51 results on '"Maria Stella Mura"'
Search Results
2. Tuberculosis Screening before Anti–Hepatitis C Virus Therapy in Prisons
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Sergio Babudieri, Andrea Soddu, Monica Murino, Paola Molicotti, Alberto A. Muredda, Giordano Madeddu, Alessandro G. Fois, Stefania Zanetti, Pietro Pirina, and Maria Stella Mura
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tuberculosis and other mycobacteria ,purified protein derivative ,PPD ,hepatitis C virus ,HCV ,prisons ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Published
- 2012
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3. Timing of antiretroviral therapy initiation after a first AIDS-defining event: temporal changes in clinical attitudes in the ICONA cohort.
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Antonella Cingolani, Alessandro Cozzi-Lepri, Adriana Ammassari, Cristina Mussini, Maria Alessandra Ursitti, Pietro Caramello, Gioacchino Angarano, Paolo Bonfanti, Andrea De Luca, Maria Stella Mura, Enrico Girardi, Andrea Antinori, Antonela D'Arminio Monforte, and Icona Foundation Study group
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Medicine ,Science - Abstract
BackgroundTime of starting antiretroviral therapy (ART) after diagnosis of specific AIDS-defining event (ADE) is a crucial aspect. Objectives of this study were to evaluate if in patients diagnosed with ADE the time to ART initiation may vary according to year of diagnosis and type of ADE.MethodsAll HIV+ persons diagnosed with an ADE over the 6 months prior to or after enrolment in the Icona Foundation study cohort and while ART-naive were grouped according to type of diagnosis: Those with ADE requiring medications interacting with ART [group A], those with ADE treatable only with ART [B] and other ADE [C]. Survival analysis by Kaplan-Meier was used to estimate the percentage of people starting ART, overall and after stratification for calendar period and ADE group. Multivariable Cox regression model was used to investigate association between calendar year of specific ADE and time to ART initiation.Results720 persons with first ADE were observed over 1996-2013 (group A, n=171; B, n=115; C, n=434). By 30 days from diagnosis, 27% (95% CI: 22-32) of those diagnosed in 1996-2000 had started ART vs. 32% (95% CI: 24-40) in 2001-2008 and 43% (95% CI: 33-47) after 2008 (log-rank p=0.001). The proportion of patients starting ART by 30 days was 13% (95% CI 7-19), 40% (95% CI: 30-50) and 38% (95% CI 33-43) in ADE groups A, B and C (log-rank p=0.0001). After adjustment for potential confounders, people diagnosed after 2008 remained at increased probability of starting ART more promptly than those diagnosed in 1996-1999 (AHR 1.72 (95% CI 1.16-2.56).ConclusionsIn our "real-life" setting, the time from ADE to ART initiation was significantly shorter in people diagnosed in more recent years, although perhaps less prompt than expected.
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- 2014
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4. Durability of different initial regimens in HIV-infected patients starting antiretroviral therapy with CD4+ counts <200 cells/mm3 and HIV-RNA >5 log10 copies/mL
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Bruno Cacopardo, M. A. Ursitti, Claudio Maria Mastroianni, Emanuele Nicastri, R. Piolini, A. Antinori, Giustino Parruti, S. Truffa, Ivan Gentile, Giovanni Cassola, E. Girardi, I. Caramma, Andrea Calcagno, Laura Monno, A d'Arminio Monforte, R. Acinapura, Francesca Ceccherini-Silberstein, A. Di Biagio, Gabriella Verucchi, Alessandra Latini, Simone Marcotullio, Nicola Gianotti, C. Balotta, Camilla Tincati, M. C. Moioli, Alessandro Tavelli, Pietro Caramello, Carmen Rita Santoro, C. Abeli, A. Londero, F. Di Martino, R. Iardino, Stefano Bonora, M. Andreoni, A. Costantini, Raffaella Libertone, F. von Schloesser, G. Prota, Annalisa Saracino, Maria Grazia Cecchetto, Antonio Cristaudo, Mauro Zaccarelli, Carmela Pinnetti, Fabrizio Carletti, N. Abrescia, Andrea Giacometti, L. Gallo, Paolo Bonfanti, G. Angarano, E. Quiros Roldan, G. Pellizzer, F. Petrone, Giovanni Mazzarello, Silvia Nozza, R. Orlando, Franco Baldelli, Giovanni Guaraldi, Paola Meraviglia, Laura Sighinolfi, S. Carrara, D. Segala, Giuliano Rizzardini, C. Suardi, P. Piano, Mauro Sciandra, Daniela Francisci, A. De Luca, Patrizia Lorenzini, Paola Cinque, Tiziana Quirino, S. Graziano, Cristina Mussini, Massimo Galli, Giuseppe Ippolito, S. Lo Caputo, Benedetto Maurizio Celesia, C. Valeriani, Matteo Bassetti, Maria Rosaria Capobianchi, Claudio Viscoli, Vinicio Manfrin, Alessandro Chiodera, Alessandra Bandera, Guglielmo Borgia, Cinzia Puzzolante, Stefano Rusconi, Leonardo Calza, Valeria Belvisi, Francesca Vichi, Serena Quartu, Roberto Cauda, J. Vecchiet, Antonio Chirianni, A. Di Caro, P.E. Manconi, Stefania Cicalini, G. Magnani, M. Lichtner, Milensu Shanyinde, Stefano Savinelli, M. Puoti, Giulia Marchetti, Laura Carenzi, Carlo Federico Perno, Annalisa Ridolfo, G. Di Perri, F. Maggiolo, A Castagna, G. Orofino, Roberto Rossotti, Francesco Mazzotta, Gianmaria Baldin, Giovanni Lapadula, A. Rodano, V. Donati, Barbara Rossetti, F. Viviani, Adriana Ammassari, N. Bobbio, Adriano Lazzarin, C. Minardi, A. Alessandrini, Katia Falasca, Maria Stella Mura, Tamara Ursini, Andrea Gori, A. Cingolani, L. Maddaloni, Alessandro Cozzi-Lepri, Francesco Castelli, Iuri Fanti, Giordano Madeddu, E. Quiros, P. Viale, Marco Borderi, M. Capozzi, and Vincenzo Vullo
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Anti-HIV Agents ,Hepatitis C virus ,Renal function ,Integrase inhibitor ,HIV Infections ,medicine.disease_cause ,Rate ratio ,03 medical and health sciences ,0302 clinical medicine ,Antiretroviral Therapy, Highly Active ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Pharmacology (medical) ,Treatment Failure ,030212 general & internal medicine ,Retrospective Studies ,Pharmacology ,AIDS-Related Opportunistic Infections ,Coinfection ,business.industry ,Retrospective cohort study ,Middle Aged ,Viral Load ,030112 virology ,CD4 Lymphocyte Count ,Discontinuation ,Treatment Outcome ,Infectious Diseases ,Cohort ,Female ,business - Abstract
ObjectivesOur aim was to investigate the durability of different initial regimens in patients starting ART with CD4+ counts 5 log10 copies/mL.MethodsThis was a retrospective study of HIV-infected patients prospectively followed in the ICONA cohort. Those who started ART with boosted protease inhibitors (bPIs), NNRTIs or integrase strand transfer inhibitors (InSTIs), with CD4+ 5 log10 copies/mL, were included. The primary endpoint was treatment failure (TF), a composite endpoint defined as virological failure (VF, first of two consecutive HIV-RNA >50 copies/mL after 6 months of treatment), discontinuation of class of the anchor drug or death. Independent associations were investigated by Poisson regression analysis in a model including age, gender, mode of HIV transmission, CDC stage, HCV and HBV co-infection, pre-treatment HIV-RNA, CD4+ count and CD4+/CD8+ ratio, ongoing opportunistic disease, fibrosis FIB-4 index, estimated glomerular filtration rate, haemoglobin, platelets, neutrophils, calendar year of ART initiation, anchor drug class (treatment group) and nucleos(t)ide backbone.ResultsA total of 1195 patients fulfilled the inclusion criteria: 696 started ART with a bPI, 315 with an InSTI and 184 with an NNRTI. During 2759 person-years of follow up, 642 patients experienced TF. Starting ART with bPIs [adjusted incidence rate ratio (aIRR) (95% CI) 1.62 (1.29–2.03) versus starting with NNRTIs; P ConclusionsIn patients starting ART with 5 log10 HIV-RNA copies/mL, the durability of regimens based on InSTIs was longer than that of NNRTI- and bPI-based regimens.
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- 2019
5. DNMT1 modulation in chronic hepatitis B patients and hypothetic influence on mitochondrial DNA methylation status during long-term nucleo(t)side analogs therapy
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Giovanni Garrucciu, Alberto Augusto Muredda, Giordano Madeddu, Sergio Babudieri, Ivana Maida, M. Melis, Silvia Ortu, and Maria Stella Mura
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DNA (Cytosine-5-)-Methyltransferase 1 ,Male ,0301 basic medicine ,Guanine ,Methyltransferase ,Bisulfite sequencing ,Organophosphonates ,Biology ,Real-Time Polymerase Chain Reaction ,medicine.disease_cause ,Antiviral Agents ,DNA, Mitochondrial ,Cytosine ,03 medical and health sciences ,Hepatitis B, Chronic ,Virology ,Telbivudine ,medicine ,Humans ,Aged ,Hepatitis B virus ,Adenine ,Lamivudine ,Nucleosides ,Entecavir ,DNA Methylation ,Middle Aged ,Cross-Sectional Studies ,030104 developmental biology ,Infectious Diseases ,Real-time polymerase chain reaction ,DNA methylation ,Leukocytes, Mononuclear ,Reverse Transcriptase Inhibitors ,Female ,Thymidine ,medicine.drug - Abstract
Inhibition of viral replication is the most important goal in patients with Hepatitis B virus chronic infection (CHB). Currently, five oral nucleo(t)side analogs (NAs), including Lamivudine, Adefovir, Telbivudine, Entecavir, and Tenofovir, have been approved for treatment. The widespread use of NAs has also been linked with a progressive growth of unlikely anomaly attributable to mitochondrial dysfunctions, not previously recognized. Here, we explore the hypothesis that NAs may cause persistent epigenetic changes during prolonged NAs therapy in CHB patients. We obtained peripheral blood mononuclear cells (PBMC) from whole blood samples of consecutive patients with chronic HBV infection, 18 receiving NAs and 20 untreated patients. All patients were Caucasian and Italians. Epigenetic analysis was performed by Bisulphite sequencing PCR to search the existence of methylated cytosine residues in the Light (L)-strands of mitochondrial DNA control region (D-loop). Gene expression analysis of DNA methyltransferases 1 was performed by a quantitative relative Real-Time Polymerase Chain Reaction (PCR). DNMT1 expression was significantly (P
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- 2017
6. Could inducible protein-10 and heparin-binding hemagglutinin improve the detection of Mycobacterium tuberculosis-infected subjects in a country with low incidence of tuberculosis ?
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Marina Cubeddu, Alessandra Bua, Maria Stella Mura, Paola Molicotti, Pietro Pirina, Melania Ruggeri, and Stefania Anna Lucia Zanetti
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Microbiology (medical) ,Tuberculosis ,QuantiFERON ,Mycobacterium tuberculosis ,Interferon-gamma ,Latent Tuberculosis ,Lectins ,Medicine ,Interferon gamma ,False Negative Reactions ,Antigens, Bacterial ,General Immunology and Microbiology ,biology ,Tuberculin Test ,business.industry ,Incidence ,Incidence (epidemiology) ,General Medicine ,Hemagglutinin ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Virology ,Chemokine CXCL10 ,Infectious Diseases ,Italy ,Immunology ,Biomarker (medicine) ,Reagent Kits, Diagnostic ,business ,Immunocompetence ,Biomarkers ,Interferon-gamma Release Tests ,medicine.drug ,Mycobacterium - Abstract
Background: This study aimed to evaluate inducible protein-10 (IP-10) as a biomarker besides interferon-gamma (IFN-γ) to improve the identification of active tuberculosis (TB) and latent tubercular infection (LTBI) in a country with a low incidence of TB.Methods: Whole blood from Mycobacterium tuberculosis-infected subjects was stimulated with region-of-difference-1 (RD1)-specific peptides and with heparin-binding hemagglutinin (HBHA) to determine the release of IP-10 and IFN-γ.Results: No statistically significant difference was observed between positive rates of IP-10 and IFN-γ after RD1-specific peptide stimulation in the TB and LTBI groups; a different response was detected in QuantiFERON TB-gold test-negative (QFT–) subjects. A significantly different proportion of positive responses was observed between IP-10 and IFN-γ following HBHA stimulation in the TB group and in the QFT– group but not in the LTBI group.Conclusions: The IP-10 test seemed to identify false-negative QFT results in some su...
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- 2015
7. Proteomic characterization of hepatitis C eradication: Enzyme switch in the healing liver
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Daniela Pagnozzi, P. Nieddu, Maria Pina Dore, Maria Stella Mura, Sergio Uzzau, Andrea Soddu, Alessandro Tanca, Paolo Cossu-Rocca, Maria Filippa Addis, Giordano Madeddu, Sergio Babudieri, and Giovannino Massarelli
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Adult ,Proteomics ,Proteome ,medicine.medical_treatment ,Alpha interferon ,Interferon alpha-2 ,Carbohydrate metabolism ,Pharmacology ,Biology ,Antiviral Agents ,Polyethylene Glycols ,Diabetes Complications ,Insulin resistance ,Downregulation and upregulation ,Virology ,Ribavirin ,medicine ,Humans ,Insulin ,Interferon-alpha ,Lipid metabolism ,Hepatitis C ,medicine.disease ,Recombinant Proteins ,Alcoholism ,Metabolic pathway ,Infectious Diseases ,Liver ,Immunology ,Female - Abstract
Lipid pathway impairment, decrease in the antioxidant pool and downregulation in amino-acid metabolism are just some of the metabolic variations attributed to chronic HCV infection. All of them have been studied separately, mainly in animal models. Thanks to proteomic analysis we managed to describe (for the fist time to the best of our knowledge), in vivo and in humans, the metabolic alterations caused by HCV, and the recovery of the same alterations during HCV treatment. We performed proteomic analysis on liver specimens of a 28-year-old woman affected by hepatitis C genotype 1a, alcoholism and diabetes mellitus type 1, before and after antiviral treatment with pegylated interferon alpha 2b and ribavirin. The subject, thanks to a patient-tailored therapy, reached Sustained Virological Response. Throughout the treatment period the patient was monitored with subsequent biochemical, clinical and psychological examinations. The data obtained by the patient's close monitoring suggest a direct interaction between insulin resistance and an active HCV genotype 1 infection, with a leading role played by the infection, and not by insulin resistance, as demonstrated by the sharp fall of the insulin units needed per day during treatment. The proteomic analysis showed that after therapy, a downregulation of enzymes involved in amino acid metabolism, glycolysis/gluconeogenesis and alcohol catabolism takes place, the latter probably due to cessation of alcohol abuse. On the contrary, the metabolic pathways linked to metabolism of the reactive oxygen species were upregulated after therapy. Finally, a significant alteration in the pathway regulated by peroxisome proliferator-activated receptor alpha (PPARA), a major regulator of lipid metabolism in the liver, was reported. These "real time" data confirm in vivo, in humans, that during HCV infection, the pathways related to fatty acids, glucose metabolism and free radical scavenging are inhibited. The same enzyme deficit is completely recovered after HCV eradication.
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- 2013
8. Mediterranean spotted fever-like illness in Sardinia, Italy: a clinical and microbiological study
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Paola Bagella, Antonello Caddeo, Giuseppe Nunnari, Giordano Madeddu, Sergio Babudieri, Giovanna Masala, Alessandra Ciervo, Giovanni Rezza, Vito Fiore, Maria Stella Mura, and Fabiola Mancini
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0301 basic medicine ,Microbiology (medical) ,Mediterranean climate ,Adult ,DNA, Bacterial ,Male ,medicine.medical_specialty ,030231 tropical medicine ,Rickettsiosis ,Biology ,Sardinia ,Boutonneuse Fever ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Socioeconomics ,Aged ,DNA isolation ,Italy ,Mediterranean spotted fever ,Infectious Diseases ,Public health ,General Medicine ,Anthropization ,Middle Aged ,medicine.disease ,Virology ,Rural environment ,Spotted fever ,Rickettsia conorii ,030104 developmental biology ,Female - Abstract
Rickettsioses represent a group of emerging infectious diseases in Europe. Climate changes and the anthropization of rural environment have favored vectors' biological cycle and geographic spread. In Sardinia, Mediterranean spotted fever (MSF) is endemic and represents an important public health problem.We investigated the etiology and the clinical presentation of MSF-like illness in northern Sardinia by enrolling patients admitted to the Infectious Disease Unit of the University of Sassari.Diagnostic tests included ELISA, Indirect immunofluorescence (IFI), DNA isolation from blood and from eschar samples with real-time PCR and genotyping. Eighty-seven patients with a mean age of 53 ± 14 years, of whom 65 (75 %) males, were included in the study. The most common diagnosis was MSF (79 %), followed by Q fever (8 %), and anaplasmosis (2 %). A tache noire was found in 58 % of rickettioses and 28 % of Coxiella burnetii infections. MSF was confirmed in 47 % of the cases by IFI and 43 % by ELISA antibody tests. The isolation of rickettsial DNA from the eschar was positive in 10/13 (77 %) of the cases due to Rickettsia conorii. Using this method, we identified the first case of R. monacensis infection in Italy.In conclusion, antibody-based tests confirmed the diagnosis in less than 50 % of the cases, whereas DNA isolation confirmed the diagnosis in 77 % of tested cases and allowed the identification of a new pathogenic species in Italy. Therefore, DNA isolation should be implemented to better identify the etiology of MSF-like illnesses and help the clinician in the management of patients.
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- 2016
9. Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy
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Luciana Contini, Giulia Bertoli, Ivana Maida, M Mannazzu, Riccardo Are, Anna Miscali, Giovanna Maria Calia, C Lovigu, Fiorenzo Delogu, Maria Stella Mura, Giordano Madeddu, Sergio Babudieri, Alberto Augusto Muredda, and Salvatore Rubino
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Rome ,Disease ,030501 epidemiology ,medicine.disease_cause ,Microbiology ,Sierra leone ,Hospitals, University ,03 medical and health sciences ,0302 clinical medicine ,Virology ,medicine ,Humans ,030212 general & internal medicine ,Ebola virus ,business.industry ,Public health ,General Medicine ,Hemorrhagic Fever, Ebola ,Case management ,University hospital ,Infectious Diseases ,Italy ,Infectious disease (medical specialty) ,Family medicine ,Parasitology ,0305 other medical science ,business ,Developed country ,Case Management - Abstract
Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts.
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- 2016
10. In the ERA of New Direct Acting Antiviral Agents HCV Sequencing Allows the Most Accurate Subtype and Genotype Assignment
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A. Manunta, A. Grieco, Lorenzo Nosotti, D. Di Paolo, Gloria Taliani, Umberto Vespasiani Gentilucci, Carlo Magni, L. Lambiase, Simona Landonio, M. Tontodonati, A. Di Biagio, C.F. Perno, F.P. Antonucci, Gabriella d'Ettorre, Valeria Cento, S. Grieco, Maria Stella Mura, Francesca Ceccherini Silberstein, Cesare Sarrecchia, Dante Romagnoli, Elisabetta Teti, Laura Gianserra, Miriam Lichtner, Giustino Parruti, Aldo Bertoli, F. De Leonardis, Adriano M. Pellicelli, P. Cacciatore, Claudio Maria Mastroianni, Laura Ambra Nicolini, M. Andreoni, Antonio Gasbarrini, Simona Francioso, Sergio Babudieri, Simona Marenco, J. Vecchiet, Martina Milana, Mario Angelico, Caterina Pasquazzi, Ivana Maida, Ilaria Lenci, Valeria Micheli, Antonio Picciotto, Marianna Aragri, Marco Romano, E. D’Amico, Giuliano Rizzardini, Filomena Morisco, V.C. Di Maio, M. Siciliano, Savino Bruno, Marco Ciotti, and M. Puoti
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Genetics ,03 medical and health sciences ,PRECLINICAL CHARACTERISATION OF JNJ-54257099 – A POTENT URIDINE-BASED NUCLEOTIDE POLYMERASE INHIBITOR IN PHASE I CLINICAL DEVELOPMENT FOR THE TREATMENT OF CHRONIC HEPATITIS C ,0302 clinical medicine ,Hepatology ,030220 oncology & carcinogenesis ,Genotype ,030211 gastroenterology & hepatology ,Biology ,Direct acting - Published
- 2016
11. First HAART in HIV-Infected Patients With High Viral Load: Value of HIV RNA Levels at 12 Weeks to Predict Virologic Outcome
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Giovanni Satta, Jesús Troya, Vincent Soriano, Marina Núñez, David L Townsend, Ivana Maida, Aimee M. Wilkin, Maria Stella Mura, Pablo Barreiro, Leticia Pérez-Saleme, and P. Samuel Pegram
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Adult ,Male ,medicine.medical_specialty ,Genotype ,Immunology ,Human immunodeficiency virus (HIV) ,HIV Infections ,Dermatology ,medicine.disease_cause ,Antiretroviral Therapy, Highly Active ,Internal medicine ,Drug Resistance, Viral ,medicine ,Humans ,Hiv infected patients ,In patient ,Longitudinal Studies ,Retrospective Studies ,Proportional hazards model ,business.industry ,Odds ratio ,Middle Aged ,Viral Load ,Virology ,VIROLOGIC FAILURE ,Treatment Outcome ,Infectious Diseases ,Virologic response ,Mutation ,RNA, Viral ,Regression Analysis ,Female ,business ,Viral load - Abstract
The aim of this study is to identify the role of incomplete suppression during the first months of highly active antiretroviral treatment (HAART) to predict virologic failure in patients with high levels of HIV replication. In a retrospective, longitudinal, and multicenter study, response to HAART was assessed in treatment-naive adults with HIV RNA >100 000 copies/mL, and factors predicting failure were analyzed through regression analyses. A total of 118 patients were included. Virologic failure occurred more often in patients with >500 copies/mL at week 12 (Cox regression: Exp (B) 3.22; P = .02). HIV RNA >500 copies/mL at week 12 predicted incomplete virologic response (odds ratio [OR] = 9.33; P = .002] but not viral rebound. Major antiretroviral resistant mutations were present in 11 of 14 patients. HIV RNA >500 copies/mL at week 12 of first HAART predicts incomplete virologic response in patients with high levels of replication at baseline. Most patients carried resistance mutations at the time of failure.
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- 2009
12. Incidence of Neutropenia and Infections During Combination Treatment of Chronic Hepatitis C with Pegylated Interferon Alfa-2a or Alfa-2b Plus Ribavirin
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Baiguera C, G. Dettori, G. Carosi, M.G. Antonini, Maria Stella Mura, Barbara Zanini, Daniela Manno, Ivana Maida, Massimo Puoti, Sergio Babudieri, and L Fenu
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Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Neutropenia ,Adolescent ,Combination therapy ,Neutrophils ,Population ,Hepacivirus ,Interferon alpha-2 ,Infections ,Antiviral Agents ,Gastroenterology ,Polyethylene Glycols ,Leukocyte Count ,chemistry.chemical_compound ,Pegylated interferon ,Interferon ,Internal medicine ,Ribavirin ,medicine ,Humans ,education ,education.field_of_study ,business.industry ,Incidence ,Interferon-alpha ,virus diseases ,General Medicine ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,medicine.disease ,Recombinant Proteins ,Treatment Outcome ,Infectious Diseases ,chemistry ,Immunology ,Absolute neutrophil count ,Drug Therapy, Combination ,Female ,business ,medicine.drug - Abstract
Combination therapy with pegylated interferon (peginterferon) plus ribavirin is associated with several side effects, including neutropenia and infection. To evaluate the incidence of neutropenia and infection between all consecutive patients with hepatitis C who were treated in two centers with peginterferon-alfa-2a and peginterferon-alfa-2b, in combination with ribavirin and actively monitored for occurrence of any infection. A total of 319 consecutive patients with chronic hepatitis C received once-weekly peginterferon alfa-2b at a weight-adjusted dose (n = 162) or peginterferon alfa-2a at a flat dose (n = 157), plus ribavirin. Neutropenia was observed in 53 patients overall (17%). There were 73 infections in 73 subjects (23% of the treated population); 4/73 required hospitalization. Infections included respiratory infections (n = 23), cellulitis (n = 17), dental abscesses (n = 13), gastroenteric infections (n = 2), and other types of infections (n = 18). The incidence of all infections was significantly associated with age, especially over 60 years (p < 0.01) but not with neutropenia or type of pegylated interferon. During the treatment with pegylated interferons and ribavirin, we did not find a correlation between neutropenia and infections. This result provides a support for the notion that current guidelines for pegylated interferons dose reduction in the treatment of chronic hepatitis C for hematologic toxicity could be overly strict.
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- 2008
13. Profile of Patients Triply Infected with HIV and the Hepatitis B and C Viruses in the HAART Era
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Leticia Pérez-Saleme, Sergio Babudieri, Ivana Maida, I. Saldívar-Cornejo, María José Ríos, Marina Núñez, Maria Stella Mura, Belén Ramos, P.S. Pegram, Víctor Sánchez-Margalet, Aimee M. Wilkin, and Vincent Soriano
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Male ,HIV Infections ,Comorbidity ,Hepacivirus ,Virus Replication ,Risk Factors ,Antiretroviral Therapy, Highly Active ,Sida ,biology ,virus diseases ,Middle Aged ,Hepatitis B ,Hepatitis C ,Hepatitis D ,Infectious Diseases ,Anti-Retroviral Agents ,Italy ,HBeAg ,Coinfection ,RNA, Viral ,Female ,Viral disease ,Hepatitis Delta Virus ,Adult ,Hepatitis B virus ,Immunology ,Antiviral Agents ,Virus ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,North Carolina ,medicine ,Humans ,Mexico ,Retrospective Studies ,Hepatitis B Surface Antigens ,business.industry ,HIV ,Hepatitis C Antibodies ,medicine.disease ,biology.organism_classification ,digestive system diseases ,Cross-Sectional Studies ,Viral replication ,Spain ,DNA, Viral ,business - Abstract
HIV-HCV-HBV-coinfected patients were assessed to characterize the viral interactions in the setting of HIV coinfection and in the HAART era. All positive anti-HCV antibody and HBs antigen-positive HIV-infected patients were identified at five HIV clinics. Antihepatitis delta (HDV) antibody, serum HIV RNA, HCV RNA, and HBV DNA quantification and genotype determinations were performed. Out of 67 patients identified 47 (70%) were receiving anti-HBV therapy. HCV RNA and HBV DNA were detectable in 52.5% and 37% of patients, respectively. All possible patterns were found, regardless of anti-HBV therapy. HDV coinfection was associated with undetectable HCV RNA [RR 9.52 (95% CI 1.85-49.01); p = 0.007]. Independent factors predicting undetectable HBV DNA lacked HBeAg [RR 13.94 (95% CI 3.05-63.72); p = 0.001] and use of anti-HBV therapy [RR 11.42 (95% CI 2.43-53.54); p = 0.002]. Replication and genotypes of HCV or HBV had no impact on the replication of the other virus. In conclusion, in this cohort of triple infection (HBV/HCV/HIV) various viral patterns were identified. Spontaneous HCV clearance was frequent, and it was independently associated with HDV coinfection. In the absence of HBV therapy, HBV most often actively replicates. HBV/HCV replication or genotypes were not related to the replication of the other virus.
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- 2008
14. Hepatitis C virus RNA levels at week-2 of telaprevir/boceprevir administration are predictive of virological outcome
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Marianna Aragri, Lorenzo Nosotti, Ilaria Lenci, Massimo Siciliano, Francesco De Leonardis, Massimo Andreoni, Mario Angelico, Carlo Magni, Domenico Di Carlo, Alessandro Mancon, Sergio Babudieri, Cesare Sarrecchia, Adriano Gasbarrini, Francesca Ceccherini-Silberstein, Gloria Taliani, Simona Landonio, Giustino Parruti, Antonio Di Biagio, Velia Chiara Di Maio, M. Tontodonati, Francesco Paolo Antonucci, Valeria Micheli, Valeria Cento, Maria Stella Mura, Carlo Federico Perno, Daniele Di Paolo, Giuliano Rizzardini, Adriano M. Pellicelli, Jacopo Vecchiet, A. Manunta, and Laura Ambra Nicolini
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Male ,NS3 protease inhibitors ,Hepacivirus ,Drug resistance ,medicine.disease_cause ,Gastroenterology ,Polyethylene Glycols ,Telaprevir ,chemistry.chemical_compound ,Viral ,Chronic ,Early response ,Viral kinetics ,Virological failure ,education.field_of_study ,biology ,Middle Aged ,Viral Load ,Prognosis ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,Hepatitis C ,Treatment Outcome ,Combination ,RNA, Viral ,Drug Therapy, Combination ,Female ,Oligopeptides ,Viral load ,medicine.drug ,Adult ,medicine.medical_specialty ,Proline ,Settore MED/12 - GASTROENTEROLOGIA ,Hepatitis C virus ,Population ,Antiviral Agents ,Drug Therapy ,Boceprevir ,Internal medicine ,Ribavirin ,medicine ,Humans ,education ,Hepatology ,business.industry ,Interferon-alpha ,Hepatitis C, Chronic ,biology.organism_classification ,chemistry ,Immunology ,RNA ,business - Abstract
Triple therapy with telaprevir/boceprevir + pegylated-interferon+ribavirin can achieve excellent antiviral efficacy, but it can be burdened with resistance development at failure.To evaluate kinetics of hepatitis C virus (HCV) RNA decay and early resistance development, in order to promptly identify patients at highest risk of failure to first generation protease inhibitors.HCV-RNA was prospectively quantified in 158 patients receiving pegylated-interferon+ribavirin+telaprevir (N = 114) or+boceprevir (N = 44), at early time-points and during per protocol follow-up. Drug resistance was contextually evaluated by population sequencing.HCV-RNA at week-2 was significantly higher in patients experiencing virological failure to triple-therapy than in patients with sustained viral response (2.3 [1.9-2.8] versus 1.2 [0.3-1.7]log IU/mL, p0.001). A 100 IU/mL cut-off value for week-2 HCV-RNA had the highest sensitivity (86%) in predicting virological success. Indeed, 23/23 (100%) patients with undetectable HCV-RNA reached success, versus 26/34 (76.5%) patients with HCV-RNA100 IU/mL, and only 11/31 (35.5%) with HCV-RNA100 IU/mL (p0.001). Furthermore, differently from failing patients, none of the patient with undetectable HCV-RNA at week-2 had baseline/early resistance.With triple therapy based on first generation protease inhibitors, suboptimal HCV-RNA decay at week-2 combined with early detection of resistance can help identifying patients with higher risk of virological failure, thus requiring a closer monitoring during therapy.
- Published
- 2015
15. A Web Portal for Clinical and Genotype Data Management for the Study of Hepatocellular Carcinoma; Workshop 'Innovation in HIV and Viral Hepatitis
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Roberta Alfieri, Maria Mercedes Santoro, Matteo Gnocchi, Marco Moscatelli, Osvaldo Carpina, Cristina Vischi, Claudia Pisano, Valentina De Murtas, Ennio Polill, Francesco Paolo Antonucci, Ivana Maida, Pierluigi Tarquini, Giovanni Garrucciu, Franco Bandiera, Dante Di Giammartino, Diletta Laccabue, Andre Olivani, Vanni Borghi, Tiziana Quirino, Ilaria Lenci, Giuseppe Tisone, Mario Angelico, Cristina Mussini, Giuliano Rizzardini, Massimo Temponi, Giustino Parruti, Maria Stella Mura, Francesca Ceccherini-Silberstein, Carlo-Federico Perno, and Luciano Milanesi
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- 2015
16. Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy
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Margherita Busso, Tullio Prestileo, Ermenegildo Francavilla, Marco Anselmo, Francesco Montella, Evangelista Sagnelli, Teresa Santantonio, Massimo Galli, Marcello Saitta, Giuseppe Foti, Cecilia Guariglia, Franco Baldelli, Simona Di Gianbenedetto, Pierluigi Viale, Francesco Castelli, Antonella d'Arminio Monforte, Angelo Pan, Gabriella D’Ettore, Maria Dorrucci, Salvatore Bruno, Tiziana Quirino, Mariangela Raimondo, Alessandro Bartoloni, Vinicio Manfrin, Giovanni Mazzarello, Eugenio Mantia, Raffaele Pempinello, Antonio Traverso, Barbara Suligoi, Fabio Bulla, Pietro Mesina, Alessia Zoncada, Gianfranco Orofino, Oliviero Bosco, Gianmichele Moise, Angelo Salomone Megna, Roberto Ferretto, Mauro Valle, Manuela Colafigli, Claudio Paternoster, S. Artioli, Giovanni Riccio, Stefania Bernardi, Paolo Grossi, Milena Zoppi, Sebastiano Maiuzzo, Giorgio Perboni, Sauro Tini, Giuseppe Ferrea, Nicoletta Ladisa, Enzo M. Farinella, Daniela Francisci, Dino Sgarabotto, Roberto Monarca, Enzo Petrelli, A. Franco, Izzo Cm, Pietro Bellissima, Francesco Ortu, Laura Sighinolfi, Antonio Chirianni, Filippo Bartalesi, Giulio De Stefano, Claudia Colomba, Laura Camoni, Salvatore Galvagna, Benedetto Maurizio Celesia, Andrea Petrucci, Camillo Baretti, Pierluigi Brugnaro, Federica Poletti, Maurilio Chimenti, Camilla Ajassa, Mario Falciano, Rosaria La Sala, Sauro Luchi, V. Portelli, Annamaria Degli Antoni, Francesco Mazzotta, Giuliano Zuccati, Vincenzo Colangeli, Ercole Concia, Giordano Madeddu, Maria Cristina Salfa, Francesca Cattelan, Nicola Acone, Vincenza Regine, Olivia Bargiacchi, Maurizio de Martino, F. Paoletti, Giovanni Cassola, Giuliano Schettino, Carlo De Stefano, Enza Anzalone, D. Aquilini, Giacomo Magnani, Vanni Borghi, Roberta Gastaldi, Alessandra Govoni, Cristina Rossi, Rita Consolini, Gioacchino Angarano, Gloria Taliani, Tommaso Fontana, Sergio Lo Caputo, Davide Vitullo, Pierpaolo Congedo, Emanuela Vaccher, Paolo Viganò, Maria Stella Mura, Claudio Cancellieri, Enrico Girardi, Francesca Savalli, Cecilia Fico, Anna Maria Cattelan, Alessandro Chiodera, Renzo Scaggiante, P. Osimani, Caterina Bramato, Nicola Pietrosillo, Giovanna D'Alessio, Salvatore Bonfante, Vincenzo Vullo, Andrea Gori, Margherita Dalessandro, Domenico Lucchino, Massimo Deseraca, Paolo Tundo, Alfredo Pennica, M. Paoloni, Antonella Castagna, Nicola Serrao, Paolo Costa, Franco Marranconi, Massimo Villa, Pietro Filippini, Maurizio Setti, Eligio Pizzigallo, Marco Tinelli, Mauro Marchili, Domenico Santoro, Cesira Nencioni, Piera Dones, Vincenzo Renda, Alberto Giannetti, Domenico La Rovere, Nicoletta Dorigoni, Guido Palamara, Angelo Iodice, Clara Gabiano, Peter Mian, Luigi Guarnieri, Andrea De Luca, Nicola Tripodi, Giovanni Cristina, Giustino Parruti, Maria Montroni, Loredana Palvarini, Marco Rizzi, Benvenuto Grisorio, Corrado Catalani, Paolo Emilio Manconi, Jacopo Vecchiett, Tiziana Carli, Riccardo Iapoce, Massimo Andreoni, Adriano Lazzarin, Giorgetta Casalino Finocchio, D Sacchini, Mario Gobber, Spartaco Sani, Marco Campus, Rosario La Rosa, Maurizio Mazzeo, Stefano Bonora, Michele Trezzi, Paolo Bassi, Angela La Gala, Alessandro Grimaldi, Dante Di Giammartino, Guido Leo, Gaetano Filice, Antonio Salvo, Paolo Bonfanti, Chiara Pasqualini, Marcello Tavio, Luca Butini, N. Abrescia, Angela Linzalone, Gianpaolo Natalini Ramponi, Pierangelo Rovere, Piero Cortese, Dario Bartolozzi, F. Resta, Miriam Lichtner, Loredana Sarmati, Francesco Cesario, Renato F. Frongillo, Ivano Mezzaroma, Carlo Ferrari, Lorenzo Minoli, Paola Di Stefano, Lucina Titone, Rosa Boncoraglio, Mariana Farenga, Giuliano Rizzardini, Stefano Aviani Barbacci, Andrea Giacometti, Andrea Antinori, Antonio Caterini, Consuelo Geraci, Piergiorgio Chiriacò, Lucio Cosco, Claudio Viscoli, Alfredo Scalzini, Sandro Piga, Massimo Arlotti, Cecilia Occhino, Roberto Luzzati, Paola Sabbatini, Guglielmo Borgia, Umberto Tirelli, Antonio Davi, Letizia Cristiano, Cristina Mussini, Roberto Cauda, Patrizio Vittucci, B. Salassa, Marco Libanore, Maria Pina Sciotti, Isa Picerno, Matteo Bassetti, Benedetto Caroleo, Oswald Moling, Danilo Tacconi, Massimo Puoti, Camoni, Laura, Raimondo, Mariangela, Dorrucci, Maria, Regine V, Salfa MC, CARPHA Study, Group, Lazzarin, Adriano, Castagna, Antonella, Camoni, L, Raimondo, M, Dorrucci, M, Regine, V, Salfa, M, Suligoi, B, Di Giammartino, D, Parruti, G, Di Stefano, P, Paoloni, M, D'Alessandro, M, Grimaldi, A, Sciotti, M, Pizzigallo, E, Vecchiett, J, De Stefano, C, La Gala, A, De Stefano, G, Linzalone, A, Cesario, F, Cosco, L, Caroleo, B, Foti, G, Serrao, N, Lucchino, D, Chirianni, A, Abrescia, N, Pempinello, R, Izzo, C, Borgia, G, Filippini, P, Sagnelli, E, Iodice, A, Megna, A, D'Alessio, G, Acone, N, Mazzeo, M, Sacchini, D, Ferrari, C, Degli Antoni, A, Magnani, G, Mussini, C, Borghi, V, Viale, P, Colangeli, V, Sighinolfi, L, Libanore, M, Govoni, A, Cancellieri, C, Bassi, P, Arlotti, M, Luzzati, R, Bassetti, M, Tirelli, U, Vaccher, E, Moise, G, Palamara, G, Bernardi, S, Falciano, M, Vullo, V, D'Ettore, G, Renda, V, Guariglia, C, Taliani, G, Mezzaroma, I, Paoletti, F, Ajassa, C, Gastaldi, R, Andreoni, M, Sarmati, L, Montella, F, Antinori, A, Giannetti, A, Pietrosillo, N, Girardi, E, Pennica, A, Cauda, R, Colafigli, M, Di Gianbenedetto, S, Caterini, A, Monarca, R, Barbacci, S, Ramponi, G, Marchili, M, Anzalone, E, Lichtner, M, Ferrea, G, Cassola, G, Viscoli, C, Mazzarello, G, Setti, M, Artioli, S, Riccio, G, Finocchio, G, Anselmo, M, Rizzi, M, Scalzini, A, Castelli, F, Quirino, T, Santoro, D, Pan, A, Zoncada, A, Bonfanti, P, Viganò, P, Villa, M, Tinelli, M, Perboni, G, Palvarini, L, Costa, P, Puoti, M, Galli, M, Rizzardini, G, Monforte, A, Lazzarin, A, Castagna, A, Gori, A, Minoli, L, Filice, G, Grossi, P, Giacometti, A, Tavio, M, Montroni, M, Butini, L, Osimani, P, Petrelli, E, Chiodera, A, Vittucci, P, Sabbatini, P, Pasqualini, C, Valle, M, Zoppi, M, Mantia, E, Schettino, G, Deseraca, M, Vitullo, D, Bargiacchi, O, Orofino, G, Bramato, C, Busso, M, Salassa, B, Farenga, M, Bonora, S, Leo, G, Poletti, F, Gobber, M, Cristina, G, Gabiano, C, Mian, P, Moling, O, Paternoster, C, Dorigoni, N, Fontana, T, Angarano, G, Ladisa, N, La Rovere, D, Fico, C, Bulla, F, Santantonio, T, Grisorio, B, Chiriacò, P, Congedo, P, Tundo, P, Resta, F, Cristiano, L, Mura, M, Madeddu, G, Mesina, P, Piga, S, Campus, M, Manconi, P, Ortu, F, Salvo, A, Baretti, C, La Sala, R, Bellissima, P, Bonfante, S, Galvagna, S, Celesia, B, La Rosa, R, Maiuzzo, S, Guarnieri, L, Bruno, S, Picerno, I, Tripodi, N, Farinella, E, Occhino, C, Titone, L, Colomba, C, Prestileo, T, Saitta, M, Dones, P, Boncoraglio, R, Davi, A, Franco, A, Portelli, V, Savalli, F, Geraci, C, Chimenti, M, Luchi, S, Catalani, C, Trezzi, M, Aquilini, D, Sani, S, Nencioni, C, Carli, T, Mazzotta, F, Lo Caputo, S, Zuccati, G, Iapoce, R, Consolini, R, Bartolozzi, D, Bartoloni, A, Bartalesi, F, DE LUCA, A, De Martino, M, Tacconi, D, Tini, S, Baldelli, F, Francisci, D, Frongillo, R, Traverso, A, Francavilla, E, Ferretto, R, Marranconi, F, Manfrin, V, Cortese, P, Rossi, C, Cattelan, F, Petrucci, A, Brugnaro, P, Sgarabotto, D, Scaggiante, R, Cattelan, A, Bosco, O, Concia, E, Rovere, P, Regine, Vincenza, Salfa, Maria Cristina, Suligoi, Barbara, and Luzzati, Roberto
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Immunology ,Infectious Diseases ,Virology ,Settore MED/17 - Malattie Infettive ,Epidemiology ,Cross-sectional study ,Human immunodeficiency virus (HIV) ,MEDLINE ,HIV Infections ,medicine.disease_cause ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,Female ,Humans ,Italy ,Middle Aged ,Prevalence ,Retrospective Studies ,medicine ,HIV Infection ,HIV, prevalence, Italy ,Cross-Sectional Studie ,business.industry ,Transmission (medicine) ,HIV ,Retrospective cohort study ,Hiv prevalence ,Northern italy ,Anti-Retroviral Agent ,business ,Viral load ,Human ,Demography - Abstract
In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.
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- 2015
17. Liver Enzyme Elevation in Hepatitis C Virus (HCV)–HIV-Coinfected Patients Prior to and after Initiating HAART: Role of HCV Genotypes
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Marina Núñez, Gianpiero D'Offizi, Sergio Babudieri, Ivana Maida, Cinzia Selva, Giuliana Solinas, Pasqualino Narciso, L Fenu, and Maria Stella Mura
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Adult ,Male ,Cellular immunity ,Genotype ,Hepatitis C virus ,Hepacivirus ,Immunology ,Population ,HIV Infections ,medicine.disease_cause ,Virus ,Flaviviridae ,Antiretroviral Therapy, Highly Active ,Virology ,Immunopathology ,medicine ,Humans ,education ,education.field_of_study ,biology ,virus diseases ,Alanine Transaminase ,Middle Aged ,biology.organism_classification ,Hepatitis C ,digestive system diseases ,Infectious Diseases ,Female ,Viral disease - Abstract
Transaminase elevation is frequently seen in hepatitis C virus (HCV)-HIV-coinfected patients receiving antiretroviral therapy (ART), representing an increase in the immune response against HCV and being one of the mechanisms proposed to be involved. There is a report claiming that HCV genotype 3 is an independent risk factor. Our objectives were to assess the incidence of liver toxicity in an HIV-HCV-coinfected population with relatively preserved cellular immunity, and the role of HCV genotypes in the elevation of liver enzymes, both at baseline and after initiating ART. All HIV(+) patients with positive anti-HCV serology and CD4(+) cell counts above 100/mm(3) who began triple ART were identified, and their HCV-RNA levels and HCV genotype were determined. Liver enzymes were determined at baseline and bimonthly during follow-up. Of anti-HCV patients 147 were included, 128 (87.1%) of whom had detectable plasma HCV-RNA. HCV-1 and HCV-4 genotypes were found to confer an increased probability of having at baseline transaminases within normal limits over the other genotypes. Severe transaminase elevations (grades 3 and 4) occurred in 5/124 patients (4.0%), all with high pre-HAART ALT and positive HCV-RNA levels. Multivariate analysis showed that patients with genotype HCV-3 had a 3.27 times higher risk of developing HAART-related transaminase elevations of any grade. In conclusion, subjects with the HCV-1 genotype more often had transaminases within normal limits at baseline. The incidence of severe transaminase elevation after initiating ART was very low (4%) in this HIV(+) population with relatively preserved cellular immunity. HCV genotype 3 was identified as a risk factor for the development of transaminase elevation of any grade.
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- 2006
18. Dental care and HIV-infected individuals: are they equally treated?
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J. Vecchiet, Claudio Arici, Pierfrancesco Grima, Canio Martinelli, Tumbarello Mario, Carlo Lajolo, Sergio Babudieri, Giovanni Rezza, Maria Stella Mura, Enrica Tamburrini, Michele Giuliani, and Roberto Cauda
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Male ,medicine.medical_specialty ,Multivariate analysis ,Attitude of Health Personnel ,MEDLINE ,Private Practice ,HIV Infections ,Public Health Dentistry ,Truth Disclosure ,Settore MED/17 - MALATTIE INFETTIVE ,Health Services Accessibility ,Dentist-Patient Relations ,Nursing ,Surveys and Questionnaires ,Hiv infected ,medicine ,Humans ,Risk factor ,General Dentistry ,Analysis of Variance ,business.industry ,Public Health, Environmental and Occupational Health ,Refusal to Treat ,HIV infection ,Dental care ,Italy ,Private practice ,Dental Care for Chronically Ill ,Family medicine ,Multivariate Analysis ,Female ,Observational study ,business ,Prejudice - Abstract
– Objective: To investigate the problems in seeking dental care faced by HIV-positive individuals in Italy. Methods: A multicenter observational study was performed by distributing an anonymous self-administered questionnaire to patients of six public healthcare facilities specialized in the treatment of individuals with HIV infection. The questions concerned personal data potentially correlated with discrimination, the patient–dentist relationship before and after HIV diagnosis, and the reasons for seeking dental care in public facilities. We also evaluated the patients’ discomfort in the patient–dentist relationship after HIV diagnosis, performing univariate and multivariate analyses. Results: Of the 1500 questionnaires distributed; 883 were filled-out completely. A total of 630 persons received dental care after HIV diagnosis: 209 (33.2%) did not tell the dentist that they were seropositive. Of those who did, 56 were refused care. For patients treated by a private dentist, having been treated by the same dentist before diagnosis was a risk factor for great discomfort in the patient–dentist relationship (P
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- 2005
19. Hepatitis C Viremia in HIV/HCV-Coinfected Patients: Lower Levels in Presence of Chronic Hepatitis B
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Maria Stella Mura, L Fenu, Nuria Camino, Vincent Soriano, Ivana Maida, Marina Núñez, Sergio Babudieri, and Juan González-Lahoz
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Adult ,Male ,HBsAg ,Human immunodeficiency virus (HIV) ,HIV Infections ,Viremia ,Hepacivirus ,medicine.disease_cause ,Hepatitis B, Chronic ,Sex Factors ,Risk Factors ,medicine ,Humans ,Pharmacology (medical) ,Retrospective Studies ,Hepatitis B Surface Antigens ,business.industry ,virus diseases ,RNA ,Hepatitis C ,Hepatitis B ,medicine.disease ,Virology ,digestive system diseases ,Titer ,Infectious Diseases ,Multivariate Analysis ,Coinfection ,RNA, Viral ,Female ,business - Abstract
Complex reciprocal interactions between hepatitis C (HCV) and hepatitis B (HBV) viruses (HBV) have been reported. We examined the influence of HBV on HCV RNA titers in 376 HCV/HIV-coinfected patients (30 were also HBsAg positive). Regression analyses identified negative HBsAg and male sex as factors associated with HCV RNA values >500,000 IU/mL.
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- 2005
20. Pericarditis Caused by Hyperinvasive Strain of Neisseria meningitidis, Sardinia, Italy, 2015
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Paola Vacca, Anna Maria Palozzi, Anna Anselmo, Cecilia Fazio, Florigio Lista, Giorgia Caruana, Paolo Castiglia, Paola Stefanelli, Maria Stella Mura, Andrea Piana, Andrea Ciammaruconi, Arianna Neri, Antonella Fortunato, and Silvia Fillo
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0301 basic medicine ,Microbiology (medical) ,Letter ,Epidemiology ,030106 microbiology ,lcsh:Medicine ,Neisseria meningitidis ,Sardinia ,medicine.disease_cause ,Meningococcal disease ,C:P1.5-1,10-8:F3-6:ST-11(cc11) ,Tazobactam ,pericarditis ,Microbiology ,serogroup C ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Pericarditis ,0302 clinical medicine ,Medicine ,lcsh:RC109-216 ,Pericarditis Caused by Hyperinvasive Strain of Neisseria meningitidis, Sardinia, Italy, 2015 ,030212 general & internal medicine ,Letters to the Editor ,bacteria ,biology ,business.industry ,lcsh:R ,Outbreak ,medicine.disease ,biology.organism_classification ,Virology ,3. Good health ,Infectious Diseases ,Italy ,hyperinvasive strain ,Multilocus sequence typing ,Neisseria ,business ,Meningitis ,medicine.drug - Abstract
To the Editor: Invasive meningococcal disease is usually defined by the occurrence of meningitis or septicemia. Pericarditis might occur during the course of invasive infection. This clinical picture, defined as disseminated meningococcal disease with pericarditis (1) or secondary meningococcal pericarditis, was reported in 1918 (2). In 1939, primary or isolated meningococcal pericarditis (1,3) was described. In this form of pericarditis, pericardial or blood cultures are positive for Neisseria meningitidis but there is no meningeal involvement or clinical meningococcemia (4). Since its description, several cases of primary meningococcal pericarditis have been reported (5). Although its pathogenesis remains largely undefined, it has been hypothesized that the onset of primary pericarditis occurs after a transient bacteremia or as a consequence of involvement of the lower respiratory tract (4). Blaser et al. reported that serogroup C meningococci are usually associated with this disease, especially in adults. However, serogroups B, W, and Y have also been identified (4). We report a case-patient with primary meningococcal pericarditis caused by a serogroup C strain of N. meningitidis. The patient was a 32-year-old man who lived in Sardinia, Italy. He had no predisposing factors, such as immunodeficiency or other chronic disorders. Disease onset occurred on August 29, 2015. Clinical manifestations were fever (temperature 38°C), hypotension, epigastralgia, arthralgia, asthenia, chest pain, and reduced vesicular murmur. The left ventricle was widely hypokinetic, and a light ST increase was observed. A blood culture was positive for N. meningitidis. The patient was given piperacillin/tazobactam (4.5 g 3×/d) and metronidazole (500 mg 3×/d) for 4 days. After 4 days, treatment with ceftriaxone (2 g 2×/d) for 4 days was started. Because of persistent fever (38.8°C), levofloxacin (500 mg 2×/d) for 23 days was also started on day 7. On day 10, ceftriaxone was replaced with piperacillin/tazobactam (4.5 g 4×/d) for 21 days. A major bilateral pleural effusion was detected on the left side. On day 11, the fever had resolved. The outcome was favorable for this patient. Drug resistance of the strain was determined by using the MIC Test Strip Method (Liofilchem, Abruzzi, Italy). Breakpoints used were those recommended by the European Committee on Antimicrobial Susceptibility Testing version 5.0 (http://www.eucast.org/). The strain was susceptible to cefotaxime, ceftriaxone, ciprofloxacin, penicillin G, and rifampin. Serogroup was determined by using slide agglutination with commercial antisera (Remel Europe, Ltd., Dartford, UK) and confirmed by PCR (6). Whole-genome sequencing was conducted to obtain molecular data and enable comparison with other meningococci of the same serogroup that were isolated in Italy. Multilocus sequence typing (MLST) and typing of porA and fetA genes and Bexsero (meningcoccal group B vaccine) antigen genes (http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm431374.htm) were conducted as described (http://neisseria.org/). Whole-genome sequence was analyzed by using the BIGSdb Genome Comparator Tool (http://pubmlst.org/neisseria/). Genomes of meningococci belonging to the same finetype were compared by using the core genome MLST (cgMLST) approach. The N. meningitidis strain of serogroup C was susceptible to all antimicrobial drugs tested. Although serogroup C was associated with 53 (41%) of 132 invasive meningococcal disease cases in Italy in 2015 (http://www.iss.it/binary/mabi/cont/Report_MBI_20151223_v4.pdf), this serogroup has not been detected in Sardinia since 2010. Molecular analyses showed that the strain belonged to the hypervirulent clonal complex (cc) 11, sequence type (ST) 11. The complete finetype was C:5–1,10–8:F3–6:ST-11(cc11). This finetype has been reported in the United States and several countries in Europe (7), including Italy, and is responsible for several disease outbreaks. In Italy, this finetype represents 61% (70/115) of all serogroup C strains collected during 2012–2015. Two outbreaks caused by this strain were reported in Italy in 2007 (8) and in 2012 (9). The N. meningitidis factor H binding protein and heparin binding protein alleles were 1.13 and 20, respectively. The N. meningitidis adhesin A variant had an insertion sequence that disrupted this gene, as described for ET-15 meningococci (10). On the basis of results of cgMLST, the strain was determined to be related to strains responsible for an outbreak in Italy in 2015. In summary, we report a case of meningococcal pericarditis caused by a strain of N. meningitidis. This strain belongs to hyperinvasive clonal complex cc11 and was identified as C:P1.5–1,10–8:F3–6:ST-11(cc11), an emerging strain in Italy and worldwide. Timely diagnosis and complete molecular characterization of this strain, which causes a rare form of invasive disease (4), is needed for appropriate management of patients with this disease.
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- 2016
21. Clinical relevance of accurate HCV genotype and subtype assignment by NS3/NS5A/NS5B direct sequencing in the era of new direct acting antiviral agents
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Carlo Magni, Francesca Ceccherini-Silberstein, M. Puoti, Claudio Maria Mastroianni, A. Di Biagio, Marco Romano, Filomena Morisco, Giustino Parruti, Antonio Gasbarrini, Gloria Taliani, M. Siciliano, Simona Landonio, V.C. Di Maio, Martina Milana, Laura Gianserra, F. Deodati, Caterina Pasquazzi, M. Andreoni, J. Vecchiet, Valeria Cento, L. Lambiase, Marianna Aragri, Simona Francioso, E. D’Amico, Gabriella d'Ettorre, Giuliano Rizzardini, D. Di Paolo, Antonio Grieco, F. De Leonardis, A. Manunta, Ivana Maida, Anna Claudia Pellicelli, Mario Angelico, K. Yu La Rosa, Miriam Lichtner, P. Cacciatore, Cesare Sarrecchia, F.P. Antonucci, Aldo Bertoli, Valeria Micheli, Antonio Picciotto, Dante Romagnoli, Savino Bruno, Laura Ambra Nicolini, Ilaria Lenci, C.F. Perno, Marco Ciotti, Lorenzo Nosotti, Simona Marenco, Elisabetta Teti, M. Tontodonati, Maria Stella Mura, R. Campoli, Nicola Caporaso, S. Grieco, Sergio Babudieri, and Umberto Vespasiani-Gentilucci
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Genetics ,chemistry.chemical_compound ,NS3 ,Hepatology ,chemistry ,Direct sequencing ,Genotype ,Gastroenterology ,Clinical significance ,Biology ,NS5A ,NS5B ,Direct acting - Published
- 2016
22. Presence of resistance associated variants in patients with virological failure to new direct acting antivirals and requirement of unconventional regimens for re-treatment
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Antonio Craxì, Filomena Morisco, M. Puoti, V.C. Di Maio, Nicola Caporaso, Anna Claudia Pellicelli, Francesca Ceccherini-Silberstein, M. Paoloni, Maria Stella Mura, G.B. Gaeta, F.P. Antonucci, Vincenza Calvaruso, R. Campoli, Gianluca Brancaccio, D. Di Paolo, Dante Romagnoli, Antonio Grieco, K. Yu La Rosa, Stefano Brillanti, Valeria Cento, Caterina Pasquazzi, Ilaria Lenci, Manuela Merli, Simona Francioso, M.C. Sorbo, M. Melis, Marco Biolato, C.F. Perno, Marianna Aragri, Aldo Bertoli, Gabriella Verucchi, Sergio Babudieri, V. Pisani, Mario Angelico, Francesca Donato, and J. Vecchiet
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Oncology ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,DIRECT ACTING ANTIVIRALS ,Virological failure ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Medicine ,030211 gastroenterology & hepatology ,In patient ,business - Published
- 2016
23. Usefulness of 99mTc-Tetrofosmin Scintigraphy in Different Variants of Kaposi’s Sarcoma
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A. Cossu, V. Migaleddu, G Madeddu, Antonio Falchi, M.V. Masala, Maria Stella Mura, Angela Spanu, F. Cottoni, Francesca Chessa, Alessandra Manca, and Gr Madeddu
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Stage classification ,Cancer Research ,Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,99mTc-tetrofosmin ,General Medicine ,medicine.disease ,Scintigraphy ,Metastasis ,medicine.anatomical_structure ,Oncology ,medicine ,Sarcoma ,business ,Lymph node ,Kaposi's sarcoma - Abstract
We investigated 99mTc-tetrofosmin scintigraphy in 27 patients with Kaposi’s sarcoma: 20 had classic (CK), 5 AIDS-associated (AK) and 2 transplantation-associated (TK) variants. Twenty-three patients had clinically evident cutaneous and/or mucosal lesions, 9 of them with associated sarcomatous lymphadenopathy; 2 TK patients had only lymph nodes or other extracutaneous Kaposi sites. Both planar and SPECT 99mTc-tetrofosmin scintigraphies were performed in all cases and neck pinhole (P)-SPECT in selected patients. 99mTc-tetrofosmin uptake was observed in 88% of patients with clinically evident cutaneous and/or extracutaneous Kaposi lesions. Scintigraphy gave additional information on cutaneous lesion extent, particularly SPECT regarding deep invasion and subclinical sites in some cases. However, scintigraphy was less sensitive in the detection of small, isolated and scattered lesions. SPECT/P-SPECT were positive in 8/8 patients with sarcomatous lymph nodes, planar imaging in 5/8, ultrasonography in 7/8, while all procedures were negative in 6 other patients with reactive or HIV infection lymph nodes. SPECT demonstrated lymphadenopathy remission in 1 TK patient after immunosuppressive therapy modification and, like planar imaging, ascertained an associated lymphoma with 67Ga-citrate combined. 99mTc-tetrofosmin scintigraphy, especially SPECT, can be useful both in the detection and staging of Kaposi sarcoma lesions as a complementary tool to clinical and other conventional diagnostic methods.
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- 2003
24. Tuberculosis Screening before Anti–Hepatitis C Virus Therapy in Prisons
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Andrea Soddu, Alessandro G. Fois, Monica Murino, Stefania Anna Lucia Zanetti, Maria Stella Mura, Paola Molicotti, Pietro Pirina, Alberto Augusto Muredda, Giordano Madeddu, and Sergio Babudieri
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Microbiology (medical) ,hepatitis C virus ,medicine.medical_specialty ,Tuberculosis ,Letter ,Epidemiology ,lcsh:Medicine ,Tuberculin ,prisons ,lcsh:Infectious and parasitic diseases ,QuantiFERON ,chemistry.chemical_compound ,Internal medicine ,medicine ,lcsh:RC109-216 ,pegylated interferon ,viruses ,Letters to the Editor ,Ethambutol ,business.industry ,Ribavirin ,lcsh:R ,Becton dickinson ,Hepatitis C ,Pyrazinamide ,medicine.disease ,tuberculosis and other mycobacteria ,Infectious Diseases ,chemistry ,Immunology ,HCV ,purified protein derivative ,business ,medicine.drug ,PPD - Abstract
To the Editor: Prisons represent a crucial setting for tuberculosis (TB) control. Worldwide, reported TB rates for correctional system populations have been 10–100× higher than rates for the local civilian populations, and TB outbreaks with a high number of TB multidrug-resistant cases have been documented (1,2). Prisons are known as social and sanitary pathology reservoirs in which TB is often associated with chronic infectious diseases caused by HIV, hepatitis B virus (HBV), or hepatitis C virus (HCV) (2). HCV prevalence among inmates is 30%–40% (range 2%–58%), which is higher than that in the general population and is related to injection drug use (3). For these reasons, effective anti-HCV therapeutic approaches are recommended by national and international guidelines for decreasing illness, death rates, and reservoirs of infection in prisons (4,5). The standard of care for patients with chronic hepatitis C infection is represented by pegylated interferon-α (Peg-IFN) and ribavirin. These drugs determine complex antiviral, immunomodulatory, and antiproliferative actions, which can cause serious side effects such as leukopenia/neutropenia and alterations in the cytokine network (3). Although severe cellular immunodeficiency can often facilitate the development of many infections, only 4 clinical cases of TB in patients undergoing HCV antiviral therapy have been described in the literature (6–8), and only 1 of these was clearly described as a TB reactivation (7). We describe a case of pulmonary TB reactivation during therapy with Peg-IFN and ribavirin in a 44-year-old white male inmate, affected by genotype 1b/4a chronic hepatitis C. After prison admission in 2009, he underwent routine screening tests for infectious diseases, which indicated HCV antibody, HBV surface antibody, HBV core IgG antibody, and tuberculin skin test positivity. Results of chest radiograph and HIV screening were negative. His previous history involved injection drug use, smoking, and alcohol consumption. Anti-HCV therapy of directly observed administration of Peg-INF α-2a (180 µg/wk) and ribavirin (1,200 mg/d) was started. During therapy, the patient had only mild musculoskeletal pain and temporary irritability. During the 12th week of treatment, HCV-RNA decreased by 1 log10; therefore, the ribavirin dose was increased to 1,600 mg per day. Even after the therapy modification, no virologic suppression was found. Although during the 33rd week of therapy the patient had weakness, cough, and 2 episodes of hemoptysis, the results of a physical examination were unremarkable. Therapy was immediately discontinued. Sputum specimens collected on 3 consecutive days were positive for acid-fast bacilli. Nucleic acid amplification assays and cultures performed on mycobacteria growth indicator tube (Bactec MGIT; Becton Dickinson, Franklin Lakes, NJ, USA) and on Lowenstein-Jensen medium were positive for Mycobacterium tuberculosis isolates that later showed sensitivity to streptomycin, isoniazid, rifampin, and ethambutol. The patient was isolated at the Institute of Respiratory Diseases, University of Sassari–Faculty of Medicine, Sassari, Italy. A chest radiograph showed opacity in the upper right lung, and a high-resolution computed tomography scan (Figure) showed multiple lesions that were considered compatible with TB. CD4+ cell count (52.4%; 669 cells/mm3) was within reference range. Figure Computed tomography image of chest of patient with tuberculosis after anti–hepatitis C virus therapy. A parenchymal distortion 32 mm in diameter is shown in the upper right lung with initial central excavation 10 mm in diameter. Similar lesions ... TB treatment with rifampin, isoniazid, pyrazinamide, and ethambutol with pyridoxine was started. After 4 weeks of therapy, 3 sputum specimens were negative for acid-fast bacilli, but a bacterial culture was still positive; mycobacteria indicator growth tube culture was negative after 5 weeks. The interaction process between the IFN-α/β system and M. tuberculosis is not well known; nevertheless, Peg- IFN, alone and in combination with ribavirin, is considered potentially immunosuppressive (4,9). Immunodeficiency caused by Peg-IFNs and ribavirin may cause lower leukopenia/lymphopenia values than expected during anti-HCV treatment and may also lower CD4+ cell count and function (10). In the patient reported here, CD4+ cell count was within the reference range, and lung TB with excavations developed after 34 weeks of therapy. Before TB diagnosis, the patient had not shown any signs or symptoms of other infections and had not mentioned serious adverse effects from Peg-IFN and ribavirin treatment. However, the initial symptoms of TB and the common side effects of Peg-IFN therapy can be similar, which could have led to a delay in the diagnosis of TB. In conclusion, even if only a few cases of active TB have been reported in the literature, it is well known that standard anti-HCV treatment increases the risk for infections. A high proportion of patients with positive purified protein derivative results, isolation of >30% of multidrug-resistant strains of M. tuberculosis, and high prevalence of HCV antibody are concomitant among inmates. These data, together with current recommendations for increasing use of Peg-IFN and ribavirin in marginalized populations in correctional facilities, show the need to consider TB risk before starting HCV antiviral therapy. The management of simultaneous HCV and M. tuberculosis infections in prisons presents particular difficulties and pitfalls to overcome. In prisons, the clinical history of inmates should be carefully evaluated, a tuberculin skin test or Quantiferon TB in Tube test (Cellestis, Melbourne, Australia) should be performed, and, if those results are positive, a chest radiograph should be taken. Before receiving Peg-IFN, purified protein derivative–positive patients should receive anti-TB chemoprophylaxis. The case described here underscores the need for a careful and multidisciplinary evaluation of inmate patients for latent TB before administration of Peg-IFN and ribavirin therapy, thus avoiding reactivation.
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- 2012
25. Rickettsia monacensis as Cause of Mediterranean Spotted Fever–like Illness, Italy
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Giovanni Rezza, Antonello Caddeo, Maria Stella Mura, Alessandra Ciervo, Ivana Maida, Fabiola Mancini, Giordano Madeddu, Sergio Babudieri, and Maria Laura Fiori
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Microbiology (medical) ,Letter ,Epidemiology ,Rhipicephalus sanguineus ,vector-borne infections ,lcsh:Medicine ,Eschar ,Tick ,Sardinia ,MSF–like illness ,lcsh:Infectious and parasitic diseases ,medicine ,lcsh:RC109-216 ,Rickettsia ,Letters to the Editor ,biology ,lcsh:R ,Rickettsia monacensis ,Mediterranean spotted fever (Boutonneuse fever) ,biology.organism_classification ,medicine.disease ,Coxiella burnetii ,Virology ,Spotted fever ,Boutonneuse fever ,Infectious Diseases ,Italy ,medicine.symptom ,Rickettsia conorii - Abstract
To the Editor: Rickettsia conorii, the etiologic agent of Mediterrenean spotted fever (MSF), is transmitted to humans by the brown dog tick (Rhipicephalus sanguineus). MSF is endemic to Italy; incidence is highest in the south and on the islands of Sardinia and Sicily (1). Recently, the use of molecular methods has enabled identification of other rickettsiae of the spotted fever group (SFG) from Ixodes ricinus ticks in northeastern Italy and in other areas of Europe (2–6). R. monacensis was identified as an etiologic agent of MSF-like illness in Spain (7). We report a case of MSF-like illness in a 28-year-old man from Sassari in northwestern Sardinia who was admitted to the Infectious Disease Unit of the University of Sassari Hospital in April 2011. At admission, he reported fever (38.2°C) and headache of 2 days’ duration. At physical examination, he had a crusty skin lesion surrounded by edema and erythema, which was compatible with inoculation eschar, on the left calf. He had no rash. Laboratory results showed a slight leukocyte increase, hypocromic and microcytic anemia (hemoglobin 10.6 g/dL [reference range 13.1–17.1 g/dL], mean corpuscular volume 67.7 fL [reference range 81–88 fL], mean corpuscular hemoglobin concentration 29.6 g/dL [reference range 33–35 g/dL]), hyperbilirubinemia (total bilirubin 1.36 mg/dL [reference range 0.2–1.3 mg/dL], direct bilirubin 0.49 mg/dL [reference range 0.0–0.6 mg/dL]), and erythrocyte sedimentation rate 37 mm/h (reference range 0–25 mm/h). The remaining parameters were within reference ranges. A small skin sample taken from the inoculation eschar and whole blood were stored at –30°C. The patient immediately started taking doxycycline 100 mg every 12 hours. Serologic tests were negative for R. conorii IgM and IgG (ELISA) and positive for SFG Rickettsia spp. IgG on indirect immunofluorescence with a titer of 128. After 24 hours of antimicrobial drug therapy, he was afebrile; he was discharged on day 3. He completed a 7-day course of doxycycline at home and recovered completely. The skin biopsy sample, collected in phosphate-buffered saline, and whole blood were obtained before antimicrobial therapy began and were subjected to DNA extraction. Bacterial detection and identification were conducted by using molecular methods based on real-time PCR, classical PCR, and nucleotide sequencing (Table). Table Selected inner primers used to amplify rickettsial gltA and ompA genes* A set of primers for gltA gene that encodes the citrate synthase enzyme (8) was used to determine that the organism belonged to the genus Rickettsia, which includes the SFG and typhus group. Each real-time PCR reaction was performed by QuantiTect SYBR Green PCR kit (QIAGEN, Hilden, Germany) by using 20 ng of purified DNA. R. conorii and R. typhii were used as positive controls for SFG and typhus group, and Anaplasma phagocytophilum, Bartonella henselae, Ehrlichia chaffeensis, and Coxiella burnetii (Bartonellaceae and Coxiellaceae members) served as negative controls. Results were checked for the specific molecular length by electrophoresis on a 3% (wt/vol) agarose gel. The skin biopsy specimen of the inoculation eschar was positive for Rickettsia spp. The whole blood sample was negative for Rickettsia spp. These results were confirmed by amplification of the ompA gene by using the ompA–F and ompA–R primers (9) and by the sequencing of the PCR amplicon. The nucleotide sequence analyzed by using the BLAST search tool (www.ncbi.n/m.nib.gov/blast) showed 100% identity with the R. monacensis isolate N72 (GenBank accession no. {"type":"entrez-nucleotide","attrs":{"text":"FJ919650.1","term_id":"289470741"}}FJ919650.1). We identified R. monacensis as cause of MSF-like illness in the patient reported here. Our results have several clinical and microbiological implications. Although MSF-like illness is highly endemic to Sardinia, to our knowledge no pathogens other than R. conorii had ever been identified. Antibodies against R. monacensis were not detected by the R. conorii ELISA commonly used in hospital laboratories. In contrast, indirect immunofluorescence, which cannot distinguish between rickettsial species because of cross-reactivity, was positive. Therefore, the cocirculation of R. monacensis and, possibly, of other SFG rickettsiae, could lead to misdiagnosis and therapeutic delay. Furthermore, in consideration of the negative result in whole blood, a small skin sample from the eschar might improve the diagnostic sensitivity of PCR. We did not perform entomologic studies. However, I. ricinus ticks, which are considered vectors of R. monacensis, are widely distributed in Italy and have been found in Sardinia, although less often than other tick species (10). Moreover, it is not excluded that other ticks might act as vectors for R. monacensis in Sardinia, where ticks of the genus Rhipicephalus are prominent. Molecular investigations of ticks could better clarify the extent of circulation of SFG rickettsiae in Sardinia. Identification of R. monacensis as a cause of MSF-like illness in Sardinia expands the list of pathogenic rickettsiae circulating in Italy. It also highlights the need for further investigation in humans and vectors to understand infection dynamics and improve diagnosis and treatment of this potentially life-threatening disease.
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- 2012
26. Timing of antiretroviral therapy initiation after a first AIDS-defining event: temporal changes in clinical attitudes in the ICONA cohort
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Antonella Cingolani, Alessandro Cozzi-Lepri, Adriana Ammassari, Cristina Mussini, Maria Alessandra Ursitti, Pietro Caramello, Gioacchino Angarano, Paolo Bonfanti, Andrea De Luca, Maria Stella Mura, Enrico Girardi, Andrea Antinori, Antonela D'Arminio Monforte, Icona Foundation Study group, Cingolani, A, Cozzi-Lepri, A, Ammassari, A, Mussini, C, Ursitti, M, Caramello, P, Angarano, G, Bonfanti, P, De Luca, A, Mura, M, Girardi, E, Antinori, A, and D'Arminio Monforte, A
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Male ,Pediatrics ,Time Factors ,HIV opportunistic infections ,Epidemiology ,HIV Infections ,Cohort Studies ,MED/17 Malattie infettive ,Antiretroviral Therapy, Highly Active ,HIV Infection ,Multidisciplinary ,Confounding ,Obstetrics and Gynecology ,Middle Aged ,HIV epidemiology ,Cohort ,Infectious diseases ,Medicine ,HIV clinical manifestations ,Female ,Research Article ,Cohort study ,Human ,Adult ,medicine.medical_specialty ,Time Factor ,Anti-HIV Agents ,Urology ,Science ,Antiretroviral Therapy ,Viral diseases ,Settore MED/17 - MALATTIE INFETTIVE ,Infectious Disease Epidemiology ,Pharmacotherapy ,Acquired immunodeficiency syndrome (AIDS) ,medicine ,Humans ,Highly Active ,Survival analysis ,Genitourinary Infections ,Proportional hazards model ,business.industry ,HIV ,Anti-HIV Agent ,medicine.disease ,Antiretroviral therapy ,Cohort Studie ,business - Abstract
Background: Time of starting antiretroviral therapy (ART) after diagnosis of specific AIDS-defining event (ADE) is a crucial aspect. Objectives of this study were to evaluate if in patients diagnosed with ADE the time to ART initiation may vary according to year of diagnosis and type of ADE. Methods: All HIV+ persons diagnosed with an ADE over the 6 months prior to or after enrolment in the Icona Foundation study cohort and while ART-naive were grouped according to type of diagnosis: Those with ADE requiring medications interacting with ART [group A], those with ADE treatable only with ART [B] and other ADE [C]. Survival analysis by Kaplan-Meier was used to estimate the percentage of people starting ART, overall and after stratification for calendar period and ADE group. Multivariable Cox regression model was used to investigate association between calendar year of specific ADE and time to ART initiation. Results: 720 persons with first ADE were observed over 1996–2013 (group A, n = 171; B, n = 115; C, n = 434). By 30 days from diagnosis, 27% (95% CI: 22–32) of those diagnosed in 1996–2000 had started ART vs. 32% (95% CI: 24–40) in 2001–2008 and 43% (95% CI: 33–47) after 2008 (log-rank p = 0.001). The proportion of patients starting ART by 30 days was 13% (95% CI 7–19), 40% (95% CI: 30–50) and 38% (95% CI 33–43) in ADE groups A, B and C (log-rank p = 0.0001). After adjustment for potential confounders, people diagnosed after 2008 remained at increased probability of starting ART more promptly than those diagnosed in 1996–1999 (AHR 1.72 (95% CI 1.16–2.56). Conclusions: In our “real-life” setting, the time from ADE to ART initiation was significantly shorter in people diagnosed in more recent years, although perhaps less prompt than expected.
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- 2013
27. Timing of cART initiation after a first AIDS-defining event (ADE): temporal changes in clinical attitudes in a large cohort of HIV-infected patients
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C Mussini, E. Girardi, A. Cingolani, Pietro Caramello, G. Angarano, A d'Arminio Monforte, Paolo Bonfanti, Adriana Ammassari, A. Antinori, A. De Luca, A Cozzi-Lepri, G. Magnani, and Maria Stella Mura
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Cervical cancer ,Cart ,medicine.medical_specialty ,business.industry ,Proportional hazards model ,Public Health, Environmental and Occupational Health ,Bacterial pneumonia ,medicine.disease ,Group B ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,medicine ,business ,Survival analysis ,Immunodeficiency - Abstract
Introduction : Criteria of cART initiation after a first ADE have been modified over time based on evidence suggesting that treatment should be initiated earlier. The impact of these changes on clinical practice is unknown. Objective of this analysis was to evaluate temporal changes of time of starting cART after a first diagnosis of ADE in ART-naive patients (pts). Methods : All HIV+ enrolled in ICONA Foundation Study who presented with a diagnosis of ADE while cART-naive regardless of CD4 cell count were included. Pts were grouped according to have ADE for which additional medications that may have interactions with cART are required (Tb, atypical mycobacteriosis, non-Hodgkin lymphoma) [group A], ADE treatable only by cART (PML, isosporidiasis/cryptosporidiasis, KS, wasting syndrome) [group B] and ADE treatable with specific drugs (PCP, toxoplasmic encephalitis, CMV disease, esoph candidiasis, bacterial pneumonia, cervical cancer, cryptococcosis) [group C]. Standard survival analysis by KM was used to estimate the cumulative percentage of pts starting cART, overall and after stratification for calendar period of diagnosis (1996-2000, 2001-2008, 2009-2011) and type of ADE (groups A, B, C). Multivariable Cox regression was used to investigate association between calendar year of ADE and time to cART initiation after controlling for demographics. Summary of results : A total of 715 pts with a first ADE were observed over 1996-2011 (group A, n=187; B, n=123; C, n=405). 519 (73%) male, median age 38 (IQR:33-45), median CD4+ 64 (23-187)/mm 3 and HIV/RNA 5.25 (4.57-5.70) log 10 cps/mL, with no differences by calendar period. By 30 days from ADE, 23% (95% CI: 19-27) of those diagnosed in 1996-2000 have started cART vs. 32% (95% CI: 25-39) in 2001-2008 and 36% (28-44) after 2009 (log-rank p=0.001). After stratifying by CD4 at ADE, 45% of pts with CD4 201/mm 3 had started cART by 30 days (p
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- 2012
28. Body fat changes and mitochondrial alterations during HBV treatment: a warning for long term administration
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Giordano Madeddu, Sergio Babudieri, Salvatore Zaru, Franca Mannu, Andrea Soddu, Maria Stella Mura, Alberto Augusto Muredda, Franco Bandiera, and Giovanni Garrucciu
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Microbiology (medical) ,Adult ,Male ,Lipodystrophy ,MEDLINE ,Bioinformatics ,Antiviral Agents ,DNA, Mitochondrial ,Statistics, Nonparametric ,Text mining ,Hepatitis B, Chronic ,medicine ,Humans ,business.industry ,Case-control study ,Hepatitis B ,Middle Aged ,Viral Load ,medicine.disease ,Term (time) ,Mitochondria ,Infectious Diseases ,Adipose Tissue ,Case-Control Studies ,RNA ,Female ,business ,Administration (government) ,Viral load - Published
- 2012
29. Chronic obstructive pulmonary disease: an emerging comorbidity in HIV-infected patients in the HAART era?
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Francesca Becciu, Giovanna Maria Calia, C Lovigu, P Pirina, Maria Laura Fiori, Valentina Spada, V Soddu, Giordano Madeddu, Sergio Babudieri, Alessandro G. Fois, Maria Stella Mura, M Mannazzu, Antonello Caddeo, and Barbara Piras
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Microbiology (medical) ,Spirometry ,Adult ,Male ,medicine.medical_specialty ,Cross-sectional study ,Population ,HIV Infections ,Comorbidity ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Internal medicine ,Antiretroviral Therapy, Highly Active ,Forced Expiratory Volume ,Surveys and Questionnaires ,medicine ,Confidence Intervals ,Odds Ratio ,Prevalence ,Humans ,Respiratory system ,education ,Lung ,COPD ,education.field_of_study ,Ritonavir ,medicine.diagnostic_test ,business.industry ,Smoking ,Total Lung Capacity ,Case-control study ,General Medicine ,Odds ratio ,HIV Protease Inhibitors ,Middle Aged ,medicine.disease ,Infectious Diseases ,Cross-Sectional Studies ,Case-Control Studies ,Immunology ,Multivariate Analysis ,Female ,business - Abstract
The objective of our study was to evaluate the presence of respiratory symptoms and chronic obstructive pulmonary disease (COPD) in a human immunodeficiency virus (HIV)-infected outpatient population and to further investigate the role of highly active antiretroviral therapy (HAART) and other possibly associated risk factors.We consecutively enrolled in a cross-sectional study HIV-infected patients and HIV-negative age, sex and smoking status matched controls. All participants completed a questionnaire for pulmonary symptoms and underwent a complete spirometry.We enrolled 111 HIV-infected patients and 65 HIV-negative age- and sex-matched controls. HIV-infected patients had a significantly higher prevalence of any respiratory symptom (p = 0.002), cough (p = 0.006) and dyspnoea (p = 0.02). HIV-infected patients also had a significantly higher prevalence of COPD in respect of HIV-negative controls (p = 0.008). Furthermore, HIV-infected individuals had significantly (p = 0.002) lower forced expiratory volume at one second (FEV1) and FEV1/forced vital capacity (FVC) ratio (Tiffeneau index) (p = 0.028), whereas the total lung capacity (TLC) was significantly higher (p = 0.018). In the multivariate analysis, significant predictors of respiratory symptoms were current smoking [adjusted odds ratio (AOR) 11.18; 95 % confidence interval (CI) 3.89-32.12] and previous bacterial pneumonia (AOR 4.41; 95 % CI 1.13-17.13), whereas the only significant predictor of COPD was current smoking (AOR 5.94; 95 % CI 1.77-19.96). HAART receipt was not associated with respiratory symptoms nor with COPD.We evidenced a high prevalence of respiratory symptoms and COPD among HIV-infected patients. HIV infection, current cigarette smoking and previous bacterial pneumonia seem to play a significant role in the development of respiratory symptoms and COPD. Thus, our results suggest that the most at-risk HIV-infected patients should be screened for COPD to early identify those who may need specific treatment.
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- 2012
30. Hepatitis E virus and hepatitis A virus exposures in an apparently healthy high-risk population in Italy
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Giulio Starnini, Angela Candido, M. Rapicetta, Andrea Soddu, Giordano Madeddu, Sergio Babudieri, Sergio Carbonara, Paola Chionne, Loreta A. Kondili, Roberto Monarca, Maria Stella Mura, and Elisabetta Madonna
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Microbiology (medical) ,Adult ,Male ,Adolescent ,viruses ,Population ,medicine.disease_cause ,Virus ,Young Adult ,Hepatitis E virus ,Risk Factors ,Seroepidemiologic Studies ,Medicine ,Humans ,Hepatitis Antibodies ,education ,Aged ,Anti hev ,education.field_of_study ,Anti hiv ,business.industry ,Infection prevalence ,Age Factors ,virus diseases ,General Medicine ,Hepatitis A ,Middle Aged ,Virology ,digestive system diseases ,Hepatitis a virus ,Hepatitis E ,Infectious Diseases ,Italy ,Population Surveillance ,Immunology ,Female ,Hepatitis A virus ,Anti hav ,business - Abstract
The prevalence of anti-hepatitis E virus (HEV) and anti-hepatitis A virus (HAV), as well as the possible links with socio-demographic and other viral risks factors, were evaluated in an inmates population.The study population consisted of 973 consecutively recruited inmates of eight Italian prisons.The anti-HEV prevalence was 11.6 % (113/973). It increased significantly by age (χ(2) for linear trend: p = 0.001) and was significantly higher among non-Italian compared to Italian inmates (15.3 vs. 10.7 %, respectively). Age40 years [odds ratio (OR) 2.1; 95 % confidence interval (CI) 1.4-3.1], non-Italian citizenship (OR 1.8; 95 % CI 1.1-2.9) and anti-HIV seropositivity (OR 2.2; 95 % CI 1.2-4.2) were the only factors independently associated to anti-HEV positivity by logistic regression analysis. The overall anti-HAV prevalence was 86.4 %, and was significantly higher in non-Italian compared to Italian prisoners (92.6 vs. 84.9 %, respectively; p = 0.02). Age older than 40 years (OR 3.6; 95 % CI 2.2-5.9),5 years formal education (OR 2.1; 95 % CI 1.3-3.2) and non-Italian nationality (OR 2.7; 95 % CI 1.5-4.8) were factors independently associated to anti-HAV positivity by the logistic regression analysis.Compared to the general population, significantly higher anti-HEV and anti-HAV prevalences were observed in an inmates population in Italy. Old age and non-Italian nationality were factors independently related to both HEV and HAV exposures. This data suggest the important role of low socio-economic factors in the transmission of both infections in high-risk populations. The possible epidemiological and/or pathogenetic links between HEV and HIV exposures need to be studied further.
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- 2012
31. Acute respiratory distress syndrome due to influenza virus A/H1N1v in a patient with HIV/HCV co-infection
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P Pirina, Giordano Madeddu, Alessandro G. Fois, Giovanni Rezza, A G V Naitana, Maria Stella Mura, and G Piredda
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Adult ,Male ,Oseltamivir ,Hepatitis C virus ,HIV Infections ,Dermatology ,Hepacivirus ,medicine.disease_cause ,Antiviral Agents ,Virus ,chemistry.chemical_compound ,Influenza A Virus, H1N1 Subtype ,Acquired immunodeficiency syndrome (AIDS) ,Medicine ,Humans ,Pharmacology (medical) ,Lung ,Respiratory Distress Syndrome ,Respiratory distress ,business.industry ,Respiratory disease ,Public Health, Environmental and Occupational Health ,virus diseases ,Hepatitis C ,medicine.disease ,Virology ,Infectious Diseases ,Treatment Outcome ,chemistry ,Immunology ,HIV-1 ,Viral disease ,business - Abstract
The clinical severity of human infection with the novel influenza virus A/H1N1v has not been completely defined, especially in HIV/hepatitis C virus (HCV) infected patients. Although most patients develop mild to moderate symptoms, severe disease may occur in a limited proportion of cases. We report the case of a 44-year-old man infected with HIV and HCV with a high CD4 cell count who developed acute respiratory distress syndrome associated with influenza virus A/H1N1v infection. The patient recovered completely after oseltamivir therapy and mechanical ventilation.
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- 2011
32. P1235 BASELINE/EARLY PRESENCE OF KNOWN AND NOVEL RESISTANCE MUTATIONS IS ASSOCIATED WITH VIRAL FAILURE IN DIFFICULT-TO-TREAT PATIENTS TREATED WITH FIRST GENERATION PROTEASE INHIBITORS
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C.F. Perno, Alessandro Gasbarrini, Marianna Aragri, J. Vecchiet, M. Andreoni, Carlo Magni, Ilaria Lenci, Valeria Cento, F.P. Antonucci, Daniele Armenia, Simona Landonio, Laura Ambra Nicolini, D. Di Paolo, M. Siciliano, M. Tontodonati, Giustino Parruti, Maria Concetta Bellocchi, Sergio Babudieri, Anna Claudia Pellicelli, Mario Angelico, Maria Stella Mura, Giuliano Rizzardini, Cesare Sarrecchia, F. De Leonardis, Gloria Taliani, F. Ceccherini-Silberstein, V.C. Di Maio, Alessandro Mancon, A. Di Biagio, Lorenzo Nosotti, Valeria Micheli, and A. Manunta
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Protease ,Hepatology ,business.industry ,medicine.medical_treatment ,medicine ,Baseline (configuration management) ,business ,Virology ,First generation - Published
- 2014
33. Does ultra-deep-sequencing in HCV patients treated with boceprevir/telaprevir-based therapy provide an added value in comparison to standard population-sequencing in the detection of resistance?
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Giustino Parruti, C.F. Perno, Francesca Ceccherini-Silberstein, Fabio Continenza, M. Puoti, V.C. Di Maio, S. Bruno, Cesare Sarrecchia, Carlo Magni, Daniele Armenia, J. Vecchiet, Mario Angelico, L. Carioti, Giuliano Rizzardini, D. Di Paolo, F. De Luca, Sergio Babudieri, Ilaria Lenci, F. De Leonardis, M. Andreoni, Marianna Aragri, M. Tontodonati, Valeria Micheli, A. De Maria, Antonio Picciotto, Maria Concetta Bellocchi, Maria Stella Mura, Valeria Cento, Ennio Polilli, Lorenzo Nosotti, Simona Francioso, Aldo Bertoli, F.P. Antonucci, and A. Manunta
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Standard Population ,Hepatology ,business.industry ,Gastroenterology ,Ultra deep sequencing ,Virology ,Telaprevir ,chemistry.chemical_compound ,chemistry ,Boceprevir ,Added value ,medicine ,business ,medicine.drug - Published
- 2014
34. Arboviral infections in Egyptian and Sardinian children and adults with aseptic meningitis and meningo-encephalitis
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Benedetti, Eleonora, El-Sawaf, Gamal, Maria Stella Mura, Ghazal, Abeer, Mahmoud El Zalabani, Elghazouly, Karim, Arpino, Carla, Helaly, Ghada, Francesca Farchi, Andrea Soddu, Venturi, Giulietta, Marchi, Antonella, Denise Cacciatore, Fiorentini, Cristiano, Maria Grazia Ciufolini, Giovanni Rezza, and Madeddu, Giordano
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- 2009
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35. Tenofovir renal safety in HIV-infected patients: results from the SCOLTA Project
- Author
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Giordano Madeddu, Paolo Bonfanti, Giuseppe V. De Socio, Silvia Carradori, Carmela Grosso, Patrizia Marconi, Giovanni Penco, Elena Rosella, Sebastiano Miccolis, Sara Melzi, Maria Stella Mura, Simona Landonio, Elena Ricci, Tiziana Quirino, null for the CISAI Group, Madeddu, G, Bonfanti, P, De Socio, G, Carradori, S, Grosso, C, Marconi, P, Penco, G, Rosella, E, Miccolis, S, Melzi, S, Mura, M, Landonio, S, Ricci, E, Quirino, T, and for the CISAI, G
- Subjects
Male ,Kidney Disease ,HIV Infections ,Sex Factor ,Comorbidity ,Severity of Illness Index ,Cohort Studies ,chemistry.chemical_compound ,Risk Factors ,Organophosphonate ,Prevalence ,Age Factor ,HIV Infection ,Prospective Studies ,Prospective cohort study ,Reverse-transcriptase inhibitor ,Incidence ,Age Factors ,virus diseases ,General Medicine ,Middle Aged ,Renal safety ,Italy ,Cohort ,Female ,Kidney Diseases ,Cohort study ,medicine.drug ,Human ,Adult ,medicine.medical_specialty ,Anti-HIV Agents ,Organophosphonates ,Biology ,Nephrotoxicity ,Follow-Up Studie ,Sex Factors ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,medicine ,Humans ,Adverse effect ,Tenofovir ,Pharmacology ,Creatinine ,Risk Factor ,Adenine ,HIV ,Anti-HIV Agent ,medicine.disease ,Virology ,Prospective Studie ,chemistry ,Cohort Studie ,Follow-Up Studies - Abstract
Objective: To evaluate the prevalence and incidence of nephrotoxicity in HIV-infected patients enrolled in the SCOLTA Project tenofovir cohort and to identify possible risk factors. Design: The SCOLTA Project is a prospective, observational, multicenter study involving 25 infectious disease departments in Italy created to assess the incidence of severe adverse events in patients receiving new antiretroviral drugs. Patients: The SCOLTA Project tenofovir cohort includes a total of 754 HIV infected patients. Results: Data including grade II-IV creatinine elevations according to ACTG scale were available in 354 patients, 237 (67%) males with a mean age of 40.1 ± 7.6 years enrolled in the SCOLTA Project tenofovir cohort. During a mean follow up of 19.5 ± 11.5 months creatinine elevations were reported in 9/354 (2.5%) patients, all males. Mean duration of tenofovir therapy at the event was 9.5 ± 5 months. The overall incidence was 1.6 (95% CI 1.5-1.7) per 100 person-years (p-y) and 0.5 (95% CI 0.4-0.6) p-y for grade III. No grade IV creatinine elevations were reported. Patients with nephrotoxicity were older and more frequently male, HCV infected, in CDC stage C and their CD4 cell count was significantly lower than those without nephrotoxicity. No significant difference was found between tenofovir co-administered antiretroviral drugs. Conclusions: Both prevalence and incidence of nephrotoxicity were low in patients receiving tenofovir in a non-selected clinical setting. Renal injury in patients receiving tenofovir seems associated with the presence of co-morbidities and with advanced HIV infection. © 2007 Elsevier Masson SAS. All rights reserved.
- Published
- 2007
36. P0915 : Clinical relevance of baseline/early detection and persistence of resistant associated variants in HCV-1 patients treated with protease-inhibitors assessed by ultra-deep sequencing
- Author
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Francesca Ceccherini-Silberstein, Valeria Cento, Valeria Micheli, Antonio Picciotto, M. Santoro, Marianna Aragri, M. Andreoni, Ilaria Lenci, D. Di Paolo, Aldo Bertoli, Carlo Magni, Mario Angelico, M. Tontodonati, S. Bruno, Maria Concetta Bellocchi, Daniele Armenia, Cesare Sarrecchia, Maria Stella Mura, Gloria Taliani, Giuliano Rizzardini, F.P. Antonucci, Sergio Babudieri, F. De Leonardis, C.F. Perno, A. De Maria, A. Manunta, Giustino Parruti, Filomena Morisco, M. Puoti, V.C. Di Maio, J. Vecchiet, F. De Luca, Lorenzo Nosotti, Simona Francioso, Ennio Polilli, and L. Carioti
- Subjects
Oncology ,medicine.medical_specialty ,Protease ,Hepatology ,business.industry ,medicine.medical_treatment ,Early detection ,Ultra deep sequencing ,Bioinformatics ,Persistence (computer science) ,Internal medicine ,medicine ,Clinical significance ,business - Published
- 2015
37. Clinical relevance of next generation sequencing on baseline detection of minority resistance associated variants in HCV-1 patients treated with protease inhibitors
- Author
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Valeria Micheli, Antonio Picciotto, Aldo Bertoli, Massimo Levrero, C.F. Perno, Ilaria Lenci, Francesca Guerrieri, F.P. Antonucci, Mario Angelico, F. De Leonardis, M. Andreoni, Lorenzo Nosotti, Giustino Parruti, Simona Francioso, Marianna Aragri, M. Santoro, Giuliano Rizzardini, Carlo Magni, F. De Luca, Ludovica Calvo, Valeria Cento, A. Manunta, J. Vecchiet, Francesca Ceccherini-Silberstein, S. Bruno, Daniele Armenia, Maria Concetta Bellocchi, D. Di Paolo, Cesare Sarrecchia, Filomena Morisco, M. Puoti, V.C. Di Maio, Sergio Babudieri, M. Tontodonati, Ennio Polilli, Maria Stella Mura, Simona Marenco, and L. Carioti
- Subjects
Protease ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Medicine ,Clinical significance ,business ,Bioinformatics ,Baseline (configuration management) ,DNA sequencing - Published
- 2015
38. [The HIV/AIDS epidemic in the Province of Sassari in the combination antiretroviral therapy era]
- Author
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Giordano, Madeddu, Giovanna Maria, Calia, Carla, Lovigu, Marco, Mannazzu, Ivana, Maida, Sergio, Babudieri, Giovanni, Rezza, and Maria Stella, Mura
- Subjects
Adult ,Male ,Acquired Immunodeficiency Syndrome ,Italy ,Antiretroviral Therapy, Highly Active ,Humans ,Female ,HIV Infections ,Retrospective Studies - Abstract
Combined antiretroviral therapy has reduced both AIDS mortality and morbidity. An unknown proportion of patients is identified early and starts therapy before developing AIDS, thus escaping epidemiological surveillance. For this reason it is important to monitor the trend of new diagnoses of HIV infection. From the comparison of patients living in the Province of Sassari with new diagnoses of HIV infection or AIDS in the period 1997-2003 some differences emerge. Males are the most affected, but the difference tends to decrease among new HIV cases. Sexual contact is the most common route of transmission among new HIV diagnoses, whereas the parenteral route prevails among AIDS cases. An increase in the percentage of foreigners has been found only among new HIV cases. The difference found between new AIDS and HIV cases emphasises the importance to implement HIV infection based surveillance systems, in order to better guide informative campaigns and other interventions.
- Published
- 2006
39. Severe liver disease associated with prolonged exposure to antiretroviral drugs
- Author
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Ivana Maida, Javier García-Samaniego, María José Ríos, Giovanni Sotgiu, Pablo Rivas, Sergio Babudieri, Maria Stella Mura, Juan González-Lahoz, Pablo Barreiro, Marina Núñez, Luz Martín-Carbonero, Carlos Toro, and Vincent Soriano
- Subjects
Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Time Factors ,Anti-HIV Agents ,HIV Infections ,Hemorrhage ,Budd-Chiari Syndrome ,Liver disease ,Internal medicine ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,Pharmacology (medical) ,Nevirapine ,Didanosine ,Transaminases ,Hepatitis ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Ascites ,Hepatitis C ,Hepatitis B ,Middle Aged ,medicine.disease ,Stavudine ,Infectious Diseases ,Spain ,Liver biopsy ,Case-Control Studies ,Immunology ,Budd–Chiari syndrome ,Female ,business ,Liver function tests ,medicine.drug - Abstract
Background: Liver damage is frequently seen in HIV-positive subjects, often resulting from coinfection with hepatitis B and/or C viruses (HCV), alcohol abuse, etc. However, the etiology of liver disease still remains unknown for a small subset of individuals. Methods: Cryptogenic liver disease (CLD) was defined as persistently elevated aminotransferases levels in the absence of hepatitis C and/or B viruses replication and of other common causes of liver disease (alcohol, medications, etc). We identified cases initially meeting this definition by examining all HIV-positive subjects attended during the year 2004 in 2 large HIV clinics in Spain. Their clinical charts were retrospectively reviewed, and their assessment completed when needed to rule out other less frequent causes of liver disease. The stage of liver fibrosis was assessed by liver biopsy and/or elastography. To assess which factors could be associated with CLD, HIV-positive controls were chosen and matched by age, gender, and CD4 status. Results: CLD was diagnosed in 17 (0.5%) out of 3200 HIV-positive patients. Their mean age was 43 years, 82.4% were male, and 76% had acquired HIV through homosexual relationships. The mean time from HIV diagnosis was >15 years, and all patients had been exposed to antiretroviral therapy. Nevirapine, stavudine, and didanosine were the drugs more frequently used by this subset of patients. None of them had liver function test abnormalities before initiating antiretroviral therapy. Advanced liver fibrosis (F3-F4 Metavir scores) was recognized in 10 (58.8%) individuals, and 9 (52.9%) had developed symptomatic liver complications, including ascites (8), portal thrombosis (6), variceal bleeding (5), and encephalopathy (2). In the case-control analysis, prolonged didanosine exposure was the only independent predictor of developing CLD in this population. Conclusions: CLD is an uncommon condition in HIV-positive individuals and might be associated with prolonged didanosine exposure. It may evolve causing severe liver complications, with variceal bleeding and portal thrombosis being particularly frequent.
- Published
- 2006
40. Rapid detection and identification of Mycobacterium tuberculosis by Real Time PCR and Bactec 960 MIGT
- Author
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Silvia, Ortu, Paola, Molicotti, Leonardo Antonio, Sechi, Pierp, Pirina, Franca, Saba, Cono, Vertuccio, Antonella, Deriu, Ivana, Maida, Maria Stella, Mura, and Stefania, Zanetti
- Subjects
DNA, Bacterial ,DNA Transposable Elements ,Humans ,Tuberculosis ,Taq Polymerase ,Mycobacterium tuberculosis ,Polymerase Chain Reaction ,Sensitivity and Specificity - Abstract
We have developed a Real-Time PCR assay to detect M. tuberculosis using the iCycler iQ detection system by TaqMan assay directly on the clinical specimen. A total of 513 clinical samples were taken from patients with suspected tuberculosis and other patients that had an active mycobacterial infection, as well as patients with diagnosed tuberculosis who were receiving antitubercular therapy. The sensitivity and specificity of this assay, 10% and 100%, respectively, were compared to those of conventional microbiological methods.
- Published
- 2006
41. Alendronate reduces bone resorption in HIV-associated osteopenia/osteoporosis
- Author
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Maria Stella Mura, Gabriella Orlando, N. Parise, Paolo Ventura, Giovanni Guaraldi, Stefano Campostrini, Roberto Esposito, Giordano Madeddu, Fabio Vescini, R. Caudarella, GUARALDI G., ORLANDO G., MADEDDU G., VESCINI F., VENTURA P., CAMPOSTRINI S., MURA MS., PARISE N., CAUDARELLA R., and ESPOSITO R.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bone density ,Osteoporosis ,Urology ,Administration, Oral ,HIV Infections ,Bone resorption ,Drug Administration Schedule ,HIV-related osteoporosis ,Bone remodeling ,Bone Density ,Internal medicine ,Antiretroviral Therapy, Highly Active ,medicine ,Clinical endpoint ,Humans ,Pharmacology (medical) ,Prospective Studies ,Femoral neck ,Bone mineral ,Alendronate ,business.industry ,alendronate ,Middle Aged ,medicine.disease ,Osteopenia ,bone resorption ,osteopenia ,Bone Diseases, Metabolic ,Infectious Diseases ,Endocrinology ,medicine.anatomical_structure ,Treatment Outcome ,Italy ,Female ,business - Abstract
To evaluate the effects of alendronate, vitamin D, and calcium supplementation on bone metabolism and bone mineral density (BMD) in both HIV-infected men and women treated with highly active antiretroviral therapy (HAART).We performed a 52-week prospective, multicenter, randomized, open-label clinical trial. Eligible participants were on stable HAART and had BMD values at the femoral neck or lumbar spine that corresponded to a t score less than -1. Patients were randomized to receive alendronate 70 mg weekly or no alendronate; calcium 1000 mg daily and vitamin D 500 IU daily were provided to all study recipients. Primary endpoint of the study was the change in bone metabolism evaluated by N-telopeptide of type 1 collagen and bone-specific alkaline phosphatase; the secondary endpoint was BMD variation.18 patients were randomized to the alendronate and 23 to the no-alendronate group (controls). The alendronate-treatment group compared to controls had a significant decrease in serum N-telopeptides, 1914 +/- 1433.4 vs. 3967 +/- 1650.5 pM/L (p = .005) after 1 year. Lumbar spine BMD increased by 4% in the alendronate group (p = .004) vs. 3.7% (p = .062) in controls, compared to baseline values. Femoral neck BMD decreased by 0.5% in the alendronate group (p = .05) and by 3.5% in the control group (p = .04). No between-groups differences for BMD were found (Delta lumbar-BMD 0.0351 +/- 0.0406 in cases and 0.0356 +/- 0.073 in controls [p = .977], Delta femoral-BMD -0.085 +/- 0.160 in cases and -0.100 +/- 0.165 in controls [p = .795]).Alendronate plus vitamin D and calcium was effective in reducing bone resorption. Alendronate improved lumbar BMD and minimized femoral BMD decrease after 52 weeks compared to treatment with vitamin D and calcium alone in patients on HAART with osteopenia/osteoporosis.
- Published
- 2004
42. Treatment-related factors and highly active antiretroviral therapy adherence
- Author
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Laura Sighinolfi, Adriana Ammassari, Sara Melzi, Antonella d'Arminio Monforte, Andrea Antinori, Maria Stella Mura, Mauro Zaccarelli, Maria Paola Trotta, and Nicoletta Ladisa
- Subjects
Drug ,medicine.medical_specialty ,Anti-HIV Agents ,media_common.quotation_subject ,Human immunodeficiency virus (HIV) ,medicine.disease_cause ,Drug Administration Schedule ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,Medicine ,Humans ,Pharmacology (medical) ,Sida ,Intensive care medicine ,Life Style ,media_common ,Related factors ,biology ,business.industry ,biology.organism_classification ,medicine.disease ,Antiretroviral therapy ,Diet ,Drug Combinations ,Infectious Diseases ,Pill ,Lentivirus ,Immunology ,Patient Compliance ,business - Abstract
Adherence to highly active antiretroviral therapy (HAART) plays a critical role in the effectiveness of HIV treatment. Nevertheless, the complexity of regimens and frequent side effects make HAART extraordinarily difficult to take, and many HIV-infected persons fail to adhere. The current study offers an overview of the relationship between adherence and antiretroviral treatment-related variables. As for other chronic diseases, medication regimen complexity also has an impact on adherence in the management of HIV infection. In particular, the authors discuss the effect of pill burden, dosing frequency, dietary instructions, number and type of different medications prescribed, short- and long-term side effects, convenience, and ability to incorporate the treatment regimen into a daily routine. Medication side effects are common in HAART-treated persons and are associated with concurrent and future nonadherence. Simplification of regimens, adjustment of the drug schedule to the patient's specific lifestyle, and anticipation and self-management of side effects are treatment-based strategies to optimize HAART adherence and ensure the most effective, convenient, safe, and well-tolerated antiretroviral treatment.
- Published
- 2003
43. [HIV and related infections in Italian penal institutions: epidemiological and health organization note]
- Author
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Sergio, Babudieri, Giulio, Starnini, Bruna, Brunetti, Sergio, Carbonara, Gian Piero, D'Offizi, Roberto, Monarca, Giovanni, Mazzarello, Stefano, Novati, Aldo, Casti, Grazia, Florenzano, Giulio, Quercia, Enzo, Iovinella, Celestino, Sardu, Anacleto, Romano, Marinella, Dierna, Serafino, Vullo, Antonio, Pintus, Ivana, Maida, Luca, Dori, Sebastiano, Ardita, Maria Stella, Mura, Massimo, Andreoni, Giovanni, Rezza, Babudieri, Sergio, Starnini, Giulio, Brunetti, Bruna, Carbonara, Sergio, D'Offizi, Gian Piero, Monarca, Roberto, Mazzarello, Giovanni, Novati, Stefano, Casti, Aldo, Florenzano, Grazia, Quercia, Giulio, Iovinella, Enzo, Sardu, Celestino, Romano, Anacleto, Dierna, Marinella, Vullo, Serafino, Pintus, Antonio, Maida, Ivana, Dori, Luca, Ardita, Sebastiano, Mura, Maria Stella, Andreoni, Massimo, and Rezza, Giovanni
- Subjects
Adult ,Male ,AIDS-Related Opportunistic Infections ,Hepatitis, Viral, Human ,Prisoners ,Prison ,Sexually Transmitted Diseases ,HIV Infections ,Prisoner ,Health Survey ,Middle Aged ,Substance Abuse, Intravenou ,Health Surveys ,AIDS-Related Opportunistic Infection ,Italy ,HIV Seroprevalence ,Prisons ,Antiretroviral Therapy, Highly Active ,Humans ,Tuberculosis ,Female ,HIV Infection ,Substance Abuse, Intravenous ,Human ,Sexually Transmitted Disease - Abstract
HIV and other infections represent an important health problem in Italian jails. In particular, HIV prevalence is high, due to the characteristics of the prison population, which is constituted by a large proportion of injecting drug users and foreigners. In addition, data from other countries suggest that risky behaviour are not uncommon during imprisonment, and transmission of HIV and other infection in this setting may also occur. Data from surveys conducted by the Penitentiary Authority in Italian jails show a decline of HIV seroprevalence from 9.7% in 1990 to 2.6% in 2001. However, these data are largely incomplete and do not account for possible biases due to self-selection of inmates toward HIV serological testing or to variations in the access to screening activities. More accurate data, possibly obtained through anonymous unlinked surveys, are needed in order to better plan health services and preventive measures.
- Published
- 2003
44. P1236 NS3, NS5A AND NS5B COEVOLUTION DURING TREATMENT WITH FIRST-GENERATION PROTEASE INHIBITORS
- Author
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Carlo Magni, M. Tontodonati, Lorenzo Nosotti, Maria Stella Mura, A. Manunta, Giuliano Rizzardini, Giustino Parruti, J. Vecchiet, Cesare Sarrecchia, Valeria Micheli, Mario Angelico, Sergio Babudieri, R. Campoli, Aldo Bertoli, D. Di Paolo, F.P. Antonucci, M. Andreoni, K. Yu, V.C. Di Maio, Valeria Cento, F. De Leonardis, C.F. Perno, and F. Ceccherini-Silberstein
- Subjects
Genetics ,NS3 ,chemistry.chemical_compound ,Protease ,Hepatology ,chemistry ,medicine.medical_treatment ,medicine ,Biology ,NS5A ,NS5B ,First generation ,Coevolution - Published
- 2014
45. Early viral dynamics in HCV-RNA decay and NS3-resistance development predict the risk of failure to first-generation protease inhibitors
- Author
-
Giustino Parruti, Gloria Taliani, Simona Francioso, Ilaria Lenci, F.P. Antonucci, Claudio Maria Mastroianni, Simona Landonio, Laura Ambra Nicolini, Ivana Maida, Valeria Micheli, Antonio Picciotto, D. Di Paolo, Giuliano Rizzardini, Lorenzo Nosotti, F. De Leonardis, Marco Massari, Antonio Gasbarrini, Anna Claudia Pellicelli, Sergio Babudieri, A. Manunta, Jacopo Vecchiet, Francesca Ceccherini-Silberstein, M. Tontodonati, A. De Maria, Ennio Polilli, Maria Stella Mura, Tamara Ursini, Cesare Sarrecchia, Simona Marenco, A. Di Biagio, Marianna Aragri, Massimo Andreoni, Mario Angelico, Valeria Cento, Fosca Niero, Alessandra Mangia, Annalisa Tortora, Alessandro Mancon, M. Siciliano, V.C. Di Maio, Carlo Federico Perno, Carlo Magni, Claudio Viscoli, and Aldo Bertoli
- Subjects
NS3 ,Protease ,Hepatology ,Resistance development ,Viral dynamics ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Medicine ,business ,Virology ,First generation - Published
- 2014
46. Arboviral infections in Egyptian and Sardinian children and adults with aseptic meningitis and meningo-encephalitis
- Author
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Carla Arpino, Abeer Ghazal, Maria Grazia Ciufolini, Karim El Ghazouly, Antonella Marchi, Francesca Farchi, Denise Cacciatore, Eleonora Benedetti, Gamal El-Sawaf, Cristiano Fiorentini, Giulietta Venturi, Mahmoud El Zalabani, Giordano Madeddu, Andrea Soddu, Giovanni Rezza, Ghada F. Helaly, and Maria Stella Mura
- Subjects
Adult ,Microbiology (medical) ,Adolescent ,Arbovirus Infections ,Meningoencephalitis ,Genus ,medicine ,Humans ,Meningitis, Aseptic ,Child ,General Immunology and Microbiology ,biology ,business.industry ,Infant ,Aseptic meningitis ,Sandfly fever Naples virus ,General Medicine ,Middle Aged ,medicine.disease ,biology.organism_classification ,Virology ,Infectious Diseases ,Italy ,Phlebovirus ,Child, Preschool ,Egypt ,business ,Meningitis ,Encephalitis - Abstract
Dear Sir,Arboviruses belonging to the Phlebovirus genus are a possible cause of central nervous system (CNS) infection during the summer months in several Mediterranean countries. In particular, To...
- Published
- 2009
47. Rotavirus infection in AIDS-associated diarrhoea
- Author
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M. Mannazzu, G.M. Calia, P. Porcu, G. Panichi, Antonio Aceti, and Maria Stella Mura
- Subjects
Microbiology (medical) ,Rotavirus infection ,Diarrhea ,Acquired Immunodeficiency Syndrome ,Infectious Diseases ,Acquired immunodeficiency syndrome (AIDS) ,business.industry ,Medicine ,Humans ,business ,medicine.disease ,Virology ,Rotavirus Infections - Published
- 1996
48. Distribution of the CCR5 Delta32 Allele in Italian HIV Type 1-Infected and Normal Individuals
- Author
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Eva Battiloro, Roberto Verna, Ettore D'Ambrosio, Ercole Concia, Antonio Aceti, Saverio Giuseppe Parisi, Giovanni Sotgiu, Massimo Andreoni, Gianfranco Cossu, and Maria Stella Mura
- Subjects
Genotype ,Receptors, CCR5 ,Immunology ,Population ,Human immunodeficiency virus (HIV) ,HIV Infections ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,law.invention ,law ,Virology ,medicine ,Humans ,Distribution (pharmacology) ,Allele ,education ,Alleles ,Polymerase chain reaction ,education.field_of_study ,Gene deletion ,Genetics, Population ,Infectious Diseases ,Italy ,HIV-1 ,Gene Deletion - Published
- 2000
49. 1011 Occurrence of infections during combination treatment with interferons and ribavirin for chronic hepatitis C: role of neutropenia and of interferon pegylation
- Author
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L Fenu, Baiguera C, M. Puoti, Sergio Babudieri, I Maida, P Pagani, S Sassu, Maria Stella Mura, M.G. Antonini, and K. Prestini
- Subjects
Hepatology ,business.industry ,Ribavirin ,Neutropenia ,medicine.disease ,Virology ,chemistry.chemical_compound ,Combined treatment ,chemistry ,Chronic hepatitis ,Interferon ,PEGylation ,Medicine ,business ,medicine.drug - Published
- 2003
50. Liver Enzyme Elevation in Hepatitis C Virus (HCV)–HIV-Coinfected Patients Prior to and after Initiating HAART: Role of HCV Genotypes.
- Author
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Ivana Maida, Sergio Babudieri, Cinzia Selva, Gianpiero D'Offizi, Luisa Fenu, Giuliana Solinas, Pasqualino Narciso, Maria Stella Mura, and Marina Núñez
- Published
- 2006
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