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152. CD4+ T-lymphocytopenia and severe infections in an HIV-negative Ethiopian man

Author

Viola P, G. Rezza, Montella F, O. Recchia, and Di Sora F

Subjects
medicine.medical_specialty, Tuberculosis, medicine.diagnostic_test, Opportunistic infection, business.industry, Immunology, Hepatosplenomegaly, Physical examination, medicine.disease, Bone marrow examination, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Immunology and Allergy, Lymphocytopenia, medicine.symptom, business, Immunodeficiency
Abstract

An Ethiopian patient was admitted to the hospital in Rome Italy in August 1993 with fever night sweats and asthenia. Physical examination revealed oral candidiasis basal rates upon pulmonary examination and a body temperature of 38.5 degrees Celsius. There was no evidence of lymphadenopathy or hepatosplenomegaly. Pulmonary tuberculosis was diagnosed. 2 consecutive enzyme-linked immunosorbent assay tests for HIV-1 and HIV-2 were negative as was a Western blot. HIV-1 p24 was not detectable in the serum and an HTLV-1 serological test was negative. Bone marrow examination total body scan and endoscopic examination of the esophagus and stomach were negative. The patient reported no risk factors for HIV infection. His sole sex partner for the past 3 years was HIV-seronegative and healthy. The patient had severe lymphocytopenia with quantitative deficiencies in CD4+ and CD8+ cell sub-groups. Although the tuberculosis was not necessarily an opportunistic infection oral candidiasis has been shown to be a highly specific indicator of HIV in patients with tuberculosis. Combined with the low CD4+ count the clinical picture was strongly suggestive of AIDS. Ethiopians who emigrated to Israel in 1991 had low CD4 counts while remaining in good physical condition without the opportunistic infections associated with AIDS. The present case indicates that the idiopathic T-lymphocytopenia found in these emigres might lead to opportunistic infections with a clinical diagnosis of AIDS. The cause of this severe immunodeficiency is unknown.

Published
1994
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154. HIV-Related Malignant Lymphoma: A Report of 46 Cases Observed in Italy1

Author

U. Tirelli, E. Vaccher, A. Ambrosini, A. Andriani, Bianco Silvestroni, G. Broccia, T. Chisesi, P. Dessalvi, M. Gobbi, F. Fassio, Lambertenghi Deliliers, F. Lanza, A. Lazzarin, F. Lombardi, G. Luzi, C. Malleo, E.A. Parrinello, R. Proto, F. Puppo, G. Rezza, G. Rossi, F. Gavosto, and S. Monfardini

Subjects
medicine.medical_specialty, Pathology, Working Formulation, business.industry, Opportunistic infection, Hematology, General Medicine, medicine.disease, Lymphoma, Nodular sclerosis, Acquired immunodeficiency syndrome (AIDS), hemic and lymphatic diseases, Immunopathology, Internal medicine, medicine, Viral disease, Stage (cooking), business
Abstract

We report 36 patients with non-Hodgkin's lymphomas (NHL) and 10 patients with Hodgkin's disease (HD), predominantly intravenous drug abusers (IVDA; 35 patients), diagnosed in 16 different Italian centers. The group of NHL has a median age of 26 years (range 16-64): 26 were IVDA, 3 polytransfused, 3 IVDA and homosexual men, 2 homosexual men and 2 without apparent risk for AIDS but carrying HIV antibodies. 81% of the evaluable patients had high-grade NHL (32% Burkitt's type) according to the Working Formulation, 15% intermediate and 4% low-grade. Out of 23 patients with stage reported, 16 (70%) were stage IV, 2 (9%) stage III, 1 (4%) stage II and 4 (17%) stage I (CNS involvement). The group with HD has a median age of 25 years (range 20-40), 9 were IVDA and 1 IVDA and homosexual. Of the 7 patients with subtype reported, 4 patients had nodular sclerosis and 3 mixed cellularity subtype. Stage III and IV were reported in 66% of the patients. The median survival is 4 months for NHL and 10 months for HD. The most common cause of death is opportunistic infection in 86% of the evaluable cases.

Published
1988
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155. Genital herpes infection in outpatients attending a sexually transmitted disease clinic in Italy

Author

E. Crescimbeni, Laura Zaratti, R. Corona, Alfonso Mele, B. Capitanio, G. Gentili, Elisabetta Franco, G. Rezza, F. Caprilli, A. Di Napoli, Susanna Conti, Augusto Panà, and Paolo Pasquini

Subjects
Adult, Male, Sexually transmitted disease, medicine.medical_specialty, Adolescent, Epidemiology, Prevalence, Asymptomatic, Internal medicine, medicine, Humans, Herpes Genitalis, business.industry, Public health, Age Factors, Sexually transmitted disease clinic, Homosexuality, Middle Aged, medicine.disease, Specific antibody, Cross-Sectional Studies, Italy, Immunology, Bisexuality, Educational Status, Female, medicine.symptom, Genital herpes, business
Abstract

Prevalence of Herpes Simplex, type 2, specific antibodies was estimated in sexually transmitted disease outpatients: 783 heterosexuals and 158 homosexual-bisexuals. The anti-HSV-2 prevalence rates were 69% in the homosexual-bisexuals and 35% in the heterosexuals. In both groups positive association with age of anti-HSV-2 prevalence was found: only in the homosexual-bisexuals negative as sociation with education level was detected. No difference exists between the two groups regarding the symptomatic/asymptomatic ratio of HSV-2 infection.

Published
1988
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156. Risk factors for cervical presence of human papillomavirus DNA among women at risk for HIV infection

Author

*, G. REZZA, **, GIULIANI, M., SERRAINO, D., BRANCA, M., BENEDETTO, A., GARBUGLIA, A., IPPOLITO, G., and FRANCESCHI, S.

Abstract

Risk factors for cervical infection with human papillomavirus (HPV) were assessed among 236 Italian women at risk for human immunodeficiency virus (HIV) infection (intravenous drug users (IVDU) or sexual partners of males at risk for HIV infection). All study participants underwent a structured interview, determination of HIV serostatus and detection of HPV cervical infection by means of polymerase chain reaction (PCR). Overall, the cervical presence of HPV DNA was ascertained in 86 of these 236 women (36·4%), while squamous intraepithelial lesions (SIL) were diagnosed in 57 (24·1%). HPV-infected and non-infected women did not differ in age, education and cigarette smoking. A statistically significant trend in the risk of HPV infection with increasing number of lifetime sexual partners was noted (P=0·01), but such trend was attenuated in multivariate analysis (multiple logistic regression (MLR) odds ratio (OR) for 20 partners vs 1=1·6, 95% confidence intervals (CI): 0·4–5·9). A nearly threefold higher risk of HPV cervical infection emerged among IVDU women (MLR–OR: 2·7, 95% CI: 1·4–5·0), and this difference was not influenced by HIV serostatus. The prevalence of HIV infection was higher among HPV-positive than HPV-negative women (62·8% and 54·0%, respectively) (MLR–OR=1·9, 95% CI: 0·9–3·8), and the proportion of women with less than 200 CD4+ cells/mm3 was slightly and not significantly higher among HPV-positive (47·1%) than negative women (37·2%).

Published
1998

157. Category of exposure to HIV and age in the progression to AIDS: longitudinal study of 1199 people with known dates of seroconversion. HIV Italian Seroconversion Study Group.

Author

P, Pezzotti, N, Phillips A, M, Dorrucci, C, Lepri A, N, Galai, D, Vlahov, and G, Rezza

Abstract

OBJECTIVES: To determine whether rate of development of AIDS is affected by category of exposure to HIV and whether the more rapid development found in older subjects persists for each exposure category. DESIGN: Longitudinal study of people with known date of seroconversion to HIV. SETTING: 16 HIV treatment centres throughout Italy. SUBJECTS: 1199 people infected with HIV through use of injected drugs, homosexual sex, or heterosexual sex. MAIN OUTCOME MEASURES: AIDS as defined by 1987 definition of Centers for Disease Control (including and excluding neoplasms) and by 1993 European definition. RESULTS: 225 subjects (18.8%) progressed to AIDS (Centers for Disease Control 1987 definition) during median follow up of 5.8 years. Univariate analyses showed more rapid progression to AIDS for older subjects compared with younger subjects and for homosexual men compared with other exposure categories. The age effect was of similar size in each exposure category and in men and women. In a bivariate model with age and exposure categories simultaneously included as covariates, differences by exposure category disappeared for use of injected drugs and heterosexual sex compared with homosexual sex (relative hazards 1.02 (95% confidence interval 0.71 to 1.45) and 1.07 (0.70 to 1.64) respectively), while the age effect remained (relative hazard 1.55 (1.32 to 1.83) for 10 year increase in age). Analyses using the other definitions for AIDS did not appreciably change these results. CONCLUSIONS: There was no evidence of differences in rate of development of AIDS by exposure category, while there was a strong tendency for more rapid development in older subjects for all three groups. This supports the view that external cofactors do not play major role in AIDS pathogenesis but that age is of fundamental importance.

Published
1996

158. Circulation of West Nile virus lineage 1 and 2 during an outbreak in Italy

Author

Maria Grazia Ciufolini, S. Piga, Antonella Marchi, Paola Bucci, Melissa Baggieri, Maria Elena Remoli, Claudia Fortuna, Caterina Rizzo, Fabio Magurano, Cristiano Fiorentini, Eleonora Benedetti, Pasquale Salcuni, G. Rezza, and Loredana Nicoletti

Subjects
Adult, Male, Microbiology (medical), Lineage (genetic), Genotype, Sequence analysis, Hospitalized patients, West Nile virus, viruses, 030231 tropical medicine, Molecular Sequence Data, Disease, Biology, medicine.disease_cause, West Nile, Disease Outbreaks, lineage 2, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Phylogeny, 030304 developmental biology, Aged, Aged, 80 and over, neurogical disease, 0303 health sciences, Molecular Epidemiology, outbreak, Outbreak, virus diseases, General Medicine, Sequence Analysis, DNA, Virology, urine, 3. Good health, Infectious Diseases, Italy, RNA, Viral, West Nile Fever, lineage
Abstract

In 2011, from 26 September to 16 October, a small outbreak of West Nile virus (WNV) disease occurred on the island of Sardinia (Italy). According to the national case definition, six cases with acute neurological disease were confirmed in hospitalized patients, and four of them died; one of these was only 34 years old. In two case, WNV RNA was detected in urine, suggesting renal involvement. Sequence analysis showed lineage 1 and 2 circulation.

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159. Significance of HIV antibody testing as a preventive measure in intravenous drug users

Author

Stefania Salmaso, Sasse H, G. Rezza, and Susanna Conti

Subjects
medicine.medical_specialty, Acquired Immunodeficiency Syndrome, Intravenous drug, biology, business.industry, Substance-Related Disorders, Sexual Behavior, Immunology, Health Behavior, Human immunodeficiency virus (HIV), Measure (physics), HIV Antibodies, medicine.disease_cause, medicine.disease, Infectious Diseases, Italy, HIV Seropositivity, biology.protein, Immunology and Allergy, Medicine, Humans, Medical emergency, Antibody, business, Intensive care medicine
Published
1988

161. Hodgkin disease and infection with the human immunodeficiency virus (HIV) in Italy

Author

Fabrice Gritti, P. G. Fassio, Emanuela Vaccher, N. Piersantelli, G. Broccia, Adriano Lazzarin, Giuseppe Luzi, Franco Mandelli, Giorgio Rossi, F. Gavosta, R. Maserti, Francesco Puppo, Marco De Gobbi, Umberto Tirelli, G. Rezza, Robert Foa, S. Monfardini, and G. Lambertenghi Deliliers

Subjects
Adult, Acquired Immunodeficiency Syndrome, business.industry, Human immunodeficiency virus (HIV), General Medicine, Disease, medicine.disease_cause, Virology, Hodgkin Disease, Internal Medicine, Medicine, Humans, In patient, business
Abstract

Excerpt To the editor: Although unusual and aggressive features have been seen in cases of Hodgkin disease in patients infected with the human immunodeficiency virus (HIV), it is not considered a c...

Published
1988

162. Hodgkin's disease in association with acquired immunodeficiency syndrome (AIDS). A report on 36 patients. Gruppo Italiano Cooperativo AIDS and Tumori

Author

U, Tirelli, E, Vaccher, G, Rezza, T, Barbui, C, Bernasconi, A, Cajozzo, A, Cargnel, F, de Lalla, P, Dessalvi, and P G, Fassio

Subjects
Adult, Male, Acquired Immunodeficiency Syndrome, Humans, Middle Aged, Hodgkin Disease
Abstract

In an Italian cooperative study on AIDS and cancer a diagnosis of Hodgkin's disease was established in 36 HIV-positive patients. The series was characterized by a high proportion of drug abusers, a high proportion of mixed cellularity and lymphocytic depletion subtypes and short survival. It is still unclear if HIV infection promotes the development of Hodgkin's disease or only modifies the course of the disease. According to the authors, however, patients who are HIV seropositive and have biopsy-proven Hodgkin's disease should be considered as fulfilling the criteria for AIDS.

Published
1989

163. Antiamebic antibodies in homosexual men

Author

Aceti A, Pennica A, Titti F, G. Rezza, Giuseppe Ippolito, Carlo A. Perucci, and D. Moretto

Subjects
Adult, Male, biology, business.industry, Entamoeba histolytica, General Medicine, Homosexuality, Middle Aged, Antibodies, Immunology, biology.protein, Medicine, Humans, Antibody, business
Published
1987

165. High prevalence of antibodies to human immunodeficiency virus in heterosexual persons attending a sexually transmitted disease clinic in Italy

Author

Leonardo Sernicola, Paolo Pasquini, Maria Antonietta Stazi, Elisabetta Franco, G. Rezza, Alfonso Mele, Grazia Prignano, Paola Verani, G. Gentili, and F. Caprilli

Subjects
Microbiology (medical), Sexually transmitted disease, Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Substance-Related Disorders, media_common.quotation_subject, Sexual Behavior, Population, Human immunodeficiency virus (HIV), Sexually Transmitted Diseases, HIV Antibodies, medicine.disease_cause, Antibodies, Viral, Medical microbiology, Acquired immunodeficiency syndrome (AIDS), Risk Factors, HIV Seropositivity, medicine, Humans, Simplexvirus, Hepatitis B Antibodies, education, media_common, education.field_of_study, biology, business.industry, Addiction, General Medicine, Homosexuality, Middle Aged, medicine.disease, Hepatitis B Core Antigens, Infectious Diseases, Italy, Immunology, biology.protein, HIV-1, Female, Antibody, business, Developed country
Abstract

The prevalence of antibodies to human immunodeficiency virus (anti-HIV-1) was determined in 924 outpatients attending a sexually transmitted disease clinic. The overall prevalence of anti-HIV-1 was 9 %. Six of 14 intravenous drug addicts and 4 of 34 patients of African origin were anti-HIV-1 positive. In the other 876 patients, the anti-HIV prevalence was 6.6 % in 467 heterosexual men, 5 % in 261 heterosexual women and 22.3 % in 148 homosexual or bisexual men. The prevalence of anti-HIV-1 in the heterosexual subjects was much higher than that expected in the general population and than that observed in patients attending sexually transmitted disease clinics in other developed countries. Intravenous drug abusers, who represent the most important group at risk for AIDS in Italy, could contribute to the spread of HIV infection through heterosexual contacts with persons without other known risk factors.

Published
1989

167. HIV, HTLV-1, and HBV infections in a cohort of Italian intravenous drug abusers: analysis of risk factors

Author

F, Titti, G, Rezza, P, Verani, S, Buttò, L, Sernicola, M, Rapicetta, B, Sarrecchia, C, Oliva, and G B, Rossi

Subjects
Male, Italy, Risk Factors, Substance-Related Disorders, Sexual Behavior, Injections, Intravenous, HIV-1, Humans, Female, HIV Antibodies, Hepatitis B Antibodies, HTLV-I Antibodies
Abstract

A seroepidemiological survey of a group of 291 intravenous drug abusers (IVDAs), 45 household contacts of IVDAs, and 39 laboratory workers has been carried out to determine the prevalence of HIV-1, HIV-2, HTLV-1, and HBV antibodies in the sera, as well as to evaluate the role of various risk factors. Among i.v. drug abusers, the prevalence was 32.3% for HIV-1 and 6.6% for HTLV-1. For both viruses, the total figures did not significantly change from 1985 through 1987, accounting for a slow viral circulation in this group. No seropositivity (HIV-1, HTLV-1) was found among laboratory workers, whereas one subject was found seropositive for HIV-1 among household contacts. From 1985 to 1986, 5 out of 58 subjects seronegative for HIV-1 and 5 out of 82 seronegative for HTLV-1 seroconverted (incidence rates of 8.6 and 6.1%, respectively). From 1986 to 1987, none out of 11 seronegatives for HIV and 1 out of 16 seronegatives for HTLV-1 seroconverted. The total figures for hepatitis B markers were 79.2% among IVDAs, 24.4% among household contacts, and 25.6% among laboratory workers. A significant correlation was found between presence of HBV markers and seropositivity for HIV and HTLV-1. A significant association with HIV-1 seropositivity was found for history of sexual intercourse with HIV-1 seropositive partners and for sexual promiscuity. These data emphasize the important role played by sexual behavior in addition to needle-sharing in the spreading of multiple infections among drug abusers.

Published
1988

168. Length of survival of patients with AIDS

Author

D Greco, M A Stazi, and G Rezza

Subjects
Adult, Male, medicine.medical_specialty, Acquired Immunodeficiency Syndrome, Letter, business.industry, Substance-Related Disorders, media_common.quotation_subject, Speech recognition, General Engineering, General Medicine, Homosexuality, medicine.disease, Text mining, Acquired immunodeficiency syndrome (AIDS), Family medicine, medicine, General Earth and Planetary Sciences, Humans, business, Child, General Environmental Science, media_common
Published
1986

169. HIV seroprevalence among 304 female prostitutes from four Italian towns

Author

R. DeMercato, A. Saracco, F. Caprilli, G. Gentili, Massimo Giuliani, Adriano Lazzarin, G. Rezza, and V. Tirelli

Subjects
Infectious Diseases, business.industry, Immunology, Human immunodeficiency virus (HIV), Immunology and Allergy, Medicine, Seroprevalence, business, medicine.disease_cause, Virology, Demography

170. Does HHV-8 have a protective role on the development of HIV encephalopathy?

Author

Barbara Ensoli, P Pezzotti, Emanuele Nicastri, M. Andreoni, Carla Arpino, G. Rezza, Maria Barbara Alliegro, Paolo Monini, De Luca A, and M. Dorrucci

Subjects
Drug, medicine.medical_specialty, biology, business.industry, media_common.quotation_subject, Encephalopathy, virus diseases, Disease, medicine.disease, Serology, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Cohort, medicine, Coinfection, biology.protein, Neurology (clinical), Antibody, business, media_common
Abstract

OBJECTIVE To evaluate risk factors for HIV encephalopathy and whether Kaposi's sarcoma (KS) and coinfection with human herpesvirus 8 (HHV-8) protect against this disease in a cohort of HIV seroconverters. METHODS Individuals with known dates of HIV seroconversion belonging to different HIV exposure categories (intravenous drug users, homosexual men, heterosexual contacts) were recruited by 17 clinical centers throughout Italy. Antibodies to HHV-8 lytic antigens were detected in a subgroup of participants using an immunofluorescence assay. Risk factors for HIV encephalopathy were evaluated using Cox proportional models. The association between KS or HHV-8 infection and HIV encephalopathy was evaluated using standard statistical techniques. RESULTS During the study period, 485 of the 1,520 participants developed acquired immunodeficiency syndrome, 38 of whom developed HIV encephalopathy. HHV-8 serologic status was determined for 390 participants. Male gender, injecting drug use, and low CD4 T-cell count were associated with HIV encephalopathy; none of the 63 participants with KS developed this disease. The risk of HIV encephalopathy did not differ significantly by HHV-8 serologic status. CONCLUSIONS HIV encephalopathy was found to be associated with male gender and intravenous drug use. The risk increased at lower CD4 T-cell counts. Although HIV encephalopathy occurred less frequently in patients with KS, no association with HHV-8 infection was found.

171. HIV infections: the global epidemiology and goals for vaccine research

Author

Miroslav Malkovsky, J. S. Cairns, Enrico Girardi, Giuseppe Ippolito, and G. Rezza

Subjects
Vaccine research, AIDS Vaccines, medicine.medical_specialty, Molecular epidemiology, business.industry, Research, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Global Health, Molecular medicine, Virology, Pharmacotherapy, Family medicine, Epidemiology, Genetics, Global health, medicine, Molecular Medicine, Humans, business, Molecular Biology, Genetics (clinical), Research Article

172. Continuous increase in HIV-1 incidence after the year 2000 among men who have sex with men in Rome: Insights from a 25-year retrospective cohort study

Author

Guido Palamara, Maria Gabriella Donà, Alessandra Latini, Fabrizio Ensoli, Massimo Giuliani, Francesca Stivali, Maria Fenicia Vescio, Fulvia Pimpinelli, F Carduccelli, G. Rezza, and A. Di Carlo

Subjects
Adult, Male, Adolescent, Epidemiology, Rome, HIV Infections, Rate ratio, Men who have sex with men, symbols.namesake, Young Adult, Age Distribution, Risk-Taking, HIV Seroprevalence, Risk Factors, Virology, Medicine, Humans, Poisson regression, Poisson Distribution, Seroconversion, Homosexuality, Male, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Retrospective cohort study, Sexually Transmitted Diseases, Viral, Middle Aged, Confidence interval, Italy, Socioeconomic Factors, Multivariate Analysis, symbols, HIV-1, business, Demography, Follow-Up Studies
Abstract

To assess trends in HIV-1 incidence and risk factors for seroconversion among men who have sex with men (MSM) resident in Rome, Italy, a retrospective longitudinal cohort study was conducted over 25 years. Incidence rates and trends were modelled using Poisson regression and risk factors were assessed by multivariate Cox models. Of 1,862 HIV-1-negative individuals, 347 seroconverted during follow-up. HIV-1 incidence rates increased from 5.2/100 persons/year (p/y) in 1986 (95% confidence interval (CI): 2.3–11.5) to 9.2/00 p/y in 1992 (95% CI: 6.4–13.0), decreased to 1.3/100 p/y in 2001 and increased until 2009 (11.7/100 p/y; 95% CI: 7.4–18.6). The risk of HIV-1 seroconversion increased during the study period in younger MSM (incidence rate ratio (IRR) = 17.18; 95% CI: 9.74–30.32 in 16–32 year-olds and IRR = 5.09; 95% CI: 2.92–8.87 in 33–41 year-olds) and in those who acquired syphilis (IRR = 7.71; 95% CI: 5.00–11.88). In contrast, the risk of seroconversion decreased among highly educated MSM (IRR = 0.54; 95% CI: 0.35–0.82) and those without Italian citizenship (IRR = 0.45; 95% CI: 0.28–0.71). The HIV epidemic in MSM living in Rome continues to expand. Targeted prevention programmes against sexually transmitted infections to enhance knowledge transfer and behavioural skills are urgently required.

173. Infection with human immunodeficiency virus, herpes simplex virus type 2, and human herpes virus 8 in remote villages of southwestern Papua New Guinea

Author

Stefano Boros, Barbara Suligoi, G. Rezza, Massimo Andreoni, Ifor L. Owen, Robert T. Danaya, Loredana Sarmati, and Edoardo Pozio

Subjects
Rural Population, Human herpesvirus 2, Herpesvirus 2, Human, viruses, Human immunodeficiency virus (HIV), Prevalence, HIV Infections, medicine.disease_cause, immunology, human herpes virus 8, Seroepidemiologic Studies, Human herpesvirus 8, disease transmission, biology, seroprevalence, Human immunodeficiency virus, Human herpes virus, adult, Herpes simplex virus 2, herpes, article, virus diseases, New guinea, sexually transmitted disease, Herpesviridae Infections, health survey, aged, Infectious Diseases, female, Population Surveillance, Herpesvirus 8, Human, epidemiology, Antibody, Settore MED/17 - Malattie Infettive, sex difference, Sexual Behavior, Sexually Transmitted Diseases, Papua New Guinea, Sex Factors, male, Human immunodeficiency virus infection, blood, Virology, medicine, Seroprevalence, Humans, human, Herpesvirus 8, endemic disease, nonhuman, isolation and purification, Herpesvirus 2, HIV, major clinical study, Herpes simplex virus, Human immunodeficiency virus antibody, adolescent, age, Herpes virus infection, rural population, sexual behavior, Immunology, biology.protein, Parasitology
Abstract

To investigate the spread of human immunodeficiency virus (HIV) and other sexually transmitted viruses, two serosurveys (the first in 1999 among 56 adults and the second in 2001 among 351 adults) were conducted in remote villages of the southwestern part of Papua New Guinea. Only one individual was positive for antibodies to HIV. In 2001, the seroprevalence of human herpes virus 8 (HHV-8) was 32.2%, and the seroprevalence of herpes simplex virus type 2 (HSV-2) was 27.4%. Both prevalence rates increased with age, and were lower in the villages near the Bensbach River. The seropositivity of HSV-2 was independently correlated with HHV-8 infection. Our data show that the inhabitants of the southwestern region of Papua New Guinea currently experience an extremely low circulation of HIV. However, the high prevalence of infectious agents that can be sexually transmitted, such as HSV-2 and to a lesser extent HHV-8, indicates the presence of behavioral patterns that may facilitate the spread of HIV in this area of currently low endemicity.

174. Risk of Developing AIDS in Newly Seropositive Intravenous Drug Abusers

Author

Luigi Ortona, R. Pristera, M. Barbanera, Fernando Aiuti, P. Costigliola, Adriano Lazzarin, G. Rezza, Alessandro Sinicco, S. Gafa, Umberto Tirelli, F. Menniti-Ippolito, G. Angarano, and B. Salassa

Subjects
Intravenous drug, business.industry, Human immunodeficiency virus (HIV), Time lag, medicine.disease_cause, medicine.disease, Virology, Virus, Substance abuse, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Immunopathology, Immunology, medicine, Immunology and Allergy, Viral disease, business
Published
1989
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175. Sir

Author

E. Raise, A. Malfitano, Alessia Carbone, Silvio Monfardini, E. Alessi, L. Contu, G. Rezza, Umberto Tirelli, Emanuela Vaccher, and Adriano Lazzarin

Subjects
medicine.medical_specialty, Pediatrics, Infectious Diseases, Intravenous drug, Acquired immunodeficiency syndrome (AIDS), business.industry, Immunology, medicine, Immunology and Allergy, Epidemic Kaposi's sarcoma, business, medicine.disease, Surgery
Published
1989
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176. Book Review / Announcement

Author

Michel Klein, Jose M. Miguel-Borja, Michael Colvin, Noboru Matsumoto, T. Terasawa, Mart M.A.C. Langenhuijsen, Rene Costello, Y. Hayashi, Hans Bebié, T. Shichishima, A. Ambrosini, Giovanni Longo, Hiroyuki Tanaka, Pierluigi Rossi Ferrini, E. Archimbaud, Yoji Ishida, Nicholas M. Papadopoulos, Shigenori Miyamura, G. Broccia, Lambertenghi Deliliers, S. Monfardini, Marchien van der Weide, G. Rossi, H. Keino, Hans Messner, Sam Berger, P. Dessalvi, Amparo Miguel, Stavroula Kokkinou, E.A. Parrinello, Carlos Piera, Juan-Carlos Reverter, Judy Falk, Arm Keating, K. Shimizu, Andrea Messori, Thoshio Kaneko, G. Luzi, Bianco Silvestroni, Haralambos M. Moutsopoulos, Subhash C. Gulati, T. Chisesi, E. Vaccher, F. Fassio, Franco Leoni, F. Lombardi, G. Rezza, Stefania Ciolli, A. Ehrsam, C. Malleo, Bayard D. Clarkson, Chihiro Shimazaki, D. Fiere, U. Tirelli, Phaedon Fessas, Francisco Cervantes, L. Campos, R. Proto, Jerrold Fried, Mariano Linares, M. Gobbi, Mayumi Tanaka, A. Andriani, Franz-Josef Schweiger, Josep-María Marti, F. Puppo, Amadeus Rosenmund, John G. Kelton, Werner Straub, Jens Atzpodien, B. Coiffier, William.J McIlroy, Gerassimos A. Pangalis, Leon M.F.M. Imandt, K. Ikuta, F. Gavosto, Alicia Miguel, D. Treille, Jürg Friedli, Ciril Rozman, A. Lazzarin, F. Lanza, Youichi Azuno, and D. Guyotat

Subjects
Hematology, General Medicine
Published
1988
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177. Risk of death among Italian AIDS cases with AIDS-defining cancers in the post-HAART era

Author

Laura Camoni, A. De Paoli, Barbara Suligoi, Diego Serraino, Benedetta Longo, L. Dal Maso, G. Rezza, Silvia Bruzzone, Pierluca Piselli, Jerry Polesel, and Stefano Boros

Subjects
Cancer Research, medicine.medical_specialty, Pathology, Transmission (medicine), Proportional hazards model, business.industry, Epidemiology, Hazard ratio, Autopsy, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, lcsh:RC254-282, Confidence interval, lcsh:Infectious and parasitic diseases, Lymphoma, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Oncology, Internal medicine, medicine, Oral Presentation, lcsh:RC109-216, business, Survival analysis
Abstract

This study intended to quantify the impact of AIDS-defining cancers on the risk of death in the post-HAART era. With this aim in mind, data regarding all Italian AIDS cases reported to the National AIDS Registry were analyzed. Between 1999 and 2005, a total of 12,433 individuals were diagnosed with AIDS in Italy. Specifically excluded from this analysis were people with AIDS who were: 1) not-Italian citizen (n = 1918); 2) resident in Italian areas where individual information on death was not available (n = 108); 3) resident in unknown areas (n = 119); 4) pediatric or vertical transmission cases (n = 50); 5) diagnosed solely at autopsy (n = 576). The presence of AIDS-defining cancers (i.e., Kaposi's sarcoma-KS, non-Hodgkin lymphoma-NHL, and invasive cervical cancer-ICC) at AIDS diagnosis is routinely ascertained at the National AIDS Registry, together with some other information, including age, sex, date of AIDS diagnosis, HIV transmission category, CD4+ cells count. Information on vital status of AIDS cases, as of December 2006, was assessed through a semi-automated linkage procedure, ensuring confidentiality of individual data, with the national death certificates database. Survival function was estimated by the Kaplan-Meier method; Cox regression model was used to estimate death hazard ratios (HR), and corresponding 95% confidence intervals (CI), associated to the presence of AIDS-defining cancers at diagnosis, adjusted for age at AIDS diagnosis, sex, HIV transmission category, and CD4+ cells count at diagnosis. Of the 9,662 AIDS cases included in the present study, 478 had KS, 429 immunoblastic NHL, 158 Burkitt's lymphoma, 69 ICC, and 58 NHL of the central nervous system (CNS). As of December 2006, 3,096 deaths were registered: of these deaths, 505 occurred among cases with AIDS-defining cancers. The proportion of AIDS cases still alive 5 years after AIDS diagnosis was 66.6 percent. The shortest survival period was seen among individuals diagnosed with CNS NHL (median survival = 4 months), followed by those with immunoblastic NHL or Burkitt's lymphoma (median survival = 16 and 38 months, respectively), whereas the longest ones were recorded among cases with ICC or KS (median not reached). In comparison with AIDS cases without AIDS-defining cancers, those with a CNS NHL had a 4.7-fold higher risk of death (95% CI: 3.5–6.4), those with immunoblastic NHL or Burkitt's lymphoma had more than twice the risk (HR = 2.6, 95% CI: 2.2–2.9; and HR = 2.3, 95% CI: 1.8–2.8, respectively), and, among women, those with ICC had a 1.8-fold elevated risk (95% CI: 1.2–2.7). Conversely, among individuals with KS (HR = 0.7, 95% CI: 0.6–0.9) the risk of death was lower than that of cases without AIDS-defining cancers. In conclusion, this exhaustive survival analysis of Italian AIDS cases in the post-HAART era highlighted the persisting lethality of NHL and the long survival of cases with KS and ICC.

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179. HBcAb Positivity Increases the Risk of Severe Hepatic Fibrosis Development in HIV/HCV-Positive Subjects from the ICONA Italian Cohort of HIV-Infected Patients

Author

Malagnino, Vincenzo, Cerva, Carlotta, Cingolani, Antonella, Ceccherini-Silberstein, Francesca, Vergori, Alessandra, Cuomo, Gianluca, Perno, Carlo Federico, Puoti, Massimo, d'Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro, Andreoni, Massimo, Sarmati, Loredana, d’Arminio Monforte (President), Icona Fundation Study Group. Board of Directors: A., Antinori (Vice-President), A., Andreoni, M., Castagna, A., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., von Schloesser, F., d’Arminio Monforte, P. Viale. Scientific Secretary: A., Antinori, A., Ceccherinisilberstein, F., Cozzi-Lepri, A., Girardi, E., Gori, A., Lo Caputo, S., Maggiolo, F., Mussini, C., Puoti, M., Antinori, C. F. Perno. Steering Committee: A., Bai, F., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capobianchi, M. R., Ceccherini-Silberstein, F., Cicalini, S., Cingolani, A., Cinque, P., d’Arminio Monforte, A., Di Biagio, A., Gagliardini, R., Gianotti, N., Guaraldi, G., Lapadula, G., Lichtner, M., Lai, A., Madeddu, G., Marchetti, G., Merlini, E., Nozza, S., Perno, C. F., Piconi, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Saracino, A., Sarmati, L., Spagnuolo, V., Svicher, V., Taramasso, L., Cozzi-Lepri, Statistical and Monitoring Team: A., Fanti, I., Galli, L., Lorenzini, P., Rodanó, A., Macchia, M., Bove, A. Tavelli. Community Advisory Board: A., Camposeragna, A., Errico, M., Manfredini, M., Perziano, A., Carletti, V. Calvino. Biological Bank INMI: F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Giacometti, S. Truffa. Participating Physicians and Centers: Italy: A., Costantini, A., Barocci (Ancona), V., Angarano, G., Monno, L., Milano (Bari), E., F. Maggiolo, C. Suardi (Bergamo), Viale, P., Donati, V., Verucchi (Bologna), G., Castelnuovo, F., Minardi, C., Quiros Roldan (Brescia), E., B. Menzaghi, C. Abeli (Busto Arsizio), L. Chessa, F. Pes (Cagliarti), B. Cacopardo, B. Celesia (Catania), J. Vecchiet, K. Falasca (Chieti), A. Pan, S. Lorenzotti (Cremona), L. Sighinolfi, D. Segala (Ferrara), P. Blanc, F. Vichi (Firenze), Cassola, G., Bassetti, M., Alessandrini, A., Bobbio, N., Mazzarello (Genova), G., M. Lichtner, L. Fondaco (Latina), P. Bonfanti, C. Molteni (Lecco), A. Chiodera, P. Milini (Macerata), G. Nunnari, G. Pellicanò (Messina), Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Poli, A., Tincati (Milano), C., C. Mussini, C. Puzzolante (Modena), C. Migliorino, G. Lapadula (Monza), Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo (Napoli), V., A. M. Cattelan, S. Marinello (Padova), A. Cascio, M. Trizzino (Palermo), D. Francisci, E. Schiaroli (Perugia), G. Parruti, F. Sozio (Pescara), C. Lazzaretti, R. Corsini (Reggio Emilia), Cristaudo, A., Vullo, V., Acinapura, R., Lamonica, S., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Onnelli, G., Plazzi, M. M., De Girolamo, G., Vergori (Roma), A., M. Cecchetto, F. Viviani (Rovigo), G. Madeddu, A. De Vito (Sassari), B. Rossetti, F. Montagnani (Siena), A. Franco, R. Fontana Del Vecchio (Siracusa), Di Giuli (Terni), C., Caramello, P., Orofino, G. C., Sciandra (Torino), M., Londero (Udine), A., V. Manfrin, G. Battagin (Vicenza), G. Starnini, A. Ialungo (Viterbo)., Malagnino, V, Cerva, C, Cingolani, A, Ceccherini-Silberstein, F, Vergori, A, Cuomo, G, Perno, C, Puoti, M, D'Arminio Monforte, A, Cozzi-Lepri, A, Andreoni, M, Sarmati, L, Malagnino, V., Cerva, C., Cingolani, A., Ceccherini-Silberstein, F., Vergori, A., Cuomo, G., Perno, C. F., Puoti, M., D'Arminio Monforte, A., Cozzi-Lepri, A., Andreoni, M., Sarmati, L., ICONA Foundation Study, Group, Castagna, A., Malagnino V., Cerva C., Cingolani A., Ceccherini-Silberstein F., Vergori A., Cuomo G., Perno C.F., Puoti M., D'Arminio Monforte A., Cozzi-Lepri A., Andreoni M., and Sarmati L.A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G C Marchetti, G Rezza, F von Schloesser, E Girardi, A Gori, S Lo Caputo, F Maggiolo, F Bai, A Bandera, S Bonora, M Borderi, A Calcagno, M R Capobianchi, S Cicalini, P Cinque, A Di Biagio, R Gagliardini, N Gianotti, G Guaraldi, G Lapadula, M Lichtner, A Lai, S Lo Caputo, G Madeddu, G Marchetti, E Merlini, C Mussini, S Nozza, S Piconi, C Pinnetti, E Quiros Roldan, R Rossotti, S Rusconi, M M Santoro, A Saracino, V Spagnuolo, V Svicher, L Taramasso, I Fanti, L Galli, P Lorenzini, A Rodanó, M Macchia, A Tavelli, A Bove, A Camposeragna, M Errico, M Manfredini, A Perziano, V Calvino, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, C Suardi, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, L Chessa, F Pes, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, F Vichi, G Cassola, M Bassetti, A Alessandrini, N Bobbio, G Mazzarello, M Lichtner, L Fondaco, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, , G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, A Poli, C Tincati, C Puzzolante, C Migliorino, G Lapadula, V Sangiovanni, G Borgia, V Esposito, G Di Flumeri, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, D Francisci, E Schiaroli, G Parruti, F Sozio, C Lazzaretti, R Corsini, A Antinori, A Cristaudo, V Vullo, R Acinapura, S Lamonica, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, G Onnelli, M M Plazzi, G De Girolamo, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, C Di Giuli, P Caramello, G C Orofino, M Sciandra, A Londero, V Manfrin, G Battagin, G Starnini, A Ialungo

Subjects
HBsAg, medicine.medical_specialty, Hepatitis C virus, Liver fibrosis, Human immunodeficiency virus (HIV), OBI, medicine.disease_cause, anti-HBc, HBV, HIV/HBV coinfection, liver fibrosis, Gastroenterology, Major Articles, NO, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Hiv infected patients, 030212 general & internal medicine, Hepatitis B virus, business.industry, liver fibrosi, virus diseases, Settore MED/17, digestive system diseases, Anti-HBc, HIV-HBV coinfection, HBV, Liver fibrosis, OBI, Infectious Diseases, AcademicSubjects/MED00290, HIV-HBV coinfection, Oncology, Cohort, 030211 gastroenterology & hepatology, business, Hepatic fibrosis
Abstract

Background The aim of this study was to investigate the impact of anti-HBc (HBcAb) positivity on the progression of liver fibrosis (Fibrosis-4 score >3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA). Methods All patients with FIB-4 Results Patients who were HBcAb+/HCV-/HBs antigen (HBsAg)- and HCV+/HBcAb+/HBsAg- or HBsAg+/HBcAb+/HCV- had CD4+ cell counts below the nadir and significantly higher prevalence of AIDS diagnosis at baseline than the other groups (P < .0001). A Cox regression model adjusted for age, HIV transmission mode, country of birth, and alcohol consumption showed a higher relative risk (HR) of progression to FIB-4 >3.25 in HCV+/HBcAb+/HBsAg- patients (HR, 7.2; 95% CI, 3 8–13.64). Conclusions HBcAb+ contributes to liver damage in HIV+/HCV+/HBcAb+/HBsAg- subjects. A careful monitoring for signs of previous HBV infection is needed in this kind of patients.

Published
2021

180. Virological response and retention in care according to time of starting ART in Italy: data from the Icona Foundation Study cohort

Author

D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, D., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., D'Arminio Monforte, A., Tavelli, A., Cozzi-Lepri, A., Castagna, A., Passerini, S., Francisci, D., Saracino, A., Maggiolo, F., Lapadula, G., Girardi, E., Perno, C. F., Antinori, A., Andreoni, M., Castelli, F., Cauda, R., Di Perri, G., Galli, M., Iardino, R., Ippolito, G., Lazzarin, A., Marchetti, G. C., Rezza, G., Von Schloesser, F., Viale, P., Ceccherini-Silberstein, F., Lo Caputo, S., Mussini, C., Puoti, M., Bai, F., Balotta, C., Bandera, A., Bonora, S., Borderi, M., Calcagno, A., Capetti, A., Capobianchi, M. R., Cicalini, S., Cingolani, A., Cinque, P., De Luca, A., Di Biagio, A., Gianotti, N., Gori, A., Guaraldi, G., Lichtner, M., Madeddu, G., Marchetti, G., Monno, L., Nozza, S., Pinnetti, C., Quiros Roldan, E., Rossotti, R., Rusconi, S., Santoro, M. M., Sarmati, L., Fanti, I., Galli, L., Lorenzini, P., Rodano, A., Macchia, M., Carletti, F., Carrara, S., Di Caro, A., Graziano, S., Petroni, F., Prota, G., Truffa, S., Giacometti, A., Costantini, A., Barocci, V., Angarano, G., Milano, E., Suardi, C., Donati, V., Verucchi, G., Castelnuovo, F., Minardi, C., Menzaghi, B., Abeli, C., Cacopardo, B., Celesia, B., Vecchiet, J., Falasca, K., Pan, A., Lorenzotti, S., Sighinolfi, L., Segala, D., Blanc, P., Vichi, F., Cassola, G., Viscoli, C., Alessandrini, A., Bobbio, N., Mazzarello, G., Fondaco, L., Bonfanti, P., Molteni, C., Chiodera, A., Milini, P., Nunnari, G., Pellicano, G., Rizzardini, G., Cannizzo, E. S., Moioli, M. C., Piolini, R., Bernacchia, D., Salpietro, S., Tincati, C., Puzzolante, C., Migliorino, C., Sangiovanni, V., Borgia, G., Esposito, V., Di Flumeri, G., Gentile, I., Rizzo, V., Cattelan, A. M., Marinello, S., Cascio, A., Trizzino, M., Schiaroli, E., Parruti, G., Sozio, F., Magnani, G., Ursitti, M. A., Cristaudo, A., Vullo, V., Acinapura, R., Moschese, D., Capozzi, M., Mondi, A., Rivano Capparuccia, M., Iaiani, G., Latini, A., Gagliardini, R., Plazzi, M. M., De Girolamo, G., Vergori, A., Cecchetto, M., Viviani, F., De Vito, A., Rossetti, B., Montagnani, F., Franco, A., Fontana Del Vecchio, R., Di Giuli, C., Caramello, P., Orofino, G. C., Sciandra, M., Bassetti, M., Londero, A., Manfrin, V., Battagin, G., Starnini, G., Ialungo, A., A d'Arminio Monforte, A Antinori, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G C Marchetti, G Rezza, F von Schloesser, F Ceccherini-Silberstein, A Cozzi-Lepri, E Girardi, S Lo Caputo, C Mussini, M Puoti, C F Perno, F Bai, C Balotta, A Bandera, S Bonora, M Borderi, A Calcagno, A Capetti, M R Capobianchi, S Cicalini, A Cingolani, P Cinque, , A Di Biagio, N Gianotti, A Gori, G Guaraldi, G Lapadula, M Lichtner, G Madeddu, F Maggiolo, L Monno, S Nozza, C Pinnetti, E Quiros Roldan, R Rossotti, S Rusconi, M M Santoro, A Saracino, L Sarmati, I Fanti, L Galli, P Lorenzini, A Rodano', M Macchia, A Tavelli, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, E Milano, C Suardi, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, F Vichi, G Cassola, C Viscoli, A Alessandrini, N Bobbio, G Mazzarello, L Fondaco, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, S Salpietro, C Tincati, C Puzzolante, C Migliorino, V Sangiovanni, G Borgia, V Esposito, G Di Flumeri, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, D Francisci, E Schiaroli, G Parruti, F Sozio, G Magnani, M A Ursitti, A Cristaudo, V Vullo, R Acinapura, D Moschese, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, R Gagliardini, M M Plazzi, G De Girolamo, A Vergori, M Cecchetto, F Viviani, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, C Di Giuli, P Caramello, G C Orofino, M Sciandra, M Bassetti, A Londero, V Manfrin, G Battagin, G Starnini, A Ialungo, D'Arminio Monforte, A, Tavelli, A, Cozzi-Lepri, A, Castagna, A, Passerini, S, Francisci, D, Saracino, A, Maggiolo, F, Lapadula, G, Girardi, E, Perno, C, Antinori, A, Andreoni, M, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, G, Rezza, G, Von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Lo Caputo, S, Mussini, C, Puoti, M, Bai, F, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, De Luca, A, Di Biagio, A, Gianotti, N, Gori, A, Guaraldi, G, Lichtner, M, Madeddu, G, Monno, L, Nozza, S, Pinnetti, C, Quiros Roldan, E, Rossotti, R, Rusconi, S, Santoro, M, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodano, A, Macchia, M, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Fondaco, L, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicano, G, Rizzardini, G, Cannizzo, E, Moioli, M, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, Di Flumeri, G, Gentile, I, Rizzo, V, Cattelan, A, Marinello, S, Cascio, A, Trizzino, M, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, Rivano Capparuccia, M, Iaiani, G, Latini, A, Gagliardini, R, Plazzi, M, De Girolamo, G, Vergori, A, Cecchetto, M, Viviani, F, De Vito, A, Rossetti, B, Montagnani, F, Franco, A, Fontana Del Vecchio, R, Di Giuli, C, Caramello, P, Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Manfrin, V, Battagin, G, Starnini, G, Ialungo, A, D'Arminio Monforte A., Tavelli A., Cozzi-Lepri A., Castagna A., Passerini S., Francisci D., Saracino A., Maggiolo F., Lapadula G., Girardi E., Perno C.F., Antinori A., Andreoni M., Castelli F., Cauda R., Di Perri G., Galli M., Iardino R., Ippolito G., Lazzarin A., Marchetti G.C., Rezza G., Von Schloesser F., Viale P., Ceccherini-Silberstein F., Lo Caputo S., Mussini C., Puoti M., Bai F., Balotta C., Bandera A., Bonora S., Borderi M., Calcagno A., Capetti A., Capobianchi M.R., Cicalini S., Cingolani A., Cinque P., De Luca A., Di Biagio A., Gianotti N., Gori A., Guaraldi G., Lichtner M., Madeddu G., Marchetti G., Monno L., Nozza S., Pinnetti C., Quiros Roldan E., Rossotti R., Rusconi S., Santoro M.M., Sarmati L., Fanti I., Galli L., Lorenzini P., Rodano A., MacChia M., Carletti F., Carrara S., Di Caro A., Graziano S., Petroni F., Prota G., Truffa S., Giacometti A., Costantini A., Barocci V., Angarano G., Milano E., Suardi C., Donati V., Verucchi G., Castelnuovo F., Minardi C., Menzaghi B., Abeli C., Cacopardo B., Celesia B., Vecchiet J., Falasca K., Pan A., Lorenzotti S., Sighinolfi L., Segala D., Blanc P., Vichi F., Cassola G., Viscoli C., Alessandrini A., Bobbio N., Mazzarello G., Fondaco L., Bonfanti P., Molteni C., Chiodera A., Milini P., Nunnari G., Pellicano G., Rizzardini G., Cannizzo E.S., Moioli M.C., Piolini R., Bernacchia D., Salpietro S., Tincati C., Puzzolante C., Migliorino C., Sangiovanni V., Borgia G., Esposito V., Di Flumeri G., Gentile I., Rizzo V., Cattelan A.M., Marinello S., Cascio A., Trizzino M., Schiaroli E., Parruti G., Sozio F., Magnani G., Ursitti M.A., Cristaudo A., Vullo V., Acinapura R., Moschese D., Capozzi M., Mondi A., Rivano Capparuccia M., Iaiani G., Latini A., Gagliardini R., Plazzi M.M., De Girolamo G., Vergori A., Cecchetto M., Viviani F., De Vito A., Rossetti B., Montagnani F., Franco A., Fontana Del Vecchio R., Di Giuli C., Caramello P., Orofino G.C., Sciandra M., Bassetti M., Londero A., Manfrin V., Battagin G., Starnini G., and Ialungo A.

Subjects
0301 basic medicine, diagnosis, hiv, communicable diseases, HIV Infections, Logistic regression, Virological response, Cohort Studies, 0302 clinical medicine, Retention in Care, Medicine, Pharmacology (medical), HIV Infection, 030212 general & internal medicine, Prospective cohort study, cd4 count determination procedure, drug, suppression, Viral Load, CD4 Lymphocyte Count, Humans, Italy, Anti-HIV Agents, virology, Infectious Diseases, blood hiv rna, Cohort, hiv, cd4 count determination procedure, communicable diseases, incomeitaly, diagnosis, virology, blood hiv rna, retention in care, incomeitaly, Viral load, HIV, ART, Cohort study, Human, Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, Settore MED/17 - MALATTIE INFETTIVE, NO, 03 medical and health sciences, HIV viral load, Internal medicine, HIV, CD4, ART, Pharmacology, business.industry, double blind, Anti-HIV Agent, HIV viral load, antiretroviral therapy, double blind, initiation, suppression, infection, Retention in care, 030112 virology, infection, initiation, Observational study, Cohort Studie, business
Abstract

Objectives To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year from ART initiation according to timing of start in a real-life setting. Methods All individuals in the Icona cohort diagnosed with HIV in 2016–17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, ≤7 days; Group 2, 8–14 days; Group 3, 15–30 days; Group 4, 31–120 days; and Group 5, >120 days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12 week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1 year (on ART with HIV-RNA Results A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1 year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1 year. Conclusions In our high-income observational setting, we did not observe differences in the 1 year rate of virological response and retention in care according to timing of ART initiation.

Published
2020

181. Incidence and risk factors for liver enzyme elevation among naive HIV-1-infected patients receiving ART in the ICONA cohort

Author

Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., ICONA Foundation Study Group:, A d'Arminio Monforte, Antinori, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, G Di Perri, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, C Marchetti, G, Rezza, G, F von Schloesser, Viale, P, A d'Arminio Monforte, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Girardi, E, S Lo Caputo, Mussini, C, Puoti, M, F Perno, C, Bai, F, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, R Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, A De Luca, A Di Biagio, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Monno, L, Nozza, S, Pinnetti, C, QUIROS ROLDAN, Maria Eugenia, Rossotti, R, Rusconi, S, M Santoro, M, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, A Di Caro, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, S Cannizzo, E, C Moioli, M, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, F Di Martino, Gentile, I, Rizzo, V, M Cattelan, A, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, A Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, M Rivano Capparuccia, Iaiani, G, Latini, A, Gagliardini, R, M Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, A De Vito, Rossetti, B, Montagnani, F, Franco, A, R Fontana Del Vecchio, Francisci, D, C Di Giuli, Caramello, P, C Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Taramasso, L, Lorenzini, P, Di Biagio, A, Lichtner, M, Marchetti, G, Rossotti, R, Lapadula, G, Cozzi-Lepri, A, Vichi, F, Antinori, A, Bonora, S, D'Arminio Monforte, A, d'Arminio Monforte, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, Gc, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Mussini, C, Puoti, M, Perno, Cf, Bai, F, Balotta, C, Bandera, A, Borderi, M, Calcagno, A, Capetti, A, Capobianchi, Mr, Cicalini, S, Cingolani, A, Cinque, P, De Luca, A, Gianotti, N, Gori, A, Guaraldi, G, Madeddu, G, Maggiolo, F, Monno, L, Nozza, S, Pinnetti, C, Quiros Roldan, E, Rusconi, S, Santoro, Mm, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, Cannizzo, E, Moioli, Mc, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, Di Martino, F, Gentile, I, Rizzo, V, Cattelan, Am, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, Ma, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, Capparuccia, Mr, Iaiani, G, Latini, A, Gagliardini, R, Plazzi, Mm, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, De Vito, A, Rossetti, B, Montagnani, F, Franco, A, Fontana Del Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, Gc, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Taramasso L., Lorenzini P., Di Biagio A., Lichtner M., Marchetti G., Rossotti R., Lapadula G., Cozzi-Lepri A., Vichi F., Antinori A., Bonora S., Cascio A., D'Arminio Monforte A., Cascio A. in ICONA Foundation Study Group., Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., Castagna, A., and A d'Arminio Monforte,i, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G Rezza, F von Schloesser, F Ceccherini-Silberstein, E Girardi, S Lo Caputo, C Mussini, M Puoti, C F Perno, F Bai, C Balotta, A Bandera, M Borderi, A Calcagno, A Capetti, M R Capobianchi, S Cicalini, A Cingolani, P Cinque, A De Luca, E Girardi, N Gianotti, A Gori, G Guaraldi, G Madeddu, F Maggiolo, L Monno, S Nozza, C Pinnetti, E Quiros Roldan, S Rusconi, M M Santoro, A Saracino, L Sarmati, I Fanti, A Rodano', M Macchia, A Tavelli, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, F Maggiolo, C Suardi, P Viale, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, G Cassola, C Viscoli, A Alessandrini, N Bobbio, G Mazzarello, S Vita, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, S Salpietro, C Tincati, C Puzzolante, C Migliorino, V Sangiovanni, G Borgia, V Esposito, F Di Martino, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, F Baldelli, E Schiaroli, G Parruti, F Sozio, G Magnani, M A Ursitti, A Cristaudo, V Vullo, R Acinapura, D Moschese, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, R Gagliardini, M M Plazzi, S Savinelli, A Vergori, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, D Francisci, C Di Giuli, P Caramello, G C Orofino, M Sciandra, M Bassetti, A Londero, G Pellizzer, V Manfrin, G Starnini, A Ialungo

Subjects
0301 basic medicine, Male, Integrase inhibitor, Hepatitis B Surface Antigen, HIV Infections, 0302 clinical medicine, Risk Factors, hivh epatitis c rna surface antigens follow-up homosexuality integrase inhibitors hepatitis b virus hepatitis b virus measurement hiv infections hepatotoxicity hepatitis c virus coinfection nucleoside reverse transcriptase inhibitors non-nucleoside reverse transcriptase inhibitors cox proportional hazards models baseline value liver enzyme raltegravir, Pharmacology (medical), HIV Infection, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Coinfection, Incidence (epidemiology), Liver Disease, Incidence, Liver Diseases, virus diseases, Hepatitis C, Middle Aged, Reverse Transcriptase Inhibitor, Infectious Diseases, Cohort, Population study, Regression Analysis, Reverse Transcriptase Inhibitors, Female, medicine.drug, Human, Microbiology (medical), Adult, medicine.medical_specialty, Anti-HIV Agents, Regression Analysi, NO, 03 medical and health sciences, Internal medicine, medicine, Humans, HIV Integrase Inhibitors, HIV Protease Inhibitor, Pharmacology, Hepatitis B Surface Antigens, business.industry, Anti-HIV Agent, HIV, ART, HIV Protease Inhibitors, medicine.disease, Raltegravir, 030112 virology, HIV Integrase Inhibitor, Prospective Studie, HIV-1, business, Adult, Anti-HIV Agents, Coinfection, Female, Hepatitis B Surface Antigens, Hepatitis C, HIV Infections, HIV Integrase Inhibitors, HIV Protease Inhibitors, HIV-1, Humans, Incidence, Liver Diseases, Male, Middle Aged, Prospective Studies, Regression Analysis, Reverse Transcriptase Inhibitors, Risk Factors
Abstract

ObjectivesTo evaluate the incidence and risk factors for liver enzyme elevations (LEE) in patients initiating first-line ART in the ICONA prospective observational cohort, between June 2009 and December 2017.Patients and methodsIn total, 6575 ART-naive patients were selected, initiating two NRTIs with the third drug being a boosted PI (n=2436; 37.0%), an NNRTI (n=2384; 36.3%) or an integrase strand transfer inhibitor (INSTI) (n=1755; 26.7%). HBV surface antigen and HCV RNA were detected in 3.9% and 5.8% of the study population. Inverse probability weighted Cox regression analysis was used to calculate the HRs, according to first-line regimen, for LEE, defined as ALT or AST increases of ≥2.5× upper limit of normal (ULN) for patients with normal baseline values or ≥2.5× baseline for patients with higher baseline values.ResultsOne hundred and eighty-three LEE occurred over 20722 patient-years of follow-up. After adjusting for the main confounders, the risk of LEE halved with INSTIs compared with NNRTIs (HR 0.46, 95% CI 0.25–0.86), with a significant reduction in the raltegravir group (HR 0.11, 95% CI 0.02–0.84 using the NNRTI class as reference). HRs for LEE were significantly higher in subjects with HBV or HCV coinfection, in patients with poorly controlled HIV infection and in those who acquired HIV through homosexual transmission.ConclusionsIn our study, INSTI use almost halved the risk of LEE compared with other regimens. This finding could be particularly important for choosing ART in patients with risk factors for liver toxicity such as HCV and HBV coinfections.

Published
2019

182. Serological Evidence of an Early Seroconversion to Simian Virus 40 in Healthy Children and Adolescents

Author

Angelo Taronna, Elisa Mazzoni, Alfredo Corallini, Ilaria Bononi, Silvia Pietrobon, Giovanni Guerra, Caterina Palmonari, Caterina Borgna-Pignatti, Manola Comar, Massimo Bovenzi, Ferruccio Casali, Roberto Marci, Giovanni Rezza, Giuseppe Barbanti-Brodano, Mauro Tognon, Fernanda Martini, A., Taronna, E., Mazzoni, A., Corallini, I., Bononi, S., Pietrobon, G., Guerra, C., Palmonari, C., Borgna Pignatti, Comar, Manola, Bovenzi, Massimo, F., Casali, R., Marci, G., Rezza, G., Barbanti Brodano, M., Tognon, and F., Martini

Subjects
Male, Viral Diseases, Epidemiology, viruses, Prevalence, lcsh:Medicine, Simian virus 40, Simian, Antibodies, Viral, Pediatrics, Serology, Cohort Studies, SV40, Epitopes, antibody, Anti-viral capsid protein 1-2-3 SV40 IgG antibodies, IgM antibodies, lcsh:Science, Pediatric Epidemiology, Child, Immune Response, Multidisciplinary, Infectious Diseases, children and adolescents, Health, Child, Preschool, Medicine, Female, Research Article, Adolescent, Clinical Research Design, Enzyme-Linked Immunosorbent Assay, Biology, Microbiology, Virus, Virology, Seroprevalence, Humans, Serologic Tests, Seroconversion, Polyomavirus Infections, IgM antibodie, lcsh:R, Infant, Newborn, Infant, Viral Vaccines, biology.organism_classification, infection, Peptide Fragments, Anti-viral capsid protein 1-2-3 SV40 IgG antibodie, Tumor Virus Infections, Early Diagnosis, Immunoglobulin M, Immunology, biology.protein, lcsh:Q, Clinical Immunology, Capsid Proteins, child, adolescent, Viral Transmission and Infection
Abstract

At present Simian virus 40 (SV40) infection in humans appears to be transmitted independently from early contaminated vaccines. In order to test the spread of SV40 infection in children, an immunologic assay employing specific SV40 synthetic peptides corresponding to its viral protein (VP) antigens was employed to estimate the seroprevalence of this polyomavirus in Italian infants and adolescents. Serum samples from 328 children and adolescents, up to 17 years, were investigated. Serum antibodies against SV40 VPs were detected by indirect enzyme-linked immunosorbent assays. The seroprevalence of this polyomavirus was calculated after stratifying the subjects by age. Anti-viral capsid protein 1-2-3 SV40 IgG antibodies were detected in 16% of the study participants. The prevalence of antibodies against SV40 VPs tended to increase with age in children, up to 10 year old (21%). Then, in the cohort of individuals aged 11-17 years, the prevalence decreased (16%). A higher prevalence rate (23%) of SV40 VP antibodies was detected in the cohorts of 1-3 year and 7-10 year old children, than in children and adolescents of the other age groups. This age corresponds to children starting nursery and primary school, respectively, in Italy. IgM antibodies against SV40 VP mimotopes were detected in 6-8 month old children suggesting that SV40 seroconversion can occur early in life. SV40 VP antibodies are present at low prevalence in Italian children (16%), suggesting that SV40 infection, although acquired early in life, probably through different routes, is not widespread. The low SV40 seroprevalence suggests that SV40 is less transmissible than other common polyomaviruses, such as BKV and JCV. Alternatively, our immunologic data could be due to another, as yet undiscovered, human polyomavirus closely related to SV40.

Published
2013

183. High prevalence of serum antibodies reacting with simian virus 40 capsid protein mimotopes in patients affected by malignant pleural mesothelioma

Author

Ferruccio Casali, Gianfranco Tassi, Elisa Mazzoni, Roberto Guaschino, Giuseppe Barbanti-Brodano, Alfredo Corallini, Marco Manfrini, Manola Comar, Fernanda Martini, Alfonso Cristaudo, Francesca Vaniglia, Mauro Tognon, Corrado Magnani, Giovanni Rezza, Massimo Bovenzi, Angelo Taronna, E., Mazzoni, A., Corallini, A., Cristaudo, A., Taronna, G., Tassi, M., Manfrini, Comar, Manola, Bovenzi, Massimo, R., Guaschino, F., Vaniglia, C., Magnani, F., Casali, G., Rezza, G., Barbanti Brodano, F., Martini, and M., Tognon

Subjects
Male, Mesothelioma, antibody neoplasia, viruses, Pleural Neoplasms, Molecular Sequence Data, Enzyme-Linked Immunosorbent Assay, Simian virus 40, Antibodies, Viral, Virus, Antigen, Pregnancy, antibody, Tumor Virus, Genetic predisposition, medicine, Neoplasm, Humans, Amino Acid Sequence, tumor virus, Multidisciplinary, biology, Biological Sciences, ELISA, mesothelioma, simian virus 40, medicine.disease, Virology, Capsid, Immunology, biology.protein, Capsid Proteins, Female, Antibody
Abstract

Human malignant pleural mesothelioma (MPM) is considered a rare tumor, but recent estimations indicate that one-quarter million people will die of this neoplasm in Europe in the next three decades. The mineral asbestos is considered the main causative agent of this neoplasm. MPM is largely unresponsive to conventional chemotherapy/radiotherapy. In addition to asbestos exposure, genetic predisposition to asbestos carcinogenesis and to simian virus (SV)40 infection has also been suggested. SV40 is a DNA tumor virus found in some studies to be associated at high prevalence with MPM. SV40 sequences have also been detected, although at a lower prevalence than in MPM, in blood specimens from healthy donors. However, some studies have failed to reveal SV40 footprints in MPM and its association with this neoplasm. These conflicting results indicate the need for further investigations with new approaches. We report on the presence of antibodies in serum samples from patients affected by MPM that specifically react with two different SV40 mimotopes. The two SV40 peptides used in indirect ELISAs correspond to viral capsid proteins. ELISA with the two SV40 mimotopes gave overlapping results. Our data indicate that in serum samples from MPM-affected patients ( n = 97), the prevalence of antibodies against SV40 viral capsid protein antigens is significantly higher (26%, P = 0.043) than in the control group (15%) represented by healthy subjects ( n = 168) with the same median age (66 y) and sex. Our results suggest that SV40 is associated with a subset of MPM and circulates in humans.

Published
2012

184. Phylogeography and epidemiological history of West Nile virus genotype 1a in Europe and the Mediterranean basin

Author

Flavia Bernini, Alessandra Lo Presti, Giovanni Rezza, Erika Ebranati, Massimo Ciccozzi, Gianguglielmo Zehender, Mauro Delogu, Massimo Galli, G. Zehender, E. Ebranati, F. Bernini, A.Lo Presti, G. Rezza, M.Delogu, M. Galli, and M. Ciccozzi

Subjects
Microbiology (medical), Mediterranean climate, WNV 2008/2009 ITALIAN EPIDEMIC, Genotype, Biology, Microbiology, Mediterranean Basin, Monophyly, Genetics, medicine, Humans, Clade, Molecular Biology, Phylogeny, Ecology, Evolution, Behavior and Systematics, Likelihood Functions, BAYESIAN PHYLOGEOGRAPHY, Mediterranean Region, Ecology, Zoonosis, WEST NILE VIRUS GENOTYPE 1A, Outbreak, Bayes Theorem, History, 20th Century, medicine.disease, SPATIO TEMPORAL PHYLODYNAMICS, Europe, Phylogeography, Infectious Diseases, Viral phylodynamics, MIGRATORY BIRDS, West Nile virus, West Nile Fever
Abstract

Aim of this study was to reconstruct the temporal and spatial phylodynamics of WNV-1a, the genotype to which the majority of European/Mediterranean viral strains belongs, by using sequences retrieved from public databases. WNV-1a isolates segregated into two major clades: the recent West Mediterranean sequences formed a single monophyletic group within clade A. Clade B included sequences from East Mediterranean and America. Phylogeographic analysis suggested that WNV-1a probably originated in sub-Saharan Africa in the early XXth century, and then spread northwards since the late 1970s, via two routes: one crossing Eastern Mediterranean and the other the Western Mediterranean countries. Our data suggest that the circulation of the virus in a given geographical area usually precedes the onset of the outbreak by one year or more, and underline the importance of the spatial–temporal phylodynamics reconstruction in clarifying the recent epidemiology and in setting up an efficient surveillance system for emerging/reemerging zoonosis.

Published
2011

185. Prevalence of Batrachochytrium dendrobatidis in Amphibians in Northwestern Italy's Protected Areas.

Author

Meletiadis A, Di Nicola MR, Bovero S, Favelli M, Pezzolato M, Grella S, Rezza G, and Acutis PL

Abstract

Chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), is a significant threat to global amphibian populations, leading to widespread declines and extinctions. In the spring of 2023, Bd presence was detected in different amphibian species within two protected areas near Turin, Piedmont, Italy, following an unusual mortality event among the common toad ( Bufo bufo ). Histological and molecular analyses confirmed Bd infection in a deceased Pelophylax sp. specimen, prompting further investigation. Sampling of 166 individuals across seven amphibian taxa revealed an overall Bd occurrence of 38.6%, with Pelophylax sp. showing the highest detection rate (50.5% of 93 individuals). A marked difference in the positivity rate was observed between the two locations, with La Mandria (67.2% of 58) exhibiting significantly higher rates than Vauda (22.9% of 35). While Bd was identified in the sampled amphibians, the exact cause of the observed mortality remains unclear and may involve other pathogens or multifactorial causes, including but not limited to Bd. These findings represent the first documented case of Bd presence in Piedmont after an 18-year gap, highlighting the potential influence of local environmental factors on infection dynamics. The study emphasises the need for expanded, standardised field sampling and further investigation into the various factors affecting amphibian health to guide conservation efforts for vulnerable amphibian species.

Published
2025
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187. Vaccinating in Different Settings: Best Practices from Italian Regions.

Author

Signorelli C, Pennisi F, D'Amelio AC, Conversano M, Cinquetti S, Blandi L, and Rezza G

Abstract

Background: The success of vaccination programs depends on a complex interplay of logistical, social, and structural factors. The objective of this study was to analyze the different approaches to vaccine administration implemented by several Italian regions since the onset of the SARS-CoV-2 pandemic., Methods: After careful qualitative review of information gathered from scientific articles, official reports (grey literature), contact with regional health authorities, and local health departments, five vaccination strategies across several Italian regions focusing on alternative vaccine providers and/or settings were identified. The innovative practices implemented by different actors covered specific topics and were then examined and described in detail., Results: In Veneto, where prevention departments were the main actor, herpes zoster vaccination coverage for the 65-year-old cohort increased from 44.4% to 54.9%; in Tuscany, family pediatricians administered 64% of all childhood vaccines; in Liguria, pharmacies delivered 70.1% of COVID-19 vaccines, while vaccinating in schools in Taranto led to higher human papilloma virus vaccination rates compared to regional and national averages. Finally, in all the regions, hospitals focused on vaccinating healthcare workers and vulnerable populations., Conclusions: The positive outcomes of these five experiences may, in a context of limited resources, encourage other national and international entities to adopt innovative practices, which offer new perspectives beyond the traditional delivery methods (i.e., local health authority vaccination centers for childhood and adolescent immunizations, and family doctors for adults and the elderly). These strategies suggest the efficacy of specific local approaches favored by regional autonomy in optimizing vaccine distribution and coverage.

Published
2024
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188. The Italian National Vaccine Prevention Plans, 1999/2020-2023/2025: challenges and obstacles to vaccine coverage goals. Commentary.

Author

Signorelli C, Oleari F, Greco D, Ruocco G, Guerra R, Rezza G, Vaia F, Campitiello MR, and Fara GM

Subjects
Italy, Humans, Child, Adolescent, Child, Preschool, Infant, Newborn, Infant, Goals, Aged, Vaccination, Vaccines, Vaccination Coverage statistics & numerical data, Immunization Programs
Abstract

Five consecutive national vaccination plans (from 1999 to 2025) were revised, outlining their objectives, challenges, and results. Vaccination coverage for children consistently approached target levels, though regional differences emerged. In contrast, coverage for adolescents, the elderly, and vulnerable groups, consistently fell short of targets. While vaccination policies in Italy over the past 25 years were ambitious and well-planned, success was primarily limited to newborns immunization, thanks to effective organizational activities. Failure to achieve goals for other population groups was partly due to inconsistent implementation of regional vaccination prevention plans.

Published
2024
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189. Therapeutic Strategies to Combat Increasing Rates of Multidrug Resistant Pathogens.

Author

Vitiello A, Rezza G, Silenzi A, Salzano A, Alise M, Boccellino MR, Ponzo A, Zovi A, and Sabbatucci M

Subjects
Humans, Bacterial Infections drug therapy, Bacterial Infections microbiology, Animals, Antibodies, Monoclonal therapeutic use, Bacteria drug effects, Drug Resistance, Multiple, Bacterial drug effects, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents pharmacology
Abstract

The emergence of antimicrobic-resistant infectious pathogens and the consequent rising in the incidence and prevalence of demises caused by or associated to infections which are not sensitive to drug treatments is one of today's major global health challenges. Antimicrobial resistance (AMR) can bring to therapeutic failure, infection's persistence and risk of serious illness, in particular in vulnerable populations such as the elderly, patients with neoplastic diseases or the immunocompromised. It is assessed that AMR will induce until 10 million deaths per year by 2050, becoming the leading cause of disease-related deaths. The World Health Organisation (WHO) and the United Nations General Assembly urgently call for new measures to combat the phenomenon. Research and development of new antimicrobial agents has decreased due to market failure. However, promising results are coming from new alternative therapeutic strategies such as monoclonal antibodies, microbiome modulators, nanomaterial-based therapeutics, vaccines, and phages. This narrative review aimed to analyse the benefits and weaknesses of alternative therapeutic strategies to antibiotics which treat multidrug-resistant bacterial infections., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2024
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190. SARS-CoV-2 genomic surveillance of migrants arriving to Europe through the Mediterranean routes.

Author

Tramuto F, Marotta C, Stefanelli P, Cernigliaro A, Maida CM, Silenzi A, Angeloni U, Di Naro D, Randazzo G, Guzzetta V, Barone T, Brusaferro S, Severoni S, Rezza G, Vitale F, and Mazzucco W

Subjects
Humans, Europe epidemiology, Genome, Viral, Refugees statistics & numerical data, Mediterranean Sea epidemiology, Italy epidemiology, Male, COVID-19 epidemiology, COVID-19 virology, SARS-CoV-2 genetics, Transients and Migrants statistics & numerical data
Abstract

Background: The implementation genomic-based surveillance on emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in low-income countries, which have inadequate molecular and sequencing capabilities and limited vaccine storage, represents a challenge for public health. To date, there is little evidence on molecular investigations of SARS-CoV-2 variants in areas where they might emerge. We report the findings of an experimental SARS-CoV-2 molecular surveillance programme for migrants, refugees, and asylum seekers arriving to Europe via Italy through the Mediterranean Sea., Methods: We descriptively analysed data on migrants collected at entry points in Sicily from February 2021 to May 2022. These entry points are integrated with a network of laboratories fully equipped for molecular analyses, which performed next-generation sequencing and used Nextclade and the Pangolin coronavirus disease 2019 (COVID-19) tools for clade/lineage assignment., Results: We obtained 472 full-length SARS-CoV-2 sequences and identified 12 unique clades belonging to 31 different lineages. The delta variant accounted for 43.6% of all genomes, followed by clades 21D (Eta) and 20A (25.4% and 11.4%, respectively). Notably, some of the identified lineages (A.23.1, A.27, and A.29) predicted their introduction into the migration area. The mutation analysis allowed us to identify 617 different amino acid substitutions, 156 amino acid deletions, 7 stop codons, and 6 amino acid insertions. Lastly, we highlighted the geographical distribution patterns of some mutational profiles occurring in the migrants' countries of origin., Conclusions: Genome-based molecular surveillance dedicated to migrant populations from low-resource areas may be useful for forecasting new epidemiological scenarios related to SARS-CoV-2 variants or other emerging pathogens, as well as for informing the updating of vaccination strategies., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Published
2024
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191. SARS-CoV-2 molecular surveillance of migrant populations arriving to Italy via the Mediterranean Sea: lessons learnt.

Author

Mazzucco W, Stefanelli P, Marotta C, Cernigliaro A, Maida CM, Angeloni U, Silenzi A, Fruscione S, Barone T, Rezza G, Vitale F, and Tramuto F

Subjects
Humans, Italy epidemiology, Sicily epidemiology, Mediterranean Sea epidemiology, Population Surveillance, High-Throughput Nucleotide Sequencing, Refugees statistics & numerical data, Epidemiological Monitoring, COVID-19 epidemiology, SARS-CoV-2, Transients and Migrants statistics & numerical data, Pandemics
Abstract

Refugees and migrants remain one of the most vulnerable people and the COVID-19 pandemic has posed additional challenges both in terms of increased risk of infection and death experienced, highlighting existing inequities in access to and utilization of health services, as underlined by World Health Organization in 2020 in the Health and Migration Programme. In the context of the Programme 'Epidemiological surveillance and control of COVID-19 in metropolitan urban areas and for the containment of the circulation of SARS-CoV-2 in the migrant population in Italy', coordinated by the Italian Centre for Disease Control and Prevention (CCM) and funded by the Italian Ministry of Health, an experimental epidemiological, virological, and molecular SARS-CoV-2 surveillance system addressed to migrant populations in Sicily through Mediterranean routes was implemented. To this end, a multidisciplinary network supported by a hub&spoke system of laboratories was established in Sicily Region (Southern Italy), using molecular and Next Generation Sequencing (NGS) techniques to identify different SARS-CoV-2 strains in relation to migration flows. Herein, the lesson learnt through this integrated surveillance model, that was in place from February 2021 till the end of the COVID-19 emergency in Italy, are reported. Overall, the data emphasized the need for enhancing molecular surveillance in the areas of the globe where testing and sequencing resources are limited. The epidemiological, virological, and molecular SARS-CoV-2 monitoring, targeted to the migrant population, may also provide a valuable experimental model.

Published
2024
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192. Climate change and the spread of Aedes mosquito-borne viruses in Europe.

Author

Rezza G

Subjects
Animals, Europe epidemiology, Humans, Chikungunya Fever transmission, Chikungunya Fever epidemiology, Chikungunya Fever prevention & control, Chikungunya Fever virology, Dengue transmission, Dengue epidemiology, Dengue prevention & control, Disease Outbreaks, Mosquito Control methods, Aedes virology, Climate Change, Mosquito Vectors virology
Abstract

Several outbreaks of chikungunya and dengue occurred on Mediterranean coasts during the hot season in the last two decades. Aedes albopictus was the vector involved in all the events. As a consequence of climate change, the 'Tiger' mosquito is now spreading through central Europe, and in the summer of 2023, for the first time, mosquito control measures were implemented in Paris to prevent autochthonous transmission of dengue. Rapid changes in the distribution of tropical disease vectors need to be taken into account in future risk assessment activities.

Published
2024
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193. An outbreak of COVID-19 after a pilgrimage to Medjugorje due to Delta sub-lineages.

Author

Lo Presti A, Rubino S, Ibba G, Ambrosio L, Di Martino A, Ferraro F, Rapiti A, Maraglino F, Frisicale EM, Rezza G, Angioj F, Uzzau S, Contini ML, Manca S, Coghe F, Orrù G, Palamara AT, and Stefanelli P

Subjects
Humans, SARS-CoV-2 genetics, Phylogeny, Disease Outbreaks, COVID-19 epidemiology
Abstract

Introduction: A COVID-19 outbreak occurred at the end of October 2021 among pilgrims returning from Medjugorje (Bosnia and Herzegovina)., Methodology: Whole genome sequencing (WGS) of SARS-CoV-2, epidemiological data, and phylogenetic analysis were used to reconstruct outbreak dynamics., Results: The results suggest that only in one case, associated with the SARS-CoV-2 sub-lineage AY.9.2, it is possible to trace back the place of contagion to Medjugorje, while the other cases were likely to be acquired in the country of origin., Conclusions: The combined use of phylogenetic data derived from WGS, and epidemiological data allowed us to study epidemic dynamics and to formulate a possible hypothesis on the place of exposure to SARS-CoV-2. The identification of different sub-lineages of the SARS-CoV-2 Delta variant also suggested that different chains of transmission contributed to the outbreak., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Alessandra Lo Presti, Salvatore Rubino, Gabriele Ibba, Luigina Ambrosio, Angela Di Martino, Federica Ferraro, Alessia Rapiti, Francesco Maraglino, Emanuela Maria Frisicale, Giovanni Rezza, Flavia Angioj, Sergio Uzzau, Maria Luciana Contini, Stefania Manca, Ferdinando Coghe, Germano Orrù, Anna Teresa Palamara, Paola Stefanelli, the AOUSS COVID team.)

Published
2024
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194. The decline of the 2022 Italian mpox epidemic: Role of behavior changes and control strategies.

Author

Guzzetta G, Marziano V, Mammone A, Siddu A, Ferraro F, Caraglia A, Maraglino F, Rezza G, Vespignani A, Longini I, Ajelli M, and Merler S

Subjects
Male, Humans, Homosexuality, Male, Sexual Behavior, Italy epidemiology, HIV Infections prevention & control, Mpox, Monkeypox, Sexual and Gender Minorities
Abstract

In 2022, a global outbreak of mpox occurred, predominantly impacting men who have sex with men (MSM). The rapid decline of this epidemic is yet to be fully understood. We investigated the Italian outbreak by means of an individual-based mathematical model calibrated to surveillance data. The model accounts for transmission within the MSM sexual contact network, in recreational and sex clubs attended by MSM, and in households. We indicate a strong spontaneous reduction in sexual transmission (61-87%) in affected MSM communities as the possible driving factor for the rapid decline in cases. The MSM sexual contact network was the main responsible for transmission (about 80%), with clubs and households contributing residually. Contact tracing prevented about half of the potential cases, and a higher success rate in tracing contacts could significantly amplify its effectiveness. Notably, immunizing the 23% of MSM with the highest sexual activity (10 or more partners per year) could completely prevent new mpox resurgences. This research underscores the importance of augmenting contact tracing, targeted immunization campaigns of high-risk groups, and fostering reactive behavioral changes as key strategies to manage and prevent the spread of emerging sexually transmitted pathogens like mpox within the MSM community., (© 2024. The Author(s).)

Published
2024
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195. Human mpox: global trends, molecular epidemiology and options for vaccination.

Author

Subissi L, Stefanelli P, and Rezza G

Subjects
Humans, Molecular Epidemiology, Vaccination, Monkeypox virus, Smallpox epidemiology, Smallpox prevention & control, Mpox, Monkeypox epidemiology, Mpox, Monkeypox prevention & control, Vaccines
Abstract

The eradication of smallpox and the cessation of vaccination have led to the growth of the susceptible human population to poxviruses. This has led to the increasing detection of zoonotic orthopoxviruses. Among those viruses, monkeypox virus (MPV) is the most commonly detected in Western and Central African regions. Since 2022, MPV is causing local transmission in newly affected countries all over the world. While the virus causing the current outbreak remains part of clade II (historically referred to as West African clade), it has a significant number of mutations as compared to other clade II sequences and is therefore referred to as clade IIb. It remains unclear whether those mutations may have caused a change in the virus phenotype. Vaccine effectiveness data show evidence of a high cross-protection of vaccines designed to prevent smallpox against mpox. These vaccines therefore represent a great opportunity to control human-to-human transmission, provided that their availability has short time-frames and that mistakes from the recent past (vaccine inequity) will not be reiterated.

Published
2024
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196. Diagnosis of Imported Dengue and Zika Virus Infections in Italy from November 2015 to November 2022: Laboratory Surveillance Data from a National Reference Laboratory.

Author

Merakou C, Amendola A, Fortuna C, Marsili G, Fiorentini C, Argentini C, Benedetti E, Rezza G, Maraglino F, Del Manso M, Bella A, Pezzotti P, Riccardo F, Palamara AT, Venturi G, and The Arbovirus Working Group

Subjects
Humans, Animals, Mosquito Vectors, Italy epidemiology, Zika Virus, Zika Virus Infection diagnosis, Aedes, Dengue diagnosis, Dengue epidemiology
Abstract

Dengue (DENV) and Zika (ZIKV) viruses are mosquito-borne human pathogens. In Italy, the presence of the competent vector Aedes albopictus increases the risk of autochthonous transmission, and a national plan for arboviruses prevention, surveillance, and response (PNA 2020-2025) is in place. The results of laboratory diagnosis of both viruses by the National Reference Laboratory for arboviruses (NRLA) from November 2015 to November 2022 are presented. Samples from 655 suspected cases were tested by both molecular and serological assays. Virus and antibody kinetics, cross-reactivity, and diagnostic performance of IgM ELISA systems were analysed. Of 524 cases tested for DENV, 146 were classified as confirmed, 7 as probable, while 371 were excluded. Of 619 cases tested for ZIKV, 44 were classified as confirmed, while 492 were excluded. All cases were imported. Overall, 75.3% (110/146) of DENV and 50% (22/44) of ZIKV cases were confirmed through direct virus detection methods. High percentages of cross reactivity were observed between the two viruses. The median lag time from symptoms onset to sample collection was 7 days for both DENV molecular (range 0-20) and NS1 ELISA (range 0-48) tests, with high percentages of positivity also after 7 days (39% and 67%, respectively). For ZIKV, the median lag time was 5 days (range 0-22), with 16% positivity after 7 days. Diagnostic performance was assessed with negative predictive values ranging from 92% to 95% for the anti-DENV systems, and of 97% for the ZIKV one. Lower positive predictive values were seen in the tested population (DENV: 55% to 91%, ZIKV: 50%). DENV and ZIKV diagnosis by molecular test is the gold standard, but sample collection time is a limitation. Serological tests, including Plaque Reduction Neutralization Test, are thus necessary. Co-circulation and cross-reactivity between the two viruses increase diagnostic difficulty. Continuous evaluation of diagnostic strategies is essential to improve laboratory testing.

Published
2023
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197. Relative effectiveness of monovalent and bivalent mRNA boosters in preventing severe COVID-19 due to omicron BA.5 infection up to 4 months post-administration in people aged 60 years or older in Italy: a retrospective matched cohort study.

Author

Mateo-Urdiales A, Sacco C, Fotakis EA, Del Manso M, Bella A, Riccardo F, Bressi M, Rota MC, Petrone D, Siddu A, Fedele G, Stefanelli P, Palamara AT, Brusaferro S, Rezza G, Pezzotti P, and Fabiani M

Subjects
Humans, Middle Aged, Aged, SARS-CoV-2 genetics, Cohort Studies, Retrospective Studies, Italy epidemiology, RNA, Messenger genetics, Vaccines, Combined, mRNA Vaccines, COVID-19 prevention & control
Abstract

Background: Limited evidence is available on the additional protection conferred by second mRNA vaccine boosters against severe COVID-19 caused by omicron BA.5 infection, and whether the adapted bivalent boosters provide additional protection compared with the monovalent ones. In this study, we aimed to estimate the relative effectiveness of a second booster with monovalent or bivalent mRNA vaccines against severe COVID-19 in Italy., Methods: Linking data from the Italian vaccination registry and the SARS-CoV-2 surveillance system, between Sept 12, 2022, and Jan 7, 2023, we matched 1:1 each person aged 60 years or older receiving a second booster with a person who had received the first booster only at least 120 days earlier. We used hazard ratios, estimated through Cox proportional hazard models, to compare the hazard of severe COVID-19 between the first booster group and each type of second booster (monovalent mRNA vaccine targeting the original strain of SARS-CoV-2, bivalent mRNA vaccine targeting the original strain plus omicron BA.1 [bivalent original/BA.1], and bivalent mRNA vaccine targeting the original strain plus omicron BA.4 and BA.5 [bivalent original/BA.4-5]). Relative vaccine effectiveness (rVE) was calculated as (1-hazard ratio) × 100., Findings: We analysed a total of 2 129 559 matched pairs. The estimated rVE against severe COVID-19 with the bivalent original/BA.4-5 booster was 50·6% (95% CI 46·0-54·8) in the overall time interval 14-118 days post-administration. Overall, rVE was 49·3% (43·6-54·4) for the bivalent original/BA.1 booster and 26·9% (11·8-39·3) for the monovalent booster. For the bivalent original/BA.4-5 booster, we did not observe relevant differences in rVE between the 60-79-year age group (overall, 53·6%; 46·8-59·5) and those aged 80 years or older (overall, 48·3%; 41·9-54·0)., Interpretation: These findings suggest that a second booster with mRNA vaccines provides additional protection against severe COVID-19 due to omicron BA.5 (the predominant circulating subvariant in Italy during the study period) in people aged 60 years or older. Although rVE decreased over time, a second booster with the original/BA.4-5 mRNA vaccine, currently the most used in Italy, was found to be still providing protection 4 months post-administration., Funding: NextGenerationEU-MUR-PNRR Extended Partnership initiative on Emerging Infectious Diseases (project number PE00000007, INF-ACT)., Translation: For the Italian translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Published
2023
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198. The impact of SARS-CoV-2 infection in patients with cystic fibrosis undergoing CFTR channel modulators treatment: a literature review.

Author

Vitiello A, Sabbatucci M, Silenzi A, Capuano A, Rossi F, Zovi A, Blasi F, and Rezza G

Subjects
Humans, Cystic Fibrosis Transmembrane Conductance Regulator genetics, RNA, Viral, SARS-CoV-2, Cystic Fibrosis drug therapy, Cystic Fibrosis metabolism, COVID-19
Abstract

Several risk factors for Coronavirus-2019 (COVID-19) disease have been highlighted in clinical evidence. Among the various risk factors are advanced age, metabolic illness such as diabetes, heart disease, and diseases of the respiratory system. Cystic Fibrosis (CF) is a rare disease with autosomal recessive transmission, characterised by a lack of synthesis of the CFTR channel protein, and multi-organ clinical symptoms mainly affecting the respiratory tract with recurrent pulmonary exacerbations. In view of the pathophysiological mechanisms, CF disease should be in theory considered a risk factor for SARS-CoV2 or severe COVID-19. However, recent clinical evidence seems to point in the opposite direction, suggesting that CF could be a protective factor against severe COVID-19. Possibly, the lack of presence or function of the CFTR channel protein could be linked to the expression of the membrane glycoprotein ACE-2, a key enzyme for the endocellular penetration of SARS-CoV-2 and related to the pathophysiology of COVID-19 disease. Furthermore, CFTR channel modulating agents could indirectly influence the expression of ACE-2, playing an important role in restoring the proper functioning of mucociliary clearance and the pulmonary microbiome in the host response to SARS-CoV-2 infection. In this review, the authors attempt to shed light on these important associations of issues that are not yet fully elucidated., (© 2023. The Author(s).)

Published
2023
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199. Risk prediction model of self-reported hypertension for telemedicine based on the sociodemographic, occupational and health-related characteristics of seafarers: a cross-sectional epidemiological study.

Author

Sagaro GG, Angeloni U, Battineni G, Chintalapudi N, Dicanio M, Kebede MM, Marotta C, Rezza G, Silenzi A, and Amenta F

Subjects
Humans, Adolescent, Adult, Self Report, Cross-Sectional Studies, Ships, Hypertension epidemiology, Telemedicine
Abstract

Objectives: High blood pressure is a common health concern among seafarers. However, due to the remote nature of their work, it can be difficult for them to access regular monitoring of their blood pressure. Therefore, the development of a risk prediction model for hypertension in seafarers is important for early detection and prevention. This study developed a risk prediction model of self-reported hypertension for telemedicine., Design: A cross-sectional epidemiological study was employed., Setting: This study was conducted among seafarers aboard ships. Data on sociodemographic, occupational and health-related characteristics were collected using anonymous, standardised questionnaires., Participants: This study involved 8125 seafarers aged 18-70 aboard 400 vessels between November 2020 and December 2020. 4318 study subjects were included in the analysis. Seafarers over 18 years of age, active (on duty) during the study and willing to give informed consent were the inclusion criteria., Outcome Measures: We calculated the adjusted OR (AOR) with 95% CIs using multiple logistic regression models to estimate the associations between sociodemographic, occupational and health-related characteristics and self-reported hypertension. We also developed a risk prediction model for self-reported hypertension for telemedicine based on seafarers' characteristics., Results: Among the 4318 participants, 55.3% and 44.7% were non-officers and officers, respectively. 20.8% (900) of the participants reported having hypertension. Multivariable analysis showed that age (AOR: 1.08, 95% CI 1.07 to 1.10), working long hours per week (AOR: 1.02, 95% CI 1.01 to 1.03), work experience at sea (10+ years) (AOR: 1.79, 95% CI 1.33 to 2.42), being a non-officer (AOR: 1.75, 95% CI 1.44 to 2.13), snoring (AOR: 3.58, 95% CI 2.96 to 4.34) and other health-related variables were independent predictors of self-reported hypertension, which were included in the final risk prediction model. The sensitivity, specificity and accuracy of the predictive model were 56.4%, 94.4% and 86.5%, respectively., Conclusion: A risk prediction model developed in the present study is accurate in predicting self-reported hypertension in seafarers' onboard ships., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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200. Estimated Effectiveness of a Primary Cycle of Protein Recombinant Vaccine NVX-CoV2373 Against COVID-19.

Author

Mateo-Urdiales A, Sacco C, Petrone D, Bella A, Riccardo F, Del Manso M, Bressi M, Siddu A, Brusaferro S, Palamara AT, Rezza G, Pezzotti P, and Fabiani M

Subjects
Adult, Humans, Female, Middle Aged, Male, Cohort Studies, Retrospective Studies, SARS-CoV-2 genetics, Vaccines, Synthetic, COVID-19 epidemiology, COVID-19 prevention & control
Abstract

Importance: Protein recombinant vaccine NVX-CoV2373 (Novavax) against COVID-19 was authorized for its use in adults in late 2021, but evidence on its estimated effectiveness in a general population is lacking., Objective: To estimate vaccine effectiveness of a primary cycle with NVX-CoV2373 against SARS-CoV-2 infection and symptomatic COVID-19., Design, Setting, and Participants: Retrospective cohort study linking data from the national vaccination registry and the COVID-19 surveillance system in Italy during a period of Omicron predominance. All adults starting a primary vaccination with NVX-CoV2373 between February 28 and September 4, 2022, were included, with follow-up ending on September 25, 2022. Data were analyzed in February 2023., Exposures: Partial (1 dose only) vaccination and full vaccination (2 doses) with NVX-CoV-2373., Main Outcomes and Measures: Notified SARS-CoV-2 infection and symptomatic COVID-19. Poisson regression models were used to estimate effectiveness against both outcomes. Adjusted estimated vaccine effectiveness was calculated as (1 - incidence rate ratio) × 100., Results: The study included 20 903 individuals who started the primary cycle during the study period. Median (IQR) age of participants was 52 (39-61) years, 10 794 (51.6%) were female, and 20 592 participants (98.5%) had no factors associated with risk for severe COVID-19. Adjusted estimated vaccine effectiveness against notified SARS-CoV-2 infection in those partially vaccinated with NVX-CoV2373 was 23% (95% CI, 13%-33%) and was 31% (95% CI, 22%-39%) in those fully vaccinated. Estimated vaccine effectiveness against symptomatic COVID-19 was 31% (95% CI, 16%-44%) in those partially vaccinated and 50% (95% CI, 40%-58%) in those fully vaccinated. Estimated effectiveness during the first 4 months after completion of the primary cycle decreased against SARS-CoV-2 infection but remained stable against symptomatic COVID-19., Conclusions and Relevance: This cohort study found that, in an Omicron-dominant period, protein recombinant vaccine NVX-CoV2373 was associated with protection against SARS-CoV-2 infection and symptomatic COVID-19. The use of this vaccine could remain an important element in reducing the impact of the SARS-CoV-2 pandemic.

Published
2023
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