindicated" in severe liver disease.
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- 2017
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5. Risk of Chronic Kidney Disease among Patients Developing Mild Renal Impairment during Tenofovir-Containing Antiretroviral Treatment.
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Giuseppe Lapadula, Davide Paolo Bernasconi, Salvatore Casari, Franco Maggiolo, Roberto Cauda, Massimo Di Pietro, Nicoletta Ladisa, Laura Sighinolfi, Sarah Dal Zoppo, Francesca Sabbatini, Alessandro Soria, Chiara Pezzoli, Annalisa Mondi, Silvia Costarelli, Maria Grazia Valsecchi, Carlo Torti, Andrea Gori, and Italian MASTER cohort
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Medicine ,Science - Abstract
BACKGROUND:Tenofovir (TDF) can cause kidney injury through tubular dysfunction, with or without drop of estimated glomerular filtration rate (eGFR). Whether mild eGFR reductions during treatment should be considered a reason for prompt TDF discontinuation, however, remains unclear. METHODS:Patients with normal pre-TDF eGFR levels, who had developed mild renal impairment (i.e., two consecutive eGFR results between 89-60 ml/min) on TDF, were observed until onset of chronic kidney disease (CKD), defined as two eGFR6 months despite mild renal impairment, current TDF use was not associated with a significantly higher rate of CKD. Other significant predictors of CKD were older age, intravenous drug use, diabetes, hypertension, lower pre-TDF eGFR, higher eGFR drop since TDF introduction and longer exposure to TDF. CONCLUSIONS:Prompt discontinuation of TDF among patients developing mild renal impairment may prevent further progression of renal damage.
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- 2016
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6. Prospective immune dynamics during the first 24 weeks of efavirenz based-antiretroviral therapy in HIV-1-infected subjects, according to CD4+ T-cell counts at presentation: the IMMUNEF clinical trial.
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Alessandro Soria, Daria Trabattoni, Nicola Squillace, Veronica Rainone, Federica Gnudi, Mario Clerici, Andrea Gori, and Alessandra Bandera
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Medicine ,Science - Abstract
Longitudinal characterization of immune recovery in the first-phase of antiretroviral therapy (ART) is poorly described. We compared immune kinetics in individuals who were diagnosed early or late with HIV-1 infection, (thus commencing ART with different CD4+ T-cell counts), in order to investigate possible mechanisms involved in subsequent poor immune recovery.Immunophenotyping, immune activation, proliferation, apoptosis, regulatory T-cells and intracellular cytokine production were compared at baseline and during 24-week follow-up in two groups of HIV-1-infected patients initiating the same ART (tenofovir/emtricitabine/efavirenz) and divided according to baseline CD4+ T-cell counts (late: ≤200/μL; early: >200/μL). Wilcoxon-rank sum test and analysis for repeated measures were used to evaluate differences between groups over time.Twenty-four out of 30 enrolled subjects were evaluable for the analysis, 13 late and 11 early presenters. Significantly lower CD4+ naïve and memory T-cells, and higher plasma viral load, as well as augmented percentages of activated (CD4+/CD25+ cells), apoptotic (CD4+/AnnexinV+/7AAD-, CD4+/caspase 8+ and CD4+/caspase 9+), and proliferating (CD8+/Ki67+ cells) lymphocytes were present at baseline in late presenters; ART resulted in a reduction of apoptotic and proliferating lymphocytes within the follow-up period.A skewing towards memory/activated/apoptotic phenotype is seen in HIV-1-infected subjects starting ART at low CD4+ T-cell counts; ART results in early (24 weeks) trend towards normalization of these parameters. Antiretroviral therapy may play a role in rapidly limiting aberrant immune exhaustion even in late presenters, while requiring more time for re-population of highly depleted naïve T-cells.EU Clinical Trial Register EUDRACT number 2008-006188-35 https://www.clinicaltrialsregister.eu/ctr-search/trial/2008-006188-35/IT.
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- 2015
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7. Imported Ciprofloxacin-Resistant Neisseria meningitidis
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Giuseppe Lapadula, Franco Viganò, Paolo Fortuna, Alberto Dolara, Simone Bramati, Alessandro Soria, Sergio Foresti, and Andrea Gori
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Meningitis ,Neisseria meningitidis ,antimicrobial drug resistance ,fluoroquinolones ,ciprofloxacin ,chemoprophylaxis ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Published
- 2009
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8. Maraviroc as intensification strategy in HIV-1 positive patients with deficient immunological response: an Italian randomized clinical trial.
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Stefano Rusconi, Paola Vitiello, Fulvio Adorni, Elisa Colella, Emanuele Focà, Amedeo Capetti, Paola Meraviglia, Clara Abeli, Stefano Bonora, Marco D'Annunzio, Antonio Di Biagio, Massimo Di Pietro, Luca Butini, Giancarlo Orofino, Manuela Colafigli, Gabriella d'Ettorre, Daniela Francisci, Giustino Parruti, Alessandro Soria, Anna Rita Buonomini, Chiara Tommasi, Silvia Mosti, Francesca Bai, Silvia Di Nardo Stuppino, Manuela Morosi, Marco Montano, Pamela Tau, Esther Merlini, and Giulia Marchetti
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Medicine ,Science - Abstract
BackgroundImmunological non-responders (INRs) lacked CD4 increase despite HIV-viremia suppression on HAART and had an increased risk of disease progression. We assessed immune reconstitution profile upon intensification with maraviroc in INRs.MethodsWe designed a multi-centric, randomized, parallel, open label, phase 4 superiority trial. We enrolled 97 patients on HAART with CD4+ResultsBy W48 both groups displayed a CD4 increase without a significant inter-group difference. A statistically significant change in CD8 favored patients in arm HAART+maraviroc versus HAART at W12 (p=.009) and W48 (p=.025). The CD4>200/µL and CD4>200/µL + CD4 gain ≥ 25% end-points were not satisfied at W12 (p=.24 and p=.619) nor at W48 (p=.076 and p=.236). Patients continuing HAART displayed no major changes in parameters of T-cell homeostasis and activation. Maraviroc-receiving patients experienced a significant rise in circulating IL-7 by W48 (p=.01), and a trend in temporary reduction in activated HLA-DR+CD38+CD4+ by W12 (p=.06) that was not maintained at W48.ConclusionsMaraviroc intensification in INRs did not have a significant advantage in reconstituting CD4 T-cell pool, but did substantially expand CD8. It resulted in a low rate of treatment discontinuations.Trial registrationClinicalTrials.gov NCT00884858 http://clinicaltrials.gov/show/NCT00884858.
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- 2013
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9. 96 Week follow-up of HIV-infected patients in rescue with raltegravir plus optimized backbone regimens: a multicentre Italian experience.
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Amedeo Capetti, Simona Landonio, Paola Meraviglia, Antonio Di Biagio, Sergio Lo Caputo, Gaetana Sterrantino, Adriana Ammassari, Barbara Menzaghi, Marco Franzetti, Giuseppe Vittorio De Socio, Giovanni Pellicanò, Elena Mazzotta, Alessandro Soria, Marianna Meschiari, Michele Trezzi, Lolita Sasset, Benedetto Maurizio Celesia, Patrizia Zucchi, Sara Melzi, Elena Ricci, and Giuliano Rizzardini
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Medicine ,Science - Abstract
BackgroundLong term efficacy of raltegravir (RAL)-including regimens in highly pre-treated HIV-1-infected patients has been demonstrated in registration trials. However, few studies have assessed durability in routine clinical settings.MethodsAntiretroviral treatment-experienced patients initiating a RAL-containing salvage regimen were enrolled. Routine clinical and laboratory follow-up was performed at baseline, week 4, 12, and every 12 weeks thereafter. Data were censored at week 96.ResultsOut of 320 patients enrolled, 292 (91.25%) subjects maintained their initial regimen for 96 weeks; 28 discontinued prematurely for various reasons: death (11), viral failure (8), adverse events (5), loss to follow-up (3), consent withdrawal (1). Eight among these 28 subjects maintained RAL but changed the accompanying drugs. The mean CD4+ T-cell increase at week 96 was 227/mm(3); 273 out of 300 patients (91%), who were still receiving RAL at week 96, achieved viral suppression (HIV-1 RNA 4 (n = 40), CD4+ T-cell gain was similar across strata: +270, +214, +216, and +240 cells/mm(3), respectively, as was the proportion of subjects with undetectable viral load. Laboratory abnormalities (elevation of liver enzymes, total cholesterol and triglycerides) were rare, ranging from 0.9 to 3.1%. The mean 96-week total cholesterol increase was 23.6 mg/dL.ConclusionsIn a routine clinical setting, a RAL-based regimen allowed most patients in salvage therapy to achieve optimal viral suppression for at least 96 weeks, with relevant immunologic gain and very few adverse events.
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- 2012
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10. KIR-HLA genotypes in HIV-infected patients lacking immunological recovery despite effective antiretroviral therapy.
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Alessandro Soria, Franca Rosa Guerini, Alessandra Bandera, Elisabetta Bolognesi, Alessia Uglietti, Caterina Fusco, Patrizia Zucchi, Renato Maserati, Giuliano Rizzardini, Mario Clerici, and Andrea Gori
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Medicine ,Science - Abstract
BACKGROUND: In HIV-infected individuals, mechanisms underlying unsatisfactory immune recovery during effective combination antiretroviral therapy (cART) have yet to be fully understood. We investigated whether polymorphism of genes encoding immune-regulating molecules, such as killer immunoglobulin-like receptors (KIR) and their ligands class I human leukocyte antigen (HLA), could influence immunological response to cART. METHODS: KIR and HLA frequencies were analyzed in 154 HIV-infected and cART-treated patients with undetectable viral load divided into two groups: 'immunological non responders' (INR, N = 50, CD4(+) T-cell count 350/mm(3)). Molecular KIR were typed using polymerase chain reaction-based genotyping. Comparisons were adjusted for baseline patient characteristics. RESULTS: The frequency of KIR2DL3 allele was significantly higher in FR than in INR (83.7% vs. 62%, P = 0.005). The functional compound genotype HLA-C1(+)/KIR2DL3(+), even at multivariable analysis, when adjusted for nadir CD4(+) T-cell count, was associated with reduced risk of INR status: odds ratio (95% Confidence Intervals) 0.34 (0.13-0.88), P = 0.03. CONCLUSIONS: Reduced presence of the inhibitory KIR2DL3 genotype detected in INR might provoke an imbalance in NK function, possibly leading to increased immune activation, impaired killing of latently infected cells, and higher proviral burden. These factors would hinder full immune recovery during therapy.
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- 2011
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11. CD4+ T cell depletion, immune activation and increased production of regulatory T cells in the thymus of HIV-infected individuals.
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Alessandra Bandera, Giulio Ferrario, Marina Saresella, Ivana Marventano, Alessandro Soria, Fabio Zanini, Francesca Sabbatini, Monica Airoldi, Giulia Marchetti, Fabio Franzetti, Daria Trabattoni, Mario Clerici, and Andrea Gori
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Medicine ,Science - Abstract
Mechanisms by which HIV affects the thymus are multiple and only partially known, and the role of thymic dysfunction in HIV/AIDS immunopathogenesis remains poorly understood. To evaluate the effects of HIV infection on intra-thymic precursors of T cells in HIV-infected adults, we conducted a detailed immunophenotypic study of thymic tissue isolated from 7 HIV-infected and 10 HIV-negative adults who were to undergo heart surgery. We found that thymuses of HIV-infected individuals were characterized by a relative depletion of CD4+ single positive T cells and a corresponding enrichment of CD8+ single positive T cells. In addition, thymocytes derived from HIV-infected subjects showed increased levels of activated and proliferating cells. Our analysis also revealed a decreased expression of interleukin-7 receptor in early thymocytes from HIV-infected individuals, along with an increase in this same expression in mature double- and single-positive cells. Frequency of regulatory T cells (CD25+FoxP3+) was significantly increased in HIV-infected thymuses, particularly in priorly-committed CD4 single positive cells. Our data suggest that HIV infection is associated with a complex set of changes in the immunophenotype of thymocytes, including a reduction of intrathymic CD4+ T cell precursors, increased expression of activation markers, changes in the expression pattern of IL-7R and enrichment of T regulatory cells generation.
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- 2010
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12. HPV 16 and 18 contribute to development of anal dysplasia in HIV infection irrespective of gender and sexual orientation
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Paolo Bonfanti, Francesca Sabbatini, Alessandro Soria, Nicola Squillace, Elisa Colella, Andrea Marco Tamburini, Adriana Di Lucia, Marco Braga, Giuseppe Lapadula, Davide Paolo Bernasconi, Biagio Eugenio Leone, Marianna Rossi, Annalisa Cavallero, Sergio Malandrin, Ambrogio Brenna, Squillace, N, Bernasconi, D, Lapadula, G, Soria, A, Sabbatini, F, Colella, E, Rossi, M, Tamburini, A, Leone, B, Brenna, A, Malandrin, S, Cavallero, A, Di Lucia, A, Braga, M, and Bonfanti, P
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Male ,HPV ,medicine.medical_specialty ,Genotype ,Sexual Behavior ,Anal Canal ,HIV Infections ,Lower risk ,Logistic regression ,anal cytologic abnormalitie ,Men who have sex with men ,Sexual and Gender Minorities ,Risk Factors ,Interquartile range ,Internal medicine ,Prevalence ,medicine ,Humans ,Pharmacology (medical) ,Homosexuality, Male ,Papillomaviridae ,Human papillomavirus 16 ,business.industry ,Health Policy ,Papillomavirus Infections ,HPV infection ,HIV ,virus diseases ,Anal dysplasia ,Odds ratio ,medicine.disease ,Confidence interval ,HPV 16 and 18 ,Infectious Diseases ,Female ,business - Abstract
Objectives: The aim of the present study was too investigate prevalence and persistence of human papilloma virus (HPV) and cytological abnormalities (CAs) in the anal swabs of people living with HIV (PLWH): men who have sex with men (MSM), men who have sex with women (MSW) and women (W). Methods: Between March 2010 and January 2019, an anal swab for cytological and HPV genotyping tests was offered to all PLWH attending our clinic. Logistic regression analysis was conducted to identify predictors of infection. Results: In all, 354 PLWH were screened: 174 MSM, 90 MSW and 61 W. Prevalence of at least one high-risk (HR) HPV was higher in MSM (91%) and W (85%) than in MSW (77%) (P < 0.05). Cytological abnormalities were found in 21.1% of the entire population. At multivariable regression analysis a lower risk for HPV infection was found for W than for MSM [odds ratio = 0.24 (95% confidence interval: 0.115–0.513)] and for MSW than for MSM [0.37 (0.180–0.773)] and there was a significantly higher risk of CAs in PLWH with HPV 16 and 18 [3.3 (1.04–10.49)]. A total of 175 PLWH (103 MSM, 33 MSW and 26 W) had at least one follow-up visit (T1) after a median (interquartile range) follow-up of 3.6 (2.1–5.7) years. The acquisition rate of HR-HPV was high, with 66.7% of PLWH negative for HR-HPV at T0 who became positive at T1 (P < 0.001). The prevalence of CAs was stable (20.6%). A significant association between CAs at T1 and persistence of HPV-16 and/or 18 was found (P < 0.05). Conclusions: HPV 16 and 18 are associated with the presence and development of CAs irrespective of sexual orientation.
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- 2021
13. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study
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Gianpaolo Lorini, Roberta D'Ambrosio, Monia Mendeni, Angelo Pan, Valentina Zuccaro, Canio Carriero, Massimo Colombo, Gianpiero Aimo, Natalia Terreni, Barbara Menzaghi, Massimo Memoli, Alessandro Soria, Aldo Autolitano, Elisabetta Degasperi, Serena Pelusi, M. Puoti, Luca Valenti, Cristiana Bianco, Ombretta Spinelli, Elisabetta Buscarini, Antonella d'Arminio Monforte, Sara Gritti, Paolo Del Poggio, Alessia Giorgini, Tiziana Quirino, T. Re, Marie Graciella Pigozzi, Maria Grazia Rumi, Maria Chiara Colombo, Giuliana Cologni, Daniele Prati, Angiola Spinetti, Stefano Fagiuoli, Mauro Viganò, Isabella Carderi, Luisa Pasulo, Pietro Lampertico, Alessio Aghemo, Paolo Bonfanti, C. Iegri, Valenti, L, Pelusi, S, Aghemo, A, Gritti, S, Pasulo, L, Bianco, C, Iegri, C, Cologni, G, Degasperi, E, D'Ambrosio, R, del Poggio, P, Soria, A, Puoti, M, Carderi, I, Pigozzi, M, Carriero, C, Spinetti, A, Zuccaro, V, Memoli, M, Giorgini, A, Vigano, M, Rumi, M, Re, T, Spinelli, O, Colombo, M, Quirino, T, Menzaghi, B, Lorini, G, Pan, A, D'Arminio Monforte, A, Buscarini, E, Autolitano, A, Bonfanti, P, Terreni, N, Aimo, G, Mendeni, M, Prati, D, Lampertico, P, and Fagiuoli, S
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Liver Cirrhosis ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Sustained Virologic Response ,Chronic liver disease ,Gastroenterology ,Antiviral Agents ,Cohort Studies ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,Medicine ,Humans ,2. Zero hunger ,Hepatology ,business.industry ,Hazard ratio ,Liver Neoplasms ,Odds ratio ,Hepatitis C, Chronic ,medicine.disease ,3. Good health ,Metformin ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,HCV ,030211 gastroenterology & hepatology ,business ,Body mass index ,medicine.drug - Abstract
The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real-life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE-Lombardia registry). In a subset (n=748), liver stiffness measurement (LSM) was available at baseline and follow-up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m2, 1.03-1.09) and diabetes (OR 2.01 [1.65-2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35-0.60]; P 
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- 2021
14. Nonalcoholic fatty liver disease and steatohepatitis in people living with HIV
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Giorgio Bozzi, Alessandro Soria, Andrea Gori, Nicola Squillace, and Alessandra Bandera
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Nonalcoholic steatohepatitis ,medicine.medical_specialty ,Cirrhosis ,Anti-HIV Agents ,Population ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,digestive system ,03 medical and health sciences ,0302 clinical medicine ,Liver steatosis ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Nonalcoholic fatty liver disease ,Prevalence ,medicine ,Humans ,Intensive care medicine ,education ,education.field_of_study ,Hepatology ,business.industry ,Gastroenterology ,nutritional and metabolic diseases ,medicine.disease ,digestive system diseases ,Fatty Liver ,030220 oncology & carcinogenesis ,Disease Progression ,030211 gastroenterology & hepatology ,Steatohepatitis ,business ,Liver cancer - Abstract
Introduction: The burden of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) is increasing worldwide. This phenomenon poses a potentially dangerous risk of rise in mortalities caused by cirrhosis and liver cancer. Owing to a complex combination of factors, NAFLD and NASH arise in a majority of people living with HIV (PLWH), but accurate estimates of prevalence differ, depending on sample selection, type of analysis, and data interpretation. The wide range of diagnostic tools used to assess liver steatosis and lack of control groups in many studies further contributes to current difficulties in properly assessing prevalence of these conditions. Areas covered: Thoroughly scrutinizing the current literature, we compared the prevalence of NAFLD and NASH in PLWH to rates found in the general population. We highlighted strengths and limitations of the studies, in order to determine the effective impact of these medical conditions in PLWH. Expert opinion: The prevalence and progression of NAFLD in human immunodeficiency virus (HIV) infection are reported to be widely variable. HIV infection itself and antiretroviral treatment have been demonstrated to play a role in the development of NAFLD. Larger and more effective studies are needed to evaluate the effects of NASH in PLWH and its progression.
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- 2019
15. Helmet CPAP to treat hypoxic pneumonia outside the ICU: an observational study during the COVID-19 outbreak
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Annalisa Benini, Marco Carbone, Alberto Pesci, Giacomo Mulinacci, Davide Gaudesi, Beatrice Noè, Giuseppe Foti, Paolo Mazzola, Robert Fruscio, Giacomo Bellani, Andrea Coppadoro, Luisa Verga, Giuseppe Bellelli, Eduardo Beck, Riccardo Di Sciacca, Maria Grazia Valsecchi, Giuseppe Citerio, Davide Ippolito, Andrea Biondi, Alessandro Soria, Paolo Bonfanti, Coppadoro, A, Benini, A, Fruscio, R, Verga, L, Mazzola, P, Bellelli, G, Carbone, M, Mulinacci, G, Soria, A, Noè, B, Beck, E, Di Sciacca, R, Ippolito, D, Citerio, G, Valsecchi, M, Biondi, A, Pesci, A, Bonfanti, P, Gaudesi, D, Bellani, G, and Foti, G
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Male ,Coronavirus pneumonia ,medicine.medical_specialty ,Respiratory rate ,medicine.medical_treatment ,Pneumonia, Viral ,Oxygen mask ,Helmet continuous positive airways pressure CPAP ,Critical Care and Intensive Care Medicine ,law.invention ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,law ,Oxygen therapy ,medicine ,Intubation ,Humans ,030212 general & internal medicine ,Continuous positive airway pressure ,Positive end expiratory pressure PEEP ,Hypoxia ,Aged ,Continuous Positive Airway Pressure ,business.industry ,Research ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,Middle Aged ,medicine.disease ,Intensive care unit ,respiratory tract diseases ,Pneumonia ,Intensive Care Units ,Treatment Outcome ,030228 respiratory system ,Respiratory failure ,Emergency medicine ,Feasibility Studies ,Female ,business ,Covid-19 ,Noninvasive ventilation ,circulatory and respiratory physiology - Abstract
Background Respiratory failure due to COVID-19 pneumonia is associated with high mortality and may overwhelm health care systems, due to the surge of patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe gas exchange impairment. Helmet is an effective interface to provide continuous positive airway pressure (CPAP) noninvasively. We report data about the usefulness of helmet CPAP during pandemic, either as treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI). Methods In this observational study we collected data regarding patients failing standard oxygen therapy (i.e., non-rebreathing mask) due to COVID-19 pneumonia treated with a free flow helmet CPAP system. Patients’ data were recorded before, at initiation of CPAP treatment and once a day, thereafter. CPAP failure was defined as a composite outcome of intubation or death. Results A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP treatment was successful in 69% of the full treatment and 28% of the DNI patients (P 2/FiO2 ratio doubled from about 100 to 200 mmHg (P P 2/FiO2 during CPAP, number of comorbidities were independently associated with CPAP failure. Helmet CPAP was maintained for 6 [3–9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wards. Conclusions Helmet CPAP treatment is feasible for several days outside the ICU, despite persistent impairment in gas exchange. It was used, without escalating to intubation, in the majority of full treatment patients after standard oxygen therapy failed. DNI patients could benefit from helmet CPAP as rescue therapy to improve survival. Trial Registration: NCT04424992
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- 2021
16. Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort
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Maria Giovanna Quaranta, Luigina Ferrigno, Xhimi Tata, Franca D'Angelo, Marco Massari, Carmine Coppola, Elisa Biliotti, Alessia Giorgini, Diletta Laccabue, Alessia Ciancio, Pier Luigi Blanc, Marzia Margotti, Donatella Ieluzzi, Maurizia Rossana Brunetto, Francesco Barbaro, Francesco Paolo Russo, Ilaria Beretta, Giulia Morsica, Gabriella Verucchi, Annalisa Saracino, Massimo Galli, Loeta A. Kondili, Cesare Mazzaro, Manuela Bertola, Ornella Schioppa, Antonio Benedetti, Laura Schiadà, Monica Cucco, Andrea Giacometti, Laura Brescini, Sefora Castelletti, Alessandro Fiorentini, Gioacchino Angarano, Michele Milella, Alfredo Di Leo, Maria Rendina, Fulvio Salvatore D'abramo, Chiara Lillo, Andrea Iannone, Mariano Piazzolla, Lorenzo Badia, Fabio Piscaglia, Francesca Benevento, Ilaria Serio, Francesco Castelli, Serena Zaltron, Angiola Spinetti, Silvia Odolini, Raffaele Bruno, Mario Mondelli, Luchino Chessa, Martina Loi, Carlo Torti, Chiara Costa, Maria Mazzitelli, Vincenzo Pisani, Vincenzo Scaglione, Enrico Maria Trecarichi, Anna Linda Zignego, Monica Monti, Francesco Madia, Letizia Attala, Piera Pierotti, Elena Salomoni, Elisa Mariabelli, Teresa Antonia Santantonio, Serena Rita Bruno, Ester Marina Cela, Matteo Bassetti, Giovanni Mazzarello, Anna Ida Alessandrini, Antonio Di Biagio, Laura Ambra Nicolini, Giovanni Raimondo, Roberto Filomia, Alessio Aghemo, Rossella Meli, Adriano Lazzarin, Stefania Salpietro, Anna Ludovica Fracanzani, Erika Fatta, Rosa Lombardi, Pietro Lampertico, Marta Borghi, Roberta D'ambrosio, Elisabetta Degasperi, Massimo Puoti, Chiara Baiguera, Federico D'amico, Maria Vinci, Maria Grazia Rumi, Massimo Zuin, Paola Zermiani, Pietro Andreone, Paolo Caraceni, Valeria Guarneri, Erica Villa, Veronica Bernabucci, Laura Bristot, Maria Luisa Paradiso, Guglielmo Migliorino, Alessandra Gambaro, Giuseppe Lapadula, Anna Spolti, Alessandro Soria, Pietro Invernizzi, Antonio Ciaccio, Martina LucÀ, Federica Malinverno, Laura Ratti, Daniela Caterina Amoruso, Federica Pisano, Ferdinando Scarano, Laura Staiano, Filomena Morisco, Valentina Cossiga, Ivan Gentile, Antonio Riccardo Buonomo, Maria Foggia, Emanuela Zappulo, Alessandro Federico, Marcello Dallio, Nicola Coppola, Caterina Sagnelli, Salvatore Martini, Caterina Monari, Gerardo Nardone, Costantino Sgamato, Liliana Chemello, Luisa Cavalletto, Daniela Sterrantino, Alberto Zanetto, Paola Zanaga, Giuseppina Brancaccio, Antonio Craxì, Salvatore Petta, Vincenza Calvaruso, Luciano Crapanzano, Salvatore Madonia, Marco Cannizzaro, Erica Maria Bruno, Anna Licata, Simona Amodeo, Adele Rosaria Capitano, Carlo Ferrari, Elisa Negri, Alessandra Orlandini, Marco Pesci, Roberto Gulminetti, Layla Pagnucco, Giustino Parruti, Paola Di Stefano, Barbara Coco, Romina Corsini, Elisa Garlassi, Massimo Andreoni, Elisabetta Teti, Carlotta Cerva, Lorenzo Baiocchi, Giuseppe Grassi, Antonio Gasbarrini, Maurizio Pompili, Martina De Siena, Gloria Taliani, Martina Spaziante, Marcello Persico, Mario Masarone, Andrea Aglitti, Gemma Calvanese, Marco Anselmo, Pasqualina De Leo, Monica Marturano, Giorgio Maria Saracco, Quaranta M.G., Ferrigno L., Tata X., D'Angelo F., Massari M., Coppola C., Biliotti E., Giorgini A., Laccabue D., Ciancio A., Blanc P.L., Margotti M., Ieluzzi D., Brunetto M.R., Barbaro F., Russo F.P., Beretta I., Morsica G., Verucchi G., Saracino A., Galli M., Kondili L.A., Mazzaro C., Bertola M., Benedetti A., Schiada L., Cucco M., Giacometti A., Brescini L., Castelletti S., Fiorentini A., Angarano G., Milella M., Leo A.D., Rendina M., Salvatore D'ABRAMO F., Lillo C., Iannone A., Piazzolla M., Badia L., Piscaglia F., Benevento F., Serio I., Castelli F., Zaltron S., Spinetti A., Odolini S., Bruno R., Mondelli M., Chessa L., Loi M., Torti C., Costa C., Mazzitelli M., Pisani V., Scaglione V., Trecarichi E.M., Zignego A.L., Monti M., Madia F., Attala L., Pierotti P., Salomoni E., Mariabelli E., Santantonio T.A., Bruno S.R., Cela E.M., Bassetti M., Mazzarello G., Alessandrini A.I., Biagio A.D., Nicolini L.A., Raimondo G., Filomia R., Aghemo A., Meli R., Lazzarin A., Salpietro S., Fracanzani A.L., Fatta E., Lombardi R., Lampertico P., Borghi M., D'ambrosio R., Degasperi E., Puoti M., Baiguera C., D'AMICO F., Vinci M., Rumi M.G., Zuin M., Zermiani P., Andreone P., Caraceni P., Guarneri V., Villa E., Bernabucci V., Bristot L., Paradiso M.L., Migliorino G., Gambaro A., Lapadula G., Spolti A., Soria A., Invernizzi P., Ciaccio A., LucA M., Malinverno F., Ratti L., Amoruso D.C., Pisano F., Scarano F., Staiano L., Morisco F., Cossiga V., Gentile I., Buonomo A.R., Foggia M., Zappulo E., Federico A., Dallio M., Coppola N., Sagnelli C., Martini S., Monari C., Nardone G., Sgamato C., Chemello L., Cavalletto L., Sterrantino D., Zanetto A., Zanaga P., Brancaccio G., Craxi A., Petta S., Calvaruso V., Crapanzano L., Madonia S., Cannizzaro M., Bruno E.M., Licata A., Amodeo S., Capitano A.R., Ferrari C., Negri E., Orlandini A., Pesci M., Gulminetti R., Pagnucco L., Parruti G., Stefano P.D., Coco B., Corsini R., Garlassi E., Andreoni M., Teti E., Cerva C., Baiocchi L., Grassi G., Gasbarrini A., Pompili M., Siena M.D., Taliani G., Spaziante M., Persico M., Masarone M., Aglitti A., Calvanese G., Anselmo M., Leo P.D., Marturano M., Saracco G.M., Quaranta, M, Ferrigno, L, Tata, X, D'Angelo, F, Massari, M, Coppola, C, Biliotti, E, Giorgini, A, Laccabue, D, Ciancio, A, Blanc, P, Margotti, M, Ieluzzi, D, Brunetto, M, Barbaro, F, Russo, F, Beretta, I, Morsica, G, Verucchi, G, Saracino, A, Galli, M, Kondili, L, Mazzaro, C, Bertola, M, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Fiorentini, A, Angarano, G, Milella, M, Leo, A, Rendina, M, Salvatore D'ABRAMO, F, Lillo, C, Iannone, A, Piazzolla, M, Badia, L, Piscaglia, F, Benevento, F, Serio, I, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Bruno, R, Mondelli, M, Chessa, L, Loi, M, Torti, C, Costa, C, Mazzitelli, M, Pisani, V, Scaglione, V, Trecarichi, E, Zignego, A, Monti, M, Madia, F, Attala, L, Pierotti, P, Salomoni, E, Mariabelli, E, Santantonio, T, Bruno, S, Cela, E, Bassetti, M, Mazzarello, G, Alessandrini, A, Biagio, A, Nicolini, L, Raimondo, G, Filomia, R, Aghemo, A, Meli, R, Lazzarin, A, Salpietro, S, Fracanzani, A, Fatta, E, Lombardi, R, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Puoti, M, Baiguera, C, D'Amico, F, Vinci, M, Rumi, M, Zuin, M, Zermiani, P, Andreone, P, Caraceni, P, Guarneri, V, Villa, E, Bernabucci, V, Bristot, L, Paradiso, M, Migliorino, G, Gambaro, A, Lapadula, G, Spolti, A, Soria, A, Invernizzi, P, Ciaccio, A, Luca, M, Malinverno, F, Ratti, L, Amoruso, D, Pisano, F, Scarano, F, Staiano, L, Morisco, F, Cossiga, V, Gentile, I, Buonomo, A, Foggia, M, Zappulo, E, Federico, A, Dallio, M, Coppola, N, Sagnelli, C, Martini, S, Monari, C, Nardone, G, Sgamato, C, Chemello, L, Cavalletto, L, Sterrantino, D, Zanetto, A, Zanaga, P, Brancaccio, G, Craxi, A, Petta, S, Calvaruso, V, Crapanzano, L, Madonia, S, Cannizzaro, M, Bruno, E, Licata, A, Amodeo, S, Capitano, A, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Gulminetti, R, Pagnucco, L, Parruti, G, Stefano, P, Coco, B, Corsini, R, Garlassi, E, Andreoni, M, Teti, E, Cerva, C, Baiocchi, L, Grassi, G, Gasbarrini, A, Pompili, M, Siena, M, Taliani, G, Spaziante, M, Persico, M, Masarone, M, Aglitti, A, Calvanese, G, Anselmo, M, Leo, P, Marturano, M, Saracco, G, Quaranta, M. G., Ferrigno, L., Tata, X., D'Angelo, F., Massari, M., Coppola, C., Biliotti, E., Giorgini, A., Laccabue, D., Ciancio, A., Blanc, P. L., Margotti, M., Ieluzzi, D., Brunetto, M. R., Barbaro, F., Russo, F. P., Beretta, I., Morsica, G., Verucchi, G., Saracino, A., Galli, M., Kondili, L. A., Mazzaro, C., Bertola, M., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Fiorentini, A., Angarano, G., Milella, M., Leo, A. D., Rendina, M., Salvatore D'ABRAMO, F., Lillo, C., Iannone, A., Piazzolla, M., Badia, L., Piscaglia, F., Benevento, F., Serio, I., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Bruno, R., Mondelli, M., Chessa, L., Loi, M., Torti, C., Costa, C., Mazzitelli, M., Pisani, V., Scaglione, V., Trecarichi, E. M., Zignego, A. L., Monti, M., Madia, F., Attala, L., Pierotti, P., Salomoni, E., Mariabelli, E., Santantonio, T. A., Bruno, S. R., Cela, E. M., Bassetti, M., Mazzarello, G., Alessandrini, A. I., Biagio, A. D., Nicolini, L. A., Raimondo, G., Filomia, R., Aghemo, A., Meli, R., Lazzarin, A., Salpietro, S., Fracanzani, A. L., Fatta, E., Lombardi, R., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Puoti, M., Baiguera, C., D'Amico, F., Vinci, M., Rumi, M. G., Zuin, M., Zermiani, P., Andreone, P., Caraceni, P., Guarneri, V., Villa, E., Bernabucci, V., Bristot, L., Paradiso, M. L., Migliorino, G., Gambaro, A., Lapadula, G., Spolti, A., Soria, A., Invernizzi, P., Ciaccio, A., Luca, M., Malinverno, F., Ratti, L., Amoruso, D. C., Pisano, F., Scarano, F., Staiano, L., Morisco, F., Cossiga, V., Gentile, I., Buonomo, A. R., Foggia, M., Zappulo, E., Federico, A., Dallio, M., Coppola, N., Sagnelli, C., Martini, S., Monari, C., Nardone, G., Sgamato, C., Chemello, L., Cavalletto, L., Sterrantino, D., Zanetto, A., Zanaga, P., Brancaccio, G., Craxi, A., Petta, S., Calvaruso, V., Crapanzano, L., Madonia, S., Cannizzaro, M., Bruno, E. M., Licata, A., Amodeo, S., Capitano, A. R., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Gulminetti, R., Pagnucco, L., Parruti, G., Stefano, P. D., Coco, B., Corsini, R., Garlassi, E., Andreoni, M., Teti, E., Cerva, C., Baiocchi, L., Grassi, G., Gasbarrini, A., Pompili, M., Siena, M. D., Taliani, G., Spaziante, M., Persico, M., Masarone, M., Aglitti, A., Calvanese, G., Anselmo, M., Leo, P. D., Marturano, M., and Saracco, G. M.
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Male ,HCV genotypes ,Ethnic group ,Linked-to-care patient ,Comorbidity ,Hepacivirus ,Logistic regression ,medicine.disease_cause ,Comorbidities ,Direct acting antivirals ,HCV Cohort ,Linked-to-care patients ,Aged ,Antiviral Agents ,Coinfection ,Female ,Hepatitis C, Chronic ,Humans ,Italy ,Middle Aged ,Transients and Migrants ,0302 clinical medicine ,Medicine ,Chronic ,Gastroenterology ,virus diseases ,Hepatitis C ,Life evaluation ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Comorbiditie ,Human ,Hepatitis C virus ,Settore MED/12 - GASTROENTEROLOGIA ,03 medical and health sciences ,Disease severity ,Antiviral Agent ,Hepaciviru ,Hepatology ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,digestive system diseases ,Direct acting antiviral ,business ,Demography - Abstract
Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively. Conclusion: Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted.
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- 2021
17. Beware of biases in observational studies on anti-spike monoclonal antibodies
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Alessandro Soria, Davide Paolo Bernasconi, Maria Grazia Valsecchi, Giuseppe Lapadula, Paolo Bonfanti, Lapadula, G, Bernasconi, D, Soria, A, Valsecchi, M, and Bonfanti, P
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Microbiology (medical) ,Infectious Diseases ,Coronavirus disease 2019 (COVID-19) ,business.industry ,medicine.drug_class ,Immunology ,MEDLINE ,Medicine ,COVID-19 ,Spike (software development) ,Observational study ,business ,Monoclonal antibody - Published
- 2021
18. The high volume of patients admitted during the SARS-CoV-2 pandemic has an independent harmful impact on in-hospital mortality from COVID-19
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Agata Ardini, Paolo Bonfanti, F Visco, Alessandro Soria, Giuseppe Lapadula, Maria Grazia Valsecchi, Stefania Galimberti, Soria, A, Galimberti, S, Lapadula, G, Visco, F, Ardini, A, Valsecchi, M, and Bonfanti, P
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Male ,Viral Diseases ,Epidemiology ,Medical Conditions ,Interquartile range ,Risk Factors ,Medicine and Health Sciences ,Cumulative incidence ,Hospital Mortality ,Multidisciplinary ,Mortality rate ,Hazard ratio ,Middle Aged ,Hospitals ,Hospitalization ,Intensive Care Units ,Infectious Diseases ,Italy ,Research Design ,Medicine ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Census ,Death Rates ,Science ,Research and Analysis Methods ,Age Distribution ,Population Metrics ,medicine ,Humans ,Pandemics ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Survey Research ,Population Biology ,Proportional hazards model ,business.industry ,SARS-CoV-2 ,Biology and Life Sciences ,COVID-19 ,Retrospective cohort study ,Covid 19 ,Confidence interval ,Health Care ,Health Care Facilities ,Medical Risk Factors ,Emergency medicine ,business - Abstract
Background During the Coronavirus disease 2019 (COVID-19) pandemic, advanced health systems have come under pressure by the unprecedented high volume of patients needing urgent care. The impact on mortality of this “patients’ burden” has not been determined. Methods and findings Through retrieval of administrative data from a large referral hospital of Northern Italy, we determined Aalen-Johansen cumulative incidence curves to describe the in-hospital mortality, stratified by fixed covariates. Age- and sex-adjusted Cox models were used to quantify the effect on mortality of variables deemed to reflect the stress on the hospital system, namely the time-dependent number of daily admissions and of total hospitalized patients, and the calendar period. Of the 1225 subjects hospitalized for COVID-19 between February 20 and May 13, 283 died (30-day mortality rate 24%) after a median follow-up of 14 days (interquartile range 5–19). Hospitalizations increased progressively until a peak of 465 subjects on March 26, then declined. The risk of death, adjusted for age and sex, increased for a higher number of daily admissions (adjusted hazard ratio [AHR] per an incremental daily admission of 10 patients: 1.13, 95% Confidence Intervals [CI] 1.05–1.22, p = 0.0014), and for a higher total number of hospitalized patients (AHR per an increase of 50 patients in the total number of hospitalized subjects: 1.11, 95%CI 1.04–1.17, p = 0.0004), while was lower for the calendar period after the peak (AHR 0.56, 95%CI 0.43–0.72, p Conclusions The pressure of a high volume of severely ill patients suffering from COVID-19 has a measurable independent impact on in-hospital mortality.
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- 2021
19. COVID-19 Mortality and Stress to the Hospital System From High Patient Load
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Paolo Bonfanti, Alessandro Soria, Giuseppe Lapadula, Soria, A, Lapadula, G, and Bonfanti, P
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,COVID-19 ,Hospitals ,Hospitalization ,Hospital system ,Patient Load ,Emergency medicine ,Internal Medicine ,Humans ,Medicine ,business - Published
- 2021
20. High rates of 30-day mortality in patients with cirrhosis and COVID-19
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Stefano Fagiuoli, Michela Triolo, Massimo Iavarone, Paolo Bonfanti, Alessandro Soria, Sara Massironi, Roberta D'Ambrosio, Nicola Pugliese, Martina Lucà, Elisabetta Buscarini, Canio Carriero, Giovanni Perricone, Maria Grazia Rumi, Paolo Poggio, Pietro Invernizzi, Angiola Spinetti, Alessandro Rimondi, Luca S. Belli, Marianna Pedaci, Mauro Viganò, Pietro Lampertico, Alessio Aghemo, Iavarone, M, D'Ambrosio, R, Soria, A, Triolo, M, Pugliese, N, Del Poggio, P, Perricone, G, Massironi, S, Spinetti, A, Buscarini, E, Viganò, M, Carriero, C, Fagiuoli, S, Aghemo, A, Belli, L, Lucà, M, Pedaci, M, Rimondi, A, Rumi, M, Invernizzi, P, Bonfanti, P, and Lampertico, P
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Liver Cirrhosis ,Male ,0301 basic medicine ,Cirrhosis ,medicine.medical_treatment ,Comorbidity ,Liver transplantation ,Liver disease ,COVID-19 Testing ,0302 clinical medicine ,Liver Function Tests ,Risk Factors ,HBV ,hepatitis ,COVID-19, coronavirus disease-2019 ,medicine.diagnostic_test ,liver transplantation ,Mortality rate ,hepatocellular carcinoma ,EPV, events per predictor variable ,Italy ,SARS-CoV-2, severe acute respiratory syndrome-associated coronavirus 2 ,Ang, angiotensin ,HCV ,Female ,030211 gastroenterology & hepatology ,INR, International normalized ratio ,Coronavirus Infections ,medicine.medical_specialty ,Pneumonia, Viral ,Hepatiti ,Antiviral Agents ,Article ,Betacoronavirus ,03 medical and health sciences ,ACE2, Angiotensin-converting enzyme 2 ,PT, prothrombin time ,Internal medicine ,medicine ,Humans ,Mortality ,Risk factor ,Pandemics ,Aged ,Retrospective Studies ,Hepatitis ,Hepatology ,Clinical Laboratory Techniques ,business.industry ,SARS-CoV-2 ,COVID-19 ,medicine.disease ,030104 developmental biology ,Liver function ,business ,Liver function tests - Abstract
Background and aims Coronavirus disease (COVID-19) is a major worldwide threat for healthy individuals as well as for patients with comorbidities, but its impact on patients with cirrhosis is currently unknown. This study aimed at evaluating the impact of COVID-19 on the clinical outcome of these patients. Methods In this multicenter retrospective study, cirrhotic patients with confirmed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were enrolled between 1st and 31th March 2020. Clinical and biochemical data at COVID-19 and at the last outpatient visit were obtained through review of medical records. Results Fifty cirrhotic patients with confirmed SARS-CoV-2 infection were enrolled (age 67 years, 70% men, 38% virus-related, 52% previously compensated cirrhosis). At diagnosis, 64% of patients presented fever, 42% shortness of breath/polypnea, 22% encephalopathy, 96% needed hospitalization or prolonged an ongoing one. Respiratory-support was necessary in 71%, 52% received antivirals, 80% heparin. Serum albumin significantly decreased, while bilirubin, creatinine and prothrombin time significantly increased at COVID-19 diagnosis compared to last available data. The proportion of patients with MELD≥15 increased from 13% to 26% (p=0.037), acute-on-chronic liver failure and and de novo acute liver injury occurred in 14 (28%) and 10 patients, respectively. Seventeen patients died after a median of 10 (4-13) days from COVID-19 diagnosis, with a 30-day-mortality rate of 34%. Severity of lung and liver (according to CLIF-C, CLIF-OF and MELD scores) diseases independently predicted mortality. Mortality was significantly higher in hospitalized cirrhotics with COVID-19 than in those hospitalized for bacterial infections. Conclusion COVID-19 is associated with liver function deterioration and elevated mortality in cirrhotic patients., Graphical abstract, Highlights − Fifty cirrhotic patients with SARS-CoV-2 infection were studied: 64% presented with fever, 42% shortness of breath/polypnea, 22% encephalopathy; respiratory-support was necessary in 71%. − The 30-day mortality was 34% (95% CI 23-49), higher in those patients with moderate/severe respiratory failure and in those who had a more deteriorated liver function, as indicated by the increased MELD and CLIF-OF scores at COVID-19 diagnosis. − The 30-days mortality rate was higher in cirrhotics with COVID-19 than in cirrhotics with bacterial infection and in COVID-19 patients without cirrhosis − No major adverse events related to the thromboprophylaxis with heparin given to 80% of patients and treatments used to tackle the coronavirus infection.
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- 2020
21. Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study
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Michela Di Pierro, Paola Faverio, Giacomo Bellani, Alessandro Soria, Dario Winterton, Maria Grazia Valsecchi, Annalisa Benini, Laura Antolini, Grazia Messinesi, Giuseppe Foti, S. Mori, Ernesto Contro, Matteo Cairo, Paolo Bonfanti, Anna Coppo, Coppo, A, Bellani, G, Winterton, D, Di Pierro, M, Soria, A, Faverio, P, Cairo, M, Mori, S, Messinesi, G, Contro, E, Bonfanti, P, Benini, A, Valsecchi, M, Antolini, L, and Foti, G
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Pulmonary and Respiratory Medicine ,Supine position ,medicine.medical_treatment ,Pneumonia, Viral ,Article ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Intensive care ,Prone Position ,Medicine ,Intubation ,Humans ,030212 general & internal medicine ,Continuous positive airway pressure ,Prospective Studies ,Prospective cohort study ,Pandemics ,Respiratory Distress Syndrome ,acute respiratory failure ,business.industry ,SARS-CoV-2 ,COVID-19 ,prone positioning ,Prone position ,030228 respiratory system ,Respiratory failure ,Anesthesia ,Feasibility Studies ,business ,Coronavirus Infections ,Respiratory Insufficiency ,Cohort study - Abstract
Background: The COVID-19 pandemic is challenging advanced health systems, which are dealing with an overwhelming number of patients in need of intensive care for respiratory failure, often requiring intubation. Prone positioning in intubated patients is known to reduce mortality in moderate-to-severe acute respiratory distress syndrome. We aimed to investigate feasibility and effect on gas exchange of prone positioning in awake, non-intubated patients with COVID-19-related pneumonia. Methods: In this prospective, feasibility, cohort study, patients aged 18–75 years with a confirmed diagnosis of COVID-19-related pneumonia receiving supplemental oxygen or non-invasive continuous positive airway pressure were recruited from San Gerardo Hospital, Monza, Italy. We collected baseline data on demographics, anthropometrics, arterial blood gas, and ventilation parameters. After baseline data collection, patients were helped into the prone position, which was maintained for a minimum duration of 3 h. Clinical data were re-collected 10 min after prone positioning and 1 h after returning to the supine position. The main study outcome was the variation in oxygenation (partial pressure of oxygen [PaO2]/fractional concentration of oxygen in inspired air [FiO2]) between baseline and resupination, as an index of pulmonary recruitment. This study is registered on ClinicalTrials.gov, NCT04365959, and is now complete. Findings: Between March 20 and April 9, 2020, we enrolled 56 patients, of whom 44 (79%) were male; the mean age was 57·4 years (SD 7·4) and the mean BMI was 27·5 kg/m2 (3·7). Prone positioning was feasible (ie, maintained for at least 3 h) in 47 patients (83·9% [95% CI 71·7 to 92·4]). Oxygenation substantially improved from supine to prone positioning (PaO2/FiO2 ratio 180·5 mm Hg [SD 76·6] in supine position vs 285·5 mm Hg [112·9] in prone position; p
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- 2020
22. Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort
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Sergio Lazzaroni, Paolo Grossi, Chiara Molteni, Maria Grazia Valsecchi, Pietro Lampertico, Luca Valenti, Alessio Aghemo, Alessia Giorgini, Antonella d'Arminio Monforte, Roberta D'Ambrosio, Federico Gatti, Omar Giglio, Daniele Bella, Davide Paolo Bernasconi, Giuseppe Lapadula, Sherrie Bhoori, Hamid Hasson, Monica Schiavini, Elisa Colella, Roberto Boldizzoni, A. Ciaccio, Simona Landonio, Andrea Capretti, Maria Cristina Vinci, Giuliano Rizzardini, Barbara Menzaghi, Elisabetta Degasperi, Caterina Uberti-Foppa, Chiara Baiguera, Andrea Lombardi, Gianpiero Aimo, Layla Pagnucco, Paolo Perini, Giuliana Cologni, Natalia Terreni, Paolo Bonfanti, Mauro Viganò, Paolo Viganò, Alessandro Soria, Roberto Rossotti, Massimo Puoti, Ombretta Spinelli, Canio Carriero, Silvia Polo, Guglielmo Marco Migliorino, Silvia Colombo, Riccardo Centenaro, Luisa Pasulo, Anna De Bona, E. Dionigi, Paolo Poggio, Franco Noventa, Isabella Carderi, Angelo Pan, Angiola Spinetti, Mariella Di Marco, Cecilia Liani, Stefano Fagiuoli, Marie Graciella Pigozzi, Marco Fava, Massimo Graffeo, Maria Grazia Rumi, Alberto Colombo, Soria, A., Fava, M., Bernasconi, D. P., Lapadula, G., Colella, E., Valsecchi, M. G., Migliorino, G. M., D'Ambrosio, R., Landonio, S., Schiavini, M., Spinetti, A., Carriero, C., Degasperi, E., Cologni, G., Gatti, F., Vigano, P., Hasson, H., Uberti-Foppa, C., Pasulo, L., Baiguera, C., Rossotti, R., Vinci, M., Puoti, M., Giorgini, A., Menzaghi, B., Lombardi, A., Pan, A., Aghemo, A., Grossi, P. A., Boldizzoni, R., Colombo, S., Vigano, M., Rumi, M. G., Del Poggio, P., Valenti, L., Giglio, O., De Bona, A., d'Arminio Monforte, A., Colombo, A., Spinelli, O., Pigozzi, M. G., Molteni, C., Bonfanti, P., Terreni, N., Perini, P., Capretti, A., Bella, D., Liani, C., Polo, S., Aimo, G., Pagnucco, L., Bhoori, S., Centenaro, R., Graffeo, M., Ciaccio, A., Dionigi, E., Lazzaroni, S., Carderi, I., Di Marco, M., Rizzardini, G., Noventa, F., Lampertico, P., Fagiuoli, S., Soria, A, Fava, M, Bernasconi, D, Lapadula, G, Colella, E, Valsecchi, M, Migliorino, G, D'Ambrosio, R, Landonio, S, Schiavini, M, Spinetti, A, Carriero, C, Degasperi, E, Cologni, G, Gatti, F, Vigano, P, Hasson, H, Uberti-Foppa, C, Pasulo, L, Baiguera, C, Rossotti, R, Vinci, M, Puoti, M, Giorgini, A, Menzaghi, B, Lombardi, A, Pan, A, Aghemo, A, Grossi, P, Boldizzoni, R, Colombo, S, Vigano, M, Rumi, M, Del Poggio, P, Valenti, L, Giglio, O, De Bona, A, d'Arminio Monforte, A, Colombo, A, Spinelli, O, Pigozzi, M, Molteni, C, Bonfanti, P, Terreni, N, Perini, P, Capretti, A, Bella, D, Liani, C, Polo, S, Aimo, G, Pagnucco, L, Bhoori, S, Centenaro, R, Graffeo, M, Ciaccio, A, Dionigi, E, Lazzaroni, S, Carderi, I, Di Marco, M, Rizzardini, G, Noventa, F, Lampertico, P, and Fagiuoli, S
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Male ,medicine.medical_specialty ,Daclatasvir ,Genotype ,Sofosbuvir ,ribavirin ,pibrentasvir ,daclatasvir ,genotype 3 ,glecaprevir ,Hepatitis C ,sofosbuvir ,sustained virological response ,velpatasvir ,Hepacivirus ,Antiviral Agents ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Ribavirin ,medicine ,Humans ,Univariate analysis ,Hepatology ,business.industry ,Glecaprevir ,Hepatitis C, Chronic ,medicine.disease ,Pibrentasvir ,Regimen ,Treatment Outcome ,chemistry ,030220 oncology & carcinogenesis ,Drug Therapy, Combination ,Female ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF+DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF+DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P=.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P=.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P=.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF+DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF+DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <> genotype.
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- 2020
23. Durability of dolutegravir plus boosted darunavir as salvage or simplification of salvage regimens in HIV-1 infected, highly treatment-experienced subjects
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Niccolò Riccardi, Fosca Niero, Maria Vittoria Cossu, Anna Maria Cattelan, Giuseppe Vittorio De Socio, Giorgio Barbarini, Stefano Rusconi, Amedeo Capetti, Giuliano Rizzardini, Gaetana Sterrantino, Benedetto Maurizio Celesia, Gian M Baldin, Giovanni Cenderello, and Alessandro Soria
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Adult ,Male ,0301 basic medicine ,Oncology ,endocrine system ,medicine.medical_specialty ,Pyridones ,030106 microbiology ,Human immunodeficiency virus (HIV) ,Salvage therapy ,HIV Infections ,medicine.disease_cause ,Piperazines ,Treatment experienced ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Oxazines ,Salvage regimen ,medicine ,Humans ,Pharmacology (medical) ,HIV Integrase Inhibitors ,030212 general & internal medicine ,Darunavir ,Aged ,Salvage Therapy ,business.industry ,Reproducibility of Results ,HIV Protease Inhibitors ,Middle Aged ,Infectious Diseases ,Italy ,chemistry ,Dolutegravir ,HIV-1 ,Female ,business ,Heterocyclic Compounds, 3-Ring ,medicine.drug - Abstract
Dolutegravir (DTG) plus boosted darunavir (bDRV) is a compact, adherence-friendly salvage regimen with the highest genetic barrier to HIV-1 resistance.Aim of the present study is to assess the long term (96-week) safety and efficacy of DTG + bDRV in a of multidrug-experienced HIV-1 infected patients, simplifying or building rescue regimens.All HIV-1-infected subjects from eleven Italian centers switched to DTG + bDRV between March 2014 and September 2015 were included and followed for minimum 96 weeks.The cohort comprises 130 subjects, switched from 42 different, complex or at least twice-daily regimens, mainly for simplification (44.6%), viral failure (30.0%) or toxicity (16.6%). At baseline 118 had documented resistance to 1-5 antiretroviral classes and 12 lacked genotypic results either for historical reasons or for problems with primer annealing; 52 (40%) had uncontrolled viral replication, three above 500.000 copies/mL. At week 96 two showed ≥50 HIV-1 RNA copies/mL, 23 had 1-49 copies/mL and 101 had no virus detected. The proportion of subjects presenting abnormal values at baseline significantly decreased for serum glucose, creatinine, AST, total cholesterol and triglycerides.These long-term data confirm the reliability of the two-drug regimen consisting of bDRV plus DTG in salvage settings in HIV-1 infection.
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- 2018
24. Evaluation of adhesion molecules and immune parameters in HIV-infected patients treated with an atazanavir/ritonavir- compared with a lopinavir/ritonavir-based regimen
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Nicola Squillace, Claudio Fenizia, Cristina Giannattasio, Francesca Sabbatini, Alessandro Maloberti, Mario Clerici, Michela Masetti, Andrea Gori, Antonio Muscatello, Alessandra Bandera, Daria Trabattoni, Alessandro Soria, Squillace, N, Trabattoni, D, Muscatello, A, Sabbatini, F, Maloberti, A, Giannattasio, C, Masetti, M, Fenizia, C, Soria, A, Clerici, M, Gori, A, and Bandera, A
- Subjects
CD4-Positive T-Lymphocytes ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Anti-HIV Agents ,T cell ,Atazanavir Sulfate ,Lopinavir/ritonavir ,HIV Infections ,CD8-Positive T-Lymphocytes ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,Lymphocyte Activation ,Carotid Intima-Media Thickness ,Gastroenterology ,Lopinavir ,Random Allocation ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,Antiretroviral Therapy, Highly Active ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,030212 general & internal medicine ,IL-2 receptor ,HIV, adhesion molecule ,Prospective cohort study ,Pharmacology ,Ritonavir ,business.industry ,Endothelial Cells ,virus diseases ,Atherosclerosis ,Atazanavir ,Regimen ,Infectious Diseases ,medicine.anatomical_structure ,Female ,business ,Cell Adhesion Molecules ,Biomarkers ,Follow-Up Studies ,medicine.drug - Abstract
Objectives To evaluate changes in pro-atherosclerotic biomarkers and endothelial function in patients initiating two different PI-based regimens as part of ART. Design Prospective randomized 24 week study. Treatment-naive HIV-infected patients with CD4+ T cell count >250 cells/mm3 started PI-based regimens including atazanavir/ritonavir (Group A) or lopinavir/ritonavir (Group B) and were followed up in an observational follow-up study until week 96. Methods The expression of immune activation and adhesion molecules on CD4+ and CD8+ cells and plasma cytokine levels were assessed at weeks 0, 4, 12, 24, 48, 72 and 96. Flow-mediated dilation (FMD), pulse-wave velocity (PWV) and intima-media thickness (IMT) were measured at weeks 0 and 24. Median changes within (signed rank test) and between (Wilcoxon test) arms were calculated. Results Twenty-seven patients were enrolled, of whom 15 were treated with atazanavir/ritonavir and 12 with lopinavir/ritonavir. After 96 weeks of ART, CD25+/CD8+ T cells and plasma concentration of MCP-1/CCL-2 rose whereas CD44+/CD8+ T cells decreased significantly in both groups. Differences between treatments were noted for HLA-DRII+/CD8+, CD44+/CD4+ and CD11a+/CD4+, with significant increases in Group B versus Group A. No differences between groups regarding IMT, PWV and FMD were found at baseline and week 24. Conclusions ART initiation with PI-based regimens led to a decrease in pro-atherosclerotic biomarkers at week 24, which then rebounded at week 96. Lopinavir/ritonavir treatment resulted in an unfavourable modulation of such markers compared with atazanavir/ritonavir treatment.
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- 2018
25. Maraviroc in addition to cART during primary HIV infection: Results from MAIN randomized clinical trial and 96-weeks follow-up
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Stefania Chiappetta, Cristina Rovelli, Marco Ripa, Manuela Pogliaghi, Silvia Nozza, Alessandro Soria, Giacomo Coppalini, Giuseppe Tambussi, Ripa, Marco, Pogliaghi, Manuela, Chiappetta, Stefania, Nozza, Silvia, Soria, Alessandro, Coppalini, Giacomo, Rovelli, Cristina, and Tambussi, Giuseppe
- Subjects
Male ,0301 basic medicine ,Human immunodeficiency virus (HIV) ,Acute infection ,HIV Infections ,medicine.disease_cause ,Primary HIV infection ,law.invention ,Maraviroc ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,Antiretroviral Therapy, Highly Active ,HIV Infection ,030212 general & internal medicine ,virus diseases ,Middle Aged ,Viral Load ,musculoskeletal system ,Treatment Outcome ,Infectious Diseases ,Anti-Retroviral Agents ,CCR5 Receptor Antagonists ,RNA, Viral ,Female ,Human ,Adult ,Cart ,medicine.medical_specialty ,030106 microbiology ,CCR5 Receptor Antagonist ,Nerve Tissue Proteins ,Follow-Up Studie ,03 medical and health sciences ,Cyclohexane ,Cyclohexanes ,Virology ,Internal medicine ,medicine ,Humans ,business.industry ,HIV ,Triazoles ,CD4 ,CD4 Lymphocyte Count ,Surgery ,Discontinuation ,body regions ,Clinical trial ,chemistry ,Nerve Tissue Protein ,Anti-Retroviral Agent ,Triazole ,business ,human activities ,Follow-Up Studies - Abstract
Background Multi-targeted treatment strategies including maraviroc (MVC) during Primary HIV Infection (PHI) may benefit from the immune-modulatory properties of this CCR5-inhibitor. Objectives We conducted a proof-of-concept clinical trial aimed at assessing whether maraviroc in addition of a combination antiretroviral therapy (cART) initiated during PHI would improve immunological and virological parameters. Study design The MAIN (Maraviroc in HIV Acute INfection) study was a randomized open-label clinical trial (EUDRACT number: 2008-007004-29) which enrolled 29 patients with PHI. Subjects were randomly assigned to receive cART-only (cART), cART + 8 weeks of MVC (ST-MVC) or cART + 48 weeks of MVC (LT-MVC), regardless of predicted co-receptor usage. After 48 weeks patients in ST-MVC and LT-MVC groups discontinued MVC. Patients were evaluated at week 48 and at week 96 of follow-up to assess differences in CD4 T-cell gain and plasma HIV-RNA. Results Twenty-nine patients were enrolled. Seven patients (24%) had a predicted CXCR4 co-receptor usage. At week 48, 27 patients (93.1%) reached HIV-RNA
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- 2016
26. Real-life effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in hepatitis C patients with previous DAA failure
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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.
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- 2019
27. Hepatitis C virus-related factors associated WITH cognitive performance in HIV-HCV-coinfected patients
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Davide Moschese, Manuela Valsecchi, Arianna Emiliozzi, Simona Di Giambenedetto, Andrea De Luca, Alessandra Bandera, Alessandro Soria, Andrea Gori, Massimiliano Fabbiani, Alberto Borghetti, Nicoletta Ciccarelli, Valeria Castelli, and Elisa Colella
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Neurology ,Settore M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA ,Hepatitis C virus ,Integrase inhibitor ,HIV Infections ,Hepacivirus ,Logistic regression ,medicine.disease_cause ,Cognitive impairment ,Liver fibrosis ,HIV ,AIDS ,HCV ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Internal medicine ,medicine ,Humans ,Cognitive Dysfunction ,Effects of sleep deprivation on cognitive performance ,HIV Integrase Inhibitors ,Pathological ,business.industry ,Coinfection ,virus diseases ,Cognition ,Middle Aged ,medicine.disease ,Hepatitis C ,030104 developmental biology ,Cross-Sectional Studies ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The contribution of HCV-related variables to cognitive impairment in HIV-HCV-coinfected patients has been poorly investigated. We selected HIV-HCV-coinfected patients undergoing cognitive examination (exploring memory, language, speed of mental processing and fine motor function) at three clinical centres. Cognitive performance was evaluated using Z-transformed scores. Logistic regression analysis was used to investigate variables associated to cognitive impairment (defined as a composite Z-score ≤ − 1). Overall, 146 HIV-HCV-coinfected patients were enrolled. Median HCV-RNA was 6.2logU/mL. HCV genotype 1a/b was the most represented (53.4%). Liver fibrosis was mild (Fib4 ≤ 1.45) in the majority of patients (44.5%). Global cognitive impairment was diagnosed in 35 (24%) subjects. Exploring each domain, a higher proportion of impairment was observed for memory (37%) followed by speed of mental processing (32.2%), fine motor functioning (24%) and language (18.5%). Among HCV-related variables, the duration of HCV infection was independently associated with global cognitive impairment (aOR 1.13 per +1 year, p = 0.016) and abnormal speed of mental processing (aOR 1.16 per +1 year, p = 0.001), while higher HCV-RNA was independently associated to fine motor functioning impairment (aOR 1.98 per +1log, p = 0.037). HCV genotype, fibrosis stage, transaminases or bilirubin levels were not related to cognitive performance. Of note, integrase inhibitor (InSTI) use was independently associated to a pathological performance in fine motor functioning (aOR 3.34, p = 0.035) and memory (aOR 3.70, p = 0.014). In conclusion, the duration of HCV infection and HCV-RNA load showed an association with cognitive impairment, suggesting a role of hepatitis-related factors in the development of cognitive disorders in HIV-HCV-coinfected patients. The association between InSTI use and altered cognitive performance should prompt investigations about potential neurotoxicity of these drugs.
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- 2019
28. Impact of the M184V Resistance Mutation on Virological Efficacy and Durability of Lamivudine-Based Dual Antiretroviral Regimens as Maintenance Therapy in Individuals With Suppressed HIV-1 RNA: A Cohort Study
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Roberta, Gagliardini, Arturo, Ciccullo, Alberto, Borghetti, Franco, Maggiolo, Dario BartolozziVincenzo Mellace, Amedeo, Capetti, Maria Rita Gismondo, Maria Luisa Biondi, Cristina, Mussini, Monica, Pecorari, Nicola, Gianotti, Daria, Sacchini, Giustino, Parruti, Ennio, Polilli, Franco, Baldelli, Stefania, Zanussi, Alessandro, Nerli, Lucia, Lenzi, Carlo, Calzetti, Angela, Vivarelli, Renato, Maserati, Fausto, Baldanti, Federica, Poletti, Vincenzo, Mondino, Marina, Malena, Antonio, Cascio, Gaetano, Filice, Giacomo, Magnani, Alessandro, Zerbini, Francesca, Lombardi, Simona Di Giambenedetto, Massimo, Andreoni, Marco, Montano, Vullo, Vincenzo, Turriziani, Ombretta, Maurizio, Zazzi, Angela, Gonnelli, Andrea De Luca, Enzo, Boeri, Stefano, Bonora, Valeria, Ghisetti, Daniela, Francisci, Paolo, Grossi, Patrizia, Bagnarelli, Luca, Butini, Romana del Gobbo, Andrea, Giacometti, Danilo, Tacconi, Laura, Monno, Grazia, Punzi, Annapaola, Callegaro, Alessia, Zoncada, Elisabetta, Paolini, Laura, Sighinolfi, Grazia, Colao, Paola, Corsi, Pierluigi, Blanc, Luisa, Galli, Paola, Meraviglia, Andrea, Tosti, Bianca, Bruzzone, Maurizio, Setti, Giovanni, Penco, Antonio Di Biagio, Cesira, Nencioni, Riccardo, Pardelli, Irene, Arcidiacono, Alberto, Degiuli, Michele De Gennaro, Alessandro, Soria, Alfredo, Focà, Latella, Surace, Lucio, Cosco, Sergio, Malandrin, Paola, Milini, Paola, Cicconi, Stefano, Rusconi, and Valeria Micheli, Vanni, Borghi, Anna Paola Callegaro, Francesco, Saladini, and Stefania, Paolucci
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,030106 microbiology ,Integrase inhibitor ,NRTI mutations ,Hiv 1 rna ,03 medical and health sciences ,Dual therapy ,Integrase inhibitors ,Lamivudine ,M184V ,0302 clinical medicine ,Maintenance therapy ,Internal medicine ,medicine ,Major Article ,dual therapy ,integrase inhibitors ,lamivudine ,In patient ,030212 general & internal medicine ,Dual therapy, Integrase inhibitors, Lamivudine, M184V, NRTI mutations ,business.industry ,virus diseases ,Resistance mutation ,Editor's Choice ,Infectious Diseases ,Neurology (clinical) ,business ,Cohort study ,medicine.drug - Abstract
Background Dual therapy (DT) with boosted protease inhibitors (bPIs) plus lamivudine has been shown to be superior to bPI monotherapy in virologically suppressed patients despite previous selection of the lamivudine resistance M184V mutation. We compared the virological efficacy of lamivudine-based DT in patients with and without a history of M184V detection. Methods We retrospectively analyzed patients with HIV-RNA ≤50 copies/mL switching to DT with at least 1 previous resistance genotype in the ARCA database. Time to virological failure (VF; HIV-RNA ≥200 copies/mL or 2 consecutive HIV-RNA >50 copies/mL) and to treatment discontinuation (TD) was analyzed by survival analysis. Results Four hundred thirty-six patients switching to lamivudine plus bPIs (70%) or integrase inhibitors (30%) were included. Patients with M184V (n = 87) were older, had lower nadir CD4+ cell count, longer duration of antiretroviral therapy and of virologic suppression, and higher rate of hepatitis C virus infection compared with patients without M184V. The 3-year probability of remaining free from VF was 91.9% (95% confidence interval [CI], 86.6–97.2) without M184V and 87.8% (95% CI, 78.4–97.2) with M184V (P = .323). The time to TD did not differ between groups. Multivariate analysis adjusting for baseline variables differing between groups also did not detect M184V as being associated with VF or TD; however, the 3-year probability of remaining free of viral blips (isolated HIV-RNA 51–199 copies/mL) was 79.8% (95% CI, 67.8%–91.8%) with M184V vs 90.1% (95% CI, 84.0%–96.2%) without M184V (P = .016). Conclusions Previous selection of M184V did not increase the risk of VF or TD with lamivudine-based DT but was associated with a higher probability of viral blips.
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- 2018
29. Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis
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Giada Carolo, Veronica Bernabucci, Luchino Chessa, Maria Luisa Russo, Giorgio Maria Saracco, Marzia Montalbano, Barbara Menzaghi, Giovanni Di Perri, Adriano Lazzarin, Silvia La Monica, Raffaele Bruno, Gian Ludovico Rapaccini, Mario U. Mondelli, Anna Maria Schimizzi, Caterina Pasquazzi, Maurizia Rossana Brunetto, Antonio Craxì, Filomena Morisco, Carmela Lo Guercio, Vania Giacomet, Alessia Giorgini, Mario Masarone, Francesca Paolo Russo, T. Zolfino, Vincenzo Sangiovanni, Alessia Ciancio, Antonella d'Arminio Monforte, Savino Bruno, E.M. Erne, Antonio Gasbarrini, Francesco Castelli, Sergio Novara, G. Nardone, Andrea De Luca, Claudio Maria Mastroianni, Gioacchino Angarano, Chiara Dentone, Renato Maserati, Anna Maria Piscaglia, Tiziana Quirino, Giuseppe Tarantino, M. Lichtner, Antonio Chirianni, Giuseppina Brancaccio, S. Paganin, Alfredo Alberti, Silvia Corradori, Edoardo G. Giannini, Carlo Torti, Chiara Boarini, Raffaele Cozzolongo, Marco Di Stefano, Alessandro Soria, Paolo Tundi, Giovanni Cassola, Debora Angrisani, Antonio Grieco, Cecilia Pravadelli, Giuliano Rizzardini, Roberto Gulminetti, Vincenzo Messina, Maria Rendina, Massimo Pirisi, Irene Cacciola, Roberto Ganga, Raffaella Lionetti, Paolo Calabrese, Laura Ponti, Filomena Simeone, Maurizio Russello, Monica Monti, Nicola Boffa, Pierluigi Tarquini, Franco Capra, Ivo Avancini, Domenico Sansonno, Stefano Fagiuoli, Michele Barone, Giacomo Vecchiet, Salvatore Rizzo, Carlo Federico Perno, Teresa Santantonio, Pierluigi Toniutto, Massimo Zuin, Nicola Caporaso, Alessandra Orlandini, Grazielle Marie Pigozzi, Martina Felder, Antonio Cristaudo, Roberto Cecere, Massimo Marignani, Vincenza Calvaruso, G. Abbati, Domenico Potenza, Maria Chiara Piras, Mario Rizzetto, Serena Cima, Marco delle Monache, Alessio Aghemo, D. Ieluzzi, Guglielmo Borgia, Giampaolo Corti, Paolo Poggio, Manuela Merli, Elena Danieli, Andrea Giacometti, Massimo Andreoni, Antonino Picciotto, Mario Angelico, Benedetta Canovari, Sara Piovesan, Anna Linda Zignego, Antonio Benedetti, Emanuele Durante, Erica Villa, Marcello Persico, Antonio Patrizio Termite, Barbara Coco, Maria Vinci, Lucio Boglione, Cristina Rossi, Paolo Angeli, Massimo Memoli, Maria Teresa Giordani, Massimo De Luca, Luisa Pasulo, Vincenzo Vullo, Mario Melazzini, Attilio Solinas, Pietro Gatti, Michele Guerra, Silvia Martini, Antonio Ascione, Massimo Puoti, Roberto Cauda, Giovanna Onnelli, Silvia Magnani, Salvatore Madonna, Giovanni Raimondo, Marco Tabone, Gloria Taliani, Dante Romagnoli, Aldo Marrone, Umberto Vespasiani Gentilucci, Luca Miele, Marcello Tavio, Andrea Antinori, Giampiero D'Offizi, Mirella Onofrio, Valentina Iodice, Lucio Cosco, Guido Piai, Luca Pani, Francesca Ceccherini Silberstein, Simona Montilla, Marco Lenzi, Luca Fontanella, Alessandro Federico, Carlo Ferrari, Giustino Parruti, Antonio Di Biagio, Gabriella Verucchi, Fabio Marsetti, Michele Milella, Maria Grazia Rumi, Antonio Izzi, Marco Marzioni, Francesca Donato, Vanni Borghi, Mariano Quartini, Massimo Colombo, Michele Imparato, Giovanni Battista Gaeta, P.L. Blanc, Alfredo Di Leo, Nicola Coppola, Alessandro Chiodera, Ivana Maida, Davide Campagnolo, Cinzia Antonini, Antonietta Romano, A. Gianstefani, Katia Falasca, Massimo Levrero, Gaetano Serviddio, Maria Paola Trotta, Olivia Morelli, Salvatore Petta, Elisabetta Teti, Maria Rita Parisi, Pietro Andreone, Ascione, Antonio, De Luca, Massimo, Melazzini, Mario, Montilla, Simona, Trotta, Maria Paola, Petta, Salvatore, Puoti, Massimo, Sangiovanni, Vincenzo, Messina, Vincenzo, Bruno, Savino, Izzi, Antonio, Villa, Erica, Aghemo, Alessio, Zignego, Anna Linda, Orlandini, Alessandra, Fontanella, Luca, Gasbarrini, Antonio, Marzioni, Marco, Giannini, Edoardo G., Craxì, Antonio, Abbati, Giuseppe, Alberti, Alfredo, Andreone, Pietro, Andreoni, Massimo, Angeli, Paolo, Angelico, Mario, Angarano, Gioacchino, Angrisani, Debora, Antinori, Andrea, Antonini, Cinzia, Avancini, Ivo, Barone, Michele, Bruno, Raffaele, Benedetti, Antonio, Bernabucci, Veronica, Blanc, Pier, Boarini, Chiara, Boffa, Nicola, Boglione, Lucio, Borghi, Vanni, Borgia, Guglielmo, Brancaccio, Giuseppina, Brunetto, Maurizia, Cacciola, Irene, Calabrese, Paolo, Calvaruso, Vincenza, Campagnolo, Davide, Canovari, Benedetta, Caporaso, Nicola, Capra, Franco, Carolo, Giada, Cassola, Giovanni, Castelli, Francesco, Cauda, Roberto, Silberstein, Francesca Ceccherini, Cecere, Roberto, Chessa, Luchino, Chiodera, Alessandro, Chirianni, Antonio, Ciancio, Alessia, Cima, Serena, Coco, Barbara, Colombo, Massimo, Coppola, Nicola, Corti, Giampaolo, Cosco, Lucio, Corradori, Silvia, Cozzolongo, Raffaele, Cristaudo, Antonio, Danieli, Elena, Monforte, Antonella D’Arminio, Monache, Marco delle, Del Poggio, Paolo, de Luca, Andrea, Dentone, Chiara, Di Biagio, Antonio, Di Leo, Alfredo, Di Perri, Giovanni, Di Stefano, Marco, D’Offizi, Giampiero, Donato, Francesca, Durante, Emanuele, Erne, Elke, Fagiuoli, Stefano, Falasca, Katia, Federico, Alessandro, Felder, Martina, Ferrari, Carlo, Gaeta, Giovanni Battista, Ganga, Roberto, Gatti, Pietro, Giacomet, Vania, Giacometti, Andrea, Gianstefani, Alice, Giordani, Maria, Giorgini, Alessia, Grieco, Antonio, Guerra, Michele, Gulminetti, Roberto, Ieluzzi, Donatella, Imparato, Michele, Iodice, Valentina, La Monica, Silvia, Lazzarin, Adriano, Lenzi, Marco, Levrero, Massimo, Lichtner, Myriam, Lionetti, Raffaella, Guercio, Carmela Lo, Madonna, Salvatore, Magnani, Silvia, Maida, Ivana, Marignani, Massimo, Marrone, Aldo, Marsetti, Fabio, Martini, Silvia, Masarone, Mario, Maserati, Renato, Mastroianni, Claudio Maria, Memoli, Massimo, Menzaghi, Barbara, Merli, Manuela, Miele, Luca, Milella, Michele, Mondelli, Mario, Montalbano, Marzia, Monti, Monica, Morelli, Olivia, Morisco, Filomena, Nardone, Gaetano, Novara, Sergio, Onnelli, Giovanna, Onofrio, Mirella, Paganin, Simona, Pani, Luca, Parisi, Maria Rita, Parruti, Giustino, Pasquazzi, Caterina, Pasulo, Luisa, Perno, Carlo Federico, Persico, Marcello, Piai, Guido, Picciotto, Antonino, Pigozzi, Grazielle Marie, Piovesan, Sara, Piras, Maria Chiara, Pirisi, Massimo, Piscaglia, Anna Maria, Ponti, Laura, Potenza, Domenico, Pravadelli, Cecilia, Quartini, Mariano, Quirino, Tiziana, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Rendina, Maria, Rizzardini, Giuliano, Rizzetto, Mario, Rizzo, Salvatore, Romagnoli, Dante, Romano, Antonietta, Rossi, Cristina, Rumi, Maria Grazia, Russello, Maurizio, Russo, Francesca Paolo, Russo, Maria Luisa, Sansonno, Domenico Ettore, Santantonio, Teresa Antonia, Saracco, Giorgio, Schimizzi, Anna Maria, Serviddio, Gaetano, Simeone, Filomena, Solinas, Attilio, Soria, Alessandro, Tabone, Marco, Taliani, Gloria, Tarantino, Giuseppe, Tarquini, Pierluigi, Tavio, Marcello, Termite, Antonio, Teti, Elisabetta, Toniutto, Pierluigi, Torti, Carlo, Tundi, Paolo, Vecchiet, Giacomo, Verucchi, Gabriella, Gentilucci, Umberto Vespasiani, Vinci, Maria, Vullo, Vincenzo, Zolfino, Teresa, Zuin, Massimo, Ascione, A, De Luca, M, Melazzini, M, Montilla, S, Trotta, M, Petta, S, Puoti, M, Sangiovanni, V, Messina, V, Bruno, S, Izzi, A, Villa, E, Aghemo, A, Zignego, A, Orlandini, A, Fontanella, L, Gasbarrini, A, Marzioni, M, Giannini, E, Craxi, A, Abbati, G, Alberti, A, Andreone, P, Andreoni, M, Angeli, P, Angelico, M, Angarano, G, Angrisani, D, Antinori, A, Antonini, C, Avancini, I, Barone, M, Bruno, R, Benedetti, A, Bernabucci, V, Blanc, P, Boarini, C, Boffa, N, Boglione, L, Borghi, V, Borgia, G, Brancaccio, G, Brunetto, M, Cacciola, I, Calabrese, P, Calvaruso, V, Campagnolo, D, Canovari, B, Caporaso, N, Capra, F, Carolo, G, Cassola, G, Castelli, F, Cauda, R, Silberstein, F, Cecere, R, Chessa, L, Chiodera, A, Chirianni, A, Ciancio, A, Cima, S, Coco, B, Colombo, M, Coppola, N, Corti, G, Cosco, L, Corradori, S, Cozzolongo, R, Cristaudo, A, Danieli, E, Monforte, A, Monache, M, Del Poggio, P, de Luca, A, Dentone, C, Di Biagio, A, Di Leo, A, Di Perri, G, Di Stefano, M, D'Offizi, G, Donato, F, Durante, E, Erne, E, Fagiuoli, S, Falasca, K, Federico, A, Felder, M, Ferrari, C, Gaeta, G, Ganga, R, Gatti, P, Giacomet, V, Giacometti, A, Gianstefani, A, Giordani, M, Giorgini, A, Grieco, A, Guerra, M, Gulminetti, R, Ieluzzi, D, Imparato, M, Iodice, V, La Monica, S, Lazzarin, A, Lenzi, M, Levrero, M, Lichtner, M, Lionetti, R, Guercio, C, Madonna, S, Magnani, S, Maida, I, Marignani, M, Marrone, A, Marsetti, F, Martini, S, Masarone, M, Maserati, R, Mastroianni, C, Memoli, M, Menzaghi, B, Merli, M, Miele, L, Milella, M, Mondelli, M, Montalbano, M, Monti, M, Morelli, O, Morisco, F, Nardone, G, Novara, S, Onnelli, G, Onofrio, M, Paganin, S, Pani, L, Parisi, M, Parruti, G, Pasquazzi, C, Pasulo, L, Perno, C, Persico, M, Piai, G, Picciotto, A, Pigozzi, G, Piovesan, S, Piras, M, Pirisi, M, Piscaglia, A, Ponti, L, Potenza, D, Pravadelli, C, Quartini, M, Quirino, T, Raimondo, G, Rapaccini, G, Rendina, M, Rizzardini, G, Rizzetto, M, Rizzo, S, Romagnoli, D, Romano, A, Rossi, C, Rumi, M, Russello, M, Russo, F, Russo, M, Sansonno, D, Santantonio, T, Saracco, G, Schimizzi, A, Serviddio, G, Simeone, F, Solinas, A, Soria, A, Tabone, M, Taliani, G, Tarantino, G, Tarquini, P, Tavio, M, Termite, A, Teti, E, Toniutto, P, Torti, C, Tundi, P, Vecchiet, G, Verucchi, G, Gentilucci, U, Vinci, M, Vullo, V, Zolfino, T, and Zuin, M
- Subjects
Cyclopropanes ,Liver Cirrhosis ,Male ,Cirrhosis ,Dasabuvir ,Elderly ,Ombitasvir ,Paritaprevir ,Aged ,80 and over ,Anilides ,Antiviral Agents ,Biomarkers ,Carbamates ,Female ,Hepacivirus ,Hepatitis C ,Chronic ,Humans ,Macrocyclic Compounds ,Ribavirin ,Ritonavir ,Sulfonamides ,Treatment Outcome ,Uracil ,Drug Therapy ,Combination ,Genotype ,Cirrhosis, Dasabuvir, Elderly, Ombitasvir, Paritaprevir, Microbiology (medical), Infectious Diseases ,Aged, 80 and over ,Hepatitis C, Chronic ,Drug Therapy, Combination ,Microbiology (medical) ,Infectious Diseases ,Gastroenterology ,chemistry.chemical_compound ,0302 clinical medicine ,2-Naphthylamine ,Medicine ,030212 general & internal medicine ,Valine ,General Medicine ,030211 gastroenterology & hepatology ,Macrocyclic Compound ,medicine.drug ,Human ,medicine.medical_specialty ,Proline ,Lactams, Macrocyclic ,Settore MED/12 - GASTROENTEROLOGIA ,Liver Cirrhosi ,Sulfonamide ,03 medical and health sciences ,Internal medicine ,Decompensation ,Hepatitis ,Antiviral Agent ,Cirrhosi ,Hepaciviru ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Anilide ,Biomarker ,medicine.disease ,chemistry ,Carbamate ,business - Abstract
Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100mg) and twice-daily dasabuvir (250mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter defined as HCV RNA negative 12weeks after the end of treatment (SVR12). Results: Patients who suffered any adverse event (AE) were 74/240 (30.8%); 13/240 (5.4%) discontinued the treatment. A multivariate analysis found albumin < 3.5g/dL (OR 2.04: 95% CI 1.0–4.2, p < 0.05) and hypertension (OR 4.6: 95% CI 2.3–9.2, p < 0.001) as variables independently associated with AE occurrence. The SVR12 was 95% (228/240). Multivariate analysis identified baseline bilirubin < 2mg/dL (OR 4.9: 95% CI 1.17–20.71, p = 0.029) as the only variable independently associated with SVR12. Conclusion: Our findings suggest that OBV/PTV/r + DSV + RBV is safe and effective in real-life use in patients with compensated cirrhosis, HCV-GT1 infection, and age over 65.
- Published
- 2018
30. THU-141-Efficacy and safety of elbasvir/grazoprevir in a large real-life cohort of HCV-infected patients
- Author
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Alberto Colombo, Sandro Panese, Mauro Viganò, Simona Landonio, Agostino Colli, Barbara Menzaghi, Caterina Uberti-Foppa, Veronica Paon, Paolo Sacchi, Maria Cristina Rossi, Francesca Cattelan, Andrea Capretti, Maria Cristina Vinci, Luisa Pasulo, Valter Vincenzi, S. Lobello, Giada Carolo, Liliana Chemello, Ombretta Spinelli, Roberta D'Ambrosio, Monia Mendeni, Franco Capra, Alessandro Soria, Roberta Soffredini, Maurizio Carrara, M. Colpani, Massimo Puoti, Giancarlo Spinzi, Alfredo Alberti, Pietro Lampertico, Luisa Cavalletto, Angiola Spinetti, Elisabetta Degasperi, Massimo Zuin, Alessio Aghemo, Laura Comi, Giovanna Cardaci, Valentina Zuccaro, Massimo Memoli, Paolo Poggio, Angelo Pan, Vinicio Manfrin, Alessia Giorgini, Marie Graciella Pigozzi, Serena Zaltron, Francesco Castelli, Franco Noventa, Paolo Grossi, Monica Schiavini, Clara Dibenedetto, Antonella d'Arminio Monforte, Roberto Gulminetti, Elisabetta Buscarini, Piergiorgio Scotton, Stefano Fagiuoli, Martina Gambato, Francesco Russo, Andrea Gori, Paolo Fabris, Caterina Pozzan, and Maria Grazia Rumi
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Cohort ,medicine ,Elbasvir, Grazoprevir ,business - Published
- 2019
31. THU-166-Treatment of 320 genotype 3 cirrhotic patients with 12 weeks of sofosbuvir/velpatasvir with or without ribavirin: Real life experience from Italy
- Author
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Giancarlo Spinzi, Vito Di Marco, Giada Carolo, Caterina Pozzan, Barbara Menzaghi, Giuliana Cologni, Roberta Soffredini, Mauro Viganò, Colombatto Piero, Carlo Magni, Serena Zaltron, Francesco Castelli, Roberta D'Ambrosio, Monia Mendeni, Alfredo Alberti, Paolo Grossi, Massimo Zuin, Maria Grazia Rumi, Veronica Paon, Luisa Pasulo, Alberto Colombo, Pietro Lampertico, Paolo Sacchi, Monica Schiavini, Alessio Aghemo, Andrea Capretti, Maria Cristina Vinci, Valter Vincenzi, Andrea Lombardi, Alessia Giorgini, Lorenzo Difrancesco, Maria Antonietta Di Rosolini, Piergiorgio Scotton, Francesco Russo, Antonio Albanese, Sandro Panese, Andrea Gori, Franco Noventa, Stefano Fagiuoli, F. Cartabellotta, Agostino Colli, Martina Gambato, Caterina Uberti-Foppa, Angelo Pan, Luisa Cavalletto, Clara Dibenedetto, Antonio Di Giacomo, Franco Capra, Angiola Spinetti, S. Lobello, M. Colpani, Ombretta Spinelli, Vinicio Manfrin, Liliana Chemello, Roberto Gulminetti, Alessandro Soria, Irene Cacciola, Maurizia Rossana Brunetto, Vincenza Calvaruso, Antonella d'Arminio Monforte, Massimo Memoli, Elisabetta Buscarini, Alessia Ciancio, and Massimo Puoti
- Subjects
medicine.medical_specialty ,chemistry.chemical_compound ,Hepatology ,chemistry ,business.industry ,Internal medicine ,Ribavirin ,Genotype ,medicine ,business ,Gastroenterology ,Sofosbuvir/velpatasvir - Published
- 2019
32. Treatment of 320 genotype 3 cirrhotic patients with 12 weeks Sofosbuvir/Velpatasvir with or without ribavirin: real life experience from Italy
- Author
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Alessia Ciancio, Angelo Pan, Pietro Lampertico, F. Cartabellotta, Barbara Menzaghi, Alessio Aghemo, S. Lo Bello, Roberta Soffredini, Roberta D'Ambrosio, Monia Mendeni, Roberto Gulminetti, Caterina Pozzan, Piergiorgio Scotton, Mauro Viganò, Sandro Panese, Francesco Russo, Maurizio Carrara, Veronica Paon, Ombretta Spinelli, P. Colombatto, Maurizia Rossana Brunetto, Stefano Fagiuoli, F. Di Lorenzo, Valter Vincenzi, Agostino Colli, Andrea Gori, Martina Gambato, Franco Noventa, Serena Zaltron, Paolo Sacchi, Francesco Castelli, Massimo Zuin, Caterina Uberti-Foppa, Claudio Rossi, Luisa Pasulo, G. Cologni, A. Albanese, V. Di Marco, Andrea Capretti, Maria Cristina Vinci, Giada Carolo, Elisabetta Buscarini, Maria Grazia Rumi, Monica Schiavini, Alessia Giorgini, Alberto Colombo, Andrea Lombardi, P. Del Poggio, Franco Capra, M. Colpani, Liliana Chemello, Carlo Magni, M.A. Di Rosolini, Luisa Cavalletto, Vinicio Manfrin, Alfredo Alberti, A d'Arminio Monforte, A. Digiacomo, Paolo Grossi, Angiola Spinetti, Giancarlo Spinzi, Paolo Fabris, Clara Dibenedetto, Massimo Memoli, Alessandro Soria, Irene Cacciola, Massimo Puoti, Vincenza Calvaruso, and G. Cardaci
- Subjects
chemistry.chemical_compound ,medicine.medical_specialty ,Hepatology ,chemistry ,business.industry ,Ribavirin ,Internal medicine ,Genotype ,Gastroenterology ,medicine ,business ,Sofosbuvir/velpatasvir - Published
- 2019
33. Efficacy and safety of Elbasvir/Grazoprevir in a large real-life cohort of HCV-infected patients
- Author
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Paolo Grossi, Sandro Panese, G. Cardaci, Barbara Menzaghi, Piergiorgio Scotton, Simona Landonio, Agostino Colli, Massimo Zuin, Caterina Uberti-Foppa, Francesco Russo, M. Colpani, Mauro Viganò, Alessia Giorgini, Maria Cristina Rossi, Elisabetta Degasperi, Serena Zaltron, Francesco Castelli, Massimo Memoli, Andrea Gori, Roberta Soffredini, Franco Noventa, S. Lobello, Ombretta Spinelli, Alessandro Soria, A d'Arminio Monforte, Luisa Pasulo, Vinicio Manfrin, Elisabetta Buscarini, Angelo Pan, Monica Schiavini, Maria Grazia Rumi, P. Del Poggio, Alberto Colombo, Valter Vincenzi, Giancarlo Spinzi, Franco Capra, Massimo Puoti, Roberto Gulminetti, Valentina Zuccaro, Stefano Fagiuoli, Alfredo Alberti, Martina Gambato, Luisa Cavalletto, F. Cattelan, Pietro Lampertico, I. Franceschet, Alessio Aghemo, Marie Graciella Pigozzi, L. Comi, Giada Carolo, Liliana Chemello, Veronica Paon, Paolo Sacchi, Andrea Capretti, Maria Cristina Vinci, Roberta D'Ambrosio, Monia Mendeni, Maurizio Carrara, Paolo Fabris, Angiola Spinetti, and Clara Dibenedetto
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Cohort ,Gastroenterology ,Medicine ,Elbasvir, Grazoprevir ,business - Published
- 2019
34. A dual regimen of ritonavir/darunavir plus dolutegravir for rescue or simplification of rescue therapy: 48 weeks' observational data
- Author
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Niccolò Riccardi, Giovanni Cenderello, Giuseppe Vittorio De Socio, Gaetana Sterrantino, Gianmaria Baldin, Maria Vittoria Cossu, Alessandro Soria, Giancarlo Orofino, Anna Maria Cattelan, Giorgio Barbarini, Giuliano Rizzardini, Fosca Niero, Stefano Rusconi, and Amedeo Capetti
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Anti-HIV Agents ,Pyridones ,Salvage therapy ,HIV Infections ,Piperazines ,Simplification ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Drug Resistance, Viral ,Oxazines ,medicine ,Dual ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Darunavir ,Creatinine ,Ritonavir ,business.industry ,Switch ,Middle Aged ,Viral Load ,030112 virology ,Surgery ,Regimen ,Infectious Diseases ,Treatment Outcome ,chemistry ,Dolutegravir ,Toxicity ,HIV-1 ,Salvage ,Drug Therapy, Combination ,Female ,Lost to Follow-Up ,business ,Viral load ,Heterocyclic Compounds, 3-Ring ,medicine.drug ,Research Article - Abstract
Background Dolutegravir (DTG) plus darunavir/ritonavir (DRV/r) is a simple combination of drugs that has the best genetic barrier to HIV-1 resistance and may be fit for salvage therapy. Methods All HIV-1-infected subjects treated with DTG plus DRV/r between March 2014 and September 2015 in eight Italian centres were included in the analysis. The main metabolic data, efficacy parameters and safety data routinely collected were provided. This observational study is aimed to assess the efficacy of such approach. The primary end-point was the proportion of subjects achieving or maintaining virologic suppression
- Published
- 2017
35. Unexpected viral relapses in hepatitis C virus-infected patients diagnosed with hepatocellular carcinoma during treatment with direct-acting antivirals
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Alessandro Soria, Andrea Gori, Massimiliano Fabbiani, Giuseppe Lapadula, Soria, A, Fabbiani, M, Lapadula, G, and Gori, A
- Subjects
Male ,Carcinoma, Hepatocellular ,Hepatitis C virus ,medicine.disease_cause ,DIRECT ACTING ANTIVIRALS ,Antiviral Agents ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,medicine ,Humans ,Aged ,Antiviral Agent ,Hepatology ,business.industry ,Liver Neoplasms ,Hepatitis C, Chronic ,Middle Aged ,medicine.disease ,Virology ,Liver Neoplasm ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,Female ,business ,Human - Published
- 2017
36. The role of baseline HIV-1 RNA, drug resistance, and regimen type as determinants of response to first-line antiretroviral therapy
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Maurizio Zazzi, PAOLO GROSSI, Fausto Baldanti, Alessandro SORIA, Nicola Gianotti, Manuela Colafigli, Valeria Ghisetti, Laura MONNO, STEFANIA ZANUSSI, Paolo Bonfanti, Irene Schiavetti, Andrea De Luca, Maria Rita Gismondo, Alessio Signori, Elena Seminari, Antonio Di Biagio, and Stefano Rusconi
- Subjects
business.industry ,Integrase inhibitor ,Retrospective cohort study ,Drug resistance ,Virology ,Regimen ,Infectious Diseases ,Cohort ,Clinical endpoint ,Medicine ,business ,Viral load ,Cohort study - 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 load 100,000 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 wGSS
- Published
- 2014
37. Multifactor risk evaluation in patients who have eradicated HCV infection: an interim analysis in the PITER cohort
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Alessandra Orlandini, Vincenza Calvaruso, Valentina Cossiga, Monica Monti, D.C. Amoruso, Andrea Iannone, A.R. Buonomo, S. Labanca, Roberta D'Ambrosio, A. Ciaccio, Giuseppina Brancaccio, Mario Masarone, Elisa Biliotti, Alessandro Soria, Chiara Baiguera, Maria Elena Tosti, Roberto Filomia, Barbara Coco, Homie Razavi, F. Baragli, Michele Quaranta, Stefano Rosato, M. Cannizzaro, C. Eleonora, Chris Estes, Marcello Dallio, Luigina Ferrigno, Loreta A. Kondili, M. Loi, V. Guarnieri, A. Ciancio, Maria Cristina Vinci, Romina Corsini, Alberto Zanetto, M. Siciliano, D. Ieluzzi, Alessia Giorgini, Savino Bruno, and L. E. Weimer
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medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Cohort ,Medicine ,In patient ,Interim analysis ,business ,Risk evaluation - Published
- 2018
38. THU-131-Effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir for retreatment of chronic hepatitis C patients with a previous failure to direct-acting antivirals: A real-life study from the NAVIGATORE Lombardia and Veneto Networks
- Author
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Sara Piovesan, Franco Noventa, Pietro Lampertico, Antonio Carlotto, Paolo Bonfanti, Alessio Aghemo, Canio Carriero, Alessandro Soria, Simona Landonio, Pierangelo Rovere, Filippo Viviani, Angiola Spinetti, Alessia Giorgini, Roberta Soffredini, Maurizio Carrara, Alessia Zoncada, Lorenzo Morini, Pietro Pozzoni, Federico Gatti, Giada Carolo, Franco Capra, Elisabetta Degasperi, Pier Giorgio Scotton, Maria Cristina Vinci, Andrea Lombardi, Paolo Angeli, Riccardo Centenaro, Luisa Pasulo, Alfredo Alberti, Franco Maggiolo, Massimo Puoti, Stefano Fagiuoli, Francesco Russo, and Stefania Paolucci
- Subjects
medicine.medical_specialty ,Hepatology ,Chronic hepatitis ,business.industry ,Medicine ,business ,Intensive care medicine ,DIRECT ACTING ANTIVIRALS ,Life study ,Sofosbuvir / velpatasvir / voxilaprevir - Published
- 2019
39. THU-180-Treatment of genotype 3 HCV infection in the large real-life 'Navigatore Lombardia' multicentre cohort: Results from three different regimens
- Author
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Maria Grazia Rumi, Mauro Viganò, Alberto Colombo, Sherrie Bhoori, Antonella d'Arminio Monforte, Riccardo Centenaro, Luisa Pasulo, Sergio Lazzaroni, Alessandro Soria, Andrea Capretti, Maria Cristina Vinci, Pietro Lampertico, Gianpiero Aimo, Chiara Molteni, Andrea Lombardi, Alessio Aghemo, Silvia Polo, Alessia Giorgini, Federico Gatti, Paola Brambilla, Elisabetta Degasperi, E. Dionigi, Anna Spolti, Paolo Bonfanti, Anna De Bona, Luca Valenti, Stefania Salpietro, Marta Borghi, Esther Merlini, Natalia Terreni, Giuliano Rizzardini, Valentina Grasso, Paolo Viganò, Sara Gritti, Paolo Grossi, Roberta D'Ambrosio, Simona Landonio, Alessandra Gambaro, Daniele Bella, Massimo Puoti, Ombretta Spinelli, Caterina Uberti-Foppa, Angelo Pan, Monica Schiavini, Mariella Di Marco, Paolo Poggio, Barbara Menzaghi, Canio Carriero, Hamid Hasson, Elisa Colella, Roberto Boldizzoni, Nunzia Bottalico, Stefano Fagiuoli, Angiola Spinetti, Cecilia Liani, Giuseppe Lapadula, Guido Colloredo Mels, Massimo Graffeo, Franco Noventa, Luciana Scabeni, Roberta Soffredini, Roberto Gulminetti, Marie Graciella Pigozzi, and Isabella Carderi
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Diabetes mellitus ,Cohort ,Genotype ,Medicine ,business ,medicine.disease - Published
- 2019
40. Effectiveness and safety of Sofosbuvir/Velpatasvir/Voxilaprevir for retreatment of chronic hepatitis C patients with a previous failure to direct-acting antivirals: a real-life study from the Navigatore Lombardia and Veneto Networks
- Author
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Pietro Pozzoni, Maria Cristina Vinci, Andrea Lombardi, Pietro Lampertico, Paolo Angeli, Alessio Aghemo, M. Puoti, F. Maggiolo, A. Carlotto, Simona Landonio, Sara Piovesan, Francesca Gatti, P. Scotton, Francesco Russo, Angiola Spinetti, Stefania Paolucci, Giada Carolo, Franco Noventa, Franco Capra, Stefano Fagiuoli, P.A. Rovere, Lorenzo Morini, Alessia Giorgini, P. Bonfanti, C. Carriero, F. Viviani, Elisabetta Degasperi, A. Zoncada, Roberta Soffredini, Riccardo Centenaro, Luisa Pasulo, Alfredo Alberti, Alessandro Soria, and Maurizio Carrara
- Subjects
medicine.medical_specialty ,Hepatology ,Chronic hepatitis ,business.industry ,Gastroenterology ,Medicine ,business ,Intensive care medicine ,Life study ,DIRECT ACTING ANTIVIRALS ,Sofosbuvir / velpatasvir / voxilaprevir - Published
- 2019
41. Neurocognitive Impairment in HIV-Infected Naïve Patients with Advanced Disease: The Role of Virus and Intrathecal Immune Activation
- Author
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Andrea Gori, Benedetta Tagliabue, Alessandra Bandera, Alessandro Soria, Giorgio Annoni, Daria Trabattoni, Monica Airoldi, Veronica Rainone, Giuseppe Lapadula, Beatrice Arosio, Mario Clerici, Airoldi, M, Bandera, A, Trabattoni, D, Tagliabue, B, Arosio, B, Soria, A, Rainone, V, Lapadula, G, Annoni, G, Clerici, M, and Gori, A
- Subjects
lcsh:Immunologic diseases. Allergy ,Adult ,Male ,Chemokine ,AIDS Dementia Complex ,Article Subject ,Anti-HIV Agents ,Immunology ,HIV Infections ,Viremia ,Virus Replication ,Virus ,Proinflammatory cytokine ,Cerebrospinal fluid ,Antiretroviral Therapy, Highly Active ,Humans ,Immunology and Allergy ,Medicine ,Longitudinal Studies ,biology ,business.industry ,General Medicine ,Middle Aged ,Viral Load ,medicine.disease ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Viral replication ,Clinical Study ,HIV-1 ,biology.protein ,Cytokines ,RNA, Viral ,Female ,lcsh:RC581-607 ,Cognition Disorders ,business ,Viral load ,Neurocognitive ,HIV, Neurodegenaration, Inflammatory response - Abstract
Objective.To investigate intrathecal immune activation parameters and HIV-RNA in HIV-associated neurocognitive disorders (HAND) of advanced naïve HIV-infected patients and to evaluate their dynamics before and after initiation of antiretroviral therapy (ART).Methods.Cross-sectional and longitudinal analysis of HIV RNA, proinflammatory cytokines (IL-6, IL-10, INF-γ, TNF-α, TGF-β1, and TGF-β2) and chemokines (MIP-1α, MIP-1β, and MCP-1) in plasma and cerebrospinal fluid (CSF) of HIV-infected patients with CD4 μL.Results.HAND was diagnosed at baseline in 6/12 patients. Baseline CSF HIV-RNA was comparable in patients with or without HAND, whereas CSF concentration of IL-6 and MIP-1β, proinflammatory cytokines, was increased in HAND patients. CSF evaluation at 12 weeks was available in 10/12 cases. ART greatly reduced HIV-RNA in all patients. Nevertheless, IL-6 and MIP-1βremained elevated after 12 weeks of therapy in HAND patients, in whom CSF HIV RNA decay was slower than the plasmatic one as well.Conclusion.Immune activation, as indicated by inflammatory cytokines, but not higher levels of HIV-RNA is observed in advanced naïve HIV-infected patients with HAND. In HAND patients, ART introduction resulted in a less rapid clearance of CSF viremia compared to plasma and no modifications of intratechal immune activation.
- Published
- 2012
42. Reply
- Author
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Giuseppe Lapadula, Alessandro Soria, Massimiliano Fabbiani, and Andrea Gori
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.disease ,Gastroenterology ,Treatment failure ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Hepatocellular carcinoma ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,business - Published
- 2017
43. Real-life effectiveness and safety of Glecaprevir/Pibrentasvir among 723 Italian patients with chronic hepatitis C: The Navigator-II study
- Author
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Clara Dibenedetto, Caterina Uberti-Foppa, Monica Schiavini, P. Del Poggio, Marie Graciella Pigozzi, Paolo Viganò, M.G. Rumi, Riccardo Centenaro, Luisa Pasulo, Marta Borghi, Barbara Menzaghi, Pietro Lampertico, Andrea Capretti, Maria Cristina Vinci, Alessio Aghemo, Carlo Magni, Elisabetta Buscarini, Massimo Zuin, Angelo Pan, A d'Arminio Monforte, Sergio Lazzaroni, Angiola Spinetti, Omar Giglio, Alessia Giorgini, A. Colli, Lorenzo Morini, M. Colpani, Giancarlo Spinzi, Roberta D'Ambrosio, Alessandro Soria, Alberto Colombo, M. Puoti, Ombretta Spinelli, Andrea Gori, Franco Noventa, Stefano Fagiuoli, F. Maggiolo, and Roberta Soffredini
- Subjects
030213 general clinical medicine ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Hepatology ,Chronic hepatitis ,business.industry ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Glecaprevir / pibrentasvir ,business - Published
- 2018
44. Outbreak of acute hepatitis A involving young men in Lombardy Region, Italy: risk factors, clinical and virological characteristics
- Author
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M. Coen, Pietro Lampertico, A. Piscitelli, Manuela Merli, Guido Gubertini, Carloandrea Orcese, Mauro Viganò, Luisa Romanò, Catia Tagliacarne, M. Puoti, Alessandro Soria, C. Oggioni, Roberto Rossotti, Massimo Iavarone, Francesco Castelli, Valeria Castelli, Andrea Gori, M. Gramegna, Danilo Cereda, Maria Grazia Rumi, Cristina Galli, S. Merli, Angiola Spinetti, A. Comelli, and L. Scaramella
- Subjects
Pediatrics ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Outbreak ,business ,Acute hepatitis - Published
- 2018
45. Similar Success Rates but Lower Incidence of Telaprevir-Related Rash in HIV/HCV Coinfected as Compared to HCV-Monoinfected Patients Treated With Triple Anti-HCV Therapy
- Author
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Alessandra Bandera, Nicola Squillace, Antonio Muscatello, Alessandro Soria, Andrea Gori, Sebastiano Leone, Silvia Limonta, Soria, A, Limonta, S, Leone, S, Muscatello, A, Squillace, N, Bandera, A, and Gori, A
- Subjects
Adult ,Male ,medicine.medical_specialty ,HIV Infections ,Infectious Disease ,Antiviral Agents ,Gastroenterology ,Telaprevir ,Retrospective Studie ,Internal medicine ,medicine ,Humans ,HIV Infection ,Pharmacology (medical) ,Retrospective Studies ,Antiviral Agent ,business.industry ,Anti hiv ,Coinfection ,Incidence (epidemiology) ,Incidence ,Medicine (all) ,Retrospective cohort study ,Hepatitis C ,Exanthema ,Middle Aged ,medicine.disease ,Virology ,Rash ,Lower incidence ,Infectious Diseases ,Oligopeptide ,Female ,medicine.symptom ,business ,Oligopeptides ,medicine.drug ,Human - Published
- 2015
46. Predictors of sustained response to therapy resumption after treatment interruption in HIV-infected patients failing antiretroviral therapy
- Author
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Antonella Castagna, Hamid Hasson, Nicola Gianotti, Massimo Cernuschi, Alessandro Soria, Laura Galli, Adriano Lazzarin, Giannotti, N, Soria, A, Galli, L, Castagna, Antonella, Cernuschi, M, Hasson, H, and Lazzarin, A.
- Subjects
Anti-HIV Agents ,medicine.medical_treatment ,Salvage therapy ,HIV Infections ,Drug Administration Schedule ,Pharmacotherapy ,Predictive Value of Tests ,Interquartile range ,Antiretroviral Therapy, Highly Active ,Virology ,medicine ,Humans ,Treatment Failure ,Sida ,Retrospective Studies ,Salvage Therapy ,Chemotherapy ,biology ,business.industry ,Retrospective cohort study ,Viral Load ,biology.organism_classification ,CD4 Lymphocyte Count ,Treatment Outcome ,Infectious Diseases ,Predictive value of tests ,HIV-1 ,RNA, Viral ,Reverse Transcriptase Inhibitors ,Drug Therapy, Combination ,business ,Viral load - Abstract
In order to evaluate whether a sustained virologic response to therapy resumption after treatment interruption can be achieved in the setting of virologic failure, we reviewed retrospectively the data relating to 56 human immunodeficiency virus (HIV)-infected subjects selected from 3,145 patient charts. At the time of treatment interruption (study entry), the median (interquartile range) CD4+ counts and HIV-RNA levels were respectively 247 (127-502) x 10(6) cells/L and 4.24 (3.68-5.02) log(10) copies/ml, and the patients had been exposed to eight (5-9) antiretroviral drugs. After treatment interruption, the patients received at least three drugs depending on their treatment history. Forty-eight weeks after the resumption of therapy, 19 of the 56 patients (34%) had HIV-RNA levels of
- Published
- 2003
47. Four years data of raltegravir-based salvage therapy in HIV-1-infected, treatment-experienced patients: The SALIR-E Study
- Author
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Benedetto Maurizio Celesia, Simona Landonio, Antonio Di Biagio, Barbara Menzaghi, Marianna Meschiari, Sara Melzi, Paola Meraviglia, Amedeo Capetti, Giovanni Francesco Pellicanò, Alessandro Soria, Giuliano Rizzardini, Sergio Lo Caputo, Elena Mazzotta, Laura Carenzi, Giuseppe Vittorio De Socio, Michele Trezzi, Lolita Sasset, Gaetana Sterrantino, Adriana Ammassari, Marco Franzetti, and Elena Ricci
- Subjects
Microbiology (medical) ,Male ,medicine.medical_specialty ,Multivariate analysis ,Anti-HIV Agents ,Resistance ,Salvage therapy ,HIV Infections ,Experienced, HIV, Raltegravir, Resistance, Salvage ,Internal medicine ,Raltegravir Potassium ,medicine ,Humans ,Pharmacology (medical) ,Viral ,Adverse effect ,Salvage Therapy ,business.industry ,Hazard ratio ,HIV ,General Medicine ,Experienced ,Raltegravir ,Salvage ,Female ,HIV-1 ,Pyrrolidinones ,RNA, Viral ,Treatment Outcome ,Viral Load ,Surgery ,Regimen ,Infectious Diseases ,Cohort ,RNA ,Observational study ,business ,medicine.drug - Abstract
Apart from the BENCHMRK study, there are no large observational experiences describing the long-term efficacy and safety of rescue regimens for human immunodeficiency virus type 1 (HIV-1) infection. Antiretroviral-experienced patients with detectable viraemia starting a raltegravir (RAL)-based regimen between March 2007 and June 2009 were consecutively enrolled and followed for ≥4 years. Data were censored at Week 206 for homogeneity. Of 333 patients, 258 (77.5%) were still on RAL-based therapy at Week 206, and 241 had undetectable HIV-1 RNA (73% in intention-to-treat analysis). Of the 75 subjects who discontinued RAL therapy, 36 were lost to follow-up, 15 changed their regimen due to virological failure, 2 simplified their regimen stopping RAL, 9 stopped all antiretrovirals and 13 died. Overall, 100 subjects (30.0%) had at least one detectable viraemia, but only 32 (9.6%) had true viral failure. Seventeen patients continued their failing regimen. 'Blips' were experienced by 53 patients (15.9%), whilst 15 (4.5%) had confirmed viral rebound due to adherence issues and were re-suppressed upon treatment re-introduction. In a multivariate analysis of predictors of interruption or failure, each baseline HIV-1 RNA log10 increase was associated with an adjusted hazard ratio for failure of 1.6; having more than 13 previous treatment courses also emerged as a predictor. Overall, adverse events were rare (n=64), with 13 deaths. Tumours were mainly early events, often fatal (7/15), mainly non-Hodgkin's lymphomas (8), followed by hepatocarcinoma (2). RAL proved effective and well tolerated in this cohort, and few patients experienced viral failure after 4 years.
- Published
- 2014
48. A case of classic neuromyelitis optica (Devic's syndrome) triggered by pegylated-interferon α
- Author
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Alessandra Bandera, Davide Mangioni, Andrea Gori, Carlo Ferrarese, Alessandro Soria, Laura Brighina, Mangioni, D, Soria, A, Brighina, L, Bandera, A, Ferrarese, C, and Gori, A
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Standard of care ,Alpha interferon ,Pegylated interferon α ,Case Report ,Interferon alpha-2 ,Polyethylene Glycol ,Polyethylene Glycols ,Interferon ,medicine ,Humans ,Pharmacology (medical) ,Adverse effect ,Pharmacology ,Neuromyelitis optica ,S syndrome ,Pegylated-interferonα ,business.industry ,Medicine (all) ,Neuromyelitis Optica ,Interferon-alpha ,Hepatitis C ,Hepatitis C, Chronic ,Recombinant Protein ,medicine.disease ,Recombinant Proteins ,Adverse events ,Immunology ,HCV ,business ,medicine.drug ,Human - Abstract
Background: Despite recent development of direct acting antivirals for treatment of hepatitis C, the current standard of care may still include pegylated-interferon, which is associated with frequent and, at times, serious adverse events. Case presentation: Here we report for the first time on a severe case of classic neuromyelitis optica (i.e., optic-spinal form) in a 32 year-old Egyptian man with chronic hepatitis C treated with pegylated-interferon α2a for 4 months. Conclusions: Treating physicians must be alerted on rare but important unexpected complications of interferon, in order to consider carefully its use especially when they deal with patients not in dire need of urgent treatment.
- Published
- 2014
49. Imported Ciprofloxacin-Resistant Neisseria meningitidis
- Author
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Sergio Foresti, Alessandro Soria, Franco Viganò, Paolo Fortuna, Andrea Gori, Simone Bramati, Giuseppe Lapadula, A. Dolara, Lapadula, G, Vigano, F, Fortuna, P, Dolara, A, Bramati, S, Soria, A, Foresti, S, and Gori, A
- Subjects
Adult ,Male ,Microbiology (medical) ,Epidemiology ,letter ,India ,lcsh:Medicine ,Drug resistance ,Meningitis, Meningococcal ,Neisseria meningitidis ,medicine.disease_cause ,Meningococcal disease ,Communicable Diseases, Emerging ,lcsh:Infectious and parasitic diseases ,Microbiology ,Neisseria meningitidis, Serogroup A ,Levofloxacin ,ciprofloxacin ,Germany ,Drug Resistance, Bacterial ,medicine ,lcsh:RC109-216 ,Meningitis ,fluoroquinolones ,Letters to the Editor ,bacteria ,Travel ,business.industry ,antimicrobial drug resistance ,lcsh:R ,chemoprophylaxis ,Petechial rash ,medicine.disease ,Virology ,Ciprofloxacin ,Infectious Diseases ,Italy ,Chemoprophylaxis ,Contact Tracing ,business ,Rifampicin ,Human ,medicine.drug - Abstract
To the Editor: Emergence and spread of antimicrobial drug resistance in community-acquired infections is a global threat. Resistance of Neisseria meningitidis raises concern because of severity of disease caused by this organism and the need for immediate treatment of infected patients. We report an imported case of meningococcal disease caused by fluoroquinolone-resistant N. meningitidis. The patient, a previously healthy, unvaccinated 43-year-old man who had traveled internationally, was hospitalized because of high fever, neck stiffness, and a diffuse petechial rash. Signs and symptoms were observed 24 hours after he had returned to Italy from a 10-day business trip during February–March 2009, to New Delhi and Chennai in India and a stopover of a few hours in Frankfurt, Germany. Microscopic examination of cerebrospinal fluid showed gram-negative diplococci and culture documented N. meningitidis serogroup A. The strain was characterized as serotype 4,21 subtype P1.9 by using monoclonal antibodies. Multilocus sequence typing performed at the National Reference Laboratory for Invasive Meningococcal Diseases in Rome characterized the strain as sequence type (ST)-4789 and belonging to clonal complex ST-5/subgroup III. Antimicrobial drug susceptibility was determined by using an agar dilution test, and MICs were determined by using an agar disk-diffusion test (Etest; AB Biodisk, Solna, Sweden) and standard techniques. The strain was resistant to ciprofloxacin, levofloxacin, and trimethoprim/sulfamethoxazole and susceptible to penicillin, ampicillin, ceftriaxone, chloramphenicol, rifampin, and azithromycin. MICs for ciprofloxacin, levofloxacin, penicillin, ampicillin, and ceftriaxone were 0.25, 0.25, 0.03, 0.12, and
- Published
- 2009
50. A Case of Cerebrospinal Fluid Viral Escape on a Dual Antiretroviral Regimen: Worth the Risk?
- Author
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Marianna Rossi, Carlo De Grandi, Luca Bisi, Antonio Muscatello, Alessandra Bandera, Davide Mangioni, Andrea Gori, Francesca Sabbatini, Alessandro Soria, Nicola Squillace, Mangioni, D, Muscatello, A, Sabbatini, F, Soria, A, Rossi, M, Bisi, L, Squillace, N, De Grandi, C, Gori, A, and Bandera, A
- Subjects
Microbiology (medical) ,Anti-Retroviral Agents ,business.industry ,Brain ,Infectious Disease ,Middle Aged ,Viral Load ,DUAL (cognitive architecture) ,Magnetic Resonance Imaging ,Virology ,Regimen ,Infectious Diseases ,Cerebrospinal fluid ,Immunology ,RNA, Viral ,Medicine ,Anti-Retroviral Agent ,Female ,HIV Infection ,business ,Viral load ,Human - Published
- 2014
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