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3,264 results on '"D’Arminio Monforte, A."'

455. Efficacy and Safety of Reparixin in Patients with Severe COVID-19 Pneumonia: A Phase 3, Randomized, Double-Blind Placebo-Controlled Study

Author

Piemonti, Lorenzo, Landoni, Giovanni, Voza, Antonio, Puoti, Massimo, Gentile, Ivan, Coppola, Nicola, Nava, Stefano, Mattei, Alessia, Marinangeli, Franco, Marchetti, Giulia, Bonfanti, Paolo, Mastroianni, Claudio Maria, Bassetti, Matteo, Crisafulli, Ernesto, Grossi, Paolo Antonio, Zangrillo, Alberto, Desai, Antonio, Merli, Marco, Foggia, Maria, Carpano, Marco, Schiavoni, Lorenzo, D’Arminio Monforte, Antonella, Bisi, Luca, Russo, Gianluca, Busti, Fabiana, Rovelli, Cristina, Perrotta, Elisabetta, Goisis, Giovanni, Gavioli, Elizabeth M., Toya, Sophie, De Pizzol, Maria, Mantelli, Flavio, Allegretti, Marcello, and Minnella, Enrico Maria

Abstract

Introduction: Polymorphonuclear cell influx into the interstitial and bronchoalveolar spaces is a cardinal feature of severe coronavirus disease 2019 (COVID-19), principally mediated by interleukin-8 (IL-8). We sought to determine whether reparixin, a novel IL-8 pathway inhibitor, could reduce disease progression in patients hospitalized with severe COVID-19 pneumonia. Methods: In this Phase 3, randomized, double-blind, placebo-controlled, multicenter study, hospitalized adult patients with severe COVID-19 pneumonia were randomized 2:1 to receive oral reparixin 1200 mg three times daily or placebo for up to 21 days or until hospital discharge. The primary endpoint was the proportion of patients alive and free of respiratory failure at Day 28, with key secondary endpoints being the proportion of patients free of respiratory failure at Day 60, incidence of intensive care unit (ICU) admission by Day 28 and time to recovery by Day 28. Results: Of 279 patients randomized, 182 received at least one dose of reparixin and 88 received placebo. The proportion of patients alive and free of respiratory failure at Day 28 was similar in the two groups {83.5% versus 80.7%; odds ratio 1.63 [95% confidence interval (CI) 0.75, 3.51]; p= 0.216}. There were no statistically significant differences in the key secondary endpoints, but a numerically higher proportion of patients in the reparixin group were alive and free of respiratory failure at Day 60 (88.7% versus 84.6%; p= 0.195), fewer required ICU admissions by Day 28 (15.8% versus 21.7%; p= 0.168), and a higher proportion recovered by Day 28 compared with placebo (81.6% versus 74.9%; p= 0.167). Fewer patients experienced adverse events with reparixin than placebo (45.6% versus 54.5%), most mild or moderate intensity and not related to study treatment. Conclusions: This trial did not meet the primary efficacy endpoints, yet reparixin showed a trend toward limiting disease progression as an add-on therapy in COVID-19 severe pneumonia and was well tolerated. Trial Registration: ClinicalTrials.gov: NCT04878055, EudraCT: 2020-005919-51. Graphical Abstract:

Published
2023
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456. Risk factors and outcomes for late presentation for HIV-positive persons in Europe: results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE).

Author

Amanda Mocroft, Jens D Lundgren, Miriam Lewis Sabin, Antonella d'Arminio Monforte, Norbert Brockmeyer, Jordi Casabona, Antonella Castagna, Dominique Costagliola, Francois Dabis, Stéphane De Wit, Gerd Fätkenheuer, Hansjakob Furrer, Anne M Johnson, Marios K Lazanas, Catherine Leport, Santiago Moreno, Niels Obel, Frank A Post, Joanne Reekie, Peter Reiss, Caroline Sabin, Adriane Skaletz-Rorowski, Ignacio Suarez-Lozano, Carlo Torti, Josiane Warszawski, Robert Zangerle, Céline Fabre-Colin, Jesper Kjaer, Genevieve Chene, Jesper Grarup, Ole Kirk, and Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in EuroCoord

Subjects
Medicine
Abstract

BackgroundFew studies have monitored late presentation (LP) of HIV infection over the European continent, including Eastern Europe. Study objectives were to explore the impact of LP on AIDS and mortality.Methods and findingsLP was defined in Collaboration of Observational HIV Epidemiological Research Europe (COHERE) as HIV diagnosis with a CD4 count ConclusionsLP has decreased over time across Europe, but remains a significant issue in the region in all HIV exposure groups. LP increased in male IDUs and female heterosexuals from Southern Europe and IDUs in Eastern Europe. LP was associated with an increased rate of AIDS/deaths, particularly in the first year after HIV diagnosis, with significant variation across Europe. Earlier and more widespread testing, timely referrals after testing positive, and improved retention in care strategies are required to further reduce the incidence of LP.

Published
2013
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457. Feasibility and effectiveness of indicator condition-guided testing for HIV: results from HIDES I (HIV indicator diseases across Europe study).

Author

Ann K Sullivan, Dorthe Raben, Joanne Reekie, Michael Rayment, Amanda Mocroft, Stefan Esser, Agathe Leon, Josip Begovac, Kees Brinkman, Robert Zangerle, Anna Grzeszczuk, Anna Vassilenko, Vesna Hadziosmanovic, Maksym Krasnov, Anders Sönnerborg, Nathan Clumeck, José Gatell, Brian Gazzard, Antonella d'Arminio Monforte, Jürgen Rockstroh, and Jens D Lundgren

Subjects
Medicine, Science
Abstract

Improved methods for targeting HIV testing among patients most likely to be infected are required; HIDES I aimed to define the methodology of a European wide study of HIV prevalence in individuals presenting with one of eight indicator conditions/diseases (ID); sexually transmitted infection, lymphoma, cervical or anal cancer/dysplasia, herpes zoster, hepatitis B/C, mononucleosis-like illness, unexplained leukocytopenia/thrombocytopenia and seborrheic dermatitis/exanthema, and to identify those with an HIV prevalence of >0.1%, a level determined to be cost effective. A staff questionnaire was performed. From October 2009- February 2011, individuals, not known to be HIV positive, presenting with one of the ID were offered an HIV test; additional information was collected on previous HIV testing behaviour and recent medical history. A total of 3588 individuals from 16 centres were included. Sixty-six tested positive for HIV, giving an HIV prevalence of 1.8% [95% CI: 1.42-2.34]; all eight ID exceeded 0.1% prevalence. Of those testing HIV positive, 83% were male, 58% identified as MSM and 9% were injecting drug users. Twenty percent reported previously having potentially HIV-related symptoms and 52% had previously tested HIV negative (median time since last test: 1.58 years); which together with the median CD4 count at diagnosis (400 cell/uL) adds weight to this strategy being effective in diagnosing HIV at an earlier stage. A positive test was more likely for non-white individuals, MSM, injecting drug users and those testing in non-Northern regions. HIDES I describes an effective strategy to detect undiagnosed HIV infection. All eight ID fulfilled the >0.1% criterion for cost effectiveness. All individuals presenting to any health care setting with one of these ID should be strongly recommended an HIV test. A strategy is being developed in collaboration with ECDC and WHO Europe to guide the implementation of this novel public health initiative across Europe.

Published
2013
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458. Virologic and immunologic response to cART by HIV-1 subtype in the CASCADE collaboration.

Author

Giota Touloumi, Nikos Pantazis, Marie-Laure Chaix, Heiner C Bucher, Robert Zangerle, Anne-Marte Bakken Kran, Rodolphe Thiebaut, Bernard Masquelier, Claudia Kucherer, Antonella d'Arminio Monforte, Laurence Meyer, Kholoud Porter, and for CASCADE Collaboration in EuroCoord

Subjects
Medicine, Science
Abstract

We aimed to compare rates of virologic response and CD4 changes after combination antiretroviral (cART) initiation in individuals infected with B and specific non-B HIV subtypes.Using CASCADE data we analyzed HIV-RNA and CD4 counts for persons infected ≥1996, ≥15 years of age. We used survival and longitudinal modeling to estimate probabilities of virologic response (confirmed HIV-RNA 500 c/ml at 6 months or ≥1000 c/ml following response) and CD4 increase after cART initiation.2003 (1706 B, 142 CRF02_AG, 55 A, 53 C, 47 CRF01_AE) seroconverters were included in analysis. There was no evidence of subtype effect overall for response or failure (p = 0.075 and 0.317, respectively) although there was a suggestion that those infected with subtypes CRF01_AE and A responded sooner than those with subtype B infection [HR (95% CI):1.37 (1.01-1.86) and 1.29 (0.96-1.72), respectively]. Rates of CD4 increase were similar in all subtypes except subtype A, which tended to have lower initial, but faster long-term, increases.Virologic and immunologic response to cART was similar across all studied subtypes but statistical power was limited by the rarity of some non-B subtypes. Current antiretroviral agents seem to have similar efficacy in subtype B and most widely encountered non-B infections in high-income countries.

Published
2013
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459. Risk of developing specific AIDS-defining illnesses in patients coinfected with HIV and hepatitis C virus with or without liver cirrhosis

Author

d'Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro, Castagna, Antonella, Antinori, Andrea, Luca, Andrea De, Mussini, Cristina, Lo Caputo, Sergio, Arlotti, Massimo, Magnani, Giacomo, Pellizzer, Gianpietro, Maggiolo, France, and Puoti, Massimo

Subjects
AIDS (Disease) -- Risk factors, AIDS (Disease) -- Demographic aspects, AIDS (Disease) -- Care and treatment, AIDS (Disease) -- Research, HIV infection -- Care and treatment, HIV infection -- Research, Hepatitis C -- Care and treatment, Hepatitis C -- Research, Comorbidity -- Research, Health, Health care industry
Published
2009

460. Establishing a hepatitis C continuum of care among HIV/hepatitis C virus-coinfected individuals in EuroSIDA

Author

Amele, S., Peters, L., Sluzhynska, M., Yakovlev, A., Scherrer, A., Domingo, P., Gerstoft, J., Viard, J. P., Gisinger, M., Flisiak, R., Bhaghani, S., Ristola, M., Leen, C., Jablonowska, E., Wandeler, G., Stellbrink, H., Falconer, K., D'Arminio Monforte, A., Horban, A., Rockstroh, J. K., Lundgren, J. D., Mocroft, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Jilich, D., Sedlacek, D., Kronborg, G., Benfield, T., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, Jelena, Aho, I., Girard, P. -M., Pradier, C., Fontas, E., Duvivier, C., Behrens, G., Degen, O., Stefan, C., Bogner, J., Fätkenheuer, G., Chkhartishvili, N., Gargalianos, P., Xylomenos, G., Armenis, K., Sambatakou, H., Szlávik, J., Gottfredsson, M., Mulcahy, F., Yust, I., Turner, D., Burke, M., Shahar, E., Hassoun, G., Elinav, H., Haouzi, M., Elbirt, D., Sthoeger, Z. M., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Zaccarelli, M., Antinori, A., Acinapura, R., Plazzi, M., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Rozentale, B., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Reiss, P., Reikvam, D. H., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Bakowska, E., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Beniowski, M., Mularska, E., Smiatacz, T., Gensing, M., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Caldeira, L., Mansinho, K., Maltez, F., Radoi, R., Oprea, C., Panteleev, A., Panteleev, O., Trofimora, T., Khromova, I., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Jevtovic, D., Tomazic, J., Miro, J. M., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Paredes, R., Tural, C., Puig, J., Bravo, I., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Sonnerborg, A., Treutiger, C. J., Flamholc, L., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Kyselyova, G., Gazzard, B., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Weber, J., Scullard, G., Clarke, A., Rasmussen, L. D., Svedhem, V., Kowalska, J. D., Guaraldi, G., Kirk, O., Bojesen, A., Raben, D., Kristensen, D., Laut, K., Larsen, J. F., Podlekareva, D., Nykjær, B., Cozzi-Lepri, A., Pelchen-Matthews, A., Amele, S., Peters, L., Sluzhynska, M., Yakovlev, A., Scherrer, A., Domingo, P., Gerstoft, J., Viard, J. P., Gisinger, M., Flisiak, R., Bhaghani, S., Ristola, M., Leen, C., Jablonowska, E., Wandeler, G., Stellbrink, H., Falconer, K., D'Arminio Monforte, A., Horban, A., Rockstroh, J. K., Lundgren, J. D., Mocroft, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Jilich, D., Sedlacek, D., Kronborg, G., Benfield, T., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, Jelena, Aho, I., Girard, P. -M., Pradier, C., Fontas, E., Duvivier, C., Behrens, G., Degen, O., Stefan, C., Bogner, J., Fätkenheuer, G., Chkhartishvili, N., Gargalianos, P., Xylomenos, G., Armenis, K., Sambatakou, H., Szlávik, J., Gottfredsson, M., Mulcahy, F., Yust, I., Turner, D., Burke, M., Shahar, E., Hassoun, G., Elinav, H., Haouzi, M., Elbirt, D., Sthoeger, Z. M., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Vullo, V., Lichtner, M., Zaccarelli, M., Antinori, A., Acinapura, R., Plazzi, M., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Rozentale, B., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Reiss, P., Reikvam, D. H., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Bakowska, E., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Beniowski, M., Mularska, E., Smiatacz, T., Gensing, M., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Caldeira, L., Mansinho, K., Maltez, F., Radoi, R., Oprea, C., Panteleev, A., Panteleev, O., Trofimora, T., Khromova, I., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Jevtovic, D., Tomazic, J., Miro, J. M., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Moreno, S., Rodriguez, J. M., Clotet, B., Jou, A., Paredes, R., Tural, C., Puig, J., Bravo, I., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Sonnerborg, A., Treutiger, C. J., Flamholc, L., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Kyselyova, G., Gazzard, B., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Weber, J., Scullard, G., Clarke, A., Rasmussen, L. D., Svedhem, V., Kowalska, J. D., Guaraldi, G., Kirk, O., Bojesen, A., Raben, D., Kristensen, D., Laut, K., Larsen, J. F., Podlekareva, D., Nykjær, B., Cozzi-Lepri, A., Pelchen-Matthews, A., Clinicum, HUS Inflammation Center, Infektiosairauksien yksikkö, Department of Medicine, and HUS Internal Medicine and Rehabilitation

Subjects
0301 basic medicine, Male, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Virological response, 0302 clinical medicine, continuum of care, Europe, HIV/HCV coinfection, sustained virological response, treatment, Adult, Antiviral Agents, Continuity of Patient Care, Female, Hepatitis C, Humans, Middle Aged, Young Adult, INFECTION, Pharmacology (medical), 030212 general & internal medicine, Continuum of care, Antiviral Agents/therapeutic use, biology, Health Policy, DEATH, virus diseases, Continuity of Patient Care/standards, ERA, 3. Good health, Infectious Diseases, Antibody, INTERFERON, Hepatitis C virus, HIV Infections/drug therapy, Infectious Disease, 03 medical and health sciences, Hepatitis C/drug therapy, PEOPLE, medicine, RATES, business.industry, HIV, medicine.disease, 030112 virology, Virology, digestive system diseases, 3121 General medicine, internal medicine and other clinical medicine, biology.protein, Hcv treatment, business
Abstract

Objectives: The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. Methods: Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24weeks after stopping treatment. Results: Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n=5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n=3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P&nbsp

Published
2019

461. Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferiority, phase 3 trials

Author

Pedro Cahn, Juan Sierra Madero, José Ramón Arribas, Andrea Antinori, Roberto Ortiz, Amanda E Clarke, Chien-Ching Hung, Jürgen K Rockstroh, Pierre-Marie Girard, Jörg Sievers, Choy Man, Alexander Currie, Mark Underwood, Allan R Tenorio, Keith Pappa, Brian Wynne, Anna Fettiplace, Martin Gartland, Michael Aboud, Kimberly Smith, Lidia Cassetti, Daniel David, Laura Figueras, Marcelo Losso, Gustavo Lopardo, Sergio Lupo, Norma Porteiro, Marisa Sánchez, Mark Bloch, David Cooper, Robert Finlayson, Anthony Kelleher, Kenneth Koh, David Lewis, James McMahon, Richard Moore, Norman Roth, Matthew Shields, Stephane De Wit, Eric Florence, Jean-Christophe Goffard, Remy Demeester, Patrick Lacor, Bernard Vandercam, Linos Vandekerckhove, Jonathan Angel, Jean-Guy Baril, Brian Conway, Alexandra De Pokomandy, Jason Szabo, Sharon Walmsley, Olivier Bouchaud, Christian Chidiac, Pierre Delobel, Cecile Goujard, Christine Katlama, Jean-Michel Molina, Gilles Pialoux, Patrick Philibert, Johannes Bogner, Stefan Esser, Ivanka Krznaric, Clara Lehmann, Christoph Spinner, Hans-Jurgen Stellbrink, Christoph Stephan, Albrecht Stoehr, Enrico Barchi, Pietro Caramello, Francesco Castelli, Anna Maria Cattelan, Antonella D'Arminio Monforte, Antonio Di Biagio, Giovanni Di Perri, Andrea Gori, Franco Maggiolo, Barbara Menzaghi, Guglielmo Migliorino, Cristina Mussini, Giovanni Penco, Massimo Puoti, Giuliano Rizzardini, Roberto Gulminetti, Adriano Lazzarin, Tiziano Quirino, Laura Sighinolfi, Pierluigi Viale, Gerardo Amaya Tapia, Jaime Andrade Villanueva, Enrique R Granados Reyes, Alma Perez Rios, Mario Santoscoy Gomez, Jan Den Hollander, Bart Rijnders, José A Hidalgo, Luis Hercilla Vasquez, Luis Illescas, Anita Olczak, Kamal Mansinho, Patricia Paula Correia Pacheco, Eugénio Teófilo, Jose Saraiva da Cunha, Rui Sarmento e Castro, Rosário Serrão, Manuela Arbune, Cristian Jianu, Anca Oprea, Liliana Preotescu, Liviu-Jany Prisacariu, Elena Belonosova, Olga Borodkina, Oxana Chernova, Natalia Gankina, Svetlana Kizhlo, Valeriy Kulagin, Nadezhda Kurina, Firaya Nagimova, Vadim Pokrovsky, Elena Ryamova, Evgeny Voronin, Alexey Yakovlev, Richard Kaplan, Sun Hee Lee, Shin-Woo Kim, Sang-Il Kim, Woo Joo Kim, Antonio Antela Lopez, Jose L Casado Osorio, Manuel A Castaño Carracedo, Ignacio De Los Santos Gil, Vicente Estrada Perez, Vicenç Falco Ferrer, Luis Force, Maria Jose Galinda Puerto, Miguel Garcia Deltoro, Josep M Gatell, Miguel A Goenaga Sanchez, Ana González Cordón, Hernando Knobel, Juan Carlos Lopez Bernaldo de Quiros, Juan E Losa Garcia, Mar Masia, Marta Montero-Alsonso, Antonio Ocampo Hermida, Juan Pasquau Liaño, Joaquin Portilla Sogorb, Federico Pulido Ortega, Antonio Rivera Roman, Jose Ramon Santos Fernandez, Rafael Torres Perea, Jesus Troya Garcia, Pompeyo Viciana Fernandez, Alexandra Calmy, Christoph Hauser, Jan Fehr, Shu-Hsing Cheng, Wen-Chien Ko, Hsi-Hsun Lin, Po-Liang Lu, Yu-Ting Tseng, Ning-Chi Wang, Wing-Wai Wong, Chia-Jui Yang, Roberto Arduino, Paul Benson, Mezgebe Berhe, Fritz Bredeek, Cynthia Brinson, Thomas Campbell, Gordon Crofoot, Douglas Cunningham, Edwin DeJesus, Robin Dretler, Joseph Eron, Kenneth Fife, Carl Fichtenbaum, Jason Flamm, Deborah Goldstein, Samir Gupta, Debbie Hagins, Margaret Hoffman-Terry, Dushyantha Jayaweera, Clifford Kinder, Daniel Klein, Cheryl McDonald, Anthony Mills, Ronald Nahass, Olayemi Osiyemi, Edgar Overton, David Parks, David Prelutsky, Moti Ramgopal, Shannon Schrader, Beverly Sha, Gary Simon, James Sims, Daniel Skiest, Jihad Slim, Karen Tashima, Blair Thedinger, Brian Gazzard, Julie Fox, Margaret Johnson, Stephen Kegg, Saye Khoo, Charles Mazhude, Chloe Orkin, Gabriel Schembri, Andrew Ustianowski, Clinical sciences, Microbiology and Infection Control, Internal Medicine, Cahn, P, Madero, J, Arribas, J, Antinori, A, Ortiz, R, Clarke, A, Hung, C, Rockstroh, J, Girard, P, Sievers, J, Man, C, Currie, A, Underwood, M, Tenorio, A, Pappa, K, Wynne, B, Fettiplace, A, Gartland, M, Aboud, M, Smith, K, Cassetti, L, David, D, Figueras, L, Losso, M, Lopardo, G, Lupo, S, Porteiro, N, Sanchez, M, Bloch, M, Cooper, D, Finlayson, R, Kelleher, A, Koh, K, Lewis, D, Mcmahon, J, Moore, R, Roth, N, Shields, M, De Wit, S, Florence, E, Goffard, J, Demeester, R, Lacor, P, Vandercam, B, Vandekerckhove, L, Angel, J, Baril, J, Conway, B, De Pokomandy, A, Szabo, J, Walmsley, S, Bouchaud, O, Chidiac, C, Delobel, P, Goujard, C, Katlama, C, Molina, J, Pialoux, G, Philibert, P, Bogner, J, Esser, S, Krznaric, I, Lehmann, C, Spinner, C, Stellbrink, H, Stephan, C, Stoehr, A, Barchi, E, Caramello, P, Castelli, F, Cattelan, A, D'Arminio Monforte, A, Di Biagio, A, Di Perri, G, Gori, A, Maggiolo, F, Menzaghi, B, Migliorino, G, Mussini, C, Penco, G, Puoti, M, Rizzardini, G, Gulminetti, R, Lazzarin, A, Quirino, T, Sighinolfi, L, Viale, P, Amaya Tapia, G, Andrade Villanueva, J, Granados Reyes, E, Perez Rios, A, Santoscoy Gomez, M, Den Hollander, J, Rijnders, B, Hidalgo, J, Hercilla Vasquez, L, Illescas, L, Olczak, A, Mansinho, K, Correia Pacheco, P, Teofilo, E, Saraiva da Cunha, J, Sarmento e Castro, R, Serrao, R, Arbune, M, Jianu, C, Oprea, A, Preotescu, L, Prisacariu, L, Belonosova, E, Borodkina, O, Chernova, O, Gankina, N, Kizhlo, S, Kulagin, V, Kurina, N, Nagimova, F, Pokrovsky, V, Ryamova, E, Voronin, E, Yakovlev, A, Kaplan, R, Lee, S, Kim, S, Kim, W, Antela Lopez, A, Casado Osorio, J, Castano Carracedo, M, De Los Santos Gil, I, Estrada Perez, V, Falco Ferrer, V, Force, L, Galinda Puerto, M, Garcia Deltoro, M, Gatell, J, Goenaga Sanchez, M, Gonzalez Cordon, A, Knobel, H, Lopez Bernaldo de Quiros, J, Losa Garcia, J, Masia, M, Montero-Alsonso, M, Ocampo Hermida, A, Pasquau Liano, J, Portilla Sogorb, J, Pulido Ortega, F, Rivera Roman, A, Santos Fernandez, J, Torres Perea, R, Troya Garcia, J, Viciana Fernandez, P, Calmy, A, Hauser, C, Fehr, J, Cheng, S, Ko, W, Lin, H, Lu, P, Tseng, Y, Wang, N, Wong, W, Yang, C, Arduino, R, Benson, P, Berhe, M, Bredeek, F, Brinson, C, Campbell, T, Crofoot, G, Cunningham, D, Dejesus, E, Dretler, R, Eron, J, Fife, K, Fichtenbaum, C, Flamm, J, Goldstein, D, Gupta, S, Hagins, D, Hoffman-Terry, M, Jayaweera, D, Kinder, C, Klein, D, Mcdonald, C, Mills, A, Nahass, R, Osiyemi, O, Overton, E, Parks, D, Prelutsky, D, Ramgopal, M, Schrader, S, Sha, B, Simon, G, Sims, J, Skiest, D, Slim, J, Tashima, K, Thedinger, B, Gazzard, B, Fox, J, Johnson, M, Kegg, S, Khoo, S, Mazhude, C, Orkin, C, Schembri, G, and Ustianowski, A

Subjects
Male, HIV Dolutegravir, HIV Infections, 030204 cardiovascular system & hematology, Piperazines, chemistry.chemical_compound, 0302 clinical medicine, Abacavir, Heterocyclic Compounds, Emtricitabine, 030212 general & internal medicine, Viral, Tenofovir/adverse effects, Lamivudine/adverse effects, Medicine(all), education.field_of_study, Adult, Anti-HIV Agents, Anti-Retroviral Agents, Double-Blind Method, Drug Therapy, Combination, Female, HIV-1, Heterocyclic Compounds, 3-Ring, Humans, Lamivudine, Middle Aged, RNA, Viral, Tenofovir, Viral Load, Heterocyclic Compounds, 3-Ring/adverse effects, General Medicine, Emtricitabine/adverse effects, Tolerability, Dolutegravir, Combination, medicine.drug, medicine.medical_specialty, Pyridones, Population, HIV Infections/drug therapy, Anti-Retroviral Agents/adverse effects, 3-Ring, 03 medical and health sciences, Drug Therapy, SDG 3 - Good Health and Well-being, Internal medicine, Oxazines, medicine, HIV-1/isolation & purification, RNA, Viral/blood, education, business.industry, Viral Load/drug effects, Regimen, chemistry, RNA, Anti-HIV Agents/adverse effects, Ritonavir, business
Abstract

Summary Background Effective two-drug regimens could decrease long-term drug exposure and toxicity with HIV-1 antiretroviral therapy (ART). We therefore aimed to evaluate the efficacy and safety of a two-drug regimen compared with a three-drug regimen for the treatment of HIV-1 infection in ART-naive adults. Methods We conducted two identically designed, multicentre, double-blind, randomised, non-inferiority, phase 3 trials: GEMINI-1 and GEMINI-2. Both studies were done at 192 centres in 21 countries. We included participants (≥18 years) with HIV-1 infection and a screening HIV-1 RNA of 500 000 copies per mL or less, and who were naive to ART. We randomly assigned participants (1:1) to receive a once-daily two-drug regimen of dolutegravir (50 mg) plus lamivudine (300 mg) or a once-daily three-drug regimen of dolutegravir (50 mg) plus tenofovir disoproxil fumarate (300 mg) and emtricitabine (200 mg). Both drug regimens were administered orally. We masked participants and investigators to treatment assignment: dolutegravir was administered as single-entity tablets (similar to its commercial formulation, except with a different film colour), and lamivudine tablets and tenofovir disoproxil fumarate and emtricitabine tablets were over-encapsulated to visually match each other. Primary endpoint was the proportion of participants with HIV-1 RNA of less than 50 copies per mL at week 48 in the intention-to-treat-exposed population, using the Snapshot algorithm and a non-inferiority margin of −10%. Safety analyses were done on the safety population. GEMINI-1 and GEMINI-2 are registered with ClinicalTrials.gov, numbers NCT02831673 and NCT02831764, respectively. Findings Between July 18, 2016, and March 31, 2017, 1441 participants across both studies were randomly assigned to receive either the two-drug regimen (n=719) or three-drug regimen (n=722). At week 48 in the GEMINI-1 intention-to-treat-exposed population, 320 (90%) of 356 participants receiving the two-drug regimen and 332 (93%) of 358 receiving the three-drug regimen achieved plasma HIV-1 RNA of less than 50 copies per mL (adjusted treatment difference −2·6%, 95% CI −6·7 to 1·5); in GEMINI-2, 335 (93%) of 360 in the two-drug regimen and 337 (94%) of 359 in the three-drug regimen achieved HIV-1 RNA of less than 50 copies per mL (adjusted treatment difference −0·7%, 95% CI −4·3 to 2·9), showing non-inferiority at a −10% margin in both studies (pooled analysis: 655 [91%] of 716 in the two-drug regimen vs 669 [93%] of 717 in the three-drug regimen; adjusted treatment difference −1·7%, 95% CI −4·4 to 1·1). Numerically, more drug-related adverse events occurred with the three-drug regimen than with the two-drug regimen (169 [24%] of 717 vs 126 [18%] of 716); few participants discontinued because of adverse events (16 [2%] in the three-drug regimen and 15 [2%] in the two-drug regimen). Two deaths were reported in the two-drug regimen group of GEMINI-2, but neither was considered to be related to the study medication. Interpretation The non-inferior efficacy and similar tolerability profile of dolutegravir plus lamivudine to a guideline-recommended three-drug regimen at 48 weeks in ART-naive adults supports its use as initial therapy for patients with HIV-1 infection. Funding ViiV Healthcare.

Published
2019

462. Determinants of loss to care and risk of clinical progression in PLWH who are re-engaged in care after a temporary loss

Author

Mussini, Cristina, primary, Lorenzini, Patrizia, additional, Cozzi-Lepri, Alessandro, additional, Mammone, Alessia, additional, Guaraldi, Giovanni, additional, Marchetti, Giulia, additional, Lichtner, Miriam, additional, Lapadula, Giuseppe, additional, Lo Caputo, Sergio, additional, Antinori, Andrea, additional, d’Arminio Monforte, Antonella, additional, and Girardi, Enrico, additional

Published
2021
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463. Development of the HIV360 international core set of outcome measures for adults living with HIV: A consensus process.

Author

Marques‐Gomes, João, Salt, Matthew J., Pereira‐Neto, Rita, Barteldes, Franca S., Gouveia‐Barros, Vera, Carvalho, Alexandre, d'Arminio‐Monforte, Antonella, De‐la‐Torre‐Rosas, Alethse, Harris, Amy, Esteves, Catarina, Maor, Carcom, Mora, Cristina, Oliveira, Carla, Sousa, Cristina, Richman, Douglas D., Martinez, Esteban, Cota‐Medeiros, Fábio, Gramacho, Filipa, Behrens, Georg M. N., and Gonçalves, Graça

Subjects
HIV-positive persons, HIV infections, EVALUATION of medical care, CONSENSUS (Social sciences), RESEARCH methodology, HEALTH outcome assessment, INTERVIEWING, DESCRIPTIVE statistics, HEALTH care teams, DATA analysis software, STANDARDS, ADULTS
Abstract

Objectives: HIV outcomes centre primarily around clinical markers with limited focus on patient‐reported outcomes. With a global trend towards capturing the outcomes that matter most to patients, there is agreement that standardizing the definition of value in HIV care is key to their incorporation. This study aims to address the lack of routine, standardized data in HIV care. Methods: An international working group (WG) of 37 experts and patients, and a steering group (SG) of 18 experts were convened from 14 countries. The project team (PT) identified outcomes by conducting a literature review, screening 1979 articles and reviewing the full texts of 547 of these articles. Semi‐structured interviews and advisory groups were performed with the WG, SG and people living with HIV to add to the list of potentially relevant outcomes. The WG voted via a modified Delphi process – informed by six Zoom calls – to establish a core set of outcomes for use in clinical practice. Results: From 156 identified outcomes, consensus was reached to include three patient‐reported outcomes, four clinician‐reported measures and one administratively reported outcome; standardized measures were included. The WG also reached agreement to measure 22 risk‐adjustment variables. This outcome set can be applied to any person living with HIV aged > 18 years. Conclusions: Adoption of the HIV360 outcome set will enable healthcare providers to record, compare and integrate standardized metrics across treatment sites to drive quality improvement in HIV care. [ABSTRACT FROM AUTHOR]

Published
2022
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464. Cost‐effectiveness of statins for primary prevention of atherosclerotic cardiovascular disease among people living with HIV in the United States

Author

Boettiger, David C, primary, Newall, Anthony T, additional, Phillips, Andrew, additional, Bendavid, Eran, additional, Law, Matthew G, additional, Ryom, Lene, additional, Reiss, Peter, additional, Mocroft, Amanda, additional, Bonnet, Fabrice, additional, Weber, Rainer, additional, El‐Sadr, Wafaa, additional, d’Arminio Monforte, Antonella, additional, de Wit, Stephane, additional, Pradier, Christian, additional, Hatleberg, Camilla I, additional, Lundgren, Jens, additional, Sabin, Caroline, additional, Kahn, James G, additional, and Kazi, Dhruv S, additional

Published
2021
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465. Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

Author

Saracino, A, Zaccarelli, M, Lorenzini, P, Bandera, A, Marchetti, G, Castelli, F, Gori, A, Girardi, E, Mussini, C, Bonfanti, P, Ammassari, A, D'Arminio Monforte, A, Moroni, M, Andreoni, M, Angarano, G, Antinori, A, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, Von Schloesser, F, Viale, P, Castagna, A, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Lo Caputo, S, Puoti, M, Balotta, C, Bonora, S, Borderi, M, Capobianchi, M, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marcotullio, S, Monno, L, Quiros Roldan, E, Rusconi, S, Cicconi, P, Fanti, I, Galli, L, Shanyinda, M, Tavelli, A, Giacometti, A, Costantini, A, Mazzoccato, S, Santoro, C, Suardi, C, Vanino, E, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Mazzotta, F, Cassola, G, Viscoli, C, Alessandrini, A, Piscopo, R, Mazzarello, G, Mastroianni, C, Belvisi, V, Caramma, I, Chiodera, A, Castelli, A, Rizzardini, G, Ridolfo, A, Piolini, R, Salpietro, S, Carenzi, L, Moioli, M, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Guida, M, Gargiulo, M, Gentile, I, Orlando, R, Baldelli, F, Francisci, D, Parruti, G, Ursini, T, Magnani, G, Ursitti, M, Vullo, V, D'Avino, A, Gallo, L, Nicastri, E, Acinapura, R, Capozzi, M, Libertone, R, Tebano, G, Viviani, F, Sasset, L, Mura, M, Rossetti, B, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Saracino A., Zaccarelli M., Lorenzini P., Bandera A., Marchetti G., Castelli F., Gori A., Girardi E., Mussini C., Bonfanti P., Ammassari A., D'Arminio Monforte A., Moroni M., Andreoni M., Angarano G., Antinori A., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Perno C. F., Von Schloesser F., Viale P., Castagna A., Ceccherini-Silberstein F., Cozzi-Lepri A., Lo Caputo S., Puoti M., Balotta C., Bonora S., Borderi M., Capobianchi M. R., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Guaraldi G., Lapadula G., Lichtner M., Madeddu G., Maggiolo F., Marcotullio S., Monno L., Quiros Roldan E., Rusconi S., Cicconi P., Fanti I., Galli L., Shanyinda M., Tavelli A., Giacometti A., Costantini A., Mazzoccato S., Santoro C., Suardi C., Vanino E., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P. E., Piano P., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Mazzotta F., Cassola G., Viscoli C., Alessandrini A., Piscopo R., Mazzarello G., Mastroianni C., Belvisi V., Caramma I., Chiodera A., Castelli A. P., Rizzardini G., Ridolfo A. L., Piolini R., Salpietro S., Carenzi L., Moioli M. C., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Guida M. G., Gargiulo M., Gentile I., Orlando R., Baldelli F., Francisci D., Parruti G., Ursini T., Magnani G., Ursitti M. A., Vullo V., D'Avino A., Gallo L., Nicastri E., Acinapura R., Capozzi M., Libertone R., Tebano G., Viviani F., Sasset L., Mura M. S., Rossetti B., Caramello P., Orofino G. C., Sciandra M., Bassetti M., Londero A., Pellizzer G., Manfrin V., Saracino, A, Zaccarelli, M, Lorenzini, P, Bandera, A, Marchetti, G, Castelli, F, Gori, A, Girardi, E, Mussini, C, Bonfanti, P, Ammassari, A, D'Arminio Monforte, A, Moroni, M, Andreoni, M, Angarano, G, Antinori, A, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, Von Schloesser, F, Viale, P, Castagna, A, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Lo Caputo, S, Puoti, M, Balotta, C, Bonora, S, Borderi, M, Capobianchi, M, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marcotullio, S, Monno, L, Quiros Roldan, E, Rusconi, S, Cicconi, P, Fanti, I, Galli, L, Shanyinda, M, Tavelli, A, Giacometti, A, Costantini, A, Mazzoccato, S, Santoro, C, Suardi, C, Vanino, E, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Mazzotta, F, Cassola, G, Viscoli, C, Alessandrini, A, Piscopo, R, Mazzarello, G, Mastroianni, C, Belvisi, V, Caramma, I, Chiodera, A, Castelli, A, Rizzardini, G, Ridolfo, A, Piolini, R, Salpietro, S, Carenzi, L, Moioli, M, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Guida, M, Gargiulo, M, Gentile, I, Orlando, R, Baldelli, F, Francisci, D, Parruti, G, Ursini, T, Magnani, G, Ursitti, M, Vullo, V, D'Avino, A, Gallo, L, Nicastri, E, Acinapura, R, Capozzi, M, Libertone, R, Tebano, G, Viviani, F, Sasset, L, Mura, M, Rossetti, B, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Saracino A., Zaccarelli M., Lorenzini P., Bandera A., Marchetti G., Castelli F., Gori A., Girardi E., Mussini C., Bonfanti P., Ammassari A., D'Arminio Monforte A., Moroni M., Andreoni M., Angarano G., Antinori A., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Perno C. F., Von Schloesser F., Viale P., Castagna A., Ceccherini-Silberstein F., Cozzi-Lepri A., Lo Caputo S., Puoti M., Balotta C., Bonora S., Borderi M., Capobianchi M. R., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Guaraldi G., Lapadula G., Lichtner M., Madeddu G., Maggiolo F., Marcotullio S., Monno L., Quiros Roldan E., Rusconi S., Cicconi P., Fanti I., Galli L., Shanyinda M., Tavelli A., Giacometti A., Costantini A., Mazzoccato S., Santoro C., Suardi C., Vanino E., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P. E., Piano P., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Mazzotta F., Cassola G., Viscoli C., Alessandrini A., Piscopo R., Mazzarello G., Mastroianni C., Belvisi V., Caramma I., Chiodera A., Castelli A. P., Rizzardini G., Ridolfo A. L., Piolini R., Salpietro S., Carenzi L., Moioli M. C., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Guida M. G., Gargiulo M., Gentile I., Orlando R., Baldelli F., Francisci D., Parruti G., Ursini T., Magnani G., Ursitti M. A., Vullo V., D'Avino A., Gallo L., Nicastri E., Acinapura R., Capozzi M., Libertone R., Tebano G., Viviani F., Sasset L., Mura M. S., Rossetti B., Caramello P., Orofino G. C., Sciandra M., Bassetti M., Londero A., Pellizzer G., and Manfrin V.

Abstract

Background: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. Methods: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. Results: A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged > 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compared to other groups. The overall median time to ART initiation was 0.6 years (yrs) (IQR 0.1-3.7), with a significant decrease over time [2002-2006 = 3.3 yrs. (0.2-9.4); 2007-2011 = 1.0 yrs. (0.1-3.9); 2012-2016 = 0.2 yrs. (0.1-2.1), p < 0.001]. By multivariate analysis, females (p < 0.01) and PWID (p < 0.001), presented a longer time to ART initiation, while older people (p < 0.001), people with higher educational levels (p < 0.001), unemployed (p = 0.02) and students (p < 0.001) were more likely to initiate ART. Moreover, PWID, unemployed vs stable employed, and pts. with lower educational levels showed a lower 1-year probability of achieving HIV-RNA suppression, while females, older patients, men who have sex wi

Published
2018

466. Switching to dual/monotherapy determines an increase in CD8+ in HIV-infected individuals: An observational cohort study

Author

Mussini, C, Lorenzini, P, Cozzi-Lepri, A, Marchetti, G, Rusconi, S, Gori, A, Nozza, S, Lichtner, M, Antinori, A, Cossarizza, A, d'Arminio Monforte, A, Castagna, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Puoti, M, Andreoni, M, Ammassari, A, Balotta, C, Bandera, A, Bonfanti, P, Bonora, S, Borderi, M, Calcagno, A, Calza, L, Capobianchi, M, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Guaraldi, G, Lapadula, G, Madeddu, G, Maggiolo, F, Marcotullio, S, Monno, L, Quiros Roldan, E, Rossotti, R, Santoro, M, Saracino, A, Zaccarelli, M, Fanti, I, Galli, L, Rodano, A, Shanyinde, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Santoro, C, Suardi, C, Donati, V, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Mastroianni, C, Pozzetto, I, Caramma, I, Chiodera, A, Milini, P, Rizzardini, G, Moioli, M, Piolini, R, Ridolfo, A, Salpietro, S, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Orlando, R, Bonadies, G, Di Martino, F, Gentile, I, Maddaloni, L, Cattelan, A, Marinello, S, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Baldin, G, Capozzi, M, Cicalini, S, Fontanelli Sulekova, L, Iaiani, G, Latini, A, Mastrorosa, I, Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, Bagella, P, Rossetti, B, Franco, A, Fontana Del Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Mussini C., Lorenzini P., Cozzi-Lepri A., Marchetti G., Rusconi S., Gori A., Nozza S., Lichtner M., Antinori A., Cossarizza A., d'Arminio Monforte A., Castagna A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G. C., Perno C. F., Rezza G., von Schloesser F., Viale P., Ceccherini-Silberstein F., Girardi E., Lo Caputo S., Puoti M., Andreoni M., Ammassari A., Balotta C., Bandera A., Bonfanti P., Bonora S., Borderi M., Calcagno A., Calza L., Capobianchi M. R., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Guaraldi G., Lapadula G., Madeddu G., Maggiolo F., Marcotullio S., Monno L., Quiros Roldan E., Rossotti R., Santoro M. M., Saracino A., Zaccarelli M., Fanti I., Galli L., Rodano A., Shanyinde M., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petrone F., Prota G., Quartu S., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Santoro C., Suardi C., Donati V., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P. E., Piano P., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Mastroianni C., Pozzetto I., Caramma I., Chiodera A., Milini P., Rizzardini G., Moioli M. C., Piolini R., Ridolfo A. L., Salpietro S., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Orlando R., Bonadies G., Di Martino F., Gentile I., Maddaloni L., Cattelan A. M., Marinello S., Cascio A., Colomba C., Baldelli F., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M. A., Cristaudo A., Vullo V., Acinapura R., Baldin G., Capozzi M., Cicalini S., Fontanelli Sulekova L., Iaiani G., Latini A., Mastrorosa I., Plazzi M. M., Savinelli S., Vergori A., Cecchetto M., Viviani F., Bagella P., Rossetti B., Franco A., Fontana Del Vecchio R., Francisci D., Di Giuli C., Caramello P., Orofino G. C., Sciandra M., Bassetti M., Londero A., Pellizzer G., Manfrin V., Starnini G., Ialungo A., Mussini, C, Lorenzini, P, Cozzi-Lepri, A, Marchetti, G, Rusconi, S, Gori, A, Nozza, S, Lichtner, M, Antinori, A, Cossarizza, A, d'Arminio Monforte, A, Castagna, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Perno, C, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Puoti, M, Andreoni, M, Ammassari, A, Balotta, C, Bandera, A, Bonfanti, P, Bonora, S, Borderi, M, Calcagno, A, Calza, L, Capobianchi, M, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Guaraldi, G, Lapadula, G, Madeddu, G, Maggiolo, F, Marcotullio, S, Monno, L, Quiros Roldan, E, Rossotti, R, Santoro, M, Saracino, A, Zaccarelli, M, Fanti, I, Galli, L, Rodano, A, Shanyinde, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petrone, F, Prota, G, Quartu, S, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Santoro, C, Suardi, C, Donati, V, Verucchi, G, Minardi, C, Quirino, T, Abeli, C, Manconi, P, Piano, P, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Mastroianni, C, Pozzetto, I, Caramma, I, Chiodera, A, Milini, P, Rizzardini, G, Moioli, M, Piolini, R, Ridolfo, A, Salpietro, S, Tincati, C, Puzzolante, C, Abrescia, N, Chirianni, A, Borgia, G, Orlando, R, Bonadies, G, Di Martino, F, Gentile, I, Maddaloni, L, Cattelan, A, Marinello, S, Cascio, A, Colomba, C, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Baldin, G, Capozzi, M, Cicalini, S, Fontanelli Sulekova, L, Iaiani, G, Latini, A, Mastrorosa, I, Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, Bagella, P, Rossetti, B, Franco, A, Fontana Del Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Mussini C., Lorenzini P., Cozzi-Lepri A., Marchetti G., Rusconi S., Gori A., Nozza S., Lichtner M., Antinori A., Cossarizza A., d'Arminio Monforte A., Castagna A., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G. C., Perno C. F., Rezza G., von Schloesser F., Viale P., Ceccherini-Silberstein F., Girardi E., Lo Caputo S., Puoti M., Andreoni M., Ammassari A., Balotta C., Bandera A., Bonfanti P., Bonora S., Borderi M., Calcagno A., Calza L., Capobianchi M. R., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Guaraldi G., Lapadula G., Madeddu G., Maggiolo F., Marcotullio S., Monno L., Quiros Roldan E., Rossotti R., Santoro M. M., Saracino A., Zaccarelli M., Fanti I., Galli L., Rodano A., Shanyinde M., Tavelli A., Carletti F., Carrara S., Di Caro A., Graziano S., Petrone F., Prota G., Quartu S., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Santoro C., Suardi C., Donati V., Verucchi G., Minardi C., Quirino T., Abeli C., Manconi P. E., Piano P., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Mastroianni C., Pozzetto I., Caramma I., Chiodera A., Milini P., Rizzardini G., Moioli M. C., Piolini R., Ridolfo A. L., Salpietro S., Tincati C., Puzzolante C., Abrescia N., Chirianni A., Borgia G., Orlando R., Bonadies G., Di Martino F., Gentile I., Maddaloni L., Cattelan A. M., Marinello S., Cascio A., Colomba C., Baldelli F., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M. A., Cristaudo A., Vullo V., Acinapura R., Baldin G., Capozzi M., Cicalini S., Fontanelli Sulekova L., Iaiani G., Latini A., Mastrorosa I., Plazzi M. M., Savinelli S., Vergori A., Cecchetto M., Viviani F., Bagella P., Rossetti B., Franco A., Fontana Del Vecchio R., Francisci D., Di Giuli C., Caramello P., Orofino G. C., Sciandra M., Bassetti M., Londero A., Pellizzer G., Manfrin V., Starnini G., and Ialungo A.

Abstract

Background: The CD4/CD8 ratio has been associated with the risk of AIDS and non-AIDS events. We describe trends in immunological parameters in people who underwent a switch to monotherapy or dual therapy, compared to a control group remaining on triple antiretroviral therapy (ART). Methods: We included patients in Icona who started a three-drug combination ART regimen from an ART-naïve status and achieved a viral load ≤ 50 copies/mL; they were subsequently switched to another triple or to a mono or double regimen. Standard linear regression at fixed points in time (12-24 months after the switch) and linear mixed model analysis with random intercepts and slopes were used to compare CD4 and CD8 counts and their ratio over time according to regimen types (triple vs. dual and vs. mono). Results: A total of 1241 patients were included; 1073 switched to triple regimens, 104 to dual (72 with 1 nucleoside reverse transcriptase inhibitor (NRTI), 32 NRTI-sparing), and 64 to monotherapy. At 12 months after the switch, for the multivariable linear regression the mean change in the log10 CD4/CD8 ratio for patients on dual therapy was -0.03 (95% confidence interval (CI) -0.05, -0.0002), and the mean change in CD8 count was +99 (95% CI +12.1, +186.3), taking those on triple therapy as reference. In contrast, there was no evidence for a difference in CD4 count change. When using all counts, there was evidence for a significant difference in the slope of the ratio and CD8 count between people who were switched to triple (points/year change ratio = +0.056, CD8 = -25.7) and those to dual regimen (ratio = -0.029, CD8 = +110.4). Conclusions: We found an increase in CD8 lymphocytes in people who were switched to dual regimens compared to those who were switched to triple. Patients on monotherapy did not show significant differences. The long-term implications of this difference should be ascertained.

Published
2018

467. Highlights of the 2017 European AIDS Clinical Society (EACS) Guidelines for the treatment of adult HIV-positive persons version 9.0

Author

Ryom, L, Boesecke, C, Bracchi, M, Ambrosioni, J, Pozniak, A, Arribas, J, Behrens, G, Mallon, P, Puoti, M, Rauch, A, Miro, J, Kirk, O, Marzolini, C, Lundgren, J, Battegay, M, d'Arminio Monforte, A, Clumeck, N, Dedes, N, Gatell, J, Horban, A, Katlama, C, Mccormack, S, Molina, J, Mussini, C, Raffi, F, Reiss, P, Stellbrink, H, Bower, M, Cinque, P, Collins, S, Compston, J, De Wit, S, Fabbri, L, Fux, C, Guaraldi, G, Martinez, E, Papapoulos, S, du Pasquier, R, Poulter, N, Williams, I, Winston, A, Berenguer, J, Bhagani, S, Bruno, R, Konov, S, Lacombe, K, Mauss, S, Mendao, L, Peters, L, Rockstroh, J, Fatkenheuer, G, Furrer, H, Mocroft, A, Morlat, P, Volny-Anne, A, Ryom L., Boesecke C., Bracchi M., Ambrosioni J., Pozniak A., Arribas J., Behrens G., Mallon P. G. M., Puoti M., Rauch A., Miro J. M., Kirk O., Marzolini C., Lundgren J. D., Battegay M., d'Arminio Monforte A., Clumeck N., Dedes N., Gatell J. M., Horban A., Katlama C., McCormack S., Molina J. -M., Mussini C., Raffi F., Reiss P., Stellbrink H. -J., Bower M., Cinque P., Collins S., Compston J., De Wit S., Fabbri L. M., Fux C. A., Guaraldi G., Martinez E., Papapoulos S., du Pasquier R., Poulter N., Williams I., Winston A., Berenguer J., Bhagani S., Bruno R., Konov S., Lacombe K., Mauss S., Mendao L., Peters L., Rockstroh J. K., Fatkenheuer G., Furrer H., Mocroft A., Morlat P., Volny-Anne A., Ryom, L, Boesecke, C, Bracchi, M, Ambrosioni, J, Pozniak, A, Arribas, J, Behrens, G, Mallon, P, Puoti, M, Rauch, A, Miro, J, Kirk, O, Marzolini, C, Lundgren, J, Battegay, M, d'Arminio Monforte, A, Clumeck, N, Dedes, N, Gatell, J, Horban, A, Katlama, C, Mccormack, S, Molina, J, Mussini, C, Raffi, F, Reiss, P, Stellbrink, H, Bower, M, Cinque, P, Collins, S, Compston, J, De Wit, S, Fabbri, L, Fux, C, Guaraldi, G, Martinez, E, Papapoulos, S, du Pasquier, R, Poulter, N, Williams, I, Winston, A, Berenguer, J, Bhagani, S, Bruno, R, Konov, S, Lacombe, K, Mauss, S, Mendao, L, Peters, L, Rockstroh, J, Fatkenheuer, G, Furrer, H, Mocroft, A, Morlat, P, Volny-Anne, A, Ryom L., Boesecke C., Bracchi M., Ambrosioni J., Pozniak A., Arribas J., Behrens G., Mallon P. G. M., Puoti M., Rauch A., Miro J. M., Kirk O., Marzolini C., Lundgren J. D., Battegay M., d'Arminio Monforte A., Clumeck N., Dedes N., Gatell J. M., Horban A., Katlama C., McCormack S., Molina J. -M., Mussini C., Raffi F., Reiss P., Stellbrink H. -J., Bower M., Cinque P., Collins S., Compston J., De Wit S., Fabbri L. M., Fux C. A., Guaraldi G., Martinez E., Papapoulos S., du Pasquier R., Poulter N., Williams I., Winston A., Berenguer J., Bhagani S., Bruno R., Konov S., Lacombe K., Mauss S., Mendao L., Peters L., Rockstroh J. K., Fatkenheuer G., Furrer H., Mocroft A., Morlat P., and Volny-Anne A.

Abstract

Background: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. Guideline highlights: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management. Recommendations on the clinical situations in which tenofovir alafenamide may be considered over tenofovir disoproxil fumarate are provided, and recommendations on which antiretrovirals can be used safely during pregnancy have been revised. Renal and bone toxicity and hepatitis C virus (HCV) treatment have been added as potential reasons for ART switches in fully virologically suppressed individuals, and dolutegravir/rilpivirine has been included as a treatment option. In contrast, dolutegravir monotherapy is not recommended. New recommendations on non-alcoholic fatty liver disease, chronic lung disease, solid organ transplantation, and prescribing in elderly are included, and human papilloma virus (HPV) vaccination recommendations have been expanded. All drug–drug interaction tables have been updated and new tables are included. Treatment options for direct-acting antivirals (DAAs) have been updated and include the latest combinations of sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Recommendations on management of DAA failure and acute HCV infection have been expanded. For treatment of tuberculosis (TB), it is underlined that intermittent treatment is contraindicated, and for resistant TB new data suggest that using a three-drug combination may be as effective as a five-drug regimen, and may reduce treatment duration from 18-24 to 6-10 months. Conclusions: Version 9.0 of the EACS Guidelines provides a holistic approach to HIV care and is translated

Published
2018

468. Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

Author

Panayidou, K, Davies, M, Anderegg, N, Egger, M, Fatti, G, Vinikoor, M, Sawry, S, Ehmer, J, Eley, B, Phiri, S, Technau, K, Chimbetete, C, Rabie, H, Boulle, A, Tanser, F, Wood, R, Wools-Kaloustian, K, Vreeman, R, Oyaro, P, Ayaya, S, Nakigozi, G, Musick, B, Yiannoutsos, C, Amorissani-Folquet, M, Takassi, E, Sylla, M, Renner, L, Malateste, K, Desmonde, S, Leroy, V, Kurniati, N, Hansudewechakul, R, Nguyen, L, Ly, P, Truong, K, Kariminia, A, Sohn, A, Edmonds, A, Yumo, H, Dusingize, J, Yotebieng, M, Judd, A, Rojo, P, Smit, C, Grabar, S, Warszwarski, J, Chene, G, Raban, D, Patel, K, Seage, G, Van Dyke, R, Oleske, J, Williams, P, Abzug, M, Succi, R, Machado, D, Pinto, J, Rouzier, V, Luque, M, Mejia, F, Khol, V, Tucker, J, Kumarasamy, N, Saghayam, S, Chandrasekaran, E, Wati, D, Vedaswari, D, Malino, I, Muktiarti, D, Fong, S, Lim, M, Daut, F, Nik Yusoff, N, Mohamad, P, Mohamed, T, Drawis, M, Nallusamy, R, Chan, K, Sudjaritruk, T, Sirisanthana, V, Aurpibul, L, Oberdorfer, P, Denjanta, S, Watanaporn, S, Kongphonoi, A, Lumbiganon, P, Kosalaraksa, P, Tharnprisan, P, Udomphanit, T, Jourdain, G, Puthanakit, T, Anugulruengkitt, S, Phadungphon, C, Chokephaibulkit, K, Lapphra, K, Phongsamart, W, Sricharoenchai, S, Du, Q, Nguyen, C, Do, V, Ha, T, An, V, Khu, D, Pham, A, Le, O, Ross, J, Sethaputra, C, Law, M, Cahn, P, Cesar, C, Fink, V, Sued, O, Dell'Isola, E, Perez, H, Valiente, J, Yamamoto, C, Grinsztejn, B, Veloso, V, Luz, P, de Boni, R, Wagner, S, Friedman, R, Moreira, R, Ferreira, F, Maia, M, de Menezes Succi, R, Barbosa Gouv E A, A, Wolff, M, Cortes, C, Rodriguez, M, Allendes, G, Pape, J, Marcelin, A, Perodin, C, Padgett, D, Madero, J, Ramirez, B, Belaunzaran, P, Vega, Y, Gotuzzo, E, Carriquiry, G, Mcgowan, C, Shepherd, B, Sterling, T, Jayathilake, K, Person, A, Rebeiro, P, Giganti, M, Castilho, J, Duda, S, Maruri, F, Vansell, H, P E Lagie, N, Gateretse, P, Munezero, J, Nitereka, V, Niyongabo, T, Twizere, C, Bukuru, H, Nahimana, T, Biziragusenyuka, J, Manyundo, R, Atsu, K, Mbuh, T, Ajeh, R, Benwi, M, Dzudie, A, Mbuh, A, Ngamani, M, Nkome, V, Amadou, D, Ngassam, E, Pefura Yone, E, Ewanoge, A, Fuhngwa, N, Moki, C, Akele, C, Kitetele, F, Lelo, P, Tabala, M, Okitolonda, E, Wenzi, L, Diafouka, M, Ekat, M, Nsonde, D, Mafou, A, Ntarambirwa, F, Tuyishimire, Y, Hakizimana, T, Ayinkamiye, J, Mukantwali, S, Kayitesi, H, Uwamahoro, O, Habumuremyi, V, Mukamana, J, Kubwimana, G, Mugenzi, P, Muhoza, B, Munyaneza, A, Ndahiro, E, Nyiransabimana, D, D'Amour Sinayobye, J, Sugira, V, Benekigeri, C, Mbaraga, G, Adedimeji, A, Anastos, K, Dilorenzo, M, Murchison, L, Addison, D, Baker, M, Brazier, E, Jones, H, Kelvin, E, Kulkarni, S, Nash, D, Tymejczyk, O, Elul, B, Cai, X, Hoover, D, Kim, H, Li, C, Shi, Q, Lancaster, K, Kuniholm, M, Parcesepe, A, Kimmel, A, Mcnairy, M, Diero, L, Plus, A, Bukusi, E, Ssali, J, Nalugoda, F, Somi, G, Lyamuya, R, Ngonyani, K, Lugina, E, Urassa, M, Michael, D, Zannou, M, Poda, A, Sarfo, F, Messou, E, Chenal, H, Minga, K, Bissagnene, E, Tanon, A, Seydi, M, Patassi, A, Koumakpai-Adeothy, S, N'Gbeche, S, Bosse, C, Kouakou, K, Folquet, M, Eboua, F, Traore, F, Dabis, F, Arrive, E, Balestre, E, Becquet, R, Bernard, C, Arikawa, S, Doring, A, Jaquet, A, Rabourdin, E, Tiendrebeogo, T, Jesson, J, Ekouevi, D, Azani, J, Coffi E, P, Gnepa, G, Kouadio, C, Tchounga, B, Maartens, G, Lettow, M, Muhairwe, J, Jores, A, Kamenova, K, Fox, M, Prozesky, H, Zangerle, R, Touloumi, G, Warszawski, J, Meyer, L, Krause, M, Ghosn, J, Leport, C, Wittkop, L, Reiss, P, Wit, F, Prins, M, Bucher, H, Gibb, D, Fatkenheuer, G, Del Amo, J, Obel, N, Thorne, C, Mocroft, A, Kirk, O, Stephan, C, Perez-Hoyos, S, Hamouda, O, Bartmeyer, B, Chkhartishvili, N, Noguera-Julian, A, Antinori, A, D'Arminio Monforte, A, Brockmeyer, N, Prieto, L, Conejo, P, Soriano-Arandes, A, Battegay, M, Kouyos, R, Mussini, C, Tookey, P, Casabona, J, Miro, J, Castagna, A, Konopnick, D, Goetghebuer, T, Sonnerborg, A, Torti, C, Sabin, C, Teira, R, Garrido, M, Haerry, D, de Wit, S, Costagliola, D, Raben, D, Barger, D, Schwimmer, C, Termote, M, Campbell, M, Frederiksen, C, Friis-Moller, N, Kjaer, J, Brandt, R, Berenguer, J, Bohlius, J, Bouteloup, V, Cozzi-Lepri, A, Dorrucci, M, Dunn, D, Furrer, H, Guiguet, M, Lambotte, O, Lodi, S, Matheron, S, Monge, S, Nakagawa, F, Paredes, R, Phillips, A, Puoti, M, Rohner, E, Schomaker, M, Sterne, J, Thiebaut, R, van der Valk, M, Hazra, R, Heckman, B, O'Gara, E, Siminski, S, Panayidou K., Davies M. -A., Anderegg N., Egger M., Fatti G., Vinikoor M., Sawry S., Ehmer J., Eley B., Phiri S., Technau K. -G. u. N., Chimbetete C., Rabie H., Boulle A., Tanser F., Wood R., Wools-Kaloustian K., Vreeman R., Oyaro P., Ayaya S., Nakigozi G., Musick B., Yiannoutsos C., Amorissani-Folquet M., Takassi E., Sylla M., Renner L., Malateste K., Desmonde S., Leroy V., Kurniati N., Hansudewechakul R., Nguyen L. V., Ly P. S., Truong K. H., Kariminia A., Sohn A. H., Edmonds A., Yumo H. A., Dusingize J. C., Yotebieng M., Judd A., Rojo P., Smit C., Grabar S., Warszwarski J., Chene G., Raban D., Patel K., Seage G. R., Van Dyke R. B., Oleske J., Williams P. L., Abzug M. J., Succi R., Machado D. M., Pinto J., Rouzier V., Luque M., Mejia F., Khol V., Tucker J., Kumarasamy N., Saghayam S., Chandrasekaran E., Wati D. K., Vedaswari D., Malino I. Y., Muktiarti D., Fong S. M., Lim M., Daut F., Nik Yusoff N. K., Mohamad P., Mohamed T. J., Drawis M. R., Nallusamy R., Chan K. C., Sudjaritruk T., Sirisanthana V., Aurpibul L., Oberdorfer P., Denjanta S., Watanaporn S., Kongphonoi A., Lumbiganon P., Kosalaraksa P., Tharnprisan P., Udomphanit T., Jourdain G., Puthanakit T., Anugulruengkitt S., Phadungphon C., Chokephaibulkit K., Lapphra K., Phongsamart W., Sricharoenchai S., Du Q. T., Nguyen C. H., Do V. C., Ha T. M., An V. T., Khu D. T. K., Pham A. N., Nguyen L. T., Le O. N., Ross J. L., Sethaputra C., Law M. G., Cahn P., Cesar C., Fink V., Sued O., Dell'isola E., Perez H., Valiente J., Yamamoto C., Grinsztejn B., Veloso V., Luz P., de Boni R., Wagner S. C., Friedman R., Moreira R., Ferreira F., Maia M., de Menezes Succi R. C., Barbosa Gouv E A A. F. a. T., Wolff M., Cortes C., Rodriguez M. F., Allendes G., Pape J. W., Marcelin A., Perodin C., Luque M. T., Padgett D., Madero J. S., Ramirez B. C., Belaunzaran P., Vega Y. C., Gotuzzo E., Carriquiry G., McGowan C. C., Shepherd B. E., Sterling T., Jayathilake K., Person A. K., Rebeiro P. F., Giganti M., Castilho J., Duda S. N., Maruri F., Vansell H., P E Lagie N., Gateretse P., Munezero J., Nitereka V., Niyongabo T., Twizere C., Bukuru H., Nahimana T., Biziragusenyuka J., Manyundo R. S., Atsu K., Mbuh T., Ajeh R., Benwi M., Dzudie A., Mbuh A., Ngamani M. L., Nkome V., Amadou D., Ngassam E., Pefura Yone E. W., Ewanoge A. N., Fuhngwa N., Moki C., Akele C., Kitetele F., Lelo P., Tabala M., Okitolonda E. W., Wenzi L., Diafouka M., Ekat M. H., Nsonde D. M., Mafou A., Ntarambirwa F., Tuyishimire Y., Hakizimana T., Ayinkamiye J., Mukantwali S., Kayitesi H., Uwamahoro O., Habumuremyi V., Mukamana J., Kubwimana G., Mugenzi P., Muhoza B., Munyaneza A., Ndahiro E., Nyiransabimana D., D'Amour Sinayobye J., Sugira V., Benekigeri C., Mbaraga G., Adedimeji A., Anastos K., Dilorenzo M., Murchison L., Ross J., Addison D., Baker M., Brazier E., Jones H., Kelvin E., Kulkarni S., Nash D., Tymejczyk O., Elul B., Cai X., Hoover D., Kim H. -Y., Li C., Shi Q., Lancaster K., Kuniholm M., Parcesepe A., Duda S., Kimmel A., McNairy M., Diero L., Plus A. M. P. A. T. H., Bukusi E., Ssali J., Nalugoda F., Somi G. R., Lyamuya R. E., Ngonyani K., Lugina E., Urassa M., Michael D., Zannou M. D., Poda A., Sarfo F. S., Messou E., Chenal H., Minga K. A., Bissagnene E., Tanon A., Seydi M., Patassi A. A., Koumakpai-Adeothy S. A., Renner L. A., N'gbeche S. M., Bosse C. A., Kouakou K., Folquet M. A., Eboua F. c. O. T., Traore F. D., Dabis F. c. O., Arrive E., Balestre E., Becquet R., Bernard C., Arikawa S. C., Doring A., Jaquet A., Rabourdin E., Tiendrebeogo T., Jesson J., Ekouevi D. K., Azani J. -C., Coffi E P., Gnepa G., Kouadio C. G. K., Tchounga B., Maartens G., Lettow M. V., Muhairwe J., Jores A., Kamenova K., Fox M. P., Prozesky H., Zangerle R., Touloumi G., Warszawski J., Meyer L., Krause M. M., Ghosn J., Leport C., Wittkop L., Reiss P., Wit F., Prins M., Bucher H., Gibb D., Fatkenheuer G., Del Amo J., Obel N., Thorne C., Mocroft A., Kirk O., Stephan C., Perez-Hoyos S., Hamouda O., Bartmeyer B., Chkhartishvili N., Noguera-Julian A., Antinori A., D'Arminio Monforte A., Brockmeyer N., Prieto L., Conejo P. R., Soriano-Arandes A., Battegay M., Kouyos R., Mussini C., Tookey P., Casabona J., Miro J. M., Castagna A., Konopnick D., Goetghebuer T., Sonnerborg A., Torti C., Sabin C., Teira R., Garrido M., Haerry D., de Wit S., Costagliola D., Raben D., Barger D., Schwimmer C., Termote M., Campbell M., Frederiksen C. M., Friis-Moller N., Kjaer J., Brandt R. S., Berenguer J., Bohlius J., Bouteloup V., Cozzi-Lepri A., Dorrucci M., Dunn D., Furrer H., Guiguet M., Lambotte O., Lodi S., Matheron S., Miro J. M. ª., Monge S., Nakagawa F., Paredes R., Phillips A., Puoti M., Rohner E., Schomaker M., Sterne J., Thiebaut R., van der Valk M., Hazra R., Heckman B., O'gara E., Siminski S., Panayidou, K, Davies, M, Anderegg, N, Egger, M, Fatti, G, Vinikoor, M, Sawry, S, Ehmer, J, Eley, B, Phiri, S, Technau, K, Chimbetete, C, Rabie, H, Boulle, A, Tanser, F, Wood, R, Wools-Kaloustian, K, Vreeman, R, Oyaro, P, Ayaya, S, Nakigozi, G, Musick, B, Yiannoutsos, C, Amorissani-Folquet, M, Takassi, E, Sylla, M, Renner, L, Malateste, K, Desmonde, S, Leroy, V, Kurniati, N, Hansudewechakul, R, Nguyen, L, Ly, P, Truong, K, Kariminia, A, Sohn, A, Edmonds, A, Yumo, H, Dusingize, J, Yotebieng, M, Judd, A, Rojo, P, Smit, C, Grabar, S, Warszwarski, J, Chene, G, Raban, D, Patel, K, Seage, G, Van Dyke, R, Oleske, J, Williams, P, Abzug, M, Succi, R, Machado, D, Pinto, J, Rouzier, V, Luque, M, Mejia, F, Khol, V, Tucker, J, Kumarasamy, N, Saghayam, S, Chandrasekaran, E, Wati, D, Vedaswari, D, Malino, I, Muktiarti, D, Fong, S, Lim, M, Daut, F, Nik Yusoff, N, Mohamad, P, Mohamed, T, Drawis, M, Nallusamy, R, Chan, K, Sudjaritruk, T, Sirisanthana, V, Aurpibul, L, Oberdorfer, P, Denjanta, S, Watanaporn, S, Kongphonoi, A, Lumbiganon, P, Kosalaraksa, P, Tharnprisan, P, Udomphanit, T, Jourdain, G, Puthanakit, T, Anugulruengkitt, S, Phadungphon, C, Chokephaibulkit, K, Lapphra, K, Phongsamart, W, Sricharoenchai, S, Du, Q, Nguyen, C, Do, V, Ha, T, An, V, Khu, D, Pham, A, Le, O, Ross, J, Sethaputra, C, Law, M, Cahn, P, Cesar, C, Fink, V, Sued, O, Dell'Isola, E, Perez, H, Valiente, J, Yamamoto, C, Grinsztejn, B, Veloso, V, Luz, P, de Boni, R, Wagner, S, Friedman, R, Moreira, R, Ferreira, F, Maia, M, de Menezes Succi, R, Barbosa Gouv E A, A, Wolff, M, Cortes, C, Rodriguez, M, Allendes, G, Pape, J, Marcelin, A, Perodin, C, Padgett, D, Madero, J, Ramirez, B, Belaunzaran, P, Vega, Y, Gotuzzo, E, Carriquiry, G, Mcgowan, C, Shepherd, B, Sterling, T, Jayathilake, K, Person, A, Rebeiro, P, Giganti, M, Castilho, J, Duda, S, Maruri, F, Vansell, H, P E Lagie, N, Gateretse, P, Munezero, J, Nitereka, V, Niyongabo, T, Twizere, C, Bukuru, H, Nahimana, T, Biziragusenyuka, J, Manyundo, R, Atsu, K, Mbuh, T, Ajeh, R, Benwi, M, Dzudie, A, Mbuh, A, Ngamani, M, Nkome, V, Amadou, D, Ngassam, E, Pefura Yone, E, Ewanoge, A, Fuhngwa, N, Moki, C, Akele, C, Kitetele, F, Lelo, P, Tabala, M, Okitolonda, E, Wenzi, L, Diafouka, M, Ekat, M, Nsonde, D, Mafou, A, Ntarambirwa, F, Tuyishimire, Y, Hakizimana, T, Ayinkamiye, J, Mukantwali, S, Kayitesi, H, Uwamahoro, O, Habumuremyi, V, Mukamana, J, Kubwimana, G, Mugenzi, P, Muhoza, B, Munyaneza, A, Ndahiro, E, Nyiransabimana, D, D'Amour Sinayobye, J, Sugira, V, Benekigeri, C, Mbaraga, G, Adedimeji, A, Anastos, K, Dilorenzo, M, Murchison, L, Addison, D, Baker, M, Brazier, E, Jones, H, Kelvin, E, Kulkarni, S, Nash, D, Tymejczyk, O, Elul, B, Cai, X, Hoover, D, Kim, H, Li, C, Shi, Q, Lancaster, K, Kuniholm, M, Parcesepe, A, Kimmel, A, Mcnairy, M, Diero, L, Plus, A, Bukusi, E, Ssali, J, Nalugoda, F, Somi, G, Lyamuya, R, Ngonyani, K, Lugina, E, Urassa, M, Michael, D, Zannou, M, Poda, A, Sarfo, F, Messou, E, Chenal, H, Minga, K, Bissagnene, E, Tanon, A, Seydi, M, Patassi, A, Koumakpai-Adeothy, S, N'Gbeche, S, Bosse, C, Kouakou, K, Folquet, M, Eboua, F, Traore, F, Dabis, F, Arrive, E, Balestre, E, Becquet, R, Bernard, C, Arikawa, S, Doring, A, Jaquet, A, Rabourdin, E, Tiendrebeogo, T, Jesson, J, Ekouevi, D, Azani, J, Coffi E, P, Gnepa, G, Kouadio, C, Tchounga, B, Maartens, G, Lettow, M, Muhairwe, J, Jores, A, Kamenova, K, Fox, M, Prozesky, H, Zangerle, R, Touloumi, G, Warszawski, J, Meyer, L, Krause, M, Ghosn, J, Leport, C, Wittkop, L, Reiss, P, Wit, F, Prins, M, Bucher, H, Gibb, D, Fatkenheuer, G, Del Amo, J, Obel, N, Thorne, C, Mocroft, A, Kirk, O, Stephan, C, Perez-Hoyos, S, Hamouda, O, Bartmeyer, B, Chkhartishvili, N, Noguera-Julian, A, Antinori, A, D'Arminio Monforte, A, Brockmeyer, N, Prieto, L, Conejo, P, Soriano-Arandes, A, Battegay, M, Kouyos, R, Mussini, C, Tookey, P, Casabona, J, Miro, J, Castagna, A, Konopnick, D, Goetghebuer, T, Sonnerborg, A, Torti, C, Sabin, C, Teira, R, Garrido, M, Haerry, D, de Wit, S, Costagliola, D, Raben, D, Barger, D, Schwimmer, C, Termote, M, Campbell, M, Frederiksen, C, Friis-Moller, N, Kjaer, J, Brandt, R, Berenguer, J, Bohlius, J, Bouteloup, V, Cozzi-Lepri, A, Dorrucci, M, Dunn, D, Furrer, H, Guiguet, M, Lambotte, O, Lodi, S, Matheron, S, Monge, S, Nakagawa, F, Paredes, R, Phillips, A, Puoti, M, Rohner, E, Schomaker, M, Sterne, J, Thiebaut, R, van der Valk, M, Hazra, R, Heckman, B, O'Gara, E, Siminski, S, Panayidou K., Davies M. -A., Anderegg N., Egger M., Fatti G., Vinikoor M., Sawry S., Ehmer J., Eley B., Phiri S., Technau K. -G. u. N., Chimbetete C., Rabie H., Boulle A., Tanser F., Wood R., Wools-Kaloustian K., Vreeman R., Oyaro P., Ayaya S., Nakigozi G., Musick B., Yiannoutsos C., Amorissani-Folquet M., Takassi E., Sylla M., Renner L., Malateste K., Desmonde S., Leroy V., Kurniati N., Hansudewechakul R., Nguyen L. V., Ly P. S., Truong K. H., Kariminia A., Sohn A. H., Edmonds A., Yumo H. A., Dusingize J. C., Yotebieng M., Judd A., Rojo P., Smit C., Grabar S., Warszwarski J., Chene G., Raban D., Patel K., Seage G. R., Van Dyke R. B., Oleske J., Williams P. L., Abzug M. J., Succi R., Machado D. M., Pinto J., Rouzier V., Luque M., Mejia F., Khol V., Tucker J., Kumarasamy N., Saghayam S., Chandrasekaran E., Wati D. K., Vedaswari D., Malino I. Y., Muktiarti D., Fong S. M., Lim M., Daut F., Nik Yusoff N. K., Mohamad P., Mohamed T. J., Drawis M. R., Nallusamy R., Chan K. C., Sudjaritruk T., Sirisanthana V., Aurpibul L., Oberdorfer P., Denjanta S., Watanaporn S., Kongphonoi A., Lumbiganon P., Kosalaraksa P., Tharnprisan P., Udomphanit T., Jourdain G., Puthanakit T., Anugulruengkitt S., Phadungphon C., Chokephaibulkit K., Lapphra K., Phongsamart W., Sricharoenchai S., Du Q. T., Nguyen C. H., Do V. C., Ha T. M., An V. T., Khu D. T. K., Pham A. N., Nguyen L. T., Le O. N., Ross J. L., Sethaputra C., Law M. G., Cahn P., Cesar C., Fink V., Sued O., Dell'isola E., Perez H., Valiente J., Yamamoto C., Grinsztejn B., Veloso V., Luz P., de Boni R., Wagner S. C., Friedman R., Moreira R., Ferreira F., Maia M., de Menezes Succi R. C., Barbosa Gouv E A A. F. a. T., Wolff M., Cortes C., Rodriguez M. F., Allendes G., Pape J. W., Marcelin A., Perodin C., Luque M. T., Padgett D., Madero J. S., Ramirez B. C., Belaunzaran P., Vega Y. C., Gotuzzo E., Carriquiry G., McGowan C. C., Shepherd B. E., Sterling T., Jayathilake K., Person A. K., Rebeiro P. F., Giganti M., Castilho J., Duda S. N., Maruri F., Vansell H., P E Lagie N., Gateretse P., Munezero J., Nitereka V., Niyongabo T., Twizere C., Bukuru H., Nahimana T., Biziragusenyuka J., Manyundo R. S., Atsu K., Mbuh T., Ajeh R., Benwi M., Dzudie A., Mbuh A., Ngamani M. L., Nkome V., Amadou D., Ngassam E., Pefura Yone E. W., Ewanoge A. N., Fuhngwa N., Moki C., Akele C., Kitetele F., Lelo P., Tabala M., Okitolonda E. W., Wenzi L., Diafouka M., Ekat M. H., Nsonde D. M., Mafou A., Ntarambirwa F., Tuyishimire Y., Hakizimana T., Ayinkamiye J., Mukantwali S., Kayitesi H., Uwamahoro O., Habumuremyi V., Mukamana J., Kubwimana G., Mugenzi P., Muhoza B., Munyaneza A., Ndahiro E., Nyiransabimana D., D'Amour Sinayobye J., Sugira V., Benekigeri C., Mbaraga G., Adedimeji A., Anastos K., Dilorenzo M., Murchison L., Ross J., Addison D., Baker M., Brazier E., Jones H., Kelvin E., Kulkarni S., Nash D., Tymejczyk O., Elul B., Cai X., Hoover D., Kim H. -Y., Li C., Shi Q., Lancaster K., Kuniholm M., Parcesepe A., Duda S., Kimmel A., McNairy M., Diero L., Plus A. M. P. A. T. H., Bukusi E., Ssali J., Nalugoda F., Somi G. R., Lyamuya R. E., Ngonyani K., Lugina E., Urassa M., Michael D., Zannou M. D., Poda A., Sarfo F. S., Messou E., Chenal H., Minga K. A., Bissagnene E., Tanon A., Seydi M., Patassi A. A., Koumakpai-Adeothy S. A., Renner L. A., N'gbeche S. M., Bosse C. A., Kouakou K., Folquet M. A., Eboua F. c. O. T., Traore F. D., Dabis F. c. O., Arrive E., Balestre E., Becquet R., Bernard C., Arikawa S. C., Doring A., Jaquet A., Rabourdin E., Tiendrebeogo T., Jesson J., Ekouevi D. K., Azani J. -C., Coffi E P., Gnepa G., Kouadio C. G. K., Tchounga B., Maartens G., Lettow M. V., Muhairwe J., Jores A., Kamenova K., Fox M. P., Prozesky H., Zangerle R., Touloumi G., Warszawski J., Meyer L., Krause M. M., Ghosn J., Leport C., Wittkop L., Reiss P., Wit F., Prins M., Bucher H., Gibb D., Fatkenheuer G., Del Amo J., Obel N., Thorne C., Mocroft A., Kirk O., Stephan C., Perez-Hoyos S., Hamouda O., Bartmeyer B., Chkhartishvili N., Noguera-Julian A., Antinori A., D'Arminio Monforte A., Brockmeyer N., Prieto L., Conejo P. R., Soriano-Arandes A., Battegay M., Kouyos R., Mussini C., Tookey P., Casabona J., Miro J. M., Castagna A., Konopnick D., Goetghebuer T., Sonnerborg A., Torti C., Sabin C., Teira R., Garrido M., Haerry D., de Wit S., Costagliola D., Raben D., Barger D., Schwimmer C., Termote M., Campbell M., Frederiksen C. M., Friis-Moller N., Kjaer J., Brandt R. S., Berenguer J., Bohlius J., Bouteloup V., Cozzi-Lepri A., Dorrucci M., Dunn D., Furrer H., Guiguet M., Lambotte O., Lodi S., Matheron S., Miro J. M. ª., Monge S., Nakagawa F., Paredes R., Phillips A., Puoti M., Rohner E., Schomaker M., Sterne J., Thiebaut R., van der Valk M., Hazra R., Heckman B., O'gara E., and Siminski S.

Abstract

Introduction: The CD4 cell count and percent at initiation of combination antiretroviral therapy (cART) are measures of advanced HIV disease and thus are important indicators of programme performance for children living with HIV. In particular, World Health Organization (WHO) 2017 guidelines on advanced HIV disease noted that >80% of children aged <5 years started cART with WHO Stage 3 or 4 disease or severe immune suppression. We compared temporal trends in CD4 measures at cART start in children from low-, middle- and high-income countries, and examined the effect of WHO treatment initiation guidelines on reducing the proportion of children initiating cART with advanced disease. Methods: We included children aged <16 years from the International Epidemiology Databases to Evaluate acquired immunodeficiency syndrome (AIDS) (IeDEA) Collaboration (Caribbean, Central and South America, Asia-Pacific, and West, Central, East and Southern Africa), the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE), the North American Pediatric HIV/AIDS Cohort Study (PHACS) and International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) 219C study. Severe immunodeficiency was defined using WHO guidelines. We used generalized weighted additive mixed effect models to analyse temporal trends in CD4 measurements and piecewise regression to examine the impact of 2006 and 2010 WHO cART initiation guidelines. Results: We included 52,153 children from fourteen low-, eight lower middle-, five upper middle- and five high-income countries. From 2004 to 2013, the estimated percentage of children starting cART with severe immunodeficiency declined from 70% to 42% (low-income), 67% to 64% (lower middle-income) and 61% to 43% (upper middle-income countries). In high-income countries, severe immunodeficiency at cART initiation declined from 45% (1996) to 14% (2012). There were annual decreases in the percentage of children with severe immuno

Published
2018

469. Incidence and predictors of single drug discontinuation according to the presence of HCV coinfection in HIV patients from the ICONA Foundation Cohort Study

Author

Leone, S, Shanyinde, M, Cozzi Lepri, A, Lampe, F, Caramello, P, Costantini, A, Giacometti, A, De Luca, A, Cingolani, A, Ceccherini Silberstein, F, Puoti, M, Gori, A, d'Arminio Monforte, A, Leone S., Shanyinde M., Cozzi Lepri A., Lampe F. C., Caramello P., Costantini A., Giacometti A., De Luca A., Cingolani A., Ceccherini Silberstein F., Puoti M., Gori A., d'Arminio Monforte A., Leone, S, Shanyinde, M, Cozzi Lepri, A, Lampe, F, Caramello, P, Costantini, A, Giacometti, A, De Luca, A, Cingolani, A, Ceccherini Silberstein, F, Puoti, M, Gori, A, d'Arminio Monforte, A, Leone S., Shanyinde M., Cozzi Lepri A., Lampe F. C., Caramello P., Costantini A., Giacometti A., De Luca A., Cingolani A., Ceccherini Silberstein F., Puoti M., Gori A., and d'Arminio Monforte A.

Abstract

To evaluate incidence rates of and predictors for any antiretroviral (ART) drug discontinuation by HCV infection status in a large Italian cohort of HIV infected patients. All patients enrolled in ICONA who started combination antiretroviral therapy (cART) containing abacavir or tenofovir or emtricitabine or lamivudine plus efavirenz or rilpivirine or atazanavir/r or darunavir/r (DRV/r) or lopinavir/r or dolutegravir or elvitegravir or raltegravir were included. Multivariate Poisson regression models were used to determine factors independently associated with single ART drug discontinuation. Inverse probability weighting method to control for potential informative censoring was applied. Data from 10,637 patients were analyzed and 1,030 (9.7%) were HCV-Ab positive. Overall, there were 15,464 ART discontinuations due to any reason in 82,415.9 person-years of follow-up (PYFU) for an incidence rate (IR) of 18.8 (95% confidence interval [95%CI] 18.5–19.1) per 100 PYFU. No difference in IR of ART discontinuation due to any reason between HCV-infected and -uninfected patients was found. In a multivariable Poisson regression model, HCV-infected participants were at higher risk of darunavir/r discontinuation due to any reason (adjusted incidence rate ratio = 1.5, 95%CI 1.01–2.22, p value = 0.045) independently of demographics, HIV-related, ART and life-style factors. Among DRV/r treated patients, we found that HCV-viremic patients had twice the risk of ART discontinuation due to any reason than HCV-aviremic patients. In conclusion, HIV/HCV coinfected patients had a marginal risk increase of DRV/r discontinuation due to any reason compared with those without coinfection.

Published
2018

470. Durability and tolerability of first-line regimens including two nucleoside reverse transcriptase inhibitors and raltegravir or ritonavir boosted-atazanavir or -darunavir: data from the ICONA Cohort *

Author

d'Arminio Monforte, A, Lorenzini, P, Cozzi-Lepri, A, Mussini, C, Castagna, A, Baldelli, F, Puoti, M, Vichi, F, Maddaloni, A, Lo Caputo, S, Gianotti, N, Antinori, A, d'Arminio Monforte A., Lorenzini P., Cozzi-Lepri A., Mussini C., Castagna A., Baldelli F., Puoti M., Vichi F., Maddaloni A., Lo Caputo S., Gianotti N., Antinori A., d'Arminio Monforte, A, Lorenzini, P, Cozzi-Lepri, A, Mussini, C, Castagna, A, Baldelli, F, Puoti, M, Vichi, F, Maddaloni, A, Lo Caputo, S, Gianotti, N, Antinori, A, d'Arminio Monforte A., Lorenzini P., Cozzi-Lepri A., Mussini C., Castagna A., Baldelli F., Puoti M., Vichi F., Maddaloni A., Lo Caputo S., Gianotti N., and Antinori A.

Abstract

Background: We aimed to mimic the ACTG 5257 trial, comparing raltegravir (RAL), ritonavir-boosted atazavavir (ATV/r) and ritonavir-boosted darunavir (DRV/r) in the observational setting. Methods: All the ICONA patients starting a first cART with 2NRTI + ATV/r, DRV/r or RAL were included. Primary end-point was treatment failure, i.e. virological failure (confirmed HIV-RNA > 200copies/mL > 6 months therapy) or discontinuation for any reason of the third drug. Secondary end-points: virological failure50 (50 copies/mL threshold), and discontinuation of the third drug due to intolerance/toxicity. Cox regression analyses were run to compare the risk of outcomes between the three regimens. Results: 2249 patients were included, 985 (44%) initiated ATV/r, 1023 (45%) DRV/r and 241 (11%) RAL; median follow-up of 3.6 years (IQR: 2.3–5.2). After controlling for baseline confounding factors, patients given ATV/r showed a 26% higher risk of treatment failure (TF) vs. DRV/r (AHR 1.26, 95%CI 1.11–1.43); patients on RAL had a lower risk of TF vs. ATV/r (AHR 0.81, 95%CI 0.66–0.99). The probability of virological failure50 was significantly lower for people initiating RAL vs. DRV/r (AHR 0.46, 95%CI 0.24–0.87) or ATV/r (AHR 0.52, 95%CI 0.27–0.99). In addition, RAL was associated to a lower risk of discontinuation for toxicity vs. both DRV/r (AHR: 0.37, 95%CI: 0.19–0.72) and ATV/r (AHR: 0.18, 95%CI: 0.09–0.34). ATV/r was associated with a higher risk of discontinuing due to toxicity (AHR 2.09, 95%CI 1.63–2.67) vs. DRV/r. Conclusions: In our observational study, we confirmed higher risk of treatment failure and lower tolerability of ATV/r-based regimens as compared to those including DRV/r or RAL.

Published
2018

472. First Italian Consensus Statement on Diagnosis, Prevention and Treatment of Cardiovascular Complications in HIV-infected Patients in the HAART Era (2006)

Author

Carosi, G., Quiros-Roldan, E., Torti, C., Antinori, A., Bevilacqua, M., Bonadonna, R. C., Bonfanti, P., Castagna, A., Cauda, R., d’Arminio-Monforte, A., Di Gregorio, P., Di Perri, G., Esposito, R., Fatuzzo, F., Gervasoni, C., Giannattasio, C., Guaraldi, G., Lazzarin, A., Lo Caputo, S., Maggi, P., Mazzotta, F., Moroni, M., Prestileo, T., Ranieri, R., Rizzardini, G., Russo, R., Galli, M., and members of the Italian Cardiovascular Risk Guidelines Working Group

Published
2007
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473. Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients

Author

Elena Vegni, Kyrie Piscopo, Lidia Borghi, Federica Bonazza, Eugenia Cao di San Marco, Antonella d'Arminio Monforte, and Francesca Bai

Subjects
Settore M-PSI/07 - PSICOLOGIA DINAMICA, Pediatrics, medicine.medical_specialty, lcsh:BF1-990, Psychological intervention, Settore M-PSI/08 - PSICOLOGIA CLINICA, Anxiety, Hospital Anxiety and Depression Scale, 03 medical and health sciences, 0302 clinical medicine, Multidisciplinary approach, medicine, Psychological testing, 030212 general & internal medicine, COVID-19 recovered patients, Depression (differential diagnoses), business.industry, mental health, Special section COVID-19, Mental health, Psychiatry and Mental health, Clinical Psychology, lcsh:Psychology, depression, medicine.symptom, post-traumatic stress, business, 030217 neurology & neurosurgery, Psychopathology
Abstract

Patients who are hospitalized for COronaVIrus Disease 2019 (COVID-19) face an extremely stressful experience that might challenge their mental health. The study aims to describe the psychological condition of recovered patients, focusing on anxiety and depression symptoms, as well as post-traumatic stress. All the recovered COVID-19 patients who accessed to a multidisciplinary followup screening program scheduled within two months after their hospital discharge were included. As far as the psychological assessment, patients completed the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised for post-traumatic stress. Socio-demographic and clinical data (days of hospitalization, intensity of received care, and number of supportive sessions with the hospital psychologist after the hospitalization) were collected. Descriptive, correlation and regression analyses were conducted. The sample includes 261 patients (68.2% men), aged between 23 and 90 (mean=58.9 st. dev=13.3). High numbers of patients reported anxiety (28%) and depression symptoms (17%), as well as post-traumatic stress (36.4%). Impaired outcomes were associated with female gender, while patient’s age was found to be negatively correlated with anxiety symptoms. 13.8% of patients underwent a psychological visit and 6.1% of them were taken in charge for psychological support. Few months after hospital discharge, individuals recovered by COVID-19 reported negative consequences on their mental health. Understanding the impact that COVID-19 and hospitalization have on recovered patients may provide insights about how to develop an effective psychological intervention to help them deal with such psychological distress and prevent further psychopathological effects.

Published
2020

474. Evaluation of virological response and resistance profile in HIV-1 infected patients starting a first-line integrase inhibitor-based regimen in clinical settings

Author

Francesca Ceccherini-Silberstein, Miriam Lichtner, Ada Bertoli, Manuela Colafigli, Franco Maggiolo, Ilaria Mastrorosa, Alessandra Vergori, Lidia Gazzola, Massimo Andreoni, Antonio Di Biagio, Carlo Federico Perno, Valeria Micheli, Caterina Gori, Daniele Armenia, Roberta Gagliardini, Giuliano Rizzardini, Cristina Mussini, Alberto Giannetti, Bianca Bruzzone, Yagai Bouba, Andrea Antinori, Antonella d'Arminio Monforte, Valentina Mazzotta, Anna Paola Callegaro, Vanni Borghi, Maria Mercedes Santoro, and William Gennari

Subjects
Antiretroviral therapy, Drug resistance, HIV-1, Integrase inhibitors, Virological response, Drug Resistance, Viral, Humans, Raltegravir Potassium, Viral Load, Anti-HIV Agents, HIV Infections, HIV Integrase, HIV Integrase Inhibitors, 0301 basic medicine, medicine.medical_specialty, Settore MED/17 - Malattie Infettive, 030106 microbiology, Integrase inhibitor, Viremia, Settore MED/07, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Virology, Internal medicine, medicine, Viral, 030212 general & internal medicine, Elvitegravir, business.industry, medicine.disease, Raltegravir, Regimen, Infectious Diseases, chemistry, Dolutegravir, business, medicine.drug
Abstract

Virological response and resistance profile were evaluated in drug-naïve patients starting their first-line integrase inhibitors (INIs)-based regimen in a clinical setting.Virological success (VS) and virological rebound (VR) after therapy start were assessed by survival analyses. Drug-resistance was evaluated at baseline and at virological failure.Among 798 patients analysed, 38.6 %, 27.1 % and 34.3 % received raltegravir, elvitegravir and dolutegravir, respectively. Baseline resistance to NRTIs, NNRTIs, PIs and INIs was: 3.9 %, 13.9 %, 1.6 % and 0.5 %, respectively. Overall, by 12 months of treatment, the probability of VS was 95 %, while the probability of VR by 36 months after VS was 13.1 %. No significant differences in the virological response were found according to the INI used. The higher pre-therapy viremia strata was (100,000 vs. 100,000-500,000 vs.500,000 copies/mL), lower was the probability of VS (96.0 % vs. 95.2 % vs. 91.1 %, respectively, P0.001), and higher the probability of VR (10.2 % vs. 15.8 % vs. 16.6 %, respectively, P = 0.010). CD4 cell count200 cell/mmOur findings confirm that patients receiving an INI-based first-line regimen achieve and maintain very high rates of VS in clinical practice.

Published
2020

475. Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice

Author

Alessandro Tebini, Elisabetta Garagiola, Chiara Atzori, Lucrezia Ferrario, Davide Croce, Antonella d'Arminio Monforte, Paola Meraviglia, Barbara Menzaghi, Teresa Bini, Giuliano Rizzardini, and Emanuela Foglia

Subjects
medicine.medical_specialty, HIV/HCV, Comorbidities, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, lcsh:R5-920, Health economics, HIV +, business.industry, Research, 030503 health policy & services, Health Policy, Incidence (epidemiology), Public health, Health services research, virus diseases, medicine.disease, Comorbidity, Economic evaluation, Management, Cohort, Coinfection, Observational study, lcsh:Medicine (General), 0305 other medical science, business
Abstract

Background Since HIV+ treatment has become more effective, the average age of people living with HIV (PLWHIV) has increased, and consequently the incidence of developing comorbidities, making the clinical and economic management of HIV+ patients more complex. Limited literature exists regarding the management of comorbidities costs. This study is aimed at defining and comparing the total annual costs of comorbidities, in an Italian cohort of HIV and HIV/HCV patients, from the National Healthcare Service perspective. The authors hypothesised that there are higher costs, for patients with multiple comorbidities, and a greater consumption of resources for HIV/HCV co-infected patients versus HIV mono-infected patients. Methods An observational retrospective multi-centre health-economics study, enrolling HIV+ and HIV/HCV consecutive patients with at least one comorbidity, was conducted. The consecutive cases, provided by three Italian infectious diseases centres, were related to the year 2016. The enrolled patients were on a stable antiviral therapy for at least six months. Demographic and clinical information was recorded. Costs related to HIV and HCV therapies, other treatments, medical examinations, hospitalizations and outpatient visits were evaluated. Data from mono-infected and co-infected groups of patients were compared, and the statistical analysis was performed by t-tests, chi-square and ANOVA. A sub-analysis excluding HCV therapy costs, was also conducted. The hierarchical sequential linear regression model was used to explore the determinants of costs, considering the investigated comorbidities. All analyses were conducted with a significant level of 0.05. Results A total of 676 patients, 82% male, mean age 52, were identified and divided into groups (338 mono-infected HIV+ and 338 co-infected HIV/HCV patients), comparable in terms of age, gender, and demographic characteristics. A trend towards higher annual costs, for patients with multiple comorbidities was observed in HIV mono-infected patients (respectively € 8272.18 for patients without comorbidities and € 12,532.49 for patients with three or more comorbidities, p-value: 0.001). Excluding anti-HCV therapies costs, HIV/HCV co-infected patients generally required more resources, with statistically significant differences related to cardiovascular events (€10,116.58 vs €11,004.28, p-value: 0.001), and neurocognitive impairments events (€7706.43 vs €11,641.29 p- value: Conclusions This study provides a differentiated and comprehensive analysis of the healthcare resources needed by HIV and HIV/HCV patients with comorbidities and may contribute to the decision process of resources allocation, in the clinical management of different HIV+ patient populations.

Published
2020

476. Do Combination Antiretroviral Therapy Regimens for HIV Infection Feature Diverse T-Cell Phenotypes and Inflammatory Profiles?

Author

Antonella d'Arminio Monforte, Debora Mondatore, Francesca Bai, Camilla Tincati, and Giulia Marchetti

Subjects
0301 basic medicine, Drug, Cart, media_common.quotation_subject, T cell, 030106 microbiology, Inflammation, Disease, Bioinformatics, 03 medical and health sciences, 0302 clinical medicine, Immune system, T-cell phenotypes, medicine, 030212 general & internal medicine, Review Articles, media_common, business.industry, combination antiretroviral therapy (cART), immune recovery, Clinical trial, Infectious Diseases, medicine.anatomical_structure, AcademicSubjects/MED00290, Oncology, inflammation, Observational study, medicine.symptom, business
Abstract

Immune abnormalities featuring HIV infection persist despite the use of effective combination antiretroviral therapy (cART) and may be linked to the development of noninfectious comorbidities. The aim of the present narrative, nonsystematic literature review is to understand whether cART regimens account for qualitative differences in immune reconstitution. Many studies have reported differences in T-cell homeostasis, inflammation, coagulation, and microbial translocation parameters across cART classes and in the course of triple vs dual regimens, yet such evidence is conflicting and not consistent. Possible reasons for discrepant results in the literature are the paucity of randomized controlled clinical trials, the relatively short follow-up of observational studies, the lack of clinical validation of the numerous inflammatory biomarkers utilized, and the absence of research on the effects of cART in tissues. We are currently thus unable to establish if cART classes and regimens are truly accountable for the differences observed in immune/inflammation parameters in different clinical settings. Questions still remain as to whether an early introduction of cART, specifically in the acute stage of disease, or newer drugs and novel dual drug regimens are able to significantly impact the quality of immune reconstitution and the risk of disease progression in HIV-infected subjects.

Published
2020

477. Dyslipidaemia after switch to tenofovir alafenamide (TAF)-based cART regimens in a cohort of HIV-positive patients: what clinical relevance?

Author

Debora Mondatore, Giulia Marchetti, A d'Arminio Monforte, C Borsino, Teresa Bini, A De Bona, Lidia Gazzola, and Gianmarco Tagliaferri

Subjects
0301 basic medicine, medicine.medical_specialty, HIV Infections, Tenofovir alafenamide, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Tenofovir, Dyslipidemias, Framingham Risk Score, Alanine, medicine.diagnostic_test, business.industry, Health Policy, Cobicistat, Odds ratio, 030112 virology, Confidence interval, Regimen, Infectious Diseases, Cohort, business, Lipid profile
Abstract

OBJECTIVES Switching from tenofovir (TDF) to tenofovir alafenamide (TAF) affects lipid profile. The aim of this study was to evaluate whether this results in an increased frequency of patients with low-density lipoprotein (LDL) above their cardiovascular-related target. METHODS All HIV patients switching from TDF to TAF, with no changes of the anchor drug, and with plasma lipids available within 6 months before and after the switch, were included. Demographic, HIV-related parameters, cardiovascular (CV) risk factors and lipid profile on both TDF and TAF were collected. The CV risk score and the relative target of LDL for each patient were calculated according to 2016 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines for the management of dyslipidaemias. Modifications in lipid profiles and in the prevalence of patients with LDL above their CV-related target were evaluated after switch to TAF. RESULTS Overall, 221 HIV patients were included, according to CV risk: 55% at low risk, 34% at moderate risk, and 11% at high/very high risk. By analysing lipid profiles according to CV risk, 38% of patients on TDF had LDL above their CV target; this prevalence increases to 60% after switching to TAF (P

Published
2020

478. Clinical management of ageing people living with HIV in Europe: the view of the care providers

Author

Veronica Svedhem, Patrick W. G. Mallon, Teresa Branco, Georg M. N. Behrens, Lene Ryom, Esteban Martínez, Johannes Hohenauer, Jürgen K. Rockstroh, Norbert Voith, Marta Boffito, Mina Psichogyiou, Christoph D. Spinner, Karine Lacombe, Antonella d'Arminio Monforte, Chelsea and Westminster Hospital, IT University of Copenhagen, Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), University of Bonn, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), National and Kapodistrian University of Athens (NKUA), University College Dublin [Dublin] (UCD), Karolinska University Hospital [Stockholm], and Technical University of Munich (TUM)

Subjects
Microbiology (medical), Aging, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030231 tropical medicine, Human immunodeficiency virus (HIV), Delphi method, Pulmonary disease, Disease, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Care delivery, Medicine, 030212 general & internal medicine, Clinical care, Original Paper, business.industry, HIV, General Medicine, medicine.disease, ddc, 3. Good health, Clinical Practice, Europe, Ageing, Infectious Diseases, Family medicine, business
Abstract

Background Although guidelines for the management of HIV infection include recommendations for aging people living with HIV (PLWH), clinical practice of European HIV care providers may vary. Method We performed a study using a 3-phase Delphi methodology by involving a panel of clinicians with expertise in HIV infection clinical management. The main aim of the study was to assess the care provider prospective on how HIV clinical care should be delivered to ageing PLWH. The first phase involved ten clinicians to identify HIV comorbidities of interest. The second and third phases recruited clinicians virtually via a web-based questionnaire that included 137 questions focussed on 11 comorbidities (e.g. cardiovascular disease, pulmonary disease, etc.). Results Results were analysed thematically and consensus (or not) among European physicians reported. Ninety-seven and 85 responses were collected in phase 2 and 3, respectively. High levels of agreement were found among clinical care providers across Europe and with the European AIDS Conference Society guidelines regarding key items of clinical management of comorbidities in ageing PLWH. Conclusion However, we identified some important gaps, such as the lack of standardisation or implementation of the assessment of frailty or menopause, which are emerging as important factors to optimise ageing PLWH clinical care. Further studies are warranted to confirm whether intensified screening translates into HIV morbidity advances.

Published
2020

479. The EuroSIDA study: 25 years of scientific achievements

Author

Laut, K, Kirk, O, Rockstroh, J, Phillips, A, Ledergerber, B, Gatell, J, Gazzard, B, Horban, A, Karpov, I, Losso, M, d'Arminio Monforte, A, Pedersen, C, Ristola, M, Reiss, P, Scherrer, A U, de Wit, S, Aho, I, Rasmussen, L D, Svedhem, V, Wandeler, G, Pradier, C, Chkhartishvili, N, Matulionyte, R, Oprea, C, Kowalska, J D, Begovac, J, Miró, J M, Guaraldi, G, Paredes, R, Raben, D, et al, University of Zurich, and Laut, K

Subjects
10234 Clinic for Infectious Diseases, AIDS, Europe, cohort studies, surveillance, 2736 Pharmacology (medical), HIV, 610 Medicine & health, 2725 Infectious Diseases, 2719 Health Policy
Published
2020

481. What do the changing patterns of comorbidity burden in people living with HIV mean for long-term management? Perspectives from European HIV cohorts

Author

d'Arminio Monforte, A. Bonnet, F. Bucher, H.C. Pourcher, V. Pantazis, N. Pelchen-Matthews, A. Touloumi, G. Wolf, E.

Abstract

Undoubtedly, comorbidities complicate long-term HIV management and have significant cost implications for healthcare systems. A better understanding of these comorbidities and underlying causes would allow for a more considered and proactive approach to the long-term management of HIV. This review examines cross-sectional analyses of six European cohort studies (Athens Multicenter AIDS Cohort Study, Aquitaine Cohort, EuroSIDA Cohort study, French claims EGB, German InGef Cohort and the Italian Cohort of Individuals, Naïve for Antiretrovirals), which included individuals with HIV followed over a certain period of time. Based on these cohorts, we examined how comorbidities have changed over time; how they compromise HIV management; and how much of a financial burden they impart. These data also provided a framework to explore the major issues of ageing and HIV and the practical implications of managing such issues in real-life practice. © 2020 British HIV Association

Published
2020

482. Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

Author

Carugati, Manuela, Aliberti, S., Sotgiu, G., Blasi, F., Gori, A., Menendez, R., Encheva, M., Gallego, M., Leuschner, P., Ruiz-Buitrago, S., Battaglia, S., Fantini, R., Pascual-Guardia, S., Marin-Corral, J., Restrepo, M. I., Aruj, Patricia Karina, Attorri, Silvia, Barimboim, Enrique, Caeiro, Juan Pablo, Garzón, María I, Cambursano, Victor Hugo, Ceccato, Adrian, Chertcoff, Julio, Lascar, Florencia, Tulio, Fernando Di, Díaz, Ariel Cordon, de Vedia, Lautaro, Ganaha, Maria Cristina, Lambert, Sandra, Lopardo, Gustavo, Luna, Carlos M, Malberti, Alessio Gerardo, Morcillo, Nora, Tartara, Silvina, Pensotti, Claudia, Pereyra, Betiana, Scapellato, Pablo Gustavo, Stagnaro, Juan Pablo, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Vincent, Jean Louis, Anseeuw, Kurt, Francois, Camille A, Van Braeckel, Eva, Djimon, Marcel Zannou, Bashi, Jules, Roger, Dodo, Nouér, Simone Aranha, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Dodo, Balkissou Adamou, Ngahane, Mbatchou, Hugo, Bertrand, Shen, Ning, Xu, Jin-fu, Rico, Carlos Andres Bustamante, Buitrago, Ricardo, Paternina, Fernando Jose Pereira, Jean-Marie, Kayembe Ntumba, Carevic, Vesna Vladic, Jakopovic, Marko, Jankovic, Mateja, Matkovic, Zinka, Mitrecic, Ivan, Jacobsson, Marie-Laure Bouchy, Christensen, Anette Bro, HeitmannBødtger, Uff e Christian, Meyer, Christian Niels, Jensen, Andreas Vestergaard, Baunbæk-knudsen, Gertrud, Petersen, Pelle Trier, Andersen, Stine, El-Wahhab, Ibrahim El-Said Abd, Morsy, Nesreen Elsayed, Shafiek, Hanaa, Sobh, Eman, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Dreher, Michael, Kolditz, Martin, Meisinger, Matthias, Pletz, Mathias W, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Siaw-Lartey, Beatrice, Dimakou, Katerina, Papapetrou, Dimosthenis, Tsigou, Evdoxia, Ampazis, Dimitrios, Bhatia, Mohit, Dhar, Raja, D’Souza, George, Garg, Rajiv, Koul, Parvaiz A, Mahesh, P A, Jayaraj, B S, Narayan, Kiran Vishnu, Udnur, Hirennappa B, Krishnamurthy, Shashi Bhaskara, Golshani, Keihan, Keatings, Vera M, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d’Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Gammino, Maria Antonia, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Petrino, Roberta, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, Kurahashi, Kiyoyasu, Bacha, Zeina Aoun, Ugalde, Daniel Barajas, Zuñiga, Omar Ceballos, Villegas, José F, Medenica, Milic, van de Garde, E M W, Mihsra, Deebya Raj, Shrestha, Poojan, Ridgeon, Elliott, Awokola, Babatunde Ishola, Nwankwo, Ogonna N O, Olufunlola, Adefuye Bolanle, Olumide, Segaolu, Ukwaja, Kingsley N, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Ravara, Sofia B, da Beira, Cova, Brocovschii, Victoria, Ion, Chesov, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Abdulbaqi, Zakeya, Bukhary, Ali, Edathodu, Jameela, Fathy, Amal, Enani, Abdullah Mushira Abdulaziz, Mohamed, Nazik Eltayeb, Memon, Jawed Ulhadi, Bogdanović, Nada, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Luis, Garcia, Noel Manuel Bordon, Alarcón, Hugo Cabello, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicens, Casas, Xavier, González, Alicia Encabo, Fernández-Almira, Maria Luisa, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, del Castillo, Juan González, Victoria, Patricia Javaloyes, Martínez, Elena Laserna, de Molina, Rosa Malo, Marcos, Pedro J, Menéndez, Rosario, PandoSandova, Ana, Aymerich, Cristina Prat, del la Torre, Alicia Lacoma, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Sanz, Francisco, Sibila, Oriol, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, van Boven, Job FM, Torra, Ester Vendrell, Pujol, Jordi Almirall, Feldman, Charles, Yum, Ho Kee, Fiogbe, Arnauld Attannon, Yangui, Ferdaous, Bilaceroglu, Semra, Dalar, Levent, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, Dhasmana, Devesh J, Ions, Rhiannon, Skeemer, Julie, Woltmann, Gerrit, Hancock, Carole, Hill, Adam T, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Allen, Karen S, Brito, Veronica, Dietz, Jessica, Dysart, Claire E, Kellie, Susan M, Franco-Sadud, Ricardo A, Meier, Garnet, Gaga, Mina, Holland, Thomas L, Bergin, Stephen P, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, Nair, Girish B, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Soni, Nilam J, Noda, Julio, Hinojosa, Cecilia I, Levine, Stephanie M, Angel, Luis F, Anzueto, Antonio, Whitlow, K Scott, Hipskind, John, Sukhija, Kunal, Wunderink, Richard G., Shah, Ray D, Mateyo, Kondwelani John, Carugati, Manuela, Aliberti, S, Sotgiu, G, Blasi, F, Gori, A, Menendez, R, Encheva, M, Gallego, M, Leuschner, P, Ruiz-Buitrago, S, Battaglia, S, Fantini, R, Pascual-Guardia, S, Marin-Corral, J, and Restrepo, M I

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Community-acquired pneumonia, 030106 microbiology, Antimicrobial treatment, Prevalence, Guideline, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Guidelines, Global Health, medicine.disease_cause, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Internal medicine, Epidemiology, Streptococcus pneumoniae, Pneumonia, Bacterial, Humans, Medicine, 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Aged, 80 and over, business.industry, Correction, General Medicine, Middle Aged, medicine.disease, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, Infectious Diseases, Practice Guidelines as Topic, Pseudomonas aeruginosa, Etiology, Original Article, Female, Guideline Adherence, business
Abstract

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p

Published
2020

484. Heightened Circulating Interferon-Inducible Chemokines, and Activated Pro-Cytolytic Th1-Cell Phenotype Features Covid-19 Aggravation in the Second Week of Illness

Author

Giulia Marchetti, Antonella d'Arminio Monforte, Camilla Tincati, Raffaele Badolato, Mauro Giacomelli, and E. Stefania Cannizzo

Subjects
lcsh:Immunologic diseases. Allergy, 0301 basic medicine, Male, Chemokine, Immunology, Mononuclear, CD38, 03 medical and health sciences, 0302 clinical medicine, Immune system, Immunopathology, Leukocytes, Immunology and Allergy, Medicine, immunopathology, Humans, Covid-19, immunity, S/M/N protein-reactive T-cells, SARS-CoV-2, Aged, COVID-19, Chemokines, Female, Interferons, Leukocytes, Mononuclear, Middle Aged, Phenotype, Th1 Cells, Original Research, biology, business.industry, Monocyte, Acquired immune system, 030104 developmental biology, medicine.anatomical_structure, Perforin, biology.protein, CXCL9, lcsh:RC581-607, business, 030215 immunology
Abstract

Covid-19 features a delayed onset of critical illness occurring approximately one week from the beginning of symptoms, which corresponds to the bridging of innate and adaptive immunity. We reasoned that the immune events occurring at the turning point of disease might mark the direction toward pathogenic versus protective inflammatory responses. Subjects with either severe (s; PaO2/FiO2 ratio 300) Covid-19 were enrolled. A range of chemokines and cytokines as well as reactive oxygen species (ROS) were measured in plasma. Dendritic and NK cell frequency, monocyte and B-/T-cell phenotype and SARS-CoV-2-specific T-cell responses were assessed in PBMC. Twenty mCovid-19 and 20 sCovid-19 individuals were studied. sCovid-19 patients displayed higher non-classical monocytes, plasma chemokines (CXCL8, CXCL9, CXCL10), cytokines (IL-6, IL-10), and ROS versus mCovid-19. sCovid-19 also showed significantly increased activated CD38+HLA-DR+ T-lymphocyte, and granzyme-B+/perforin+ pro-cytolytic T-cells. All Covid-19 patients showed SARS-CoV-2 specific-T-cell response with a predominance of Th1 bi- or trifunctional IFN-γ/IL-2/TNF-α-expressing CD4+, while no difference according to disease severity was observed. Severe Covid-19 features heightened circulating IFN-inducible chemokines and activated pro-cytolytic Th1 cell phenotype in the second week of illness, yet SARS-CoV-2-specific responses are similar to that of mild illness. Altogether, our observations suggest Th1 polarization coupled to higher cytolytic profile in sCovid-19 as correlate of disease pathogenesis and as potential targets to be investigated in the roadmap to therapy and vaccine development.

Published
2020

485. Effect of changes in body mass index on the risk of cardiovascular disease and diabetes mellitus in HIV-positive individuals: results from the D: A: D study

Author

Christian Pradier, Locadiah Kuwanda, Andrew N. Phillips, Antonella d'Arminio Monforte, Lene Ryom, Stéphane De Wit, Caroline A. Sabin, Fabrice Bonnet, Kathy Petoumenos, Camilla Ingrid Hatleberg, Rainer Weber, Amanda Mocroft, Peter Reiss, Jens D Lundgren, Matthew Law, University of Zurich, Global Health, Infectious diseases, AII - Infectious diseases, and APH - Aging & Later Life

Subjects
Adult, Male, medicine.medical_specialty, Human immunodeficiency virus (HIV), HIV Infections, 610 Medicine & health, Disease, 030204 cardiovascular system & hematology, Weight Gain, medicine.disease_cause, Body Mass Index, Diabetes Complications, 10234 Clinic for Infectious Diseases, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Poisson regression, 2. Zero hunger, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Infectious Diseases, Increased risk, Cardiovascular Diseases, symbols, Female, medicine.symptom, business, Body mass index, Weight gain
Abstract

BACKGROUND: Weight gain is common among people with HIV once antiretroviral treatment is commenced. We assess the effect of changes in body mass index (BMI), from different baseline BMI levels, on the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). METHODS: D:A:D participants receiving antiretroviral treatment were followed from their first BMI measurement to the first of either CVD or DM event, or earliest of January 2, 2016 or 6 months after last follow-up. Participants were stratified according to their baseline BMI, and changes from baseline BMI were calculated for each participant. Poisson regression models were used to assess the effects of changes on BMI on CVD or DM events. RESULTS: There were 2104 CVD and 1583 DM events over 365,287 and 354,898 person-years [rate: CVD 5.8/1000 (95% confidence interval: 5.5 to 6.0); DM 4.5/1000 (95% confidence interval: 4.2 to 4.7)]. Participants were largely men (74%), baseline mean age of 40 years, and median BMI of 23.0 (IQR: 21.0-25.3). A risk of CVD by change in BMI from baseline, stratified by baseline BMI strata showed little evidence of an increased risk of CVD with an increased BMI in any baseline BMI strata. An increase in BMI was associated with an increased risk of DM across all baseline BMI strata. CONCLUSIONS: Although increases in BMI across all levels of baseline BMI were not associated with an increased risk of CVD, such changes were consistently associated with an increased risk of DM. There was also some evidence of an increased risk of CVD with a decrease in BMI.

Published
2020

486. Switching from TDF to TAF or dual therapy (DT)-based regimens in HIV-infected in individuals with viral load <=50 copies/ml: does eGFR matter?

Author

Vergori, A., Gagliardini, R., Gianotti, N., Gori, A., Lichtner, M., Saracino, A., De Vito, A., Cascio, A., Di Biagio, A., d’Arminio Monforte, A., Antinori, A., Cozzi Lepri, and A., Nunnari, G., and G. F. Pellicanò.

Subjects
Tenofovir disoproxil fumarate, eGFR, HIV, Tenofovir alafenamide, Switch, dual therapy, HIV, Tenofovir alafenamide, Tenofovir disoproxil fumarate, Antiretroviral therapy, Switch, eGFR, dual therapy, Antiretroviral therapy
Published
2020

489. Biomass to Liquids (BtL) Process Simulation, Economics and Environmental Impact Assessment for a 3000 bbl/d Plant

Author

Letizia Bua, d'Arminio Monforte Alessandra, Carnelli Lino, Chiodini Andrea, Antonio Caretta, and Rapone Irene

Subjects
Diesel fuel, Synthetic fuel, Waste management, business.industry, Acid gas, Fossil fuel, Biomass, Environmental science, Fischer–Tropsch process, business, Naphtha, Syngas
Abstract

The biomass to liquids process (BtL) is an interesting path to produce synthetic petroleum via biomass gasification and Fischer Tropsch (FT) synthesis. The scope of this work is to describe, to simulate and to assess the economic and the environmental impact of the BtL multistep process. The process simulation tool is CheOpe, the economics have been estimated via Aspen Process Economic Analyzer V7.2.1 and the environmental assessment via GaBi V6.0. In this study, cobalt-based catalyst kinetics are simulated in a FT slurry bubble column reactor. The feedstock for FT is the syngas obtained from biomass gasification. The first step is a syngas reforming followed by a water gas shift (WGS) section to adjust the H2 to CO ratio to about 2 (required for FT catalysis) and then by a Rectisol® island to remove the acid gases (H2S, poison for FT catalysis, and CO2, inert gas in FT reaction). Finally, after the FT reaction section, the last step is the upgrading (UPG) of FT products to produce diesel and naphtha. An estimation of CAPEX for a 3000 bbl/d capacity plant has been carried out. Estimated investment costs are about M€ 400. This result has been paired with a life cycle assessment (LCA) in order to complete a decisional frame. LCA points out the environmental advantages in the use of BtL-fuels in the reduction of CO2 global emissions, if compared to the ones relevant to fossil fuels. This result respects the recent EU Directives limits.

Published
2020

490. Cause-specific mortality after diagnosis of cancer among HIV-positive patients: a collaborative analysis of cohort studies

Author

Peter Reiss, Margaret T May, Matthias Cavassini, Sophie Grabar, Christoph Wyen, Sophie Abgrall, Fabrice Bonnet, Julia del Amo, Amy C. Justice, Antonella d'Arminio Monforte, Ferdinand W. N. M. Wit, Katharina Grabmeier-Pfistershammer, Leah Shepherd, Ramón Teira, Juan Berenguer, M. John Gill, Adam Trickey, Jodie L. Guest, Janne Vehreschild, Dominique Costagliola, Jonathan A C Sterne, Gestionnaire, Hal Sorbonne Université, University of Bristol [Bristol], University of Calgary, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Groupe hospitalier Broca, University Hospital of Cologne [Cologne], German Centre for Infection Research (DZIF), University of Amsterdam [Amsterdam] (UvA), Stichting HIV Monitoring [Amsterdam], Universiteit van Amsterdam (UvA), Amsterdam Institute for Global Health & Development [Amsterdam, The Netherlands], VU University Medical Center [Amsterdam], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Université de Lausanne = University of Lausanne (UNIL), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Medizinische Universität Wien = Medical University of Vienna, Emory University School of Medicine, Emory University [Atlanta, GA], University College of London [London] (UCL), Università degli Studi di Milano = University of Milan (UNIMI), Institute of Health Carlos III, Yale School of Medicine [New Haven, Connecticut] (YSM), VA Connecticut Healthcare System, Department for International Development (Reino Unido), NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos), Medical Research Council (Reino Unido), Unión Europea. Comisión Europea. 7 Programa Marco, Institut National de la Santé et de la Recherche Médicale (Francia), Swiss National Science Foundation, Ministerio de Sanidad y Consumo (España), Red de Investigación Cooperativa en Investigación en Sida (España), National Institutes of Health (Estados Unidos), Canadian Institutes of Health Research, Global Health, Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lausanne (UNIL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Università degli Studi di Milano [Milano] (UNIMI), Yale University School of Medicine, United Kingdom Department for International Development, National Institute on Alcohol Abuse and Alcoholism (United States), Medical Research Council (United Kingdom), 7º Programa Marco - Comisión Europea, Institut National de la Santé et de la Recherche Médicale, Red Española de Investigación en SIDA, and National Institutes of Health (United States)

Subjects
Cancer Research, Lung Neoplasms, ADM, Human immunodeficiency virus (HIV), Uterine Cervical Neoplasms, medicine.disease_cause, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medical diagnosis, Cancer, Lymphoma, AIDS-Related, education.field_of_study, Mortality rate, Liver Neoplasms, Cohort, cohort, Middle Aged, Prognosis, Hodgkin Disease, 3. Good health, Survival Rate, NADM, PLHIV, cancer, mortality, Infectious Causes of Cancer, Oncology, 030220 oncology & carcinogenesis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, Cohort study, Adult, medicine.medical_specialty, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, IDLIC, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, Mortality, education, Acquired Immunodeficiency Syndrome, business.industry, medicine.disease, United Kingdom, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

People living with HIV (PLHIV) are more likely than the general population to develop AIDS‐defining malignancies (ADMs) and several non‐ADMs (NADMs). Information is lacking on survival outcomes and cause‐specific mortality after cancer diagnosis among PLHIV. We investigated causes of death within 5 years of cancer diagnosis in PLHIV enrolled in European and North American HIV cohorts starting antiretroviral therapy (ART) 1996–2015, aged ≥16 years, and subsequently diagnosed with cancer. Cancers were grouped: ADMs, viral NADMs and nonviral NADMs. We calculated cause‐specific mortality rates (MR) after diagnosis of specific cancers and compared 5‐year survival with the UK and France general populations. Among 83,856 PLHIV there were 4,436 cancer diagnoses. Of 603 deaths after ADM diagnosis, 292 (48%) were due to an ADM. There were 467/847 (55%) and 74/189 (39%) deaths that were due to an NADM after nonviral and viral NADM diagnoses, respectively. MR were higher for diagnoses between 1996 and 2005 versus 2006–2015: ADMs 102 (95% CI 92–113) per 1,000 years versus 88 (78–100), viral NADMs 134 (106–169) versus 111 (93–133) and nonviral NADMs 264 (232–300) versus 226 (206–248). Estimated 5‐year survival for PLHIV diagnosed with liver (29% [19–39%]), lung (18% [13–23%]) and cervical (75% [63–84%]) cancer was similar to general populations. Survival after Hodgkin's lymphoma diagnosis was lower in PLHIV (75% [67–81%]). Among ART‐treated PLHIV diagnosed with cancer, MR and causes of death varied by cancer type, with mortality highest for liver and lung cancers. Deaths within 5 years of NADM diagnoses were more likely to be from cancer than AIDS., What's new? People with HIV live longer than they used to, thanks to advances in antiretroviral therapy. These improvements reduced the incidence of AIDS‐defining malignancies, such as Kaposi's sarcoma, but the increased life expectancy has led to more diagnoses of cancers not traditionally associated with HIV. Here, the authors studied cause‐specific mortality among people with HIV diagnosed with cancer. For those people, within 5 years after a cancer diagnosis, cause of death was more likely to be cancer than AIDS. Survival rates after diagnosis varied by cancer type, but were similar to rates among the general population.

Published
2020

491. Virologic and immunologic outcomes of treatment with integrase inhibitors in a real-world setting: The RESPOND cohort consortium

Author

Bastian Neesgaard, Amanda Mocroft, Robert Zangerle, Ferdinand Wit, Fiona Lampe, Huldrych F Günthard, Coca Necsoi, Matthew Law, Cristina Mussini, Antonella Castagna, Antonella d'Arminio Monforte, Christian Pradier, Nikoloz Chkhartisvilli, Juliana Reyes-Uruena, Jörg Janne Vehreschild, Jan-Christian Wasmuth, Anders Sönnerborg, Christoph Stephan, Lauren Greenberg, Josep M Llibre, Alain Volny-Anne, Lars Peters, Annegret Pelchen-Matthews, Vani Vannappagari, Joel Gallant, Armin Rieger, Mike Youle, Dominique Braun, Stephane De Wit, Kathy Petoumenos, Vanni Borghi, Vincenzo Spagnuolo, Tengiz Tsertsvadze, Jens Lundgren, Lene Ryom, RESPOND study group, Neesgaard, B., Mocroft, A., Zangerle, R., Wit, F., Lampe, F., Gunthard, H. F., Necsoi, C., Law, M., Mussini, C., Castagna, A., Monforte, A. D., Pradier, C., Chkhartisvilli, N., Reyes-Uruena, J., Vehreschild, J. J., Wasmuth, J. -C., Sonnerborg, A., Stephan, C., Greenberg, L., Llibre, J. M., Volny-Anne, A., Peters, L., Pelchen-Matthews, A., Vannappagari, V., Gallant, J., Rieger, A., Youle, M., Braun, D., de Wit, S., Petoumenos, K., Borghi, V., Spagnuolo, V., Tsertsvadze, T., Lundgren, J., Infectious diseases, and APH - Aging & Later Life

Subjects
0301 basic medicine, Male, Psychologie appliquée, Integrase inhibitor, Blood Pressure, HIV Infections, Cardiovascular Medicine, Vascular Medicine, HIV Integrase Inhibitors/therapeutic use, Geographical Locations, Cohort Studies, Endocrinology, Medical Conditions, 0302 clinical medicine, Chronic Kidney Disease, Medicine and Health Sciences, Medicine, Public and Occupational Health, 030212 general & internal medicine, Immune Response, education.field_of_study, Multidisciplinary, Reverse-transcriptase inhibitor, Pharmaceutics, Sciences bio-médicales et agricoles, Middle Aged, Viral Load, Vaccination and Immunization, Europe, Cardiovascular Therapy, Treatment Outcome, Nephrology, Cardiovascular Diseases, Hypertension, Cohort, Reverse Transcriptase Inhibitors, Female, Biologie, Viral load, Research Article, medicine.drug, Adult, medicine.medical_specialty, Reverse Transcriptase Inhibitors/therapeutic use, Endocrine Disorders, Science, Immunology, Population, Cardiology, HIV Infections/drug therapy, Antiretroviral Therapy, HIV/drug effects, HIV Protease Inhibitors/therapeutic use, 03 medical and health sciences, Antiviral Therapy, Drug Therapy, Internal medicine, Diabetes Mellitus, Renal Diseases, Humans, HIV Integrase Inhibitors, education, business.industry, Biology and Life Sciences, HIV, Odds ratio, HIV Protease Inhibitors, 030112 virology, Confidence interval, Viral Load/drug effects, CD4 Lymphocyte Count, Regimen, Metabolic Disorders, People and Places, Preventive Medicine, business
Abstract

Objectives To compare virologic and immunologic outcomes of integrase inhibitor (INSTI)-containing, contemporary boosted protease inhibitor (PI/b)-containing and non-nucleotide reverse transcriptase inhibitor (NNRTI)-containing regimens in a real-life setting. Methods Using logistic regression, virologic and immunologic outcomes of INSTI use were compared to outcomes of PI/b or NNRTI treatment 12 months after treatment start or switch, for participants in the RESPOND cohort consortium. A composite treatment outcome (cTO) was used, defining success as viral load (VL), SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

492. 2019 update of the European AIDS Clinical Society Guidelines for treatment of people living with HIV version 10.0

Author

Ryom, L., Cotter, A., de Miguel, R., Béguelin, C., Podlekareva, D., Arribas, J. R., Marzolini, C., Mallon, P. G. M., Rauch, A., Kirk, O., Molina, J. M., Guaraldi, G., Winston, A., Bhagani, S., Cinque, P., Kowalska, J. D., Collins, S., Battegay, M., de Miguel Buckley, Rosa, d'Arminio Monforte, Antonella, Bracchi, Margherita, Dedes, Nikos, Horban, Andrzej, Katlama, Christine, Latysheva, Inga, Lundgren, Jens D., McCormack, Sheena, Mussini, Cristina, Pozniak, Anton, Pulido, Federico, Raffi, François, Reiss, Peter, Stellbrink, Hans-J. rgen, Vasylyev, Marta, Gibbons, Sara, Livio, Françoise, Behrens, Georg, Bower, Mark, Compston, Juliet, de Wit, Stéphane, Fabbri, Leonardo M., Fux, Christoph A., Gisslen, Magnus, Martínez, Esteban, Miro, José M., Negredo, Eugenia, Poulter, Neil, Sebastiani, Giada, Berenguer, Juan, Boesecke, Christoph, Bruno, Raffaele, Konov, Svilen, Lacombe, Karine, Mauss, Stefan, Mendão, Luís, Peters, Lars, Puoti, Massimo, Rockstroh, J. rgen K., Ambrosioni, Juan, de Castro, Nathalie, Fätkenheuer, Gerd, Furrer, Hansjakob, Oprea, Cristiana, Volny-Anne, Alain, Sullivan, Ann, Mulcahy, Fiona, Wensing, Annemarie, Global Health, Infectious diseases, AII - Infectious diseases, and APH - Aging & Later Life

Subjects
0301 basic medicine, antiretroviral treatment, hepatitis C virus, European AIDS Clinical Society (EACS) Guidelines, HIV, comorbidities, drug-drug interactions, hepatitis B virus, opportunistic infections, prescribing in elderly patients, Integrase inhibitor, HIV Infections, Comorbidity, Piperazines, Tertiary Care Centers, chemistry.chemical_compound, 0302 clinical medicine, Neoplasms, Doravirine, Drug Interactions, Pharmacology (medical), 030212 general & internal medicine, 610 Medicine & health, Incidence, Health Policy, Age Factors, Lamivudine, EACS Governing Board, Treatment Outcome, Infectious Diseases, Anti-Retroviral Agents, Dolutegravir, Drug Therapy, Combination, Heterocyclic Compounds, 3-Ring, medicine.drug, medicine.medical_specialty, Pyridones, European AIDS Clinical Society (EACS) guideline (HIV), 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Immune reconstitution inflammatory syndrome, Virology, Oxazines, medicine, Humans, HIV Integrase Inhibitors, Intensive care medicine, Retrospective Studies, business.industry, 1103 Clinical Sciences, Guideline, Triazoles, medicine.disease, 030112 virology, Regimen, chemistry, drug–drug interactions, business
Abstract

BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines cover key aspects of HIV management with major updates every two years.GUIDELINE HIGHLIGHTS: The 2019 Guidelines were extended with a new section focusing on drug-drug interactions and other prescribing issues in people living with HIV (PLWH). The recommendations for treatment-naïve PLWH were updated with four preferred regimens favouring unboosted integrase inhibitors. A two-drug regimen with dolutegravir and lamivudine, and a three-drug regimen including doravirine were also added to the recommended initial regimens. Lower thresholds for hypertension were expanded to all PLWH and for cardiovascular disease prevention, the 10-year predicted risk threshold for consideration of antiretroviral therapy (ART) modification was lowered from 20% to 10%. Frailty and obesity were added as new topics. It was specified to use urine albumin to creatinine ratio to screen for glomerular disease and urine protein to creatinine ratio for tubular diseases, and thresholds were streamlined with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendations. Hepatitis C virus (HCV) treatment recommendations were split into preferred and alternative treatment options. The algorithm for management of recently acquired HCV infection was updated and includes recommendations for early chronic infection management. Treatment of resistant tuberculosis (TB) was streamlined with the World Health Organization (WHO) recommendations, and new tables on immune reconstitution inflammatory syndrome, on when to start ART in the presence of opportunistic infections and on TB drug dosing were included.CONCLUSIONS: The EACS Guidelines underwent major revisions of all sections in 2019. They are available in four different formats including a new interactive web-based version and are translated into Chinese, French, German, Japanese, Portuguese, Russian and Spanish.

Published
2020

493. The relationship between smoking, current CD4, viral load and cancer in persons living with HIV

Author

Mocroft, A, Petoumenos, Wit, F, J Vehreschild, J, Guaraldi, G, M Miro, J, Greenberg, L, Oellinger, A, Egle, A, F Günthard, H, C Bucher, H, S De Wit, Necsoi, C, Castagna, A, Spagnuolo, V, A D’Arminio Monforte, Reiss, P, Chkhartishvili, N, Bolokadze, N, Hoy, J, Sonnenborg, A, Svedhem, V, Bower, M, Volny-Anne, A, Garges, H, Rogatto, F, Neesgaard, B, Peters, L, D Lundgren, J, and Ryom, L

Published
2020

495. T-cell phenotypes, apoptosis and inflammation in HIV+ patients on virologically effective cART with early atherosclerosis.

Author

Esther Merlini, Kety Luzi, Elisa Suardi, Alessandra Barassi, Maddalena Cerrone, Javier Sánchez Martínez, Francesca Bai, Gian Vico Melzi D'Eril, Antonella D'Arminio Monforte, and Giulia Marchetti

Subjects
Medicine, Science
Abstract

OBJECTIVE: We investigated the potential relationship between T-cell phenotype, inflammation, endotoxemia, and atherosclerosis evaluated by carotid intima-media thickness (IMT) in a cohort of HIV-positive patients undergoing long-term virologically suppressive combination antiretroviral therapy (cART). DESIGN: We studied 163 patients receiving virologically suppressive cART. METHODS: We measured IMT (carotid ultrasound); CD4+/CD8+ T-cell activation (CD38, CD45R0), differentiation (CD127), apoptosis (CD95), and senescence (CD28, CD57) (flow cytometry); plasma sCD14, IL-6, TNF- α, sVCAM-1, hs-CRP, anti-CMV IgG (ELISA); LPS (LAL). The results were compared by Mann-Whitney, Kruskal-Wallis or Chi-square tests, and factors associated with IMT were evaluated by multivariable logistic regression. RESULTS: Of 163 patients, 112 demonstrated normal IMT (nIMT), whereas 51 (31.3%) had pathological IMT (pIMT: ≥1 mm). Of the patients with pIMT, 22 demonstrated an increased IMT (iIMT), and 29 were shown to have plaques. These patient groups had comparable nadir and current CD4+, VLs and total length of time on cART. Despite similar proportions of CD38-expressing CD8+ cells (p = .95), pIMT patients exhibited higher activated memory CD8+CD38+CD45R0+ cells (p = .038) and apoptotic CD4+CD95+ (p = .01) and CD8+CD95+ cells (p = .003). In comparison to nIMT patients, iIMT patients tended to have lower numbers of early differentiated CD28+CD57- memory CD4+ (p = .048) and CD28-CD57-CD8+ cells (p = .006), both of which are associated with a higher proliferative potential. Despite no differences in plasma LPS levels, pIMT patients showed significantly higher circulating levels of sCD14 than did nIMT patients (p = .046). No differences in anti-CMV IgG was shown. Although circulating levels of sCD14 seemed to be associated with a risk of ATS in an unadjusted analysis, this effect was lost after adjusting for classical cardiovascular predictors. CONCLUSIONS: Despite the provision of full viral suppression by cART, a hyperactivated, pro-apoptotic T-cell profile characterizes HIV-infected patients with early vascular damage, for whom the potential contribution of subclinical endotoxemia and anti-CMV immunity should be investigated further.

Published
2012
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496. HIV-Infected Late Presenter Patients

Author

Antonella D'Arminio Monforte, Andrea Antinori, Enrico Girardi, Francesca Ceccherini-Silberstein, Giulia Marchetti, Caroline Anne Sabin, and Julio S. Montaner

Subjects
Immunologic diseases. Allergy, RC581-607
Published
2012
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497. Circulating sCD14 is associated with virological response to pegylated-interferon-alpha/ribavirin treatment in HIV/HCV co-infected patients.

Author

Giulia Marchetti, Paola Nasta, Francesca Bai, Francesca Gatti, Giusi Maria Bellistrì, Camilla Tincati, Federica Borghi, Giampiero Carosi, Massimo Puoti, and Antonella d'Arminio Monforte

Subjects
Medicine, Science
Abstract

Microbial translocation (MT) through the gut accounts for immune activation and CD4+ loss in HIV and may influence HCV disease progression in HIV/HCV co-infection. We asked whether increased MT and immune activation may hamper anti-HCV response in HIV/HCV patients.98 HIV/HCV patients who received pegylated-alpha-interferon (peg-INF-alpha)/ribavirin were retrospectively analyzed. Baseline MT (lipopolysaccharide, LPS), host response to MT (sCD14), CD38+HLA-DR+CD4+/CD8+, HCV genotype, severity of liver disease were assessed according to Early Virological Response (EVR: HCV-RNA

Published
2012
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498. Role of In Vitro Stimulation with Lipopolysaccharide on T-Cell Activation in HIV-Infected Antiretroviral-Treated Patients

Author

Camilla Tincati, Giusi M. Bellistrì, Giuseppe Ancona, Esther Merlini, Antonella d’Arminio Monforte, and Giulia Marchetti

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

We investigated the effect of LPS in vitro stimulation on T-cell activation in HIV-infected patients with different CD4+ recovery on HAART. PBMCs from 30 HIV-positive, HAART-treated, aviremic individuals with different CD4+ reconstitution (Low Responders: CD4+ < 350/μL; Intermediate Responders: CD4+ 350–599/μL; High Responders: CD4+ ≥ 600/μL) were cultured with LPS and the proportion of HLA-DR/CD38- and Ki67-expressing CD4+/CD8+ T-cells was measured (flow cytometry). Upon LPS stimulation, significantly higher CD4+ and CD8+HLA-DR+ cells were shown in LR and IR versus HIV-negative controls. While no differences in the proportion of LPS-stimulated CD4+CD38+ cells were recorded amongst HIV-positive subgroups, CD8+CD38+ cells were more elevated in patients with lower CD4+ recovery on HAART (i.e., LR and IR). Upon in vitro LPS stimulation, HLA-DR and CD38 expression on T-cells are differentially regulated. While HLA-DR induction reflects impaired CD4+ reconstitution on HAART, cell-surface CD38 expression is increased only on CD8+ T-cells, allowing to speculate that the sole induction of CD38 on CD4+ cells may not be sufficient to depict LPS-driven immune activation in HIV.

Published
2012
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499. Virological Response in Cerebrospinal Fluid to Antiretroviral Therapy in a Large Italian Cohort of HIV-Infected Patients with Neurological Disorders

Author

Maria Letizia Giancola, Patrizia Lorenzini, Antonella Cingolani, Francesco Baldini, Simona Bossolasco, Teresa Bini, Laura Monno, Giovanna Picchi, Antonella d’Arminio Monforte, Paola Cinque, Valerio Tozzi, and Andrea Antinori

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

The aim of the present study was to analyse the effect of antiretroviral (ARV) therapy and single antiretroviral drugs on cerebrospinal fluid (CSF) HIV-RNA burden in HIV-infected patients affected by neurological disorders enrolled in a multicentric Italian cohort. ARVs were considered “neuroactive” from literature reports. Three hundred sixty-three HIV-positive patients with available data from paired plasma and CSF samples, were selected. One hundred twenty patients (33.1%) were taking ARVs at diagnosis of neurological disorder. Mean CSF HIV-RNA was significantly higher in naïve than in experienced patients, and in patients not taking ARV than in those on ARV. A linear correlation between CSF HIV-RNA levels and number of neuroactive drugs included in the regimen was also found (r=−0.44, P

Published
2012
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500. Reduced Central Memory CD4+ T Cells and Increased T-Cell Activation Characterise Treatment-Naive Patients Newly Diagnosed at Late Stage of HIV Infection

Author

Francesca Bai, Camilla Tincati, Esther Merlini, Carlotta Pacioni, Elisabetta Sinigaglia, Giovanni Carpani, Antonella d'Arminio Monforte, and Giulia Marchetti

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Objectives. We investigated immune phenotypes of HIV+ patients who present late, considering late presenters (LPs, CD4+ < 350/μL and/or AIDS), advanced HIV disease (AHD, CD4+ < 200/μL and/or AIDS), and AIDS presenters (AIDS-defining condition at presentation, independently from CD4+). Methods. Patients newly diagnosed with HIV at our clinic between 2007–2011 were enrolled. Mann-Whitney/Chi-squared tests and logistic regression were used for statistics. Results. 275 patients were newly diagnosed with HIV between January/2007–March/2011. 130 (47%) were LPs, 79 (29%) showed AHD, and 49 (18%) were AIDS presenters. LP, AHD, and AIDS presenters were older and more frequently heterosexuals. Higher CD8+%, lower CD127+CD4+%, higher CD95+CD8+%, CD38+CD8+%, and CD45R0+CD38+CD8+% characterized LP/AHD/AIDS presentation. In multivariate analysis, older age, heterosexuality, higher CD8+%, and lower CD127+CD4+% were confirmed associated with LP/AHD. Lower CD4+ and higher CD38+CD8+% resulted independently associated with AIDS presentation. Conclusions. CD127 downregulation and immune activation characterize HIV+ patients presenting late and would be studied as additional markers of late presentation.

Published
2012
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