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1. Off-label use of combined antiretroviral therapy, analysis of data collected by the Italian Register for HIV-1 infection in paediatrics in a large cohort of children

Author

Chiappini, E., Lisi, C., Giacomet, V., Erba, P., Bernardi, S., Zangari, P., Di Biagio, A., Taramasso, L., Giaquinto, C., Rampon, O., Gabiano, C., Garazzino, S., Tagliabue, C., Esposito, S., Bruzzese, E., Badolato, R., Zanaboni, D., Cellini, M., Dedoni, M., Mazza, A., Pession, A., Giannini, A. M., Salvini, F., Dodi, I., Carloni, I., Cazzato, S., Tovo, P. A., de Martino, M., Galli, L., Parigi, S., Orlandi, F., de Martino, A., Pinzani, R., Abbagnato, L., Ruggeri, M., Baldi, F., Faldella, G., Chiriaco, P., Dessi, C., Panto, M. G., Anastasio, E., Govoni, M. R., Bigi, M., Bondi, E., Borea, R., Cenderello, G., Tommasi, D., Nogare, E. R. D., Saitta, M., Felici, L., Consolini, R., Antonellini, A., Anzidei, G., Genovese, O., Catania, S., Natale, F., Olmeo, P., Cristiano, L., Portelli, V., Rabusin, M., Di Pietro, G. M., Fabrizio, L., Chiappini, Elena, Lisi, Catiuscia, Giacomet, Vania, Erba, Paola, Bernardi, Stefania, Zangari, Paola, Di Biagio, Antonio, Taramasso, Lucia, Giaquinto, Carlo, Rampon, Osvalda, Gabiano, Clara, Garazzino, Silvia, Tagliabue, Claudia, Esposito, Susanna, Bruzzese, Eugenia, Badolato, Raffaele, Zanaboni, Domenico, Cellini, Monica, Dedoni, Maurizio, Mazza, Antonio, Pession, Andrea, Giannini, Anna Maria, Salvini, Filippo, Dodi, Icilio, Carloni, Ine, Cazzato, Salvatore, Tovo, Pier Angelo, de Martino, Maurizio, and Galli, Luisa

Subjects
Register (sociolinguistics), Pediatrics, medicine.medical_specialty, HAART, Adolescent, Anti-HIV Agents, Off-label therapy, Human immunodeficiency virus (HIV), HIV Infections, Infectious and parasitic diseases, RC109-216, HIV-1 infection, medicine.disease_cause, Off-label use, Retrospective Studie, Antiretroviral Therapy, Highly Active, medicine, Humans, Highly Active, HIV Infection, Child, Children, Antiretroviral therapy, CD4 Lymphocyte Count, Off-Label Use, Retrospective Studies, Viral Load, HIV-1, business.industry, Research, Anti-HIV Agent, virus diseases, Large cohort, Infectious Diseases, business, Human
Abstract

Background Early start of highly active antiretroviral therapy (HAART) in perinatally HIV-1 infected children is the optimal strategy to prevent immunological and clinical deterioration. To date, according to EMA, only 35% of antiretroviral drugs are licenced in children Methods An observational retrospective study investigating the rate and the outcomes of off-label prescription of HAART was conducted on 225 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018. Results 22.2% (50/225) of included children were receiving an off-label HAART regimen at last check. Only 26% (13/50) of off-label children had an undetectable viral load (VL) before the commencing of the regimen and the 52.0% (26/50) had a CD4 + T lymphocyte percentage > 25%. At last check, during the off label regimen, the 80% (40/50) of patients had an undetectable VL, and 90% (45/50) of them displayed CD4 + T lymphocyte percentage > 25%. The most widely used off-label drugs were: dolutegravir/abacavir/lamivudine (16%; 8/50), emtricitbine/tenofovir disoproxil (22%; 11/50), lopinavir/ritonavir (20%; 10/50) and elvitegravir/cobicistat/emtricitabine/ tenofovir alafenamide (10%; 10/50). At logistic regression analysis, detectable VL before starting the current HAART regimen was a risk factor for receiving an off-label therapy (OR: 2.41; 95% CI 1.13–5.19; p = 0.024). Moreover, children Conclusion The prescription of an off-label HAART regimen in perinatally HIV-1 infected children was common, in particular in children with detectable VL despite previous HAART and in younger children, especially those receiving their first regimen. Our data suggest similar proportions of virological and immunological successes at last check among children receiving off-label or on-label HAART. Larger studies are needed to better clarify efficacy and safety of off-label HAART regimens in children, in order to allow the enlargement of on-label prescription in children.

Published
2022

3. Recommendations for the diagnosis of pediatric tuberculosis

Author

Chiappini, E., Lo Vecchio, A., Garazzino, S., Marseglia, G. L., Bernardi, F., Castagnola, E., Tomà, P., Cirillo, D., Russo, C., Gabiano, C., Ciofi, D., Losurdo, G., Bocchino, M., Tortoli, E., Tadolini, M., Villani, A., Guarino, A., Esposito, S., and for the Italian Pediatric TB Study Group

Published
2016
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4. Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

Author

Chappell, E., Riordan, A., Jourdain, G., Soriano-Arandes, A., Ene, L., Scherpbier, H., Warszawski, J., Collins, I., Smit, C., Marques, L., Klein, N., Guillén, S., Judd, A., Thorne, C., Goodall, R., Königs, C., Spoulou, V., Prata, F., Goetghebuer, T., Chiappini, E., Galli, L., Naver, L., Giaquinto, C., Gibb, D., Marczynska, M., Okhonskaia, L., Klimkait, T., Lallemant, M., Ngo-Giang-Huong, N., Kiseleva, G., Malyuta, R., Volokha, A., Hainaut, M., Delforge, M., Le Chenadec, J., Ramos, E., Dialla, O., Wack, T., Laurent, C., Ait Si Selmi, L., Leymarie, I., Ait Benali, F., Brossard, M., Boufassa, L., Floch-Tudal, C., Firtion, G., Hau, I., Chace, A., Bolot, P., Blanche, S., Levine, M., Bicëtre, L., Fourcade, C., Heller-Roussin, B., Runel-Belliard, C., Tricoire, J., Chirouze, C., Reliquet, V., Brouard, J., Kebaili, K., Fialaire, P., Lalande, M., Schultze-Strasser, S., Baumann, U., Niehues, T., Neubert, J., Kobbe, R., Berlin, C., Feiterna-Sperling, C., Buchholz, B., Notheis, G., de Martino, M., Angelo Tovo, P., Patrizia, O., Larovere, D., Ruggeri, M., Faldella, G., Baldi, F., Badolato, R., Montagnani, C., Venturini, E., Lisi, C., Di Biagio, A., Taramasso, L., Giacomet, V., Erba, P., Esposito, S., Lipreri, R., Salvini, F., Tagliabue, C., Cellini, M., Bruzzese, E., Lo Vecchio, A., Rampon, O., Donà, D., Romano, A., Dodi, I., Maccabruni, A., Consolini, R., Bernardi, S., Tchidjou Kuekou, H., Genovese, O., Olmeo, P., Cristiano, L., Mazza, A., Gabiano, C., Garazzino, S., Pellegatta, A., Pajkrt, D., Weijsenfeld, A., de Boer CG, Jurriaans, S., Back, N., Zaaijer, H., Berkhout, B., Cornelissen, M., Schinkel, C., Wolthers, K., Fraaij, P., van Rossum AMC, van der Knaap LC, Visser, E., Koopmans, M., van Kampen JJA, Pas, S., Henriet, S., van de Flier, M., van Aerde, K., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F., Schölvinck, E., de Groot-de Jonge, H., Niesters, H., van Leer-Buter CC, Knoester, M., Bont, L., Geelen, S., Wolfs, T., Nauta, N., Ang, C., van Houdt, R., Pettersson, A., Vandenbroucke-Grauls, C., Reiss, P., Bezemer, D., van Sighem AI, Wit, F., Boender, T., Zaheri, S., Hillebregt, M., de Jong, A., Bergsma, D., Grivell, S., Jansen, A., Raethke, M., Meijering, R., de Groot, L., van den Akker, M., Bakker, Y., Claessen, E., El Berkaoui, A., Koops, J., Kruijne, E., Lodewijk, C., Munjishvili, L., Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Rutkens, T., Schoorl, M., Timmerman, A., Tuijn, E., Veenenberg, L., van der Vliet, S., Wisse, A., Woudstra, T., Tuk, B., Popielska, J., Pokorska-Śpiewak, M., Ołdakowska, A., Zawadka, K., Coupland, U., DorobaLaura Marques, M., Teixeira, C., Fernandes, A., Voronin, E., Miloenko, M., Labutina, S., Tomás Ramos, J., Prieto, L., Luisa Navarro, M., Saavedra, J., Santos, M., Angeles Muñoz, M., Ruiz, B., Mc Phee CF, de Ory SJ, Alvarez, S., Ángel Roa, M., Beceiro, J., Martínez, J., Badillo, K., Apilanez, M., Pocheville, I., Garrote, E., Colino, E., Gómez Sirvent, J., Garzón, M., Román, V., Montesdeoca, A., Mateo, M., José Muñoz, M., Angulo, R., Neth, O., Falcón, L., Terol, P., Luis Santos, J., Moreno, D., Lendínez, F., Grande, A., José Romero, F., Lillo, M., Losada, B., Herranz, M., Bustillo, M., Guerrero, C., Collado, P., Antonio Couceiro, J., Pérez, A., Isabel Piqueras, A., Bretón, R., Segarra, I., Gavilán, C., Jareño, E., Montesinos, E., Dapena, M., Álvarez, C., Gloria Andrés, A., Marugán, V., Ochoa, C., Alfayate, S., Isabel Menasalvas, A., de Miguel, E., Aebi-Popp, K., Asner, S., Aubert, V., Battegay, M., Baumann, M., Bernasconi, E., Böni, J., Brazzola, P., Bucher, H., Calmy, A., Cavassini, M., Ciuffi, A., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C., Grawe, C., Günthard, H., Haerry, D., Hasse, B., Hirsch, H., Hoffmann, M., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Kovari, H., Kouyos, R., Ledergerber, B., Martinetti, G., de Tejada BM, Metzner, K., Müller, N., Nicca, D., Paioni, P., Pantaleo, G., Polli, C., Posfay-Barbe, K., Rauch, A., Rudin, C., Schmid, P., Scherrer, A., Speck, R., Tarr, P., Thanh Lecompte, M., Trkola, A., Vernazza, P., Wagner, N., Wandeler, G., Weber, R., Wyler, C., Yerly, S., Techakunakorn, P., Hansudewechakul, R., Kham, C., Wanchaitanawong, V., Theansavettrakul, S., Sai, M., Nanta, S., Ngampiyaskul, C., Phanomcheong, S., Hongsiriwon, S., Karnchanamayul, W., Kwanchaipanich, R., Kanjanavanit, S., Kamonpakorn, N., Nantarukchaikul, M., Layangool, P., Mekmullica, J., Lucksanapisitkul, P., Watanayothin, S., Lertpienthum, N., Warachit, B., Hanpinitsak, S., Potchalongsin, S., Thanasiri, P., Krikajornkitti, S., Attavinijtrakarn, P., Srirojana, S., Bunjongpak, S., Puangsombat, A., Na-Rajsima, S., Ananpatharachai, P., Akarathum, N., Phuket, V., Lawtongkum, W., Kheunjan, P., Suriyaboon, T., Saipanya, A., Than-In-At, K., Jaisieng, N., Suaysod, R., Chailoet, S., Naratee, N., Kawilapat, S., Kaleeva, T., Baryshnikova, Y., Soloha, S., Bashkatova, N., Raus, I., Glutshenko, O., Ruban, Z., Prymak, N., Bailey, H., Bamford, A., Butler, K., Doerholt, K., Doherty, C., Foster, C., Francis, K., Harrison, I., Kenny, J., Letting, G., Mcmaster, P., Murau, F., Nsangi, E., Peters, H., Prime, K., Shackley, F., Shingadia, D., Storey, S., Tudor-Williams, G., Turkova, A., Welch, S., Jeannie Collins, I., Cook, C., Crichton, S., Dobson, D., Fairbrother, K., M Gibb D, Harper, L., Le Prevost, M., Van Looy, N., Walsh, A., Thrasyvoulou, L., Bernatoniene, J., Manyika, F., Sharpe, G., Subramaniam, B., Sloper, K., Fidler, K., Hague, R., Price, V., Clapson, M., Flynn, J., Cardoso, A., Abou-Rayyah, M., Gurtin, D., Yeadon, S., Segal, S., Ball, C., Hawkins, S., Dowie, M., Bandi, S., Percival, E., Eisenhut, M., Duncan, K., Clough, S., Anguvaa, L., Conway, S., Flood, T., Pickering, A., Murphy, C., Daniels, J., Lees, Y., Thompson, F., Williams, B., Pope, S., Cliffe, L., Smyth, A., Southall, S., Freeman, A., Freeman, H., Christie, S., Gordon, A., Rogahn, D., Clarke, L., Jones, L., Offerman, B., Greenberg, M., Benson, C., Ibberson, L., Faust, S., Hancock, J., Sharland, M., Lyall, H., Monrose, C., Seery, P., Menson, E., Callaghan, A., Bridgwood, A., Evans, J., Blake, E., Yannoulias, A., Critchton, S., Duff, C., Gomezpena, D., Lundin, R., Mangiarini, L., Nardone, A., Posfay Barbe, Klara, Universidad de Alcalá - University of Alcalá (UAH), Department of Sciences for Woman and Child's Health, Università degli Studi di Firenze = University of Florence (UniFI), Épidémiologie clinique, santé mère-enfant et VIH en Asie du Sud-Est (IRD_PHPT), Harvard University-Chiang Mai University (CMU), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de Saint-Denis [Ile-de-France], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Pédiatrie Médicale [Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'hématologie : Immuno-Hématologie pédiatrique et transplantation de moelle osseuse, Hôpital Debrousse, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Universitätsklinikum Frankfurt, Infectious Diseases, San Martino Hospital, Università degli studi di Genova = University of Genoa (UniGe), Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Maternal-Infantile Department, Unit of Paediatrics and Oncohematology, University Hospital of Parma, Department of Infectious Diseases, IRCCS S. Matteo, Department of Paediatrics, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), Dipartimento di Ingegneria [Benevento], Università degli Studi del Sannio, University of Twente, Institut de génétique humaine (IGH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment [Bilthoven] (RIVM), Architecture et réactivité de l'ARN (ARN), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Synthèse, Structure et Propriétés de Matériaux Fonctionnels (STEP), SYstèmes Moléculaires et nanoMatériaux pour l’Energie et la Santé (SYMMES), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Département Interfaces pour l'énergie, la Santé et l'Environnement (DIESE), Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Stichting HIV Monitoring, Universidade Federal do Ceará = Federal University of Ceará (UFC), Departamento de Química Orgánica, Universidade de Vigo, Polytechnical University of Valencia, Fac Biol, Dept Genet, Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Service des maladies infectieuses, Hôpitaux Universitaires de Genève (HUG), University of Basel (Unibas), Dysfonctions métaboliques et diabètes: Mécanismes et approches thérapeutiques, Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM), University Heart Centre Freiburg - Bad Krozingen, Prapokklao Hospital [Chanthaburi, Thailand], Nakornping Hospital [Chiang Mai, Thailand], Samutsakhon Hospital [Samutsakhon, Thailand], Kalasin Hospital [Kalasin, Thailand], Sanpatong Hospital [Chiang Mai, Thailand], Chiang Mai University (CMU), Microbiology Department, St. Jame's Hospital, University of Edinburgh, Infectious Diseases and Microbiology Unit, Great Ormond Street Hospital for Children [London] (GOSH)-Institute of Child Health, European Synchrotron Radiation Facility (ESRF), Centre for Ecology and Hydrology [Bangor] (CEH), Natural Environment Research Council (NERC), Jet Propulsion Laboratory (JPL), NASA-California Institute of Technology (CALTECH), University of London [London], London South Bank University (LSBU), Dipartimento di Pediatria, Azienda Ospedaliera di Padova, Université Grenoble Alpes - UFR Pharmacie (UGA UFRP), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) Study Group in EuroCoord, Florence University, Harvard University [Cambridge]-Chiang Mai University (CMU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), University of Genoa (UNIGE), Catholic University of Rome, University of Twente [Netherlands], Institut de Chimie du CNRS (INC)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), University of the Basque Country [Bizkaia] (UPV/EHU), Université Nice Sophia Antipolis (... - 2019) (UNS), Pediatrics, Virology, Chappell, Elizabeth, Riordan, Andrew, Jourdain, Gonzague, Soriano-Arandes, Antoni, Ene, Luminita, J Scherpbier, Henriette, Warszawski, Josiane, J Collins, Intira, Smit, Colette, Marques, Laura, Klein, Nigel, Guillén, Sara, Judd, Ali, Thorne, Claire, Goodall, Ruth, Königs, Christoph, Spoulou, Vana, Prata, Filipa, Goetghebuer, Tessa, Chiappini, Elena, Galli, Luisa, Naver, Lar, Giaquinto, Carlo, M Gibb, Diana, Marczynska, Magdalena, Okhonskaia, Liubov, Klimkait, Thoma, Lallemant, Marc, Ngo-Giang-Huong, Nicole, Kiseleva, Galyna, Malyuta, Ruslan, Volokha, Alla, Hainaut, Marc, Delforge, Marc, Le Chenadec, Jerome, Ramos, Elisa, Dialla, Olivia, Wack, Thierry, Laurent, Corine, Ait Si Selmi, Lamya, Leymarie, Isabelle, Ait Benali, Fazia, Brossard, Maud, Boufassa, Leila, Floch-Tudal, Corinne, Firtion, Ghislaine, Hau, Isabelle, Chace, Anne, Bolot, Pascal, Blanche, Stéphane, Levine, Martine, Kremlin Bicëtre, Le, Fourcade, Corinne, Heller-Roussin, Brigitte, Runel-Belliard, Camille, Tricoire, Joëlle, Chirouze, Catherine, Reliquet, Véronique, Brouard, Jacque, Kebaili, Kamila, Fialaire, Pascale, Lalande, Muriel, Schultze-Strasser, Stephan, Baumann, U, Niehues, T, Neubert, J, Kobbe, R, Berlin, Charite, Feiterna-Sperling, C, Königs, C, Buchholz, B, Notheis, G, de Martino, Maurizio, Angelo Tovo, Pier, Patrizia, Osimani, Larovere, Domenico, Ruggeri, Maurizio, Faldella, Giacomo, Baldi, Francesco, Badolato, Raffaele, Montagnani, Carlotta, Venturini, Elisabetta, Lisi, Catiuscia, Di Biagio, Antonio, Taramasso, Lucia, Giacomet, Vania, Erba, Paola, Esposito, Susanna, Lipreri, Rita, Salvini, Filippo, Tagliabue, Claudia, Cellini, Monica, Bruzzese, Eugenia, LO VECCHIO, Andrea, Paediatric Infectious Diseases / Rheumatology / Immunology, Amsterdam institute for Infection and Immunity, AII - Infectious diseases, Amsterdam Reproduction & Development (AR&D), APH - Aging & Later Life, Infectious diseases, and Global Health

Subjects
0301 basic medicine, medicine.medical_treatment, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], HIV Infections, Rate ratio, Cohort Studies, 0302 clinical medicine, Pregnancy, Antiretroviral Therapy, Highly Active, Prevalence, 030212 general & internal medicine, Child, poor immune response, ddc:618, Immunosuppression, Viral Load, Hepatitis B, Thailand, 3. Good health, Europe, Thailand/epidemiology, Infectious Diseases, Cohort, Coinfection, Female, Cohort study, Adult, Microbiology (medical), viral suppression, medicine.medical_specialty, Adolescent, Anti-HIV Agents, antiretroviral therapy, 030106 microbiology, Europe/epidemiology, 03 medical and health sciences, children, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, Internal medicine, medicine, Humans, HIV, Aged, Settore MED/38 - Pediatria Generale e Specialistica, business.industry, Immunity, medicine.disease, HIV Infections/drug therapy/epidemiology, CD4 Lymphocyte Count, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Anti-HIV Agents/therapeutic use, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background In human immunodeficiency virus (HIV)–positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. Methods Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children Results Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P ≤ .03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P < .001). Conclusions One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders.

Published
2020

5. Children living with HIV in Europe: do migrants have worse treatment outcomes?

Author

Chappell, E., Kohns Vasconcelos, M., Goodall, R. L., Galli, L., Goetghebuer, T., Noguera-Julian, A., Rodrigues, L. C., Scherpbier, H., Smit, C., Bamford, A., Crichton, S., Navarro, M. L., Ramos, J. T., Warszawski, J., Spolou, V., Chiappini, E., Venturini, E., Prata, F., Kahlert, C., Marczynska, M., Marques, L., Naver, L., Thorne, C., Gibb, D. M., Giaquinto, C., Judd, A., Collins, I. J., Goodall, R., Rodrigues, L., Duff, C., Gomezpena, D., Jackson, C., Lundin, R., Mangiarini, L., Milanzi, E., Nardone, A., Hainaut, M., Van der Kelen, E., Delforge, M., Le Chenadec, J., Ramos, E., Dialla, O., Wack, T., Laurent, C., Ait si Selmi, L., Leymarie, I., Ait Benali, F., Brossard, M., Boufassa, L., Floch-Tudal, C., Firtion, G., Hau, I., Chace, A., Bolot, P., Blanche, S., Granier, M., Labrune, P., Lachassine, E., Dollfus, C., Levine, M., Fourcade, C., Heller-Roussin, B., Runel-Belliard, C., Tricoire, J., Monpoux, F., Chirouze, C., Reliquet, V., Brouard, J., Kebaili, K., Fialaire, P., de Villeneuve, A., Lalande, M., de Flandres, J., Mazingue, F., Partisani, M. L., de Martino, M., Angelo Tovo, P., Gabiano, C., Carloni, I., Larovere, D., Baldi, F., Miniaci, A., Pession, A., Badolato, R., Panto, G., Anastasio, E., Montagnani, C., Bianchi, L., Allodi, A., Di Biagio, A., Grignolo, S., Giacomet, V., Marchisio, P., Banderali, G., Tagliabue, C., Cellini, M., Bruzzese, E., Di Costanzo, P., Lo Vecchio, A., Dona, D., Rampon, O., Romano, A., Dodi, I., Esposito, S., Zuccaro, V., Zanaboni, D., Consolini, R., Bernardi, S., Genovese, O., Cristiano, L., Mazza, A., Garazzino, S., Mignone, F., Silvestro, E., Portelli, V., Kinderziekenhuis, E., van der Kuip, M., Pajkrt, D., Scherpbier, H. J., de Boer, C., Weijsenfeld, A. M., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Wolthers, K. C., Fraaij, P. L. A., van Rossum, A. M. C., Vermont, C. L., van der Knaap, L. C., Visser, E., Boucher, C. A. B., Koopmans, M. P. G., van Kampen, J. J. A., Henriet, S. S. V., van Aerde, M. K., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F. F., Burger, D., Scholvinck, E. H., de Groot-de Jonge, H., Niesters, H. G. M., van Leer-Buter, C. C., Knoester, M., Bont, L. J., Geelen, S. P. M., Loeffen, Y. G. T., Wolfs, T. F. W., Nauta, N., Schuurman, R., Hofstra, L. M., Wensing, A. M. J., Reiss, P., Zaheri, S., Boyd, A. C., Bezemer, D. O., van Sighem, A. I., Wit, F. W. M. N., Hillebregt, M. M. J., Woudstra, T. J., Bergsma, D., van de Sande, L., Rutkens, T., van der Vliet, S., Lelivelt, K. J., Scheijgrond, A., de Groot, L., van den Akker, M., Bakker, Y., EI Berkaoui, A., Bezemer, M., Bretin, N., Djoechro, E., Groters, M., Kruijne, E., Lodewijk, C., Lucas, E., Munjishvili, L., Paling, F., Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M., Schnorr, P., Tuijn, E., Veenenberg, L., Visser, K. M., Witte, E. C., Popielska, J., Pokorska-Spiewak, M., Oldakowska, A., Zawadka, K., Coupland, U., Doroba, M., Teixeira, C., Fernandes, A., Soler-Palacin, P., Antoinette Frick, M., Perez-Hoyos, S., Mur, A., Lopez, N., Mendez, M., Mayol, L., Vallmanya, T., Calavia, O., Garcia, L., Coll, M., Pineda, V., Rius, N., Rovira, N., Duenas, J., Fortuny, C., Jose Mellado, M., Escosa, L., Garcia Hortelano, M., Sainz, T., Gonzalez-Tome, M. I., Rojo, P., Blazquez, D., Prieto-Tato, L., Epalza, C., Tomas Ramos, J., Guillen, S., Saavedra, J., Santos, M., Santiago, B., de Ory, S. J., Carrasco, I., Munoz-Fernandez, M. A., Angel Roa, M., Penin, M., Martinez, J., Badillo, K., Onate, E., Pocheville, I., Garrote, E., Colino, E., Gomez Sirvent, J., Garzon, M., Roman, V., Angulo, R., Neth, O., Falcon, L., Terol, P., Luis Santos, J., Moreno, D., Lendinez, F., Peromingo, E., Uberos, J., Ruiz, B., Grande, A., Jose Romero, F., Perez, C., Lillo, M., Losada, B., Herranz, M., Bustillo, M., Collado, P., Antonio Couceiro, J., Vila, L., Calvino, C., Isabel Piqueras, A., Oltra, M., Gavilan, C., Montesinos, E., Dapena, M., Alvarez, C., Jimenez, B., Gloria Andres, A., Marugan, V., Ochoa, C., Alfayate, S., Isabel Menasalvas, A., del Prado, Y. R., Navernaver, L., Soeria-Atmadja, S., Belfrage, E., Hagas, V., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Baumann, M., Bernasconi, E., Boni, J., Braun, D. L., Bucher, H. C., Calmy, A., Cavassini, M., Ciuffi, A., Crisinel, P. A., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C. A., Gunthard, H. F., Haerry, D., Hasse, B., Hirsch, H. H., Hoffmann, M., Hosli, I., Huber, M., Kaiser, L., Keiser, O., Klimkait, T., Kottanattu, L., Kouyos, R. D., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Marzolini, C., Metzner, K. J., Muller, N., Nicca, D., Paioni, P., Pantaleo, G., Perreau, M., Polli, C., Rauch, A., Rudin, C., Scherrer, A. U., Schmid, P., Speck, R., Stockle, M., Sultan-Beyer, L., Tarr, P., Thanh Lecompte, M., Trkola, A., Vernazza, P., Wagner, N., Wandeler, G., Weber, R., Yerly, S., Lyall, H., Butler, K., Doerholt, K., Doherty, C., Foster, C., Harrison, I., Kenny, J., Klein, N., Letting, G., Mcmaster, P., Murau, F., Nsangi, E., Prime, K., Riordan, A., Shackley, F., Shingadia, D., Storey, S., Tudor-Williams, G., Turkova, A., Welch, S., Cook, C., Dobson, D., Fairbrother, K., Prevost, M. L., Van Looy, N., Peters, H., Francis, K., Thrasyvoulou, L., Fidler, K., Bernatoniene, J., Manyika, F., Sharpe, G., Subramaniam, B., Hague, R., Price, V., Flynn, J., Cardoso, A., Abou - Rayyah, M., Yeadon, S., Segal, S., Hawkins, S., Dowie, M., Bandi, S., Percival, E., Eisenhut, M., Duncan, K., Anguvaa, L., Wren, L., Flood, T., Pickering, A., Murphy, C., Daniels, J., Lees, Y., Thompson, F., Williams, A., Williams, B., Pope, S., Libeschutz, S., Cliffe, L., Southall, S., Freeman, A., Freeman, H., Christie, S., Gordon, A., Rosie Hague, D., Clarke, L., Jones, L., Brown, L., Greenberg, M., Benson, C., Ibberson, L., Patel, S., Hancock, J., Sharland, M., Lyall, E. G. H., Seery, P., Kirkhope, N., Raghunanan, S., Callaghan, A., Bridgwood, A., Evans, J., Blake, E., Yannoulias, A., Department of Sciences for Woman and Child's Health, Florence University, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Paediatric Infectious Diseases / Rheumatology / Immunology, Amsterdam institute for Infection and Immunity, Infectious diseases, AII - Infectious diseases, Amsterdam Reproduction & Development (AR&D), Medical Microbiology and Infection Prevention, Gastroenterology and Hepatology, Global Health, APH - Aging & Later Life, Biomedical Engineering and Physics, ACS - Atherosclerosis & ischemic syndromes, 1, Elizabeth Chappell, 2 3 4, Malte Kohns Vasconcelo, L Goodall 1, Ruth, 5, Luisa Galli, 6, Tessa Goetghebuer, 9 10, Antoni Noguera-Julian 7 8, C Rodrigues 2, Laura, Scherpbier 11, Henriette, Smit 12, Colette, 1 13 14, Alasdair Bamford, 1, Siobhan Crichton, Luisa Navarro 10 15 16 17, Marissa, T Ramos 18, Jose, Warszawski 19 20, Josiane, Spolou 21, Vana, 5, Elena Chiappini, 5, Elisabetta Venturini, Prata 22, Filipa, Kahlert 23, Christian, Marczynska 24, Magdalena, Marques 25, Laura, Naver 26, Lar, Thorne 14, Claire, M Gibb 1, Diana, Giaquinto 27, Carlo, 1, Ali Judd, 1, Intira Jeannie Collin, Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC), European, Goodall, Ruth, Rodrigues, Laura, Duff, Charlotte, Gomezpena, Daniel, Jackson, Charlotte, Lundin, Rebecca, Mangiarini, Laura, Milanzi, Edith, Nardone, Alessandra, Hainaut, Marc, Van der Kelen, Evelyne, Delforge, Marc, Le Chenadec, Jerome, Ramos, Elisa, Dialla, Olivia, Wack, Thierry, Laurent, Corine, Ait Si Selmi, Lamya, Leymarie, Isabelle, Ait Benali, Fazia, Brossard, Maud, Boufassa, Leila, Floch-Tudal, Corinne, Firtion, Ghislaine, Hau, Isabelle, Chace, Anne, Bolot, Pascal, Blanche, Stéphane, Granier, Michèle, Labrune, Philippe, Lachassine, Eric, Dollfus, Catherine, Levine, Martine, Fourcade, Corinne, Heller-Roussin, Brigitte, Runel-Belliard, Camille, Tricoire, Joëlle, Monpoux, Fabrice, Chirouze, Catherine, Reliquet, Véronique, Brouard, Jacque, Kebaili, Kamila, Fialaire, Pascale, de Villeneuve, Arnaud, Lalande, Muriel, de Flandres, Jeanne, Mazingue, Françoise, Luisa Partisani, Maria, de Martino, Maurizio, Angelo Tovo, Pier, Gabiano, Clara, Carloni, Ine, Larovere, Domenico, Baldi, Francesco, Miniaci, Angela, Pession, Andrea, Badolato, Raffaele, Pantò, Grazia, Anastasio, Elisa, Montagnani, Carlotta, Bianchi, Leila, Allodi, Alessandra, Di Biagio, Antonio, Grignolo, Sara, Giacomet, Vania, Marchisio, Paola, Banderali, Giuseppe, Tagliabue, Claudia, Cellini, Monica, Bruzzese, Eugenia, DI COSTANZO, Pasquale, LO VECCHIO, Andrea, Donà, Daniele, Rampon, Osvalda, Romano, Amelia, Dodi, Icilio, Esposito, Susanna, Zuccaro, Valentina, Zanaboni, Domenico, Consolini, Rita, Bernardi, Stefania, Genovese, Orazio, Cristiano, Letizia, Mazza, Antonio, Garazzino, Silvia, Mignone, Federica, Silvestro, Erika, Portelli, Vincenzo, Pediatric surgery, Pediatrics, and Virology

Subjects
children, Europe, HIV, migrant, mortality, Adolescent, Child, Humans, Treatment Outcome, Viral Load, Anti-HIV Agents, HIV Infections, Transients and Migrants, medicine.medical_treatment, Human immunodeficiency virus (HIV), lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], medicine.disease_cause, 0302 clinical medicine, Medicine, Pharmacology (medical), 030212 general & internal medicine, health care economics and organizations, Health Policy, Hazard ratio, virus diseases, Immunosuppression, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, population characteristics, 0305 other medical science, Viral load, geographic locations, education, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, 030505 public health, business.industry, Proportional hazards model, medicine.disease, Confidence interval, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Observational study, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract

Contains fulltext : 249078.pdf (Publisher’s version ) (Open Access) OBJECTIVES: To assess the effect of migrant status on treatment outcomes among children living with HIV in Europe. METHODS: Children aged

Published
2022

6. Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC) study group

Author

Chappell, E., Turkova, A., Goetghebuer, T., Jackson, C., Chiappini, E., Galli, L., Gingaras, C., Judd, A., Spoulou, V., Lisi, C., Ansone, S., Wolfs, T., Marczynska, M., Ene, L., Plotnikova, Y., Voronin, E., Samarina, A., Jourdain, G., Ngo-Giang-Huong, N., Fortuny, C., Navarro, M. L., Ramos, J. T., Naver, L., Crisinel, P. -A., Bailey, H., Malyuta, R., Volokha, A., Bamford, A., Crichton, S., Foster, C., Thorne, C., Collins, I. J., Giaquinto, C., Gibb, D. M., Critchton, S., Duff, C., Goodall, R., Gomezpena, D., Lundin, R., Mangiarini, L., Milanzi, E., Nardone, A., Hainaut, M., Van der Kelen, E., Delforge, M., de Martino, M., Tovo, P. A., Gabiano, C., Carloni, I., Larovere, D., Baldi, F., Miniaci, A., Pession, A., Badolato, R., Panto, G., Anastasio, E., Montagnani, C., Venturini, E., Bianchi, L., Allodi, A., Di Biagio, A., Grignolo, S., Giacomet, V., Marchisio, P., Banderali, G., Tagliabue, C., Cellini, M., Bruzzese, E., Di Costanzo, P., Lo Vecchio, A., Dona', D., Rampon, O., Romano, A., Dodi, I., Esposito, S., Zuccaro, V., Zanaboni, D., Consolini, R., Bernardi, S., Genovese, O., Cristiano, L., Mazza, A., Garazzino, S., Mignone, F., Silvestro, E., Portelli, V., Pajkrt, D., Scherpbier, H. J., Weijsenfeld, A. M., de Boer, C. G., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Wolthers, K. C., Fraaij, P. L. A., van Rossum, A. M. C., Vermont, C. L., van der Knaap, L. C., Visser, E. G., Boucher, C. A. B., Koopmans, M. P. G., van Kampen, J. J. A., Pas, S. D., Henriet, S. S. V., van de Flier, M., van Aerde, K., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F. F., Scholvinck, E. H., de Groot-De Jonge, H., Niesters, H. G. M., van Leer-Buter, C. C., Knoester, M., Bont, L. J., Geelen, S. P. M., Wolfs, T. F. W., Nauta, N., Schuurman, R., Verduyn-Lunel, F., Wensing, A. M. J., Reiss, P., Zaheri, S., Bezemer, D. O., van Sighem, A. I., Smit, C., Wit, F. W. M. N., Hillebregt, M., de Jong, A., Woudstra, T., Bergsma, D., Grivell, S., Meijering, R., Raethke, M., Rutkens, T., de Groot, L., van den Akker, M., Bakker, Y., Bezemer, M., El Berkaoui, A., Geerlinks, J., Koops, J., Kruijne, E., Lodewijk, C., Lucas, E., van der Meer, R., Munjishvili, L., Paling, F., Peeck, B., Ree, C., Regtop, R., Ruijs, Y., van de Sande, L., Schoorl, M., Schnorr, P., Tuijn, E., Veenenberg, L., van der Vliet, S., Wisse, A., Witte, E. C., Tuk, B., Popielska, J., Pokorska-Spiewak, M., Oldakowska, A., Zawadka, K., Coupland, U., Doroba, M., Miloenko, M., Labutina, S., Soler-Palacin, P., Frick, M. A., Perez-Hoyos, S., Mur, A., Lopez, N., Mendez, M., Mayol, L., Vallmanya, T., Calavia, O., Garcia, L., Coll, M., Pineda, V., Rius, N., Rovira, N., Duenas, J., Noguera-Julian, A., Mellado, M. J., Escosa, L., Hortelano, M. G., Sainz, T., Gonzalez-Tome, M. I., Rojo, P., Blazquez, D., Prieto, L., Guillen, S., Saavedra, J., Santos, M., Munoz, M. A., Ruiz, B., Fernandez, C., Phee, M., de Ory, S. J., Alvarez, S., Roa, M. A., Beceiro, J., Martinez, J., Badillo, K., Apilanez, M., Pocheville, I., Garrote, E., Colino, E., Sirvent, J. G., Garzon, M., Roman, V., Montesdeoca, A., Mateo, M., Munoz, M. J., Angulo, R., Neth, O., Falcon, L., Terol, P., Santos, J. L., Moreno, D., Lendinez, F., Grande, A., Romero, F. J., Perez, C., Lillo, M., Losada, B., Herranz, M., Bustillo, M., Guerrero, C., Collado, P., Couceiro, J. A., Perez, A., Piqueras, A. I., Breton, R., Segarra, I., Gavilan, C., Jareno, E., Montesinos, E., Dapena, M., Alvarez, C., Andres, A. G., Marugan, V., Ochoa, C., Alfayate, S., Menasalvas, A. I., de Miguel, E., Soeria-Atmadja, S., Belfrage, E., Hagas, V., Aebi-Popp, K., Anagnostopoulos, A., Asner, S., Battegay, M., Baumann, M., Bernasconi, E., Boni, J., Braun, D. L., Bucher, H. C., Calmy, A., Cavassini, M., Ciuffi, A., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C. A., Grawe, C., Gunthard, H. F., Haerry, D., Hasse, B., Hirsch, H. H., Hoffmann, M., Hosli, I., Huber, M., Kahlert, C. R., Kaiser, L., Keiser, O., Klimkait, T., Kottanattu, L., Kouyos, R. D., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Marzolini, C., Metzner, K. J., Muller, N., Nicca, D., Paioni, P., Pantaleo, G., Perreau, M., Polli, Ch., Rauch, A., Rudin, C., Scherrer, A. U., Schmid, P., Speck, R., Stockle, M., Tarr, P., Thanh Lecompte, M., Trkola, A., Vernazza, P., Wagner, N., Wandeler, G., Weber, R., Wyler, C. A., Yerly, S., Wannarit, P., Techakunakorn, P., Hansudewechakul, R., Wanchaitanawong, V., Theansavettrakul, S., Nanta, S., Ngampiyaskul, C., Phanomcheong, S., Hongsiriwon, S., Karnchanamayul, W., Kwanchaipanich, R., Kanjanavanit, S., Kamonpakorn, N., Nantarukchaikul, M., Layangool, P., Mekmullica, J., Lucksanapisitkul, P., Watanayothin, S., Lertpienthum, N., Warachit, B., Hanpinitsak, S., Potchalongsin, S., Thanasiri, P., Krikajornkitti, S., Attavinijtrakarn, P., Srirojana, S., Bunjongpak, S., Puangsombat, A., Na-Rajsima, S., Ananpatharachai, P., Akarathum, N., Lawtongkum, W., Kheunjan, P., Suriyaboon, T., Saipanya, A., Than-In-At, K., Jaisieng, N., Suaysod, R., Chailoet, S., Naratee, N., Kawilapat, S., Kaleeva, T., Baryshnikova, Y., Soloha, S., Bashkatova, N., Raus, I., Glutshenko, O., Ruban, Z., Prymak, N., Kiseleva, G., Lyall, H., Butler, K., Doerholt, K., Doherty, C., Harrison, I., Kenny, J., Klein, N., Letting, G., Mcmaster, P., Murau, F., Nsangi, E., Prime, K., Riordan, A., Shackley, F., Shingadia, D., Storey, S., Tudor-Williams, G., Welch, S., Cook, C., Dobson, D., Fairbrother, K., Le Prevost, M., Van Looy, N., Peters, H., Francis, K., Thrasyvoulou, L., Fidler, K., Bernatoniene, J., Manyika, F., Sharpe, G., Subramaniam, B., Hague, R., Price, V., Flynn, J., Cardoso, A., Abou-Rayyah, M., Yeadon, S., Segal, S., Hawkins, S., Dowie, M., Bandi, S., Percival, E., Eisenhut, M., Duncan, K., Anguvaa, L., Wren, L., Flood, T., Pickering, A., Murphy, C., Daniels, J., Lees, Y., Thompson, F., Williams, A., Williams, B., Pope, S., Libeschutz, S., Cliffe, L., Southall, S., Freeman, A., Freeman, H., Christie, S., Gordon, A., Hague, D. R., Clarke, L., Jones, L., Brown, L., Greenberg, M., Benson, C., Ibberson, L., Patel, S., Hancock, J., Sharland, M., Lyall, E. G. H., Seery, P., Kirkhope, N., Raghunanan, S., Callaghan, A., Bridgwood, A., Evans, J., Blake, E., Yannoulias, A., Chappell, E., Turkova, A., Goetghebuer, T., Jackson, C., Chiappini, E., Galli, L., Gingaras, C., Judd, A., Spoulou, V., Lisi, C., Ansone, S., Wolfs, T., Marczynska, M., Ene, L., Plotnikova, Y., Voronin, E., Samarina, A., Jourdain, G., Ngo-Giang-Huong, N., Fortuny, C., Navarro, M. L., Ramos, J. T., Naver, L., Crisinel, P. -A., Bailey, H., Malyuta, R., Volokha, A., Bamford, A., Crichton, S., Foster, C., Thorne, C., Collins, I. J., Giaquinto, C., Gibb, D. M., Critchton, S., Duff, C., Goodall, R., Gomezpena, D., Lundin, R., Mangiarini, L., Milanzi, E., Nardone, A., Hainaut, M., Van der Kelen, E., Delforge, M., de Martino, M., Tovo, P. A., Gabiano, C., Carloni, I., Larovere, D., Baldi, F., Miniaci, A., Pession, A., Badolato, R., Panto, G., Anastasio, E., Montagnani, C., Venturini, E., Bianchi, L., Allodi, A., Di Biagio, A., Grignolo, S., Giacomet, V., Marchisio, P., Banderali, G., Tagliabue, C., Cellini, M., Bruzzese, E., Di Costanzo, P., Lo Vecchio, A., Dona, D., Rampon, O., Romano, A., Dodi, I., Esposito, S., Zuccaro, V., Zanaboni, D., Consolini, R., Bernardi, S., Genovese, O., Cristiano, L., Mazza, A., Garazzino, S., Mignone, F., Silvestro, E., Portelli, V., Pajkrt, D., Scherpbier, H. J., Weijsenfeld, A. M., de Boer, C. G., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Wolthers, K. C., Fraaij, P. L. A., van Rossum, A. M. C., Vermont, C. L., van der Knaap, L. C., Visser, E. G., Boucher, C. A. B., Koopmans, M. P. G., van Kampen, J. J. A., Pas, S. D., Henriet, S. S. V., van de Flier, M., van Aerde, K., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F. F., Scholvinck, E. H., de Groot-De Jonge, H., Niesters, H. G. M., van Leer-Buter, C. C., Knoester, M., Bont, L. J., Geelen, S. P. M., Wolfs, T. F. W., Nauta, N., Schuurman, R., Verduyn-Lunel, F., Wensing, A. M. J., Reiss, P., Zaheri, S., Bezemer, D. O., van Sighem, A. I., Smit, C., Wit, F. W. M. N., Hillebregt, M., de Jong, A., Woudstra, T., Bergsma, D., Grivell, S., Meijering, R., Raethke, M., Rutkens, T., de Groot, L., van den Akker, M., Bakker, Y., Bezemer, M., El Berkaoui, A., Geerlinks, J., Koops, J., Kruijne, E., Lodewijk, C., Lucas, E., van der Meer, R., Munjishvili, L., Paling, F., Peeck, B., Ree, C., Regtop, R., Ruijs, Y., van de Sande, L., Schoorl, M., Schnorr, P., Tuijn, E., Veenenberg, L., van der Vliet, S., Wisse, A., Witte, E. C., Tuk, B., Popielska, J., Pokorska-Spiewak, M., Oldakowska, A., Zawadka, K., Coupland, U., Doroba, M., Miloenko, M., Labutina, S., Soler-Palacin, P., Frick, M. A., Perez-Hoyos, S., Mur, A., Lopez, N., Mendez, M., Mayol, L., Vallmanya, T., Calavia, O., Garcia, L., Coll, M., Pineda, V., Rius, N., Rovira, N., Duenas, J., Noguera-Julian, A., Mellado, M. J., Escosa, L., Hortelano, M. G., Sainz, T., Gonzalez-Tome, M. I., Rojo, P., Blazquez, D., Prieto, L., Guillen, S., Saavedra, J., Santos, M., Munoz, M. A., Ruiz, B., Fernandez, C., Phee, M., de Ory, S. J., Alvarez, S., Roa, M. A., Beceiro, J., Martinez, J., Badillo, K., Apilanez, M., Pocheville, I., Garrote, E., Colino, E., Sirvent, J. G., Garzon, M., Roman, V., Montesdeoca, A., Mateo, M., Munoz, M. J., Angulo, R., Neth, O., Falcon, L., Terol, P., Santos, J. L., Moreno, D., Lendinez, F., Grande, A., Romero, F. J., Perez, C., Lillo, M., Losada, B., Herranz, M., Bustillo, M., Guerrero, C., Collado, P., Couceiro, J. A., Perez, A., Piqueras, A. I., Breton, R., Segarra, I., Gavilan, C., Jareno, E., Montesinos, E., Dapena, M., Alvarez, C., Andres, A. G., Marugan, V., Ochoa, C., Alfayate, S., Menasalvas, A. I., de Miguel, E., Soeria-Atmadja, S., Belfrage, E., Hagas, V., Aebi-Popp, K., Anagnostopoulos, A., Asner, S., Battegay, M., Baumann, M., Bernasconi, E., Boni, J., Braun, D. L., Bucher, H. C., Calmy, A., Cavassini, M., Ciuffi, A., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C. A., Grawe, C., Gunthard, H. F., Haerry, D., Hasse, B., Hirsch, H. H., Hoffmann, M., Hosli, I., Huber, M., Kahlert, C. R., Kaiser, L., Keiser, O., Klimkait, T., Kottanattu, L., Kouyos, R. D., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Marzolini, C., Metzner, K. J., Muller, N., Nicca, D., Paioni, P., Pantaleo, G., Perreau, M., Polli, Ch., Rauch, A., Rudin, C., Scherrer, A. U., Schmid, P., Speck, R., Stockle, M., Tarr, P., Thanh Lecompte, M., Trkola, A., Vernazza, P., Wagner, N., Wandeler, G., Weber, R., Wyler, C. A., Yerly, S., Wannarit, P., Techakunakorn, P., Hansudewechakul, R., Wanchaitanawong, V., Theansavettrakul, S., Nanta, S., Ngampiyaskul, C., Phanomcheong, S., Hongsiriwon, S., Karnchanamayul, W., Kwanchaipanich, R., Kanjanavanit, S., Kamonpakorn, N., Nantarukchaikul, M., Layangool, P., Mekmullica, J., Lucksanapisitkul, P., Watanayothin, S., Lertpienthum, N., Warachit, B., Hanpinitsak, S., Potchalongsin, S., Thanasiri, P., Krikajornkitti, S., Attavinijtrakarn, P., Srirojana, S., Bunjongpak, S., Puangsombat, A., Na-Rajsima, S., Ananpatharachai, P., Akarathum, N., Lawtongkum, W., Kheunjan, P., Suriyaboon, T., Saipanya, A., Than-In-At, K., Jaisieng, N., Suaysod, R., Chailoet, S., Naratee, N., Kawilapat, S., Kaleeva, T., Baryshnikova, Y., Soloha, S., Bashkatova, N., Raus, I., Glutshenko, O., Ruban, Z., Prymak, N., Kiseleva, G., Lyall, H., Butler, K., Doerholt, K., Doherty, C., Harrison, I., Kenny, J., Klein, N., Letting, G., Mcmaster, P., Murau, F., Nsangi, E., Prime, K., Riordan, A., Shackley, F., Shingadia, D., Storey, S., Tudor-Williams, G., Welch, S., Cook, C., Dobson, D., Fairbrother, K., Le Prevost, M., Van Looy, N., Peters, H., Francis, K., Thrasyvoulou, L., Fidler, K., Bernatoniene, J., Manyika, F., Sharpe, G., Subramaniam, B., Hague, R., Price, V., Flynn, J., Cardoso, A., Abou-Rayyah, M., Yeadon, S., Segal, S., Hawkins, S., Dowie, M., Bandi, S., Percival, E., Eisenhut, M., Duncan, K., Anguvaa, L., Wren, L., Flood, T., Pickering, A., Murphy, C., Daniels, J., Lees, Y., Thompson, F., Williams, A., Williams, B., Pope, S., Libeschutz, S., Cliffe, L., Southall, S., Freeman, A., Freeman, H., Christie, S., Gordon, A., Hague, D. R., Clarke, L., Jones, L., Brown, L., Greenberg, M., Benson, C., Ibberson, L., Patel, S., Hancock, J., Sharland, M., Lyall, E. G. H., Seery, P., Kirkhope, N., Raghunanan, S., Callaghan, A., Bridgwood, A., Evans, J., Blake, E., and Yannoulias, A.

Subjects
Adult, Male, Acquired Immunodeficiency Syndrome, Adolescent, Infant, HIV, HIV Infections, Eastern, Adolescents, Newborn, Thailand, Europe, malignancie, Neoplasms, malignancies, Humans, Children, Aged, Child, Europe, Eastern, Infant, Newborn
Abstract

Objectives: Investigate trends over time and predictors of malignancies among children and young people with HIV. Design: Pooled data from 17 cohorts in 15 countries across Europe and Thailand. Methods: Individuals diagnosed with HIV and presenting to paediatric care less than 18 years of age were included. Time at risk began at birth for children with documented vertically acquired HIV, and from first HIV-care visit for others. Children were followed until death, loss-to-follow-up, or last visit in paediatric or adult care (where data after transfer to adult care were available). Rates of reported malignancies were calculated overall and for AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (NADM) separately. Risk factors for any malignancy were explored using Poisson regression, and for mortality following a malignancy diagnosis using Cox regression. Results: Among 9632 individuals included, 140 (1.5%) were ever diagnosed with a malignancy, of which 112 (80%) were ADM. Overall, the rate of any malignancy was 1.18 per 1000 person-years; the rate of ADM decreased over time whereas the rate of NADM increased. Male sex, being from a European cohort, vertically acquired HIV, current severe immunosuppression, current viral load greater than 400 copies/ml, older age, and, for those not on treatment, earlier calendar year, were risk factors for a malignancy diagnosis. Fifty-eight (41%) individuals with a malignancy died, a median 2.4 months (IQR 0.6-8.8) after malignancy diagnosis. Conclusion: The rate of ADM has declined since widespread availability of combination ART, although of NADM, there was a small increase. Mortality following a malignancy was high, warranting further investigation.

Published
2021

7. Italian consensus statement on paediatric HIV infection

Author

Giaquinto, C., Penazzato, M., Rosso, R., Bernardi, S., Rampon, O., Nasta, P., Ammassari, A., Antinori, A., Badolato, R., Castelli Gattinara, G., d’Arminio Monforte, A., De Martino, M., De Rossi, A., Di Gregorio, P., Esposito, S., Fatuzzo, F., Fiore, S., Franco, A., Gabiano, C., Galli, L., Genovese, O., Giacomet, V., Giannattasio, A., Gotta, C., Guarino, A., Martino, A., Mazzotta, F., Principi, N., Regazzi, M. B., Rossi, P., Russo, R., Saitta, M., Salvini, F., Trotta, S., Viganò, A., Zuccotti, G., and Carosi, G.

Published
2010
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8. Missed opportunities to prevent mother-to-child transmission of HIV in Italy

Author

Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, Tk., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E, De Martino, M, Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Chiappini, E., Gervaso, P., Montagnani, C., De Martino, M., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, Pa., Silvestro, E., Virano, S., Portelli, V., Pellegatta, A., Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, T. K., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E., De Martino, M., Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Gervaso, P., Montagnani, C., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, P. A., Silvestro, E., Virano, S., Portelli, V., and Pellegatta, A.

Subjects
Male, 0301 basic medicine, Pediatrics, newborns, medicine.medical_treatment, children, HIV, missed opportunities, mothers, pregnancy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Health Services Accessibility, Health Policy, Infectious Diseases, Pharmacology (medical), 0302 clinical medicine, newborn, Childbirth, Registries, 030212 general & internal medicine, Pregnancy Complications, Infectious, Transmission (medicine), mother, virus diseases, Settore MED/38, children, HIV, missed opportunities, mothers, newborns, pregnancy, Italy, Female, medicine.medical_specialty, Mother to child transmission, Anti-HIV Agents, Prenatal care, Risk Assessment, 03 medical and health sciences, medicine, Humans, Caesarean section, Peripartum Period, Pregnancy, Cesarean Section, business.industry, Infant, Newborn, Infant, medicine.disease, 030112 virology, Infectious Disease Transmission, Vertical, missed opportunitie, business
Abstract

OBJECTIVES: Vertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother-to-child transmission of HIV. METHODS: The Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. RESULTS: We found 79 HIV-1-infected children newly diagnosed after birth in Italy. Thirty-two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty-one newborns received antiretroviral prophylaxis and 39 received infant formula. CONCLUSIONS: We found an unacceptable number of missed opportunities to prevent mother-to-child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns.

Published
2019

11. Prognostic factors and survival in children with perinatal HIV-1 infection

Author

Tovo, P.A., Martino M. de, Gabiano, C., Cappello, N., D'Elia, R., Loy, A., Plebani, A., Zuccotti, G.V., Dallacasa, P., Ferraris, G., Caselli, D., Fundaro, C., D'Argenio, P., Galli, L., Principi, N., Stegagno, M., Ruga, E., and Palomba, E.

Subjects
HIV infection in children -- Prognosis
Published
1992

13. Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis: an Italian multicenter study

Author

Chiappini, Elisabetta, Krzysztofiak, A., Bozzola, E., Gabiano, C., Esposito, S., Lo Vecchio, A., Govoni, M. R., Vallongo, C., Dodi, I., Castagnola, E., Rossi, N., Valentini, Piero, Cardinale, F., Salvini, F., Bona, G., Bossi, Giuliana, Olivieri, A. N., Russo, F., Fossali, E., Bottone, G., Dellepiane, M., De Martino, M., Villani, Andrea, Galli, Lavinia Maddalena, Chiappini E. (ORCID:0000-0002-9782-0712), Valentini P. (ORCID:0000-0001-6095-9510), Bossi G., Villani A., Galli L., Chiappini, Elisabetta, Krzysztofiak, A., Bozzola, E., Gabiano, C., Esposito, S., Lo Vecchio, A., Govoni, M. R., Vallongo, C., Dodi, I., Castagnola, E., Rossi, N., Valentini, Piero, Cardinale, F., Salvini, F., Bona, G., Bossi, Giuliana, Olivieri, A. N., Russo, F., Fossali, E., Bottone, G., Dellepiane, M., De Martino, M., Villani, Andrea, Galli, Lavinia Maddalena, Chiappini E. (ORCID:0000-0002-9782-0712), Valentini P. (ORCID:0000-0001-6095-9510), Bossi G., Villani A., and Galli L.

Abstract

Background: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae. Methods: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed. Results: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0–11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53–1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae. Conclusion: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.

Published
2018

16. Indications to hospital admission and isolation of children wish possibile or defined tuberculosis: systematic review and proposed recommendations for pediatric patients leaving in developed countries

Author

Lo Vecchio, A, Lancella, L, Gabiano, C, Garazzino, S, Scotto, R, Raffaldi, I, Assante, Lr, Villani, A, Esposito, S, BOCCHINO, MARIALUISA, GUARINO, ALFREDO, Lo Vecchio, A, Bocchino, Marialuisa, Lancella, L, Gabiano, C, Garazzino, S, Scotto, R, Raffaldi, I, Assante, Lr, Villani, A, Esposito, S, and Guarino, Alfredo

Published
2015

17. Combined antiretroviral therapy reduces hyperimmunoglobulinemia in HIV-1 infected children

Author

Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, DI BARI, DANIELA COLOMBA, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, CAVALLINI, RAFFAELLA, D'ANASTASIO, ELISABETTA, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, CECCHI, MARIA TERESA, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, PINZANI, ROBERTO, VIGANO', ALDO, Giacomet, V, Bianchi, R, SALVINI, FRANCESCO, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, DE MARCO, GIUSEPPINA, Tarallo, L, TANCREDI, FERNANDO ANTONIO, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, SANFILIPPO, ALESSIA, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, PALMA, PASQUALE, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, Molesini, M, Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, Di Bari, C, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, Cavallini, R, Anastasio, E, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, Cecchi, MT, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, Pinzani, R, Vigano, A, Giacomet, V, Bianchi, R, Salvini, F, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, De Marco, G, Tarallo, L, Tancredi, F, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, Sanfilippo, A, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, Palma, P, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, and Molesini, M

Subjects
Adult, medicine.medical_specialty, Adolescent, immunogiobulins, Immunology, immunoglobulins, combined antiretroviral therapy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Gastroenterology, children, Hypergammaglobulinemia, Internal medicine, medicine, Humans, Immunology and Allergy, Child, Therapeutic regimen, biology, business.industry, Immunoglobulins, Intravenous, Infant, Normal population, hiv-1 infection, Settore MED/38, Antiretroviral therapy, HIV Reverse Transcriptase, Infectious Diseases, Child, Preschool, Intravenous IG, HIV-1, biology.protein, HIV-1 infection, Drug Evaluation, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Antibody, business, Viral load
Abstract

Objective: To evaluate the effect of combined antiretroviral therapy on serum immunoglobulin (Ig) levels in HIV-1 perinatally infected children.Methods: Data from 1250 children recorded by the Italian Register for HIV Infection in Children from 1985 to 2002 were analysed. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using means and standard deviations of normal population for each age period. Combined antiretroviral therapy has become widespread in Italy since 1996, thus differences in Ig z-scores between the periods 1985-1995 and 1996-2002 were analysed. Data according to type of therapeutic regimen were also analysed.Results: Between the two periods 1985-1995 and 1996-2002, significant (P < 0.0001) decreases in IgG (6.29 +/- 4.72 versus 4.44 +/- 4.33), IgM (9.25 +/- 13.32 versus 5.61 +/- 7.93), and IgA (10.25 +/- 15.68 versus 6.48 +/- 11.56) z-scores, together with a parallel significant (P < 0.0001) increase in CD4 T-lymphocyte percentages, were found. These decreases were confirmed regardless of whether the children were receiving intravenous Ig or not. Ig z-scores were significantly higher in children receiving mono-therapy than in those receiving double-combined therapy (IgG, P < 0.0001; IgM, P = 0.003; IgA, P = 0.031) and in the latter children than in those receiving three or more drugs (P < 0.0001 for all z-scores). Ig z-scores correlated inversely with CD4 T lymphocyte percentages and, directly, with viral loads.Conclusions: Our data show that in HIV-1 infected children combined antiretroviral therapy leads to reduction of hyperimmunoglobulinemia which parallels restoration of CD4 T-lymphocyte percentage and viral load decrease, which it turn probably reflects improved B-lymphocyte functions.(C) 2004 Lippincott Williams Wilkins.

Published
2004

18. Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period

Author

Chiappini E., Galli L., Tovo P.A., Gabiano C., Lisi C., Giacomet V., Bernardi S., Esposito S., Rosso R., Giaquinto C., Badolato R., Guarino A., Maccabruni A., Cellini M., Salvini F., Di Bari C., Dedoni M., Dodi I., de Martino M, Italian Register for HIV infection in children [. . ., Osimani P., Da Riol R., MASI, MASSIMO, SPECCHIA, FERNANDO GIUSEPPE, LANARI, MARCELLO, Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giacomet, V, Bernardi, S, Esposito, S, Rosso, R, Giaquinto, C, Badolato, R, Guarino, Alfredo, Maccabruni, A, Masi, M, Cellini, M, Salvini, F, Di Bari, C, Dedoni, M, Dodi, I, de Martino, M, for the Italian Register for HIV infection in, c. h. i. l. d. r. e. n., Bruzzese, Eugenia, Chiappini E., Galli L., Tovo PA., Gabiano C., Lisi C., Giacomet V., Bernardi S., Esposito S., Rosso R., Giaquinto C., Badolato R., Guarino A., Maccabruni A., Masi M., Cellini M., Salvini F., Di Bari C., Dedoni M., Dodi I., de Martino M, Italian Register for HIV infection in children [.., Osimani P., Specchia F., Lanari M, Da Riol R., and ]

Subjects
Male, Adolescent, Age Factors, Antiretroviral Therapy, Highly Active, Child, Child, Preschool, Female, HIV Infections, HIV Protease Inhibitors, Humans, Infant, Infant, Newborn, Infectious Disease Transmission, Vertical, Italy, Multivariate Analysis, Proportional Hazards Models, Registries, Reverse Transcriptase Inhibitors, Treatment Outcome, Viral Load, Infectious Disease Transmission, Antiretroviral Therapy, perinatal HIV infection, cohort study, Vertical, Highly Active, Preschool, antiretroviral drugs, Newborn
Abstract

Background: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown. Methods: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis. Results: Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p

Published
2012

19. Risk of perinatal HIV infection in infants born in Italy to immigrant mothers

Author

Author:, Chiappini, Galli, E, Lisi, L, Gabiano, C, Giaquinto, C, Giacomet, C, Buffolano, V, Esposito, W, Badolato, S, Berbardi, R, Cellini, S, M, Dodi, I, Faldella, G, Osimani, P, Genovese, O, Nicastro, E, Viscoli, C, Salvini, F, Tovo, Pa, Martino, De, Italian Register for HIV Infection in Children: Maccabruni, Mazza, A, Rabusin, T, Acutis, M, Ruggeri, Ms, Anzidei, M, Casadei, G, Catania, Am, S, Consolini, Rita, Chiappini, E, Galli, L, Lisi, C, Gabiano, C, Giaquinto, C, Giacomet, V, Buffolano, Wilma, Esposito, S, Badolato, R, Berbardi, S, Cellini, M, Dodi, I, Faldella, G, Osimani, P, Genovese, O, Nicastro, Emanuele, Viscoli, C, Salvini, F, Tovo, Pa, Maurizio de, M, Italian Register for HIV Infection in, C. h. i. l. d. r. e. n., Chiappini E., Galli L., Lisi C., Gabiano C., Giaquinto C., Giacomet V., Buffolano W., Esposito S., Badolato R., Berbardi S., Cellini M., Dodi I., Faldella G., Osimani P., Genovese O., Nicastro E., Viscoli C., Salvini F., Tovo PA., Maurizio de M., and Italian Register for HIV Infection in Children.

Subjects
Male, Postnatal Care, Microbiology (medical), Pediatrics, medicine.medical_specialty, media_common.quotation_subject, Immigration, Emigrants and Immigrants, HIV Infections, hiv, infants. TO-CHILD TRANSMISSION, Perinatal hiv, Pregnancy, Risk Factors, Prevalence, Humans, Medicine, Pregnancy Complications, Infectious, media_common, business.industry, Infant, Newborn, Infectious Disease Transmission, Vertical, Infectious Diseases, Italy, Female, business
Published
2011

20. The second generation of HIV-1 vertically exposed infants: a case series from the Italian Register for paediatric HIV infection

Author

Calitri C, Gabiano C, Galli L, Chiappini E, Giaquinto C, Buffolano W, Genovese O, Esposito S, Bernardi S, De Martino M, Tovo PA, Italian Register for HIV Infection in Children, Lo Vecchio A., Calitri, C, Gabiano, C, Galli, L, Chiappini, E, Giaquinto, C, Buffolano, W, Genovese, O, Esposito, S, Bernardi, S, De Martino, M, Tovo, Pa, Italian Register for HIV Infection in, Children, and Lo Vecchio, A.

Subjects
HIV
Abstract

BACKGROUND: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing. METHODS: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children. RESULTS: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450/μL (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 - 3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection. CONCLUSIONS: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants.

Published
2014

21. Duration of ruptured membranes and vertical transmission of HIV-1: a meta-analysis from 15 prospective cohort studies

Author

Bulterys, M. B., Fowler, M. G., Hanson, I. C., Lemay, M., Mayaux, M. J., Mofenson, L., Newell, M. -L., Peavy, H., Peckham, C., Read, J. S., Rother, C., Simpson, B. J., Van Dyke, R. B., Harris, D. R., Peavy, H. H., Easley, K., Khammy, A., Nugent, R. P., Mitchell, R., Owen, W., Van Dyke, R., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Krogstad, P., Mullins, J., Wolinsky, S., Korber, B., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Lapointe, N., Boucher, M., Fauvel, M., Hankins, C., Samson, J., Newell, M. L., Peckham, C. S., Thorne, C. N., Giaquinto, C., Ruga, E., De Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., de Alba, C., Garcia Rodriguez, M. C., Bates, I., de Josee, I., Hawkins, F., Martinez Zapico, R., Pena, J. M., Gonzalez Garcia, J., Arribas Lopez, J. R., Asensi-Botet, F., Otero, M. C., Peerez-Tamarit, D., Moya, A., Galbis, M. J., Scherpbier, H., Boer, K., Bohlin, A. B., Lindgren, S., Anzen, B., Belfrage, E., Lidin-Jansson, G., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Ferrazin, A., De Maria, A., Gotta, C., Mur, A., Vinolas, M., Paya, A., Loepez-Vilchez, M. A., Coll, O., Fortuny, C., Boguna, J., Casellas Caro, M., Canet, Y., Pardi, G., Ravizza, M., Semprini, E., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Zanelli, S., Duse, M., Soresina, A., Scaravelli, G., Stegagno, M., De Santis, M., Muggiasca, M. L., Vigano, A., Spinillo, A., Ravagni Probizer, F., Bucceri, A., Rancilio, L., Taylor, G. P., Lyall, H., Penn, Z., Blott, M., Valerius, N. H., Martinelli, P., Buffolano, W., Tibaldi, C., Ziarati, N., Semprini, A., Della Torre, M., Parazzini, F., Dallacasa, P., Bianchi, U., Pachi, A., Mancuso, S., Villa, P., Conti, M., Principi, N., Muggiasca, M., Marchisio, P., Zara, C., Ravagni, F., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tadrist, B., Thevenieau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, N., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J., Delattre, P., Stien, L., Audibert, F., Labrune, P., Vial, M., Mazy, F., Sitbon, D., Crenn-Hebert, C., Floch-Tudal, C., Akakpo, R., Daveau, C., Leblanc, A., Cesbron, P., Duval-Arnould, M., Huraux-Rendu, C., Lemerle, S., Touboul, C., Guerin, M., Maingueneau, C., Reynaud, I., Rousseau, T., Ercoil, V., Lanza, M., Denavit, M., Garnier, J., Lahsinat, K., Pia, P., Allouche, C., Nardou, M., Grall, F., May, A., Dallot, M., Lhuillier, P., Cecile, W., Mezin, R., Bech, A., Lobut, J., Algava, G., Chalvon Dermesay, A., Busuttil, R., Jacquemot, M., Bader-Meunier, B., Fridman, S., Codaccioni, X., Maxingue, F., Thomas, D., Alain, J., De Lumley, L., Tabaste, J., Bailly Salin, P., Seaume, H., Guichard, A., Kebaill, K., Roussouly, C., Botto, C., De Lanete, A., Wipff, P., Cravello, L., De Boisse, P., Leclaire, M., Michel, G., Crumiere, C., Lefevre, V., Le Lorier, B., Pauly, I., Robichez, B., Seguy, D., Delhinger, M., Rideau, F., Talon, P., Benos, P., Huret, C., Nicolas, J., Heller-Roussin, B., Saint-Leger, S., Delaporte, M., Hubert, C., De Sarcus, B., Karoubi, P., Mechinaud, F., Bertcrottiere, D., Bongain, A., Monpoux, F., De Gennes, C., Devianne, F., Nisand, I., Rousset, M., Mouchnino, G., Muray, J., Munzer, M., Quereux, C., Brossard, V., Clavier, B., Allemon, M., Rotten, D., Stephan, J., Varlet, M., Guyot, B., Narcy, P., Bardinet, F., De Caunes, F., Jeny, R., Robin, M., Raison Boulley, A., Savey, L., Berrebi, A., Tricoire, J., Borderon, J., Fignon, A., Guillot, F., Maria, B., Broyard, A., Chitrit, Y., Firtion, G., Mandelbrot, L., Lafay Pillet, M., Parat, S., Boissinot, C., Garec, N., Levine, M., Ottenwalter, A., Schaller, F., Vilmer, E., Courpotin, C., Brunner, C., Ciraru-Vigneron, N., Hatem-Gantzer, G., Fritel, X., Wallet, A., Bouille, J., Milliez, J., Bensaid Mrejen, D., Dermer, E., Noseda, G., Bardou, D., Cressaty, J., Francoual, C., Carlus Moncomble, C., Cohen, H., Blanche, S., Bastion, H., Benifla, J., Benkhatar, F., Berkane, N., Hervee, F., Ronzier, M., Mayaux, Mj., de Martino, M., Tovo, P. -A., Galli, L., Gabiano, C., Ferraris, G., Garetto, S., Palomba, E., Riva, C., Vierucci, A., de Luca, M., Farina, S., Fundaro, C., Genovese, O., Mereu, G., Forni, G. L., Casadei, A., Zuccotti, G. V., Riva, E., Cellini, M., Baraldi, C., Consolini, R., Palla, G., Ruggeri, M., Ciccimarra, F., Guarino, A., Osimani, P., Benaglia, G., Romano, A., De Mattia, D., Caselli, D., Boni, S., Dell'Erba, G., Bassanetti, F., Sticca, M., Timpano, C., Magnani, C., Salvatore, C., Lipreri, R., Tornaghi, R., Pinzani, R., Cecchi, M. T., Bezzi, T., Battisti, L., Bresciani, E., Castelli Gattinara, G., Nasi, C., Pellegatta, A., Mazza, A., Baldi, F., Altobelli, R., Deiana, M., Colnaghi, C., Tarallo, L., Tondo, U., Anastasio, E., Chiriaco, P. G., Ruggeri, C., Scott, G., Hutto, C., O'Sullivan, M., Malmsberry, A., Willoughby, A., Burns, D., Goedert, J., Landesman, S., Minkoff, H., Mendez, H., Holman, S., Rubinstein, A., Durako, S., Muenz, L., Goodwin, S., Bryson, Y., Dillon, M., Nielsen, K., Boyer, P., Liao, D., Keller, M., Deveikis, A., Nesheim, S., Lindsay, M., Lee, F., Nahmias, A., Sawyer, M., Vink, P., Farley, J., Alger, L., Abrams, E., Bamji, M., Lambert, G., Schoenbaum, E., Thomas, P., Weedon, J., Palumbo, P., Denny, T., Oleske, J., Bulterys, M., Simonds, R., Ethier-Ives, J., Rogers, M., Schluchter, M., Kutner, M., Kaplan, S., Kattan, M., Lipshultz, S., Mellins, R., Shearer, W., Sopko, G., Sloand, E., Wu, M., Kind, C., Nadal, D., Rudin, C., Siegrist, C. -A., Wyler, C. -A., Cheseaux, J. -J., Aebi, C., Gnehm, H., Schubiger, G., Klingler, J., Hunziker, U., Kuchler, H., Gianinazzi, M., Buhlmann, U., Biedermann, K., Lauper, U., Irion, O., Brunelli, A., Spoletini, G., Schreyer, A., Hosli, I., Saurenmann, E., Drack, G., Isenschmid, M., Poorbeik, M., Schupbach, J., Perrin, L., Erb, P., Joller, H., Kovacs, A., Stek, A., Chan, L., Khoury, M., Diaz, C., Pacheco-Acosta, E., Tuomala, R., Cooper, E., Mesthene, D., Pitt, J., Higgins, A., Moroso, G., Rich, K., Turpin, D., Cooper, N., Davenny, K., Thompson, B., Andiman, W., Simpson, J., THE INTERNATIONAL PERINATAL HIV, Group, Martinelli, Pasquale, Bulterys M.B., Fowler M.G., Hanson I.C., Lemay M., Mayaux M.J., Mofenson L., Newell M.-L., Peavy H., Peckham C., Read J.S., Rother C., Simpson B.J., Van Dyke R.B., Harris D.R., Peavy H.H., Easley K., Khammy A., Nugent R.P., Mitchell R., Owen W., Van Dyke R., Widmayer S., Bardeguez A., Hanson C., Wiznia A., Luzuriaga K., Viscarello R., Ho D., Koup R., Chen I., Krogstad P., Mullins J., Wolinsky S., Korber B., Walker B., Ammann A., Clapp S., McDonald D., Lapointe N., Boucher M., Fauvel M., Hankins C., Samson J., Newell M.L., Peckham C.S., Thorne C.N., Giaquinto C., Ruga E., De Rossi A., Truscia D., Grosch-Worner I., Schafer A., Mok J., Johnstone F., Jiminez J., de Alba C., Garcia Rodriguez M.C., Bates I., de Josee I., Hawkins F., Martinez Zapico R., Pena J.M., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Peerez-Tamarit D., Moya A., Galbis M.J., Scherpbier H., Boer K., Bohlin A.B., Lindgren S., Anzen B., Belfrage E., Lidin-Jansson G., Levy J., Barlow P., Hainaut M., Peltier A., Ferrazin A., De Maria A., Gotta C., Mur A., Vinolas M., Paya A., Loepez-Vilchez M.A., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Semprini E., Castagna C., Fiore S., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Zanelli S., Duse M., Soresina A., Scaravelli G., Stegagno M., De Santis M., Muggiasca M.L., Vigano A., Spinillo A., Ravagni Probizer F., Bucceri A., Rancilio L., Taylor G.P., Lyall H., Penn Z., Blott M., Valerius N.H., Martinelli P., Buffolano W., Tibaldi C., Ziarati N., Semprini A., Della Torre M., Parazzini F., Dallacasa P., Bianchi U., Pachi A., Mancuso S., Villa P., Conti M., Principi N., Muggiasca M., Marchisio P., Zara C., Ravagni F., Vignali M., Rossi G., Selvaggi L., Greco P., Vimercati A., Massi G., Innocenti T., Fiscella A., Sansone M., Benedetto C., Tadrist B., Thevenieau D., Gondry J., Paulard B., Alisy C., Brault D., Tordjeman N., Mamou J., Rozan M., Colombani D., Pincemaille O., Salvetti A., Chabanier C., Hernandorena X., Leroy J., Schaal J., Balde P., Faucher P., Lachassinne E., Benoit S., Douard D., Hocke C., Barjot P., Brouard J., Delattre P., Stien L., Audibert F., Labrune P., Vial M., Mazy F., Sitbon D., Crenn-Hebert C., Floch-Tudal C., Akakpo R., Daveau C., Leblanc A., Cesbron P., Duval-Arnould M., Huraux-Rendu C., Lemerle S., Touboul C., Guerin M., Maingueneau C., Reynaud I., Rousseau T., Ercoil V., Lanza M., Denavit M., Garnier J., Lahsinat K., Pia P., Allouche C., Nardou M., Grall F., May A., Dallot M., Lhuillier P., Cecile W., Mezin R., Bech A., Lobut J., Algava G., Chalvon Dermesay A., Busuttil R., Jacquemot M., Bader-Meunier B., Fridman S., Codaccioni X., Maxingue F., Thomas D., Alain J., De Lumley L., Tabaste J., Bailly Salin P., Seaume H., Guichard A., Kebaill K., Roussouly C., Botto C., De Lanete A., Wipff P., Cravello L., De Boisse P., Leclaire M., Michel G., Crumiere C., Lefevre V., Le Lorier B., Pauly I., Robichez B., Seguy D., Delhinger M., Rideau F., Talon P., Benos P., Huret C., Nicolas J., Heller-Roussin B., Saint-Leger S., Delaporte M., Hubert C., De Sarcus B., Karoubi P., Mechinaud F., Bertcrottiere D., Bongain A., Monpoux F., De Gennes C., Devianne F., Nisand I., Rousset M., Mouchnino G., Muray J., Munzer M., Quereux C., Brossard V., Clavier B., Allemon M., Rotten D., Stephan J., Varlet M., Guyot B., Narcy P., Bardinet F., De Caunes F., Jeny R., Robin M., Raison Boulley A., Savey L., Berrebi A., Tricoire J., Borderon J., Fignon A., Guillot F., Maria B., Broyard A., Chitrit Y., Firtion G., Mandelbrot L., Lafay Pillet M., Parat S., Boissinot C., Garec N., Levine M., Ottenwalter A., Schaller F., Vilmer E., Courpotin C., Brunner C., Ciraru-Vigneron N., Hatem-Gantzer G., Fritel X., Wallet A., Bouille J., Milliez J., Bensaid Mrejen D., Dermer E., Noseda G., Bardou D., Cressaty J., Francoual C., Carlus Moncomble C., Cohen H., Blanche S., Bastion H., Benifla J., Benkhatar F., Berkane N., Hervee F., Ronzier M., Mayaux MJ., de Martino M., Tovo P.-A., Galli L., Gabiano C., Ferraris G., Garetto S., Palomba E., Riva C., Vierucci A., de Luca M., Farina S., Fundaro C., Genovese O., Mereu G., Forni G.L., Casadei A., Zuccotti G.V., Riva E., Cellini M., Baraldi C., Consolini R., Palla G., Ruggeri M., Ciccimarra F., Guarino A., Osimani P., Benaglia G., Romano A., De Mattia D., Caselli D., Boni S., Dell'Erba G., Bassanetti F., Sticca M., Timpano C., Magnani C., Salvatore C., Lipreri R., Tornaghi R., Pinzani R., Cecchi M.T., Bezzi T., Battisti L., Bresciani E., Castelli Gattinara G., Nasi C., Pellegatta A., Mazza A., Baldi F., Altobelli R., Deiana M., Colnaghi C., Tarallo L., Tondo U., Anastasio E., Chiriaco P.G., Ruggeri C., Scott G., Hutto C., O'Sullivan M., Malmsberry A., Willoughby A., Burns D., Goedert J., Landesman S., Minkoff H., Mendez H., Holman S., Rubinstein A., Durako S., Muenz L., Goodwin S., Bryson Y., Dillon M., Nielsen K., Boyer P., Liao D., Keller M., Deveikis A., Nesheim S., Lindsay M., Lee F., Nahmias A., Sawyer M., Vink P., Farley J., Alger L., Abrams E., Bamji M., Lambert G., Schoenbaum E., Thomas P., Weedon J., Palumbo P., Denny T., Oleske J., Bulterys M., Simonds R., Ethier-Ives J., Rogers M., Schluchter M., Kutner M., Kaplan S., Kattan M., Lipshultz S., Mellins R., Shearer W., Sopko G., Sloand E., Wu M., Kind C., Nadal D., Rudin C., Siegrist C.-A., Wyler C.-A., Cheseaux J.-J., Aebi C., Gnehm H., Schubiger G., Klingler J., Hunziker U., Kuchler H., Gianinazzi M., Buhlmann U., Biedermann K., Lauper U., Irion O., Brunelli A., Spoletini G., Schreyer A., Hosli I., Saurenmann E., Drack G., Isenschmid M., Poorbeik M., Schupbach J., Perrin L., Erb P., Joller H., Kovacs A., Stek A., Chan L., Khoury M., Diaz C., Pacheco-Acosta E., Tuomala R., Cooper E., Mesthene D., Pitt J., Higgins A., Moroso G., Rich K., Turpin D., Cooper N., Davenny K., Thompson B., Andiman W., and Simpson J.

Subjects
Time Factors, Epidemiology, Infectious Disease Transmission, Prevention of perinatal transmission, Extraembryonic Membranes, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, Pregnancy, Risk Factors, INFECTION, Vertical, Immunology and Allergy, HIV Infection, MOTHER-TO-CHILD, Pregnancy Complications, Infectious, Prospective cohort study, prevention of perinatal transmission, vertical transmission, obstetrics/gynaecology, epidemiology, Obstetrics, Transmission (medicine), Infectious, HUMAN-IMMUNODEFICIENCY-VIRUS, MOTHER-TO-CHILD, ZIDOVUDINE PROPHYLAXIS, RISK-FACTORS, TYPE-1, PREGNANCY, INFECTION, TRIAL, PREVENTION, Breast Feeding, Infectious Diseases, Meta-analysis, HUMAN-IMMUNODEFICIENCY-VIRUS, Vertical transmission, Regression Analysis, TRIAL, Female, Delivery, Obstetrics gynaecology, Human, medicine.medical_specialty, Time Factor, Ruptured membranes, Immunology, Regression Analysi, NO, ZIDOVUDINE PROPHYLAXIS, Extraembryonic Membrane, medicine, Humans, TYPE-1, business.industry, Risk Factor, Infant, Newborn, Infant, Obstetric, Delivery, Obstetric, Newborn, PREVENTION, Infectious Disease Transmission, Vertical, Pregnancy Complications, Obstetrics/gynaecology, RISK-FACTORS, Cohort Studie, business
Abstract

Objective: To test the a priori hypothesis that longer duration of ruptured membranes is associated with increased risk of vertical transmission of HIV. Design: The relationship between duration of ruptured membranes and vertical transmission of HIV was evaluated in an individual patient data meta-analysis. Methods: Eligible studies were prospective cohort studies including at least 100 mother-child pairs, from regions where HIV-infected women are counselled not to breastfeed. Analyses were restricted to vaginal deliveries and non-elective Cesarean sections; elective Cesarean section deliveries (those performed before onset of labour and before rupture of membranes) were excluded. Results: The primary analysis included 4721 deliveries with duration of ruptured membranes ≤ 24 h. After adjusting for other factors known to be associated with vertical transmission using logistic regression analysis to assess the strength of the relationship, the risk of vertical HIV transmission increased approximately 2% with an increase of 1 h in the duration of ruptured membranes [adjusted odds ratio, 1.02; 95% confidence interval, 1.01-1.04; for each 1 h increment]. There were no significant interactions of duration of ruptured membranes with study cohort or with any of the covariates, except maternal AIDS. Among women diagnosed with AIDS, the estimated probability of transmission increased from 8% to 31% with duration of ruptured membranes of 2 h and 24 h respectively (P < 0.01). Conclusions: These results support the importance of duration of ruptured membranes as a risk factor for vertical transmission of HIV and suggest that a diagnosis of AIDS in the mother at the time of delivery may potentiate the effect of duration of ruptured membranes. © 2001 Lippincott Williams & Wilkins.

Published
2001

22. The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1--a meta-analysis of 15 prospective cohort studies. The International Perinatal HIV Group

Author

Andiman W., Boucher M., Burns D., Bryson Y., Farley J., Fowler H., Gabiano C., Galli L., Hutto C., Kind C., Korber B., Kovacs A., Krogstad P., Landesman S., Lapointe N., Lemay M., Lew J., Mandelbrot L., Mayaux M.J., Mellins R., Minkoff H., Mofenson L., Nielsen K., Newell M.L., Pardi G., Peavy H., Peckham C., Read J., Rother C., Rudin C., Scott G., Semprini A., Shearer W., Simonds R., Simpson B., Stek A., Tovo P.A., Tuomala R., Van Dyke R., Weedon J., de Martino M., Lindsay M., Belair S., Chan L., Harris D., Kalish L., Muenz L., Nugent R., Schluchter M., Durako S., Goodwin S., Mitchell R., Nourjah P., Owen W., Widmayer S., Bardeguez A., Hanson C., Wiznia A., Luzuriaga K., Viscarello R., Ho D., Koup R., Chen I., Mullins J., Wolinsky S., Walker B., Ammann A., Clapp S., McDonald D., Fauvel M., Hankins C., Samson J., Bailey A., Giaquinto C., Ruga E., De Rossi A., Truscia D., Grosch Worner I., Schafer A., Mok J., Johnstone F., Jiminez J., de Alba C., Garcia Rodriguez M., Bates I., de Jose I., Hawkins F., Zapico R.M., Asensi Botet F., Otero M., Perez Tamarit D., Moya A., Galbis M., Scherpbier H., Boer K., Bohlin A., Lindgren S., Ehrnst A., Anzen B., Belfrage E., Levy J., Alimenti A., Barlow P., Ferrazin A., De Maria A., Gotta C., Maritati V., Mur A., Rovira M., Paya A., Coll O., Fortuny C., Boguna J., Caro M.C., Canet Y., Ravizza M., Castagna C., Fiore S., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Duse M., Soresina A., Scaravelli G., De Santis M., Muggiasca M., Vigano A., Marchisio P., Iasci A., Spinillo A., Bucceri A., Grossi E., Rancilio L., Della Torre M., Dallacasa P., Pachi A., Principi N., Zara C., Vignali M., Rossi G., Selvaggi L., Greco P., Vimercati A., Massi G., Innocenti T., Fiscella A., Sansone M., Benedetto C., Tibaldi C., Ziarati N., Tadrist B., Thevenicau D., Gondry J., Paulard B., Alisy C., Brault D., Tordjeman P., Mamou J., Rozan M., Colombani D., Pincemaille O., Salvetti A., Chabanier C., Hernandorena X., Leroy J., Schaal J., Balde P., Faucher P., Lachassinne E., Benoit S., Douard D., Hocke C., Barjot P., Brouard J, Delattre P, Stien L, Audibert F, Labrune P, Vial M, Mazy F, Sitbon D, Crenn Hebert C, Floch Tudal C, Akakpo R, Daveau C, Leblanc A, Cesbron P, Duval Arnould H, Huraux Rendu C, Lemerle S, Touboul C, Guerin M, Maingueneau C, Reynaud I, Rousseau T, Ercoil V, Lanza M, Denavit M, Garnier J, Lahsinat K, Pia R, Allouche C, Nardou M, Grall F, May A, Dallot M, Lhuillier P, Cecile W, Mezin R, Balde P, Bech A, Lobut J, Algava G, Dermesay AC, Busuttil R, Jacquemot M, Bader Meunier B, Fridman S, Codaccioni X, Maxingue F, Thomas D, Alain J, De Lumley L, Tabaste J, Salin PB, Seaume H, Guichard A, Kebaili K, Roussouly C, Botto C, De Lanete A, Wipff P, Cravello L, De Boisse P, Leclaire M, Michel G, Crumiere C, Lefevre V, Le Lorier B, Pauly I, Robichez B, Seguy D, Dehlinger M, Rideau F, Talon P, Benos P, Huret C, Nicolas J, Heller Roussin B, Saint Leger S, Delaporte M, Hubert C, De Sarcus B, Karoubi P, Mechinaud F, 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H, Sopko G, Sloand E, Wu M, Kind C, Nadal D, Rudin C, Siegrist CA, Wyler CA, Cheseaux JJ, Aebi C, Gnehm H, Schubiger G, Klingler J, Hunziker U, Kuchler H, Gianinazzi M, Buhlmann U, Biedermann K, Lauper U, Irion O, Brunelli A, Spoletini G, Schreyer A, Hosli I, Saurenmann E, Drack G, Isenschmid M, Poorbeik M, Schupbach J, Perrin L, Erb P, Joller H, Bryson Y, Dillon M, Nielsen R, Boyer P, Liao D, Keller M, Deveikis A, Kovacs A, Stek A, Chan L, Rother C, Khoury M, Diaz C, Pacheco Acosta E, Tuomala R, Cooper E, Mesthene D, Pitt J, Higgins A, Moroso G, Rich K, Turpin D, Cooper N, Fowler M, Nugent R, Smeriglio V, McKinlay S, Kalish L, Ellis S, Andiman W, PIGNATA, CLAUDIO, GUARINO, ALFREDO, Andiman, W., Boucher, M., Burns, D., Bryson, Y., Farley, J., Fowler, H., Gabiano, C., Galli, L., Hutto, C., Kind, C., Korber, B., Kovacs, A., Krogstad, P., Landesman, S., Lapointe, N., Lemay, M., Lew, J., Mandelbrot, L., Mayaux, M. J., Mellins, R., Minkoff, H., Mofenson, L., Nielsen, K., Newell, M. L., Pardi, G., Peavy, H., Peckham, C., Read, J., Rother, C., Rudin, C., Scott, G., Semprini, A., Shearer, W., Simonds, R., Simpson, B., Stek, A., Tovo, P. A., Tuomala, R., Van Dyke, R., Weedon, J., de Martino, M., Lindsay, M., Belair, S., Chan, L., Harris, D., Kalish, L., Muenz, L., Nugent, R., Schluchter, M., Durako, S., Goodwin, S., Mitchell, R., Nourjah, P., Owen, W., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Mullins, J., Wolinsky, S., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Fauvel, M., Hankins, C., Samson, J., Bailey, A., Giaquinto, C., Ruga, E., De Rossi, A., Truscia, D., Grosch Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., de Alba, C., Garcia Rodriguez, M., Bates, I., de Jose, I., Hawkins, F., Zapico, R. M., Asensi Botet, F., Otero, M., Perez Tamarit, D., Moya, A., Galbis, M., Scherpbier, H., Boer, K., Bohlin, A., Lindgren, S., Ehrnst, A., Anzen, B., Belfrage, E., Levy, J., Alimenti, A., Barlow, P., Ferrazin, A., De Maria, A., Gotta, C., Maritati, V., Mur, A., Rovira, M., Paya, A., Coll, O., Fortuny, C., Boguna, J., Caro, M. C., Canet, Y., Ravizza, M., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Soresina, A., Scaravelli, G., De Santis, M., Muggiasca, M., Vigano, A., Marchisio, P., Iasci, A., Spinillo, A., Bucceri, A., Grossi, E., Rancilio, L., Della Torre, M., Dallacasa, P., Pachi, A., Principi, N., Zara, C., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tibaldi, C., Ziarati, N., Tadrist, B., Thevenicau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, P., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J, Delattre, P, Stien, L, Audibert, F, Labrune, P, Vial, M, Mazy, F, Sitbon, D, Crenn Hebert, C, Floch Tudal, C, Akakpo, R, Daveau, C, Leblanc, A, Cesbron, P, Duval Arnould, H, Huraux Rendu, C, Lemerle, S, Touboul, C, Guerin, M, Maingueneau, C, Reynaud, I, Rousseau, T, Ercoil, V, Lanza, M, Denavit, M, Garnier, J, Lahsinat, K, Pia, R, Allouche, C, Nardou, M, Grall, F, May, A, Dallot, M, Lhuillier, P, Cecile, W, Mezin, R, Balde, P, Bech, A, Lobut, J, Algava, G, Dermesay, Ac, Busuttil, R, Jacquemot, M, Bader Meunier, B, Fridman, S, Codaccioni, X, Maxingue, F, Thomas, D, Alain, J, De Lumley, L, Tabaste, J, Salin, Pb, Seaume, H, Guichard, A, Kebaili, K, Roussouly, C, Botto, C, De Lanete, A, Wipff, P, Cravello, L, De Boisse, P, Leclaire, M, Michel, G, Crumiere, C, Lefevre, V, Le Lorier, B, Pauly, I, Robichez, B, Seguy, D, Dehlinger, M, Rideau, F, Talon, P, Benos, P, Huret, C, Nicolas, J, Heller Roussin, B, Saint Leger, S, Delaporte, M, Hubert, C, De Sarcus, B, Karoubi, P, Mechinaud, F, Bertcrottiere, D, Bongain, A, Monpoux, F, De Gennes, C, Devianne, F, Nisand, I, Rousset, M, Mouchnino, G, Muray, J, Munzer, M, Quereux, C, Brossard, V, Clavier, B, Allemon, M, Rotten, D, Stephan, J, Varlet, M, Guyot, B, Narey, P, Bardinet, F, De Caunes, F, Jeny, R, Robin, M, Bouley, Ar, Savey, L, Berrebi, A, Tricoire, J, Borderon, J, Fignon, A, Guillot, F, Maria, B, Broyard, A, Chitrit, Y, Firtion, G, Mandelbrot, L, Pillet, Ml, Parat, S, Boissinot, C, Garec, N, Levine, M, Ottenwalter, A, Schaller, F, Vilmer, B, Courpotin, C, Brunner, C, Ciraru Vigneron, N, Hatem Gantzer, G, Fritel, X, Wallet, A, Bouille, J, Milliez, J, Mrejen, Db, Dermer, E, Noseda, G, Bardou, D, Cressaty, J, Francoual, C, Moncomble, Cc, Cohen, H, Blanche, S, Bastion, H, Benifla, J, Benkhatar, F, Berkane, N, Herve, F, Ronzier, M, Mayaux, Mj, de Martino, M, Tovo, Pa, Galli, L, Gabiano, C, Ferraris, G, Rancillo, L, Bucceri, A, Tulisso, S, Scolfaro, C, Riva, C, Vierucci, A, de Luca, M, Farina, S, Fundaro, C, Genovese, O, Mercu, G, Forni, G, Stegagno, M, Falconieri, P, Zuccotti, G, Riva, E, Cellini, M, Baraldi, C, Consolini, R, Palla, G, Ruggeri, M, Pignata, Claudio, Guarino, Alfredo, Osimani, P, Metri, A, Antonellini, A, Benaglia, G, Romano, A, Dallacasa, P, De Mattia, D, Caselli, D, Boni, S, Dell'Erba, G, Bassanetti, F, Sticca, M, Timpano, C, Magnani, C, Salvatore, C, Gambaretto, G, Lipreri, R, Tornaghi, R, Pinzani, R, Cecchi, M, Bezzi, T, Battisti, L, Bresciani, E, Gattinara, G, Berrino, R, Pellegatta, A, Mazza, A, Baldi, F, Micheletti, E, Ruga, E, Altobelli, R, Deiana, M, Colnaghi, C, Tarallo, L, Tondo, U, Anastasio, E, Duse, M, Chiriaco, P, Contardi, I, Ruggeri, C, Ibba, P, Scott, G, Hutto, C, O'Sullivan, M, Malmsberry, A, Willoughby, A, Burns, D, Goedert, J, Landesman, S, Minkoff, H, Mendez, H, Holman, S, Rubinstein, A, Durako, S, Muenz, L, Goodwin, S, Nesheim, S, Lindsay, M, Clark, S, Lee, F, Nahmias, A, Sawyer, M, Vink, P, Farley, J, Alger, L, Abrams, E, Bamji, M, Lambert, G, Schoenbaum, E, Thea, D, Thomas, P, Weedon, J, Palumbo, P, Bardeguez, A, Denny, T, Oleske, J, Simonds, R, Orloff, S, Ethier Ives, J, Rogers, M, Schluchter, M, Kutner, M, Kaplan, S, Kattan, M, Lipshultz, S, Mellins, R, Shearer, W, Peavy, H, Sopko, G, Sloand, E, Wu, M, Kind, C, Nadal, D, Rudin, C, Siegrist, Ca, Wyler, Ca, Cheseaux, Jj, Aebi, C, Gnehm, H, Schubiger, G, Klingler, J, Hunziker, U, Kuchler, H, Gianinazzi, M, Buhlmann, U, Biedermann, K, Lauper, U, Irion, O, Brunelli, A, Spoletini, G, Schreyer, A, Hosli, I, Saurenmann, E, Drack, G, Isenschmid, M, Poorbeik, M, Schupbach, J, Perrin, L, Erb, P, Joller, H, Bryson, Y, Dillon, M, Nielsen, R, Boyer, P, Liao, D, Keller, M, Deveikis, A, Kovacs, A, Stek, A, Chan, L, Rother, C, Khoury, M, Diaz, C, Pacheco Acosta, E, Tuomala, R, Cooper, E, Mesthene, D, Pitt, J, Higgins, A, Moroso, G, Rich, K, Turpin, D, Cooper, N, Fowler, M, Nugent, R, Smeriglio, V, Mckinlay, S, Kalish, L, Ellis, S, and Andiman, W

Abstract

To evaluate the relation between elective cesarean section and vertical transmission of human immunodeficiency virus type 1 (HIV-1), we performed a meta-analysis using data on individual patients from 15 prospective cohort studies. North American and European studies of at least 100 mother-child pairs were included in the meta-analysis. Uniform definitions of modes of delivery were used. Elective cesarean sections were defined as those performed before onset of labor and rupture of membranes. Multivariate logistic-regression analysis was used to adjust for other factors known to be associated with vertical transmission. The primary analysis included data on 8533 mother-child pairs. After adjustment for receipt of antiretroviral therapy, maternal stage of disease, and infant birth weight, the likelihood of vertical transmission of HIV-1 was decreased by approximately 50 percent with elective cesarean section, as compared with other modes of delivery (adjusted odds ratio, 0.43; 95 percent confidence interval, 0.33 to 0.56). The results were similar when the study population was limited to those with rupture of membranes shortly before delivery. The likelihood of transmission was reduced by approximately 87 percent with both elective cesarean section and receipt of antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, as compared with other modes of delivery and the absence of therapy (adjusted odds ratio, 0.13; 95 percent confidence interval, 0.09 to 0.19). Among mother-child pairs receiving antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, rates of vertical transmission were 2.0 percent among the 196 mothers who underwent elective cesarean section and 7.3 percent among the 1255 mothers with other modes of delivery. The results of this meta-analysis suggest that elective cesarean section reduces the risk of transmission of HIV-1 from mother to child independently of the effects of treatment with zidovudine.

Published
1999

23. Recommendations for pediatric tuberculosis vaccination in Italy

Author

Montagnani, C, Esposito, S, Galli, L, Chiappini, E, Principi, N, de Martino, M, Bosis, S, Tagliabue, C, Senatore, L, Ascolese, B, Villani, A, Lancella, L, Cursi, L, Grandin, A, Marabotto, C, Ciofi, D, Festini, F, Anziati, M, Becciani, S, Remaschi, G, Sollai, S, Tersigni, C, Venturini, E, Guarino, A, Lo Vecchio, A, Scotto, R, Gabiano, C, Garazzino, S, Le Serre, D, Raffaldi, I, Bernardi, F, Bertazzoni, E, Blasi, F, Bocchino, M, Assante, L, Castagnola, E, Losurdo, G, Codecasa, L, Di Mauro, G, Faccini, M, Marseglia, G, Mascolo, A, Di Comite, A, Stronati, M, Matteelli, A, Migliori, Gb, D’Ambrosio, L, Centis, R, Pasinato, Cirillo, Tortoli, Russo, Scaglione, F, Scala, E, and Tomà, P

Subjects
Pediatrics, medicine.medical_specialty, Tuberculosis, Immunology, Breastfeeding, Tuberculin, Reviews, Disease, Tuberculous meningitis, 03 medical and health sciences, 0302 clinical medicine, children, prevention, BCG, tuberculosis, vaccination, vaccine, 030225 pediatrics, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Immunization Schedule, Pharmacology, business.industry, medicine.disease, Settore MED/38, Pediatric tuberculosis, Vaccination, Italy, BCG Vaccine, business, BCG vaccine
Abstract

Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged

Published
2015

24. Drug use and upper gastrointestinal complications in children: A case-control study

Author

Bianciotto, M, Chiappini, E, Raffaldi, I, Gabiano, C, Tovo, P, Sollai, S, De Martino, M, Mannelli, F, Tipo, V, Da Cas, R, Traversa, G, Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Bersani, Giulia, De Nisco, Alessia, Riccardi, Riccardo, Italian, Multicenter Study Group For Drug And Vaccine Safety In Children, Bianciotto, M, Chiappini, E, Raffaldi, I, Gabiano, C, Tovo, Pa, Sollai, S, de Martino, M, Mannelli, F, Tipo, V, Da Cas, R, Traversa, G, Menniti Ippolito, F, Capuano, Annalisa, and Rafaniello, Concetta

Subjects
Male, Pediatrics, Gastrointestinal Diseases, Anti-Inflammatory Agents, Logistic regression, THERAPY, Upper Gastrointestinal Tract, Adrenal Cortex Hormones, PEPTIC-ULCER DISEASE, gastrointestinal complications, drug use, adverse events, case-control study, Medicine, Prospective Studies, Prospective cohort study, Child, media_common, RISK, Anti-Inflammatory Agents, Non-Steroidal, NONSTEROIDAL ANTIINFLAMMATORY DRUGS, ASSOCIATION, Anti-Bacterial Agents, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, Child, Preschool, ANTIBIOTIC-ASSOCIATED HYPOPROTHROMBINEMIA, SAFETY, Population study, Female, medicine.symptom, Non-Steroidal, Drug, medicine.medical_specialty, Settore BIO/14 - FARMACOLOGIA, media_common.quotation_subject, TOLERABILITY, IBUPROFEN, Drug Therapy, Melena, Humans, Adverse effect, Preschool, Acetaminophen, business.industry, Case-control study, Infant, Logistic Models, Concomitant, Case-Control Studies, Pediatrics, Perinatology and Child Health, business
Abstract

Objective: To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods: This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results: 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p

Published
2013

25. Missed opportunities to prevent mother‐to‐child transmission of HIV in Italy.

Author

Di Biagio, A, Taramasso, L, Gustinetti, G, Burastero, G, Giacomet, V, La Rovere, D, Genovese, O, Giaquinto, C, Rampon, O, Carloni, I, Hyppolite, TK, Palandri, L, Bernardi, S, Bruzzese, E, Badolato, R, Gabiano, C, Chiappini, E, De Martino, M, Galli, L, and Osimani, Patrizia

Subjects
HIV infection transmission, VERTICAL transmission (Communicable diseases), HIV infections, HIV-positive persons, INFANT formulas, MOTHERS, ANTIRETROVIRAL agents, EARLY diagnosis, PREVENTION
Abstract

Objectives: Vertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother‐to‐child transmission of HIV. Methods: The Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. Results: We found 79 HIV‐1‐infected children newly diagnosed after birth in Italy. Thirty‐two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty‐one newborns received antiretroviral prophylaxis and 39 received infant formula. Conclusions: We found an unacceptable number of missed opportunities to prevent mother‐to‐child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns. [ABSTRACT FROM AUTHOR]

Published
2019
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26. Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period

Author

Chiappini E, Galli L, Tovo PA, Gabiano C, Lisi C, Giacomet V, Bernardi S, Esposito S, Rosso R, Giaquinto C, Badolato R, GUARINO, ALFREDO, Maccabruni A, Masi M, Cellini M, Salvini F, Di Bari C, Dedoni M, Dodi I, de Martino M, Osimani P, Cordiali R., Larovere D, De Serio G, Giannini AM, Quercia M., Ruggeri M., Miniaci A, Specchia F, Ciccia M, Faldella G, Baldi F, Lanari M. Ciccia M, Bertulli C, Sorlini A, Ricci F, Dessy C, Pintor M, Fenu ML, Cavallini R, Aliffi A, Anastasio E, Aloe M., Abbagnato L., Merlino S, Fiumana E, Burnelli R, Bonsignori F, Gervaso P, Sollai S., Viscoli C, Cosso D, Timitilli A, Amoretti M., Vigano` A, Zuccotti GV, Mameli C, Fabiano V, Coletto S, Nello F, Riva E, Bettiga C, Picciolli, Irene, Preti Valentina, Tagliaferri Laura, Lipreri R, Mancini L., Mariotti I, Manzotti E, Giubbarelli F., GIANNATTASIO, ANTONIETTA, LO VECCHIO, ANDREA, BRUZZESE, EUGENIA, Tarallo L, Buffolano W., Pennazzato M, Rampon O., Dalle Nogare ER, Sanfilippo A, Romano A, Saitta M, Bandello MA, Tchana I, Maccabruni A., Felici L., Verrotti M., Consolini R, Palla G, Magnani C., Palma P, Pontrelli G, Tchidjou K. H, Genovese O, Falconieri P, Casadei M, Valentini P, Casadei, Martino, Anzidei, Cerilli, Catania Ajissa, Castelli Gattinara G., Cristiano R, Labalestra G, Portelli V., Mazza A, Chiarello P, Garazzino S, Mignone F, Calitri C., Rabusin M, Verzegnassi F., Pellegatta A., Boscardini L, Fortunati P, Da Riol R., Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giacomet, V, Bernardi, S, Esposito, S, Rosso, R, Giaquinto, C, Badolato, R, Guarino, Alfredo, Maccabruni, A, Masi, M, Cellini, M, Salvini, F, Di Bari, C, Dedoni, M, Dodi, I, de Martino, M, Osimani, P, Cordiali, R., Larovere, D, De Serio, G, Giannini, Am, Quercia, M., Ruggeri, M., Miniaci, A, Specchia, F, Ciccia, M, Faldella, G, Baldi, F, Lanari M., Ciccia M, Bertulli, C, Sorlini, A, Ricci, F, Dessy, C, Pintor, M, Fenu, Ml, Cavallini, R, Aliffi, A, Anastasio, E, Aloe, M., Abbagnato, L., Merlino, S, Fiumana, E, Burnelli, R, Bonsignori, F, Gervaso, P, Sollai, S., Viscoli, C, Cosso, D, Timitilli, A, Amoretti, M., Vigano`, A, Zuccotti, Gv, Mameli, C, Fabiano, V, Coletto, S, Nello, F, Riva, E, Bettiga, C, Picciolli, Irene, Preti, Valentina, Tagliaferri, Laura, Lipreri, R, Mancini, L., Mariotti, I, Manzotti, E, Giubbarelli, F., Giannattasio, Antonietta, LO VECCHIO, Andrea, Bruzzese, Eugenia, Tarallo, L, Buffolano, W., Pennazzato, M, Rampon, O., Dalle Nogare, Er, Sanfilippo, A, Romano, A, Saitta, M, Bandello, Ma, Tchana, I, Maccabruni, A., Felici, L., Verrotti, M., Consolini, R, Palla, G, Magnani, C., Palma, P, Pontrelli, G, Tchidjou, K. H., Genovese, O, Falconieri, P, Casadei, M, Valentini, P, Casadei, Martino, Anzidei, Cerilli, Catania, Ajissa, Castelli Gattinara, G., Cristiano, R, Labalestra, G, Portelli, V., Mazza, A, Chiarello, P, Garazzino, S, Mignone, F, Calitri, C., Rabusin, M, Verzegnassi, F., Pellegatta, A., Boscardini, L, Fortunati, P, and Da Riol, R.

Abstract

BACKGROUND: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown. METHODS: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis. RESULTS: Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p < 0.0001). Significant change in the use of each antiretroviral drug occurred over the time periods (p < 0.0001). Factors independently associated with virological and immunological success were as follows: later calendar periods, younger age at regimen (only for virological success) and higher CD4(+) T-lymphocyte percentage at baseline. Use of unboosted PI was associated with lower adjusted hazard ratio (aHR) of virological or immunological success with respect to NNRTI- and boosted PI-based regimens, with no difference among these two latter types. CONCLUSION: Use of new generation antiretroviral drugs in Italian HIV-infected children is increasing. No different viro-immunological outcomes between NNRTI- and boosted PI-based cART were observed

Published
2012

27. Effectiveness and safety of the A-H1N1 vaccine in children: a hospital-based case-control study

Author

Menniti Ippolito F, Da Cas R, Sagliocca L, Traversa G, Ferrazin F, Santuccio C, Tartaglia L, Trotta F, Di Pietro P, Renna S, Rossi R, Domenichini B, Gamba S, Trovato F, Tovo P, Bianciotto M, Calitri C, Gabiano C, Raffaldi I, Urbino A, Da Dalt L, Bavero V, Giordano L, Baraldi M, Bertuola F, Lorenzon E, Parata F, Perilongo G, Vendramin S, Frassineti M, Calvani AM, Chiappini E, De Martino M, Fancelli C, Mannelli F, Mazzantini R, Sollai S, Venturini E, Pirozzi N, Rauchi U, Reale A, Mores N, Bersani G, De Nisco A, Chiaretti A, Riccardi R, Romagnoli C, Tipo V, Dinardo M, Pisapia T, RAFANIELLO, Concetta, Fucà F, Di Rosa E., CAPUANO, Annalisa, PARRETTA, Elisabetta, Menniti Ippolito, F, Da Cas, R, Sagliocca, L, Traversa, G, Ferrazin, F, Santuccio, C, Tartaglia, L, Trotta, F, Di Pietro, P, Renna, S, Rossi, R, Domenichini, B, Gamba, S, Trovato, F, Tovo, P, Bianciotto, M, Calitri, C, Gabiano, C, Raffaldi, I, Urbino, A, Da Dalt, L, Bavero, V, Giordano, L, Baraldi, M, Bertuola, F, Lorenzon, E, Parata, F, Perilongo, G, Vendramin, S, Frassineti, M, Calvani, Am, Chiappini, E, De Martino, M, Fancelli, C, Mannelli, F, Mazzantini, R, Sollai, S, Venturini, E, Pirozzi, N, Rauchi, U, Reale, A, Mores, N, Bersani, G, De Nisco, A, Chiaretti, A, Riccardi, R, Romagnoli, C, Tipo, V, Dinardo, M, Pisapia, T, Capuano, Annalisa, Parretta, Elisabetta, Rafaniello, Concetta, Fucà, F, and Di Rosa, E.

Published
2011

28. Italian Register for HIV Infection in Children. Risk of perinatal HIV infection in infants born in Italy to immigrant mothers

Author

Chiappini E, Galli L, Lisi C, Gabiano C, Giaquinto C, Giacomet V, Esposito S, Badolato R, Berbardi S, Cellini M, Dodi I, Faldella G, Osimani P, Genovese O, Nicastro E, Viscoli C, Salvini F., BUFFOLANO, WILMA, Chiappini, E, Galli, L, Lisi, C, Gabiano, C, Giaquinto, C, Giacomet, V, Buffolano, Wilma, Esposito, S, Badolato, R, Berbardi, S, Cellini, M, Dodi, I, Faldella, G, Osimani, P, Genovese, O, Nicastro, E, Viscoli, C, and Salvini, F.

Published
2011

29. Is the interruption of antiretroviral treatment during pregnancy an additional major risk factor for mother-to-child transmission of HIV type 1?

Author

Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, W, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, De Benedictis, F, Osimani, P, La Rovere, D, Quercia, M, Baldi, F, Ciccia, M, Faldella, A, Masi, M, Plebani, A, Spinelli, E, Dedoni, M, Gariel, D, Chiarello, P, Magnolia, Mg, Sticca, M, Vivalda, L, Bezzi, Teresa Maria, Fiumana, Elisa, Bianchi, L, Battiglia, N, Gervaso, P, Bondi, E, Cosso, D, Gotta, C, Ginocchio, L, Rosso, R, Viscoli, C, Amoretti, C, Esposito, S, Farina, F, Giacomet, V, Lipreri, R, Salvatici, E, Stucchi, S, Palazzi, G, Paolucci, P, De Luca, G, Giannattasio, A, Tancredi, F, Tarallo, L, Rampon, O, Dalle Nogare, E, Romano, A, Saitta, M, Mariani, B, Biver, P, Consolini, R, Palla, G, De Fanti, A, Dodi, I, Verna, M, Bove, G, Casadei, Am, Castelli Gattinara, G, Catania, S, Martino, Am, Sirufo, Mm, Ganau, A, Cristiano, L, Scolfaro, C, Versace, A, Portelli, V, Gentilini, L, Mazza, A, Bernardon, M, Bua, J, Rabusin, M, Pellegatta, A, Fortunati, P., Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, Wilma, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, and Italian Register for HIV Infection in, C. h. i. l. d. r. e. n.

Subjects
Microbiology (medical), antiretroviral treatment, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, HIV Infections, transmission mother-to-child, HIV infection, Cohort Studies, HIV, Italian Register for HIV Infection in Children, therapeutic use, Cohort Studies, Delivery, Obstetric, Female, HIV Infections, drug therapy/transmission, HIV-1, isolation /&/ purification, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious, drug therapy, Pregnancy Trimester, First, Pregnancy Trimester, Third, Prospective Studies, Risk Factors, Viral Load, Withholding Treatment, Pregnancy, Risk Factors, medicine, Elective Cesarean Delivery, Humans, Prospective Studies, Risk factor, Pregnancy Complications, Infectious, Maternal Transmission, Obstetrics, business.industry, Infant, Newborn, Viral Load, medicine.disease, Delivery, Obstetric, Confidence interval, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, Infectious Diseases, Withholding Treatment, Cohort, HIV-1, Gestation, Female, business, Viral load
Abstract

There is currently an experts' agreement discouraging interruption of antiretroviral treatment (ART) during the first trimester of pregnancy in women infected with human immunodeficiency virus type 1 (HIV-1). However, this recommendation is poorly supported by data. We evaluated the effects of discontinuing ART during pregnancy on the rate of mother-to-child transmission.Logistic regression models were performed in a prospective cohort of 937 children who were perinatally exposed to HIV-1 to estimate adjusted odds ratios for confounding factors on mother-to-child transmission, including maternal interruption of ART.Among 937 pregnant women infected with HIV-1, ART was interrupted in 81 (8.6%) in the first trimester and in 11 (1.2%) in the third trimester. In the first trimester, the median time at suspension of ART was 6 weeks (interquartile range [IQR], 5-6 weeks) and the time without treatment was 8 weeks (IQR, 7-11 weeks). In the third trimester, the median time at suspension of ART was 32 weeks (IQR, 23-36 weeks) and the time without treatment was 6 weeks (IQR, 2-9 weeks). The plasma viral load was similar in women who had treatment interrupted in the first trimester and in those who did not have treatment interrupted. Overall, the rate of mother-to-child transmission in the whole cohort was 1.3% (95% confidence interval [CI], 0.7%-2.3%), whereas it was 4.9% (95% CI, 1.9%-13.2%) when ART was interrupted in the first trimester and 18.2% (95% CI, 4.5%-72.7%) when ART was interrupted in the third trimester. In the multiple logistic regression models, only interruption of ART during either the first or the third trimester, maternal mono- or double therapy, delivery by a mode other than elective cesarean delivery, and a viral load at delivery4.78 log(10) copies/mL were independently associated with an increased rate of mother-to-child transmission.Discontinuing ART during pregnancy increases the rate of mother-to-child transmission of HIV-1, either when ART is stopped in the first trimester and subsequently restarted or when it is interrupted in the third trimester. This finding supports recommendations to continue ART in pregnant women who are already receiving treatment for their health.

Published
2009

30. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy

Author

Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, Pier Angelo, Gabiano, C, Urbino, A, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Manuela, O, Carlo, C, Mores, N, Romagnoli, C, Chiaretti, A, Compagnone, A, Riccardi, R, Delogu, G, Sali, M, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Sodano, G, Maccariello, A, Rafaniello, C, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, Arrigo, T, Italian Multicentre Study Group for Drug, Vaccine Safety in Children, Menniti Ippolito, Francesca, Da Cas, Roberto, Traversa, Giuseppe, Santuccio, Carmela, Felicetti, Patrizia, Tartaglia, Loriana, Trotta, Francesco, Di Pietro, Pasquale, Barabino, Paola, Renna, Salvatore, Riceputi, Laura, Tovo, Pier Angelo, Gabiano, Clara, Urbino, Antonio, Baroero, Luca, Le Serre, Daniele, Virano, Silvia, Perilongo, Giorgio, Daverio, Marco, Gnoato, Elisa, Maretti, Michela, Galeazzo, Beatrice, Rubin, Giulia, Scanferla, Stefania, Da Dalt, Liviana, Stefani, Chiara, Zerbinati, Claudia, Chiappini, Elena, Sollai, Sara, De Martino, Maurizio, Mannelli, Francesco, Becciani, Sabrina, Giacalone, Martina, Montano, Simona, Remaschi, Giulia, Stival, Alessia, Furbetta, Mario, Abate, Piera, Leonardi, Ilaria, Pirozzi, Nicola, Raucci, Umberto, Reale, Antonino, Rossi, Rossella, Russo, Cristina, Mancinelli, Livia, Manuela, Onori, Carlo, Concato, Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Compagnone, Adele, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Prete, Valentina, Tipo, Vincenzo, Dinardo, Michele, Auricchio, Fabiana, Polimeno, Teodoro, Sodano, Giuseppe, Maccariello, Alessandra, Rafaniello, Concetta, Fucà, Fortunata, Di Rosa, Eleonora, Altavilla, Domenica, Mecchio, Anna, and Arrigo, Teresa

Subjects
Male, Pediatrics, Laboratory-confirmed case, Emergency Medical Services, Immunology and Microbiology (all), Laboratory-confirmed cases, Case-control study, Children, Influenza vaccine effectiveness, Seasonal influenza, Influenza vaccine effectivene, Emergency medical services, Medicine, Child, Vaccine effectiveness, Vaccination, Hospitalization, Systematic review, Infectious Diseases, Treatment Outcome, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, Influenza Vaccines, Child, Preschool, Molecular Medicine, Veterinary (all), Female, Case-Control Studie, Influenza Vaccine, Settore BIO/19 - MICROBIOLOGIA GENERALE, Human, medicine.medical_specialty, Settore BIO/14 - FARMACOLOGIA, Adolescent, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Immunology and Microbiology(all), Influenza, Human, Humans, Influenza-like illness, General Veterinary, General Immunology and Microbiology, business.industry, Emergency Medical Service, Public Health, Environmental and Occupational Health, Infant, Emergency department, veterinary(all), Confidence interval, Surgery, Case-Control Studies, Case-control study, Children, Influenza vaccine effectiveness, Laboratory-confirmed cases, influenza in children, business
Abstract

•Vaccine effectiveness in children visiting an Emergency Department for influenza.•Test negative case-control study in 11 paediatric centres in two influenza seasons.•Vaccine effectiveness in preventing ED visits: 38% (95% CI -52% to 75%).•Add information for recommendation for vaccination in children. Objective: To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children. Methods: We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children. Results: Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%). Discussion: This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children. © 2014 The Authors.

Published
2013

31. A Pre-HAART Follow-up Study of the Hematologic Manifestations in Children With Perinatal HIV-1 Infection: Suggestions for Reclassification of Clinical Staging

Author

Consolini R, Bencivelli W, Legitimo A, Galli L, Tovo P, Gabiano C, De Martino M, for the Italian Register for HIV infection in children [ . . ., MASI, MASSIMO, Consolini R, Bencivelli W, Legitimo A, Galli L, Tovo P, Gabiano C, De Martino M, for the Italian Register for HIV infection in children [ .., Masi M, and ]

Subjects
medicine.medical_specialty, Anemia, HIV Infections, Disease, Perinatal hiv, Single entity, Internal medicine, medicine, Humans, Intensive care medicine, Survival analysis, business.industry, Incidence, Incidence (epidemiology), Infant, Newborn, Follow up studies, Infant, Hematology, Prognosis, medicine.disease, Hematologic Diseases, Survival Analysis, Antiretroviral therapy, Italy, Oncology, Pediatrics, Perinatology and Child Health, Disease Progression, HIV-1, business, Follow-Up Studies
Abstract

Hematologic manifestations in perinatally human immunodeficiency virus-1-infected children have not been widely described in literature. Knowledge of the spontaneous evolution of this disease is essential for achieving optimum care of patients. We analyzed the main hematologic manifestations developed in the prehighly active antiretroviral therapy period of 1217 children, collected from the Italian Register for HIV infection. In 111 patients, the hematologic sign was the first clinical manifestation. Among anemic and neutropenic patients, the fraction of patients in clinical class C was significantly higher than the corresponding fraction in class B (76%, P

Published
2007

32. Changing patterns of clinical events in perinatally HIV-1 infected children during the era of HAART

Author

Chiappini E., Galli L., Tovo P.A., Gabiano C., Lisi C., Castelli Gattinara G., Esposito S., Viganò A., Giaquinto C., Rosso R., Guarino A., de Martino M., The Italian Register for HIV Infection in Children [. . ., Osimani P., Fortunati P., SPECCHIA, FERNANDO GIUSEPPE, Chiappini E., Galli L., Tovo PA., Gabiano C., Lisi C., Castelli Gattinara G., Esposito S., Viganò A., Giaquinto C., Rosso R., Guarino A., de Martino M., The Italian Register for HIV Infection in Children [.., Osimani P., Specchia F., Fortunati P., and ]

Subjects
HIV-INFECTION, CHILDREN, COMBINED ANTIRETROVIRAL THERAPY
Abstract

Background: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. Method: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985–1995) and post-HAART periods (1996–2000, and 2001–2005). Of this group, 773 children (55.1%) were followed from birth. Median observation time was 8.58 years (interquartile range, 3.71–13.72). Results: Overall, 666 (47.5%) children developed AIDS and 420 (29.9%) died. Improved survival over time was evidenced at Kaplan–Meier analysis (P15% in 58.5% children with pneumonia. Conclusions: Progressive reductions of both mortality and rates of class B and C clinical events, including organ complications, were evidenced in the HAART era. Nevertheless, severe bacterial infections, particularly pneumonia, still occurred at considerable high rates, even in the absence of a severe CD4 cell depletion.

Published
2007

33. The Mode of Delivery and the Risk of Vertical Transmission of Human Immunodeficiency Virus Type 1 — A Meta-Analysis of 15 Prospective Cohort Studies

Author

Andiman, W., Boucher, M., Burns, D., Bryson, Y., Farley, J., Fowler, H., Gabiano, C., Galli, L., Hutto, C., Kind, C., Korber, B., Kovacs, A., Krogstad, P., Landesman, S., Lapointe, N., Lemay, M., Lew, J., Mandelbrot, L., Mayaux, Mj, Mellins, R., Minkoff, H., Mofenson, L., Nielsen, K., Newell, Ml, Pardi, G., Peavy, H., Peckham, C., Read, J., Rother, C., Rudin, C., Scott, G., Semprini, A., Shearer, W., Simonds, R., Simpson, B., Stek, A., Tovo, Pa, Tuomala, R., Dyke, R., Weedon, J., Martino, M., Lindsay, M., Belair, S., Chan, L., Harris, D., Kalish, L., Muenz, L., Nugent, R., Schluchter, M., Durako, S., Goodwin, S., Mitchell, R., Nourjah, P., Owen, W., Widmayer, S., Bardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R., Ho, D., Koup, R., Chen, I., Mullins, J., Wolinsky, S., Walker, B., Ammann, A., Clapp, S., Mcdonald, D., Fauvel, M., Hankins, C., Samson, J., Bailey, A., Giaquinto, C., Ruga, E., Rossi, A., Truscia, D., Grosch-Worner, I., Schafer, A., Mok, J., Johnstone, F., Jiminez, J., Alba, C., Garcia-Rodriguez, M., Bates, I., Jose, I., Hawkins, F., Zapico, Rm, Asensi-Botet, F., Otero, M., Perez-Tamarit, D., Moya, A., Galbis, M., Scherpbier, H., Boer, K., Bohlin, A., Lindgren, S., Ehrnst, A., Anzen, B., Belfrage, E., Levy, J., Alimenti, A., Barlow, P., Ferrazin, A., Maria, A., Gotta, C., Maritati, V., Mur, A., Rovira, M., Paya, A., Coll, O., Fortuny, C., Boguna, J., Caro, Mc, Canet, Y., Ravizza, M., Castagna, C., Fiore, S., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Soresina, A., Scaravelli, G., Santis, M., Muggiasca, M., Vigano, A., Marchisio, P., Iasci, A., Spinillo, A., Bucceri, A., Grossi, E., Rancilio, L., Della Torre, M., Dallacasa, P., Pachi, A., Principi, N., Zara, C., Vignali, M., Rossi, G., Selvaggi, L., Greco, P., Vimercati, A., Massi, G., Innocenti, T., Fiscella, A., Sansone, M., Benedetto, C., Tibaldi, C., Ziarati, N., Tadrist, B., Thevenicau, D., Gondry, J., Paulard, B., Alisy, C., Brault, D., Tordjeman, P., Mamou, J., Rozan, M., Colombani, D., Pincemaille, O., Salvetti, A., Chabanier, C., Hernandorena, X., Leroy, J., Schaal, J., Balde, P., Faucher, P., Lachassinne, E., Benoit, S., Douard, D., Hocke, C., Barjot, P., Brouard, J., Delattre, P., Stien, L., Audibert, F., Labrune, P., Vial, M., Mazy, F., Sitbon, D., Crenn-Hebert, C., Floch-Tudal, C., Akakpo, R., Daveau, C., Leblanc, A., Cesbron, P., Duval-Arnould, H., Huraux-Rendu, C., Lemerle, S., Touboul, C., Guerin, M., Maingueneau, C., Reynaud, I., Rousseau, T., Ercoil, V., Lanza, M., Denavit, M., Garnier, J., Lahsinat, K., Pia, R., Allouche, C., Nardou, M., Grall, F., May, A., Dallot, M., Lhuillier, P., Cecile, W., Mezin, R., Bech, A., Lobut, J., Algava, G., Dermesay, Ac, Busuttil, R., Jacquemot, M., Bader-Meunier, B., Fridman, S., Codaccioni, X., Maxingue, F., Thomas, D., Alain, J., Lumley, L., Tabaste, J., Salin, Pb, Seaume, H., Guichard, A., Kebaili, K., Roussouly, C., Botto, C., Lanete, A., Wipff, P., Cravello, L., Boisse, P., Leclaire, M., Michel, G., Crumiere, C., Lefevre, V., Le Lorier, B., Pauly, I., Robichez, B., Seguy, D., Dehlinger, M., Rideau, F., Talon, P., Benos, P., Huret, C., Nicolas, J., Heller-Roussin, B., Saint-Leger, S., Delaporte, M., Hubert, C., Sarcus, B., Karoubi, P., Mechinaud, F., Bertcrottiere, D., Bongain, A., Monpoux, F., Gennes, C., Devianne, F., Nisand, I., Rousset, M., Mouchnino, G., Muray, J., Munzer, M., Quereux, C., Brossard, V., Clavier, B., Allemon, M., Rotten, D., Stephan, J., Varlet, M., Guyot, B., Narey, P., Bardinet, F., Caunes, F., Jeny, R., Robin, M., Bouley, Ar, Savey, L., Berrebi, A., Tricoire, J., Borderon, J., Fignon, A., Guillot, F., Maria, B., Broyard, A., Chitrit, Y., Firtion, G., Pillet, Ml, Parat, S., Boissinot, C., Garec, N., Levine, M., Ottenwalter, A., Schaller, F., Vilmer, B., Courpotin, C., Brunner, C., Ciraru-Vigneron, N., Hatem-Gantzer, G., Xavier FRITEL, Wallet, A., Bouille, J., Milliez, J., Mrejen, Db, Dermer, E., Noseda, G., Bardou, D., Cressaty, J., Francoual, C., Moncomble, Cc, Cohen, H., Blanche, S., Bastion, H., Benifla, J., Benkhatar, F., Berkane, N., Herve, F., Ronzier, M., Ferraris, G., Rancillo, L., Tulisso, S., Scolfaro, C., Riva, C., Vierucci, A., Luca, M., Farina, S., Fundaro, C., Genovese, O., Mercu, G., Forni, G., Stegagno, M., Falconieri, P., Zuccotti, G., Riva, E., Cellini, M., Baraldi, C., Consolini, R., Palla, G., Ruggeri, M., Pignata, C., Guarino, A., Osimani, P., Metri, A., Antonellini, A., Benaglia, G., Romano, A., Mattia, D., Caselli, D., Boni, S., Erba, G., Bassanetti, F., Sticca, M., Timpano, C., Magnani, C., Salvatore, C., Gambaretto, G., Lipreri, R., Tornaghi, R., Pinzani, R., Cecchi, M., Bezzi, T., Battisti, L., Bresciani, E., Gattinara, G., Berrino, R., Pellegatta, A., Mazza, A., Baldi, F., Micheletti, E., Altobelli, R., Deiana, M., Colnaghi, C., Tarallo, L., Tondo, U., Anastasio, E., Chiriaco, P., Contardi, I., Ruggeri, C., Ibba, P., O Sullivan, M., Malmsberry, A., Willoughby, A., Goedert, J., Mendez, H., Holman, S., Rubinstein, A., Nesheim, S., Clark, S., Lee, F., Nahmias, A., Sawyer, M., Vink, P., Alger, L., Abrams, E., Bamji, M., Lambert, G., Schoenbaum, E., Thea, D., Thomas, P., Palumbo, P., Denny, T., Oleske, J., Orloff, S., Ethier-Ives, J., Rogers, M., Kutner, M., Kaplan, S., Kattan, M., Lipshultz, S., Sopko, G., Sloand, E., Wu, M., Nadal, D., Siegrist, Ca, Wyler, Ca, Cheseaux, Jj, Aebi, C., Gnehm, H., Schubiger, G., Klingler, J., Hunziker, U., Kuchler, H., Gianinazzi, M., Buhlmann, U., Biedermann, K., Lauper, U., Irion, O., Brunelli, A., Spoletini, G., Schreyer, A., Hosli, I., Saurenmann, E., Drack, G., Isenschmid, M., Poorbeik, M., Schupbach, J., Perrin, L., Erb, P., Joller, H., Dillon, M., Nielsen, R., Boyer, P., Liao, D., Keller, M., Deveikis, A., Khoury, M., Diaz, C., Pacheco-Acosta, E., Cooper, E., Mesthene, D., Pitt, J., Higgins, A., Moroso, G., Rich, K., Turpin, D., Cooper, N., Fowler, M., Smeriglio, V., Mckinlay, S., and Ellis, S.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Anti-HIV Agents, Birth weight, HIV Infections, Cohort Studies, Pregnancy, Risk Factors, medicine, Birth Weight, Humans, Rupture of membranes, Pregnancy Complications, Infectious, Prospective cohort study, Cesarean Section, Obstetrics, business.industry, Infant, Newborn, General Medicine, Odds ratio, Delivery, Obstetric, medicine.disease, Infectious Disease Transmission, Vertical, Confidence interval, Logistic Models, Multivariate Analysis, Immunology, HIV-1, Female, business, Zidovudine, Cohort study
Abstract

Background To evaluate the relation between elective cesarean section and vertical transmission of human immunodeficiency virus type 1 (HIV-1), we performed a meta-analysis using data on individual patients from 15 prospective cohort studies. Methods North American and European studies of at least 100 mother-child pairs were included in the meta-analysis. Uniform definitions of modes of delivery were used. Elective cesarean sections were defined as those performed before onset of labor and rupture of membranes. Multivariate logistic-regression analysis was used to adjust for other factors known to be associated with vertical transmission. Results The primary analysis included data on 8533 mother-child pairs. After adjustment for receipt of antiretroviral therapy, maternal stage of disease, and infant birth weight, the likelihood of vertical transmission of HIV-1 was decreased by approximately 50 percent with elective cesarean section, as compared with other modes of delivery (adjusted odds ratio, 0.43; 95 percent confidence interval, 0.33 to 0.56). The results were similar when the study population was limited to those with rupture of membranes shortly before delivery. The likelihood of transmission was reduced by approximately 87 percent with both elective cesarean section and receipt of antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, as compared with other modes of delivery and the absence of therapy (adjusted odds ratio, 0.13; 95 percent confidence interval, 0.09 to 0.19). Among mother-child pairs receiving antiretroviral therapy during the prenatal, intrapartum, and neonatal periods, rates of vertical transmission were 2.0 percent among the 196 mothers who underwent elective cesarean section and 7.3 percent among the 1255 mothers with other modes of delivery. Conclusions The results of this meta-analysis suggest that elective cesarean section reduces the risk of transmission of HIV-1 from mother to child independently of the effects of treatment with zidovudine.

Published
1999

34. Virologic, immunologic, and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Atovo, P. i. e. r., Gabiano, C., Castelli Gattinara, G., Guarino, A., Baddato, R., Giaquinto, C., Lisi, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Gattinara, Gc, Guarino, Alfredo, Baddato, R, Giaquinto, C, Lisi, C, and DE MARTINO, M.

Subjects
medicine.medical_specialty, Pediatrics, Anti-HIV Agents, medicine.medical_treatment, Immunology, combined antiretroviral therapy, CD4-CD8 Ratio, HIV Infections, HIV-1 infection, Asymptomatic, Drug Administration Schedule, Acquired immunodeficiency syndrome (AIDS), Immunopathology, Antiretroviral Therapy, Highly Active, Medicine, Immunology and Allergy, Humans, Sida, ART, infants, Chemotherapy, biology, business.industry, Age Factors, Infant, Viral Load, biology.organism_classification, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, CD4 Lymphocyte Count, Infectious Diseases, Treatment Outcome, Child, Preschool, Lentivirus, Disease Progression, HIV-1, Viral disease, medicine.symptom, business, Epidemiologic Methods, Viral load
Abstract

Objective: To investigate the impact of early versus deferred combined antiretroviral treatment (ART) in asymptomatic or moderately symptomatic [Centers for Disease Control and Prevention (CDC) category N, A or B] infants with perinatal HIV-1 infection. Methods: A multi-centre nationwide case-control study was conducted. Data from 30 infants treated with combined ART with three or more drugs before 6 months of age were compared with data from 103 infants starting ART with three or more drugs after 6 months of age. The median follow-up time was 4.1 years (range, 1.0-6.5 years). Results: No difference was evident in the first available viral load and CD4 T-lymphocyte percentage between the two groups of children. Early-treated infants showed significantly lower viral loads than infants receiving deferred treatment at all the follow-up periods. A higher proportion of early-treated infants than infants receiving deferred treatment (73.3% versus 30.1%; P < 0.0001) reached an undetectable viral load. Higher CD4 T-lymphocyte percentages were found in early-treated infants at 13-24 (P < 0.0001), 25-36 (P < 0.0001), and 37-48 (P = 0.003) months of age. No early-treated infant versus 20 of 103 (19.4%) infants receiving deferred ART (P=0.02) showed a CD4 T-lymphocyte percentage of less than 15% at one time point during follow-up. No CDC category A, B or C clinical event occurred in early-treated infants over the follow-up period while 44 of 103 (42.7%) infants receiving deferred treatment presented a decline in the CDC category. Kaplan-Meier analyses revealed significant differences in CDC category A (P = 0.0002), B (P = 0.0003), and C (P = 0.0018) event-free survivals. Conclusion: The data suggest virologic, immunologic, and clinical benefits from early administration of ART.

Published
2006

35. Early triple therapy vs mono or dual therapy for children with perinatal HIV infection

Author

Chiappini, E, Galli, L, Gabiano, C, Tovo, Pa, de Martino, M, Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini E., Galli L., Gabiano C., Tovo P A., De Martino M., for the Italian Register for HIV Infection in Children: [.., Osimani P., Specchia F., Molesini M., and ]

Subjects
Perinatal HIV infection, Pediatrics, medicine.medical_specialty, HIV INFECTIONS, business.industry, Therapy, General Medicine, Virology, Perinatal hiv, medicine, INFANT, Dual therapy, business, MATERNAL-FETAL RELATIONS, DISEASE TRANSMISSION, ANTIHIV AGENTS
Abstract

The time at which antiretroviral therapy (ART) should be initiated in children with perinatal human immunodeficiencyvirus (HIV) infection remains controversial. In a cohort study, Berk et al1 reported clinical benefit from mono/dual ART started before 60 days of life in 10 children compared with treatment administered at 61 to 120 days of life in 16 children. The 23 children who received early triple ART were not investigated because none of them progressed to category C diagnosis by 3 years of age. We performed a similar analysis in a cohort study of a larger data set of children with a longer follow-up to evaluate the outcomes of early and very early triple ART.

Published
2006

36. Virologic, immunologic and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection

Author

Chiappini E., Galli L., Tovo P.A., Gabiano C., Castelli Gattinara G., Guarino A., Badolato R., Giaquinto C., Lisi C., de Martino M., the Italian Register for HIV Infection in Children [. . . Osimani P., . Molesini M., SPECCHIA, FERNANDO GIUSEPPE, Chiappini E., Galli L., Tovo PA., Gabiano C., Castelli Gattinara G., Guarino A., Badolato R., Giaquinto C., Lisi C., de Martino M., the Italian Register for HIV Infection in Children [.. Osimani P., Specchia F., Molesini M., and ]

Subjects
EARLY COMBINED ANTIRETROVIRAL THERAPY, INFANTS, PERINATAL HIV-1 INFECTION
Abstract

Objective: To investigate the impact of early versus deferred combined antiretroviral treatment (ART) in asymptomatic or moderately symptomatic [Centers for Disease Control and Prevention (CDC) category N, A or B] infants with perinatal HIV-1 infection. Methods: A multi-centre nationwide case–control study was conducted. Data from 30 infants treated with combined ART with three or more drugs before 6 months of age were compared with data from 103 infants starting ART with three or more drugs after 6 months of age. The median follow-up time was 4.1 years (range, 1.0–6.5 years). Results: No difference was evident in the first available viral load and CD4 T-lymphocyte percentage between the two groups of children. Early-treated infants showed significantly lower viral loads than infants receiving deferred treatment at all the follow-up periods. A higher proportion of early-treated infants than infants receiving deferred treatment (73.3% versus 30.1%; P < 0.0001) reached an undetectable viral load. Higher CD4 T-lymphocyte percentages were found in early-treated infants at 13– 24 (P < 0.0001), 25–36 (P < 0.0001), and 37–48 (P ¼ 0.003) months of age. No earlytreated infant versus 20 of 103 (19.4%) infants receiving deferred ART (P ¼ 0.02) showed a CD4 T-lymphocyte percentage of less than 15% at one time point during follow-up. No CDC category A, B or C clinical event occurred in early-treated infants over the follow-up period while 44 of 103 (42.7%) infants receiving deferred treatment presented a decline in the CDC category. Kaplan–Meier analyses revealed significant differences in CDC category A (P ¼ 0.0002), B (P ¼ 0.0003), and C (P ¼ 0.0018) eventfree survivals. Conclusion: The data suggest virologic, immunologic, and clinical benefits from early administration of ART.

Published
2006

37. The management of HCV infected pregnant women and their children European paediatric HCV network

Author

Pembrey, Lucy, Newell, Marie Louise, Tovo, Pier Angelo, Amoroso, A., Bevilaqua, E., Asensi Botet, F., Pereda, A., Balossini, V., Bona, G., Zaffaroni, M., Bandelloni, A., Coscia, A., Fabris, C., Aime, S., Belloni, C., Bossi, G., Salati, B., Boucher, C., Buffolano, W., Butler, K., Roura, L. Cabero, Sanges, J. M. Bertran, Cigna, P., Ciria, L. M., Ginard, C. Servera, Teruel, G. Claret, Fortuny, C., Coll, O., Corrias, A., Ledda, R., Floris, S., De Maria, A., Echeverria, J., Cilla, G., LANARI, MARCELLO, Tridapalli, E., Venturi, V., Fischler, B., Bohlin, A. B., Lindgren, S., Lindh, G., Giacomet, V., Merlo, M., Figini, C., Erba, P., Viganò, A., Hannam, S., Mieli Vergani, G., Hatzakis, A., Inchley, C., Fjaerli, H. O., Maccabruni, A., Marcellini, M., Sartorelli, M. R., Fontelos, P. Martin, Mazza, A., Mok, J. Y. Q., Mûr, A., Viñolas, M., Paternoster, D. M., Grella, P., Polywka, S., Quinti, I., Casadei, A. M., Rojahn, A., Berg, A., Rosso, R., Ferrando, S., Bassetti, D., Contreras, J. Ruiz, Manzanares, A., Extremera, A. Ruiz, Salvini, F., Zuccotti, G. V., Schmitz, T., Grosch Wörner, I., Sperling, C. Feiterna, Piening, T., Vegnente, A., Iorio, R., Versace, A., Lazier, L., Palomba, E., Gabiano, C., Balbo, L., Zanetti, A., Tanzi, E., FALDELLA, GIACOMO, Pembrey, L., Newell, M. L., Tovo, P. A., Amoroso, A., Bevilacqua, E., Asensi Botet, F., Pereda, A., Balossini, V., Bona, G., Zaffaroni, M., Bandelloni, A., Coscia, A., Fabris, C., Iorio, Raffaele, Vegnente, Angela, Pembrey, Lucy, Newell, Marie-Louise, Tovo, Pier-Angelo, Bevilaqua, E., Asensi-Botet, F., Aime, S., Belloni, C., Bossi, G., Salati, B., Boucher, C., Buffolano, W., Butler, K., Roura, L. Cabero, Sanges, J.M. Bertran, Cigna, P., Ciria, L.M., Ginard, C. Servera, Teruel, G. Claret, Fortuny, C., Coll, O., Corrias, A., Ledda, R., Floris, S., De Maria, A., Echeverria, J., Cilla, G., Faldella, Giacomo, Lanari, M., Tridapalli, E., Venturi, V., Fischler, B., Bohlin, A.-B., Lindgren, S., Lindh, G., Giacomet, V., Merlo, M., Figini, C., Erba, P., Viganò, A., Hannam, S., Mieli-Vergani, G., Hatzakis, A., Inchley, C., Fjaerli, H.O., Maccabruni, A., Marcellini, M., Sartorelli, M.R., Fontelos, P. Martin, Mazza, A., Mok, J.Y.Q., Mûr, A., Viñolas, M., Paternoster, D.M., Grella, P., Polywka, S., Quinti, I., Casadei, A.M., Rojahn, A., Berg, A., Rosso, R., Ferrando, S., Bassetti, D., Contreras, J. Ruiz, Manzanares, A., Extremera, A. Ruiz, Salvini, F., Zuccotti, G.V., Schmitz, T., Grosch-Wörner, I., Sperling, C. Feiterna, Piening, T., Vegnente, A., Iorio, R., Versace, A., Lazier, L., Palomba, E., Gabiano, C., Balbo, L., Zanetti, A., and Tanzi, E.

Subjects
Pediatrics, medicine.medical_specialty, Psychological intervention, Breastfeeding, Pregnancy, Prenatal Diagnosis, Diagnosis, medicine, Humans, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, Hepatitis C, Clinical management, Mother-to-child transmission, Paediatric, Follow-up, Hepatology, business.industry, Transmission (medicine), Gastroenterology, Infant, Newborn, virus diseases, Evidence-based medicine, medicine.disease, digestive system diseases, Infectious Disease Transmission, Vertical, Europe, Immunology, Female, Viral disease, business, Diagnosi
Abstract

Background/Aims: As evidence accumulates relating to mother-to-child (vertical) transmission of hepatitis C virus (HCV), it is timely to draw up guidelines for the clinical management of HCV infected pregnant women and their children. Methods: A review of evidence from the European Paediatric HCV Network (EPHN) prospective study of HCV infected women and their children and other published studies. Meeting of EPHN clinical experts to reach a consensus on recommendations for management. Each recommendation was graded according to the level of evidence. Results/conclusions: Although several risk factors for mother-to-child transmission have been identified, none are modifiable and there are currently no interventions available to prevent vertical transmission of HCV. Data on timing of loss of maternal antibodies and reliability of diagnostic tests inform the optimum follow-up schedule for confirmation or exclusion of infection in children born to HCV infected women. Based on the current evidence, routine antenatal screening for HCV should not be introduced and neither elective caesarean section nor avoidance of breastfeeding should be recommended to HCV infected women to prevent mother-to-child transmission of HCV. HCV/HIV co-infected women should follow existing HIV guidelines. © 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Published
2005

38. Persistently high IgA serum levels are a marker of immunological or virological failure of combined antiretroviral therapy in children with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Tovo, P. A., Gabiano, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini E., Galli L., Tovo PA., Gabiano C., de Martino M., Osimani P, Masi M., Specchia F., Molesini M., and The Italian Register for HIV Infection in Children

Subjects
Adolescent, Anti-HIV Agents, Immunology, HIV Infections, HIV-1 infection, Perinatal hiv, Antiretroviral Therapy, Highly Active, Clinical Studies, Immunology and Allergy, Medicine, Humans, Treatment Failure, Child, viremia, business.industry, combinedantiretroviral therapy, hyper-IgA, Infant, Newborn, Normal population, Infant, Viral Load, Antiretroviral therapy, Virological failure, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Immunoglobulin A, Child, Preschool, HIV-1, Drug Monitoring, business, Viral load, Biomarkers, Follow-Up Studies
Abstract

Summary Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with ≥ 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7·3%) children with immunological failure and from 54 (23·1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0·042) than children without. After 3–12 months of therapy immunologically failed children displayed higher viral loads (P < 0·0001) and IgA (P = 0·043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4+ T-lymphocyte percentages (P = 0·005) and higher IgA z-scores (P < 0·0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3–12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.

Published
2005

39. Determinants of mother-to-infant human immunodeficiency virus 1 transmission before and after the introduction of zidovudine prophylaxis

Author

de Martino, M, Galli, L, Tovo, PA, Gabiano, C, Pezzotti, P, Wagner, TM, Rezza, G, Osimani, P, De Mattia, D, Di Bari, C, Ruggeri, M, Baldi, F, Ciccia, M, Lanari, M, Masi, M, Venturi, V, Battisti, L, Duse, M, Chiriaco, PG, Cavallini, R, Dessi, C, Pintor, C, Anastasio, E, SABATINO, GIOVANNI, Sticca, M, Pomero, G, Bezzi, T, Chiappini, E, De Luca, M, Gervaso, P, Cecchi, MT, Bassetti, D, Gotta, C, Rosso, R, Timitilli, A, Tondo, U, Mussini, P, Bricalli, D, BUCCERI, ANDREA, Ferraris, G, Giovannini, M, Mosca, F, Lipreri, R, Guarino, A, Plebani, A, Riva, E, RIVA, SILVIA, Vigano, A, Zuccotti, GV, Cellini, M, Buffolano, W, Tarallo, L, D'Elia, R, Giaquinto, C, Rampon, O, Dalle Nogare, ER, Romano, A, Caselli, D, Maccabruni, A, Consolini, R, Benaglia, G, Magnani, C, Anzidei, G, Pistilli, AMC, Gattinara, GC, Catania, S, Facente, C, Falconieri, P, Fundaro, C, Genovese, O, Rendeli, C, Bionda, S, Cristiano, L, Garetto, S, Riva, C, PALOMBA, ERIKA, Portelli, V, Mazza, A, SALVATORE, CLAUDIO, Pellegatta, A, Molesini, M, de Martino, M, Galli, L, Tovo, PA, Gabiano, C, Pezzotti, P, Wagner, TM, Rezza, G, Osimani, P, De Mattia, D, Di Bari, C, Ruggeri, M, Baldi, F, Ciccia, M, Lanari, M, Masi, M, Venturi, V, Battisti, L, Duse, M, Chiriaco, PG, Cavallini, R, Dessi, C, Pintor, C, Anastasio, E, Sabatino, G, Sticca, M, Pomero, G, Bezzi, T, Chiappini, E, De Luca, M, Gervaso, P, Cecchi, MT, Bassetti, D, Gotta, C, Rosso, R, Timitilli, A, Tondo, U, Mussini, P, Bricalli, D, Bucceri, A, Ferraris, G, Giovannini, M, Mosca, F, Lipreri, R, Guarino, A, Plebani, A, Riva, E, Riva, S, Vigano, A, Zuccotti, GV, Cellini, M, Buffolano, W, Tarallo, L, D'Elia, R, Giaquinto, C, Rampon, O, Dalle Nogare, ER, Romano, A, Caselli, D, Maccabruni, A, Consolini, R, Benaglia, G, Magnani, C, Anzidei, G, Pistilli, AMC, Gattinara, GC, Catania, S, Facente, C, Falconieri, P, Fundaro, C, Genovese, O, Rendeli, C, Bionda, S, Cristiano, L, Garetto, S, Riva, C, Palomba, E, Portelli, V, Mazza, A, Salvatore, C, Pellegatta, A, and Molesini, M

Subjects
immunodeficiency virus 1
Abstract

Background: Randomized controlled trials have demonstrated that zidovudine therapy decreases the mother-to-infant transmission of human immunodeficiency virus 1 (HIV-1). Data from large observational studies may provide further important findings on the effectiveness at the population level of combined treatments in decreasing transmission.Objective: To evaluate time trends in prophylactic interventions and the determinants of transmission both before and after the introduction of antiretroviral prophylaxis, and in treated and untreated mother-infant pairs after 1995.Design and Setting: Analysis of prospective data on 3770 children born to HIV-1-infected women between 1985 and 1999 and reported to the Italian Register for HIV Infection in Children.Main Outcome Measures: Logistic regression random effects models were used to estimate crude and adjusted odds ratios for several factors potentially influencing vertical transmission for 2periods-1985 through 1995 (January 1, 1985, through December 31,1995) and 1996 through 1999 (January 1, 1996, through December 31, 1999), and between treated and untreated children after 1995.Results: The transmission rate was 15.5% in the 19851995 period and 5.8% in the 1996-1999 period. By 1999, prophylactic interventions had greatly increased. Antiretroviral treatment (ART) usage was 89.9%, (55.1% combination ART) and the elective cesarean delivery rate was 81.3%. In multivariate analysis, only elective cesarean delivery was associated with a lower risk of mother-to-infant transmission before 1995. After 1995, nonbreastfeeding and receipt of ART were protective whereas elective cesarean delivery was not significantly protective in multivariate analysis. Transmission risk was reduced by 76% with an incomplete zidovudine regimen, 88% with a complete regimen, and 93% when the mother received combination ART. In the 1996-1999 period, the transmission rate for nonbreastfeeding mother-infant pairs was 8.6% with elective cesarean delivery, 4.4% with any ART, and 2.4% with these interventions combined.Conclusion: Prophylactic interventions, and in particular ART, reduced perinatal HIV-1 transmission at a population level in Italy.

Published
2004

40. Adherence to antiretroviral therapy and its determinants in children with HIV infection: a multicentre, national study

Author

GIACOMET V, ALBANO F, STARACE F, DE FRANCISCIS A, GIAQUINTO C, CASTELLI GATTINARA G, GABIANO C, GALLI L, VIGAN A, CASELLI D, BRUZZESE, EUGENIA, GUARINO, ALFREDO, Giacomet, V, Albano, F, Starace, F, DE FRANCISCIS, A, Giaquinto, C, CASTELLI GATTINARA, G, Bruzzese, Eugenia, Gabiano, C, Galli, L, Vigan, A, Caselli, D, and Guarino, Alfredo

Abstract

AIM: To investigate rates and determinants of adherence to antiretroviral therapy in Italian children infected with the human immunodeficiency virus (HIV). METHODS: An observational, cross-sectional multicentre study was performed through a structured interview with the caregivers of HIV-infected children. The interview included quantitative information on adherence in the 4 d before interview. Sociodemographic, clinical and psychosocial characteristics of children were recorded. RESULTS: 129 children (median age 96 mo) were enrolled, of whom 94 were on highly active antiretroviral therapy (HAART). Twenty-one (16%) omitted more than 5% of total doses in 4 d and were considered non-adherent. However, only 11% of caregivers reported that therapy had been administered at the correct times. No significant difference was found between age and the stage of HIV infection. Children aware of their HIV status were less adherent. Individual drugs showed a broad adherence pattern and children who received HAART were more adherent. Children receiving therapy from foster parents were more adherent than those receiving drugs from biological parents or relatives. CONCLUSIONS: Adherence is a major problem in children. Psychological rather than clinical or sociodemographic features and types of drug are major determinants of adherence.

Published
2003

41. Puberty in perinatal HIV-1 infection: a multicentre longitudinal study of 212 children

Author

de Martino M, Tovo PA, Galli L, Gabiano C, Chiarelli F, Zappa M, Gattinara GC, Bassetti D, Giacomet V, Chiappini E, Duse M, Garetto S, Caselli D, Italian Register for HIV infection in Children ( Catania S, FundaroÁ C, Cellini M, Lipreri R, Zuccotti GV, Cecchi MT, Mazza A, Masi M, Consolini R, Bezzi MT, Benaglia G, Ganau A., GUARINO, ALFREDO, de Martino, M, Tovo, Pa, Galli, L, Gabiano, C, Chiarelli, F, Zappa, M, Gattinara, Gc, Bassetti, D, Giacomet, V, Chiappini, E, Duse, M, Garetto, S, Caselli, D, Italian Register for HIV infection in Children, ( Catania S, Fundaroá, C, Cellini, M, Lipreri, R, Zuccotti, Gv, Cecchi, Mt, Guarino, Alfredo, Mazza, A, Masi, M, Consolini, R, Bezzi, Mt, Benaglia, G, and Ganau, A.

Subjects
Male, Percentile, Pediatrics, medicine.medical_specialty, Longitudinal study, adolescence, HIV-1, perinatal infection, puberty, Tanner stage, Adolescent, Anti-HIV Agents, Immunology, HIV Infections, Age Distribution, Acquired immunodeficiency syndrome (AIDS), Immunopathology, medicine, Immunology and Allergy, Humans, Longitudinal Studies, Child, Rank correlation, business.industry, Puberty, Infant, Newborn, medicine.disease, Confidence interval, Log-rank test, Fetal Diseases, Infectious Diseases, El Niño, Female, business
Abstract

OBJECTIVE: To define age at entry into Tanner stages in children with perinatal HIV-1 infection. DESIGN: Multicentre longitudinal study including 212 perinatally HIV-1-infected children (107 girls and 105 boys) followed-up during puberty (from 8 and 9 years onwards in girls and boys, respectively). Healthy children (843 girls and 821 boys) provided reference percentiles. P2 or B2 stages in girls and P2 or G2 stages in boys defined onset of puberty. METHODS: The cumulative probability [95% confidence limit (CI)] of entry into each stage at different ages was estimated by the Kaplan-Meier product-limit method; differences were evaluated by log rank test. Relationships were tested using the Spearman's rank correlation coefficient. RESULTS: Ages of girls [years (95%CI)] at P2 [12.9 (12.6-13.2)], P3 [13.4 (13.0-13.8)], P4 [14.6 (14.0-15.2)], B2 [12.7 (12.2-13.2)], B3 [13.3 (12.8-14.0)] and B4 [14.6 (14.0-15.2)] stages were > 97th percentile (> or = 21 month delay) of controls. Ages of boys [years (95%CI)] at P2 [12.6 (12.1-13.1)], P3 [13.9 (13.4-14.4)], P4 [14.9 (14.2-15.6)], G2 [12.1 (11.5-12.7)], G3 [13.6 (13.1-14.1)] and G4 [14.9 (14.1-15.7)] stages were at the 75-97th percentiles (< or = 15 month delay). Age at onset of puberty was not related to clinical and immunological condition, antiretroviral treatment, weigh for height and age at onset of severe disease or immune suppression. CONCLUSION: Perinatal HIV-1 infection interferes with sexual maturation. The mechanisms by which this occurs should be elucidated and intervention strategies designed. Intervention could save much psychological distress, since associated linear growth failure can exacerbate adolescents' feelings of being different and unwell.

Published
2001

43. Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period

Author

Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giacomet, V, Bernardi, S, Esposito, S, Rosso, R, Giaquinto, C, Badolato, R, Guarino, A, Maccabruni, A, Masi, M, Cellini, M, Salvini, F, Bari, Di, Dedoni, C, Dodi, M, I, Martino, De, M, Italian Register for HIV Infection in Children: Other Partecipants:Osimani, Cordiali, P, Larovere, R, D, Serio, De, Giannini, G, Quercia, Am, Ruggeri, M, Miniaci, M, Specchia, A, Ciccia, F, Faldella, M, Baldi, G, Lanari, G, Ciccia, M, Bertulli, M, Sortini, C, Ricci, A, Dessy, F, Pintor, C, Fenu, C, Cavallini, Ml, Aliffi, R, Anastasio, A, Aloe, E, Abbagnato, M, Merlino, L, Fiumana, S, Burnelli, E, Bonsignori, R, Gervaso, F, Prato, P, Viscoli, M, Cosso, C, Timitilli, D, Amoretti, A, Giacomet, M, Coletto, V, S, Nello, Di, Riva, F, Bettiga, E, Piccioli, C, Preti, I, Tagliaferri, V, Liprieri, L, Mancini, R, Mariotti, L, Giubbarelli, I, Giannattasio, F, A, Vecchio, Lo, Bruzzese, A, Tarallo, E, Buffolano, L, Pennazzato, W, Rampon, M, O, Dalle, Nogare, Sanfilippo, Er, Romano, A, Saitta, A, Bandello, M, Maccabruni, Ma, Felici, A, Verrotti, L, and Consolini, Rita

Published
2012

44. The Italian Register for HIV Infection in Children. Predictive value of the HIV paediatric classification system for the long-term course of perinatally infected children

Author

Writing Committee: Galli L., de Martino M., Tovo P. A., Gabiano C., Zappa M. Other participants, PIGNATA, CLAUDIO, Writing Committee: Galli, L., de Martino, M., Tovo, P. A., Gabiano, C., Zappa M., Other participant, and Pignata, Claudio

Subjects
HIV Infection
Abstract

To compare the Centers for Disease Control and Prevention (CDC) paediatric classification system with the long-term course of perinatal human immunodeficiency virus type 1 (HIV-1) infection. Prospective study on 366 perinatally infected children followed-up from birth and checked at least every 2 months. Survival, smoothed hazard, adjusted hazard ratio of death, and transition probabilities in clinical and immunological categories were outcome measures. Survival was 49% (95% CI : 40-58%) at 8 years. The risk of death was high before the age of 2, relatively low between ages 2 and 7, and contained thereafter. Children did not advance through the categories sequentially. Survival at 8 years was 61.7% (95% CI : 49.8-73.6%) in those children who had passed through clinical category A; the hazard ratio of death was 2.5 (95% CI : 1.7-3.8) for 175 (47.9%) children who skipped this category. Transition probability in clinical category B was 39.9% (95% CI : 32.3-45.6%) after one year, but 59.1% (95% CI : 51.4-66.8%) after 5 years. Before 2 years of age, the probability of entry into category C (40%; 95% CI : 35-45%) was higher than that of entry into immunological category 3 (28%; 95% CI : 22-34%). Conclusions The classification system stands comparison with the clinical reality, but the CD4-positive cell thresholds in infancy should be adjusted and category B indicator diseases better distributed to improve their predictive value.

Published
2000

46. Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection. Italian Register for HIV Infection in Children and the Italian National AIDS Registry

Author

de Martino M, Tovo PA, Balducci M, Galli L, Gabiano C, Rezza G, Pezzotti P, Osimani P, Di Bari C, Larovere D, Ruggeri m, Masi M, SpecchiaM, Battisti L, Duse M, Crispino P, Carrara P, Pintor C, Dedoni M, Dessì C, Loriano D, Anastasio E, Bezzi T, De Luca M, Farina S, Vierucci A, Bassetti D, Pontali E, Boni S, Marazzi M. G, Tasso L, Giovanettoni C, Salvini F, Pinzani R, Marchisio P, Viganò A, Tornaghi R, Zuccotti G. V, Riva E, Giovannini M, Lipreri R, Conio S, Ferraris G, Cellini M, Baraldi C, Tarallo L, Giaquinto C, Ruga E, Rampon O, Dalle Nogare E. R, Sanfilippo A, Romano A, Benaglia G, Dodi I, Caselli D, maccabruni A, Pacati I, Consolini R, Palla G, Cecchi M. T, Vecchi C, Anzidei G, Cerilli S, Chiodi R, Castelli Gattianra G, Krzysztofiak A, Bernardi S, Fundarò C, Genovese O, Colafati G. S, Catania A, Ajassa C, Mazza A, Garetto S, Riva C, Scolfaro C., GUARINO, ALFREDO, BERNI CANANI, ROBERTO, de Martino, M, Tovo, Pa, Balducci, M, Galli, L, Gabiano, C, Rezza, G, Pezzotti, P, Osimani, P, Di Bari, C, Larovere, D, Ruggeri, M, Masi, M, Specchiam, Battisti, L, Duse, M, Crispino, P, Carrara, P, Pintor, C, Dedoni, M, Dessì, C, Loriano, D, Anastasio, E, Bezzi, T, De Luca, M, Farina, S, Vierucci, A, Bassetti, D, Pontali, E, Boni, S, Marazzi, M. G., Tasso, L, Giovanettoni, C, Salvini, F, Pinzani, R, Marchisio, P, Viganò, A, Tornaghi, R, Zuccotti, G. V., Riva, E, Giovannini, M, Lipreri, R, Conio, S, Ferraris, G, Cellini, M, Baraldi, C, Guarino, Alfredo, BERNI CANANI, Roberto, Tarallo, L, Giaquinto, C, Ruga, E, Rampon, O, Dalle Nogare, E. R., Sanfilippo, A, Romano, A, Benaglia, G, Dodi, I, Caselli, D, Maccabruni, A, Pacati, I, Consolini, R, Palla, G, Cecchi, M. T., Vecchi, C, Anzidei, G, Cerilli, S, Chiodi, R, Castelli Gattianra, G, Krzysztofiak, A, Bernardi, S, Fundarò, C, Genovese, O, Colafati, G. S., Catania, A, Ajassa, C, Mazza, A, Garetto, S, Riva, C, and Scolfaro, C.

Abstract

CONTEXT: Since the introduction of combined antiretroviral therapy, mortality rates in adults with human immunodeficiency virus type 1 (HIV-1) infection have decreased. However, little information is available outside the setting of controlled trials on survival of perinatally HIV-infected children treated with antiretroviral therapy. OBJECTIVE: To assess effect of availability of antiretroviral therapy on decreasing mortality in perinatally HIV-infected children. DESIGN: Population-based, multicenter longitudinal study involving data collected by the Italian Register for HIV Infection in Children. SETTING: A network of 106 pediatric clinical centers. SUBJECTS: A total of 1142 children born between November 1980 and December 1997 with perinatally acquired HIV infection with a median follow-up of 5.9 years. MAIN OUTCOME MEASURE: Time to HIV-related death calculated for birth cohort and calendar period and grouped by distribution of predominant type of antiretroviral therapy administered over time. RESULTS: Survival was longer in the 1996-1997 birth cohort (crude relative hazard [RH] of death, 0.39; 95% confidence interval [CI], 0.15-0.96) and 1996-1998 calendar period (crude RH of death, 0.65; 95% CI, 0.45-0.95) than in birth cohort and calendar period 1980-1995, but not when adjusted for maternal antiretroviral treatment during pregnancy and clinical condition at time of delivery, gestational age, and birth weight (adjusted RH of death, 0.55; 95% CI, 0.20-1.50, for birth cohort; and adjusted RH of death, 0.71, 95% CI, 0.43-1.16, for calendar period). In a multivariate model with 1980-1995 as comparison, the 1996-1997 birth cohort had an RH of 0.57 (95% CI, 0.22-1.47; P=.27) but RH for calendar period 1996-1998 was 0.63 (95% CI, 0.47-0.85; P

Published
2000

47. Pertussis immunization in HIV-1-infected infants: a model to assess the effects of repeated T cell-dependent antigen administrations on HIV-1 progression

Author

Tovo P. A., de Martino M., Gabiano C., Galli L. Other participants, PIGNATA, CLAUDIO, Tovo, P. A., de Martino, M., Gabiano, C., Galli L., Other participant, and Pignata, Claudio

Subjects
HIV-1-infected infant, Pertussis immunization
Abstract

Several data evidence that HIV-1 replication may increase in temporal association with immunizations, raising concerns on potential negative effects of vaccinations on HIV-1 progression. Among patients prospectively followed by the "Italian Register for HIV infection in children", we evaluated, using the Cox-Mantel method, conditional probabilities of progressing to CDC clinical categories 'B' or 'C', and immunological categories '2' or '3' in 88 children immunized against pertussis and 244 non-immunized. No selection criteria were followed in vaccinating children. No significant differences were observed between the two groups. The lack of a significant impact on clinical and immunological deterioration by the repeated administrations of a T cell-dependent vaccine endorses the current recommendations for routine immunizations in HIV-1-infected children.

Published
2000

48. Rapid disease progression in HIV-1 perinatally infected children born to mothers receiving zidovudine monotherapy during pregnancy. The Italian register for HIV Infection in Children

Author

de Martino M, Galli L, Tovo P. A, Gabiano C, Osimani P, Zizzadoro P, de Mattia D, Ruggeri M, Lanari M, Dalla Vecchia S, Masi M, Miniaci A, Baldi F, Dell' Erba G, Battisti L, Duse M, Crispino P, Uberti E, Bresciani E, Chiriacò P. G, Pintor C, Dedoni M, Loriano D, Dessì C, Anastasio L, Sabatino G, Sticca M, Berrino R, Lodato A, Vierucci A, Farina S, de Luca M, de Maria A, Fioredda F, Boni S, Marazzi M. G, Pontali E, Forni GL, Gotta C, Tasso, L, Gambaretto G, Meo A, Plebani R, Pinzani R, Salvini F, Marchisio P, Massironi E, Tornaghi R, Zuccotti GV, Riva S, de Carlis S, Ferraris G, Bucceri A, Lipreri R, Cellini M, Tarallo L, Giaquinto C, Ruga E, Rampon O, Romano A, Benaglia G, Caselli D, Maccabruni A, Consolini R, Palla G, Antonellini A, Magnani C, Cecchi T, Castelli Gattinara G, Bernardi S, Cancrini C, Fundarò C, Genovese O, Rendeli C, Timpano C, Anzidei G, Catania S, Stegagno M, Mazza A, Salvatore C, Scolfaro C, Palomba E, Riva C, Pellegatta A., GUARINO, ALFREDO, PIGNATA, CLAUDIO, de Martino, M, Galli, L, Tovo, P. A., Gabiano, C, Osimani, P, Zizzadoro, P, de Mattia, D, Ruggeri, M, Lanari, M, Dalla Vecchia, S, Masi, M, Miniaci, A, Baldi, F, Dell' Erba, G, Battisti, L, Duse, M, Crispino, P, Uberti, E, Bresciani, E, Chiriacò, P. G., Pintor, C, Dedoni, M, Loriano, D, Dessì, C, Anastasio, L, Sabatino, G, Sticca, M, Berrino, R, Lodato, A, Vierucci, A, Farina, S, de Luca, M, de Maria, A, Fioredda, F, Boni, S, Marazzi, M. G., Pontali, E, Forni, Gl, Gotta, C, Tasso, L, Gambaretto, G, Meo, A, Plebani, R, Pinzani, R, Salvini, F, Marchisio, P, Massironi, E, Tornaghi, R, Zuccotti, Gv, Riva, S, de Carlis, S, Ferraris, G, Bucceri, A, Lipreri, R, Cellini, M, Guarino, Alfredo, Pignata, Claudio, Tarallo, L, Giaquinto, C, Ruga, E, Rampon, O, Romano, A, Benaglia, G, Caselli, D, Maccabruni, A, Consolini, R, Palla, G, Antonellini, A, Magnani, C, Cecchi, T, Castelli Gattinara, G, Bernardi, S, Cancrini, C, Fundarò, C, Genovese, O, Rendeli, C, Timpano, C, Anzidei, G, Catania, S, Stegagno, M, Mazza, A, Salvatore, C, Scolfaro, C, Palomba, E, Riva, C, and Pellegatta, A.

Abstract

OBJECTIVE: To investigate the outcome in children perinatally infected with HIV-1 whose mothers received zidovudine (ZDV) monotherapy in pregnancy. DESIGN: Observational retrospective study of a prospectively recruited cohort. SETTING: Italian Register for HIV Infection in Children. PATIENTS: A group of 216 children perinatally infected with HIV-1, born in 1992-1997 and derived prospectively from birth: 38 children had mothers receiving ZDV monotherapy and for 178 children the mothers received no antiretroviral treatment during pregnancy. MAIN OUTCOME MEASURES: The estimated probability of developing severe disease or severe immune suppression, survival probability [95% confidence interval (CI)] within 3 years, and the hazard ratio (95% CI), adjusted for year of birth, maternal clinical condition at delivery, birthweight and treatments (Pneumocystis carinii pneumonia chemoprophylaxis and/or antiretroviral therapy before the onset of severe disease, severe immune suppression or death) were compared. RESULTS: Comparison of HIV-1-infected children whose mothers were treated with ZDV with children whose mothers were not treated showed that the former group had a higher probability of developing severe disease [57.3% (95% CI 40.9-74.3) versus 37.2% (95% CI 30.0-45.4); log-rank test 7.83, P = 0.005; adjusted hazard ratio 1.8 (95% CI 1.1-3.1)] or severe immune suppression [53.9% (95% CI 36.3-73.5) versus 37.5% (95% CI 30.0-46.2); log-rank test 5.58, P = 0.018; adjusted hazard ratio 2.4, (95% CI: 1.3-4.3)] and a lower survival [72.2% (95% CI 50.4-85.7) versus 81.0% (95% CI 73.7-86.5); log-rank test 4.23, P = 0.039; adjusted hazard ratio of death 1.9 (95% CI 1.1-3.6)]. CONCLUSIONS: This epidemiological observation could stimulate virologic studies to elucidate whether this rapid progression depends on in utero infection or transmission of resistant virus. Findings may suggest a need to hasten HIV-1 diagnosis in infants of ZDV-treated mothers and undertake an aggressive antiretroviral therapy in those found to be infected

Published
1999

49. Italian guidelines for antiretroviral therapy in children with human immunodeficiency virus-type 1 infection

Author

De Martino M., Tovo P., Giaquinto C., De Rossi A., Galli L., Gabiano C., Floridia M., Ferraris g., Ruga E., Castelli Gattinara G., Scolafaro C., Vierucci A., Viganò A., Zuccotti G. V., Fundarò C., Caselli D., De Maria A., Duse M., Plebani A., Timpano C., Lanari M., Stegagno M., Lipreri R., Gotta C., Ruggeri M., Loriao D., Osimani P., m. Cellini M., Forni G. L., Benaglia G., Antonellini A., De Mattia D., Pintor C., Mazza A., Romano A., Consolini R., Marazzi M. G., GUARINO, ALFREDO, Cecchi M. T., Zizzadoro P., Battisti L., Bezzi T., Salvatore C., Ciccia M., Bionda S., Metri A. M., Anastasio E., Magnani C., Sticca M., Tarallo L., Masi M., Gamberetto G., Catania S., Micheletti E., Pellegatta A., Dessi C., Baldi F., Ibba P., Bresciani E., Nasi C., Falconieri P., Tasso L., Altobelli R., Chiariacò P. G., Ruggeri C., Magni L. A., Tondo U., Contardi I., Tommasi D., Di Gregorio F., Meo A., Resta F., Molesini M., Sabatino G., Portelli V., PIGNATA, CLAUDIO, De Martino, M., Tovo, P., Giaquinto, C., De Rossi, A., Galli, L., Gabiano, C., Floridia, M., Ferraris, G., Ruga, E., Castelli Gattinara, G., Scolafaro, C., Vierucci, A., Viganò, A., Zuccotti, G. V., Fundarò, C., Caselli, D., De Maria, A., Duse, M., Plebani, A., Timpano, C., Lanari, M., Stegagno, M., Lipreri, R., Gotta, C., Ruggeri, M., Loriao, D., Osimani, P., m. Cellini, M., Forni, G. L., Benaglia, G., Antonellini, A., De Mattia, D., Pintor, C., Mazza, A., Romano, A., Consolini, R., Pignata, Claudio, Marazzi, M. G., Guarino, Alfredo, Cecchi, M. T., Zizzadoro, P., Battisti, L., Bezzi, T., Salvatore, C., Ciccia, M., Bionda, S., Metri, A. M., Anastasio, E., Magnani, C., Sticca, M., Tarallo, L., Masi, M., Gamberetto, G., Catania, S., Micheletti, E., Pellegatta, A., Dessi, C., Baldi, F., Ibba, P., Bresciani, E., Nasi, C., Falconieri, P., Tasso, L., Altobelli, R., Chiariacò, P. G., Ruggeri, C., Magni, L. A., Tondo, U., Contardi, I., Tommasi, D., Di Gregorio, F., Meo, A., Resta, F., Molesini, M., Sabatino, G., and Portelli, V.

Abstract

Human immunodeficiency virus-type 1 (HIV-1) infection and its treatment are peculiar in children. Adherence and compliance must be carefully taken into account before initiating or changing therapy and in the choice of drugs. Even in the absence of paediatric-specific trial results and notwithstanding drug-labelling notations, all antiretroviral drugs should be used when indicated. A combined therapy is compulsory. Therapy is highly recommended in category C or category 3 and recommended in category B children. Indications in categories N1, N2, A1 or A2 are limited. A triple association is recommended in category C or category 3 children or in those with a high viral load, when compliance is guaranteed. A step-down strategy is not advisable. Infants' treatment should be inserted into controlled studies. Therapy should be changed when serious side effects or poor tolerance (choose drugs with a different toxicity and greater tolerance), poor compliance (individualize the motives) or treatment failure (evaluate progression and adherence) occurs.

Published
1999

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