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3. Stalk forming fouling diatoms : a problem for the hydro- electricity industry

Author

Ravizza, M

Abstract

The Tarraleah power scheme (102.2 MW) is a significant component of Tasmania's Hydro-Electric generation system operated by Hydro Tasmania, which contributes 60% of Australia's renewable energy. The efficiency of this scheme is negatively impacted by the presence of biofouling, consisting mainly of diatoms and bacterial slimes, which can grow up to 5 mm thick on the canal walls and cause up to 10% reduction in flow carrying capacity, therefore reducing power generation capability. In Tarraleah No. 1 Canal biofouling is constantly present, although the amount varies seasonally, from location to location, and dependent on canal cleaning regimes. Engineering studies have demonstrated that the effective roughness of the biofilm is much greater than its physical roughness, which has implications for the frictional drag induced by the biofilm. Observations of the canal wall during outages indicate that fouling is less prevalent on the southern wall of the canal, which is less shaded by vegetation, thus indicating that the fouling diatoms prefer low light conditions. The succession of fouling diatoms begins with Tabellaria flocculosa which dominates under low flow regimes (< 2 m s-1) and progresses to the stalk-forming Gomphonema tarraleahae which is the dominant species in high velocity areas. In this study, the target species G. tarraleahae was compared with other stalk forming diatoms, both marine and freshwater species (Licmophora flabellata, Didymosphenia geminata and Gomphonema cf. manubrium), to elucidate the environmental factors promoting their stalk formation and to determine the best strategies to mitigate their impact. Both laboratory culture studies and field experiments were conducted. Simulated laboratory trials were conducted on the marine stalk-forming diatom Licmophora flabellata, to define environmental factors influencing its growth and stalk formation. Growth rates in multiwell plates were estimated using in vivo fluorescence in a plate reader. Low to moderate light intensities (50, 100 and 150 ˜í¬¿mol photons m-2 s-1) produced no or poor growth, while growth rates of 0.24 -0.42 div/day were achieved at the highest light intensities of 233 ˜í¬¿mol photons m-2 s-1. High growth rates coincided with long stationary growth periods (21-36 days) and long (800-3500˜í¬¿m) branching stalks. With this eutrophic estuarine diatom N, P and Si nutrients had no effect on growth nor stalks, while high turbulence reduced stalk length but not growth. Pulse Amplitude Modulated (PAM) fluorometry was applied to define light and nutrient responses of the diatom biofouling on both walls of Tarraleah No. 1 Canal at three different depths (top, medium and bottom). Rapid light curves (RLC) and Fv/Fm (indicators of physiological health) confirmed that biofouling was suppressed by high light (on the south wall at a depth less than 1 m) and inhibited by silica whilst nitrogen or phosphate addition had no effect. To further confirm the critical role of light for Tarraleah hydrocanal fouling an experimental rig was designed and built on the banks beside the no.1 Canal. It comprised four pipes through which natural Tarraleah water was allowed to flow at 1.22 m s-1 but under varying substratum conditions (metal, opaque PVC, frosted PVC and clear PVC) and light levels (0 in the metal pipe and maximum of 6, 1937 and 2957 ˜í¬¿mol photons m-2 s-1 in the opaque PVC, frosted PVC and clear PVC pipes, respectively). Nutrient bioassays using PAM fluorometry on fouling samples harvested on a monthly basis during winter and spring showed significant effects of both pipe material and nutrients on photosynthetic performance. Optimal fouling dominated by T. flocculosa (81.4 ‚Äö- 96.4% of cells) occurred at medium light (in opaque and frosted PVC), and Fv/Fm responded positively to silica in April 2013 and to nitrogen and phosphate addition in July 2013. Unexpectedly, photosynthetically viable diatom fouling communities (Fv/Fm 0.36-0.59) were observed in the metal pipe even after 2 months in complete darkness. The New Zealand stalk-forming diatom Didymosphenia geminata represents a potentially invasive freshwater pest, of considerable concern if it were to become established in Tasmania. Comparative PAM nutrient responses were studied for New Zealand Buller River D. geminata, Lake Rotoiti G. cf. manubrium and Tasmanian G. tarraleahae. Although these freshwater stalk-forming diatoms had different requirements in terms of light, flow rate and nutrients, all three species were inhibited by silica addition while D. geminata was also stimulated by iron. Like G. tarraleahae, D. geminata blooms preferentially occur in hydrologically stable oligotrophic waters, but are remarkably tolerant towards light and occur over a wide range of flow velocities. Comparative PAM nutrient assays on L. flabellata cultures showed no prohibitive effect from silica addition with that eutrophic diatom. The present results call for species-specific approaches towards mitigating the impact of fouling diatoms. In L. flabellata and D. geminata high light intensities stimulated stalk formation and length. While these species were adapted to stable low flow waters, G. tarraleahae showed preferences for high velocity flow and low light intensities. L. flabellata showed more tolerance towards nutrient addition and could grow under a wide range of temperatures, but D. geminata and G. tarraleahae instead were adapted to oligotrophic waters and cold temperatures. Currently mitigation methods in Tarraleah No. 1 Canal involve scrubbing of the canal walls on a regular basis, but this is expensive and benefits are short-lived with rapid fouling regrowth occurring, notably in spring. Alternative mitigation solutions including clearing vegetation along canals and the application of white paint on the canal walls have shown better promise to increase light-intensity to mitigate lowlight adapted G. tarraleahae fouling. However, this clearly is not a universal strategy that can be applied to all fouling diatoms. Undoubtedly, the best approach for all fouling species would be to stop their attachment to the substratum, even though this remains a challenging task that requires continued research.

Published
2023
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7. CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Author

Floridia, M., Pinnetti, C., Masuelli, G., Spinillo, A., Savasi, V. M., Liuzzi, G., Degli Antoni, A. M., Sansone, M., Guaraldi, G., Dalzero, S., Maso, G., Francisci, D., Sterrantino, G., Ravizza, M., Tamburrini, E., Di Lorenzo, F., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Portelli, V., Bernardon, M., Bussolaro, S., Della Pieta, I., Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M. A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., De Martino, M., Parazzini, F., Vella, S., Floridia M., Pinnetti C., Masuelli G., Spinillo A., Savasi V.M., Liuzzi G., Degli Antoni A.M., Sansone M., Guaraldi G., Dalzero S., Maso G., Francisci D., Sterrantino G., Ravizza M., Tamburrini E., Di Lorenzo F., Meli M., Campolmi I., Vichi F., Del Pin B., Marocco R., Mastroianni C., Mercurio V.S., Zanaboni D., Nardini G., Stentarelli C., Beghetto B., Molinari A., Crisalli M.P., Donisi A., Ruggieri A., Piepoli M., Cerri V., Zuccotti G., Giacomet V., Paradiso L., Forlanini F., Longoni E., Placido G., Milini P., Savalli F., Sabbatini F., Papalini C., Bernini L., Grossi P., Rizzi L., Portelli V., Bernardon M., Bussolaro S., Della Pieta I., Sorz A., Meloni A., Chiodo A., Dedoni M., Ortu F., Piano P., Citernesi A., Bordoni Vicini I., Luzi K., Roccio M., Vimercati A., Calabretti D., Gigante S., Guerra B., Cervi F., Simonazzi G., Margarito E., Capretti M.G., Marsico C., Faldella G., Martinelli P., Agangi A., Capone A., Maruotti G.M., Tibaldi C., Trentini L., Todros T., Frisina V., Savasi V., Cardellicchio E., Giaquinto C., Fiscon M., Rubino E., Franceschetti L., Badolato R., Forleo M.A., Tassis B., Ruggiero M., Genovese O., Cafforio C., Casadei A.M., Cavaliere A.F., Cellini M., Marconi A.M., Ierardi M., Simonetti S.C., Alfieri N., Agrati S., Polizzi C., Mattei A., Pirillo M.F., Amici R., Galluzzo C.M., Donnini S., Baroncelli S., Cerioli A., De Martino M., Parazzini F., and Vella S.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Multivariate analysis, 030106 microbiology, CD4-CD8 Ratio, Human immunodeficiency virus (HIV), HIV Infections, CD8-Positive T-Lymphocytes, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, CD4/CD8 ratio, Pregnancy, CD4, CD8, HIV suppression, Preterm delivery, Female, Humans, Infant, Newborn, Pregnancy Outcome, Pregnant Women, Viral Load, Pregnancy Complications, Infectious, medicine, 030212 general & internal medicine, business.industry, Obstetrics, Infectious, Infant, General Medicine, Newborn, medicine.disease, Pregnancy Complications, Infectious Diseases, Increased risk, National study, Outcome data, business
Abstract

Purpose: To evaluate associations between CD4/CD8 ratio and pregnancy outcomes in women with HIV. Methods: We evaluated, in a national study of pregnant women with HIV receiving antiretroviral treatment (ART), values of CD4/CD8 ratio at entry in pregnancy, changes between first and third trimester, and possible associations with preterm delivery, low birthweight, and HIV-RNA < 50 copies/ml at third trimester in univariate and multivariate analyses. Results: Among 934 women, 536 (57.4%) were already on ART at conception. CD4/CD8 ratio (baseline value 0.570) increased significantly between the first and third trimesters, particularly in women who started ART in pregnancy (+ 0.163, vs. + 0.036 in women already on treatment). The rate of CD4/CD8 ratio normalization, defined by achieving a ratio ≥ 1 at the third trimester, was 13.2%. In multivariable analyses, women who entered pregnancy with a CD4/CD8 ratio < 0.3, compared to women with ratio ≥ 1, were almost four-times less likely to have third-trimester HIV-RNA < 50 copies/ml (AOR 0.258, 95%CI 0.111–0.601), and more than twice as likely to have preterm delivery (AOR 2.379, 95%CI 1.082–5.232). For preterm delivery, also a baseline CD4/CD8 ratio between 0.3 and 0.45 was significantly associated with an increased risk (AOR: 3.415, 95%CI 1.690–6.900). Conclusion: We described for the first time independent associations of low CD4/CD8 ratio with preterm delivery and HIV-RNA suppression.

Published
2021

9. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. D., Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S. Mercurio V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. D., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordonivicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F. M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., Vella, S., Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. Degli, Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S.Mercurio, V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., BordoniVicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F.M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G.C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Parazzini, F., and Vella, S.

Subjects
Male, 0301 basic medicine, medicine.medical_treatment, HIV Infections, 0302 clinical medicine, Pregnancy, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Complications, Infectious, Darunavir, medicine.diagnostic_test, Obstetrics, Pregnancy Outcome, virus diseases, Alanine Transaminase, Viral Load, Cholesterol, Treatment Outcome, Infectious Diseases, Premature birth, Gestation, Female, Drugs in pregnancy, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Anti-HIV Agents, Atazanavir Sulfate, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, pharmacology, pharmacology (medical), infectious diseases, medicine, Humans, Caesarean section, Triglycerides, Pharmacology, business.industry, Infant, Newborn, Infant, Bilirubin, medicine.disease, 030112 virology, Atazanavir, azatanavir sulfate, Lipid profile, business
Abstract

Background Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study. Methods Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score). Results Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P

Published
2017
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12. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, M., Masuelli, G., Tassis, B., Franceschetti, L., Savasi, V. M., Spinillo, A., Tamburrini, E., Guaraldi, G., Dalzero, S., Sansone, M., Chiodo, A., Degli Antoni, A. M., Pinnetti, C., Liuzzi, G., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., della Pieta, I., Sorz, A., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Badolato, R., Forleo, M. A., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., de Martino, M., Parazzini, F., and Vella, S.

Subjects
medicine.medical_specialty, Multivariate analysis, Anti-HIV Agents, Integrase inhibitor, HIV Infections, Overweight, Weight Gain, Cohort Studies, Pregnancy, Internal medicine, medicine, Humans, Pharmacology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Pharmacology, business.industry, Weight change, Odds ratio, medicine.disease, Obesity, Infectious Diseases, Reverse Transcriptase Inhibitors, Female, medicine.symptom, business, Weight gain
Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes. Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses. Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+ T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65). Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2021

14. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series

Author

Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S., Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, and Mori F, Ortolani P, Dalle Nogare ER, Di Lorenzo F, Sterrantino G, Meli M, Polemi S, Nocentini J, Baldini M, Montorzi G, Mazzetti M, Rogasi P, Borchi B, Vichi F, Del Pin B, Pinter E, Anzalone E, Marocco R, Mastroianni C, Mercurio VS, Carocci A, Grilli E, Maccabruni A, Zaramella M, Mariani B, Natalini Raponi G, Guaraldi G, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S.

Subjects
Infectious Disease Transmission, Prenatal diagnosis, HIV Infections, 0302 clinical medicine, Birth defect, Pregnancy, Odds Ratio, Vertical, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, education.field_of_study, Amniocentesi, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Obstetrics, Infectious, Obstetrics and Gynecology, Amniocentesis, birth defects, chorionic villus sampling, HIV, invasive testing, mother-to child HIV transmission, pregnancy, prenatal diagnosis, Birth defects, Chorionic villus sampling, Invasive testing, Mother-to child HIV transmission, Anti-Retroviral Agents, Chorionic Villi Sampling, Female, Adult, medicine.medical_specialty, Prenatal diagnosi, Population, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Humans, education, Fetal Death, Analysis of Variance, Chi-Square Distribution, business.industry, Infectious Disease Transmission, Vertical, Odds ratio, medicine.disease, Confidence interval, Pregnancy Complications, business, Chi-squared distribution
Abstract

Objectives To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting University and hospital clinics. Population Pregnant women with HIV. Methods Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures Rate of invasive testing, intrauterine death, HIV transmission. Results Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011–2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.

Published
2016
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15. Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol

Author

Tibaldi, C., Masuelli, G., Sansone, M., Tassis, B., Cetin, I., Franceschetti, L., Spinillo, A., Simonazzi, G., Vimercati, A., Dalzero, S., Meloni, A., Bernardon, M., Frisina, V., Polizzi, C., Todros, T., Martinelli, P., Floridia, M., Ravizza, M., Trentini, L., Tiso, G., Brambilla, T., Savasi, V., Personeni, C., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Forleo, M. A., Badolato, R., Roccio, M., Zanaboni, D., Sirico, A., Maruotti, G. M., Capone, A., Guerra, B., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Crupano, F. M., Calabretti, D., Ravizz, M., Marconi, A. M., Galiano, V., Ierardi, S. C. S. M., Chiodo, A., Ortu, F., Piano, P., Dedoni, I. M., Maso, G., Belcaro, C., Rizzante, E., Alberico, S., Citernesi, A., Vicini, I. B., Luzi, K., Tibaldi C, Masuelli G, Sansone M, Tassis B, Cetin I, Franceschetti L, Spinillo A, Simonazzi G, Vimercati A, Dalzero S, Meloni A, Bernardon M, Frisina V, Polizzi C, Todros T, Martinelli P, Floridia M, Ravizza M, and for SIGO-HIV Study Group.

Subjects
0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Young adult, Hiv transmission, Delivery complications, Vaginal delivery, business.industry, Obstetrics, Cesarean Section, HIV, Mode of delivery, Delivery, Obstetric, Female, Italy, Viral Load, Obstetric, General Medicine, medicine.disease, Infectious Diseases, Delivery complication, business, Viral load, Delivery
Abstract

PURPOSE: To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. METHODS: Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). RESULTS: Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p

Published
2019

20. Evolving treatment implementation among HIV- infected pregnant women and their partners: Results from a national surveillance study in Italy, 2001-2015

Author

Floridia, M., Frisina, V. b., Ravizza, M., Marconi, A. M., Pinnetti, C., Cetin, I., Sansone, M., Molinari, A., Cervi, F., Meloni, A., Luzi, K., Masuelli, G., Tamburrini, E., Ensoli, B., Moroni, M., Lazzarin, A., Sagnelli, E., Antinori, A., Carosi, G., Marcotullio, S., Mazzotta, F., Vella, S., Ammassari, A., Antonucci, G., Andreoni, M., Angarano, G., Armignacco, O., Babudieri, S., Baldelli, F., Bini, T., Bonfanti, Bonora, P., Borderi, S., Bruno, M., Bucciardini, R., Castagna, R, Cattelan, A., Cauda, A. M., Cerioli, R., Chirianni, A., Cingolani, A., Cinque, A., D'Arminio, Monforte, Carli, De, Luca, De, Perri, Di, Pietro, Di, Hamad, El, Errico, I., Ferrazzi, M., Gabrielli, E., Galli, E., Giaquinto, M., Girardi, C., Gori, E., Grossi, A., Guaraldi, P., Liuzzi, G., Caputo, Lo, Maggiolo, S., Malena, F., Maserati, M., Mastroianni, R., Matteelli, C., Morrone, A., Murri, A., Mussini, R., Nasta, C., Oldrini, P., Oleari, M., Orlando, F., Palù, G., Pempinello, G., Perno, R., Prestileo, C., Pompa, T., Puoti, M. G., Puro, M., Rancilio, V., Rasi, L., Rizzardini, G., Savasi, G., Signorini, V. M., Sighinolfi, L., Stagnitta, L., Starace, M., Starnini, F., Sterrantino, G., Suter, G., Tambussi, F., Tavio, G., Torti, M., Tozzi, C., Trotta, V., Vaccher, M. P., Viganò, E., Visintini, A., Vullo, R., Zuccotti, V., Dell'Isola, G. V., Manfredini, S., Parisi, V., Pezzoli, S., M. C., Floridia, M, Frisina, V, Ravizza, M, Marconi, A, Pinnetti, C, Cetin, I, Sansone, M, Molinari, A, Cervi, F, Meloni, A, Luzi, K, Masuelli, G, Tamburrini, E, Ensoli, B, Moroni, M, Lazzarin, A, Sagnelli, E, Antinori, A, Carosi, G, Marcotullio, S, Mazzotta, F, Vella, S, Ammassari, A, Antonucci, G, Andreoni, M, Angarano, G, Armignacco, O, Babudieri, S, Baldelli, F, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Bruno, R, Bucciardini, R, Castagna, A, Cattelan, A, Cauda, R, Cerioli, A, Chirianni, A, Cingolani, A, Cinque, P, d'Arminio Monforte, A, De Carli, G, De Luca, A, Di Perri, G, Di Pietro, M, El Hamad, I, Errico, M, Ferrazzi, E, Gabrielli, E, Galli, M, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Liuzzi, G, Lo Caputo, S, Maggiolo, F, Malena, M, Maserati, R, Mastroianni, C, Matteelli, A, Morrone, A, Murri, R, Mussini, C, Nasta, P, Oldrini, M, Oleari, F, Orlando, G, Palu, G, Pempinello, R, Perno, C, Prestileo, T, Pompa, M, Puoti, M, Puro, V, Rancilio, L, Rasi, G, Rizzardini, G, Savasi, V, Signorini, L, Sighinolfi, L, Stagnitta, M, Starace, F, Starnini, G, Sterrantino, G, Suter, F, Tambussi, G, Tavio, M, Torti, C, Tozzi, V, Trotta, M, Vaccher, E, Vigano, A, Visintini, R, Vullo, V, Zuccotti, G, Dell'Isola, S, Manfredini, V, Parisi, S, Pezzoli, M, Zona, S, Floridia, M., Frisina, V., Ravizza, M., Marconi, A. M., Pinnetti, C., Cetin, I., Sansone, M., Molinari, A., Cervi, F., Meloni, A., Luzi, K., Masuelli, G., Tamburrini, E., Ensoli, B., Moroni, M., Lazzarin, A., Sagnelli, E., Antinori, A., Carosi, G., Marcotullio, S., Mazzotta, F., Vella, S., Ammassari, A., Antonucci, G., Andreoni, M., Angarano, G., Armignacco, O., Babudieri, S., Baldelli, F., Bini, T., Bonfanti, P., Bonora, S., Borderi, M., Bruno, R., Bucciardini, R., Castagna, A., Cattelan, A. M., Cauda, R., Cerioli, A., Chirianni, A., Cingolani, A., Cinque, P., d'Arminio Monforte, A., De Carli, G., De Luca, A., Di Perri, G., Di Pietro, M., El Hamad, I., Errico, M., Ferrazzi, E., Gabrielli, E., Galli, M., Giaquinto, C., Girardi, E., Gori, A., Grossi, P., Guaraldi, G., Liuzzi, G., Lo Caputo, S., Maggiolo, F., Malena, M., Maserati, R., Mastroianni, C., Matteelli, A., Morrone, A., Murri, R., Mussini, C., Nasta, P., Oldrini, M., Oleari, F., Orlando, G., Palu, G., Pempinello, R., Perno, C. -F., Prestileo, T., Pompa, M. G., Puoti, M., Puro, V., Rancilio, L., Rasi, G., Rizzardini, G., Savasi, V. M., Signorini, L., Sighinolfi, L., Stagnitta, M., Starace, F., Starnini, G., Sterrantino, G., Suter, F., Tambussi, G., Tavio, M., Torti, C., Tozzi, V., Trotta, M. P., Vaccher, E., Vigano, A., Visintini, R., Vullo, V., Zuccotti, G. V., Dell'Isola, S., Manfredini, V., Parisi, S., Pezzoli, M. C., and Zona, S.

Subjects
0301 basic medicine, Male, Infectious Disease Transmission, HIV Infections, Pre-Exposure Prophylaxi, Miscarriage, Cohort Studies, Pre-exposure prophylaxis, 0302 clinical medicine, Pregnancy, Prevalence, Medicine, Vertical, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, Treatment implementation, Obstetrics, Health Policy, Medicine (all), Infectious, Pregnancy Outcome, Articles, 3. Good health, Sexual Partner, Sexual Partners, Italy, Serodiscordant, Chemoprophylaxis, Female, Live birth, Adolescent, Adult, Anti-HIV Agents, Fertilization, Humans, Infectious Disease Transmission, Vertical, Pre-Exposure Prophylaxis, Cohort study, Human, medicine.medical_specialty, 03 medical and health sciences, Environmental health, business.industry, Public Health, Environmental and Occupational Health, Anti-HIV Agent, medicine.disease, 030112 virology, Pregnancy Complications, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Background The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. Methods The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study. The study period was divided in three intervals of five years each (2001-2005, 2006-2010, 2011-2015), and the analysis evaluated temporal trends in rates of HIV diagnosis in pregnancy, maternal antiretroviral treatment at conception, prevalence of HIV infection among partners of pregnant women with HIV, and proportion of seronegative and seropositive male partners receiving antiretroviral treatment. Results The analysis included 2755 pregnancies in women with HIV. During the three time intervals considered the rate of HIV diagnosis in pregnancy (overall 23.3%), and the distribution of HIV status among male partners (overall 48.7% HIV- negative, 28.6% HIV-positive and 22.8% unknown) remained substantially unchanged. Significant increases were observed in the proportion of women with HIV diagnosed before pregnancy who were on antiretroviral treatment at conception (from 62.0% in 2001-2005 to 81.3% in 2011-2015, P < 0.001), and in the proportion of HIV-positive partners on antiretroviral treatment (from 73.3% in 2001-2005 to 95.8% in 2011-2015, P = 0.002). Antiretroviral treatment was administered in 99.1% of the pregnancies that did not end early because of miscarriage, termination, or intrauterine death, and in 75.3% of those not ending in a live birth. No implementation of antiretroviral treatment was introduced among male HIV-negative partners. Conclusions The results suggest good implementation of antiretroviral treatment among HIV-positive women and their HIV-positive partners, but no implementation, even in recent years, of Pre-Exposure Prophylaxis (PrEP) among uninfected male partners. Further studies should assess the determinants of this occurrence and clarify the attitudes and the potential barriers to PrEP use.

Published
2017

21. Abstract form for the Irish Journal of Medical Science v workshop on gastroduodenal pathology and Helicobacter pylori July 5th — 7th 1992 — Dublin, Ireland

Author

Logan, R. P. H., Gummett, P. A., Walker, M. M., Karim, Q. N., Baron, J. H., Misiewicz, J. J., Trieber, G., Walker, S., Klotz, U., Lozniewski, A., Weber, M., de Korwin, J. D., Floquet, J., Conroy, M. C., Burdin, J. C., Mannes, G. A., Bayerdörffer, E., Höchter, W., Weingart, J., Heldwein, W., Sommer, A., Müller-Lissner, S., Bomschein, W., Miehlke, S., Weinzierl, M., Ruckdeschel, G., von Wulffen, H., Köpcke, W., Stolte, M., Rune, S. J., Justesen, T., Hansen, J. M., Jensen, T. G., Eriksen, J., Thomsen, O. ø., Scheibel, J., Bonnevie, O., Bremmelgaard, A., Vilien, M., Knuhtsen, S., Elsborg, L., Hansen, J., Lauritsen, K., Wulff, H. R., Boixeda, D., Ballestero, S., Cantón, R., De Rafael, L., Martinm de Argila, C., Pozuelo, M. J., Sampedro, J., Baquero, F., Grigoriev, P. Ya., Isakov, V. A., Iakovenko, E. P., Hirschl, A. M., Brandstätter, G., Dragosics, B., Hentschel, E., Kundi, M., Rotter, M. L., Schütze, K., Taufer, M., Neri M, Susi D, Bovani I, Pindo R, Cuccurullo F., Coelho, L. G. V., Passos, M. C. F., Chausson, Y., Vieira, W. L. S., Castro, F. J., Franco, J. M. M., Fernandes, M. L. M., Castro, L. P., Jonas, C., De Koster, E., Van Gossum, M., Depierreux, M., Cheval, M., Deltenre, M., Schütz, E., Bethke, B., Lee, A., Hegedus, E., O’Rourke, J., Larsson, H., Sjöstedt, S., Veress, B., Nord, C. E., Sobala, G. M., George, R., Tompkins, D., Finlay, J., Manning, A., Sant, S., Xia, H. X., Daw, M., Gilvarry, J., Keane, C. T., O’Morain, C., Rubio, M. A., Hegarty, B., Blum, A. L., Sulser, E., Stadelmann, O., Munoz, N., Buiatti, E., Vivas, J., Oliver, W., Cano, E., Peraza, S., Castro, D., Sanchez, V., Andrade, O., Benz, M., Mendz, G. L., Hazell, S. L., Salmela, K. S., Roire, R. P., Hook-Nikanne, J., Kosunen, T. U., Salaspur, M., Luke, C. J., Reynolds, D. D. J., Penn, C. W., Bode, G., Mauch, F., Ditschuneit, H., Malfertheiner, P., Ferrero, Richard L., Agnes Labigne, Eaton, K. A., Krakowka, S., Mobley, H. L. T., Hu, Li-Tai, Foxall, P. A., Moran, A. P., Helander, I. M., Altman, C., Sobhani, I., Vissugaire, C., Migrant, M., Etienne, J. P., Sommi, P., Ricci, V., Fiocca, R., Cova, E., Figura, N., Romano, M., Ivey, K. J., Solcia, E., Ventura, U., Nilius, M., Schieffer, S., Hengels, K. J., Jablonowski, H., Strohmeyer, G., Cabrai, M. D., Barbosa, A. J. A., Lima Hr., G. F., Oliveira, C. A., Polak, J. M., Oderda, G., Villani, L., Altare, F., Morra, I., Miserendino, L., Ansaldi, N., Dixon, M. F., Wyatt, J. I., Axon, A. T. R., Beattie, S., Hamilton, H., Shabib, S., Cutz, E., Drumm, B., Sherman, P., Noach, L. A., Rolf, T., Bosma, N. B., Schwartz, M. P., Oosting, J., Rauws, E. A. J., Tytgat, G. N. J., Andrew, A., Nardone, G., d’Ormiento, F., Pontillo, M., Lobo, A. J., Uff, J. S., McNulty, C. N. M., Wilkinson, S. P., Suriani, R., Pallante, C., Ravizza, M., Galliano, D., Sallio, D., Malandrino, M., Oneglio, R., Colozza, M., Mazzucco, D., Gaia, E., Eidt, S., Vincent, P., Gottrand, F., Turck, D., Lecomte-Houcke, M., Leclerc, H., Bonvicini, F., Pretolani, S., Baraldini, M., Cilla, D., Baldinelli, S., Bazocchi, E., Acampora, P., Careddu, N., Brocchi, E., Gasbarrini, G., Joubert, M., Bazin, N., Thiaucourt, D., Protte, E., Gissler, C., Duprez, A., Merlin, P., Forestier, S., Labenz, J., Gyenes, E., Rühl, G. H., Börsch, G., Daskalopoulos, G., Carrick, J., Lian, R., Wagner, S., Bleck, J., Gebel, M., Bär, W., Manns, M., Lamouliatte, H., Bernard, P. H., Cayla, R., Vialette, G., Quinton, A., Mégraud, F., Lemaire, M., Quinten, A., De Mascarel, A., Webb, P., Forman, D., Knight, T., Wilson, A., Graves, S., Newell, D., Elder, J., Tonelli, E., Gatte, M. R. A., Ghironzi, G. C., Giulianelli, G., Bamford, K. B., Collins, J. S. A., Bickley, J., Johnston, B. T., Potts, S., Boston, V., Owen, R. J., Sloan, J., Basso, L., Lawlor, S., Clune, J., Szelényi, H., Stohmeyer, G., Macedo, G., Iglésias, I., Chaves, A. P., Loureiro, A., Katelaris, P. H., Seow, F., Lin, B., Napoli, J., Hones, D. B., Ngu, M. C., Akopyantz, Natalia S., Bukanov, Nikolay O., Westblom, T. Ulf, Berg, Douglas E., Nyst, J. F., Denis, P., Buset, M., De Reuck, M., Nielsen, H., Andersen, L. P., Birkholz, Sabine, Knipp, Ulrich, Nietzki, Claudia, Opferkuch, Wolfgang, Crabtree, J. E., Peichl, P., Lindly, I. J. D., Deusch, K., Seifirth, C., Funk, A., Dahie, I., Reut, K., Classen, M., Gionchetti, P., Vaira, D., Campieri, M., Bertinelli, E., Menegatti, M., Belluzzi, A., Briognola, C., Miglioli, M., Barbara, L., Tommaso, A. Di, Magistris, M. T. De, Bugnoli, M., Petracca, R., Covacci, A., Censini, S., Rappuoli, R., Abrignani, S., Territo, M. C., Smela, K. L., Reeve, J. R., Lee, T. D., Walsh, J. H., Armellini, D., Crabtree, J. E., Xiang, Z. Y., Mitchell, H. M., Hu, P. J., Li, Y. Y., Wang, Z. J., Zhao, S. M., Liu, Q., Chen, M., Du, G. G., Filipe, M. I., Reed, P. I., Craanen, M. E., Blok, P., Dekker, W., Colombo, E., Redaelli, D., Santangelo, M., Spinelli, M., Farinati, F., Valiante, F., Delia Libera, G., Germanà, B., Baffa, R., Rugge, M., Vianelo, F., Di Mario, F., Sipponen, Pentti, Rokkas, T., Popotheodorou, G., Kaldgeropoulos, N., Deprez, C., Galand, P., Fox, J. G., Wishnok, P., Murphy, J. C., Tannenbaum, S., Correa, P., Parsonnet, Julie, Macor, C., Da Broi, G. L., Avellinio, C., Reifen, R., Rasooly, I., Millson, M. E., Murphy, K., Thomas, J. E., Eastham, E. J., Malorgio, E., Dell’Olio, D., Kemmer, T. P., Dominguez-Munoz, J. E., Klingel, H., Gatto, M. R. A., Olivieri, R., Bayeli, R. F., Abate, L., De Gregorio, L., Aziz, J., Esposito, E., Basagni, C., Guilluy, R., Rousseau-Tsangaris, M., Brazier, J. L., Wadstiöm, Torkel, Tyszkiewicz, Tadeusz, Bergenzaun, Per, Olsson, Karin, Birac, C., Tall, F., Albenque, M., Labigne, A., Megraud, F., Feldman, R. A., Deeks, J., Glupczynski, Y., Burette, A., Goossens, H., Van den Boore, C., Butzler, J. P., Veldhuyzen van Zanten, S., Best, L., Benzanson, G., Haldane, D., Hazell, S., Mapstone, N. P., Lynch, D. A. F., Quirke, P., Taylor, D. E., Chang, N., Eaton, M., Stockdale, E., Salama, S. M., Thompson, L., Cockayne, A., Spiller, R. C., Leen, E., Sweeney, E., Klann, H., Hatz, R., Bornschein, W., Simon, T., Eimiller, A., Bolle, F., Schweikert, C., Köpeke, W., Moss, S. F., Bishop, A. E., Calam, J., Cahill, R. J., Xia, H., Solnick, J., and Tompkins, L.

Published
1992
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22. Treatment

Author

Goodwin, C. S., Worsley, B., Pillai, E., Willems, V., Janisch, H. D., Langmaack, H., Sanchez, P., Alcalde, M., Lancho, A., Carpintero, P., Garcia, R., Pajares, J. M., Grigoriev, P. Ya., Isakov, V. A., Iakovenko, E. P., Iakovenko, A. V., Vogt, K., Hahn, H., Rehmann, I. H., Hedding-Eckerich, M., Blessing, J., Sobala, G. M., Lynch, D. A. F., Gallacher, B., Dixon, M. F., Axon, A. T. R., Bayerdörffer, E., Mannes, G., Sommer, A., Höchter, W., Weingart, J., Hatz, R., Miehlke, S., Lehn, N., Ruckdeschel, G., Dirschedl, P., Stolte, M., Adamek, R. J., Wegener, M., Birkholz, S., Opferkuch, W., Rühl, G. H., Wedmann, B., Labenz, J., Gyenes, E., R’hl, G. H., Börsch, G., Maieron, R., Rizzi, C., Zoratti, L., Andreoli, S., Da Broi, G. L., Beltrami, C. A., Chengyl, Zhuya, Yangiong, Mou, Jiesong, Hua, Zhenhua, Zhang, Bierti, L., Bolis, E. G., Di Battista, R., de Franchis, R., McAvinchey, D. J., Laurence, M., O’Riordan, J., Fantazi, M., Khawaja, M., Bologna, E, Stroppiana, M., Peyre, S., Pulitano’, R., Sategna-Guidetti, C., Martin, E., Alarcön, T., Sanz, J. C., Jimonez, M. I., López-Brea, M., Burette, A., Glupczynski, Y., Deprez, C., Di Mario, F., Ferrana, M., Battaglia, G., Dotto, P., Vianello, F., Grasso, G. A., Fiocca, R., Villiani, L., Luinetti, O., Gianatti, A., Boldorini, R., Lazzaroni, M., Bianchi Porro, G., Trespi, E., Perego, M., Alvisi, C., Cesana, B., Solcia, E., Logan, R. P. H., Greaves, R. R., Gummett, P. A., Walker, M. M., Karim, Q. N., Duggan, A. E., Baron, J. H., Misiewicz, J. J., Lohmarm, J., Porst, L. H. H., Schönlebe, J., Riedel, H., Catalano, F., Rizzo, G., Ayoubi Khajekini, M. T., Branciforte, G., Inserra, G., Liberti, A., Suriani, R., Pallante, C., Ravizza, M., Mazzucco, D., Galliano, D., Malandrino, M., Oneglio, R., Colozza, M., Gaia, E., Sallio, F., Colozza, D., Grandis, C., Forte, G. B., Bottiglieri, M. E., Durasco, R., Grimaldi, E., Rocco, P., Xia, H. X., Daw, M. A., Sant, S., Beattie, S., Keane, C. T., O’Morain, C. A., Larsson, H., Berglund, M. L., Tessaro, P., Schiavon, R., Contini, M. G., Ton, T., Norberto, L., Cassaro, M., Rugge, M., Guido, M., Baffa, R., Gloriosa, S., Turatello, F., Naccarato, R., Collins, R., O’Moram, C., Kemmer, T. P., Dominguez-Munoz, J. E., Klingel, H., Malfertheiner, P., McCarthy, C. J., McDermott, M., Hourihane, D., O’Morain, C., Droy-Lefiax, M. T., Forestier, B., Guillomain, D., Plique, O., Brugmann, D., Mégraud, F., Lamouliatte, H., Bernard, P. H., Cayla, R., Mégraud, M., de Mascarel, A., Quintonl, A., McLaren, A., McDowell, S. R., McColm, A. A., O’Malley, C., Bagshaw, J., Bouffant, F., Marelli, P., Cellini, L., Campa, M., Dainelli, B., Soldani, G., del Tacca, M., Ferrini, G., Larcinese, G., Semperlotti, N., Molnar, Gy., Fzentmihalyi, A., Takats, A., Gero, G., Penyige, J., Mark, Gy., Martínez-Gómez, J., García-Novo, D., Acuña-Quinõs, D., Gimeno, M., Vigneri, S., Termini, R., Scialabba, A., Pisciotta, G., Gusmaroli, R., Milesi, F., Mule, P., Menegatti, M., Reale, C., Holten, J., and Vaira, D.

Published
1992
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23. Evolving treatment implementation among HIV- infected pregnant women and their partners: Results from a national surveillance study in Italy, 2001-2015

Author

Floridia, M, Frisina, V, Ravizza, M, Marconi, A, Pinnetti, C, Cetin, I, Sansone, M, Molinari, A, Cervi, F, Meloni, A, Luzi, K, Masuelli, G, Tamburrini, E, Ensoli, B, Moroni, M, Lazzarin, A, Sagnelli, E, Antinori, A, Carosi, G, Marcotullio, S, Mazzotta, F, Vella, S, Ammassari, A, Antonucci, G, Andreoni, M, Angarano, G, Armignacco, O, Babudieri, S, Baldelli, F, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Bruno, R, Bucciardini, R, Castagna, A, Cattelan, A, Cauda, R, Cerioli, A, Chirianni, A, Cingolani, A, Cinque, P, d'Arminio Monforte, A, De Carli, G, De Luca, A, Di Perri, G, Di Pietro, M, El Hamad, I, Errico, M, Ferrazzi, E, Gabrielli, E, Galli, M, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Liuzzi, G, Lo Caputo, S, Maggiolo, F, Malena, M, Maserati, R, Mastroianni, C, Matteelli, A, Morrone, A, Murri, R, Mussini, C, Nasta, P, Oldrini, M, Oleari, F, Orlando, G, Palu, G, Pempinello, R, Perno, C, Prestileo, T, Pompa, M, Puoti, M, Puro, V, Rancilio, L, Rasi, G, Rizzardini, G, Savasi, V, Signorini, L, Sighinolfi, L, Stagnitta, M, Starace, F, Starnini, G, Sterrantino, G, Suter, F, Tambussi, G, Tavio, M, Torti, C, Tozzi, V, Trotta, M, Vaccher, E, Vigano, A, Visintini, R, Vullo, V, Zuccotti, G, Dell'Isola, S, Manfredini, V, Parisi, S, Pezzoli, M, Zona, S, Floridia M., Frisina V., Ravizza M., Marconi A. M., Pinnetti C., Cetin I., Sansone M., Molinari A., Cervi F., Meloni A., Luzi K., Masuelli G., Tamburrini E., Ensoli B., Moroni M., Lazzarin A., Sagnelli E., Antinori A., Carosi G., Marcotullio S., Mazzotta F., Vella S., Ammassari A., Antonucci G., Andreoni M., Angarano G., Armignacco O., Babudieri S., Baldelli F., Bini T., Bonfanti P., Bonora S., Borderi M., Bruno R., Bucciardini R., Castagna A., Cattelan A. M., Cauda R., Cerioli A., Chirianni A., Cingolani A., Cinque P., d'Arminio Monforte A., De Carli G., De Luca A., Di Perri G., Di Pietro M., El Hamad I., Errico M., Ferrazzi E., Gabrielli E., Galli M., Giaquinto C., Girardi E., Gori A., Grossi P., Guaraldi G., Liuzzi G., Lo Caputo S., Maggiolo F., Malena M., Maserati R., Mastroianni C., Matteelli A., Morrone A., Murri R., Mussini C., Nasta P., Oldrini M., Oleari F., Orlando G., Palu G., Pempinello R., Perno C. -F., Prestileo T., Pompa M. G., Puoti M., Puro V., Rancilio L., Rasi G., Rizzardini G., Savasi V. M., Signorini L., Sighinolfi L., Stagnitta M., Starace F., Starnini G., Sterrantino G., Suter F., Tambussi G., Tavio M., Torti C., Tozzi V., Trotta M. P., Vaccher E., Vigano A., Visintini R., Vullo V., Zuccotti G. V., Dell'Isola S., Manfredini V., Parisi S., Pezzoli M. C., Zona S., Floridia, M, Frisina, V, Ravizza, M, Marconi, A, Pinnetti, C, Cetin, I, Sansone, M, Molinari, A, Cervi, F, Meloni, A, Luzi, K, Masuelli, G, Tamburrini, E, Ensoli, B, Moroni, M, Lazzarin, A, Sagnelli, E, Antinori, A, Carosi, G, Marcotullio, S, Mazzotta, F, Vella, S, Ammassari, A, Antonucci, G, Andreoni, M, Angarano, G, Armignacco, O, Babudieri, S, Baldelli, F, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Bruno, R, Bucciardini, R, Castagna, A, Cattelan, A, Cauda, R, Cerioli, A, Chirianni, A, Cingolani, A, Cinque, P, d'Arminio Monforte, A, De Carli, G, De Luca, A, Di Perri, G, Di Pietro, M, El Hamad, I, Errico, M, Ferrazzi, E, Gabrielli, E, Galli, M, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Liuzzi, G, Lo Caputo, S, Maggiolo, F, Malena, M, Maserati, R, Mastroianni, C, Matteelli, A, Morrone, A, Murri, R, Mussini, C, Nasta, P, Oldrini, M, Oleari, F, Orlando, G, Palu, G, Pempinello, R, Perno, C, Prestileo, T, Pompa, M, Puoti, M, Puro, V, Rancilio, L, Rasi, G, Rizzardini, G, Savasi, V, Signorini, L, Sighinolfi, L, Stagnitta, M, Starace, F, Starnini, G, Sterrantino, G, Suter, F, Tambussi, G, Tavio, M, Torti, C, Tozzi, V, Trotta, M, Vaccher, E, Vigano, A, Visintini, R, Vullo, V, Zuccotti, G, Dell'Isola, S, Manfredini, V, Parisi, S, Pezzoli, M, Zona, S, Floridia M., Frisina V., Ravizza M., Marconi A. M., Pinnetti C., Cetin I., Sansone M., Molinari A., Cervi F., Meloni A., Luzi K., Masuelli G., Tamburrini E., Ensoli B., Moroni M., Lazzarin A., Sagnelli E., Antinori A., Carosi G., Marcotullio S., Mazzotta F., Vella S., Ammassari A., Antonucci G., Andreoni M., Angarano G., Armignacco O., Babudieri S., Baldelli F., Bini T., Bonfanti P., Bonora S., Borderi M., Bruno R., Bucciardini R., Castagna A., Cattelan A. M., Cauda R., Cerioli A., Chirianni A., Cingolani A., Cinque P., d'Arminio Monforte A., De Carli G., De Luca A., Di Perri G., Di Pietro M., El Hamad I., Errico M., Ferrazzi E., Gabrielli E., Galli M., Giaquinto C., Girardi E., Gori A., Grossi P., Guaraldi G., Liuzzi G., Lo Caputo S., Maggiolo F., Malena M., Maserati R., Mastroianni C., Matteelli A., Morrone A., Murri R., Mussini C., Nasta P., Oldrini M., Oleari F., Orlando G., Palu G., Pempinello R., Perno C. -F., Prestileo T., Pompa M. G., Puoti M., Puro V., Rancilio L., Rasi G., Rizzardini G., Savasi V. M., Signorini L., Sighinolfi L., Stagnitta M., Starace F., Starnini G., Sterrantino G., Suter F., Tambussi G., Tavio M., Torti C., Tozzi V., Trotta M. P., Vaccher E., Vigano A., Visintini R., Vullo V., Zuccotti G. V., Dell'Isola S., Manfredini V., Parisi S., Pezzoli M. C., and Zona S.

Abstract

Background The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. Methods The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study. The study period was divided in three intervals of five years each (2001-2005, 2006-2010, 2011-2015), and the analysis evaluated temporal trends in rates of HIV diagnosis in pregnancy, maternal antiretroviral treatment at conception, prevalence of HIV infection among partners of pregnant women with HIV, and proportion of seronegative and seropositive male partners receiving antiretroviral treatment. Results The analysis included 2755 pregnancies in women with HIV. During the three time intervals considered the rate of HIV diagnosis in pregnancy (overall 23.3%), and the distribution of HIV status among male partners (overall 48.7% HIV- negative, 28.6% HIV-positive and 22.8% unknown) remained substantially unchanged. Significant increases were observed in the proportion of women with HIV diagnosed before pregnancy who were on antiretroviral treatment at conception (from 62.0% in 2001-2005 to 81.3% in 2011-2015, P < 0.001), and in the proportion of HIV-positive partners on antiretroviral treatment (from 73.3% in 2001-2005 to 95.8% in 2011-2015, P = 0.002). Antiretroviral treatment was administered in 99.1% of the pregnancies that did not end early because of miscarriage, termination, or intrauterine death, and in 75.3% of those not ending in a live birth. No implementation of antir

Published
2017

24. CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy.

Author

Floridia, Marco, Pinnetti, Carmela, Masuelli, Giulia, Spinillo, Arsenio, Savasi, Valeria M., Liuzzi, Giuseppina, Degli Antoni, Anna M., Sansone, Matilde, Guaraldi, Giovanni, Dalzero, Serena, Maso, Gianpaolo, Francisci, Daniela, Sterrantino, Gaetana, Ravizza, Marina, Tamburrini, Enrica, The Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy, Floridia, M., Ravizza, M., Tamburrini, E., and Di Lorenzo, F.

Subjects
RNA analysis, HIV infections, STATISTICS, PREMATURE infants, CONFIDENCE intervals, FIRST trimester of pregnancy, THIRD trimester of pregnancy, MULTIVARIATE analysis, PREGNANT women, PREGNANCY outcomes, HIGHLY active antiretroviral therapy, LOW birth weight, RISK assessment, DESCRIPTIVE statistics, T cells, ODDS ratio
Abstract

Purpose: To evaluate associations between CD4/CD8 ratio and pregnancy outcomes in women with HIV. Methods: We evaluated, in a national study of pregnant women with HIV receiving antiretroviral treatment (ART), values of CD4/CD8 ratio at entry in pregnancy, changes between first and third trimester, and possible associations with preterm delivery, low birthweight, and HIV-RNA < 50 copies/ml at third trimester in univariate and multivariate analyses. Results: Among 934 women, 536 (57.4%) were already on ART at conception. CD4/CD8 ratio (baseline value 0.570) increased significantly between the first and third trimesters, particularly in women who started ART in pregnancy (+ 0.163, vs. + 0.036 in women already on treatment). The rate of CD4/CD8 ratio normalization, defined by achieving a ratio ≥ 1 at the third trimester, was 13.2%. In multivariable analyses, women who entered pregnancy with a CD4/CD8 ratio < 0.3, compared to women with ratio ≥ 1, were almost four-times less likely to have third-trimester HIV-RNA < 50 copies/ml (AOR 0.258, 95%CI 0.111–0.601), and more than twice as likely to have preterm delivery (AOR 2.379, 95%CI 1.082–5.232). For preterm delivery, also a baseline CD4/CD8 ratio between 0.3 and 0.45 was significantly associated with an increased risk (AOR: 3.415, 95%CI 1.690–6.900). Conclusion: We described for the first time independent associations of low CD4/CD8 ratio with preterm delivery and HIV-RNA suppression. [ABSTRACT FROM AUTHOR]

Published
2021
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26. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, Marco, Masuelli, Giulia, Tassis, Beatrice, Franceschetti, Laura, Savasi, Valeria Maria, Spinillo, Arsenio, Tamburrini, Enrica, Guaraldi, Giovanni, Dalzero, Serena, Sansone, Matilde, Chiodo, Antonella, Antoni, Anna Maria Degli, Pinnetti, Carmela, Liuzzi, Giuseppina, Ravizza, Marina, Floridia, M., Ravizza, M., Tamburrini, E., Ravizza, M., Tamburrini, E., Lorenzo, F. Di, Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Pin, B. Del, Marocco, R., Mastroianni, C., Mercurio, V.S., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., Pietà, I. Della, Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. Bordoni, Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M.A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Dalzero, S., Ierardi, M., Simonetti, S.C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Cerioli, A., Martino, M. De, Parazzini, F., Tamburrini, E., Vella, S., Martinelli, P., and Ravizza, M.

Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes.Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses.Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65).Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2020
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27. Abacavir/Lamivudine and Tenofovir/Emtricitabine in Pregnant Women with Hiv: Laboratory and Clinical Outcomes in an Observational National Study

Author

Floridia, M., Pinnetti, C., Ravizza, M., Masuelli, G., Personeni, C., Sansone, M., Antoni, A. D., Guaraldi, G., Spinillo, A., Tassis, B., Dalzero, S., Liuzzi, G., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, B., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., and Baroncelli, S.

Subjects
0301 basic medicine, HIV Infections, Hemoglobins, 0302 clinical medicine, Abacavir, Anemia, Cholesterol, Emtricitabine, HIV-RNA, Lamivudine, Low birthweight, Pregnancy, Preterm delivery, Tenofovir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Outcome, virus diseases, Lipoproteins, LDL, Drug Combinations, Infectious Diseases, Hypertension, RNA, Viral, Female, medicine.drug, Adult, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, 03 medical and health sciences, Internal medicine, medicine, Humans, AIDS-Associated Nephropathy, Cesarean Section, business.industry, Abacavir/Lamivudine, medicine.disease, 030112 virology, Dideoxynucleosides, CD4 Lymphocyte Count, Pregnancy Complications, HIV-1, Observational study, business
Abstract

Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study.Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC.The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P0.001), and had lower CD4 counts (475/mm vs. 533/mm, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030).In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.

Published
2018

28. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

Author

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, M., Tibaldi, C., Trentini, L., Todros, T., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., Floridia, M, Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M. [, Faldella G., and ]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, birth weight, HIV, pregnancy, preterm delivery, Health Policy, Infectious Diseases, Pharmacology (medical), Birth weight, Emigrants and Immigrants, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Pregnancy, Preterm delivery, CD4 Lymphocyte Count, Female, HIV-1, Humans, Premature Birth, Viral Load, Infant, Low Birth Weight, 03 medical and health sciences, medicine, Obstetrics, business.industry, Low Birth Weight, Infant, Odds ratio, medicine.disease, 030112 virology, Confidence interval, Pregnancy rate, Low birth weight, Premature birth, medicine.symptom, business, Viral load
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

Published
2016

30. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Ravizza, M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E.R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V.S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A.M., Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Tozzi, V., Massetti, P., Casadei, A.M., Cavaliere, A.F., Cellini, M., Castelli Gattinara, G., Marconi, A.M., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., and Degli Antoni, A.

Published
2016
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31. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M., Ravizza, M., Masuelli, G., Dalzero, S., Pinnetti, C., Cetin, I., Meloni, A., Spinillo, A., Rubino, E., Francisci, D., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, Claudio Maria, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Alberico, S., Maso, G., Tropea, M., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Garetto, S., Brambilla, T., Savasi, V., Crepaldi, A., Giaquinto, C., Fiscon, M., Rinaldi, R., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Liuzzi, G., Tozzi, V., Massetti, Anna Paola, Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci, D, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Martinelli, Pasquale, Floridia M, Ravizza M, Masuelli G, Dalzero S, Pinnetti C, Cetin I, Meloni A, Spinillo A, Rubino E, Francisci D, Tamburrini E, Faldella G, Guerra B, and for the Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy

Subjects
Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, body mass index, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Body Mass Index, BMI, weight gain, HIV-1, Pregnancy, Medicine, Humans, HIV infection, pregnancy, Pregnancy Complications, Infectious, business.industry, Obstetrics, Cesarean Section, Infectious, Pregnancy Outcome, HIV, medicine.disease, Pregnancy Complications, Infectious Diseases, Italy, National study, Female, medicine.symptom, business, Weight gain, Body mass index
Abstract

Although most of the women (69.4%) had a normal BMI at start of pregnancy, only 37% had an adequate weight gain during pregnancy. Inadequate body weight gain was more common (44.8%) than excessive weight gain (18.2%), but 40% of overweight women and 50% of obese women had an excessive weight gain in pregnancy, with about 9% of the women in these categories gaining >18 kg during pregnancy (Table 1). Only 1.9% of the women had a vaginal delivery; elective and nonelective cesarean deliveries accounted for 81.3% and 16.7% of deliveries, respectively. Compared to underweight/normal women, overweight/obese women had similar occurrences of preterm delivery (23.4% vs 22.7%, P = .871), significantly lower rates of low birthweight (14.2% vs 24.2%, P = .007) and nonelective cesarean deliveries (11.7% vs 18.3%, P = .042), and a significantly higher occurrence of fasting plasma glucose >92 mg/dL at 20–28 weeks (12.1% vs 6.6%, P = .027), hypertension during pregnancy (6.4% vs 2.7%, P = .019), and gestational age–adjusted birthweight >90th percentile (15.5% vs 5.0%, P < .001). Complications of delivery, major birth defects, and HIV transmission were similar between the 2 groups (7.3% vs 7.6%, P = .881; 2.6% vs 3.5%, P = .589; and 0.8% vs 0.5%, P = .661, respectively). An inadequate weight gain during pregnancy was associated with an increased risk of nonelective cesarean delivery (OR, 1.589 [95% CI, 1.077–2.346], P = .020). Excessive weight gain during pregnancy was not associated with either hypertension (OR, 1.364 [95% CI, .537–3.465], P = .514) or 20–28 week glucose level of >92 mg/dL (OR, 0.841 [95% CI, .399–1.772], P = .648), but was significantly associated with birthweight >90th percentile (OR, 2.271 [95% CI, 1.229–4.195], P = .009), and appeared to be protective against low birthweight (OR, 0.544 [95% CI, .323–.918], P = .023) and birthweight

Published
2013

32. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M, Masuelli, G, Ravizza, M, Tassis, B, Cetin, I, Sansone, M, Degli Antoni, A, Simonazzi, G, Maccabruni, A, Francisci, D, Frisina, V, Liuzzi, G, Dalzero, S, Tamburrini, Enrica, Tamburrini, E (ORCID:0000-0003-4930-426X), Floridia, M, Masuelli, G, Ravizza, M, Tassis, B, Cetin, I, Sansone, M, Degli Antoni, A, Simonazzi, G, Maccabruni, A, Francisci, D, Frisina, V, Liuzzi, G, Dalzero, S, Tamburrini, Enrica, and Tamburrini, E (ORCID:0000-0003-4930-426X)

Abstract

Background: Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study.Methods: Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score).Results: Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P < 0.001).Conclusions: In this observational study, the two main HIV PIs currently recommended by perinatal guidelines showed similar safety and activity in pregnancy, with no evidence of differences between the two drugs in terms of main pregnancy outcomes. Based on the minor differences observed in laboratory measures, prescribing physicians might prefer either drug in some particular situations where the different impacts of treatment on lipid profile and bilirubin may have clinical relevance.

Published
2018

33. Treatment change in pregnancy is a significant risk factor for detectable HIV-1 RNA in plasma at end of pregnancy

Author

Floridia, M, Ravizza, M, Pinnetti, C, Tibaldi, C, Bucceri, A, Anzidei, G, Fiscon, M, Molinari, A, Martinelli, P, Dalzero, S, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy, Anceschi, Maurizio Marco, Massetti, Anna Paola, Mastroianni, Claudio Maria, Floridia M., Ravizza M., Pinnetti C., Tibaldi C., Bucceri A., Anzidei G., Fiscon M., Molinari A., Martinelli P., Dalzero S., Tamburrini E., Faldella G., Guerra B., Floridia, M., Ravizza, M., Pinnetti, C., Tibaldi, C., Bucceri, A., Anzidei, G., Fiscon, M., Molinari, A., Martinelli, Pasquale, Dalzero, S., Tamburrini, E., and Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y.

Subjects
antiretroviral treatment, Adult, medicine.medical_specialty, Multivariate analysis, Time Factors, Pregnancy Trimester, Third, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Drug Administration Schedule, Cohort Studies, Young Adult, Pregnancy, Risk Factors, Medicine, Humans, Pharmacology (medical), Young adult, Pregnancy Complications, Infectious, Univariate analysis, treatment, business.industry, Obstetrics, Confounding, Infant, Newborn, HIV, Odds ratio, Viral Load, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, CD4 Lymphocyte Count, Infectious Diseases, Logistic Models, Anti-Retroviral Agents, Withholding Treatment, HIV-1, RNA, Viral, Female, business, Viral load, Cohort study
Abstract

To investigate the risk factors for an HIV-1 RNA plasma viral load above 400 copies/mL in the third trimester of pregnancy.Data from a large national study were used. The possible determinants were assessed in univariate analyses and in a multivariate logistic regression model in order to adjust for possible confounders.Among 662 pregnancies followed between 2001 and 2008, 131 (19.8%) had an HIV-1 plasma copy number above 400/mL at the third trimester of pregnancy. In the multivariate analysis, the variables significantly associated with this occurrence were earlier calendar year (adjusted odds ratio [AOR] per additional calendar year, 0.70; 95% CI, 0.63-0.77; P.001), lower CD4 count at enrollment (AOR per 100 cells lower, 1.18; 95% CI, 1.09-1.27; P.001), HIV-1 RNA levels above 400 copies per mL at enrollment (AOR, 2.23; 95% CI, 1.50-3.33; P.001), and treatment modification during pregnancy (AOR, 1.66; 95% CI, 1.07-2.57; P=.024).Treatment changes in pregnancy significantly increase the risk of an incomplete viral suppression at the end of pregnancy. In HIV-infected women of childbearing age, proper preconception care, which includes the preferential prescription of regimens with the best safety profile in pregnancy, is likely to prevent an incomplete viral suppression at the end of pregnancy.

Published
2011

34. Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

Author

Floridia, M., Masuelli, G., Tamburrini, E., Cetin, I., Liuzzi, G., Martinelli, Paolo, Guaraldi, G., Spinillo, A., Vimercati, A., Maso, G., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, Bianca, Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. Degli, Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Angeli, G., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Rizzante, E., Belcaro, C., Meloni, Antonio, Dedoni, M., Ortu, F., Piano, Pierluigi, Citernesi, A., Vicini, I. Bordoni, Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, Filippo, Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Tassis, B., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, Matteo, Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., DE MARTINO, MARIA CRISTINA, Parazzini, F., and Vella, S.

Subjects
Antiretroviral treatment, HIV diagnosis, HIV testing, pregnancy, women's health, medicine.medical_specialty, Pediatrics, Longitudinal study, Adolescent, Epidemiology, Short Report, HIV Infections, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Odds Ratio, Humans, 030212 general & internal medicine, Young adult, 030219 obstetrics & reproductive medicine, business.industry, Odds ratio, medicine.disease, Female, Italy, Infectious Diseases, Confidence interval, Family planning, business, Cohort study
Abstract

SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Published
2017

35. Il bene giuridico alimentare

Author

Alcaro, F., Bellizzi, A., Bucelli, A., Caponi, R., Cartei, F. F., Chiaromonte, W., Conte, G., Conti, C., Corsi, C., Donati, F., Felicioni, P., Gasparri, W., Giunta, F., Giunti, P., Gulina, G., Landini, S., Lopes Pegna, O., Lucarelli, P., Nazzaro, A. C., Pagni, I., Palazzo, F. C., Papa, M., Picchi, M., Proto Pisani, A., Putortí, V., Ravizza, M., Re, L., Roselli, O., Ruschi, F., Silvestri, C., Stolzi, I., Tamburi, F., Tarli Barbieri, G., Tesi, G., Tonini, P., Vallauri, M. L., Vallini, A., Vettori, G., and Viciani, S.

Subjects
Alimento-bene giuridico- bioassiologia
Published
2017

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

Author

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

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

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

Published
2001
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37. Combination antiretroviral therapy and duration of pregnancy

Author

Aebi, C, Battegay, M, Bernasconi, E, Biedermann, K, Cheseaux, JJ, Drack, G, Erb, P, Flepp, M, Francioli, P, Furrer, HJ, Gianinazzi, MP, Gyr, T, Hirschel, B, Hosli, I, Hug, I, Irion, O, Keller, K, Kind, C, Laubereau, B, Lauper, U, Lorenzi, P, Matter, L, Nadal, D, Perrin, L, Rickenbach, M, Rudin, C, Schreyer, A, Schupbach, J, Telenti, A, Vernazza, P, Wolf, K, Wunder, D, Wyler, CA, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Seel, K, Schafer, A, Mok, J, Johnstone, F, Jimenez, J, Garcia-Rodriguez, MC, Bates, I, de Jose, I, Hawkins, F, de Gevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Lidman, K, Christensson, B, Levy, J, Hainaut, M, Peltier, A, Barlow, P, Wibaut, S, Lecroart, MC, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Martinez-Gomez, P, Carreras, R, Coll, O, Fortuny-Guasch C, Boguna, J, Caro, MC, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, De Santis, M, Semprini, AE, Savasi, V, Vigano, A, Probizer, FR, Maccabruni, A, Bucceri, A, Rancilio, L, Taylor, GP, Lyall, H, Penn, Z, Valerius, NH, Martinelli, P, Buffolano, W, Sansone, M, Tibaldi, C, Ziarati, N, Benedetto, C, Niemiec, T, Horban, A, Newell M.-L., Aebi C., Battegay M., Bernasconi E., Biedermann K., Cheseaux J.-J., Drack G., Erb P., Flepp M., Francioli P., Furrer H.J., Gianinazzi M.-P., Gyr T., Hirschel B., Hosli I., Hug I., Irion O., Keller K., Kind C., Laubereau B., Lauper U., Lorenzi P., Matter L., Naddal D., Perrin L., Rickenbach M., Rudin C., Schreyer A., Schupbach J., Telenti A., Vernazza P., Wolf K., Wunder D., Wyler C.-A., Giaquinto C., Ruga E., De Rossi A., Grosh-Worner I., Seel K., Schafer A., Mok J., Johnstone F., Jimenez J., Garcia-Rodriguez M.C., Bates I., De Jose I., Hawkins F., Ladron de Gevara C., Ma Pena J., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Perez-Tamarit D., Ridaura S., Gregori P., De la Torre R., Scherpbier H., Kreyenbroek M., Boer K., Bohlin A.B., Lindgren S., Ehrnst A., Belfrage E., Lidman K., Christensson B., Levy J., Hainaut M., Peltier A., Barlow P., Wibaut S., Lecroart M.C., Ferrazin A., Bassetti D., De Maria A., Gotta C., Mur A., Paya A., Vinolas M., Lopez-Vilchez M.A., Martinez-Gomez P., Carreras R., Coll O., Fortuny C., Boguna J., Casellas Caro M., Canet Y., Pardi G., Ravizza M., Guerra B., Lanari M., Bianchi S., Bovicelli L., Prati E., Duse M., Scaravelli G., Stegagno M., De Santis M., and Semprini A.E.

Subjects
Epidemiology, HIV Infections, Substance Abuse, Intravenou, Cohort Studies, Pregnancy, Immunology and Allergy, Medicine, HIV Infection, Prospective Studies, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, Prospective cohort study, Obstetrics, Infectious, Substance Abuse, Pregnancy Outcome, Gestational age, Viral Load, Antiretroviral therapy, Reverse Transcriptase Inhibitor, Infectious Diseases, Combination, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, Intravenous, Prematurity, Delivery, Zidovudine, Viral load, Infant, Premature, Human, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Combination therapy, Anti-HIV Agents, Immunology, CD4 Lymphocyte Count, Delivery, Obstetric, Gestational Age, HIV-1, Humans, Infant, Newborn, Drug Therapy, antiretroviral therapy, combination therapy, epidemiology, pregnancy, prematurity, Premature, business.industry, Infant, Anti-HIV Agent, Obstetric, Odds ratio, Newborn, medicine.disease, Surgery, Pregnancy Complications, Prospective Studie, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objective: To assess the association between type and timing of initiation of antiretroviral therapy in pregnancy and duration of pregnancy. Design: Prospective study. Methods: Data on 3920 mother child pairs were examined (3015 mother-child pairs from the European Collaborative Study and 905 from the Swiss Mother + Child HIV Cohort Study). Factors examined included gestational age, antiretroviral therapy during pregnancy, maternal CD4 count, viral load, illicit drug use (IDU) and mode of delivery. Deliveries at less than 37 weeks were defined as premature. Results: The prematurity rate was 17% and median gestational age 39 weeks. Twenty-three per cent (896 of 3920) of women received antiretroviral therapy during pregnancy: 64% (573 of 896) zidovudine monotherapy, 24% (215) combination therapy without protease inhibitors (PI) and 12% (108) combination therapy with PI. In multivariate analysis, adjusted for maternal CD4 count and IDU, odds ratio (OR) of prematurity was 2.60 195% confidence interval (CI), 1.43-4.751 and 1.82 (95% CI, 1.13-2.92) for infants exposed to combination therapy with and without a Pl, respectively, compared to no treatment. Exposure to monotherapy was not associated with prematurity, but severe immunosuppression and IDU in pregnancy were. Women on combination therapy from before pregnancy were twice as likely to deliver prematurely as those starting therapy in the third trimester (OR, 2.17 95% CI, 1.03-4.58). Conclusions: Pregnancy issues should be discussed when making decisions about initiation of combination antiretroviral therapy for HIV-infected women. Elective caesarean section to reduce vertical transmission at 36 weeks rather than 38 weeks may be advisable in women on combination therapy with PI. © 2000 Lippincott Williams & Wilkins.

Published
2000
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38. Atazanavir and lopinavir profile in pregnant women with HIV: tolerability, activity and pregnancy outcomes in an observational national study

Author

Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Degli Antoni, A., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., Tamburrini, E., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, Giovanni, Nardini, Giulia, Stentarelli, Chiara, Beghetto, Barbara, Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Giacomet, V, Martinelli, Pasquale, Degli Antoni, A, Spinillo, A, Fiscon, M, Francisci, D, Liuzzi, G, Pinnetti, C, Marconi, Am, Tamburrini, E, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Floridia, M1, Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y., Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [.., Capretti, M.G., Marsico, C., Faldella, G., and ].

Subjects
Pyridines, Pyridine, HIV Infections, Triglyceride, Lopinavir, Liver Function Tests, Pregnancy, HIV Infection, Pharmacology (medical), Viral, Pregnancy Complications, Infectious, triglycerides, pre-term delivery, medicine.diagnostic_test, Liver Function Test, Obstetrics, Medicine (all), Pregnancy Outcome, Infectious, virus diseases, HIV, pregnancy, RNA, Lipid, Viral Load, Lipids, Infectious Diseases, Tolerability, Oligopeptide, Population study, RNA, Viral, Female, medicine.symptom, bilirubin, Viral load, Oligopeptides, Human, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, Atazanavir Sulfate, Infectious Disease, Bilirubin, Cholesterol, Pre-term delivery, Triglycerides, Pharmacology, cholesterol, Settore MED/17 - MALATTIE INFETTIVE, medicine, Humans, business.industry, Anti-HIV Agent, medicine.disease, Atazanavir, CD4 Lymphocyte Count, Pregnancy Complications, Immunology, Pregnancy Complications, Infectiou, business, Liver function tests, Weight gain
Abstract

BACKGROUND: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. METHODS: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. RESULTS: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P = 0.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P < 0.001 for both comparisons) and bilirubin levels were significantly higher in the atazanavir group (1.53 versus 0.46 mg/dL, P < 0.001). CONCLUSIONS: In this observational study atazanavir and lopinavir showed similar safety and activity in pregnancy, with no differences in the main pregnancy outcomes. Atazanavir use was associated with a better lipid profile and with higher bilirubin levels. Overall, the study findings confirm that these two HIV protease inhibitors represent equally valid alternative options.

Published
2014

40. Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011

Author

Floridia, M., Mastroiacovo, P., Tamburrini, E., Tibaldi, C., Todros, T., Crepaldi, A., Sansone, M., Fiscon, M., Liuzzi, G., Guerra, B., Vimercati, A., Vichi, F., Vicini, I., Pinnetti, C., Marconi, A. M., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Alberico, S., Maso, G., Tropea, M., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Spinillo, A., Roccio, M., Miccolis, A., Bassi, E., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Trentini, L., Masuelli, G., Garetto, S., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Mastroiacovo, P, Tamburrini, E, Tibaldi, C, Todros, T, Crepaldi, A, Sansone, M, Fiscon, M, Liuzzi, G, Guerra, B, Vimercati, A, Vichi, F, Vicini, I, Pinnetti, C, Marconi, A, Ravizza, M, Martinelli, Pasquale, and The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy

Subjects
Male, HIV Infections, transcriptase inhibitors, Cohort Studies, chemistry.chemical_compound, Pregnancy, Prevalence, Birth Weight, Young adult, Pregnancy Complications, Infectious, education.field_of_study, Obstetrics, Coinfection, Antiretroviral therapy, birth defects, efavirenz, HIV, non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, pregnancy, protease inhibitors, women, Obstetrics and Gynecology, Abnormalities, Drug-Induced, Middle Aged, Italy, Maternal Exposure, Reverse Transcriptase Inhibitors, Female, Cohort study, Adult, medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, Birth weight, Population, Antiretroviral Therapy, Birth defects, HIV-1, Young Adult, Hepatitis B, Chronic, medicine, Humans, education, business.industry, Infant, Newborn, Odds ratio, Hepatitis C, Chronic, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, chemistry, business
Abstract

Objective We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design Observational study. Setting University and hospital clinics. Population Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.

Published
2013

41. Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. Update 2011

Author

Antinori A, Marcotullio S, Ammassari A, Andreoni M, Angarano G, Armignacco O, Carosi G, Cinque P, d'Arminio Monforte A, Di Perri G, Ensoli B, Floridia M, Galli M, Mastroianni C, Matteelli A, Mazzotta F, Moroni M, Palù G, Puoti M, Puro V, Rizzardini G, Sagnelli E, Vella S, Vullo V, Lazzarin A Collaborators (88) Ensoli B, Lazzarin A, Babudieri S, Baldelli F, Bini T, Bonfanti P, Bonora S, Borderi M, Bruno R, Bucciardini R, Castagna A, Castelli F, Cattelan AM, Cauda R, Cerioli A, Chirianni A, Cingolani A, Monforte Ad, De Carli G, De Luca A, Di Pietro M, El Hamad I, Errico M, Filice G, Gabrielli E, Gaeta G. B., Gervasoni C, Giacomet V, Giaquinto C, Girardi E, Gori A, Grossi P, Guaraldi G, Liuzzi G, Caputo SL, Maggi P, Maggiolo F, Malena M, Maserati R, Morrone A, Murri R, Mussini C, Nasta P, Oldrini M, Oleari F, Orlando G, Pali G, Perno CF, Prestileo T, Pompa MG, Rancilio L, Ravizza M, Savasi VM, Signorini L, Sighinolfi L, Stagnitta M, Starace F, Starnini G, Sterrantino G, Tamburrini E, Tambussi G, Tavio M, Torti C, Tozzi V, Trotta MP, Vaccher E, Visintini R, Zuccotti V., Antinori, A, Marcotullio, S, Ammassari, A, Andreoni, M, Angarano, G, Armignacco, O, Carosi, G, Cinque, P, d'Arminio Monforte, A, Di Perri, G, Ensoli, B, Floridia, M, Galli, M, Mastroianni, C, Matteelli, A, Mazzotta, F, Moroni, M, Palù, G, Puoti, M, Puro, V, Rizzardini, G, Sagnelli, E, Vella, S, Vullo, V, Lazzarin, A Collaborators (88) Ensoli B, Lazzarin, A, Babudieri, S, Baldelli, F, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Bruno, R, Bucciardini, R, Castagna, A, Castelli, F, Cattelan, Am, Cauda, R, Cerioli, A, Chirianni, A, Cingolani, A, Monforte, Ad, De Carli, G, De Luca, A, Di Pietro, M, El Hamad, I, Errico, M, Filice, G, Gabrielli, E, Gaeta, G. B., Gervasoni, C, Giacomet, V, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Liuzzi, G, Caputo, Sl, Maggi, P, Maggiolo, F, Malena, M, Maserati, R, Morrone, A, Murri, R, Mussini, C, Nasta, P, Oldrini, M, Oleari, F, Orlando, G, Pali, G, Perno, Cf, Prestileo, T, Pompa, Mg, Rancilio, L, Ravizza, M, Savasi, Vm, Signorini, L, Sighinolfi, L, Stagnitta, M, Starace, F, Starnini, G, Sterrantino, G, Tamburrini, E, Tambussi, G, Tavio, M, Torti, C, Tozzi, V, Trotta, Mp, Vaccher, E, Visintini, R, and Zuccotti, V.

Published
2012

42. Rubella susceptibility profile in pregnant women with HIV

Author

Floridia, M., Pinnetti, C., Ravizza, M., Tibaldi, C., Sansone, M., Fiscon, M., Guaraldi, G., Guerra, B., Alberico, S., Spinillo, A., Castelli, P., Dalzero, S., Cavaliere, A. F., Tamburrini, E., Massetti, Anna Paola, Mastroianni, Claudio Maria, Anceschi, Maurizio Marco, The Italian Group On Surveillance On Antiretroviral Treatment In Pregnancy, F. O. R., Floridia M., Pinnetti C., Ravizza M., Tibaldi C., Sansone M., Fiscon M., Guaraldi G., Guerra B., Alberico S., Spinillo A., Castelli P., Dalzero S., Cavaliere A.F., Tamburrini E., Faldella G., and Martinelli, Pasquale

Subjects
Microbiology (medical), medicine.medical_specialty, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Rubella, medicine, Humans, Pregnancy Complications, Infectious, Pregnancy, Obstetrics, business.industry, Infectious, HIV, HIV infection, medicine.disease, Virology, Pregnancy Complications, pregnancy, Rubella Infection, Infectious Diseases, rubella infection, Female, business
Published
2011

43. Italian guidelines for the use of antiretroviral agents and the diagnostic-clinical management of HIV-1 infected persons. Update December 2014

Author

Antinori, A, Marcotullio, S, Andreoni, M, Ammassari, A, d'Arminio Monforte, A, Galli, M, Girardi, Enrico, Mazzotta, F, Mussini, C, Puoti, M, Lazzarin, A, Angarano, G, Armignacco, O, Babudieri, S, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Breveglieri, M, Bruno, R, Capobianchi, Mr, Cagarelli, R, Calcagno, A, Castagna, A, Castelli, F, Cattelan, Am, Cauda, R, Cerioli, A, Chirianni, A, Cinque, P, Corbelli, Gm, D'Ettorre, G, De Carli, G, De Luca, A, Di Biagio, A, Di Perri, G, Di Pietro, M, El Hamad, I, Errico, M, Finarelli Alba, C, Gaeta, Gb, Gervasoni, C, Giacomet, V, Gianotti, N, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Ivanovic, J, Lichtner, M, Liuzzi, G, Lo Caputo, S, Maggi, P, Maggiolo, F, Malena, M, Marchetti, G, Maserati, R, Mastroianni, C, Matteelli, Alberto, Nicastri, E, Nozza, S, Oldrini, M, Pascucci, Mg, Perno, Cf, Prestileo, T, Puro, V, Rancilio, L, Ravizza, M, Rizzardini, G, Rusconi, S, Santoro, M, Sighinolfi, L, Stagnitta, M, Starnini, G, Tamburrini, E, Tambussi, G, Tavio, M, Torti, C, Viscoli, C, Visintini, R, Vullo, V, Zaccarelli, M, and Zuccotti, G. v.

Subjects
Italy, Anti-HIV Agents, HIV-1, Humans, HIV Infections
Published
2015

44. HIV RNA viral load and CD4+ T-cell counts in HIV-infected pregnant women with and without treatment discontinuation in early pregnancy

Author

Tamburini E, Ravizza M, Floridia M, Tibaldi C, Alberico S, Anzidei G, Maccabruni A, Meloni A, Degli Antoni A, Mori F, Dalzero S, Conserva V, Pannetti C, Ferrazzi E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, GUERRA, BRUNELLA, Tamburini E, Ravizza M, Floridia M, Tibaldi C, Alberico S, Anzidei G, Maccabruni A, Meloni A, Degli Antoni A, Mori F, Dalzero S, Conserva V, Pannetti C, Ferrazzi E, Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, Guerra B, and ]

Published
2008

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

Author

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

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

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

Published
1999
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46. Diagnosis of HIV infection in pregnancy: data from a national cohort of pregnant women with HIV in Italy

Author

Floridia M., Ravizza M., Tamburrini E., Anzidei G., Tibaldi C., Maccabruni A., Guaraldi G., Alberico S., Vimercati A., Degli Antoni A. Ferrazzi E., The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, GUERRA, BRUNELLA, Floridia M., Ravizza M., Tamburrini E., Anzidei G., Tibaldi C., Maccabruni A., Guaraldi G., Alberico S., Vimercati A., Degli Antoni A. Ferrazzi E., The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [, Guerra B., and ]

Subjects
Adult, medicine.medical_specialty, Epidemiology, HIV Infections, Asymptomatic, Statistics, Nonparametric, Cohort Studies, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Risk Factors, HIV, pregnancy, medicine, Prevalence, Humans, Diagnostic Errors, Pregnancy Complications, Infectious, Sida, Chi-Square Distribution, biology, Transmission (medicine), Obstetrics, business.industry, Infant, Newborn, Odds ratio, medicine.disease, biology.organism_classification, Infectious Disease Transmission, Vertical, Infectious Diseases, Logistic Models, Italy, Population Surveillance, Immunology, Female, medicine.symptom, business, Cohort study, Research Article
Abstract

We analysed the characteristics of the pregnancies with a previously undetected HIV infection in a national observational study of pregnant women with HIV in Italy. In a total of 443 pregnancies with available date of HIV diagnosis, 118 were characterized by a previously undetected HIV infection (26·6%, 95% CI 22·5–30·8). The following factors were independently associated with this occurrence in a multivariate analysis (adjusted odds ratios; 95% CIs): foreign nationality (5·1, 2·8–9·3); no pre-conception counselling (35·9, 4·8–266·1); first pregnancy (2·1, 1·2–4·0); asymptomatic status (6·8, 1·5–30·6). Women with previously undetected infection started antiretroviral treatment significantly later during pregnancy (P

Published
2006

47. Lipid profile during pregnancy in HIV-infected women

Author

Floridia, M, Tamburrini, E, Ravizza, M, Tibaldi, C, Ravagni Probizer, M F, Anzidei, G, Sansone, M, Mori, F, Rubino, E, Meli, M, Dalzero, S, Guaraldi, G, Italian Grp Surveillance Antiretro, Lanari, M, Guerra, B, Floridia, M, Tamburrini, E, Ravizza, M, Tibaldi, C, Ravagni Probizer, M F, Anzidei, G, Sansone, M, Mori, F, Rubino, E, Meli, M, Dalzero, S, Guaraldi, G, Italian Grp Surveillance Antiretro, Lanari, M, and Guerra, B

Subjects
HIV Infections, Triglyceride, chemistry.chemical_compound, Pregnancy, Hiv infected, Hyperlipidemia, HIV Infection, Pharmacology (medical), Pregnancy Complications, Infectious, triglycerides, medicine.diagnostic_test, Stavudine, Infectious Diseases, Treatment Outcome, Italy, Population Surveillance, Population study, lipids (amino acids, peptides, and proteins), Female, Pregnancy Trimester, Pregnancy Trimesters, pregnancy, Human, medicine.drug, Adult, medicine.medical_specialty, Logistic Model, protease inhibitors, Hyperlipidemias, cholesterol, HIV, protease inhibitor, Internal medicine, medicine, Humans, HIV Protease Inhibitor, Triglycerides, Cholesterol, business.industry, Cholesterol, HDL, Cholesterol, LDL, HIV Protease Inhibitors, medicine.disease, Lipid Metabolism, Endocrinology, Logistic Models, chemistry, Pregnancy Complications, Infectiou, HIV-1, Lipid profile, business
Abstract

Purpose: We investigated the evolution of serum lipid levels in HIV-infected pregnant women and the potential effect of antiretroviral treatment during pregnancy using data from a national surveillance study. Method: Fasting lipid measurements collected during routine care in pregnancy were used, analyzing longitudinal changes and differences in lipid values at each trimester by protease inhibitors (Pls) and stavudine use. Multivariate analyses were used to control for simultaneous factors potentially leading to hyperlipidemia. Study population included 248 women. Results: Lipid values increased progressively and significantly during pregnancy: mean increases between the first and third trimesters were 141.6 mg/dL for triglycerides (p

Published
2006

48. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: A multicentre case series

Author

Floridia, M, Masuelli, G., Meloni, A., Cetin, I., Tamburrini, Enrica, Cavaliere, Anna Franca, Dalzero, S., Sansone, M., Alberico, S., Guerra, B., Spinillo, A., Chiadò Fiorio Tin, M., Ravizza, M., Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Floridia, M, Masuelli, G., Meloni, A., Cetin, I., Tamburrini, Enrica, Cavaliere, Anna Franca, Dalzero, S., Sansone, M., Alberico, S., Guerra, B., Spinillo, A., Chiadò Fiorio Tin, M., Ravizza, M., and Tamburrini, Enrica (ORCID:0000-0003-4930-426X)

Abstract

Objectives: To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design: Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting: University and hospital clinics. Population: Pregnant women with HIV. Methods: Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures: Rate of invasive testing, intrauterine death, HIV transmission. Results: Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011-2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions: The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract: No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.

Published
2016

49. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Floridia, M., primary, Pirillo, M.F., additional, Degli Antoni, A., additional, Molinari, A., additional, Tamburrini, E., additional, Pinnetti, C., additional, Guaraldi, G., additional, Nardini, G., additional, Masuelli, G., additional, Dalzero, S., additional, Cetin, I., additional, Sansone, M., additional, Amici, R., additional, Ravizza, M., additional, Mori, F., additional, Ortolani, P., additional, dalle Nogare, E.R., additional, Di Lorenzo, F., additional, Sterrantino, G., additional, Meli, M., additional, Polemi, S., additional, Nocentini, J., additional, Baldini, M., additional, Montorzi, G., additional, Mazzetti, M., additional, Rogasi, P., additional, Borchi, B., additional, Vichi, F., additional, Del Pin, B., additional, Pinter, E., additional, Anzalone, E., additional, Marocco, R., additional, Mastroianni, C., additional, Mercurio, V.S., additional, Carocci, A., additional, Grilli, E., additional, Maccabruni, A., additional, Zaramella, M., additional, Mariani, B., additional, Natalini Raponi, G., additional, Stentarelli, C., additional, Beghetto, B., additional, Degli Antoni, A.M., additional, Crisalli, M.P., additional, Donisi, A., additional, Piepoli, M., additional, Cerri, V., additional, Zuccotti, G., additional, Giacomet, V., additional, Coletto, S., additional, Di Nello, F., additional, Madia, C., additional, Placido, G., additional, Vivarelli, A., additional, Castelli, P., additional, Savalli, F., additional, Portelli, V., additional, Sabbatini, F., additional, Francisci, D., additional, Bernini, L., additional, Grossi, P., additional, Rizzi, L., additional, Alberico, S., additional, Maso, G., additional, Airoud, M., additional, Soppelsa, G., additional, Meloni, A., additional, Dedoni, M., additional, Cuboni, C., additional, Ortu, F., additional, Piano, P., additional, Citernesi, A., additional, Bordoni Vicini, I., additional, Luzi, K., additional, Spinillo, A., additional, Roccio, M., additional, Vimercati, A., additional, Miccolis, A., additional, De Gennaro, A., additional, Guerra, B., additional, Cervi, F., additional, Simonazzi, G., additional, Margarito, E., additional, Capretti, M.G., additional, Marsico, C., additional, Faldella, G., additional, Martinelli, P., additional, Agangi, A., additional, Capone, A., additional, Maruotti, G.M., additional, Tibaldi, C., additional, Trentini, L., additional, Todros, T., additional, Frisina, V., additional, Brambilla, T., additional, Savasi, V., additional, Personeni, C., additional, Giaquinto, C., additional, Fiscon, M., additional, Rubino, E., additional, Bucceri, A., additional, Matrone, R., additional, Scaravelli, G., additional, Genovese, O., additional, Cafforio, C., additional, Liuzzi, G., additional, Tozzi, V., additional, Massetti, P., additional, Casadei, A.M., additional, Cavaliere, A.F., additional, Cellini, M., additional, Castelli Gattinara, G., additional, Marconi, A.M., additional, Sacchi, V., additional, Ierardi, M., additional, Polizzi, C., additional, Mattei, A., additional, Galluzzo, C.M., additional, Donnini, S., additional, Baroncelli, S., additional, Floridia, M., additional, Villani, P., additional, Cusato, M., additional, Cerioli, A., additional, De Martino, M., additional, Mastroiacovo, P., additional, Parazzini, F., additional, and Vella, S., additional

Published
2016
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50. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, GREGORI, PIETRO, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, LEVY, JOHANNA, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, DE MARIA, ANTONELLA, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, PEREZ, JESUS MARIA, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, BRAMBILLA, TERESA, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, Perez, JM, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, Brambilla, T, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, and Marczynska, M

Subjects
Europe, antiretroviral therapy, HIV, uninfected children, abnormalities
Abstract

Concerns have been raised over possible adverse effects of prophylactic antiretroviral therapy (ART) on the fetus and newborn. We analyzed data relating to uninfected children enrolled in the European Collaborative Study and investigated the association between ART exposure, perinatal problems, and major adverse health events later in life. Median length of follow-up was 2.2 (0-15.9) years. Of the 2414 uninfected children, 687 (28%) were exposed to ART in all three periods (antenatal, intrapartum, and neonatal). Of the 1008 infants exposed to ART at any time, 906 (90%) were exposed antenatally, 840 (83%) neonatally, and 750 (74%) both antenatally and neonatally. ART exposure was not significantly associated with pattern or prevalence of congenital abnormalities or low birth weight. In multivariate analysis, prematurity was associated with exposure to combination therapy without a protease inhibitor (PI) (OR = 2.66; 95% CI: 1.52-4.67) and with a PI (OR = 4.14; 95% CI: 2.36-7.23). ART exposure was associated with anemia in early life (P < .001). There was no evidence of an association with clinical manifestations suggestive of mitochondrial abnormalities. The absence of serious adverse events in this large cohort of uninfected children exposed to prophylactic ART in the short to medium term is reassuring.

Published
2004

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