Prevalence of echinococcosis in humans, livestock and dogs in northern Italy

AbstractThe presence of Echinococcus sp. cysts was investigated in 822 sheep, 123 goats and 112,521 cattle from Lombardy region, North Italy. Faecal samples from 40 sheepdogs were also analyzed, with 9 samples containing taeniid eggs (22.5 %), 8 samples being coproantigen-positive (20 %), and one dog from a northern province (Lecco) positively confirmed by PCR. Cystic Echinococcosis (CE) was detected in 0.36 % of sheep and in 0.29 % of cattle in 2004. No goat resulted to be infected. Data from CE patients treated in Lombardy were collected by inspecting hospital discharge records. In 2004, 156 CE-related admissions (62 % male and 38 % female) were reported in Lombardy. Total hospital stay was 1,372 days (1,286 for inpatients, 86 for outpatients). Most patients (72.4 %) were residents in Lombardy and 1.9 % were from Piedmont; the remaining patients were from central and southern Italy. According to acquired data CE resulted hypoendemic in animals in Lombardy. Prevalence rates in humans were higher than expected in this region, usually considered as non-endemic. Assessment of the prevalence of CE in humans remains a difficult, costly, time-consuming and labourintensive task. The present study suggests establishing a National Registry of Cystic Echinococcosis with the aim to highlight regional risk factors and to benefit from its matching both clinical and epidemiological data

Changes in circulation of B and non-B HIV strains: spotlight on a reference centre for infectious diseases in Northern Italy

Stored demographic data and HIV RT and protease sequences of 877 HIV patients attending for the first time the HIV/AIDS outpataient clinics of a reference Infectious Diseases centre in Northern Italy between 1999 and 2006 were stratified by 3-years spanning periods according to date of HIV infection. In the period 1980-1982, new infections were entirely caused by HIV-1 subtype B strains and were all diagnosed in injection drug users, 88.9% of whom were males. Injection drug users accounted for 12.8% of new infections in 2004-2006. The frequencly of heteroswxually-trasnmitted infections consistently increases until 2000 (from almost none to 51.5%) remaining stable afterwards. About half of heterosexual paatients were females. HIV infections among homosexual men increased from 0% in 1980-1982 to 15-21% between 1998 and 2006. Overall, the frequency of non-B subtypes HIV strains increased from 0% in 1980-1982 ti 20.3% in 2004-2006 with a greater impact in heterosexuals (from 0% in 1980-1982 to 30.5% in 2004-2006). In conclusion, a picture of the changing scenario of circulating HIV types and subtypes in a reference Infectious Diseases centre in Northern Italy over the past 26 years is provided. A progressive modification in risk factors for HIV infection and a significant increase in the frequency of non-B HIV strains were observed

Paritaprevir, ritonavir, ombitasvir, and dasabuvir with and without ribavirin in people with HCV genotype 1 and recent injecting drug use or receiving opioid substitution therapy

Background: Direct-acting antiviral therapy for hepatitis C virus (HCV) infection is safe and effective, but there are little data among people who have recently injected drugs. This study evaluated the efficacy, and safety of paritaprevir/ritonavir, ombitasvir, dasabuvir with or without ribavirin for chronic HCV genotype (G) 1 among people with recent injecting drug use and/or receiving OST. Methods: D3FEAT is an international open-label study that recruited treatment-naïve participants with recent injecting drug use (previous 6 months) and/or receiving OST with chronic HCV G1 infection between June 2016 and February 2017 in seven countries. Participants received paritaprevir/ritonavir, ombitasvir, dasabuvir with (G1a) or without ribavirin (G1b) administered twice daily in a one-week electronic blister pack (records timing of each dose) for 12 weeks. The primary endpoint was undetectable HCV RNA 12 weeks post-treatment (SVR12). Results: Among 87 participants (median age 48 years), 23% were female, 8% had cirrhosis, and 90% had G1a. Overall, 71% were receiving OST, 61% injected in the previous six months, 45% injected in the previous month, and 15% injected > daily. Treatment completion was 97% (84 of 87). There were no virological breakthroughs, but three discontinuations (loss to follow-up, n = 1; non-adherence, n = 1; incarceration, n = 1). SVR was 91% (79 of 87, 95% CI, 83%–96%). Five participants who completed treatment did not have SVR (loss to follow-up, n = 1; death, n = 1; virologic relapse, n = 3). Drug use prior to and during treatment did not impact SVR12. Treatment-related adverse events were observed in 46 (53%) patients (six grade 3, no grade 4). Five (6%) patients had at least one serious adverse event (two possibly/probably related to therapy; nausea and myoclonus). Two cases of reinfection were observed. Conclusion: Paritaprevir/ritonavir, ombitasvir, and dasabuvir with or without ribavirin for 12 weeks is effective among people with HCV genotype 1 with recent injecting drug use and/or receiving OST.Jason Grebelya, Brian Conwayb, Evan B. Cunninghama, Chris Fraserc, Alberto Moriggiad, Ed Ganee, Catherine Stedmanf, Curtis Cooperg, Erika Castroh, Patrick Schmidi, Kathy Petoumenosa, Behzad Hajarizadeha, Phillipa Marksa, Amanda Erratta, Olav Dalgardj, Karine Lacombek, Jordan J. Feldl, Julie Bruneaum, Jean-Pierre Dauloueden, Jeff Powiso, Philip Bruggmannp, Gail V. Matthewsa, Ian Kronborgq, David Shawr, Adrian Dunlops, Margaret Hellardt, Tanya L. Applegatea, Sione Crawfordu, Gregory J Dorea, on behalf of the D3FEAT Study Grou

Paritaprevir, ritonavir, ombitasvir, and dasabuvir with and without ribavirin in people with HCV genotype 1 and recent injecting drug use or receiving opioid substitution therapy.

Direct-acting antiviral therapy for hepatitis C virus (HCV) infection is safe and effective, but there are little data among people who have recently injected drugs. This study evaluated the efficacy, and safety of paritaprevir/ritonavir, ombitasvir, dasabuvir with or without ribavirin for chronic HCV genotype (G) 1 among people with recent injecting drug use and/or receiving OST. D3FEAT is an international open-label study that recruited treatment-naïve participants with recent injecting drug use (previous 6 months) and/or receiving OST with chronic HCV G1 infection between June 2016 and February 2017 in seven countries. Participants received paritaprevir/ritonavir, ombitasvir, dasabuvir with (G1a) or without ribavirin (G1b) administered twice daily in a one-week electronic blister pack (records timing of each dose) for 12 weeks. The primary endpoint was undetectable HCV RNA 12 weeks post-treatment (SVR12). Among 87 participants (median age 48 years), 23% were female, 8% had cirrhosis, and 90% had G1a. Overall, 71% were receiving OST, 61% injected in the previous six months, 45% injected in the previous month, and 15% injected > daily. Treatment completion was 97% (84 of 87). There were no virological breakthroughs, but three discontinuations (loss to follow-up, n = 1; non-adherence, n = 1; incarceration, n = 1). SVR was 91% (79 of 87, 95% CI, 83%-96%). Five participants who completed treatment did not have SVR (loss to follow-up, n = 1; death, n = 1; virologic relapse, n = 3). Drug use prior to and during treatment did not impact SVR12. Treatment-related adverse events were observed in 46 (53%) patients (six grade 3, no grade 4). Five (6%) patients had at least one serious adverse event (two possibly/probably related to therapy; nausea and myoclonus). Two cases of reinfection were observed. Paritaprevir/ritonavir, ombitasvir, and dasabuvir with or without ribavirin for 12 weeks is effective among people with HCV genotype 1 with recent injecting drug use and/or receiving OST

Testing the structure of multistage stochastic programs

Contamination, Additional stages, Out-of-sample scenarios, Polyhedral risk objectives, Bond portfolio management,