Delayed presentation and late testing for HIV : demographic and behavioural risk factors in a multicenter study in Italy

Ensuring timely access to care for persons with HIV is an important public health goal. To identify factors associated with delayed presentation to medical care after testing HIV-positive or with late HIV testing, we studied 968 patients at their first HIV care visit, enrolled in a multicenter study in Italy from 1997-2000. Patients completed a questionnaire on HIV-testing history, sexual behavior, and drug use behavior. Delayed presenters were patients with >6 months between their first HIV-positive test and presentation for HIV care; late testers were patients with CD4 count < 200 /mm or clinically defined AIDS at their first HIV-positive test. Among the study patients, 255 (26.3%) were delayed presenters, and 280 (28.9%) were late testers. In multinomial logistic regression analysis, injection drug use significantly increased (odds ratio [OR]= 5.04) the probability of delayed presentation but reduced (OR = 0.55) the chance of late testing. A previous HIV-negative test was associated with a reduced risk of both delayed presentation (OR = 0.39) and late testing (OR = 0.36). Unemployment was positively associated with delayed presentation and increasing age with late testing, whereas HIV counseling at the time of first positive HIV test strongly (OR = 0.42) reduced the odds of delayed presentation. Interventions aimed at promoting timely access to care of HIV-infected persons should consider differentiated programs for delayed presentation and late testing

Hepatitis type E in Italy : a seroepidemiological survey

The seroprevalence of antibodies to HEV was determined in three different Italian populations (volunteer blood donors, normal healthy individuals, and intravenous drug users [IVDUs]). The seroprevalence in the populations ranged from 0.74% to 1.94%, with higher rates among IVDUs and individuals over 40 years of age. None of 35 patients diagnosed with acute hepatitis A but 10 of 153 (6.5%) patients with acute nonA, nonB, nonC hepatitis were found to be positive for anti-HEV antibody. One of these antibody positive cases was linked to travel, while the remaining 9 were not associated with travel to endemic areas. These data suggest a possible low circulation of HEV in Italy