Recent transmission clustering of HIV-1 C and CRF17_BF strains characterized by NNRTI-related mutations among newly diagnosed men in central Italy

Increased evidence of relevant HIV-1 epidemic transmission in European countries is being reported, with an increased circulation of non-B-subtypes. Here, we present two recent HIV-1 non-B transmission clusters characterized by NNRTI-related amino-acidic mutations among newly diagnosed HIV-1 infected men, living in Rome (Central-Italy)

Genetic divergence of HIV-1 B subtype in Italy over the years 2003\u20132016 and impact on CTL escape prevalence

HIV-1 is characterized by high genetic variability, with implications for spread, and immune-escape selection. Here, the genetic modification of HIV-1 B subtype over time was evaluated on 3,328 pol and 1,152 V3 sequences belonging to B subtype and collected from individuals diagnosed in Italy between 2003 and 2016. Sequences were analyzed for genetic-distance from consensus-B (Tajima-Nei), non-synonymous and synonymous rates (dN and dS), CTL escapes, and intra-host evolution over four time-spans (2003\u20132006, 2007\u20132009, 2010\u20132012, 2013\u20132016). Genetic-distance increased over time for both pol and V3 sequences (P < 0.0001 and 0.0003). Similar results were obtained for dN and dS. Entropy-value significantly increased at 16 pol and two V3 amino acid positions. Seven of them were CTL escape positions (protease: 71; reverse-transcriptase: 35, 162, 177, 202, 207, 211). Sequences with 653 CTL escapes increased from 36.1% in 2003\u20132006 to 54.0% in 2013\u20132016 (P < 0.0001), and showed better intra-host adaptation than those containing 642 CTL escapes (intra-host evolution: 3.0 7 10 123 [2.9 7 10 123\u20133.1 7 10 123] vs. 4.3 7 10 123 [4.0 7 10 123\u20135.0 7 10 123], P[LRT] < 0.0001[21.09]). These data provide evidence of still ongoing modifications, involving CTL escape mutations, in circulating HIV-1 B subtype in Italy. These modifications might affect the process of HIV-1 adaptation to the host, as suggested by the slow intra-host evolution characterizing viruses with a high number of CTL escapes

Parietal resting-state EEG alpha source connectivity is associated with subcortical white matter lesions in HIV-positive people

Objective Parietal resting-state electroencephalographic (rsEEG) alpha (8–10 Hz) source connectivity is abnormal in HIV-positive persons. Here we tested whether this abnormality may be associated with subcortical white matter vascular lesions in the cerebral hemispheres. Methods Clinical, rsEEG, and magnetic resonance imaging (MRI) datasets in 38 HIV-positive persons and clinical and rsEEG datasets in 13 healthy controls were analyzed. Radiologists visually evaluated the subcortical white matter hyperintensities from T2-weighted FLAIR MRIs (i.e., Fazekas scale). In parallel, neurophysiologists estimated the eLORETA rsEEG source lagged linear connectivity from parietal cortical regions of interest. Results Compared to the HIV participants with no/negligible subcortical white matter hyperintensities, the HIV participants with mild/moderate subcortical white matter hyperintensities showed lower parietal interhemispheric rsEEG alpha lagged linear connectivity. This effect was also observed in HIV-positive persons with unimpaired cognition. This rsEEG marker allowed good discrimination (area under the receiver operating characteristic curve &gt; 0.80) between the HIV-positive individuals with different amounts of subcortical white matter hyperintensities. Conclusions The parietal rsEEG alpha source connectivity is associated with subcortical white matter vascular lesions in HIV-positive persons, even without neurocognitive disorders. Significance Those MRI-rsEEG markers may be used to screen HIV-positive persons at risk of neurocognitive disorders

Monitoraggio del trattamento dell'epatite C con il dosaggio delle catene leggere libere

Scopo del lavoro. Monitorare mediante il dosaggio delle catene leggere libere, la risposta al trattamento dell’epatite C in soggetti in terapia con Ribavirina (dose in funzione del peso corporeo) ed interferone (1.5ug/kg/ settimana). Materiali e Metodi. Sono stati esaminati 6 soggetti (3 maschi e 3 femmine) con crioglobulinemia di tipo II e III in terapia combinata con interferone e ribavidina. I pazienti sono stati monitorati prima dell’inizio della terapia(T0) e dopo 4 settimane di trattamento (T1) eseguendo su campioni di sangue periferico i dosaggi di: catene leggere libere Kappa e lambda (FLC k e l kit: The Binding Site/Radim); valutazione quantitativa del numero di copie virali del virus HCV (Cobas Amplicor HCV); determinazione della Proteina C reattiva ultrasensibile hs-PCR (Vitros-Fusion 5.1, Ortho Clinica-Diagnostics). I dati sono stati analizzati con test non parametrici per la mediana (Mann-Whitney) e correlazione di Person mediante SPSS v.17, significatività p0,05

Manuale di autovalutazione della comunicazione in ambito HIV/AIDS

Gruppo AIDS C.A.R.E. Il volume destinato all’autovalutazione della comunicazione dei professionisti sanitari che lavorano con le persone HIV/AIDS, si propone di approfondire gli aspetti comunicativi e relazionali nelle diverse fasi della malattia, delineando, in maniera semplice, le modalità per creare un buon clima e una buona relazione. Il documento si compone di due parti. La prima parte prevede 24 riquadri relativi a temi che sono stati identificati come fondamentali nell’ambito della comunicazione HIV/AIDS e che riguardano direttamente la comunicazione o gli aspetti organizzativi della comunicazione stessa nelle diverse fasi dell’infezione. Ogni riquadro inizia con uno scopo (i risultati sui pazienti e i “familiari”) e contiene da 5 a 25 criteri specifici, seguiti dove necessario, da una serie di esempi (frasi o espressioni di chiarimento). Nella seconda parte sono riportate relazioni su temi specifici della comunicazione e del counselling nonché una breve descrizione delle diverse tecniche per il sostegno psicologico al paziente e agli operatori. Per il suo livello di specificità e concretezza esso rappresenta anche un importante strumento per la formazione dell’equipe di professionisti impegnati nella lotta all’infezione da HIV/AIDS

Splenic abscess due to Streptococcus anginosus. Case report

Splenic abscess is a rare condition. Haematogenous seeding to the spleen from an infection at a distant site, most often endocarditis, is been the most common predisposing condition but an increase has been observed in immuno-compromised patients too. Fever, leukocytosis and left upper quadrant pain are suggestive, but the signs and symptoms of splenic abscesses are often non-specific. Rare is the onset with diarrhoea as in our case. Ultrasound and computed tomography are reliable diagnostic tools. Splenectomy and antibiotics are the treatments of choice. We describe a case of splenic abscess with gas level and peritonitis from dissemination of Streptococcus anginosus (of Streptococcus millerii group) from duodenal ulcer contamined. It was diagnosed with CT, ultrasound, and abdomen X-ray with contrast then treated with splenectomy and peritoneal lavag

Pharmacogenetics as a tool to tailor antiretroviral therapy: a review

Highly active antiretroviral therapy (HAART) has substantially changed human immunodeficiency virus (HIV) infection from an inexorably fatal condition into a chronic disease with a longer life expectancy. This means that HIV patients should receive antiretroviral drugs lifelong, and the problems concerning with a chronic treatment (tolerability, side effects, adherence to treatment) have now become dominant. In this context, strategies for the treatment personalization have taken a central role in optimizing the therapeutic response and prevention of adverse drug reactions. In this setting, the study of pharmacogenetics features could be a very useful tool in clinical practice; moreover, nowadays the study of genetic profiles allows optimizations in the therapeutic management of People Living With HIV (PLWH) through the use of test introduced into clinical practice and approved by international guidelines for the adverse effects prevention such as the genetic test HLA-B*5701 to detect hypersensitivity to Abacavir. For other tests further studies are needed: CYP2B6 516 G > T testing may be able to identify patients at higher risk of Central Nervous System side effects following standard dosing of Efavirenz, UGT1A1*28 testing before initiation of antiretroviral therapy containing Atazanavir may aid in identifying individuals at risk of hyperbilirubinaemia. Pharmacogenetics represents a ​​research area with great growth potential which may be useful to guide the rational use of antiretrovirals

SARS-Cov-2 pneumonia and concurrent myelodysplasia complicated by pseudomonas aeruginosa over-infection

The new virus called severe acute respiratory syndrome coronavirus 2 (SARSCov-2) causing Coronavirus disease 2019 (COVID-19) has spread quickly in several countries and it has become pandemic. Different types of clinical manifestations are attributed to this infection. Some mechanisms related to the infection regarding the immune response are not still elucidated. Herein we reported a case of a 66-years-old patient affected by myelodysplasia who was referred to our hospital because of clinical and radiological manifestations of viral pneumonia. The clinical course has become complicated due to bacterial secondary over-infection by Pseudomonas aeruginosa during stay in internal medicine unit whilst a persistent positive oral and naso-pharyngeal swab test was reported up to 100 days of admission. The patient had a fast clinical and radiological worsening that led her to be admitted to an intensive care unit. Despite intubation and mechanical ventilation she died in a few days