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1. Five-hub General Conceptual Framework to improve the vaccination coverage for newly arrived migrants

Author

Tosti, ME, Marchetti, G, Scarso, S, D'Angelo, F, Russo, ML, Marceca, M, Karnaki, P, Papaevgeniou, N, and Declich, S

Subjects
Public Health, Environmental and Occupational Health
Abstract

Background Within the Project “Increased Access for Newly Arrived Migrants-AcToVax4NAM” (Grant n 101018349, 3rd EU Health Programme), a General Conceptual Framework (GCF) was developed for understanding how to improve vaccination coverage for Newly Arrived Migrants (NAM), by characterizing and critically analysing system barriers and possible solutions to increase vaccination Methods A logical pathway was hypothesized based on conceptual hubs in the immunization process. The identification of barriers and solutions was carried on by: a) non-systematic revision of scientific and grey literature, institutions and relevant websites, and documents suggested by Consortium Partners; b) qualitative research conducted in each Consortium Country. The GCF was used as a guide for the above mentioned activities and organize results into the GCF itself to enrich it with content Results 5 conceptual hubs were identified: ENTITLEMENT to vaccination, REACHABILITY of people to be vaccinated, ADHERENCE to vaccination, ACHIEVEMENT of vaccination, EVALUATION of the intervention. All hubs are linked sequentially, starting with Entitlement without which the process cannot take place. Hubs are connected: if vaccination does not take place, it’s important to go back to the previous hubs to understand the barriers. Reachability-Adherence-Achievement are closely related because some approaches are cross-cutting, such as proximity interventions which, in addition to allowing the system to approach NAM, promote adherence and thus possibility of completing the process. Other strategies may be implemented with different purposes: training aims to foster a culturally competent approach to facilitate adherence and avoid vaccination hesitancy, but also to improve competence in the entire process and lead to vaccination completion Conclusions The proposed GCF facilitates identification of barriers and possible solutions to the effective achievement of immunization, at all stages of the process Key messages • The GCF can be the basis for the creation of country-specific flow-charts through which to test strategies aimed at increasing immunization coverage in NAM. • The GCF will be useful at EU level, to facilitate both the harmonisation of approaches and interventions and the evaluation of comparable approaches.

Published
2022

3. Global, regional, and national burden of hepatitis B, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Sheena, BS, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Ali, HA, Adane, MM, Adegboye, OA, Adnani, QES, Advani, SM, Afzal, MS, Afzal, S, Meybodi, MA, Ahadinezhad, B, Ahinkorah, BO, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, MB, Rashid, TA, Akalu, GT, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, AZ, Alem, DT, Alhalaiqa, FAN, Alhassan, RK, Ali, L, Ali, MA, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, RM, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, CL, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, AE, Arabloo, J, Arab-Zozani, M, Argaw, AM, Argaw, ZG, Arshad, M, Artamonov, AA, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Jafari, AA, Azarian, G, Bagheri, S, Bahadory, S, Baig, AA, Banach, M, Barati, N, Barrow, A, Batiha, A-MM, Ramirez, DFB, Belgaumi, UI, Berhie, AY, Bhagat, DS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, VS, Bijani, A, Biondi, A, Bodicha, BBA, Bojia, HA, Boloor, A, Bosetti, C, Braithwaite, D, Briko, NI, Butt, ZA, Camera, LA, Chakinala, RC, Chakraborty, PA, Charan, J, Chen, S, Choi, J-YJ, Choudhari, SG, Chowdhury, FR, Chu, D-T, Chung, S-C, Cortesi, PA, Cowie, BC, Culbreth, GT, Dadras, O, Dai, X, Dandona, L, Dandona, R, De la Hoz, FP, Debela, SA, Dedefo, MG, Demeke, FM, Demie, TGG, Demissie, GD, Molla, MD, Desta, AA, Dhamnetiya, D, Dhimal, ML, Dhimal, M, Didehdar, M, Doan, LP, Dorostkar, F, Drake, TM, Eghbalian, F, Ekholuenetale, M, El Sayed, I, Zaki, MES, Elhadi, M, Elmonem, MA, Elsharkawy, A, Enany, S, Enyew, DB, Erkhembayar, R, Eskandarieh, S, Esmaeilzadeh, F, Ezzikouri, S, Farrokhpour, H, Fetensa, G, Fischer, F, Foroutan, M, Gad, MM, Gaidhane, AM, Gaidhane, S, Galles, NC, Gallus, S, Gebremeskel, TG, Gebreyohannes, EA, Ghadiri, K, Ghaffari, K, Ghafourifard, M, Ghamari, S-H, Ghashghaee, A, Gholami, A, Gholizadeh, A, Gilani, A, Goel, A, Golechha, M, Goleij, P, Golinelli, D, Gorini, G, Goshu, YA, Griswold, MG, Gubari, MIM, Gupta, B, Gupta, S, Gupta, VB, Gupta, VK, Haddadi, R, Halwani, R, Hamid, SS, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hariri, S, Hasaballah, A, Hasan, SMM, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Heidari, G, Herteliu, C, Heyi, DZ, Hezam, K, Holla, R, Hosseini, M-S, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Huang, J, Hussein, NR, Iavicoli, I, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Irham, LM, Islam, JY, Ismail, NE, Jacobsen, KH, Jadidi-Niaragh, F, Mamaghani, AJ, Jayaram, S, Jayawardena, R, Jebai, R, Jha, RP, Joseph, N, Joukar, F, Kaambwa, B, Kabir, A, Kabir, Z, Kalhor, R, Kandel, H, Kanko, TKT, Kantar, RS, Karaye, IM, Kassa, BG, Bohan, PMK, Keykhaei, M, Khader, YS, Khajuria, H, Khan, G, Khan, IA, Khan, J, Ab Khan, M, Khanali, J, Khater, AM, Khatib, MN, Khodadost, M, Khoja, AT, Khosravizadeh, O, Khubchandani, J, Kim, GR, Kim, H, Kim, MS, Kim, YJ, Kocarnik, JM, Kolahi, A-A, Koteeswaran, R, Kumar, GA, La Vecchia, C, Lal, DK, Landires, I, Lasrado, S, Lazarus, J, Ledda, C, Lee, DW, Lee, S-W, Lee, YY, Levi, M, Li, J, Lim, SS, Lobo, SW, Lopukhov, PD, Loureiro, JA, MacLachlan, JH, Razek, HMAE, Razek, MMAE, Majeed, A, Makki, A, Malekpour, M-R, Malekzadeh, R, Malik, AA, Mansour-Ghanaei, F, Mansournia, MA, Martins-Melo, FR, Matthews, PC, Mendoza, W, Menezes, RG, Meretoja, TJ, Mersha, AG, Mestrovic, T, Miller, TR, Minh, LHN, Mirica, A, Mirmoeeni, S, Mirrakhimov, EM, Misra, S, Mithra, P, Moazen, B, Mohamadkhani, A, Mohammadi, M, Mohammed, S, Moka, N, Mokdad, AH, Moludi, J, Momtazmanesh, S, Monasta, L, Moradi, G, Moradzadeh, M, Moradzadeh, R, Moraga, P, Mostafavi, E, Mubarik, S, Muniyandi, M, Murray, CJL, Naghavi, M, Naimzada, MD, Swamy, SN, Natto, ZS, Nayak, BP, Nazari, J, Negoi, I, Negru, SM, Nejadghaderi, SA, Kandel, SN, Nguyen, HLT, Ngwa, CH, Niazi, RK, Nnaji, CA, Noubiap, JJ, Nowroozi, A, Nunez-Samudio, V, Oancea, B, Ochir, C, Odukoya, OO, Oh, I-H, Olagunju, AT, Olakunde, BO, Bali, AO, Omer, E, Otstavnov, SS, Oumer, B, Padubidri, JR, Pana, A, Pandey, A, Park, E-C, Kan, FP, Patel, UK, Paudel, U, Petcu, I-R, Piracha, ZZ, Pollok, RCG, Postma, MJ, Pourshams, A, Poustchi, H, Rabiee, M, Rabiee, N, Rafiei, A, Rafiei, S, Raghuram, PM, Rahman, M, Rahmani, AM, Rahmawaty, S, Rajesh, A, Ranasinghe, P, Rao, CR, Rao, SJ, Rashidi, M, Rashidi, M-M, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Rezaei, N, Rezapour, A, Rezazadeh-Khadem, S, Rodriguez, JAB, Rwegerera, GM, Sabour, S, Saddik, B, Saeb, MR, Saeed, U, Sahebkar, A, Saif-Ur-Rahman, K, Salahi, S, Salimzadeh, H, Sampath, C, Samy, AM, Sanabria, J, Sanmarchi, F, Santric-Milicevic, MM, Sarveazad, A, Sathian, B, Sawhney, M, Seidu, A-A, Sepanlou, SG, Seylani, A, Shahabi, S, Shaikh, MA, Shaker, E, Shakhmardanov, MZ, Shannawaz, M, Shenoy, SM, Shetty, JK, Shetty, PH, Shibuya, K, Il Shin, J, Shobeiri, P, Sibhat, MM, Singh, AD, Singh, JA, Singh, S, Skryabin, VY, Skryabina, AA, Sohrabpour, AA, Song, S, Tabaeian, SP, Tadesse, EG, Taheri, M, Tampa, M, Tan, K-K, Tavakoli, A, Tbakhi, A, Tefera, BN, Tehrani-Banihashemi, A, Tesfaw, HM, Thapar, R, Thavamani, A, Tohidast, SA, Tollosa, DN, Tosti, ME, Tovani-Palone, MR, Traini, E, Mai, TNT, Trihandini, I, Tusa, BS, Ullah, I, Vacante, M, Tahbaz, SV, Valdez, PR, Varthya, SB, Vo, B, Waheed, Y, Weldesenbet, AB, Woldemariam, M, Xu, S, Jabbari, SHY, Yaseri, M, Yeshaw, Y, Yigit, V, Yirdaw, BW, Yonemoto, N, Yu, C, Yunusa, I, Zahir, M, Zaki, L, Zamani, M, Zamanian, M, Zastrozhin, MS, Vos, T, Ward, JW, Dirac, MA, Sheena, BS, Hiebert, L, Han, H, Ippolito, H, Abbasi-Kangevari, M, Abbasi-Kangevari, Z, Abbastabar, H, Abdoli, A, Ali, HA, Adane, MM, Adegboye, OA, Adnani, QES, Advani, SM, Afzal, MS, Afzal, S, Meybodi, MA, Ahadinezhad, B, Ahinkorah, BO, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, MB, Rashid, TA, Akalu, GT, Aklilu, A, Akram, T, Al Hamad, H, Alahdab, F, Alem, AZ, Alem, DT, Alhalaiqa, FAN, Alhassan, RK, Ali, L, Ali, MA, Alimohamadi, Y, Alipour, V, Alkhayyat, M, Almustanyir, S, Al-Raddadi, RM, Altawalah, H, Amini, S, Amu, H, Ancuceanu, R, Andrei, CL, Andrei, T, Anoushiravani, A, Ansar, A, Anyasodor, AE, Arabloo, J, Arab-Zozani, M, Argaw, AM, Argaw, ZG, Arshad, M, Artamonov, AA, Ashraf, T, Atlaw, D, Ausloos, F, Ausloos, M, Azadnajafabad, S, Azangou-Khyavy, M, Jafari, AA, Azarian, G, Bagheri, S, Bahadory, S, Baig, AA, Banach, M, Barati, N, Barrow, A, Batiha, A-MM, Ramirez, DFB, Belgaumi, UI, Berhie, AY, Bhagat, DS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhojaraja, VS, Bijani, A, Biondi, A, Bodicha, BBA, Bojia, HA, Boloor, A, Bosetti, C, Braithwaite, D, Briko, NI, Butt, ZA, Camera, LA, Chakinala, RC, Chakraborty, PA, Charan, J, Chen, S, Choi, J-YJ, Choudhari, SG, Chowdhury, FR, Chu, D-T, Chung, S-C, Cortesi, PA, Cowie, BC, Culbreth, GT, Dadras, O, Dai, X, Dandona, L, Dandona, R, De la Hoz, FP, Debela, SA, Dedefo, MG, Demeke, FM, Demie, TGG, Demissie, GD, Molla, MD, Desta, AA, Dhamnetiya, D, Dhimal, ML, Dhimal, M, Didehdar, M, Doan, LP, Dorostkar, F, Drake, TM, Eghbalian, F, Ekholuenetale, M, El Sayed, I, Zaki, MES, Elhadi, M, Elmonem, MA, Elsharkawy, A, Enany, S, Enyew, DB, Erkhembayar, R, Eskandarieh, S, Esmaeilzadeh, F, Ezzikouri, S, Farrokhpour, H, Fetensa, G, Fischer, F, Foroutan, M, Gad, MM, Gaidhane, AM, Gaidhane, S, Galles, NC, Gallus, S, Gebremeskel, TG, Gebreyohannes, EA, Ghadiri, K, Ghaffari, K, Ghafourifard, M, Ghamari, S-H, Ghashghaee, A, Gholami, A, Gholizadeh, A, Gilani, A, Goel, A, Golechha, M, Goleij, P, Golinelli, D, Gorini, G, Goshu, YA, Griswold, MG, Gubari, MIM, Gupta, B, Gupta, S, Gupta, VB, Gupta, VK, Haddadi, R, Halwani, R, Hamid, SS, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hariri, S, Hasaballah, A, Hasan, SMM, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Heidari, G, Herteliu, C, Heyi, DZ, Hezam, K, Holla, R, Hosseini, M-S, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Huang, J, Hussein, NR, Iavicoli, I, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Irham, LM, Islam, JY, Ismail, NE, Jacobsen, KH, Jadidi-Niaragh, F, Mamaghani, AJ, Jayaram, S, Jayawardena, R, Jebai, R, Jha, RP, Joseph, N, Joukar, F, Kaambwa, B, Kabir, A, Kabir, Z, Kalhor, R, Kandel, H, Kanko, TKT, Kantar, RS, Karaye, IM, Kassa, BG, Bohan, PMK, Keykhaei, M, Khader, YS, Khajuria, H, Khan, G, Khan, IA, Khan, J, Ab Khan, M, Khanali, J, Khater, AM, Khatib, MN, Khodadost, M, Khoja, AT, Khosravizadeh, O, Khubchandani, J, Kim, GR, Kim, H, Kim, MS, Kim, YJ, Kocarnik, JM, Kolahi, A-A, Koteeswaran, R, Kumar, GA, La Vecchia, C, Lal, DK, Landires, I, Lasrado, S, Lazarus, J, Ledda, C, Lee, DW, Lee, S-W, Lee, YY, Levi, M, Li, J, Lim, SS, Lobo, SW, Lopukhov, PD, Loureiro, JA, MacLachlan, JH, Razek, HMAE, Razek, MMAE, Majeed, A, Makki, A, Malekpour, M-R, Malekzadeh, R, Malik, AA, Mansour-Ghanaei, F, Mansournia, MA, Martins-Melo, FR, Matthews, PC, Mendoza, W, Menezes, RG, Meretoja, TJ, Mersha, AG, Mestrovic, T, Miller, TR, Minh, LHN, Mirica, A, Mirmoeeni, S, Mirrakhimov, EM, Misra, S, Mithra, P, Moazen, B, Mohamadkhani, A, Mohammadi, M, Mohammed, S, Moka, N, Mokdad, AH, Moludi, J, Momtazmanesh, S, Monasta, L, Moradi, G, Moradzadeh, M, Moradzadeh, R, Moraga, P, Mostafavi, E, Mubarik, S, Muniyandi, M, Murray, CJL, Naghavi, M, Naimzada, MD, Swamy, SN, Natto, ZS, Nayak, BP, Nazari, J, Negoi, I, Negru, SM, Nejadghaderi, SA, Kandel, SN, Nguyen, HLT, Ngwa, CH, Niazi, RK, Nnaji, CA, Noubiap, JJ, Nowroozi, A, Nunez-Samudio, V, Oancea, B, Ochir, C, Odukoya, OO, Oh, I-H, Olagunju, AT, Olakunde, BO, Bali, AO, Omer, E, Otstavnov, SS, Oumer, B, Padubidri, JR, Pana, A, Pandey, A, Park, E-C, Kan, FP, Patel, UK, Paudel, U, Petcu, I-R, Piracha, ZZ, Pollok, RCG, Postma, MJ, Pourshams, A, Poustchi, H, Rabiee, M, Rabiee, N, Rafiei, A, Rafiei, S, Raghuram, PM, Rahman, M, Rahmani, AM, Rahmawaty, S, Rajesh, A, Ranasinghe, P, Rao, CR, Rao, SJ, Rashidi, M, Rashidi, M-M, Rawaf, DL, Rawaf, S, Rawassizadeh, R, Rezaei, N, Rezapour, A, Rezazadeh-Khadem, S, Rodriguez, JAB, Rwegerera, GM, Sabour, S, Saddik, B, Saeb, MR, Saeed, U, Sahebkar, A, Saif-Ur-Rahman, K, Salahi, S, Salimzadeh, H, Sampath, C, Samy, AM, Sanabria, J, Sanmarchi, F, Santric-Milicevic, MM, Sarveazad, A, Sathian, B, Sawhney, M, Seidu, A-A, Sepanlou, SG, Seylani, A, Shahabi, S, Shaikh, MA, Shaker, E, Shakhmardanov, MZ, Shannawaz, M, Shenoy, SM, Shetty, JK, Shetty, PH, Shibuya, K, Il Shin, J, Shobeiri, P, Sibhat, MM, Singh, AD, Singh, JA, Singh, S, Skryabin, VY, Skryabina, AA, Sohrabpour, AA, Song, S, Tabaeian, SP, Tadesse, EG, Taheri, M, Tampa, M, Tan, K-K, Tavakoli, A, Tbakhi, A, Tefera, BN, Tehrani-Banihashemi, A, Tesfaw, HM, Thapar, R, Thavamani, A, Tohidast, SA, Tollosa, DN, Tosti, ME, Tovani-Palone, MR, Traini, E, Mai, TNT, Trihandini, I, Tusa, BS, Ullah, I, Vacante, M, Tahbaz, SV, Valdez, PR, Varthya, SB, Vo, B, Waheed, Y, Weldesenbet, AB, Woldemariam, M, Xu, S, Jabbari, SHY, Yaseri, M, Yeshaw, Y, Yigit, V, Yirdaw, BW, Yonemoto, N, Yu, C, Yunusa, I, Zahir, M, Zaki, L, Zamani, M, Zamanian, M, Zastrozhin, MS, Vos, T, Ward, JW, and Dirac, MA

Abstract

BACKGROUND: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. METHODS: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. FINDINGS: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 0

Published
2022

4. Obesity and Dysmetabolic Factors among Deceased COVID-19 Adults under 65 Years of Age in Italy: A Retrospective Case-Control Study

Author

Kondili, L, Quaranta, M, Viganò, M, Tata, X, D'Angelo, F, Lo Noce, C, Palmieri, L, Onder, G, D'Amico, F, Inglese, E, Puoti, M, Aghemo, A, Tosti, M, Kondili, LA, Quaranta, MG, Tosti, ME, Kondili, L, Quaranta, M, Viganò, M, Tata, X, D'Angelo, F, Lo Noce, C, Palmieri, L, Onder, G, D'Amico, F, Inglese, E, Puoti, M, Aghemo, A, Tosti, M, Kondili, LA, Quaranta, MG, and Tosti, ME

Abstract

Background: Italy has witnessed high levels of COVID-19 deaths, mainly at the elderly age. We assessed the comorbidity and the biochemical profiles of consecutive patients ≤65 years of age to identify a potential risk profile for death. Methods: We retrospectively analyzed clinical data from consecutive hospitalized-for-COVID-19 patients ≤65 years, who were died (593 patients) or discharged (912 patients) during February–December 2020. Multivariate logistic regression identified the mortality risk factors. Results: Overweight (adjusted odds ratio (adjOR) 5.53, 95% CI 2.07–14.76), obesity (adjOR 8.58, CI 3.30–22.29), dyslipidemia (adjOR 10.02, 95% CI 1.06–94.22), heart disease (adjOR 17.68, 95% CI 3.80–82.18), cancer (adjOR 13.28, 95% CI 4.25–41.51) and male sex (adjOR 5.24, 95% CI 2.30–11.94) were associated with death risk in the youngest population. In the older population (46-65 years of age), the overweight and obesity were also associated with the death risk, however at a lower extent: the adjORs varyied from 1.49 to 2.36 for overweight patients and from 3.00 to 4.07 for obese patients. Diabetes was independently associated with death only in these older patients. Conclusion: Overweight, obesity and dyslipidemia had a pivotal role in increasing young individuals’ death risk. Their presence should be carefully evaluated for prevention and/or prompt management of SARS-CoV2 infection in such high-risk patients to avoid the worst outcomes.

Published
2022

6. Clinical, epidemiological and virological features of acute hepatitis B in Italy

Author

Zuccaro O, Romanò L, Mele A, Mariano A, Clementi M, Tosti ME, Taliani G, Galli C, Zanetti AR, Spada E, Raise E, Eseme FE, Maio G, Rummo G, Maio P, Di Giuli C, Bellissima P, Bonfante S, Chiriacò P, Cacopardo B, Blanc P, Palattella S, Santantonio T, Guastadisegni A, Amoroso P, Fabris P, Giordani MT, Vullo V, Giuberti T, Schivazzappa S, Trezzi M, Biagetti C, Pocaterra D, Sagnelli E, Messina V, Antonucci G, Spallanzani L, Vairo F, Marinelli M, Paladini S, Tagliacarne C., VERUCCHI, GABRIELLA, Zuccaro O, Romanò L, Mele A, Mariano A, Clementi M, Tosti ME, Taliani G, Galli C, Zanetti AR, Spada E, Raise E, Eseme FE, Maio G, Rummo G, Maio P, Di Giuli C, Bellissima P, Bonfante S, Chiriacò P, Cacopardo B, Blanc P, Palattella S, Santantonio T, Guastadisegni A, Amoroso P, Fabris P, Giordani MT, Vullo V, Giuberti T, Schivazzappa S, Trezzi M, Verucchi G, Biagetti C, Pocaterra D, Sagnelli E, Messina V, Antonucci G, Spallanzani L, Vairo F, Marinelli M, Paladini S, Tagliacarne C, Zuccaro, O., Romano, L., Mele, A., Mariano, A., Clementi, M., Tosti, M. E., Taliani, G., Galli, C., Zanetti, A. R., and Spada, E.

Subjects
Adult, Male, Microbiology (medical), Hepatitis B virus, medicine.medical_specialty, Adolescent, Genotype, Epidemiology, Genotypes, Gene mutation, medicine.disease_cause, Cohort Studies, Young Adult, Basal (phylogenetics), 80 and over, medicine, Humans, Hepatitis B Vaccines, Prospective Studies, Acute infection, Hepatitis B, Mutations, Risk factors, Aged, Acute Disease, Aged, 80 and over, Female, Follow-Up Studies, Hepatitis B Core Antigens, Italy, Middle Aged, Infectious Diseases, business.industry, Promoter, General Medicine, medicine.disease, Virology, Mutation, Immunology, Acute hepatitis B, business
Abstract

Purpose: To evaluate the association of hepatitis B virus (HBV) genotypes, basal core promoter (BCP)/precore (PC) and S gene mutations with the clinical-epidemiological characteristics of acute hepatitis B (AHB) in Italy. Methods: During July 2005–January 2007, 103 symptomatic AHB patients were enrolled and prospectively followed up at 15 national hospitals. HBV genotypes, BCP/PC and S gene variants were determined by nested-PCR and direct sequence analysis. Results: Genotype D, A and F were detected in 49, 45 and 6% of patients, respectively. BCP, PC, and BCP plus PC variants were found in 3.1, 11.3 and 7.2% of patients, respectively. At enrollment, 68.3% of patients were hepatitis B e antigen (HBeAg)-positive and 31.7% HBeAg-negative. BCP/PC mutations were more common in HBeAg-negative than in HBeAg-positive patients (p&nbsp

Published
2015

8. Hepatitis B immunity in teenagers vaccinated as infants: an Italian 17-year follow-up study

Author

Spada, E, Romanò, L, Tosti, Me, Zuccaro, O, Paladini, S, Chironna, M, Coppola, Rc, Cuccia, M, Mangione, R, Marrone, F, Negrone, Fs, Parlato, A, Zamparo, E, Zotti, Carla Maria, Mele, A, Zanetti, Ar, and the Study Group

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, HBsAg, Adolescent, Booster, hepatitis B, immune memory, long-term protection, vaccination, Immunization, Secondary, Gastroenterology, Group A, complex mixtures, Group B, Immunity, Internal medicine, medicine, Humans, Hepatitis B Vaccines, Hepatitis B Antibodies, Hepatitis B Surface Antigens, biology, business.industry, Infant, General Medicine, Hepatitis B, medicine.disease, Vaccination, Infectious Diseases, Italy, Cohort, biology.protein, Female, Antibody, business, Immunologic Memory, Follow-Up Studies
Abstract

We assessed the persistence of hepatitis B surface antigen antibody (anti-HBs) and immune memory in a cohort of 571 teenagers vaccinated against hepatitis B as infants, 17 years earlier. Vaccinees were followed-up in 2003 and in 2010 (i.e. 10 years and 17 years after primary vaccination, respectively). When tested in 2003, 199 vaccinees (group A) had anti-HBs

Published
2014
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9. Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Author

Rosina F, Tosti ME, Borghesio E, Masocco M, Mele A, Coppola C, Milella M, Borgia G, Andreone P, Koch M, Zignego AL, Romano M, Carrara M, Almasio PL, Azzola E, Nardone G, Benedetti A, Carosi G, Mazzotta F, Sagnelli E, Rizzetto M, for the AIFA Study Group, Italian Association for the Study of the Liver, Italian Society for Infectious, Tropical Diseases, Italian Association of Hospital Gastroenterologists, Italian Society of Gastroenterology, LOGUERCIO, Carmelina, Rosina, F, Tosti, Me, Borghesio, E, Masocco, M, Mele, A, Coppola, C, Milella, M, Borgia, G, Andreone, P, Koch, M, Zignego, Al, Romano, M, Carrara, M, Almasio, Pl, Azzola, E, Nardone, G, Benedetti, A, Carosi, G, Mazzotta, F, Sagnelli, E, Rizzetto, M, for the AIFA Study, Group, Italian Association for the Study of the, Liver, Italian Society for, Infectiou, Tropical, Disease, Italian Association of Hospital, Gastroenterologist, Italian Society of, Gastroenterology, and Loguercio, Carmelina

Published
2014

10. Acute Hepatitis B After the Implementation of Universal Vaccination in Italy: Results From 22 Years of Surveillance (1993-2014)

Author

Tosti, Me, Alfonsi, V, Lacorte, E, Mele, A, Galli, C, Zanetti, Ar, Romanò, L, SEIEVA Collaborating Group including Ferrigno, L, Crateri, S, Iantosca, G, Badoni, G, D'Angelo, F, Sudano, L, Ruffier, M, Fischer, M, Augschiller, M, Gamper, S, Foppa, A, Lechthaler, T, Thaler, J, Steinmair, B, Grandi, C, Carraro, V, Franchini, S, Zotti, C, Lanzafame, P, Malaspina, S, Gallone, A, Castella, A, Valenza, G, Silano, V, Tacca, M, Iodice, S, Marchisio, A, Costantino, A, Giovanetti, F, Susani, F, Tagliacarne, C, Donadini, A, Nespoli, C, Trezzi, L, Gennati, G, Monteverdi, A, Boldori, L, De Grada, P, Gattinoni, A, Brugnoli, R, Belloni, A, Binotto, M, Pinciroli, G, Pesci, L, Senegaglia, P, Crippa, S, Altomonte, G, Lodola, S, Aquino, I, Castelli, N, Zecca, E, Nieri, M, Zecca, F, Pasquale, L, Piedacci, G, Giompapa, E, Zorzut, F, Rocco, G, Brianti, G, Gallo, T, Zuliani, M, Breda, A, Feltrin, O, Russo, F, Zanella, F, Mel, R, Soppelsa, M, Zolin, R, Todescato, A, Bacciolo, N, Rizzato, D, Pupo, A, Nicolardi, L, Flora, M, Boin, F, De Sisti, C, D'Ettore, G, Caracciolo, V, Penon, M, Bellè, M, Cafarra, L, Zivelonghi, G, Soffritti, S, Foroni, M, Finarelli, A, Borrini, B, Gualanduzzi, C, Capra, A, Sacchi, A, Mattei, G, Gardenghi, L, Gianninoni, A, Sancini, R, Dalle Donne, E, Rangoni, R, Cova, M, Bevilacqua, L, Fiumana, E, Bondi, B, Pecci, A, Mela, M, Briata, M, Michele, P, Turello, V, Opisso, A, Zoppi, G, Torracca, P, Ricci, M, Capellini, A, Pecori, L, Mazzotta, F, Balocchini, E, Ghiselli, G, Marchini, P, Di Vito, A, Wanderlingh, W, Raso, E, Mazzoli, F, Berti, C, Galletti, N, Grandi, E, Ferrentino, M, Marinari, M, Lombardi, A, Barbieri, A, Bagnoli, A, Bandini, M, Lezzi, I, Verdelli, F, Beltrano, A, Bindi, R, Sansone, C, Boncompagni, G, Zacchini, F, Baretti, S, Baroncini, O, Staderini, C, Filidei, P, Chiapparini, L, Barghini, F, Cadoni, M, Tagliavento, G, Fiacchini, D, Damiani, N, Pelliccioni, A, Liverani, A, Peccerillo, G, Vaccaro, A, Spadoni, M, Rossini, R, Pasqualini, F, Priori, A, Burattini, N, Cimica, S, Vitale, V, Laici, F, Migliozzi, F, Moretti, G, Ciarrocchi, G, Impullitti, S, Angelini, C, Tosti, A, Giaimo, M, Buscosi, A, Pasquale, A, Ciani, C, Santocchia, F, Proietti, M, Paoloni, Mc, Ercole, A, Russo, P, Cerocchi, C, Grillo, P, Loffredo, M, Labriola, V, Pendenza, A, Nappi, M, Bueti, P, Santucci, L, Mangiagli, F, Varrenti, D, Aquilani, S, Dionette, P, Corpolongo, D, Di Luzio, G, Di Giacomo, M, Graziani, M, Mancini, C, Turchi, C, Granchelli, C, Soldato, G, D'Eugenio, F, Albanesi, I, Ferrara, M, Citarella, A, Fossi, E, Parlato, A, Alfieri, R, Scotto, M, Caiazzo, Al, Chironna, M, Prato, R, Matera, R, Menolascina, S, Colamaria, R, Azzollini, N, Madaro, A, Scalzo, G, Ancona, A, Pedote, P, Moffa, G, Pagano, I, Angelillis, R, Ferraro, M, Aprile, V, Turco, Gl, Minerba, S, Caputi, G, Negrone, F, Maldini, M, Russo, T, Aloia, F, Giuffrida, S, Mangione, R, Consacra, R, Cuccia, M, Rinnone, S, Delogu, F, Fracasso, D, Saba, A, Puggioni, A, Frongia, O, Marras, M, Crasta, M, Mereu, G, Steri, G, and Santus, S

Subjects
Male, HBsAg, Pediatrics, Health Knowledge, Attitudes, Practice, breakthrough infections, HBV, hepatitis B vaccination, surveillance, vaccination failure, Adolescent, Adult, Child, Child, Preschool, Female, Hepatitis B, Hepatitis B virus, Humans, Infant, Infant, Newborn, Italy, Mass Vaccination, Middle Aged, Retrospective Studies, Risk Factors, Treatment Failure, Vaccination, Young Adult, Hepatitis B Vaccines, Microbiology (medical), Infectious Diseases, medicine.disease_cause, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Practice, Health Knowledge, 030211 gastroenterology & hepatology, Viral hepatitis, medicine.medical_specialty, Hepatitis B vaccine, 03 medical and health sciences, Preschool, business.industry, Retrospective cohort study, medicine.disease, Newborn, Immunization, Attitudes, Immunology, business
Abstract

Background Hepatitis B vaccination has proven to be very safe and highly effective. This study assessed the proportion of successfully vaccinated individuals among cases with acute hepatitis B, the proportion of preventable cases if individuals were vaccinated as recommended, and the reasons for failures. Methods We analyzed data reported to the Italian Surveillance System for Acute Viral Hepatitis from 1993 to 2014. Results A total of 362 of 11 311 (3.2%) cases with acute hepatitis B were vaccinated. Of the 277 cases for whom immunization data were available, 50 (18%) received a complete vaccination course according to the correct schedule and before exposure to hepatitis B virus. Molecular characterization of 17 of these cases showed that 6 were infected with S-gene mutants. Among the 10 949 unvaccinated cases, 213 (1.9%) escaped mandatory vaccination and 2821 (25.8%) were not vaccinated despite being at increased risk of infection. Among the latter, the most common risk factors were cohabitation with hepatitis B surface antigen (HBsAg) carriers, intravenous drug use, and homosexual/bisexual practices. Thirty-seven percent of the unvaccinated households with HBsAg carriers were aware of their risk. Lack of trust in the vaccination, negative attitude, and inaccurate beliefs followed by lack of or poor communication and low perceived severity of the disease were the most frequent reasons for vaccine hesitancy. Conclusions Development of acute disease in successfully vaccinated individuals is a rare event. Further efforts are needed to enhance the vaccine coverage rate in individuals at increased risk of infection.

Published
2016

12. Acute hepatitis A in Italy: incidence, risk factors and preventive measures

Author

Tosti, Me, Spada, E, Romano', L, Zanetti, A, Mele, A, SEIEVA collaborating group, and Zotti, Carla Maria

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Population, Disease, Young Adult, Liver disease, Risk Factors, Virology, Internal medicine, medicine, Humans, Child, education, Aged, Aged, 80 and over, education.field_of_study, Hepatology, business.industry, Incidence, Incidence (epidemiology), Case-control study, Infant, Outbreak, Hepatitis A, Middle Aged, Hepatitis B, medicine.disease, Surgery, Vaccination, Infectious Diseases, Italy, Case-Control Studies, Child, Preschool, Population Surveillance, Acute Disease, Female, Viral hepatitis, business
Abstract

The incidence of, and risk factors for, acute hepatitis A (AHA) were assessed by using data collected from the Italian surveillance system of acute viral hepatitis (SEIEVA). To this end, a case-control study within a population-based surveillance for acute viral hepatitis was performed. AHA incidence has been estimated since 1991; the association with considered risk factors was analysed from 2001 to 2006 employing cases of acute hepatitis B (AHB) as controls. The incidence of AHA declined from 4 / 100 000 in 1991 to 1.4/100 000 in 2006, with a peak during 1996-1998 due to an outbreak in southern Italy. The incidence of AHA was highest among persons aged 15-24 years. The case-fatality rate was 2.9 / 10 000. Contact with individuals with AHA [adjusted OR (OR(adj)) = 3.8, 95% CI 2.7-5.5; population-attributable risk (PAR) = 7.5%], travelling to endemic areas (OR(adj) = 3.1, 95% CI = 2.6-3.8; PAR = 19.5%), ingestion of raw shellfish (OR(adj) = 1.8, 95% CI = 1.6-2.1; PAR = 26.6%), and cohabitation with day care children (OR(adj) = 1.3, 95% CI = 1.01-1.7; PAR = 2.3%) were the main important risk factors. In 2003, an outbreak, with high case-fatality rate occurred among intravenous drug users, in a central Italian town. A weak association was found for male homosexuality when acute hepatitis C cases were employed as controls (OR(adj) = 1.4 CI, 95% CI = 1.1-1.9). Hepatitis A virus infections are currently occurring more frequently in adults, in whom the disease is most severe. In conclusion, looking at the attributable risks, at present most of the AHA infections are due to shellfish consumption, travel to endemic areas and contact with patients with AHA. Vaccination of individuals at increased risk of infection, as well as persons with underling liver disease and those at increased risk of complications, combined with surveillance of shellfish retail outlets are efficient control measures.

Published
2008

13. Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Author

Rosina, F, Tosti, Me, Borghesio, E, Masocco, M, Mele, A, Coppola, C, Milella, M, Borgia, G, Andreone, P, Koch, M, Zignego, Al, Romano, M, Carrara, M, Almasio, Pl, Azzola, E, Nardone, G, Benedetti, A, Carosi, G, Mazzotta, F, Sagnelli, E, Rizzetto, M, AIFA Study Group, Italian Association for the Study of the Liver, Italian Society for Infectious, Tropical, Diseases, Italian Association of Hospital Gastroenterologists, Italian Society of Gastroenterology, Italian Association for the Study of the Liver AISF, Tropical Diseases SIMIT, Italian Association of Hospital Gastroenterologists AIGO, and Contini, Carlo

Subjects
Peg-interferon/ribavirin, therapy, chronic hepatitis C, hepatitis C virus genotype cC, NO
Published
2014

15. Infections caused by filamentous fungi in patients with hematologic malignancies. A report of 391 cases by GIMEMA Infection Program

Author

Pagano L, Girmenia C, Mele L, Ricci P, Tosti ME, Nosari A, Buelli M, Allione B, Corvatta L, D'Antonio D, Montillo M, Melillo L, Chierichini A, Cenacchi A, Tonso A, Cudillo L, Candoni A, Savignano C, Bonini A, Martino P, Del Favero A, GIMEMA Infection Program, Gruppo Italiano Malattie Ematologiche dell'Adulto, PICARDI, MARCO, Pagano, L, Girmenia, C, Mele, L, Ricci, P, Tosti, Me, Nosari, A, Buelli, M, Picardi, Marco, Allione, B, Corvatta, L, D'Antonio, D, Montillo, M, Melillo, L, Chierichini, A, Cenacchi, A, Tonso, A, Cudillo, L, Candoni, A, Savignano, C, Bonini, A, Martino, P, Del Favero, A, GIMEMA Infection, Program, and Gruppo Italiano Malattie Ematologiche, Dell'Adulto

Subjects
Adult, Aged, 80 and over, Male, Leukemia, Adolescent, Fungi, Filamentous fungi infection, Middle Aged, Prognosis, Survival Rate, Aspergillus, Treatment Outcome, Mycoses, Risk Factors, Hematologic Neoplasms, Humans, Hematologic malignancies, Female, Prospective Studies, Child, Aged, Retrospective Studies
Abstract

BACKGROUND AND OBJECTIVES: To evaluate the clinical characteristics of patients with hematologic malignancies developing a filamentous fungi infection (FFI) and to define the prognostic factors for their outcome. DESIGN AND METHODS: A retrospective study, conducted on patients admitted to 14 Hematology divisions of tertiary care or university hospitals, participating in the GIMEMA Infection Program, over a ten-year period (1988-1997). The study included patients with hematological malignancies and a histologically and/or microbiologically proven or probable FFI. RESULTS: We included 391 patients (male/female: 262/129, median age 49 years) with hematologic malignancies (225 acute myeloid leukemia, 67 acute lymphocytic leukemia, 30 chronic myeloid leukemia, 22 non-Hodgkin's lymphoma, 12 myelodysplastic syndrome, 10 aplastic anemia, 7 Hodgkin's disease, 8 chronic lymphocytic leukemia, 5 multiple myeloma, and 5 hairy cell leukemia) who developed a proven FFI. Eighty percent of the patients had been neutropenic for an average of 14 days before the infection, and 71% had an absolute neutrophil count lower than 0.5 x 10(9)/L at the time of FFI diagnosis. The primary sites of infection were: lungs (85%), nose and paranasal sinus (10%), and other sites (5%). The diagnosis was made while still alive in 310 patients (79%), and at autopsy in the remaining 81 patients (21%). Chest X-ray was diagnostic in 77% of patients with pulmonary FFI, while computed tomography (CT) scan of the thorax was positive in 95% of cases. A significant diagnostic advantage for CT scan was observed in 145 patients who had both a chest X-ray and CT scan. Aspergillus was identified as the cause of FFI in 296 patients, Mucorales in 45 patients, Fusarium in 6 patients and other filamentous fungi species in 4 patients, while in a further 40 patients no agent was identifiable. The overall mortality rate three months after the diagnosis of FFI was 74%, and fungal infection had been the cause of death in 51% of patients. INTERPRETATION AND CONCLUSIONS: Our retrospective study shows that FFI still remains a life-threatening complication in neutropenic patients. Despite appropriate treatment, half of the patients die due to this complication. The use of glucocorticoids and recovery from neutropenia are the most important prognostic factors. Mucorales infections are associated with a significantly poorer prognosis than those due to Aspergillus spp.

Published
2001

17. Acute hepatitis B 14 years after the implementation of universal vaccination in Italy: areas of improvement and emerging challenges

Author

Mele, A, Tosti, Me, Mariano, A, Pizzuti, R, Ferro, A, Borrini, B, Zotti, Carla Maria, Lopalco, P, Curtale, F, Balocchini, E, Spada, E, and NATIONAL SURVEILLANCE SYSTEM FOR ACUTE VIRAL HEPATITIS SEIEVA COLLABORATING GROUP

Subjects
Adult, Male, Microbiology (medical), Hepatitis B virus, medicine.medical_specialty, Pediatrics, Adolescent, National Health Programs, Population, medicine.disease_cause, Risk Factors, medicine, Humans, Infection control, Hepatitis B Vaccines, Child, education, education.field_of_study, Immunization Programs, business.industry, Incidence, Incidence (epidemiology), Vaccination, Infant, Newborn, Infant, Odds ratio, Hepatitis B, medicine.disease, Surgery, Infectious Diseases, Italy, Case-Control Studies, Child, Preschool, Population Surveillance, Acute Disease, Female, Viral hepatitis, business
Abstract

Background Italy had intermediate-level endemicity for hepatitis B virus (HBV) infection in the 1970s and 1980s. In 1991, vaccination of infants and adolescents became mandatory. We report the impact of universal vaccination 14 years after its beginning. Methods We performed a case-control study within a population-based surveillance for acute viral hepatitis. The incidence of acute hepatitis B (AHB) was estimated for the time since 1991, and the association between AHB and the considered risk factors was analyzed for the period 2001-2005. Results The incidence of AHB progressively decreased from 1991 to 2005, mainly for persons in the age groups targeted by the universal vaccination campaign: there was a 24-fold and 50-fold decrease in the 15-24-year and 0-14-year age groups, respectively; for the > or =25-year age group, the incidence halved. Owing to the persons' ages, approximately 3% of total AHB cases should have been the target of vaccination campaign. In 2004-2005, foreigners accounted for 14% of total cases and for 57% of persons who should have been targets for vaccination. Missed opportunities for immunization were documented for approximately 50% of patients with AHB who reported cohabitation with HBV carriers and for 70% of those who reported injection drug use. The strongest associations with AHB were found for blood transfusion (adjusted odds ratio [OR(adj)], 8.4; 95% confidence interval [CI], 2.7-26), cohabitation with HBV carriers (OR(adj), 5.3; 95% CI, 3.6-7.7), injection drug use (OR(adj), 3.8; 95% CI, 2.5-5.8), and unsafe sexual practices (OR(adj), 2.8; 95% CI, 1.9-4.2). Conclusion Universal vaccination has contributed to a decreasing AHB incidence in Italy, especially by reducing the risk of infection among persons aged 15-24 years. Most infections occur in persons aged > or =25 years in association with injection drug use, unsafe sexual activity, percutaneous treatment, and iatrogenic exposure. Improvement of vaccine coverage in high-risk groups and adherence to infection control measures during surgery and percutaneous treatment are needed. The high risk still associated with blood transfusion needs to be further investigated, with consideration of occult HBV infection in blood donors. The potential spread of HBV infection from the immigrant population deserves adequate health policy prevention programs.

Published
2008

19. Hepatitis A outbreak in Italy associated with frozen berries

Author

De Medici, D, primary, Alfonsi, V, additional, Bruni, R, additional, Busani, L, additional, Ciccaglione, AR, additional, Di Pasquale, S, additional, Equestre, M, additional, Escher, M, additional, Ricotta, L, additional, Rizzo, C, additional, Scavia, G, additional, Taffon, S, additional, Tosti, ME, additional, Pompa, MG, additional, Martini, V, additional, Iannazzo, S, additional, Losio, MN, additional, Varisco, G, additional, Pavoni, E, additional, Massaro, M, additional, Cappelletti, B, additional, Noè, P, additional, Menghi, A, additional, Guizzardi, S, additional, Lena, R, additional, Plutino, G, additional, Monteleone, D, additional, and Borrello, S, additional

Published
2014
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24. HIV-HCV RNA loads and liver failure in coinfected patients with coagulopathy

Author

Dragoni, F., Cafolla, A., Gentile, G., Mazzucconi, Mg, Vella, S., Di Corpo, U., Tosti, Me, Giulio Pisani, Donato, V., and Martino, P.

Subjects
Adult, CD4-Positive T-Lymphocytes, Male, HIV-RNA load, HCV-RNA load, liver failure, coinfection, coagulopathic patients, HIV Infections, Hepacivirus, Humans, Lymphocyte Count, Ultrasonography, Portal Vein, HIV, Alanine Transaminase, Organ Size, Blood Coagulation Disorders, Middle Aged, Hepatitis C, Cross-Sectional Studies, Liver, RNA, Viral, Female, Spleen, Follow-Up Studies
Abstract

The aim of this study was to measure contemporaneously HCV-RNA load, HIV-RNA load and CD4+ lymphocyte count in HCV/HIV coinfected patients with coagulopathy and to examine the relationship between these parameters and the liver failure.A cross-sectional study was performed on 54 patients with severe coagulopathy: 39 HCV/HIV coinfected and 15 HCV+/HIV- comparable for age and HCV exposure time. HCV-RNA and HIV-RNA load, CD4+ lymphocyte count, biochemical and ultrasonographic parameters were evaluated at the time of entry to the study.Mean HCV-RNA load was significantly higher in coinfected patients (643,872 717,687 copies/mL) than in HCV+/HIV- (mean 161,573 276,896 copies/mL) (p = 0.01). The 39 HCV/HIV coinfected patients had a mean HIV-RNA load of 205,913 456,311 copies/mL (range 4,000-2,500,000) and a mean CD4+ lymphocyte count of 206.5171/microL (range 5-693). Five of the 39 (12.8%) coinfected patients had liver failure. In these five patients the mean HCV-RNA load (770,200 996,426 copies/mL) was high but not significantly different from that in the 34 HCV+/HIV+ patients (623,496 682,239 copies/mL) without liver failure (p = 1.0). Coinfected patients with liver failure had a significantly higher HIV-RNA load (mean 764, 599 978,542 copies/mL) and lower CD4+ lymphocyte count (mean 52.655. 6/microL) than those observed in coinfected patients without liver failure (p = 0.007 and p = 0.03, respectively). A significant inverse correlation was found between CD4+ lymphocyte count and HIV-RNA load (r = -0.37, p = 0.01).HCV-RNA load is significantly higher in HIV+ than in HIV- patients with coagulopathy. Liver failure was found only in the HCV/HIV coinfected patients with severe immunodepression, expressed either by low CD4+ lymphocyte count or by high HIV-RNA load.

Published
1999

26. Caspofungin for the treatment of candidaemia in patients with haematological malignancies

Author

Pagano, Livio, Fianchi, Luana, Fanci, R, Candoni, A, Caira, Morena, Posteraro, Brunella, Morselli, M, Valentini, Cg, Farina, Giuliana, Mitra, Me, Offidani, M, Sanguinetti, Maurizio, Tosti, Me, Nosari, A, Leone, Giuseppe, Viale, P., Pagano, Livio (ORCID:0000-0001-8287-928X), Posteraro, Brunella (ORCID:0000-0002-1663-7546), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Pagano, Livio, Fianchi, Luana, Fanci, R, Candoni, A, Caira, Morena, Posteraro, Brunella, Morselli, M, Valentini, Cg, Farina, Giuliana, Mitra, Me, Offidani, M, Sanguinetti, Maurizio, Tosti, Me, Nosari, A, Leone, Giuseppe, Viale, P., Pagano, Livio (ORCID:0000-0001-8287-928X), Posteraro, Brunella (ORCID:0000-0002-1663-7546), and Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059)

Abstract

This study was prospectively conducted in 11 haematology divisions over a 2-year period to evaluate the efficacy of caspofungin in 24 neutropenic patients with haematological malignancies (HM) and candidaemia. These patients had received chemotherapy for HM and were neutropenic (PNN < 0.5 x 10(9)/L) for a median of 12 days (2-41) before candidaemia. The patients received caspofungin for a median duration of 12 days (range 6-26), obtaining a favourable overall response of 58%. At 30 days, 11 patients had died (46%); candidaemia was responsible for mortality in six patients (25%). These results suggest that treatment of candidaemia with caspofungin in neutropenic HM was efficacious, as it is in non-haematological subgroups.

Published
2010

28. Ongoing outbreak of hepatitis A in Italy: preliminary report as of 31 May 2013

Author

Rizzo, C, primary, Alfonsi, V, additional, Bruni, R, additional, Busani, L, additional, Ciccaglione, AR, additional, De Medici, D, additional, Di Pasquale, S, additional, Equestre, M, additional, Escher, M, additional, Montano-Remacha, MC, additional, Scavia, G, additional, Taffon, S, additional, Carraro, V, additional, Franchini, S, additional, Natter, B, additional, Augschiller, M, additional, Tosti, ME, additional, and Central Task Force on Hepatitis A, C, additional

Published
2013
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29. All-trans retinoic acid in association with low dose cytosine arabinoside in the treatment of acute myeoid leukemia in elderly patients

Author

Di Febo, Annalaura, Laurenti, Luca, Falcucci, Paolo, Tosti, Me, Fianchi, Luana, Pagano, Livio, Leone, Giuseppe, Laurenti, Luca (ORCID:0000-0002-8327-1396), Pagano, Livio (ORCID:0000-0001-8287-928X), Di Febo, Annalaura, Laurenti, Luca, Falcucci, Paolo, Tosti, Me, Fianchi, Luana, Pagano, Livio, Leone, Giuseppe, Laurenti, Luca (ORCID:0000-0002-8327-1396), and Pagano, Livio (ORCID:0000-0001-8287-928X)

Abstract

All-trans retinoic acid (ATRA) has shown a synergistic activity in combination with cytosine arabinoside in vitro in the treatment of acute myeloid leukaemia (AML). In this paper we report the results of treatment with low dose cytosine arabinoside (LDAC) with or without ATRA in 28 patients with acute myeloid leukaemia aged over 60 years: 14 patients received only LDAC and the other 14 LDAC + ATRA. The patients of the 2 groups showed similar clinical features: in 10 patients AML developed after a myelodysplastic form and 4 patients presented a previous malignancy. All the patients received subcutaneous (sc) LDAC (15 mg twice a day for 14 days) and in 14 patients oral ATRA (45 mg/sqm in the same days) was added to LDAC; the courses were repeated every 4 weeks from diagnosis to relapse. The treatment was well tolerated and the patients could self-administer sc LDAC and oral ATRA at home. No statistically significant differences were observed in complete remission rate (21% vs. 50%, respectively) and resistant rate (57% vs. 29%), but the patients treated with the combination of the 2 drugs had a better time to treatment failure (15 weeks vs. 30 weeks, respectively) (P = 0.045) and a longer survival (37 weeks vs. 66 weeks) (P = 0.019). Our experience, although with a low number of patients, confirms the efficacy of ATRA in combination with sc LDAC in the treatment of AML in elderly patients.

Published
2007

30. Second malignancy after treatment of adult acute myeloid leukemia: cohort study on adult patients enrolled in the GIMEMA trials

Author

Pagano, L, Pulsoni, A, Tosti, M, Caramatti, C, Cerri, R, Falcucci, P, Fazi, P, Fianchi, L, Martino, B, Mattei, D, Offidani, M, Pacilli, L, Pogliani, E, Rotoli, B, Specchia, G, Visani, G, Vignetti, M, Voso, M, Leone, G, Mandelli, F, Tosti, ME, Voso, MT, Mandelli, F., POGLIANI, ENRICO MARIA, Pagano, L, Pulsoni, A, Tosti, M, Caramatti, C, Cerri, R, Falcucci, P, Fazi, P, Fianchi, L, Martino, B, Mattei, D, Offidani, M, Pacilli, L, Pogliani, E, Rotoli, B, Specchia, G, Visani, G, Vignetti, M, Voso, M, Leone, G, Mandelli, F, Tosti, ME, Voso, MT, Mandelli, F., and POGLIANI, ENRICO MARIA

Abstract

No abstract available

Published
2004

34. Acute leukemia following a previous malignancy: Do acute lymphoid leukemia and acute myeloid leukemia have common risk factors?

Author

Pagano, L, Pulsoni, Alessandro, Tosti, Me, Mele, A, Mele, L, Corvatta, L, Miraglia, E, Almici, C, Manna, A, Del Poeta, G, Lanza, F, Masini, L, Recchia, A, Equitani, F, Leone, G, Mandelli, F, and Italian GIMEMA Group

Subjects
Oncology, Adult, medicine.medical_specialty, Time Factors, Adolescent, Acute Biphenotypic Leukemia, medicine.medical_treatment, Antineoplastic Agents, Malignancy, Immunophenotyping, NO, AML, Risk Factors, hemic and lymphatic diseases, Internal medicine, Neoplasms, medicine, Humans, ALL, secondary acute leukemia, Aged, Aged, 80 and over, Leukemia, Radiation-Induced, Chemotherapy, Acute leukemia, Hematology, Radiotherapy, business.industry, Cancer, Myeloid leukemia, Retrospective cohort study, Neoplasms, Second Primary, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma, medicine.disease, Combined Modality Therapy, Italy, Leukemia, Myeloid, Hematologic Neoplasms, Myelodysplastic Syndromes, Immunology, Acute Disease, business
Abstract

Introduction: Within the framework of the GIMEMA Study Group, the characteristics of acute lymphoid leukemia and acute myeloid leukemia occurring in patients who have suAered a previous malignancy were studied. Assessment was also made of the clinical course, laboratory features and overall outcome of these conditions. Materials and methods: A four-year, multi-center retrospective study was conducted to evaluate the eAect of treatment for previous hematological malignancy on the development of secondary leukemia. The study collected in the GIMEMA Archive of Adult Acute Leukemia 3934 new cases of acute leukemia (2964 AML, 901 ALL, 60 acute biphenotypic leukemia). Among these cases, data were evaluated from patients with a personal history of a previous malignancy, and included inquiring into demographic data, history of neoplastic diseases in the 1st degree relatives, type and treatment of the previous malignancy, latency until the development of a secondary acute leukemia diagnosis, laboratory features, treatment and outcome at the onset of secondary acute leukemia. Results: Approximately 200 (5.1%) patients presented a previous malignancy. Twenty-one were aAected by ALL and 179 by AML. The proportion of patients with secondary AML was higher than that of patients with secondary ALL (179/2964 vs 21/901, O.R. 2.69‐95% C.I. 1.66‐4.39, P50.001). The median latency, from the onset of the previous malignancy to the development of secondary ALL was 27 months and to the development of secondary AML was 52 months (P50.05). Furthermore, of patients who previously received chemotherapy more developed a second AML (66/127 sAML vs 5/21 sALL; O.R. 3.46‐ 95% C.I. 1.10‐11.56, P50.01). Conclusion: In most cases, chemotherapy treatment for a previous malignancy can play a role in the development of secondary AML. In almost all cases of secondary ALL, the role of previous drugs does not appear to be relevant. On the basis of our analysis, performed systematically for the first time on a large adult series of acute leukemia, we conclude that in these patients a biological predisposition to cancer may be suspected. The Hematology Journal (2000) 1, 329‐332

35. Acute myeloid leukemia following breast cancer experience of GIMEMA group

Author

Pagano, L., Pulsoni, A., Mele, L., Tosti, Me, Mele, A., Nosari, A., Invernizzi, R., Martino, B., Visani, G., Avvisati, G., Equitani, F., Di Bona, E., Clavio, M., Levis, A., Coser, P., Miceli, S., Almici, C., anna candoni, Masini, L., Vischia, F., Recchia, A., Cerri, R., Leone, G., and Mandelli, F.

36. Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

Author

Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L. A., Vella, S., Quaranta, M. G., Rosato, S., Tosti, M. E., Weimer, L. E., Ferrigno, L., D’Angelo, F., Falzano, L., Benedetti, A., Schiadà, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Di Leo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, Peter, Rimenti, G., Rossini, A., Contessi, G. B., Castelli, Fulvio, Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, Lucia, Quintieri, F., De Siena, Martina, Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall’Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., DelundefinedPin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, Francesca, Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., DiundefinedBiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, Chiara, Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D’ArminioundefinedMonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, Margherita, D’Ambrosio, R., Degasperi, E., Vinci, Maria Rosaria, Villa, E., Bernabucci, V., Bristot, Luca, Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, Alex, Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D’Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, Enrico, Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, Maria Chiara, Montalto, G., Licata, A., Capitano, A. R., Craxì, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, Paolo, Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, Antonio, Siciliano, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D’Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, Roberto, Cingolani, Antonella, Lamonica, S., D’Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, Antonio, D’Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, Patrizia, Dell’Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, Monia, Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, A, Viti, R, Kondili, L, Rosato, S, Vella, S, Mennini, F, Quaranta, M, Tosti, M, Weimer, L, Ferrigno, L, D'Angelo, F, Falzano, L, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Drenaggi, D, Mazzaro, C, Angarano, G, Milella, M, Dileo, A, Rendina, M, Contaldo, A, Iannone, A, La Fortezza, F, Rizzi, M, Cologni, G, Bolondi, L, Benevento, F, Serio, I, Andreone, P, Caraceni, P, Guarneri, V, Margotti, M, Simonetti, G, Mazzella, G, Verucchi, G, Donati, V, Mian, P, Rimenti, G, Rossini, A, Contessi, G, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Leandro, G, Cozzolongo, R, Zappimbulso, M, Russello, M, Benigno, R, Coco, C, Torti, C, Costa, C, Greco, G, Mazzitelli, M, Pisani, V, Cosco, L, Quintieri, F, Desiena, M, Giancotti, F, Vecchiet, J, Falasca, K, Mastroianni, A, Apuzzo, G, Chidichimo, L, Foschi, F, Dall'Aglio, A, Libanore, M, Segala, D, Sighinolfi, L, Bartolozzi, D, Salomoni, E, Blanc, P, Baragli, F, Delpin, B, Mariabelli, E, Mazzotta, F, Poggi, A, Zignego, A, Monti, M, Madia, F, Xheka, A, Cela, E, Santantonio, T, Bruno, S, Viscoli, C, Alessandrini, A, Curti, C, Dibiagio, A, Nicolini, L, Balletto, E, Mastroianni, C, Blerta, K, Prati, D, Raffaele, L, Andreoletti, M, Perboni, G, Costa, P, Manzini, L, Raimondo, G, Filomia, R, Lazzarin, A, Morsica, G, Salpietro, S, Puoti, M, Baiguera, C, Vassalli, S, Rumi, M, Labanca, S, Zuin, M, Giorgini, A, Orellana, D, D'Arminiomonforte, A, Debona, A, Solaro, S, Fargion, S, Valenti, L, Periti, G, Pelusi, S, Galli, M, Calvi, E, Milazzo, L, Peri, A, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Vinci, M, Villa, E, Bernabucci, V, Bristot, L, Pereira, F, Chessa, L, Pasetto, M, Loi, M, Gori, A, Beretta, I, Pastore, V, Soria, A, Strazzabosco, M, Ciaccio, A, Gemma, M, Borgia, G, Foggia, A, Zappulo, E, Gentile, I, Buonomo, A, Abrescia, N, Maddaloni, A, Caporaso, N, Morisco, F, Camera, S, Donnarumma, L, Coppola, C, Amoruso, D, Staiano, L, Saturnino, M, Coppola, N, Martini, S, Monari, C, Federico, A, Dallio, M, Loguercio, C, Gaeta, G, Brancaccio, G, Nardone, G, Sgamato, C, D'Adamo, G, Alberti, A, Gonzo, M, Piovesan, S, Chemello, L, Buggio, A, Cavalletto, L, Barbaro, F, Castelli, E, Floreani, A, Cazzagon, N, Franceschet, I, Russo, F, Zanetto, A, Franceschet, E, Madonia, S, Cannizzaro, M, Montalto, G, Licata, A, Capitano, A, Craxi, A, Petta, S, Calvaruso, V, Rini, F, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Bruno, R, Lombardi, A, Zuccaro, V, Gulminetti, R, Asti, A, Villaraggia, M, Mondelli, M, Ludovisi, S, Baldelli, F, Di Candilo, F, Parruti, G, Di Stefano, P, Sozio, F, Gizzi, M, Brunetto, M, Colombatto, P, Coco, B, Surace, L, Foti, G, Pellicano, S, Fornaciari, G, Schianchi, S, Vignoli, P, Massari, M, Corsini, R, Garlassi, E, Ballardini, G, Andreoni, M, Cerva, C, Angelico, M, Gasbarrini, A, Siciliano, M, De Siena, M, Nosotti, L, Taliani, G, Biliotti, E, Santori, M, Spaziante, M, Tamburini, F, Vullo, V, D'Ettorre, G, Cavallari, E, Gebremeskel, T, Pavone, P, Cauda, R, Cingolani, A, Lamonica, S, D'Offizi, G, Lionetti, R, Visco Comandini, U, Grieco, A, D'Aversa, F, Picardi, A, De Vincentis, A, Galati, G, Gallo, P, Dell'Unto, C, Aghemo, A, Gatti Comini, A, Persico, M, Masarone, M, Anselmo, M, De Leo, P, Marturano, M, Brunelli, E, Ridolfi, F, Schimizzi, A, Ayoubi Khajekini, M, Framarin, L, Di Perri, G, Cariti, G, Boglione, L, Cardellino, C, Marinaro, L, Saracco, G, Ciancio, A, Toniutto, P, Alterini, G, Capra, F, Ieluzzi, D, Kondili LA, Vella S, Quaranta MG, Rosato S, Tosti ME, Weimer LE, Ferrigno L, D'Angelo F, Falzano L, Benedetti A, Schiadà L, Cucco M, Giacometti A, Brescini L, Castelletti S, Drenaggi D, Mazzaro C, Angarano G, Milella M, Di Leo A, Rendina M, Contaldo A, Iannone A, La Fortezza F, Rizzi M, Cologni G, Bolondi L, Benevento F, Serio I, Andreone P, Caraceni P, Guarneri V, Margotti M, Simonetti G, Mazzella G, Verucchi G, Donati V, Mian P, Rimenti G, Rossini A, Contessi GB, Castelli F, Zaltron S, Spinetti A, Odolini S, Leandro G, Cozzolongo R, Zappimbulso M, Russello M, Benigno R, Coco C, Torti C, Costa C, Greco G, Mazzitelli M, Pisani V, Cosco L, Quintieri F, De Siena M, Giancotti F, Vecchiet J, Falasca K, Mastroianni A, Apuzzo G, Chidichimo L, Foschi FG, Dall'Aglio AC, Libanore M, Segala D, Sighinolfi L, Bartolozzi D, Salomoni E, Blanc P, Baragli F, Del Pin B, Mariabelli E, Mazzotta F, Poggi A, Zignego AL, Monti M, Madia F, Xheka A, Cela EM, Santantonio TA, Bruno SR, Viscoli C, Alessandrini AI, Curti C, Di Biagio A, Nicolini LA, Balletto E, Mastroianni C, Blerta K, Prati D, Raffaele L, Andreoletti M, Perboni G, Costa P, Manzini L, Raimondo G, Filomia R, Lazzarin A, Morsica G, Salpietro S, Puoti M, Baiguera C, Vassalli S, Rumi MG, Labanca S, Zuin M, Giorgini A, Orellana D, D'Arminio Monforte A, Debona A, Solaro S, Fargion S, Valenti L, Periti G, Pelusi S, Galli M, Calvi E, Milazzo L, Peri A, Lampertico P, Borghi M, D'Ambrosio R, Degasperi E, Vinci M, Villa E, Bernabucci V, Bristot L, Pereira F, Chessa L, Pasetto MC, Loi M, Gori A, Beretta I, Pastore V, Soria A, Strazzabosco M, Ciaccio A, Gemma M, Borgia G, Foggia A, Zappulo E, Gentile I, Buonomo AR, Abrescia N, Maddaloni A, Caporaso N, Morisco F, Camera S, Donnarumma L, Coppola C, Amoruso DC, Staiano L, Saturnino MR, Coppola N, Martini S, Monari C, Federico A, Dallio M, Loguercio C, Gaeta GB, Brancaccio G, Nardone G, Sgamato C, D'Adamo G, Alberti A, Gonzo M, Piovesan S, Chemello L, Buggio A, Cavalletto L, Barbaro F, Castelli E, Floreani A, Cazzagon N, Franceschet I, Russo FP, Zanetto A, Franceschet E, Madonia S, Cannizzaro M, Montalto G, Licata A, Capitano AR, Craxì A, Petta S, Calvaruso V, Rini F, Ferrari C, Negri E, Orlandini A, Pesci M, Bruno R, Lombardi A, Zuccaro V, Gulminetti R, Asti A, Villaraggia M, Mondelli M, Ludovisi S, Baldelli F, Di Candilo F, Parruti G, Di Stefano P, Sozio F, Gizzi MC, Brunetto MR, Colombatto P, Coco B, Surace L, Foti G, Pellicano S, Fornaciari G, Schianchi S, Vignoli P, Massari M, Corsini R, Garlassi E, Ballardini G, Andreoni M, Cerva C, Angelico M, Gasbarrini A, Siciliano M, De Siena M, Nosotti L, Taliani G, Biliotti E, Santori M, Spaziante M, Tamburini F, Vullo V, D'Ettorre G, Cavallari EN, Gebremeskel TS, Pavone P, Cauda R, Cingolani A, Lamonica S, D'Offizi G, Lionetti R, Visco Comandini U, Grieco A, D'Aversa F, Picardi A, De Vincentis A, Galati G, Gallo P, Dell'Unto C, Aghemo A, Gatti Comini A, Persico M, Masarone M, Anselmo M, De Leo P, Marturano M, Brunelli E, Ridolfi F, Schimizzi AM, Ayoubi Khajekini M, Framarin L, Di Perri G, Cariti G, Boglione L, Cardellino C, Marinaro L, Saracco GM, Ciancio A, Toniutto P, Alterini G, Capra F, Ieluzzi D., Marcellusi, A., Viti, R., Kondili, L. A., Rosato, S., Vella, S., Mennini, F. S., Quaranta, M. G., Tosti, M. E., Weimer, L. E., Ferrigno, L., D'Angelo, F., Falzano, L., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Dileo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, P., Rimenti, G., Rossini, A., Contessi, G. B., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, L., Quintieri, F., Desiena, M., Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall'Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., Delpin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, F., Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., Dibiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, C., Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D'Arminiomonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Vinci, M., Villa, E., Bernabucci, V., Bristot, L., Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, A., Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D'Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, E., Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, M., Montalto, G., Licata, A., Capitano, A. R., Craxi, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, P., Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, A., Siciliano, M., De Siena, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D'Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, R., Cingolani, A., Lamonica, S., D'Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, A., D'Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, P., Dell'Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, M., Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L.A., Quaranta, M.G., Tosti, M.E., Weimer, L.E., D’Angelo, F., Schiadà, L., Di&nbsp, Leo, A., Contessi, G.B., De&nbsp, Siena, M., Foschi, F.G., Dall’Aglio, A.C., Del&nbsp, Pin, B., Zignego, A.L., Cela, E.M., Santantonio, T.A., Bruno, S.R., Alessandrini, A.I., Biagio, A., Nicolini, L.A., Rumi, M.G., D’Arminio&nbsp, Monforte, A., D’Ambrosio, R., Pasetto, M.C., Buonomo, A.R., Amoruso, D.C., Saturnino, M.R., Gaeta, G.B., D’Adamo, G., Russo, F.P., Capitano, A.R., Craxì, A., Gizzi, M.C., Brunetto, M.R., D’Ettorre, G., Cavallari, E.N., Gebremeskel, T.S., D’Offizi, G., D’Aversa, F., Dell’Unto, C., Schimizzi, A.M., Saracco, G.M., Cosco, Alfredo, Dall’Aglio, A. C., Salomoni, Valentina, Nicolini, Elvira, Calvi, Marta, Soria, Giovanni, D'Adamo, Danilo, ALONSO ALBERTI, MARIA PALOMA CARMEN, Orlandini, Giovanni, DE ASTIS, Fabio, Sozio, Concetta, Terzini, Angelico, DE SIENA, ANDREA URIEL, Taliani, Sabrina, Spaziante, Agata, Lamonica, Emilia, and Capra, Carlo

Subjects
Liver Cirrhosis, Pediatrics, Time Factors, Settore MED/09 - Medicina Interna, National Health Programs, ERADICATION, OUTBREAK, antiviral treatment, anti HCV, economic consequences, Hepacivirus, LIVER FIBROSIS, Severity of Illness Index, Health Services Accessibility, COST-EFFECTIVENESS, Indirect costs, 0302 clinical medicine, Epidemiology, virus infection, 030212 general & internal medicine, health care economics and organizations, cost effectiveness, 030503 health policy & services, Health Policy, Health services research, health, Hepatitis C, Markov Chains, chronic hepatitis C, virus infection, fibrosis progression, cost effectiveness, liver fibrosis, Italy, Pharmacology, Public Health, Environmental and Occupational Health, Cohort, Settore SECS-P/03 - Scienza delle Finanze, Disease Progression, Public Health, 0305 other medical science, Viral hepatitis, Anti-HCV antiviral treatment, CHRONIC HEPATITIS-C, medicine.medical_specialty, Genotype, Settore MED/12 - GASTROENTEROLOGIA, VIRUS-INFECTION, Antiviral Agents, NO, 03 medical and health sciences, Cost Savings, Humans, medicine, MANAGEMENT, chronic hepatitis C, INDUCED DISEASES, METAANALYSIS, Health economics, business.industry, Public health, Environmental and Occupational Health, medicine.disease, FIBROSIS PROGRESSION, business
Abstract

OBJECTIVE:\ud We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.\ud \ud METHODS:\ud A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.\ud \ud RESULTS:\ud The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively.\ud \ud CONCLUSIONS:\ud This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV.

Published
2019

38. The use and efficacy of empirical versus pre-emptive therapy in the management of fungal infections: the HEMA e-Chart Project

Author

Annamaria Nosari, Chiara Cattaneo, Pierluigi Viale, Giuseppe Rossi, Livio Pagano, Mario Mancinelli, Morena Caira, Mario Tumbarello, Maria Elena Tosti, Rosa Fanci, Nicola Vianelli, Maria Grazia Garzia, Franco Aversa, Alessandro Bonini, Pagano L, Caira M, Nosari A, Cattaneo C, Fanci R, Bonini A, Vianelli N, Garzia MG, Mancinelli M, Tosti ME, Tumbarello M, Viale P, Aversa F, and Rossi G

Subjects
Adult, Male, medicine.medical_specialty, Antifungal Agents, Neutropenia, Adolescent, medicine.medical_treatment, FEBRILE NEUTROPIA, Antineoplastic Agents, Kaplan-Meier Estimate, Hematopoietic stem cell transplantation, EMPIRICAL THERAPY, Young Adult, Internal medicine, medicine, Humans, In patient, hematological malignancies, Antibiotic prophylaxis, Young adult, Intensive care medicine, Aged, Aged, 80 and over, Chemotherapy, Hematology, business.industry, Hematopoietic Stem Cell Transplantation, Antibiotic Prophylaxis, Middle Aged, medicine.disease, Transplantation, Settore MED/15 - MALATTIE DEL SANGUE, Mycoses, Online-Only Articles, Hematologic Neoplasms, Female, business
Abstract

Background Neutropenic patients with persistent fever despite antibiotic therapy are managed with empirical or pre-emptive antifungal therapy. The aim of the present study was to evaluate the current clinical use and efficacy of these two approaches in patients with high risk hematologic conditions. Design and Methods An electronic medical record system, the "Hema e-Chart", was designed and implemented to collect information prospectively on infectious complications, particularly on invasive fungal diseases, in patients with hematologic malignancies treated with chemotherapy and/or autologous or allogenic hemopoietic stem cell transplantation. The patients were enrolled from Hematology units distributed widely across Italy. Results Three hundred and ninety-seven adults with hematologic malignancies treated with chemotherapy with persistent fever and suspected invasive fungal disease were evaluable for the study (190 treated had been treated with empirical antifungal therapy and 207 with pre-emptive antifungal therapy). There was a significantly lower incidence of proven/probable invasive fungal diseases in patients treated with empirical antifungal therapy (n=14, 7.4%) than in patients treated with pre-emptive therapy (n=49, 23.7%) (P

Published
2011

39. Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Author

Rosina, Floriano, Tosti, Maria Elena, Borghesio, Elisabetta, Masocco, Maria, Mele, Alfonso, Coppola, Carmine, Milella, Michele, Borgia, Guglielmo, Andreone, Pietro, Koch, Maurizio, Zignego, Anna Linda, Romano, Mario, Carrara, Maurizio, Almasio, Piero Luigi, Azzola, Emilio, Nardone, Gerardo, Benedetti, Antonio, Carosi, Giampiero, Mazzotta, Francesco, Sagnelli, Evangelista, Rizzetto, Mario, Mascolo, M. C., Cursaro, C., Scuteri, A., Crespi, C., Gianstefani, A., Ranieri, J., Monti, M., Corti, G., Blanc, P. L., Baragli, F., Bellentani, S., Gasbarrini, A., Pompili, M., Mecenate, F., Picardi, A., Vespasiani, U., Nosotti, Null, Null, A. Picardi, Ricci, G. L., Paffetti, A., Mastropietro, C., Moretti, A., Spagnolo, A. L., Puoti, C., Bellis, L., Regazzetti, A., Maffezzini, E., Pietrangelo, A., Abbati, G., Borghi, A., Sardini, C., Raimondo, G., Scribano, L., Martines, D., Svegliati Baroni, G., Faraci, G., Schi anchi, S., Fornaciari, G., Massari, M., Fabris, P., Bertin, T., Salvagnini, M., Madonia, S., Calì, A., Civitavecchia, G., Pirisi, M., Smirne, C., Andreoletti, M., Morisco, F., Caporaso, N., Gentile, I., Brancaccio, G., Gaeta, G. B., Liberti, A., Iannece, M. D., Rocco, A., Federico, A., Loguercio, C., Riegler, G., Esposito, P., Fargion, S., Fatta, E., Masutti, F., Bonaventura, M. E., Autolitano, A., Russello, M., Bellia, A., Toniutto, P., Bitetto, D., Pasulo, L., Lucà, M. G., Grattagliano, I., Palasciano, G., Romagno, D., Giannelli, G., Napoli, N., Plattella, M. S., Cassano, P., Gobbo, G., Monti, V., Raspanti, A., Cuccorese, Null, Colombo, A. E., Mandelli, G., Spinzi, G. C., Floridia, Null, Messina, V., Bonfante, S., Bellissima, P., Toti, M., Vecchiet, J., Falasca, K., Portelli, V., Stefano, G. De, Pietromatera, G., Viganò, P., Re, T., Andreoni, M., Null, G. Raineri, Grossi, P. A., Caputo, S., Cassola, G., Feasi, M., Biagio, A. Di, Nicolini, LAURA AMBRA, Giannini, EDOARDO GIOVANNI, Corbo, M., Foti, G., Kunkar, A., Caterini, L., Migliorini, D., Chiodera, A., Calleri, G., Spezia, C., Framarin, L., Null, M. Berrutti, Ciancio, A., Baiguera, C., Puoti, M., Vento, S., Contini, C., Boccia, S., Casiraghi, M. A., Simone, L., Tacconi, D., Caremani, M., Almi, P., Chimenti, M., Cosco, Null, Messeri, D., Esperti, F. C., Lomonaco, L., Pazzi, P., Fornari, F., Comparato, G., Casetti, T., Foschi, F. G., Samori, A., Ferretti, E., Marin, R., Campo, N., Testa, R., Rizzo, S., Rosina, F, Tosti, ME, Borghesio, E, Masocco, M, Mele, A, Coppola, C, Milella, M, Borgia, G, Andreone, P, Koch, M, Zignego, AL, Romano, M, Carrara, M, Almasio, PL, Azzola, E, Nardone, G, Benedetti, A, Carosi, G, Mazzotta, F, Sagnelli, E, Rizzetto, M, Rosina, F., Tosti, M. E., Borghesio, E., Masocco, M., Mele, A., Coppola, C., Milella, M., Borgia, Guglielmo, Andreone, P., Koch, M., Zignego, A. L., Romano, M., Carrara, M., Almasio, P. L., Azzola, E., Nardone, GERARDO ANTONIO PIO, Benedetti, A., Carosi, G., Mazzotta, F., Sagnelli, E., Rizzetto, M., Aifa, Aisf, Simit, Aigo, Sige, Gentile, Ivan, Morisco, Filomena, Et, Al, Floriano Rosina, Maria Elena Tosti, Elisabetta Borghesio, Maria Masocco, Alfonso Mele, Carmine Coppola, Michele Milella, Guglielmo Borgia, Pietro Andreone, Maurizio Koch, Anna Linda Zignego, Mario Romano, Maurizio Carrara, Piero Luigi Almasio, Emilio Azzola, Gerardo Nardone, Antonio Benedetti, Giampiero Carosi, Francesco Mazzotta, Evangelista Sagnelli, and Mario Rizzetto

Subjects
Registrie, Male, Cirrhosis, medicine.disease_cause, Polyethylene Glycol, Gastroenterology, Polyethylene Glycols, chemistry.chemical_compound, Hepatitis Viruses, Hepatitis Viruse, Prospective Studies, Viral, Registries, Chronic, Prospective cohort study, Drug Carrier, Drug Carriers, Settore MED/12 - Gastroenterologia, Medicine (all), Recombinant Protein, Middle Aged, Hepatitis C, Recombinant Proteins, Treatment Outcome, Italy, Combination, RNA, Viral, Population study, Drug Therapy, Combination, Female, Human, medicine.medical_specialty, Genotype, Hepatitis C virus, Alpha interferon, Ribavirin, Sustained virological response (SVR), Treatment, Antiviral Agents, Follow-Up Studie, Hepatology, Drug Therapy, Internal medicine, medicine, Humans, Antiviral Agent, business.industry, Interferon-alpha, HCV therapy, Hepatitis C, Chronic, medicine.disease, Clinical trial, Prospective Studie, chemistry, Immunology, RNA, Follow-Up Studies, business
Abstract

a b s t r a c t Background: Data on the efficacy of Peg-interferon/ribavirin therapy for chronic hepatitis C are mostly derived from treatment of selected patients enrolled in clinical trials. This study aimed to assess the effectiveness of Peg-interferon/ribavirin therapy in “real world” chronic hepatitis C patients in Italy. Methods: Independent observational multicentre study including consecutive patients receiving Peginterferon/ribavirin in the 18 months before (retrospective phase) and after (prospective phase) the start of the study. Results: 4176 patients were eligible. The final study population consisted of 2051 patients in the retrospective and 2073 in the prospective phase. Sustained virological response was achieved by 1036 patients (50.5%) during the retrospective phase: 325 were genotypes 1/4 (34.1%) and 684 were genotypes 2/3 (67.2%) and by 800 patients (38.6%) during the prospective phase: 300 were genotypes 1/4 (28.4%) and 473 were genotypes 2/3 (51.5%). During multivariate analysis genotypes 2/3 were significantly associated with higher sustained virological response rates; cirrhosis and -glutamil-transpeptidase >2 times the normal limit were associated with poorer response. Conclusions: The response to Peg-interferon/ribavirin therapy in “real world” clinical practice is distinctly lower than in registration trials. The difference in response rates was more pronounced among easy-totreat than among difficult-to-treat hepatitis C virus genotypes.

Published
2014

40. Caspofungin for the treatment of candidaemia in patients with haematological malignancies

Author

Maria Enza Mitra, Caterina Giovanna Valentini, Giuliana Farina, Annamaria Nosari, Livio Pagano, Massimo Offidani, Morena Caira, Brunella Posteraro, Maurizio Sanguinetti, Pierluigi Viale, Monica Morselli, Luana Fianchi, Anna Candoni, Rosa Fanci, Giuseppe Leone, Maria Elena Tosti, Pagano L, Fianchi L, Fanci R, Candoni A, Caira M, Posteraro B, Morselli M, Valentini CG, Farina G, Mitra ME, Offidani M, Sanguinetti M, Tosti ME, Nosari A, Leone G, and Viale P

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Antifungal Agents, Neutropenia, Drug-Related Side Effects and Adverse Reactions, Candidaemia, Caspofungin, Leukaemia, medicine.medical_treatment, Antineoplastic Agents, Echinocandins, Lipopeptides, Young Adult, chemistry.chemical_compound, Pharmacotherapy, Internal medicine, medicine, Humans, Prospective Studies, caspofungin, Prospective cohort study, Mycosis, Fungemia, Aged, Chemotherapy, Hematology, business.industry, Candidiasis, General Medicine, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Infectious Diseases, chemistry, Hematologic Neoplasms, leukaemia, Female, business
Abstract

This study was prospectively conducted in 11 haematology divisions over a 2-year period to evaluate the efficacy of caspofungin in 24 neutropenic patients with haematological malignancies (HM) and candidaemia. These patients had received chemotherapy for HM and were neutropenic (PNN < 0.5 × 109/L) for a median of 12 days (2–41) before candidaemia. The patients received caspofungin for a median duration of 12 days (range 6–26), obtaining a favourable overall response of 58%. At 30 days, 11 patients had died (46%); candidaemia was responsible for mortality in six patients (25%). These results suggest that treatment of candidaemia with caspofungin in neutropenic HM was efficacious, as it is in non-haematological subgroups.

Published
2010

41. Evaluation of the effects of Human leukocyte INF-alpha on the immune response to the HBV vaccine in healthy unvaccinated individuals

Author

Paola Chionne, Francesca Urbani, Elisabeth A. Haygreen, Enrica Montefiore, Maria Rapicetta, Maria Grimaldi, Maria Rosaria Capobianchi, Imerio Capone, Ernesto Palazzini, Elisabeth Taylor, Persephone Borrow, Paola Rizza, Maria Elena Tosti, A. Scuteri, Marzia Margotti, Pietro Andreone, Filippo Belardelli, Carmela Cursaro, Concetta Castilletti, Giuseppe Claudio Viscomi, Marina Selleri, David F. Tough, Angela Candido, Rizza P, Capone I, Urbani F, Montefiore E, Rapicetta M, Chionne P, Candido A, Tosti ME, Grimaldi M, Palazzini E, Viscomi G, Cursaro C, Margotti M, Scuteri A, Andreone P, Taylor E, Haygreen EA, Tough DF, Borrow P, Selleri M, Castilletti C, Capobianchi M, and Belardelli F.

Subjects
Adult, CD4-Positive T-Lymphocytes, Male, Adolescent, Adjuvant, Interferon, Vaccine, medicine.medical_treatment, Enzyme-Linked Immunosorbent Assay, CD8-Positive T-Lymphocytes, medicine.disease_cause, Peripheral blood mononuclear cell, Interferon-gamma, Immune system, Adjuvants, Immunologic, Immunity, medicine, Humans, Hepatitis B Vaccines, Hepatitis B Antibodies, Antigen-presenting cell, Aged, Hepatitis B virus, General Veterinary, General Immunology and Microbiology, business.industry, Public Health, Environmental and Occupational Health, Interferon-alpha, Dendritic cell, Middle Aged, Flow Cytometry, Virology, Lymphocyte Subsets, Infectious Diseases, Cytokine, Immunoglobulin G, Immunology, Leukocytes, Mononuclear, Molecular Medicine, Female, business
Abstract

HBV vaccine needs 3 injections over 6 months to induce immunity. Thus, the use of adjuvants capable of inducing earlier immune protection would be highly desirable. Most adjuvants may act by inducing cytokines, and among them, type I interferons (IFNs), deserve a special attention in view of the potent immunomostimulatory activity observed in mouse models and on dendritic cell functions. The aim of the present trial was to evaluate the effects of IFN-alpha administered as an adjuvant of HBV vaccine in healthy unvaccinated individuals. No significant enhancing effect on the antibody response was observed, in spite of an early and transient upregulation of costimulatory molecule expression on peripheral blood mononuclear cells, which may be suggestive of an IFN-mediated activation of antigen presenting cells. We conclude that, under the conditions used in this trial, natural IFN-alpha does not act as an adjuvant of the HBV vaccine in healthy unvaccinated individuals.

Published
2008

42. Zygomycosis in Italy: A survey of FIMUA-ECMM (Federazione Italiana di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

Author

Alessandro Bonini, Giulia Morace, Francesco Cristini, Mariagrazia Garzia, Cristina Cattaneo, Anna Maria Tortorano, G. Lombardi, L. Ferrari, Morena Caira, Roberto Bandettini, Annamaria Nosari, N. Manca, Caterina Giovanna Valentini, R. R. Minniti, M. R. Rossi, Marisa R. Nucci, Patrizia Pecile, Maria Anna Viviani, Fausto Rossini, Luca Fumagalli, Nicola Vianelli, Anna Maria Barbui, A d'Arminio Monforte, G. Farina, L. Savi, Marta Stanzani, Fabio Facchetti, F. Pallavicini, S. Giordano, P. M. Placanica, Maria Teresa Montagna, Alessandro Busca, Maria Elena Tosti, Marta Riva, I. Caserta, Corrado Girmenia, E. Mirone, Clara Romano, Anna Chierichini, Anna Candoni, Marco Picardi, R. Piane, P. Spedini, V. Selva, Pier Leopoldo Capecchi, Matteo Bassetti, L. Ricci, Brunella Posteraro, O. Morelli, G. P. Gesu, M. Mettimano, P. Scarpellini, Rosa Fanci, Francesco Bruno, Roberto Monastero, Livio Pagano, D. Giudici, Luana Fianchi, Elio Castagnola, Paolo Grossi, C. Ossi, A. Pan, G. Pinsi, M. La Sorda, F. Rossano, Maurizio Sanguinetti, Pagano, L, Valentini, Cg, Posteraro, B, Girmenia, C, Ossi, C, Pan, A, Candoni, A, Nosari, A, Riva, M, Cattaneo, C, Rossini, F, Fianchi, L, Caira, M, Sanguinetti, M, Gesu, Gp, Lombardi, G, Vianelli, N, Stanzani, M, Mirone, E, Pinsi, G, Facchetti, F, Manca, N, Savi, L, Mettimano, M, Selva, V, Caserta, I, Scarpellini, P, Morace, G, D'Arminio Monforte, A, Grossi, P, Giudici, D, Tortorano, Am, Bonini, A, Ricci, L, Picardi, Marco, Rossano, F, Fanci, R, Pecile, P, Fumagalli, L, Ferrari, L, Capecchi, Pl, Romano, C, Busca, A, Barbui, A, Garzia, M, Minniti, Rr, Farina, G, Montagna, Mt, Bruno, F, Morelli, O, Chierichini, A, Placanica, Pm, Castagnola, E, Bandettini, R, Giordano, S, Monastero, R, Tosti, Me, Rossi, Mr, Spedini, P, Piane, R, Nucci, M, Pallavicini, F, Bassetti, M, Cristini, F, LA Sorda, M, and Viviani, M. L.

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Epidemiology, Antifungal drug, Immunocompromised Host, Pharmacotherapy, Zygomycosis, Drug Resistance, Fungal, Amphotericin B, Internal medicine, medicine, Humans, Pharmacology (medical), Child, Mycosis, Aged, Pharmacology, Immunocompromised host, Aged, 80 and over, business.industry, Mortality rate, Mucormycosis, Infant, Middle Aged, medicine.disease, Surgery, Infectious Diseases, Oncology, Italy, Child, Preschool, Female, business, medicine.drug
Abstract

The aims of the study were to analyze the clinical and epidemiological characteristics and treatments for patients who developed zygomycosis enrolled in Italy during the European Confederation of Medical Mycology of medical mycology survey. This prospective multicenter study was performed between 2004 and 2007 at 49 italian Departments. 60 cases of zygomycosis were enrolled: the median age was 59.5 years (range 1-87), with a prevalence of males (70%). The majority of cases were immunocompromised patients (42 cases, 70%), mainly hematological malignancies (37). Among non-immunocompromised (18 cases, 30%), the main category was represented by patients with penetrating trauma (7/18, 39%). The most common sites of infection were sinus (35%) with/without CNS involvement, lung alone (25%), skin (20%), but in 11 cases (18%) dissemination was observed. According to EORTC criteria, the diagnosis of zygomycosis was proven in 46 patients (77%) and in most of them it was made in vivo (40/46 patients, 87%); in the remaining 14 cases (23%) the diagnosis was probable. 51 patients received antifungal therapy and in 30 of them surgical debridement was also performed. The most commonly used antifungal drug was liposomal amphotericin B (L-AmB), administered in 44 patients: 36 of these patients (82%) responded to therapy. Altogether an attributable mortality rate of 32% (19/60) was registered, which was reduced to 18% in patients treated with L-AmB (8/44). Zygomycosis is a rare and aggressive filamentous fungal infection, still associated with a high mortality rate. This study indicates an inversion of this trend, with a better prognosis and significantly lower mortality than that reported in the literature. It is possible that new extensive, aggressive diagnostic and therapeutic procedures, such as the use of L-AmB and surgery, have improved the prognosis of these patients.

43. A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and delta cohort.

Author

Kondili LA, Brancaccio G, Tosti ME, Coco B, Quaranta MG, Messina V, Ciancio A, Morisco F, Cossiga V, Claar E, Rosato V, Ciarallo M, Cacciola I, Ponziani FR, Cerrito L, Coppola R, Longobardi F, Biliotti E, Rianda A, Barbaro F, Coppola N, Stanzione M, Barchiesi F, Fagiuoli S, Viganò M, Massari M, Russo FP, Ferrarese A, Laccabue D, Di Marco V, Blanc P, Marrone A, Morsica G, Federico A, Ieluzzi D, Rocco A, Foschi FG, Soria A, Maida I, Chessa L, Milella M, Rosselli Del Turco E, Madonia S, Chemello L, Gentile I, Toniutto P, Bassetti M, Surace L, Baiocchi L, Pellicelli A, De Santis A, Puoti M, Degasperi E, Niro GA, Zignego AL, Craxi A, Raimondo G, Santantonio TA, Brunetto MR, and Gaeta GB

Subjects
Humans, Female, Male, Italy epidemiology, Adult, Middle Aged, Cross-Sectional Studies, Cohort Studies, Liver Cirrhosis epidemiology, Liver Cirrhosis virology, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular virology, Comorbidity, Aged, Hepatitis B Surface Antigens blood, Liver Neoplasms epidemiology, Liver Neoplasms virology, Interferons therapeutic use, Antiviral Agents therapeutic use, Hepatitis D, Chronic epidemiology, Hepatitis Delta Virus immunology, Hepatitis Delta Virus genetics
Abstract

Background and Aims: We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility., Methods: This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model., Results: Of 5492 HBsAg-positive enrolled patients, 4152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age ≤ 40 years vs. 2.1%; P < 0.001), more often females (males 43.0% vs. 68.6%; P < 0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care., Conclusions: CHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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44. Surface antigen serocleared hepatitis B virus infection increases the risk of mixed cryoglobulinemia vasculitis in male patients with chronic hepatitis C.

Author

Morrone A, Fiorilli V, Cinti L, Roberto P, Ferri AL, Visentini M, Pulsoni A, Spinelli FR, De Santis A, Antonelli G, Basili S, Tosti ME, Conti F, and Casato M

Subjects
Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Female, Aged, Hepatitis B complications, Hepatitis B immunology, Hepatitis B epidemiology, Case-Control Studies, Hepatitis B virus immunology, Adult, Sex Factors, Hepacivirus immunology, Cryoglobulinemia immunology, Cryoglobulinemia etiology, Cryoglobulinemia blood, Hepatitis B Surface Antigens blood, Hepatitis B Surface Antigens immunology, Hepatitis C, Chronic complications, Hepatitis C, Chronic immunology, Vasculitis immunology, Vasculitis epidemiology, Vasculitis etiology
Abstract

Mixed cryoglobulinemia vasculitis (MCV) is caused in ~90% of cases by chronic hepatitis C virus (HCV pos MCV) and more rarely by hepatitis B virus (HBV) infection, or apparently noninfectious. HCV pos MCV develops in only ~5% of patients with chronic hepatitis C (CHC), but risk factors other than female gender have not been identified so far. We conducted a retrospective case control study investigating whether past active HBV infection, defined by hepatitis B surface antigen (HBsAg) seroclearance and anti-core antibody (HBcAb) positivity, could be a risk factor for developing HCV pos MCV. The prevalence of HBsAg seroclearance was 48% within 123 HCV pos MCV patients and 29% within 257 CHC patients (p=0.0003). Multiple logistic regression including as variables gender, birth year, age at HBV testing, cirrhosis, and hepatocellular carcinoma, confirmed an association of HBsAg seroclearance with HCV pos MCV [adjusted odds ratio (OR) 2.82, 95% confidence interval (95% CI) 1.73-4.59, p<0.0001]. Stratification by gender, however, showed that HBsAg seroclearance was associated with HCV pos MCV in male [OR 4.63, 95% CI 2.27-9.48, p<0.0001] and not in female patients [OR 1.85, 95% 95% CI 0.94-3.66, p=0.076]. HBsAg seroclearance, and more likely occult HBV infection, is an independent risk factor for HCV pos MCV in male CHC patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Morrone, Fiorilli, Cinti, Roberto, Ferri, Visentini, Pulsoni, Spinelli, De Santis, Antonelli, Basili, Tosti, Conti and Casato.)

Published
2024
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45. Impact of the COVID-19 pandemic on the Italian national viral hepatitis surveillance: an interrupted time series analysis, 2006-2022.

Author

Russotto A, Vicentini C, Ferrigno L, Crateri S, Russo R, Tosti ME, and Zotti CM

Subjects
Humans, Italy epidemiology, Incidence, SARS-CoV-2, Hepatitis B epidemiology, Pandemics, Hepatitis, Viral, Human epidemiology, COVID-19 epidemiology, Interrupted Time Series Analysis, Hepatitis C epidemiology
Abstract

Objectives: This study aimed to assess the impact of the COVID-19 pandemic on national surveillance of viral hepatitis in Italy., Study Design: Interrupted time series analysis., Methods: Using an interrupted time series analysis with a customised AutoRegressive Integrated Moving Average model on hepatitis cases reported to the Integrated Epidemiological System of Acute Viral Hepatitis from 2006 to 2022, we examined trends in incidence, time to diagnosis and time to epidemiological investigations for hepatitis A, hepatitis B and hepatitis C., Results: The quarterly incidence of hepatitis B (-0.251, P = 0.05) and hepatitis C (-0.243, P = 0.003) significantly decreased with the onset of the pandemic. Surveillance times for hepatitis B (5.496, P < 0.001) and hepatitis C (35.723, P < 0.001), measured as days lost per quarter, significantly increased 12 and 24 months after the pandemic's start. This aligns with a notable rise in quarterly incidence at 36 months for both (0.032, P = 0.030 for hepatitis B; 0.040, P < 0.001 for hepatitis C)., Conclusions: The decrease in reported cases could be due to an increase in infection prevention control and containment measures put in place in a pandemic context. However, a delay in the initiation of epidemiological investigations was observed, which could lead to a further increase in incidence in the future., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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46. Local radiotherapy and measurable residual disease-driven immunotherapy in patients with early-stage follicular lymphoma (FIL MIRO): final results of a prospective, multicentre, phase 2 trial.

Author

Pulsoni A, Ferrero S, Tosti ME, Luminari S, Dondi A, Cavallo F, Merli F, Liberati AM, Cenfra N, Renzi D, Zanni M, Boccomini C, Ferreri AJM, Rattotti S, Zilioli VR, Bolis SA, Bernuzzi P, Musuraca G, Gaidano G, Perrone T, Stelitano C, Tucci A, Corradini P, Bigliardi S, Re F, Cencini E, Mannarella C, Mannina D, Celli M, Tani M, Annechini G, Assanto GM, Grapulin L, Guarini A, Cavalli M, De Novi LA, Bomben R, Ciabatti E, Genuardi E, Drandi D, Della Starza I, Arcaini L, Ricardi U, Gattei V, Galimberti S, Ladetto M, Foà R, and Del Giudice I

Subjects
Humans, Male, Female, Middle Aged, Aged, Prospective Studies, Adult, Immunotherapy methods, Neoplasm Staging, Antibodies, Monoclonal, Humanized therapeutic use, Aged, 80 and over, Lymphoma, Follicular radiotherapy, Lymphoma, Follicular drug therapy, Lymphoma, Follicular therapy, Lymphoma, Follicular pathology, Neoplasm, Residual
Abstract

Background: The mainstay of treatment for early-stage follicular lymphoma is local radiotherapy, with a possible role for anti-CD20 monoclonal antibody (mAb). We aimed to evaluate the effect of these treatments using a measurable residual disease (MRD)-driven approach., Methods: This prospective, multicentre, phase 2 trial was conducted at 27 centres of the Fondazione Italiana Linfomi (FIL) in Italy. Eligible participants were adults (≥18 years) with newly diagnosed, histologically confirmed follicular lymphoma (stage I or II; grade I-IIIa). Patients were initially treated with 24 Gy involved-field radiotherapy over 12 days; those who were MRD-positive after radiotherapy or during follow-up received eight intravenous doses (1000 mg per dose; one dose per week) of the anti-CD20 mAb ofatumumab. The primary endpoint was the proportion of patients who were MRD-positive after involved-field radiotherapy and became MRD-negative after ofatumumab treatment. Patients were included in the primary endpoint analysis population if they were positive for BCL2::IGH rearrangement at enrolment in peripheral blood or bone marrow samples. MRD positivity was defined as the persistence of BCL2::IGH rearrangement in peripheral blood or bone marrow, assessed centrally by laboratories of the FIL MRD Network. The trial was registered with EudraCT, 2012-001676-11., Findings: Between May 2, 2015, and June 1, 2018, we enrolled 110 participants, of whom 106 (96%) were eligible and received involved-field radiotherapy. Of these, 105 (99%) were White, one (1%) was Black, 50 (47%) were male, and 56 (53%) were female. Of 105 participants in whom BCL2::IGH status was evaluable, 32 (30%) had a detectable BCL2::IGH rearrangement at baseline. After radiotherapy, 12 (40%) of 30 patients reached MRD-negative status, which was long-lasting (at least 36 or 42 months) in three (25%). In those who were MRD-positive after radiotherapy, ofatumumab induced MRD-negativity in 23 (92%; 95% CI 74-99) of 25 evaluable patients. After a median follow-up of 46·1 months (IQR 42·8-50·8), 14 (61%) of these 23 patients remain in complete response and are MRD-negative. The most common grade 3-4 adverse events were infusion-related reactions, observed in four patients., Interpretation: Local radiotherapy is frequently not associated with the eradication of follicular lymphoma. An MRD-driven, anti-CD20 monoclonal antibody consolidation enables molecular remission to be reached in almost all patients and is associated with a reduced incidence of relapse over time. A clinical advantage of an MRD-driven consolidation is therefore suggested., Funding: AIRC Foundation for Cancer Research in Italy, Novartis International, and GlaxoSmithKline., Competing Interests: Declaration of interests AP reports support for the study from Novartis and AIRC 5 × 1000; payment or honoraria for lectures or presentations from Takeda Pharmaceuticals, Roche, Janssen Pharmaceuticals, and BeiGene; payment for expert testimony from Takeda Pharmaceuticals and Roche; support for attending meetings and/or travel from Takeda Pharmaceuticals, Roche, Janssen Pharmaceuticals, BeiGene, Pfizer, and AbbVie; and participation on a data safety monitoring board or advisory board for Takeda Pharmaceuticals, Roche, and Janssen Pharmaceuticals. SL reports payment or honoraria for lectures or presentations from Roche, BeiGene, Regeneron Pharmaceuticals, and Kite Pharma; support for attending meetings and/or travel from Roche and BeiGene; and participation on a data safety monitoring board or advisory board from Roche, Regeneron Pharmaceuticals, Miltenyi Biomedicine, Takeda Pharmaceuticals, Sobi, and Incyte. GG reports consulting fees from AbbVie, AstraZeneca, BeiGene, Incyte, Lilly, and Johnson & Johnson and payment or honoraria for lectures or presentations from AbbVie, AstraZeneca, BeiGene, Incyte, Lilly, Johnson & Johnson, and Hikma Pharmaceuticals. PC received consulting fees from AbbVie, ADC Therapeutics, Amgen, BeiGene, Celgene, Daiichi Sankyo, Eli Lilly, Gilead/Kite, GSK, Incyte, Janssen Pharmaceuticals, Jazz Pharma, Novartis, Pfizer, Roche, Sanofi, Sobi, and Takeda Pharmaceuticals and payment for lectures from AbbVie, Amgen, Celgene, Gilead/Kite, Incyte, Janssen Pharmaceuticals, Jazz Pharma, Novartis, Roche, Sanofi, Sobi, and Takeda Pharmaceuticals. LA received consulting fees from Roche, Janssen-Cilag, Verastem Oncology, Incyte, EUSA Pharma, Celgene/Bristol Myers Squibb, Kite/Gilead, ADC Therapeutics, and Novartis and payment or honoraria for lectures or presentations from EUSA Pharma and Novartis. ML received grants or contracts from Roche, BeiGene, ADC Therapeutics, and Janssen Pharmaceuticals and consulting fees and/or payment or honoraria from AbbVie, Amgen, ADC Therapeutics, Sobi, BeiGene, Bristol Myers Squibb, EUSA Pharma, Gilead/Kite, Novartis, Incyte, Janssen Pharmaceuticals, Jazz Pharma, Lilly, Regeneron Pharmaceuticals, Roche, Ellipses Pharma, GSK, and Istituto Gentili. IDG received payment or honoraria for lectures or presentations from Takeda Pharmaceuticals, Janssen Pharmaceuticals, Roche, and AstraZeneca; support for attending meetings and/or travel from Takeda Pharmaceuticals, Janssen Pharmaceuticals, Roche, and AstraZeneca; and support for participation on a data safety monitoring board or advisory board from Takeda Pharmaceuticals and Roche. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Published
2024
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47. The Opportunity Provided by Vaccination Offer to Refugees from Ukraine in European Countries.

Author

Marchetti G, D'Angelo F, Ferrari C, Bellini A, Sabato M, Scarso S, Karnaki P, Marceca M, Russo ML, Tosti ME, and Declich S

Abstract

(1) The Russian invasion of Ukraine forced many people to leave their country and seek asylum in various European countries, with serious consequences from a health perspective. In this context, we describe the health measures undertaken by AcToVax4NAM Consortium Countries (Cyprus-Germany-Greece-Italy-Malta-Poland-Romania-Spain) to prevent Vaccine-Preventable Disease (VPD) outbreaks in the context of mass movements of populations that resulted from the crisis in Ukraine. (2) We collected information on the vaccinations offered to Ukrainians in the Consortium Countries. (3) All these countries have provided Temporary Protection (TP) status to refugees from Ukraine and have followed the recommendations of European and International Agencies to offer them vaccinations according to the National Immunisation Programmes. The COVID-19 vaccination is offered in all countries with regard to the general population. Most countries provide information on TP and access to health/vaccination services in the Ukrainian language. (4) The information collected shows a common effort to ensure the adequate planning of health and vaccination services for refugees from Ukraine and, very often, to include them in the national vaccination offer. It is important that this initial response towards people who have fled Ukraine will be continued following the emergency but, more importantly, that it serves as a best practice towards all migrants and refugees entering the EU.

Published
2024
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48. Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review.

Author

Criscuolo M, Tosti ME, Broccoli A, Varettoni M, Maraglino AME, Anastasia A, Cantonetti M, Trentin L, Kovalchuk S, Orsucci L, Deodato M, Spolzino A, Volpetti S, Annibali O, Storti S, Stelitano C, Marchesi F, Morè S, Fianchi L, Falini B, Pulsoni A, Tiacci E, Zinzani PL, and Pagano L

Abstract

Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2-169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4-409.2 months), while the median OS from second cancer was 27.6 months (range: 1-117.8 months). The SIR was 0.86 (95% CI: 0.54-1.30) for males and 1.13 (95% CI: 0.36-2.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm.

Published
2024
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49. Exploring COVID-19 Vaccination Willingness in Italy: A Focus on Resident Foreigners and Italians Using Data from PASSI and PASSI d'Argento Surveillance Systems.

Author

Contoli B, Tosti ME, Asta F, Minardi V, Marchetti G, Casigliani V, Scarso S, Declich S, and Masocco M

Abstract

(1) The COVID-19 pandemic exacerbated health disparities, both between foreign and autochthonous populations. Italy was one of the European countries that was the most affected by the COVID-19 pandemic; however, only limited data are available on vaccine willingness. This study aims to assess the propensity of foreign and autochthonous populations residing in Italy to be vaccinated and the relative associated factors. (2) Data were collected and analysed from the two Italian surveillance systems, PASSI and PASSI d'Argento, in the period of August 2020-December 2021. The data include those of the Italian resident adult population over 18 years old. A multinomial logistic regression model, stratified by citizenship, was used to assess the associations of sociodemographic, health, and COVID-19 experience variables with vaccination attitudes. (3) This study encompassed 19,681 eligible subjects. Considering the willingness to be vaccinated, foreign residents were significantly less certain to get vaccinated (49.4% vs. 60.7% among Italians). Sociodemographic characteristics, economic difficulties, and trust in local health units emerged as factors that were significantly associated with vaccine acceptance. Having received the seasonal flu vaccine was identified as a predictor of COVID-19 vaccine acceptance among foreign and Italian residents. (4) This study underscores the significance of tailoring interventions to address vaccine hesitancy based on the diverse characteristics of foreign and Italian residents. This research offers practical insights for public health strategies, highlighting the importance of tailored educational campaigns, improved communication, and nuanced interventions to enhance vaccine acceptance and uptake within both populations.

Published
2024
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50. Prevalence of chronic HCV infection in EU/EEA countries in 2019 using multiparameter evidence synthesis.

Author

Thomadakis C, Gountas I, Duffell E, Gountas K, Bluemel B, Seyler T, Pericoli FM, Kászoni-Rückerl I, El-Khatib Z, Busch M, Schmutterer I, Vanwolleghem T, Klamer S, Plettinckx E, Mortgat L, Van Beckhoven D, Varleva T, Kosanovic Licina ML, Nemeth Blazic T, Nonković D, Theophanous F, Nemecek V, Maly M, Christensen PB, Cowan S, Rüütel K, Brummer-Korvenkontio H, Brouard C, Steffen G, Krings A, Dudareva S, Zimmermann R, Nikolopoulou G, Molnár Z, Kozma E, Gottfredsson M, Murphy N, Kondili LA, Tosti ME, Ciccaglione AR, Suligoi B, Nikiforova R, Putnina R, Jancoriene L, Seguin-Devaux C, Melillo T, Boyd A, van der Valk M, Op de Coul E, Whittaker R, Kløvstad H, Stępień M, Rosińska M, Valente C, Marinho RT, Popovici O, Avdičová M, Kerlik J, Klavs I, Maticic M, Diaz A, Del Amo J, Lundberg Ederth J, Axelsson M, and Nikolopoulos G

Abstract

Background: Epidemiological data are crucial to monitoring progress towards the 2030 Hepatitis C Virus (HCV) elimination targets. Our aim was to estimate the prevalence of chronic HCV infection (cHCV) in the European Union (EU)/European Economic Area (EEA) countries in 2019., Methods: Multi-parameter evidence synthesis (MPES) was used to produce national estimates of cHCV defined as: π = π rec ρ rec  + π ex ρ ex  + π non ρ non ; π rec , π ex , and π non represent cHCV prevalence among recent people who inject drugs (PWID), ex-PWID, and non-PWID, respectively, while ρ rec , ρ ex , and ρ non represent the proportions of these groups in the population. Information sources included the European Centre for Disease Prevention and Control (ECDC) national operational contact points (NCPs) and prevalence database, the European Monitoring Centre for Drugs and Drug Addiction databases, and the published literature., Findings: The cHCV prevalence in 29 of 30 EU/EEA countries in 2019 was 0.50% [95% Credible Interval (CrI): 0.46%, 0.55%]. The highest cHCV prevalence was observed in the eastern EU/EEA (0.88%; 95% CrI: 0.81%, 0.94%). At least 35.76% (95% CrI: 33.07%, 38.60%) of the overall cHCV prevalence in EU/EEA countries was associated with injecting drugs., Interpretation: Using MPES and collaborating with ECDC NCPs, we estimated the prevalence of cHCV in the EU/EEA to be low. Some areas experience higher cHCV prevalence while a third of prevalent cHCV infections was attributed to PWID. Further efforts are needed to scale up prevention measures and the diagnosis and treatment of infected individuals, especially in the east of the EU/EEA and among PWID., Funding: ECDC., Competing Interests: IG: He is currently an employee of MSD Greece. He joined MSD after his post-doctoral work at the University of Cyprus. TV: He has received grants from Gilead Sciences and Bristol Myers Squibb; he has served as a consultant for Janssen Pharmaceuticals, Gilead Sciences, AbbVie, Bristol Myers Squibb; and he has served as a sponsored lecturer for Gilead Sciences and Abbvie. PBC: He has received unrestricted research grants for other studies from Abbvie, Gilead, and MSD. MG: He has received consultancy and speaker’s fees from Gilead Sciences. LAK: She has received personal lecturer fee from Abbvie and Gilead Sciences and an institutional grant from Gilead Italy Fellowship 2022. LJ: She has received honorarium for lectures from AbbVie and MSD; offered consultancy to AbbVie, MSD, Tamro; and received conference attending fee from AbbVie, MSD, Pfizer, Swixx Biopharma. CSD: She has received educational and research grants for other studies from Abbvie and Gilead Sciences. MV: He participated in advisory boards (ViiV, Gilead, and MSD–fees paid to his institution); he has received independent research grants from ViiV and Gilead (paid to his institution). CV: She has received honorarium for lectures and consultancy from AbbVie, Gilead, MSD, and ViiV Healthcare. AD: She has received a grant for another study and speaker fee at a conference about HIV from Gilead Sciences. AB: He has received speaker's fees from Gilead Sciences. GN: He has received an ASKLEPIOS grant (HIV-related competitive grant) from Gilead Sciences (Greece). All other authors declare no conflict of interest., (© 2023 The Author(s).)

Published
2023
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