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12. Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting

Author

Prati, D, Gasbarrini, A, Mazzotta, F, Sagnelli, E, Carosi, G, Abrescia, N, Alberti, Alfredo, Ambu, S, Andreone, P, Andriulli, A, Angelico, M, Antonucci, G, Ascione, A, Belli, Ls, Bruno, R, Bruno, S, Burra, Patrizia, Camma, C, Caporaso, N, Cariti, G, Cillo, U, Coppola, N, Craxi, A, DE LUCA, A, DE MARTIN, E, DI MARCO, V, Fagiuoli, S, Ferrari, C, Gaeta, Gb, Galli, M, Grieco, A, Grossi, P, Licata, A, Maida, I, Mangia, A, Marino, N, Maserati, R, Missale, G, Mondelli, M, Nasta, P, Niro, G, Persico, M, Petrelli, E, Picciotto, A, Piscaglia, F, Pollicino, T, Puoti, C, Puoti, M, Raimondo, G, Rumi, Mg, Santantonio, T, Smedile, A, Squadrito, G, Baroni, Gs, Taliani, G, Tavio, M, Toti, M, Bonino, F, Brunetto, Mr, Cacopardo, B, Caremani, M, Cauda, R, Colombo, M, DI PERRI, G, Donato, F, Farci, P, Fattovich, G, Filice, G, Ghinelli, F, Guadagnino, V, Lazzarin, A, Levrero, M, Licata, G, Orani, A, Paffetti, A, Pastore, G, Piccinino, F, Pizzigallo, E, Pontisso, Patrizia, Portelli, V, Rizzetto, M, Rossi, A, Stroffolini, T, Ubaldi, E, Santantanio, T, Alberti, A., Antonucci, Gf, Craxi, A., Prati D, Gasbarrini A, Mazzotta F, Sagnelli E, Carosi G, Abrescia N, Alberti A, Ambu S, Andreone P, Andriulli A, Angelico M, Antonucci GF, Ascione A, Belli LS, Bruno R, Bruno S, Burra P, Cammà, C, Caporaso N, Cariti G, Cillo U, Coppola N, Craxì, A, De Luca A, De Martin E, Di Marco, V, Fagiuoli S, Ferrari C, Gaeta GB, Galli M, Grieco A, Grossi P, Licata, A, Maida I, Mangia A, Marino N, Maserati R, Missale G, Mondelli M, Nasta P, Niro G, Persico M, Petrelli E, Picciotto A, Piscaglia F, Pollicino T, Prati D, Puoti C, Puoti M, Raimondo G, Rumi MG, Sagnelli E, Santantonio T, Smedile A, Squadrito G, Baroni GS, Taliani G, Tavio M, Toti M, Bonino F, Brunetto MR, Cacopardo B, Caremani M, Cauda R, Colombo M, Di Perri G, Donato F, Farci P, Fattovich G, Filice G, Ghinelli F, Guadagnino V, Lazzarin A, Levrero M, Licata G, Orani A, Paffetti A, Pastore G, Piccinino F, Pizzigallo E, Pontisso P, Portelli V, Rizzetto M, Rossi A, Stroffolini T, Ubaldi E., Italian Association for the Study of the Liver, Italian Society of Infectious, Tropical Disease, Italian Society for the Study of Sexually Transmitted Diseases: Prati D., Gasbarrini A., Mazzotta F., Sagnelli E., Carosi G., Abrescia N., Alberti A., Ambu S., Andreone P., Andriulli A., Angelico M., Antonucci G.F., Ascione A., Belli L.S., Bruno R., Bruno S., Burra P., Cammà C., Caporaso N., Cariti G., Cillo U., Coppola N., Craxì A., De Luca A., De Martin E., Di Marco V., Fagiuoli S., Ferrari C., Gaeta G.B., Galli M., Grieco A., Grossi P., Licata A., Maida I., Mangia A., Marino N., Maserati R., Missale G., Mondelli M., Nasta P., Niro G., Persico M., Petrelli E., Picciotto A., Piscaglia F., Pollicino T., Puoti C., Puoti M., Raimondo G., Rumi M.G., Santantonio T., Smedile A., Squadrito G., Baroni G.S., Taliani G., Tavio M., Toti M., Bonino F., Brunetto M.R., Cacopardo B., Caremani M., Cauda R., Colombo M., Di Perri G., Donato F., Farci P., Fattovich G., Filice G., Ghinelli F., Guadagnino V., Lazzarin A., Levrero M., Licata G., Orani A., Paffetti A., Pastore G., Piccinino F., Pizzigallo E., Pontisso P., Portelli V., Rizzetto M., Rossi A., Stroffolini T., Ubaldi E., Prati, D, Gasbarrini, A, Mazzotta, F, Sagnelli, E, Carosi, G, Abrescia, N, Alberti, A, Ambu, S, Andreone, P, Andriulli, A, Angelico, M, Antonucci, G, Ascione, A, Belli, L, Bruno, R, Bruno, S, Burra, P, Caporaso, N, Cariti, G, Cillo, U, Coppola, N, De Luca, A, De Martin, E, Fagiuoli, S, Ferrari, C, Gaeta, G, Galli, M, Grieco, A, Grossi, P, Maida, I, Mangia, A, Marino, N, Maserati, R, Missale, G, Mondelli, M, Nasta, P, Niro, G, Persico, M, Petrelli, E, Picciotto, A, Piscaglia, F, Pollicino, T, Puoti, C, Puoti, M, Raimondo, G, Rumi, M, Santantonio, T, Smedile, A, Squadrito, G, Baroni, G, Taliani, G, Tavio, M, Toti, M, Bonino, F, Brunetto, M, Cacopardo, B, Caremani, M, Cauda, R, Colombo, M, Di Perri, G, Donato, F, Farci, P, Fattovich, G, Filice, G, Ghinelli, F, Guadagnino, V, Lazzarin, A, Levrero, M, Licata, G, Orani, A, Paffetti, A, Pastore, G, Piccinino, F, Pizzigallo, E, Pontisso, P, Portelli, V, Rizzetto, M, Rossi, A, Stroffolini, T, and Ubaldi, E

Subjects
Liver Cirrhosis, ANTIVIRAL TREATMENT, Human immunodeficiency virus (HIV), HIV Infections, Hepacivirus, ANTIVIRAL THERAPY, PEGYLATED INTERFERON-ALPHA-2B, LIVER-TRANSPLANTATION, PEGINTERFERON ALPHA-2A, HIV-INFECTED PATIENTS, VIRUS-COINFECTED PATIENTS, RAPID VIROLOGICAL RESPONSE, Antiviral therapy, medicine.disease_cause, Gastroenterology, Polyethylene Glycols, HBV, guidelines, Acute hepatitis, Chronic hepatitis, Settore MED/12 - Gastroenterologia, liver transplantation, Hepatitis C, Recombinant Proteins, acute hepatitis, antiviral therapy, chronic hepatitis, cirrhosis, elderly patients, hbv, hcv, hdv, hiv, CLINICAL PRACTICE GUIDELINES, Cirrhosis, HCV, Drug Therapy, Combination, Antiviral therapy Acute hepatitis Chronic hepatitis,Cirrhosis, Elderly patients, HBV, HCV, HDV, HIV Liver transplantation, Elderly patient, Acute hepatiti, medicine.medical_specialty, Genotype, Alpha interferon, Interferon alpha-2, CHRONIC HEPATITIS C, Antiviral Agents, Hepatitis B, Chronic, Internal medicine, HDV, Drug Resistance, Viral, Ribavirin, medicine, Humans, Cirrhosi, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, Interferon-alpha, HIV, Hepatitis C, Chronic, medicine.disease, Elderly patients, Family medicine, Expert opinion, Chronic hepatiti, business
Abstract

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies.

Published
2010

15. Current practice of hepatitis C treatment in Southern Italy

Author

Stroffolini, T, Spadaro, Aldo, Guadagnino, V, Cosentino, S, Fatuzzo, F, Galdieri, A, Cacopardo, B, Scalisi, I, Sapienza, M, Russello, M, Scifo, G, Frugiuele, P, Foti, G, Almasio, Pl, Morace, Carmela, Stroffolini, T, Spadaro, A, Guadagnino, V, Cosentino, S, Fatuzzo, F, Galdieri, A, Cacopardo, B, Scalisi, I, Sapienza, M, Russello, M, Scifo, G, Frugiuele, P, Foti, G, and Almasio, PL

Subjects
Adult, Male, medicine.medical_specialty, Multivariate analysis, Hepatitis C virus, Alcohol abuse, Hepacivirus, Interferon alpha-2, medicine.disease_cause, Antiviral Agents, Polyethylene Glycols, Treatment Refusal, Sex Factors, Internal medicine, Ribavirin, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Hepatology, business.industry, Gastroenterology, Antiviral therapy, Interferon-alpha, Alanine Transaminase, Hepatitis C, Hepatitis C Antibodies, Middle Aged, medicine.disease, Recombinant Proteins, Alcoholism, Treatment Outcome, Italy, Current practice, Immunology, HCV, Hcv treatment, Educational Status, RNA, Viral, Female, business
Abstract

Background Only a small proportion of subjects referring to hospitals for hepatitis C virus (HCV) positivity receives antiviral therapy. Aim To evaluate the rate of antiviral treatment and the causes for no treatment in HCV-RNA positive subjects seen in hospital settings. Patients and methods A prospective study enrolling over a 6-month period (February–July 2009) all consecutive anti-HCV positive subjects initially referred (naive patients) to 12 liver units in Southern Italy for HCV treatment. Results Out of 608 subjects evaluated, 74 (12.2%) had no detectable HCV-RNA in the serum and thus were excluded. Of the remaining 534 HCV-RNA positive subjects, 357 (66.9%) were not treated for the following reasons: 49.9% were older than 65 years of age (75% of them >70 years), 14.3% had normal liver enzymes, 13.2% had compensated/decompensated cirrhosis, 10.4% refused treatment, 9.8% had ongoing substance or alcohol abuse. Multivariate analysis showed that females (O.R. 2.27; C.I. 95% 1.05–4.90) and subjects with low educational level (O.R. 4.38; C.I. 95% 1.27–15.11) were more likely to decline therapy. Conclusions The majority of patients with HCV infection does not receive antiviral treatment. The effectiveness of the current standard therapy for HCV infection is low despite its good efficacy.

Published
2010

16. Retrospective, observational, multicentre study on an Italian population affected by chronic hepatitis C who failed to clear HCV-RNA after the combined therapy (PEG-IFN and ribavirin): NADIR study

Author

Morisco, F, Stroffolini, T, Medda, E, Amoruso, Dc, Almasio, Pl, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, NADIR Study Group, Aceti, A, Amaddeo, G, Ancarani, F, Arcuri, P, Attili, A, Bandiera, F, Bellati, G, Benigno, R, Benini, F, Bombardieri, G, Bruno, S, Capretti, A, Carrara, M, Cottone, C, Cozzolongo, R, Demelia, L, Di Gaetano, G, Esposito, P, Fanelli, G, Gaeta, Gb, Giannini, Eg, Giorgini, A, Grieco, A, Guadagnino, V, Lanzini, A, Lo Bello, S, Lupo, S, Maracci, M, Marchi, S, Martines, D, Mazzella, G, Miele, L, Milan, M, Milani, S, Minoli, G, Montalto, G, Morrone, A, Nosotti, L, Paroli, M, Pastore, G, Persico, Marcello, Piccinino, F, Pinzello, Gb, Pozzi, M, Roffi, L, Russello, M, Russo, M, Sagnelli, E, Savarino, V, Soccorsi, F, Squadrito, G, Tabone, M, Tarsetti, F, Tesini, Em, Testa, R, Tripi, S, Gianfranca, S, Vandelli, C, Zignego, A. L., Morisco, F., Stroffolini, T., Medda, E., Amoruso, D. C., Almasio, P. L., Villa, E., Zuin, M., Paris, B., Stanzione, M., Caporaso, N., Nadir Study Group, Mazzella, Giuseppe, Morisco, F, Stroffolini, T, Medda, E, Amoruso, DC, Almasio, PL, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, Montalto, G, Morisco, Filomena, T., Stroffolini, E., Medda, D. C., Amoruso, P. L., Almasio, E., Villa, M., Zuin, B., Pari, M., Stanzione, and Caporaso, Nicola

Subjects
Adult, Male, non-responders, relapser, Genotype, body mass index, cirrhosis, hepatitis c virus, nonresponder, pegylated-interferon, Infectious Disease, Hepacivirus, virus, Interferon alpha-2, Antiviral Agents, Polyethylene Glycol, Polyethylene Glycols, Medication Adherence, hepatitis C, Risk Factors, Retrospective Studie, Virology, Ribavirin, Humans, Age Factor, Treatment Failure, Retrospective Studies, Aged, Antiviral Agent, Settore MED/12 - Gastroenterologia, HCV, Antiviral therapy, Body mass index, Cirrhosis, Hepatitis C virus, Nonresponder, Pegylated-interferon, Relapser, Cirrhosi, Hepaciviru, Hepatology, Risk Factor, Age Factors, Interferon-alpha, Hepatitis C, Chronic, Middle Aged, Recombinant Protein, Recombinant Proteins, Italy, RNA, Viral, Female, Hepatitis C viru, Human
Abstract

There is a lack of information on the characteristics of patients with chronic hepatitis C virus infection (HCV) who fail to respond to antiviral treatment. We studied HCV-positive subjects with chronic liver diseases treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) who failed to clear HCV in routine clinical practice. A total of 2150 consecutive adult patients treated with PEG-IFN plus RBV therapy in 46 Italian centres between 1 July 2004, and 30 June 2005, were studied. Of the 2150 patients, 923 (42.9%) (M/F 585/335, mean age 54.8 years) failed to achieve a serum HCV-RNA clearance. Of these 923 patients, 429 (46.5%) were nonresponders, 298 (32.3%) relapsers, 168 (18.2%) drop-outs for noncompliance or adverse events and 28 (3.0%) were lost during follow-up. Overall, 642 (70.6%) patients received adequate therapy (defined as more than 80% of the drug doses for >80% of the time). Genotypes 1-4 were observed in 76.9% of cases; genotypes 2-3 in 21.2% and mixed in 1.9%, respectively. Multiple logistic regression analysis identified genotypes 1 and 4 as the sole independent predictors of the likelihood of nonresponse to therapy compared with relapse (OR: 4.38; 95% CI = 2.28-8.4). Age older than 65 years was the sole independent factor associated with no adherence to therapy (OR: 2.22; 95% CI = 1.36-3.62). Patients who fail to respond to treatment are a nonhomogeneous population with different features, and the sole factor that discriminates nonresponse from relapse is the distribution of genotypes 1-4. Co-morbidities are unable to determine the type of treatment failure and inadequate adherence to therapy mostly affects patients older than 65 years of age. © 2009 Blackwell Publishing Ltd.

Published
2010

17. Determinants of virologic and immunologic outcomes in chronically HIV-infected subjects undergoing repeated treatment interruptions: The Istituto Superiore di Sanità-Pulsed Antiretroviral Therapy (ISS-PART) study

Author

Palmisano, L., Giuliano, M., Bucciardini, R., Fragola, V., Andreotti, M., Galluzzo, C. M., Pirillo, M. F., Weimer, L. E., Arcieri, R., Germinario, E. A. P., Amici, R., Mancini, M. G., D'Arminio Monforte, A., Castelli, F., Caramello, P., Vella, S., Abrescia, N., Figoni, M., Viglietti, R., Angarano, G., Saracino, A., Anselmo, M., Antinori, A., Sette, P., Zaccarelli, M., Liuzzi, G., Arlotti, M., Martelli, L. T., Ortolani, P., Bassetti, D., Di Biagio, A., Bisio, F., Bellissima, P., Branz, F., Dorigoni, N., Cadeo, G., Vangi, D., Bertelli, D., Bergamasco, A., Caggese, L., Volonterio, A., Orofino, G. C., Carosella, S., Gennero, L., Caremani, M., Tacconi, D., Carosi, G., Tomasoni, L., Patroni, A., Chiodo, F., Borderi, M., Calza, L., Gritti, F., Fasulo, G., Chirianni, A., Gargiulo, M., Colomba, A., Dalle Nogare, E. R., Di Lorenzo, F., Prestileo, T., Bini, T., Cicconi, P., De Lalla, F., Giordani, M. T., De Stefano, C., De Stefano, G., Delia, S., Ciardi, M., Di Perri, G., Sinicco, A., Sales, P., Dini, M., Simeone, M., Esposito, R., Guaraldi, G., Beghetto, B., Fatuzzo, F., La Rosa, R., Ferrari, C., Calzetti, C., Ferraro, T., Cosco, L., Ghinelli, F., Sighinolfi, L., Guadagnino, V., Caroleo, B., Izzi, A., Izzo, C., Franco, A., Lazzarin, A., Castagna, A., Fusetti, G., Leoncini, F., Pozzi, M., Sbaragli, S., Marzetti, M., Magnani, G., Bonazzi, L., Barchi, E., Zoboli, G., Pintus, A., Mandas, A., Soddu, M. L., Zucca, F., Mannucci, P. M., Gringeri, A., Marani Toro, G., Graziani, R. V., Consorti, A., Mazzotta, F., Di Pietro, M., Ble, C., Meneghetti, F., Sasset, L., Cattelan, A. M., Menichetti, F., Savalli, E., Mian, P., Pristera, R., Mignani, E., Artioli, S., Mura, M. S., Mannazzu, M., Narciso, P., Bellagamba, R., Orani, A., Perini, P., Ortona, L., De Luca, A., Murri, R., Pagano, G., Alessandrini, A., Paladini, A., Vinattieri, M. A., Carbonai, S., Pastore, G., Ladina, N., Tateo, M., Piersantelli, N., Penco, G., Petrelli, E., Balducci, M., Pippi, L., Gonnelli, A., Puppo, F., Murdaca, G., Raise, E., Pasquirucci, A., Riccio, G., Bartolacci, V., Carrega, G., Rizzardini, G., Migliorino, G., Russo, R., Casentino, S., Celesia, M., Soranzo, M. L., Macor, A., Salassa, B., Soscia, F., Roberti, L., Di Toro, M. T., Stagno, A., Beltrami, C., Suter, F., Maggiolo, F., Ripamonti, D., Tantimonaco, G., Grisorio, B., Tassara, A., Rossi, P., Tinelli, M., Regazzetti, A., Tirelli, U., Voltaggio, G., Cinelli, R., Toti, M., Baldari, M., Carli, T., Ricciardi, B., Trezzi, M., Vigevani, G. M., Capetti, A., Landonio, S., Vullo, V., Massetti, P., Zauli, T., and Casolari, S.

Subjects
Adult, Male, medicine.medical_specialty, Anti-HIV Agents, medicine.medical_treatment, HIV Infections, Drug resistance, Drug Administration Schedule, law.invention, Randomized controlled trial, Drug Resistance, Multiple, Viral, law, Internal medicine, medicine, Humans, Pharmacology (medical), Protease inhibitor (pharmacology), Structured treatment interruptions, Chemotherapy, Reverse-transcriptase inhibitor, biology, business.industry, HIV, Middle Aged, biology.organism_classification, CD4 Lymphocyte Count, Clinical trial, Chronic infection, Regimen, Infectious Diseases, Immunology, Lentivirus, RNA, Viral, Female, business, medicine.drug
Abstract

Background: Factors influencing the outcome of structured treatment interruptions (STIs) in HIV chronic infection are not fully elucidated. Methods: In ISS-PART, 273 subjects were randomly assigned to arm A (137 assigned to continuous highly active antiretroviral therapy [HAART]) and arm B (136 assigned to 5 STIs of 1, 1, 2, 2, and 3 months'duration, each followed by 3 months of therapy). Main outcome measures were the proportion of subjects with a CD4 count >500 cells/mm 3 , the rate of virologic failure, and the emergence of resistance at 24 months. Results: The proportion of subjects with a CD4 count >500 cells/mm 3 was higher in arm A than in arm B (86.5% vs. 69.1%; P = 0.0075). Pre-HAART CD4 cell count and male gender were independent predictors of a CD4 count >500 cells/mm 3 in arm B. The overall risk of virologic failure was not increased in arm B; however, it was higher in the 38 subjects who had resistance mutations in the rebounding virus. Archived mutations at baseline and the use of a regimen that included an unboosted protease inhibitor (PI), compared with nonnucleoside reverse transcriptase inhibitor-based HAART, independently predicted the emergence of plasma mutations during STI (P = 0.002 for DNA mutations and P = 0.048 for PI-based HAART). Conclusions: Our results suggest that patients with preexisting mutations and treated with unboosted PI-based HAART should not be enrolled in studies of time-fixed treatment interruptions, being at higher risk of developing plasma mutations during STI and virologic failure at therapy reinstitution.

Published
2007

18. Tuberculosis in HIV-infected persons in the context of wide availability of highly active antiretroviral therapy

Author

Girardi, E., Antonucci, G., Vanacore, P., Palmieri, F., Matteelli, A., Iemoli, E., Carradori, S., Salassa, B., Pasticci, M. B., Raviglione, M. C., Ippolito, G., Babudieri, S., Bassetti, M., Rosso, R., Carbonara, S., Celesia, B. M., Chirianni, A., Di Perri, G., Fabietti, P., Gabutti, A., Guadagnino, V., Manfrin, V., Zacchini, F., Burzacchini, F., Giacometti, A., Tassara, A., Traverso, A., Giorni, P., Gobbi, M., Mariani, R., Di Gennaro, G., Panella, L., Losappio, R., Beltrami, C., Costigliola, P., Fasulo, G., Moling, O., Bertelli, D., Tedoldi, S., Potenza, D., Manconi, P. E., Zichichi, S., Nacca, C., Fatuzzo, F., La Rosa, R., Galvagna, S., Grosso, C., Vecchiet, J., Longoni, E., Guaglianone, L., Pan, A., Pellicano, S., Raineri, G., Ferrara, S., Anzalone, E., Gallo, A., Cataldini, S., Dodi, F., Petronio, A., Salone, G., De Luca Andrioli, E. P., De Checchi, G., Villa, M., Pardelli, R., Tardio, A., Urbani, C., Gattuso, G., Matini, L., Casciano, G., Loschiavo, F., Errante, I., Giani, G., Meraviglia, P., Molteni, C., Guaraldi, G., Foresti, S., Abbrescia, N., Izzo, C., Filippini, P., Noce, S., Dalle Nogare, E. R., Farinella, E., Sacchi, P., Scudeller, L., Petrelli, E., Alterio, L., Paolillo, F., Savalli, E., Doria, R., Catalani, M., Brizzi, M., Storaci, N., Natalini Raponi, G. P., Martelli, L. T., Grisetti, S., Lanini, S., and Santopadre, P.

Subjects
Male, Epidemiology, Antitubercular Agents, Severity of Illness Index, Cohort Studies, Antiretroviral Therapy, Highly Active, Prospective Studies, Sida, biology, Incidence (epidemiology), Incidence, Antiretroviral therapy, HIV infection, Italy, Multicenter study, Tuberculosis, AIDS-Related Opportunistic Infections, Adult, Age Distribution, Chi-Square Distribution, Female, Follow-Up Studies, Humans, Logistic Models, Middle Aged, Sex Distribution, Statistics, Nonparametric, Survival Rate, Treatment Outcome, Tuberculosis, Pulmonary, Statistics, virus diseases, Pulmonary, Cohort study, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Antiretroviral Therapy, Context (language use), Acquired immunodeficiency syndrome (AIDS), Tuberculosis diagnosis, Internal medicine, medicine, Highly Active, Nonparametric, business.industry, medicine.disease, biology.organism_classification, Immunology, business
Abstract

Highly active antiretroviral therapy (HAART) greatly reduces the risk of developing tuberculosis for HIV-infected persons. Nonetheless, HIV-associated tuberculosis continues to occur in countries where HAART is widely used. To identify the characteristics of HIV-infected persons who develop tuberculosis in the context of the availability of HAART, the current authors analysed data taken from 271 patients diagnosed, in Italy, during 1999-2000. These patients represent 0.7% of the 40,413 HIV-infected patients cared for in the clinical units participating in this current study. From the data it was observed that 20 patients (7.4%) had a previous episode of tuberculosis whose treatment was not completed. Eighty-one patients (29.9%) were diagnosed with HIV at tuberculosis diagnosis, 108 (39.8%) were aware of their HIV status but were not on antiretroviral treatment and 82 (30.3%) were on antiretroviral treatment. Patients on antiretroviral treatment were significantly less immunosuppressed than patients with HIV diagnosed concurrently with tuberculosis, or other patients not on antiretrovirals (median CD4 lymphocytes count: 220 cells x mm(-3) versus 100 cells x mm(-3), and 109 cells x mm(-3), respectively). No significant differences in clinical presentation of tuberculosis according to antiretroviral therapy status were recorded. Failure of tuberculosis control interventions (e.g. noncompletion of treatment) and of HIV care (delayed diagnosis of HIV infection and suboptimal uptake of therapy) may contribute to continuing occurrence of HIV-associated tuberculosis in a country where highly active antiretroviral therapy is largely available. However, a significant proportion of cases occur in patients who are on antiretroviral treatment.

Published
2004

19. 929 HEPATITIS C VIRUS INFECTION IN AN ENDEMIC SOUTHERN AREA OF ITALY 14 YEARS LATER: EVIDENCE FOR A VANISHING INFECTION

Author

Guadagnino, V., primary, Stroffolini, T., additional, Caroleo, B., additional, Ippolito, F. Menniti, additional, Rapicetta, M., additional, Ciccaglione, A.R., additional, Chionne, P., additional, Madonna, E., additional, Costantino, A., additional, De Sarro, G., additional, Foca, A., additional, Lentini, M., additional, and Staltari, O., additional

Published
2012
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21. Clinical presentation and natural history of chronic persistent hepatitis. A multicentre retrospective study on 1197 cases

Author

Giusti, G, Galanti, B, Gaeta, G. B., Sagnelli, E, Piccinino, F, Ruggiero, G, Ascione, A, Linardi, C, Bianco, C, Borgia, C, Guadagnino, V, Bortolotti, F, Fattovich, Giovanna, Brunetto, M, Cesaro, G, Chiaramnonte, M, Floreani, A, Coltorti, M, Dioguardi, S. F., Oldano, S, Frezza, M, Giacchino, R, Navone, C, Terragna, A, Gottardi, E, Maggiore, G, Maio, G, Milella, M, Pastore, G, Santantonio, T, Scalisi, I, Vassallo, R, and Zancan, L.

Subjects
chronic persistent hepatitis, natural history, retrospective cohort study
Published
1991

24. A randomized controlled trial of pegylated interferon alpha-2a (40 KD) or interferon alpha-2a plus ribavirin and amantadine vs interferon alpha-2a and ribavirin in treatment-naive patients with chronic hepatitis C

Author

Mangia, A., primary, Ricci, G. L., additional, Persico, M., additional, Minerva, N., additional, Carretta, V., additional, Bacca, D., additional, Cela, M., additional, Piattelli, M., additional, Annese, M., additional, Maio, G., additional, Conte, D., additional, Guadagnino, V., additional, Pazienza, V., additional, Festi, D., additional, Spirito, F., additional, and Andriulli, A., additional

Published
2005
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25. A randomised controlled trial on pegylated interferon alfa-2a (40kd) (Pegasys) or IFN alfa-2a (ROFERON-A) plus ribavrin (RBV) and amantadine (AMA) vs IFN alfa-2a and RBV in naïve patients with chronic HCV

Author

Mangia, A., primary, Ricci, G.L., additional, Minerva, N., additional, Persico, M., additional, Carretta, V., additional, Bacca, D., additional, Cela, M., additional, Piattelli, M., additional, di Festi, D., additional, Annese, M., additional, Guadagnino, V., additional, Spirito, F., additional, and Andriulli, A., additional

Published
2003
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27. CMV and atherosclerosis

Author

Guadagnino, V., primary, Procopio, B., additional, Izzi, A., additional, Costa, C., additional, Del Giudice, A.C., additional, Scerbo, P., additional, Giancotti, A., additional, and Pujia, A., additional

Published
1997
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32. A randomized controlled trial of pegylated interferonα-2a (40 KD) or interferonα-2a plus ribavirin and amantadinevsinterferonα-2a and ribavirin in treatment-naïve patients with chronic hepatitis C.

Author

Mangia, A., Ricci, G. L., Persico, M., Minerva, N., Carretta, V., Bacca, D., Cela, M., Piattelli, M., Annese, M., Maio, G., Conte, D., Guadagnino, V., Pazienza, V., Festi, D., Spirito, F., and Andriulli, A.

Subjects
HEPATITIS C virus, AMANTADINE, RIBAVIRIN, INTERFERONS, ANTIVIRAL agents, HEPATITIS C, IMMUNOTHERAPY
Abstract

We determined whether triple therapy comprising amantadine (AMA), ribavirin (RBV) and either peginterferon (PEG-IFN)α-2a or conventional IFNα-2a would improve sustained virological response (SVR) rates over dual therapy with IFNα-2a and RBV in patients with chronic HCV infection. A total of 362 treatment-naïve patients were randomized to 48 weeks of treatment with: PEG-IFNα-2a 180 μg/week (group A) or IFNα-2a 3 MU tiw (groups B and C). All patients received RBV 1000 or 1200 mg/day and those in groups A and B received AMA 200 mg/day. SVR was defined as an undetectable HCV RNA after 24 weeks of untreated follow-up. At the end of therapy, 74.4% (95% CI 0.66–0.82) of patients in group A were HCV RNA-negative compared with 42.5% (95% CI 0.33–0.50) of those in group B (P = 0.0001) and 48.8% (95% CI 0.40–0.56) of those in group C. SVR was achieved in a significantly greater proportion of patients in group A compared with groups B and C: 65.3% (95% CI 0.53–0.56), 33.3% (95% CI 0.25–0.41) and 44.6% (95% CI 0.36–0.53;P = 0.0001) respectively. In patients with genotype 1, SVR rates were 55.2, 22.8 and 28.8% with the three regimens respectively. Factors independently associated with SVR were HCV genotype 2 or 3, therapy with PEG-IFN, female gender and age. In treatment-naïve patients with chronic hepatitis C, triple therapy with PEG-IFNα-2a, RBV and AMA produces higher SVR than dual or triple therapy with conventional IFNα-2a. [ABSTRACT FROM AUTHOR]

Published
2005
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34. Prophylaxis of Hepatitis C with Intramuscular Immunoglobulin: Clinical and Economic Appraisal.

Author

Palumbo, F., Piazza, M., Manzin, A., Sagliocca, L., Clementi, M., Tosone, G., Guadagnino, V., Stazi, M.A., Orlando, R., Borgia, G., Rosa, D., and Abrignani, S.

Subjects
HEPATITIS C, IMMUNOGLOBULINS
Abstract

Hepatitis C virus (HCV) affects millions of individuals worldwide. In most cases, HCV infection progresses to chronic liver disease and, subsequently, to liver cirrhosis and hepatocellular carcinoma. HCV is transmitted by the parenteral route, for example by transfusion of blood or blood products, injection during drug abuse, etc., and by the inapparent parenteral route (penetration of the virus through difficult-to-identify microlesions present on the skin or mucosae), for example, sexual exposure or household exposure to infected contacts, etc. The cost of chronic hepatitis C and its sequelae is high in both financial and human terms. At present, only anti-HCV screening of blood/organ/tissue donors and universal precautions for the prevention of blood-borne infections are recommended for HCV prevention. Before the discovery of the main aetiological agent of non-A, non-B hepatitis (HCV), several randomised controlled clinical trials demonstrated that standard intramuscular immunoglobulin exerted a preventive effect on post-transfusional and sexual and /or horizontal transmission of non-A, non-B hepatitis. When serological tests for HCV infection became available, bimonthly inoculation of standard unscreened intramuscular immunoglobulin (prepared from plasma pools containing about 2% of anti-HCV-positive units) was demonstrated to significantly prevent sexually transmitted HCV infection. The immunoglobulin used contained high titres of anti-HCV neutralising antibodies (anti-E2 neutralisation of binding assay), whereas currently available commercial screened immunoglobulin (prepared from anti-HCV-negative blood units) did not. This finding suggested that anti-HCV neutralising antibodies are concentrated only in anti-HCV-positive units (which are currently discarded). Thus, anti-HCV hyperimmune globulin (HCIg) can be produced only from anti-HCV-positive units. The neutralising titre can be increased by the exclusive use of units with higher titres of neutralising antibodies. Unlike other hyperimmune globulins, which are produced from a limited number of selected donors, HCIg should be produced from a large number of units so as to contain neutralising antibodies to the different HCV strains. HCIg will have a number of advantages: (i) it is easy to produce and inexpensive; (ii) it has a long half-life, allowing infrequent administration; (iii) new additional viral inactivation procedures have been introduced to eradicate transmission of infection, and (iv) it may be possible to neutralise all the emerging HCV strains. HCIg could be used in all individuals at risk of HCV infection (sexual partners, haemodialysis patients, etc), in preventing reinfection of transplanted livers, and perhaps also in the treatment of chronic hepatitis C, alone or associated with other drugs. [ABSTRACT FROM AUTHOR]

Published
1999

38. [HBsAg (hepatitis B virus surface antigen) contamination in the dental environment]

Author

Piazza M, Valletta G, Picciotto L, Guadagnino V, Borgia G, Nappa S, Battagliese G, Matarasso S, Sammartino G, Alberto Laino, M., Piazza, G., Valletta, L., Picciotto, V., Guadagnino, Borgia, Guglielmo, Nappa, Salvatore, G., Battagliese, S., Matarasso, Sammartino, Gilberto, and Laino, Alberto

Subjects
Dental Instruments, Hepatitis B Surface Antigens, Italy, Carrier State, Dental Offices, Environmental Microbiology, Equipment Contamination, Humans, Hepatitis B, Dental Equipment
Published
1987

39. Epatite cronica persistente: risultati preliminari di uno studio multicentrico italiano

Author

Giusti, G., Gaeta, G. B., Galanti, B., Gallo, C., Piccinino, F., Ruggiero, G., Sagnelli, E., Ascione, A., Bianco, S., Borgia, G., Bortolotti, F., Brunetto, M., Cacciatore, L., Cesaro, G., Chiaramonte, M., Coltorti, M., Cozzolino, G., Dioguardi, F. S., Fattovich, Giovanna, Floreani, A., Frezza, M., Giacchino, R., Gottardi, E., Guadagnino, V., Linardi, C., Maggiore, G., Maio, G. G., Milella, M., Navone, C., Oldani, S., Pastore, G., Santantonio, T., Scalisi, I., Terragna, A., Vassallo, R., and Zancan, L.

Subjects
epatite cronica persistente, studio multicentrico, epatite cronica virale, prognosi
Published
1986

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