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1. Missed opportunities to prevent mother-to-child transmission of HIV in Italy

Author

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

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

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

Published
2019

3. Management of fever in children: Summary of the Italian pediatric society guidelines

Author

Chiappini E, Principi N, Longhi R, Tovo PA, Becherucci P, Bonsignori F, Esposito S, Festini F, Galli L, Lucchesi B, Mugelli A, de Martino M, Writing Committee of the Italian Pediatric Society Panel for the Management of Fever in Children, FALDELLA, GIACOMO, Chiappini E, Principi N, Longhi R, Tovo PA, Becherucci P, Bonsignori F, Esposito S, Festini F, Galli L, Lucchesi B, Mugelli A, de Martino M, Faldella G, and Writing Committee of the Italian Pediatric Society Panel for the Management of Fever in Children.

Subjects
Pediatrics, medicine.medical_specialty, Tympanic Membrane, Thermometers, MEDLINE, Ibuprofen, Signs and symptoms, Body weight, antipyretics, children, fever, guidelines, Body Temperature, Multidisciplinary approach, Health care, medicine, Humans, Pharmacology (medical), Child, Societies, Medical, Acetaminophen, Pharmacology, business.industry, Body Weight, Age Factors, Infant, Newborn, Guideline, Analgesics, Non-Narcotic, National guideline, Systematic review, Italy, Family medicine, Axilla, Practice Guidelines as Topic, business
Abstract

This article summarizes the Italian Pediatric Society guideline on the management of the signs and symptoms of fever in children, prepared as part of the National Guideline Program (NGLP).Relevant publications in English and Italian were identified through searches of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through December 31, 2007. Based on the consensus of a multidisciplinary expert panel, the strength of the recommendations was categorized into 5 grades (A-E) according to NGLP methodology.In the health care setting, axillary measurement of body temperature using a digital thermometer is recommended in children aged4 weeks; for children agedor =4 weeks, axillary measurement using a digital thermometer or tympanic measurement using an infrared thermometer is recommended. When body temperature is measured at home by parents or care-givers, axillary measurement using a digital thermometer is recommended for all children. Children who are afebrile when seen by the clinician but are reported to have had fever by their caregivers should be considered febrile. In special circumstances, high fever may be a predictive factor for severe bacterial infection. Use of physical methods of reducing fever is discouraged, except in the case of hyperthermia. Use of antipyretics-paracetamol (acetaminophen) or ibuprofen-is recommended only when fever is associated with discomfort. Combined or alternating use of antipyretics is discouraged. The dose of antipyretic should be based on the child's weight rather than age. Whenever possible, oral administration of paracetamol is preferable to rectal administration. Use of ibuprofen is not recommended in febrile children with chickenpox or dehydration. Use of ibuprofen or paracetamol is not contraindicated in febrile children with asthma. There is insufficient evidence to form any recommendations concerning fever in children with other chronic conditions, but caution is advised in cases of severe hepatic/renal failure or severe malnutrition. Newborns with fever should always be hospitalized because of the elevated risk of severe disease; paracetamol may be used, with the dose adjusted to gestational age. Use of paracetamol or ibuprofen is not effective in preventing febrile convulsion or the adverse effects of vaccines.

Published
2009

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

Author

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

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

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

Published
2004

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

Author

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

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

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

Author

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

Subjects
HIV
Abstract

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

Published
2014

7. Medical care related laboratory-confirmed bloodstream infections in paediatrics

Author

Virano, S, Scolfaro, C, Garazzino, S, De Intinis, C, Ghisetti, V, Raffaldi, I, Calitri, C, Tovo, Pa, Regina Margherita Children’s Hospital Bloodstream Infections Study Group including Plazzotta, C, Zotti, Cm, Neve, V, Conio, A, Vitale, P, Giacchino, M, Bertin, D, Carraro, F, Le Serre, D, Iannandrea, S, Grassitelli, Sm, Luccoli, L, Esposito, I, Ragazzi, P, Carlino, C, Porcellini, Mg, Bonaudo, R, Calvo, Pl, Baldi, M, Laudati, R, Ferraris, S, Aidala, E, Valori, A, Banaudi, E, Riggi, C, Bertino, E, Coscia, A, Di Nicola, P, Cavecchia, I, Cerchio, R, Bosetti, Fm, Bianciotto, M, Farina, D, and Manzoni, P

Subjects
Male, Methicillin-Resistant Staphylococcus aureus, Staphylococcus aureus, Drug Resistance, Anti-Bacterial Agents, Bacteremia, Child, Child, Preschool, Cross Infection, Drug Resistance, Multiple, Bacterial, Female, Hospitals, Pediatric, Hospitals, Teaching, Humans, Incidence, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Italy, Prospective Studies, Risk Factors, Staphylococcal Infections, Pediatrics, Preschool, Pediatric, Teaching, Bacterial, Newborn, Hospitals, Intensive Care Units, Multiple
Abstract

The aim of this survey was to describe the incidence, epidemiology, microbiology, risk factors and outcome of medical care related laboratory-confirmed bloodstream infections (LCBIs) observed during a twelve-month prospective study in a Paediatric Teaching Hospital in Turin, Italy. Inclusion criteria were clinical signs of sepsis and positivity of one or more of the following tests: blood culture, polymerase chain reaction for bacterial and fungal DNA on blood, and culture on intravascular device tips. In all, 140 episodes of sepsis were documented in 131 children: 37 (26.4%) were healthcare outpatient-associated, 91 (65.0%) healthcare-associated and 12 (8.6%) community-acquired. The overall incidence of healthcare-associated LCBIs was 13.6/1,000 hospitalized patients and incidence density 1.4/1,000 inpatient days. The overall mortality was 3.9%. Forty-seven (36.7%) episodes involved newborns and 107 (83.6%) episodes were observed in children with an indwelling central venous catheter. Coagulase-negative staphylococci (26.8%), Staphylococcus aureus (15.2%), Escherichia coli (8.7%) and Candida spp. (7.2%) were responsible for the majority of cases. 9.5% of S. aureus isolates were methicillin-resistant and 6.5% of Gram negatives were extended-spectrum beta-lactamase-producing. Incidence and epidemiology of medical care related LCBIs were similar to the existing literature data. LCBIs caused by antibiotic-resistant microorganisms were fewer and mortality rate was lower. Most of the LCBIs recorded involved newborns and oncological children.

Published
2015

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

Author

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

Abstract

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

Published
2012

9. Effectiveness of immunoglobulin replacement therapy on clinical outcome in patients with primary antibody deficiencies: results from a multicenter prospective cohort study

Author

Quinti I, Soresina A, Guerra A, Rondelli R, Spadaro G, Agostini C, Milito C, Trombetta AC, Visentini M, Martini H, Plebani A, Fiorilli M, IPINet Investigators, De Mattia D, Martire B, Cardinale F, Ranieri G, Silvestri F, Masi M, Cossu F, Anastasio E, Schillirò G, Matucci A, Vultaggio A, Aricò M, Pietrogrande MC, Delle Piane RM, Panisi C, Cambiaghi G, Pignata C, Putti MC, Trizzino A, Bertolini P, Consolini R, Ugazio AG, Duse M, Iacobini M, Moschese V, Cancrini C, Finocchi A, Pesce AM, Cagliuso M, Conti V, Granata G, Mitrevski M, Cecere F, Tovo PA, Martino S, Montin D, Nespoli L, Marinoni M, Pellegrini FP, Cazzola G.A., PESSION, ANDREA, Quinti., I, Soresina, A., Guerra, A., Rondelli, R., Spadaro, Giuseppe, Agostini, C., Milito, C., Trombetta, A. C., Visentini, M., Martini, H., Plebani, A., Fiorilli, M., De Mattia, D., Martire, B., Cardinale, F., Ranieri, G., Silvestri, F., Masi, M., Pession, A., Cossu, F., Anastasio, E., Schillirò, G., Matucci, A., Vultaggio, A., Aricò, M., Pietrogrande, M. C., Delle Piane, R. M., Panisi, C., Cambiaghi, G., Pignata, Claudio, Putti, M. C., Trizzino, A., Bertolini, P., Consolini, R., Ugazio, A. G., Duse, M., Iacobini, M., Moschese, V., Cancrini, C., Finocchi, A., Pesce, A. M., Cagliuso, M., Conti, V., Granata, G., Mitrevski, M., Cecere, F., Tovo, P. A., Martino, S., Montin, D., Nespoli, L., Marinoni, M., Pellegrini, F. P., Cazzola, G. A., Quinti I, Soresina A, Guerra A, Rondelli R, Spadaro G, Agostini C, Milito C, Trombetta AC, Visentini M, Martini H, Plebani A, Fiorilli M, IPINet Investigator, De Mattia D, Martire B, Cardinale F, Ranieri G, Silvestri F, Masi M, Pession A, Cossu F, Anastasio E, Schillirò G, Matucci A, Vultaggio A, Aricò M, Pietrogrande MC, Delle Piane RM, Panisi C, Cambiaghi G, Pignata C, Putti MC, Trizzino A, Bertolini P, Consolini R, Ugazio AG, Duse M, Iacobini M, Moschese V, Cancrini C, Finocchi A, Pesce AM, Cagliuso M, Conti V, Granata G, Mitrevski M, Cecere F, Tovo PA, Martino S, Montin D, Nespoli L, Marinoni M, Pellegrini FP, and Cazzola GA.

Subjects
Male, bronchiectasis, X-linked agammaglobulinemia, Comorbidity, Gastroenterology, Immunoglobulin G, 0302 clinical medicine, Agammaglobulinemia, Risk Factors, Immunology and Allergy, Prospective Studies, Child, Prospective cohort study, 0303 health sciences, biology, Incidence, common variable immunodeficiency, Middle Aged, 3. Good health, Treatment Outcome, Italy, Female, Intravenous, Adult, x-linked agammaglobulinemia, medicine.medical_specialty, immunoglobulin replacement, Adolescent, effectiveness, iga, Immunology, Disease-Free Survival, Injections, Databases, 03 medical and health sciences, Immunoglobulin replacement, common variable immunodeficiency, X-linked agammaglobulinemia, bronchiectasis, IgA, effectiveness, Internal medicine, medicine, Humans, Risk factor, Preschool, Factual, Aged, 030304 developmental biology, Settore MED/38 - Pediatria Generale e Specialistica, Bronchiectasis, business.industry, Common variable immunodeficiency, Infant, Pneumonia, X-Linked, medicine.disease, Databases, Factual, Injections, Intravenous, Child, Preschool, Immunoglobulin A, Follow-Up Studies, Common Variable Immunodeficiency, Genes, X-Linked, Genes, biology.protein, Trough level, business, 030215 immunology
Abstract

A 5-years multicenter prospective study on 201 patients with common variable immunodeficiencies and 101 patients with X-linked agammaglobulinemia over a cumulative follow-up period of 1,365 patient-years was conducted to identify prognostic markers and risk factors for associated clinical co-morbidities, the effects of long-term immunoglobulin treatment and the IgG trough level to be maintained over time required to minimise infection risk. Overall, 21% of the patients with common variable immunodeficiencies and 24% of patients with X-linked agammaglobulinemia remained infection free during the study. A reduction of pneumonia episodes has been observed after initiation of Ig replacement. During the observation time, pneumonia incidence remained low and constant over time. Patients with pneumonia did not have significant lower IgG trough levels than patients without pneumonia, with the exception of patients whose IgG trough levels were persistently < 400 mg/dL. In X-linked agammaglobulinemia, the only co-morbidity risk factor identified for pneumonia by the final multivariable model was the presence of bronchiectasis. In common variable immunodeficiencies, our data allowed us to identify a clinical phenotype characterised by a high pneumonia risk: patients with low IgG and IgA levels at diagnosis; patients who had IgA level < 7 mg/dL and who had bronchiectasis. The effect of therapy with immunoglobulins at replacement dosage for non-infectious co-morbidities (autoimmunity, lymphocytic hyperplasia and enteropathy) remains to be established. A unique general protective trough IgG level in antibody deficiency patients will remain undefined because of the major role played by the progression of lung disease in X-linked agammaglobulinemia and in a subset of patients with common variable immunodeficiencies.

Published
2011

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

Author

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

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

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

Published
1999

11. Excluding hepatitis C virus (HCV) infection by serology in young infants of HCV infected mothers

Author

England, K, Pembrey, L, Tovo, PA, Newell, ML, European Paediatric HCV Network [. . ., FALDELLA, GIACOMO, LANARI, MARCELLO, England, K, Pembrey, L, Tovo, PA, Newell, ML, European Paediatric HCV Network [.., Faldella, G, Lanari, M, and ]

Subjects
paediatric HCV, maternal antibodie, virus diseases, antibody lo, digestive system diseases, serological diagnosis
Abstract

Aim: To identify the age at which HCV infection can be accurately excluded by serology in young children born to HCV-infected mothers and to determine an appropriate schedule of antibody testing, most informative to clinical practice. Methods: Children born to HCV-infected mothers were followed in centres of the European Paediatric HCV Network. Turnbull survival analysis techniques were used to estimate the age at which HCV-uninfected children will lose maternally acquired HCV antibodies. Factors associated with age at antibody loss were assessed in logistic regression. Results: In 1104 children followed from birth and later confirmed to be HCV uninfected, an estimated 57% will have lost passively acquired HCV antibodies before 6 mo of age and an estimated 95% by 12 mo. Maternal HCV viraemia antenatally was associated with later,. and maternal HIV-HCV co-infection with earlier loss of antibody. Actual antibody testing of uninfected children at 12 mo identified 82% of those tested to be anti-HCV negative. Conclusions: Serological confirmation of HCV uninfection remains necessary given the uncertainty in the specificity of virological tests. These results suggest that, in most children, HCV infection can be ruled out with serological testing at an earlier age than previously thought, and that nearly all children born to HCV-infected mothers will have lost passively acquired maternal antibodies by 1 y of age. Antibody loss was significantly later among children born to HCV viraemic mothers. The earlier loss of HCV antibodies in children born to HIV co-infected mothers may be due to HIV treatment.

Published
2005

12. Scuola e pediatria

Author

BURGIO GR, DE BENEDICTIS FM, TOVO PA, CORSELLO, Giovanni, BURGIO GR, CORSELLO G, DE BENEDICTIS FM, and TOVO PA

Published
2005

13. Three broad modalities in the natural history of vertically acquired hepatitis C virus infection

Author

Pembrey, L, Tovo, PA, Newell, ML, for the European Paediatric Hepatitis C. Virus Network: [. . ., FALDELLA, GIACOMO, LANARI, MARCELLO, Pembrey, L, Tovo, PA, Newell, ML, for the European Paediatric Hepatitis C Virus Network: [.., Faldella G., M. Lanari, and ]

Subjects
INDIVIDUALS, PERSISTENCE, PROGRESSION, TO-CHILD TRANSMISSION
Abstract

Background. Little is known about the natural history of vertically acquired hepatitis C virus (HCV) infection. Methods. We performed a large, multicenter, prospective study of children born to HCV-infected women in Europe. Children were considered to be infected on the basis of >= 2 polymerase chain reaction (PCR) test results positive for HCV RNA and/or test results positive for anti-HCV antibody 118 months after birth. Results. Two hundred sixty-six children with vertical HCV infection were followed up until a median of 4.2 years of age ( range, 3.2 months to 15.9 years of age). Twenty-six children were coinfected with human immunodeficiency virus. Hepatomegaly, the only clinical sign reported, was found in 10% of children and was significantly associated with a high proportion of abnormal alanine transaminase (ALT) levels ( adjusted odds ratio [OR], 4.17; 95% confidence interval [CI], 1.67-10.42; P = .002). An estimated 21%-25% of children may have cleared the virus (i.e., had 2 consecutive PCR test results negative for HCV RNA, normal ALT levels, and no clinical signs) at a median age of 14.9 months. A high proportion of positive PCR test results obtained in the first year of life was associated with a lower likelihood of clearance ( OR, 9.77; 95% CI, 2.92-32.67; P < .0001) and persistent viremia in children 11 year old ( adjusted OR, 2.92; 95% CI, 1.09-7.80; P = .03). Conclusions. We confirm the low prevalence of HCV-related clinical signs and symptoms among vertically infected children in the first 10-15 years of life. Approximately 20% of children appear to clear the infection, 50% have evidence of chronic asymptomatic infection, and 30% have evidence of chronic active infection. Although viremia and abnormal ALT levels were associated with hepatomegaly, further investigation is necessary before these markers can be used in the clinical management of HCV infection in children.

Published
2005

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

Author

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

Subjects
immunodeficiency virus 1
Abstract

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

Published
2004

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

Author

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

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

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

Published
2001

16. Management of acute pharyngitis in children: summary of the Italian National Institute of Health guidelines

Author

Chiappini, E, Principi, N, Mansi, N, Serra, Agostino, De Masi, S, Camaioni, A, Esposito, S, Felisati, G, Galli, L, Landi, M, Speciale, Am, Bonsignori, F, Marchisio, P, de Martino, M, Collaborators Becherucci P, Italian Panel on the Management of Pharyngitis in C. h. i. l. d. r. e. n., Bellussi, L, De Gaudio, M, Di Simone, L, Di Mauro, G, Di Pietro, P, Festini, F, Gaini, Rm, Maiolino, Luigi, Mele, G, Marseglia, Gl, Novelli, A, Pisani, P, Puglisi, S, Rugiu, Mg, Tovo, Pa, Tulimiero, P, Varricchio, A, Venturini, E, Rosati, G. V., Chiappini, E, Principi, N, Mansi, N, Serra, A, De Masi, S, Camaioni, A, Esposito, S, Felisati, G, Galli, L, Landi, M, Speciale, A, Bonsignori, F, Marchisio, P, and de Martino, M

Subjects
Pediatrics, medicine.medical_specialty, MEDLINE, Acute Pharyngitis, Government Agencies, medicine, Humans, Pharmacology (medical), Child, Pharmacology, Acute Disease, Evidence-Based Medicine, Italy, Pharyngitis, Practice Guidelines as Topic, business.industry, Evidence-based medicine, Guideline, Amoxicillin, Government Agencie, Penicillin, Systematic review, Pharyngiti, medicine.symptom, business, medicine.drug, Human
Abstract

Background Discrepancies in the management of pharyngitis in children have been reported in Europe and the United States, and recommendations concerning the use of clinical scores, rapid antigen diagnostic tests (RADTs) or throat cultures, and the indications for antibiotic treatment largely differ. Objective This article summarizes the Italian guidelines on the management of pharyngitis in children issued by the National Institute of Health. Methods A multidisciplinary panel of experts (the Guidelines Development Group) developed and used a set of key questions to conduct a systematic review of the literature. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through April 30, 2011. Final recommendations were scaled according to the Italian National Guidelines Program grading. Results Eighteen clinical questions were defined, and 44 recommendations were issued. None of the available scoring systems is sufficiently accurate to identify group A β-hemolytic streptococci (GABHS) pharyngitis in settings with low prevalence for rheumatic disease. RADT should be performed by trained personnel in every child with a history and signs/symptoms suggestive of GABHS pharyngitis. RADT is not recommended in children with a McIsaac score of 0 or 1 with ≥2 signs/symptoms suggestive of viral infection. Backup culture in children with negative RADT result is not recommended. Culture test with antibiotic susceptibility assay should be performed exclusively for epidemiologic purposes. Streptococcal antibody titers are of no value in diagnosing acute pharyngitis. Antibiotic therapy is recommended in microbiologically documented GABHS pharyngitis. Because penicillin V is not available in Italy, amoxicillin (50 mg/kg/d in 2–3 doses orally) for 10 days is the first choice of treatment. In noncompliant cases, benzathine penicillin may be administered. Although not routinely recommended due to the high cost and wide spectrum of activity, a 5-day course with a second-generation cephalosporin may be used in noncompliant cases. Macrolides should be limited to children with demonstrated type I hypersensitivity to penicillin. Ibuprofen or paracetamol is recommended for relief of pain or fever associated with discomfort. Because the carrier state is not associated with increased risk of suppurative complications and risk of GABHS transmission to contacts is minimal, the carrier state should never be investigated and treated. Recommendations for the management of suppurative complications are given. Conclusions This guideline provides a comprehensive, evidence based, tool for the diagnosis and therapy of acute pharyngitis in children.

Published
2012

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

Author

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

Published
2012

18. Human immunodeficiency virus-related cancer in children: incidence and treatment outcome--report of the Italian Register

Author

Caselli D, Klersy C, de Martino M, Gabiano C, Galli L, Tovo PA, Aricò M, Giaquinto C. Giacomet V, Castelli Gattinara G, Livadiotti S, Minoli L, Maccabruni A, Fundarò C, Osimani P, De maria A, Rossi G, Dessì C, Viganò A, Plebani A, Riva C, De mattia D, Salvatore C, Mazza A., GUARINO, ALFREDO, Caselli, D, Klersy, C, de Martino, M, Gabiano, C, Galli, L, Tovo, Pa, Aricò, M, Giaquinto C., Giacomet V, Castelli Gattinara, G, Livadiotti, S, Minoli, L, Maccabruni, A, Fundarò, C, Osimani, P, Guarino, Alfredo, De maria, A, Rossi, G, Dessì, C, Viganò, A, Plebani, A, Riva, C, De mattia, D, Salvatore, C, and Mazza, A.

Subjects
Male, Cancer Research, medicine.medical_specialty, Pediatrics, Adolescent, HIV Infections, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Neoplasms, Epidemiology, medicine, Humans, Prospective Studies, Registries, Risk factor, Sida, Child, Lymphoma, AIDS-Related, Acquired Immunodeficiency Syndrome, Perinatal Exposure, biology, business.industry, Incidence (epidemiology), Incidence, Lymphoma, Non-Hodgkin, Infant, Newborn, Infant, biology.organism_classification, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Treatment Outcome, Oncology, El Niño, Italy, Child, Preschool, Female, Viral disease, business
Abstract

PURPOSE: To outline the incidence, presenting features, treatment response, and outcome of human immunodeficiency virus (HIV)–associated malignancies in infancy and childhood, together with the estimated risk of HIV-associated cancer in children born to mothers infected with HIV. PATIENTS AND METHODS: The Italian Register for HIV Infection in Children collected data by specific registration and follow-up forms. By March 1999, 5,060 children were recruited, including 4,889 with perinatal exposure to HIV-1. Overall, 1,331 infected children were enrolled onto the Register and classified according to current Centers for Disease Control criteria; of them, 1,163 were vertically infected (24% of those with perinatal exposure). Of these 1,163, 569 (49%) were considered to have been prospectively followed-up since they had been registered at birth or within the first 3 months of age. RESULTS: Of the 1,331 children observed for a median time of 6.5 years, 35 developed 36 malignancies, four of which occurred in patients with blood-borne risk. For the 1,163 vertically infected children, the cumulative number of years of observation was 7,178 child-years and the cumulative incidence of HIV-associated tumors was 4.18 per 1,000 children/yr (95% confidence interval [CI], 2.92 to 5.98). When only the 569 vertically infected children prospectively followed up since birth were considered, the cumulative number of years of observation was 2,803 child-years. In this group, 10 tumors were observed, with a cumulative incidence of HIV-associated tumors of 3.57 per 1,000 children per year (95% CI, 1.92 to 6.63). CONCLUSION: The risk of cancer was significantly higher but not restricted to symptomatic and/or immune-compromised children. Cancer-directed treatment should be given promptly to these patients, who have a fair chance to survive their tumor in view of potential highly aggressive antiretroviral therapy–associated improvement in survival and quality of life.

Published
2000

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

Author

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

Abstract

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

Published
2000

21. Persistence rate and progression of vertically acquired hepatitis C infection

Author

Tovo PA, Pembrey LJ, Newell ML, IORIO, RAFFAELE, Tovo, Pa, Pembrey, Lj, Newell, Ml, and Iorio, Raffaele

Subjects
medicine.medical_specialty, Hepatitis C virus, Viremia, medicine.disease_cause, Asymptomatic, Gastroenterology, Flaviviridae, Internal medicine, medicine, Immunology and Allergy, hepatitis, biology, medicine.diagnostic_test, Hepatitis C, medicine.disease, biology.organism_classification, digestive system diseases, Infectious Diseases, Alanine transaminase, Liver biopsy, Immunology, HCV, biology.protein, vertical transmission, Viral disease, medicine.symptom
Abstract

Data were collected from 104 infected children who were followed up from birth for a mean of 49 (range, 6-153) months in 22 European centers, to outline the natural history of perinatal hepatitis C virus (HCV) infection. Fifty-four children were persistently HCV RNA positive, 44 were occasionally positive, and 6 never had detectable viremia. At least 90% of the children had evidence of ongoing infection at the latest analysis. Eighteen children became HCV RNA negative at their last assessments, but 40% of these had high alanine aminotransferase (ALT) concentrations. Infection was asymptomatic in all but 2 children, who developed hepato-megaly. Mean ALT concentrations decreased substantially after the first 2 years of life; 14 children had persistently normal ALT values. Signs of minimal to moderate inflammation were noted in all 20 patients who underwent liver biopsy. Perinatal HCV infection is usually asymptomatic in the first years of life, but the virus persists in most children, even in the absence of elevated ALT activity.

Published
2000

22. Risk of triple-class virological failure in children with HIV: a retrospective cohort study

Author

Pursuing Later Treatment Options II project team for the Collaboration of Observational HIV Epidemiological Research Europe, Castro, H, Judd, A, Gibb, Dm, Butler, K, Lodwick, Rk, van Sighem, A, Ramos, Jt, Warsawski, J, Thorne, C, Noguera Julian, A, Obel, N, Costagliola, D, Tookey, Pa, Colin, C, Kjaer, J, Grarup, J, Chene, G, Collaborators: Antinori A, Phillips A., Castagna, A, Cozzi Lepri, A, De Luca, A, De Wit, S, Dorrucci, M, Duval, X, García, F, Ghosn, J, Günthard, H, Ledergerber, B, Lo Caputo, S, Lodwick, R, Masquelier, B, Meyer, L, Mocroft, A, Mussini, C, Paraskevis, D, Paredes, R, Pérez Hoyos, S, Phillips, A, Pillay, D, Podzamczer, D, Reiss, P, Stephan, C, Teira, R, Torti, Carlo, Touloumi, G, Zangerle, R, Warszawski, J, Dabis, F, Krause, Mm, Leport, C, de Wolf, F, Prins, M, Bücher, Hc, Sabin, C, Gibb, D, Fätkenheuer, G, Del Amo, J, Kirk, O, Antinori, A, Monforte, Ad, Tovo, Pa, de Martino, M, Brockmeyer, Nh, Battegay, M, Francioli, P, Carnicer Pont, D, Casabona, J, Miró, Jm, de Wit, S, Goetghebuer, T, Torti, C, Garrido, M, Dedes, N, Weller, I, d'Arminio Monforte, A, Collin Filleul, F, Schwimmer, C, Ellefson, M, Paulsen, M, Bohlius, J, Bouteloup, V, Bucher, Hc, Egger, M, Furrer, H, Lambotte, O, Lewden, C, Matheron, S, Miro, J, Puoti, M, Reekie, J, Smit, C, Sterne, J, Thiebaut, R, and Wittkop, L.

Published
2011

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

Author

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

Abstract

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

Published
1999

25. Is it safe to discontinue primary Pneumocystis jiroveci pneumonia prophylaxis in patients with virologically suppressed HIV infection and a CD4 cell count <200 cells/microL?

Author

Opportunistic Infections Project Team of the Collaboration of Observational HIV Epidemiological Research in Europe, Mocroft, A, Reiss, P, Kirk, O, Mussini, C, Girardi, E, Morlat, P, Stephan, C, De Wit, S, Doerholt, K, Ghosn, J, Bucher, Hc, Lundgren, Jd, Chene, G, Miro, Jm, Collaborators: Weller I, Furrer H., Costagliola, D, Ledergerber, B, Lundgren, J, Grarup, J, Touloumi, G, Warszawski, J, Meyer, L, Dabis, F, Krause, Mm, Leport, C, de Wolf, F, Porter, K, Dorrucci, M, Sabin, C, Gibb, D, Fätkenheuer, G, Del Amo, J, Obel, N, Thorne, C, Pérez Hoyos, S, Antinori, A, d'Arminio Monforte, A, Tovo, Pa, de Martino, M, Brockmeyer, Nh, Ramos, J, Battegay, M, Carnicer, D, Tookey, P, Casbona, J, Miró, Jm, Castagna, A, de Wit, S, Torti, Carlo, Teira, R, Garrido, M, Bucher, H, Egger, M, Furer, H, Lewden, C, Newell, Ml, Phillips, A, Stearne, J, Telenti, A, Collin Filleul, F, Ellefson, M, Fabre Colin, C, Kjaer, J, Schwimmer, C, Paulsen, M, and Dedes, N.

Published
2010

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

Author

Tovo, Pa, Demartino, M, Gabiano, C, Cappello, N, Delia, R, Loy, A, Plebani, A, Zuccotti, Gv, Dallacasa, P, Ferraris, G, Caselli, D, Fundaro, C, Dargenio, P, Galli, L, Principi, N, Stegagno, M, Ruga, E, Palomba, Other contributors to the Italian Register for HIV Infection in children: Mazzoni, Calabri, Pl, Timpano, G, Duse, C, Schettini, M, Rizzi, F, Belloni, M, Iannuzzi, M, Romano, C, G, and Consolini, Rita

Subjects
Hepatitis, Univariate analysis, medicine.medical_specialty, Pediatrics, business.industry, Obstetrics and Gynecology, General Medicine, Disease, medicine.disease, Perinatal hiv, Surgery, Acquired immunodeficiency syndrome (AIDS), medicine, Viral disease, business, Survival analysis, Cohort study, Parotitis
Abstract

The signs that may arise after perinatal infection with human immunodeficiency virus type 1 (HIV-1) have been classified by the Centers for Disease Control, but the clinical usefulness of the classification system and the prognostic importance of each disease pattern have not been established. We sought to address these issues by analysing data from the Italian Register for HIV infection in children. We studied 1887 children born to HIV-1-seropositive mothers. 1045 were identified at birth and the others were registered later (median age 4.8 [range 0.4-72] months). HIV-1-associated signs developed in 433 (81.8%) of 529 seropositive infected children at a median age of 5 (0.03-84) months. These signs appeared significantly earlier in the 102 children who died of HIV-1-related illness than in those who are still alive (median 3 [0.03-55] vs 6 [0.03-84] months; p less than 0.001). The cumulative proportion surviving at age 9 years was 49.5% (95% confidence interval 27-65%) and the median survival time was 96.2 months. Separate analysis of the 112 seropositive infected children followed from birth and older than 15 months gave similar results. Hepatomegaly, splenomegaly, lymphadenopathy, parotitis, skin diseases, and recurrent respiratory tract infections formed the mildest disease pattern. Lymphoid interstitial pneumonitis and thrombocytopenia were signs of intermediate disease. By contrast, in multivariate analysis specific secondary infectious diseases, severe bacterial infections, progressive neurological disease, anaemia, and fever were significant and independent negative predictors of survival. Growth failure, persistent oral candidosis, hepatitis, and cardiopathy were associated in univariate analysis with significantly shorter survival. Our findings suggest that the outlook for children with perinatal HIV-1 infection is better than previously thought and that a new clinical staging system of single disease patterns is needed.

Published
1992

28. Changing patterns of clinical events in perinatally HIV-1-infected children during the era of HAART. The Italian Register for HIV Infection in Children

Author

WRITING COMMITTEE CHIAPPINI, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Gattinara, Gc, Esposito, S, Viganò, A, Giaquinto, C, Rosso, R, Guarino, A, Osimani, DE MARTINO M. MEMBERS OF THE ITALIAN REGISTER FOR HIV INFECTION IN CHILDREN P., Cordiali, R., DE MATTIA, D., Manzionna, M., DI BARI, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Schumacher, R., Duse, M., Sinelli, M., Bennato, V., Dessì, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Zicchinella, D., Sticca, M., Pomero, G., Contiero, R., Fiumana, E., Gervaso, P., Gabrielli, G., Braccesi, G., Becherucci, S., DE GAUDIO, M., Innocenti, L., Cecchi, M. T., Ginocchio, F., Nicolini, L. A., Ciravegna, B. W., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Bojanin, J., Porta, A., Principi, N., Giacomet, V., Bianchi, R., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., MORETTI MILANO, C., Cellini, M., Cano, M. C., Palazzi, G., Bruzzese, E., Giannattazio, A., Tarallo, L., Tancredi, F., D'Elia, R., Rampon, O., DALLE NOGARE, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Consolini, Rita, Legitimo, Annalisa, Magnani, C., Falconieri, P., Fundarò, C., Salvucci, P. VALENTINI S., Casadei, A. M., Bernardi, S., Palma, P., Anzidei, M., Cerilli, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Gentilini, L., Mignone, F., Versace, A., Antonielli, E., Sovatzis, S., Scolfaro, C., Palomba, E., Portelli, V., Rabusin, M., Pellegatta, A., and Fortunati, P.

Published
2007

29. Cancer rates after year 2000 significantly decrease in children with perinatal HIV infection: A study by the Italian Register for HIV Infection in Children

Author

Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giaquinto, C, Rampon, O, Gattinara, Gc, De Marco, G, Osimani, P, Manzionna, M, Miniaci, A, Pintor, C, Rosso, R, Esposito, S, Viganò, A, Dodi, I, Maccabruni, A, Fundarò, C, de Martino, M, Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, Elena, Galli, Luisa, Tovo, Pier-Angelo, Gabiano, Clara, Lisi, Catiuscia, Giaquinto, Carlo, Rampon, Osvalda, Gattinara, Guido Castelli, De Marco, Giulio, Osimani, Patrizia, Manzionna, Mariano, Miniaci, Angela, Pintor, Carlo, Rosso, Raffaella, Esposito, Susanna, Viganò, Alessandra, Dodi, Icilio, Maccabruni, Anna, Fundarò, Carlo, De Martino, Maurizio, Italian Register for HIV Infection in, Children, and Lanari, M.

Subjects
Registrie, Pediatrics, Cancer Research, Time Factors, HIV Infections, Antiretroviral Therapy, Highly Active, Neoplasms, HIV Infection, Registries, Sida, Child, biology, Incidence (epidemiology), Medicine (all), Incidence, Child, Preschool, Disease Progression, Humans, Infant, Infant, Newborn, Italy, Treatment Outcome, Oncology, symbols, Population study, Viral disease, Human, medicine.medical_specialty, cancer rates, HIV infection, children, Time Factor, Antiretroviral Therapy, symbols.namesake, Acquired immunodeficiency syndrome (AIDS), medicine, cancer, Highly Active, Poisson regression, Preschool, Settore MED/38 - Pediatria Generale e Specialistica, Perinatal HIV infection, business.industry, Cancer, Newborn, medicine.disease, biology.organism_classification, Italian Register for HIV infection in children, El Niño, Neoplasm, business
Abstract

Purpose To evaluate the impact of highly active antiretroviral therapy (HAART) on cancer incidence in HIV-infected children throughout a 20-year period. Patients and Methods An observational population study was conducted on 1,190 perinatally HIV-infected children enrolled onto the Italian Register for HIV Infection in Children from 1985 to 2004 and never lost to follow-up (total observation time, 10,037.66 years). Cancer rates were calculated in the pre-HAART (1985 to 1995), early HAART (1996 to 1999), and late HAART (2000 to 2004) periods and compared using Poisson regression adjusted for age. The proportion of HAART-treated children increased from 4.1% in 1996 to 60.4% in 1999 and to 81.5% in 2004. In the same time frame, the proportion of children receiving HAART for at least 2 years increased from 3.1% to 77.0%. Results Overall, 35 cancers occurred. Cancer rates were 4.49 (95% CI, 2.37 to 6.64), 4.09 (95% CI, 1.68 to 6.50), and 0.76 (95% CI, 0.00 to 1.80) per 1,000 children per year in 1985 to 1995, 1996 to 1999, and 2000 to 2004, respectively. Notably, there was no significant difference comparing the periods from 1985 to 1995 and 1996 to 1999 (P = .081). By contrast, cancer rates were significantly lower in the period from 2000 to 2004 than in 1996 to 1999 (P < .0001). Results were confirmed by separately analyzing data from children observed from birth (P = .418 for 1985 to 1995 v 1996 to 1999; P = .001 for 1996 to 1999 v 2000 to 2004). Conclusion Dramatically reduced cancer rates were observed only in the late HAART period in parallel to the increasing proportion of children receiving HAART therapy.

Published
2007

30. Human papillomavirus vaccination. Consensus Conference in pediatric age

Author

Bartolozzi, G, Bona, G, Ciofi, M, DE MARTINO, M, DI PIETRO, P, Duse, M, Esposito, S, Gasparini, Roberto, Mariani, L, Marostica, G, Paravati, F, Plebani, A, Principi, N, Zuccotti, Gv, and Tovo, Pa

Subjects
Settore MED/38 - Pediatria Generale e Specialistica, Consensus, Adolescent, Papillomavirus Infections, Uterine Cervical Neoplasms, Sexually Transmitted Diseases, Viral, Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18, Italy, Practice Guidelines as Topic, Humans, Female, Papillomavirus Vaccines, Child, Developing Countries, Societies, Medical
Abstract

Genital human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide. Spontaneous clearance of HPV infection occurs in most cases, but chronic infection with high risk genotypes is associated with the development of cervical cancer. In particular, HPV 16 and 18 are responsible for 70% of cancers of the cervix and, in variable proportions, for cancers of the vagina, vulva, anus, penis and oropharinx. Low risk HPV genotypes, such as HPV 6 and 11, cause genital warts. Two prophylactic vaccines using virus like particles (VLPs) of L1 capside protein of HPV 16 and 18 have been developed. Of these, one also containing VLPs of HPV 6 and 11, has been approved by FDA, EMEA and AIFA for use in 9-26 year-old females. Large scale studies have shown that these vaccines are safe, well tolerated, elicits high levels of neutralizing antibodies, prevent chronic HPV infections due to genotypes present in the vaccine, and associated cervical lesions (and genital wars for the quadrivalent vaccine). To be effective the vaccines should be given prior to sexual debut. In Italy, the vaccination will be offered to 12 year-old girls. This article is the result of a targeted Consensus Conference by a panel of experts, which reviews the cornerstones of HPV infection, its association with cervical cancer, the advances in prophylactic vaccines, and the primary role of the paediatrician for the optimal adoption of this new preventive strategy.

Published
2007

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

Author

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

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

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

Published
2006

32. Onset of clinical signs in children with HIV-1 perinatal infection. Italian Register for HIV Infection in Children

Author

Galli L, de Martino M, Tovo PA, Gabiano C, Zappa M, Giaquinto C, Tulisso S, Vierucci A, Guerra M, Marchisio P, Plebani A, Zuccotti GV, Martino AM, Dallacasa P, Stegagno M, Belloni M, Castelli Gattinara G, Caselli D, Duse M, Corrias A, Consolini R, Cocchi P, Risso S, Ferraris G, Forni G. L, Mazzoni P. L, Portelli V, Benaglia G, Mazza A, Cellini M, Ruggeri M, De Mattia D, Falconieri P, Ciccimarra F, Bassanetti F, Anastasio E, Micheletti E, Masi M, Bresciani E, De Manzini A, Lusardi P, Baldi F, Eisenstecken M, Dell'Erba G, Sticca M, Berrino R., GUARINO, ALFREDO, Galli, L, de Martino, M, Tovo, Pa, Gabiano, C, Zappa, M, Giaquinto, C, Tulisso, S, Vierucci, A, Guerra, M, Marchisio, P, Plebani, A, Zuccotti, Gv, Martino, Am, Dallacasa, P, Stegagno, M, Belloni, M, Castelli Gattinara, G, Caselli, D, Duse, M, Corrias, A, Consolini, R, Cocchi, P, Risso, S, Ferraris, G, Forni, G. L., Mazzoni, P. L., Portelli, V, Benaglia, G, Mazza, A, Cellini, M, Guarino, Alfredo, Ruggeri, M, De Mattia, D, Falconieri, P, Ciccimarra, F, Bassanetti, F, Anastasio, E, Micheletti, E, Masi, M, Bresciani, E, De Manzini, A, Lusardi, P, Baldi, F, Eisenstecken, M, Dell'Erba, G, Sticca, M, and Berrino, R.

Subjects
Male, Acquired Immunodeficiency Syndrome, Hepatitis, Viral, Human, Infant, Newborn, Infant, CD4 Lymphocyte Count, Cohort Studies, Survival Rate, AIDS-Related Complex, Child, Preschool, Diarrhea, Infantile, Splenomegaly, Disease Progression, HIV-1, Birth Weight, Humans, Female, Age of Onset, Hepatomegaly, Probability
Abstract

OBJECTIVE: To investigate the timing of onset of each clinical sign in infants and children with HIV-1 perinatal infection. DESIGN AND METHODS: A total of 200 HIV-1-infected children followed-up from birth were studied. Failure and conditional probabilities were estimated by the Kaplan-Meier product-limit method. Cox proportional hazard analysis was used to evaluate independently associated factors. Results of 934 seroreverters were used to calculate reference values of CD4+ cell counts and predictivity of early signs. RESULTS: Median age at the onset of any sign was 5.2 months (range, 0.03-56 months). The probability of remaining asymptomatic was 19% [95% confidence interval (CI), 14-25.1] at 12 months and 6.1% (95% CI, 2.6-11.7) at 5 years. Lymphadenopathy (69.5%), splenomegaly (62.4%) and hepatomegaly (58.4%) were the most common signs in the first year of life. Peculiar to the first year of life (compared with subsequent ages) was the onset of primary HIV-1 hepatitis and diarrhoea (rate ratios, 23.3 and 15.2, respectively). When CD4+ cell counts in the asymptomatic stage (age, 2 months; range, 0.03-5.9 months) were below rather than above the fifth percentile in seroreverters, onset of signs was earlier [3 range, 0.03-19) versus 5 (range, 0.03-56) months]. Children manifesting signs before the 5.2-month breakpoint had a lower survival rate [74% (range, 65.9-82%) at 12 months and 45% (range, 32.9-57%) at 5 years] than children manifesting signs later [98% (range, 92.2-100%) at 12 months and 74% (range, 60.3-87.7%) at 5 years]. Children whose birthweight was < or = 2400 g had an earlier onset (24 months; range, 1-57 months) of severe conditions than children with higher birthweight (71 months; range, 1-71 months). Development of lymphadenopathy or hepatosplenomegaly within 3 months of life were reliable indicators of infection. CONCLUSIONS: This study describes the sequence of onset of signs in perinatal HIV-1 infection. Infection is shown to progress faster than in adults and in a different manner. Low birthweight, early decreased CD4+ cell counts, and early onset of signs are predictive of rapid progression.

Published
1995

34. A significant sex - but not elective cesarean section - Effect on; mother-to-child transmission of hepatitis C virus infection

Author

Tovo, PA, Pembrey, L, Newell, ML, Amoroso, A, Asensi-Botet, F, Pereda, A, Balossini, V, Bona, G, Zaffaroni, M, Bandelloni, A, Coscia, A, Fabris, C, Aime, S, Belloni, C, Bossi, G, Salati, B, Boucher, C, Buffolano, W, Butler, K, Roura, LC, Sanges, JMB, Cigna, P, Ciria, LM, Ginard, CS, Teruel, GC, Fortuny-Guasch C, Coll, O, Corrias, A, Ledda, R, Floris, S, De Maria, A, Echeverria, J, Cilla, G, Faldella, G, Lanari, M, Tridapalli, E, Venturi, V, Fischler, B, Bohlin, AB, Lindgren, S, Lindh, G, Giacomet, V, Merlo, M, Figini, C, Erba, P, Vigano, A, Hannam, S, Mieli-Vergani, G, Hatzakis, A, Inchley, C, Fjaerli, HO, Maccabruni, A, Marcellini, M, Sartorelli, MR, Fontelos, PM, Mazza, A, Mok, JYQ, Mur, A, Vinolas, M, Paternoster, DM, Grella, P, Polywka, S, Quinti, I, Casadei, AM, Rojahn, A, Berg, A, Rosso, R, Ferrando, S, Bassetti, D, Contreras, JR, Manzanares, A, Extremera, AR, Salvini, F, Zuccotti, GV, Schmitz, T, Grosch-Worner, I, Sperling, CF, Piening, T, Vegnente, A, Iorio, R, Versace, A, Garetto, S, Lazier, L, Bressio, S, Riva, C, Alfarano, A, Wejstal, R, Norkrans, G, Zanetti, A, Tanzi, E, and European Paediat Hepatitis C Virus

Published
2005

35. Antiretroviral therapy, fat redistribution and hyperlipidaemia in HIV-infected children in Europe. European Paediatric Lipodystrophy Group

Author

Viganò, A, Thorne, C, Brambilla, P, AND THE ITALIAN REGISTER FOR HIV INFECTION IN CHILDREN TOVO PA, NEWELL M. L., Gabiano, C, Galli, L, DE MARTINO, M, Rovere, La, Pellegatta, Sticca, Bezzi, T., Basetti, D., Rosso, R., Ferrando, S., Cristina, Lipreri, Merlo, Bianchi, R., Schneider, L., Brambilla, P., Guarino, A., Giaquinto, C., Giacomet, V., Ebo, Romano, A., Maccabruni, A., and Consolini, Rita

Published
2004

37. Prognostic value of a CCR5 defective allele in paediatric HIV-1 infection

Author

Romiti, Ml, Colognesi, C, Cancrini, C, Mas, A, Berrino, M, Salvatori, F, Orlandi, P, Jansson, M, Palomaba, E, Bertan, Jm, Galli, L, Hernandez, M, Amoroso, A, Tovo, Pa, Rossi, P, IN CO-OPERATION WITH EUROPEAN CONCERT ACTION, Etasg, and EUROPEAN SHARED COST PROJECT GROUP AND THE ITALIAN REGISTER FOR HIV INFECTION IN, C

Subjects
Settore MED/02
Published
2000

38. Pertussis immunization in HIV-1-infected infants: a model to assess the effects of repeated T cell-dependent antigen administrations on HIV-1 progression. Italian Register for HIV infection in children

Author

Tovo, Pa, Martino, De, Gabiano, M, Galli, C, L, Italian Register for HIV infection, Partecipants:, Osimani, P, Mattia, De, Zizzadoro, D, Ruggeri, P, Masi, M, Dell'Erba, M, Lanari, G, Bosi, M, Chiriacò, I, Duse, Pg, Crispino, M, Soresina, P, Bresciani, Ar, Battisti, E, Pintor, L, Chiappe, C, Belloni, F, Loriano, M, Ibba, D, Berrino, P, Nasi, R, Sticca, C, Palmieri, M, Anastasio, M, Bezzi, E, Vierucci, T, Guarino, A, Farina, A, Cecchi, S, Maria, De, Fioredda, A, Donelli, F, Marazzi, E, Pontali, Mg, Forni, E, Cosso, Gl, Gotta, D, Lobello, C, Tondo, D, Micheletti, U, Ruggeri, E, Plebani, C, Pinzani, A, Salvini, R, Marchisio, S, Esposito, P, Massironi, S, Zuccotti, E, Riva, Gv, Gamboni, E, Ferraris, A, Rancilio, G, Vegni, L, Altoberlli, C, Liprieri, R, Conio, R, Lizzoli, S, Gambaretto, F, Cellini, G, Pignata, M, Pozzi, C, Guarino, N, Romano, A, Todeschini, A, Giaquinto, A, Ruga, C, Rampon, E, O, Consolini, Rita, and Legitimo, Annalisa

Published
2000

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

Author

Andiman, W., Boucher, M., Burns, D., Bryson, Y., Farley, J., Fowler, H, Gabiano, C., Gall, L., Hutto, C., Kind, C, Korber, B., Kovacs, A., Krogstad, P., Landesman, S., Lapointe, N., Lemay, M, Lew, J, Mandelbrot, L., Mayaux, Mj, Mellins, R., Minkoff, H., Mofenson, L., Nielsen, K, Newell, Ml, Pardi, G., Peavy, H., Peckham, C., Read, J., Rother, C, Rudin, C., Scott, G., Semprini, A., Shearer, W., Simonds, R., Simpson, A, Stek, A., Tovo, Pa, Tuomala, R., Van Dyke, R., Weedon, J., de Martino, M., Lindsay, M., Belair, S., Chan, L., Harris, D, Kalish, L., Muenz, L., Nugent, R., Schluchter, M., Durako, S., Goodwin, S., Mitchell, R., Nourjah, P., Owen, W., Widmayer, S., Ardeguez, A., Hanson, C., Wiznia, A., Luzuriaga, K., Viscarello, R, Ho, D., Koup, R., Chen, I., Mullins, J., Wolinsky, S., Walker, B, Ammann, A., Clapp, S., Mcdonald, D, Fauvel, M., Hankins, C, Samson, J., Bailey, A., Giaquinto, Carlo, Ruga, E., DE ROSSI, Anita, and Truscia, D.

Subjects
ZIDOVUDINE PROPHYLAXIS, INFANT HIV TRANSMISSION, MOTHER-TO-CHILD, MOTHER-TO-CHILD, INFANT HIV TRANSMISSION, CESAREAN-SECTION, ZIDOVUDINE PROPHYLAXIS, CESAREAN-SECTION
Published
1999

46. Long-Term Non Progressors Among Children with Perinatal HIV-1 Infection

Author

Tovo, Pa, Martino, De, Gabiano, M, Galli, C, Ferraris, L, Marchisio, G, Giaquinto, P, Tulisso, C, Zuccotti, S, Loy, Gv, Vierucci, A, A, Castelli, Gattinara, Caselli, G, Plebani, D, Fundarò, A, Dallacasa, C, Belloni, P, M, The Italian Register for HIV Infection in Children: Mazzoni, Timpano, Pl, Ruggeri, C, and Consolini, Rita

Published
1997

48. Mode of delivery and gestational age influence perinatal HIV-1 transmission

Author

Tovo, Pa, Demartino, M, Gabiano, C, Galli, L, Cappello, N, Ruga, E, Tulisso, S, Vierucci, A, Loy, A, Zuccotti, Gv, Bucceri, Am, Plebani, A, Marchisio, P, Caselli, D, Liviadotti, S, Dallacasa, P, The Italian Register for HIV Infection in Children: Fundaro, Stegagno, C, Timpano, M, Ruggeri, C, Duse, M, Belloni, M, Cocchi, M, Risso, P, Forni, S, Lipreri, Gl, Ciccimarra, R, F, and Consolini, Rita

Published
1996

49. Vaccinations in children with clinical or social problems

Author

Principi, N., Plebani, A., Azzari, C., Gabutti, G., Barberi, I., Bartolozzi, G., Belloni, A., Borsellino, G., Caccamo, L., Carapella, E., Cascio, G., Castello, M., Cavagni, G., Comodo, N., Crovari, P., Duse, M., Faldella, G., Franco, E., Galli, E., Giammanco, G., Grossi, A., Moschese, V., Nespoli, L., Novembre, E., Oppizio, M., Pietrogrande, C., Pignatta, C., PAOLO ROSSI, Salpietro, C., Salvioli, Gp, Tovo, Pa, Tozzi, A., and Ugazio, Ag

Subjects
Settore MED/38 - Pediatria Generale e Specialistica
Published
1996

50. ONSET OF CLINICAL SIGNS IN CHILDREN WITH HIV-1 PERINATAL INFECTION

Author

Galli, L, Demartino, M, Tovo, Pa, Gabiano, C, Zappa, M, Giaquinto, C, Tulisso, S, Vierucci, A, Guerra, M, Marchisio, P, Plebani, A, Zuccotti, Gv, Martino, Am, Dallacasa, P, Stegagno, M, The Italian Register for HIV Infection in Children: BELLONI, Gattinara, M, Caselli, Gc, Duse, D, Corrias, M, A, and Consolini, Rita

Published
1995

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