The epidemic of HIV infection and AIDS, promotion of testing, and innovative strategies

In Europe, the incidence of new diagnoses of HIV infection in 2008 was 86.7 cases per one million population, and most cases were attributable to sexual transmission. In Italy, in 2007, the incidence was 60.0 cases per one million population (in the areas in which surveillance exists), and 73.7% of the cases were attributable to sexual transmission. At present, there are an estimated 170 000-180 000 persons living with HIV/AIDS in Italy, some of whom are unaware of being infected. Based on available epidemiological data and taking into consideration the level of risk of exposure to HIV, we describe several proposals for promoting access to HIV testing in diverse population groups and contexts, including some innovative approaches. The promotion of HIV testing is fundamental for public health and human rights and must be associated with treatment, care and prevention activities, which must be guaranteed for the entire population

HIV virology and pathogenetic mechanisms of infection: a brief overview

Studies on HIV virology and pathogenesis address the complex mechanisms that result in the HIV infection of the cell and destruction of the immune system. These studies are focused on both the structure and the replication characteristics of HIV and on the interaction of the virus with the host. Continuous updating of knowledge on structure, variability and replication of HIV, as well as the characteristics of the host immune response, are essential to refine virological and immunological mechanisms associated with the viral infection and allow us to identify key molecules in the virus life cycle that can be important for the design of new diagnostic assays and specific antiviral drugs and vaccines. In this article we review the characteristics of molecular structure, replication and pathogenesis of HIV, with a particular focus on those aspects that are important for the design of diagnostic assays

Design and implementation of a smart system to control aromatic herb dehydration process

Drying is a process aimed at reducing the water content in plant materials below a limit where the activity of microbes and decomposing enzymes deteriorate the quality of medicinal and aromatic plants. Today, the interest of consumers towards medicinal and aromatic herbs has registered a growing trend. This study aims at designing a low-cost real-time monitoring and control system for the drying process of aromatic herbs and evaluating drying ecacy on the microbial community associated with the studied herbs. Hot-air drying tests of sage and laurel leaves were carried out in a dryer desiccator cabinet at 40 C and 25% relative humidity using three biomass densities (3, 4 and 5 kg/m 2 ). The prototype of the smart system is based on an Arduino Mega 2560 board, to which nine Siemens 7MH5102-1PD00 load cells and a DHT22 temperature and humidity sensor were added. The data acquired by the sensors were transmitted through Wi-Fi to a ThingSpeak account in order to monitor the drying process in real time. The variation in the moisture content of the product and the drying rate were obtained. The system provided a valid support decision during the drying process, allowing for the precise monitoring of the evolution of the biomass moisture loss and drying rate for laurel and sage. The three dierent biomass densities employed did not provide significant dierences in the drying process for sage. Statistically significant dierences among the three tests were found for laurel in the final part of the process. The microbial loads of the aromatic herbs after drying were influenced by the dierent leaf structures of the species; in particular, with laurel leaves, microbial survival increased with increasing biomass density. Finally, with the drying method adopted, the two species under consideration showed a dierent microbial stability and, consequently, had a dierent shelf life, longer for sage than laurel, as also confirmed by water activity (aw) values

Incidence of Newly HIV Diagnosed Cases among Foreign Migrants in Italy: 2006-2013

Objective: In Europe, during the last years the proportion of foreign migrants among AIDS and HIV cases is growing. In Italy, the number of new cases of HIV represented by foreign migrants has progressively increased, but the new HIV diagnoses incidence among foreign migrants has decreased, because of the increase in the total number of foreign migrants in recent years. Nevertheless, the new HIV diagnoses incidence among foreign migrants is still high if compared to that among Italians. The aim of the study was to analyze the characteristics of foreign migrants with a new HIV diagnosis and the new HIV diagnoses incidence among foreign migrants diagnosed in Italy between 2006 and 2013. Methods: The new diagnoses incidence was calculated as the ratio between the number of new HIV diagnoses among foreign migrants and the number of foreign migrants residing in Italy. The new HIV diagnoses incidence was compared with that among Italians using the standardized incidence ratio (SIR) adjusted by age and gender. Results: During the study period (2006-2013), of the 25,545 new diagnoses reported by the HIV surveillance system, 28.8% were among foreign migrants. The incidence of new HIV diagnoses among foreign migrants for the entire study period was 26.7 cases per 100,000 foreign migrant residents, compared to 5.1 per 100,000 among Italians. The incidence of new HIV diagnoses decreased over time for foreign migrants: from 42.5 per 100,000foreign migrant residents in 2006 to 20.0 per 100,000 foreign migrant residents in 2013, whereas for Italians it remained stable. The SIR confirmed the marked difference between the two populations: specifically the overall incidence of new diagnoses was more than four times higher among foreign migrants, compared to Italians.Conclusion: The results stress the need to reinforce the efforts aimed at reducing the circulation of HIV in this population

Biochemical and computational studies of the interaction between a glucosamine derivative, NAPA, and the IKKα kinase

The glucosamine derivative 2-(N-Acetyl)-L-phenylalanylamido-2-deoxy-β-D-glucose (NAPA), was shown to inhibit the kinase activity of IKKα, one of the two catalytic subunits of IKK complex, decreasing the inflammatory status in osteoarthritis chondrocytes. In the present work we have investigated the inhibition mechanism of IKKα by NAPA by combining computational simulations, in vitro assays and Mass Spectrometry (MS) technique. The kinase in vitro assay was conducted using a recombinant IKKα and IKKtide, a 20 amino acid peptide substrate derived from IkBα kinase protein and containing the serine residues Ser32 and Ser36. Phosphorylated peptide production was measured by Ultra Performance Liquid Chromatography coupled with Mass Spectrometry (UPLC-MS), and the atomic interaction between IKKα and NAPA has been studied by molecular docking and Molecular Dynamics (MD) approaches. Here we report that NAPA was able to inhibit the IKKα kinase activity with an IC50 of 0.5 mM, to decrease the Km value from 0.337 mM to 0.402 mM and the Vmax from 0.0257 mM·min-1 to 0.0076 mM·min-1. The computational analyses indicate the region between the KD, ULD and SDD domains of IKKα as the optimal binding site explored by NAPA. Biochemical data indicate that there is a non-significant difference between Km and Ki whereas there is a statistically significant difference between the two Vmax values. This evidence, combined with computational results, consistently indicates that the inhibition is non-competitive, and that the NAPA binding site is different than that of ATP or IKKtide

The continued ageing of people with AIDS in Italy: recent trend from the national AIDS Registry

Introduction. In industrialized countries, the availability of highly active antiretroviral  therapy (HAART) caused a slow but substantial ageing of the AIDS epidemic mainly  due to the longer survival of persons with HIV/AIDS which has turned HIV into a manageable, chronic disease. The number of older people with AIDS is growing in many  European countries.We described the impact of AIDS among persons aged 50 years or more in Italy and  compared the characteristics of these cases with those of persons diagnosed with AIDS  at an age younger than 50. Methods. The source of data was the Italian AIDS Registry, from 1982 to 2011. We  defined “older” persons those aged 50 years or more, and younger individuals those aged  less  than  50  years.  We  built  two  multivariate  logistic  regression  models:  the  first  one  to identify factors associated with being older, and the second one to identify AIDS-defining diseases correlated with being older. Variables with a P value of < 0.05 were  entered in the model.Results. Of the total AIDS cases, 10.5% were among persons older than 49 years. This  proportion progressively increased from 0.0% in 1983 to 26.4% in 2011. Among older  cases, the incidence of AIDS was 2.0 per 100 000 residents in 1996, then decreased  to 1.4 per 100 000 in 2000 and levelled off around 1 per 100 000 residents until 2011.  Compared to younger cases, older cases were more frequently males, Italians, diagnosed  with AIDS in recent years, residing in Northern or Central Italy, non-injecting drug users, and late testers. Discussion. These findings stress the need for physicians to consider carefully the possibility of HIV infection among older individuals not to miss the opportunity to deliver  prevention messages, offer HIV testing, and make an early diagnosis.  

Suggested strategies for the laboratory diagnosis of HIV infection in Italy

HIV/AIDS surveillance data indicate that, in 2008, approximately one-fourth of all HIV infections in adults remain undiagnosed in Italy and that close to 60% of Aids diagnosed individuals discovered their seropositivity at the diagnosis of AIDS. Late diagnosis of HIV infection is associated with increased mortality and morbidity and increased cost to healthcare services. From a public health perspective, knowledge of HIV status is associated with a reduction in risk behaviour. Thus, a routine screening for HIV infection is important for both a better prognostic outcome, and control of HIV spreading in the population. In Italy there are not shared guidelines for the laboratory diagnosis. In this paper, we suggest two algorithms that can be adopted for the diagnosis of HIV infection in individuals undergoing HIV testing

Il methotrexate nella terapia dell'artrite periferica in corso di rettocolite ulcerosa

Objective: To evaluate efficacy of methotrexate treatment in peripheral arthritis of ulcerative colitis. Methods: We studied 18 patients (10/8 M/F; mean age: 38.90 yrs; range: 21-65 yrs), with peripheral arthritis (14 with polyarticular, 4 with oligoarticular subset) associate ulcerative colitis. Methotrexate 20 mg/ week was administered in our patients, who were already receiving mesalazina for inflammatory bowel disease. At baseline, after 3 (T1), 6 (T2) and 12 months (T3) serological parameters (ESR and CRP), functional status (HAQ) and disease activity (VAS, GH, Ritchie articular index) were evaluated. Results: During the therapy a significant improvement was observed in disease activity, functional status and serological parameters since T1. ESR and CRP did not change at T2 and T3. Instead VAS, GH, Ritchie articular index and HAQ had a significant and gradual improvement from T1 to T3. Conclusion: Methotrexate treatment was efficacious in the treatment of peripheral arthritis associate ulcerative colitis. This drug induced improvement in disease activity, functional status and serological parameters after 3 months of therapy

Estimates of the Number of People Living with HIV in Italy

Objective. To estimate the HIV prevalence and the number of people living with HIV (PLHIV) in Italy with a projection for 2020. Methods. Two methods elaborated by Joint United Nations Programme on HIV/AIDS (UNAIDS) were used: Estimate and Projection Package and Spectrum. Results. A total of 123,000 (115,000–145,000) individuals aged 15 or more were estimated to be living with HIV in Italy at the end of 2012 and the estimated HIV prevalence was 0.28 (0.24–0.32) per 100 residents aged 15 or more. In 2012, the estimated number of new HIV infections among adults was 3,000 (2,700–4,000), and the number of adults in need for ART was 93,000 (80,000–110,000). The projection estimates that 130,000 (110,000–150,000) adults will live with HIV/AIDS in 2020 in Italy. Conclusion. Estimates of PLHIV in Italy stress the high number of PLHIV in need of care and treatment, as well as the need for more information and prevention campaigns