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De Carli G, Carletti F, Spaziante M, Gruber CEM, Rueca M, Spezia PG, Vantaggio V, Barca A, De Liberato C, Romiti F, Scicluna MT, Vaglio S, Feccia M, Di Rosa E, Gianzi FP, Giambi C, Scognamiglio P, Nicastri E, Girardi E, Maggi F, Vairo F. Outbreaks of autochthonous Dengue in Lazio region, Italy, August to September 2023: preliminary investigation. Euro Surveill 2023; 28:2300552. [PMID: 37917030 PMCID: PMC10623645 DOI: 10.2807/1560-7917.es.2023.28.44.2300552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023] Open
Abstract
Between August and September 2023, three distinct autochthonous dengue virus transmission events occurred in Lazio, Italy, with the main event in Rome. The events involved three different dengue serotypes. No link with previous imported cases was identified. Here we describe the epidemiological and phylogenetic analysis of the first autochthonous cases and the implemented control actions. The multiple transmission events call for a strengthening of the vector control strategies and future research to better characterise the risk in countries like Italy.
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Affiliation(s)
- Gabriella De Carli
- These authors contributed equally to this work and share first authorship
- Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Fabrizio Carletti
- These authors contributed equally to this work and share first authorship
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Martina Spaziante
- Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | | | - Martina Rueca
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Pietro Giorgio Spezia
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Valentina Vantaggio
- Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Alessandra Barca
- Directorate for Health and Social Policy, Lazio Region, Rome, Italy
| | - Claudio De Liberato
- UOC Diagnostica generale, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Federico Romiti
- UOC Diagnostica generale, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Maria Teresa Scicluna
- UOC Virologia, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Rome, Italy
| | - Stefania Vaglio
- Lazio Regional Blood Center, Italy; and Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Mariano Feccia
- Lazio Regional Transplant Center, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Enrico Di Rosa
- Department of Prevention, Local Health Authority Roma 1, Rome, Italy
| | | | - Cristina Giambi
- Department of Prevention, Local Health Authority Latina, Latina, Italy
| | - Paola Scognamiglio
- Directorate for Health and Social Policy, Lazio Region, Rome, Italy
- Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Emanuele Nicastri
- These authors contributed equally to this work and share first authorship
- Highly Infectious Diseases Isolation Unit, Clinical Department, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Francesco Vairo
- Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
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Rueca M, Berno G, Agresta A, Spaziante M, Gruber CEM, Fabeni L, Giombini E, Butera O, Barca A, Scognamiglio P, Girardi E, Maggi F, Valli MB, Vairo F, Sars-CoV-Lazio Genomic Surveillance Study Group. Genomic and Epidemiologic Surveillance of SARS-CoV-2 in the Pandemic Period: Sequencing Network of the Lazio Region, Italy. Viruses 2023; 15:2192. [PMID: 38005872 PMCID: PMC10674723 DOI: 10.3390/v15112192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, large-scale genomic sequencing has immediately pointed out that SARS-CoV-2 has rapidly mutated during the course of the pandemic, resulting in the emergence of variants with a public health impact. In this context, strictly monitoring the circulating strains via NGS has proven to be crucial for the early identification of new emerging variants and the study of the genomic evolution and transmission of SARS-CoV-2. Following national and international guidelines, the Lazio region has created a sequencing laboratory network (WGSnet-Lazio) that works in synergy with the reference center for epidemiological surveillance (SERESMI) to monitor the circulation of SARS-CoV-2. Sequencing was carried out with the aims of characterizing outbreak transmission dynamics, performing the genomic analysis of viruses infecting specific categories of patients (i.e., immune-depressed, travelers, and people with severe symptoms) and randomly monitoring variant circulation. Here we report data emerging from sequencing activities carried out by WGSnet-Lazio (from February 2020 to October 2022) linked with epidemiological data to correlate the circulation of variants with the clinical and demographic characteristics of patients. The model of the sequencing network developed in the Lazio region proved to be a useful tool for SARS-CoV-2 surveillance and to support public health measures for epidemic containment.
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Affiliation(s)
- Martina Rueca
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Giulia Berno
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Alessandro Agresta
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Martina Spaziante
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | | | - Lavinia Fabeni
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Emanuela Giombini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Ornella Butera
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Alessandra Barca
- Direzione Regionale Salute E Integrazione Sociosanitaria, Area Promozione Della Salute E Prevenzione-Regione Lazio, 00145 Rome, Italy
| | - Paola Scognamiglio
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
- Direzione Regionale Salute E Integrazione Sociosanitaria, Area Promozione Della Salute E Prevenzione-Regione Lazio, 00145 Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Fabrizio Maggi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Maria Beatrice Valli
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
| | - Francesco Vairo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, 00149 Rome, Italy
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Colavita F, Meschi S, Gruber CEM, Rueca M, Vairo F, Matusali G, Lapa D, Giombini E, De Carli G, Spaziante M, Messina F, Bonfiglio G, Carletti F, Lalle E, Fabeni L, Berno G, Puro V, Bartolini B, Di Caro A, Ippolito G, Capobianchi MR, Castilletti C. Virological and Serological Characterisation of SARS-CoV-2 Infections Diagnosed After mRNA BNT162b2 Vaccination Between December 2020 and March 2021. Front Med (Lausanne) 2022; 8:815870. [PMID: 35127770 PMCID: PMC8810639 DOI: 10.3389/fmed.2021.815870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vaccines for coronavirus disease 2019 (COVID-19) are proving to be very effective in preventing severe illness; however, although rare, post-vaccine infections have been reported. The present study focuses on virological and serological features of 94 infections that occurred in Lazio Region (Central Italy) between 27 December 2020, and 30 March 2021, after one or two doses of mRNA BNT162b2 vaccine. METHODS We evaluated clinical features, virological (viral load; viral infectiousness; genomic characterisation), and serological (anti-nucleoprotein Ig; anti-Spike RBD IgG; neutralising antibodies, nAb) characteristics of 94 post-vaccine infections at the time of diagnosis. Nasopharyngeal swabs (NPSs) and serum samples were collected in the framework of the surveillance activities on SARS-CoV-2 variants established in Lazio Region (Central Italy) and analysed at the National Institute for Infectious Diseases "L. Spallanzani" in Rome. RESULTS The majority (92.6%) of the post-vaccine infections showed pauci/asymptomatic or mild clinical course, with symptoms and hospitalisation rate significantly less frequent in patients infected after full vaccination course as compared to patients who received a single dose vaccine. Although differences were not statistically significant, viral loads and isolation rates were lower in NPSs from patients infected after receiving two vaccine doses as compared to patients with one dose. Most cases (84%) had nAb in serum at the time of infection diagnosis, which is a sub-group of vaccinees, were found similarly able to neutralise Alpha and Gamma variants. Asymptomatic individuals showed higher nAb titres as compared to symptomatic cases (median titre: 1:120 vs. 1:40, respectively). Finally, the proportion of post-vaccine infections attributed either to Alpha and Gamma variants was similar to the proportion observed in the contemporary unvaccinated population in the Lazio region, and mutational analysis did not reveal enrichment of a defined set of Spike protein substitutions depending on the vaccination status. CONCLUSION Our study conducted using real-life data, emphasised the importance of monitoring vaccine breakthrough infections, through the characterisation of virological, immunological, and clinical features associated with these events, in order to tune prevention measures in the next phase of the COVID-19 pandemic.
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Affiliation(s)
- Francesca Colavita
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Silvia Meschi
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | | | - Martina Rueca
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Francesco Vairo
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Giulia Matusali
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Daniele Lapa
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Emanuela Giombini
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Gabriella De Carli
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Martina Spaziante
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Francesco Messina
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Giulia Bonfiglio
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Fabrizio Carletti
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Eleonora Lalle
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Lavinia Fabeni
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Giulia Berno
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Vincenzo Puro
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Barbara Bartolini
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Antonino Di Caro
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
- Unicamillus, International Medical University, Roma, Italy
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
| | - Maria Rosaria Capobianchi
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
- Unicamillus, International Medical University, Roma, Italy
| | - Concetta Castilletti
- National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Roma, Italy
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Biliotti E, Giampaoli O, Sciubba F, Marini F, Tomassini A, Palazzo D, Capuani G, Esvan R, Spaziante M, Taliani G, Miccheli A. Urinary metabolomics of HCV patients with severe liver fibrosis before and during the sustained virologic response achieved by direct acting antiviral treatment. Biomed Pharmacother 2021; 143:112217. [PMID: 34560544 DOI: 10.1016/j.biopha.2021.112217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection induces a long-term inflammatory response and oxidative-stress in the liver microenvironment, leading to hepatic fibrosis and metabolic alterations. Direct-acting-antiviral-agents (DAAs) induce HCV-clearance, even though liver damage is only partially restored. In this context, understanding the impact of viral-eradication on liver metabolic activities could allow optimizing the metabolic care of the patient. The present prospective longitudinal study aims at characterizing the urinary metabolic profile of HCV-induced severe liver fibrosis and the metabolic changes induced by DAAs and HCV-clearance by nuclear magnetic resonance-based metabolomics. The urinary metabolic profile of 23 HCV males with severe liver fibrosis and 20 age-matched healthy-controls was analyzed by NMR-based-metabolomics before starting DAAs, at the end-of-therapy, after one and three months of follow-up. The urinary metabolic profile of patients with severe liver fibrosis was associated to pseudouridine, hypoxanthine, methylguanidine and dimethylamine, highlighting a profile related to oxidative damage, and to tyrosine and glutamine, related to a decreased breakdown of aromatic aminoacids and ammonia detoxification, respectively. 1-methylnicotinamide, a catabolic intermediate of nicotinamide-adenine-dinucleotide, was significantly increased in HCV-patients and restored after HCV-clearance, probably due to the reduced hepatic inflammation. 3-hydroxy-3-methylbutyrate, an intermediate of leucine-catabolism which was permanently restored after HCV-clearance, suggested an improvement of skeletal muscle protein synthesis. Finally, 3-hydroxyisobutyrate and 2,3-dihydroxy-2-methylbutyrate, intermediates of valine-catabolism, glycine and choline increased temporarily during therapy, resulting as potential biomarkers of DAAs systemic effects.
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Affiliation(s)
- Elisa Biliotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Ottavia Giampaoli
- Department of Chemistry, Sapienza University of Rome, Rome, Italy; NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy
| | - Fabio Sciubba
- Department of Chemistry, Sapienza University of Rome, Rome, Italy; NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy
| | - Federico Marini
- Department of Chemistry, Sapienza University of Rome, Rome, Italy; NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy
| | - Alberta Tomassini
- Department of Chemistry, Sapienza University of Rome, Rome, Italy; NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy
| | - Donatella Palazzo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgio Capuani
- Department of Chemistry, Sapienza University of Rome, Rome, Italy; NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy
| | - Rozenn Esvan
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Martina Spaziante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Gloria Taliani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Alfredo Miccheli
- NMR-based Metabolomics Laboratory (NMLab), Sapienza University of Rome, Rome, Italy; Department of Environmental Biology, Sapienza University of Rome, Rome, Italy.
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Spaziante M, Venditti C, Butera O, Messina F, Di Caro A, Tonziello G, Lanini S, Cataldo MA, Puro V. Importance of Surveillance of New Delhi Metallo-Beta-Lactamase Klebsiella pneumoniae: Molecular Characterization and Clonality of Strains Isolated in the Lazio Region, Italy. Infect Drug Resist 2021; 14:3659-3665. [PMID: 34526785 PMCID: PMC8435879 DOI: 10.2147/idr.s318717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction New Delhi metallo-β-lactamase producing Klebsiella pneumoniae (NDM-Kpn) strains have been causing healthcare-associated infections worldwide. The aim of this study was to describe the molecular mechanisms of antimicrobial resistance and to analyze the clonality of NDM-Kpn isolates collected between January 2019 and June 2020 from patients admitted to hospitals from the Lazio region, Italy. Methods We performed a retrospective cohort study. Whole-genome sequencing (WGS) was performed on all NDM-Kpn strains; clonality and genetic relationships were further investigated. Results During the surveillance period, 17 NDM-Kpn isolates were obtained from 17 patients admitted to seven different hospitals. Eight different sequence types (STs) were detected: ST147 (n = 4), ST383 (n = 4), ST15 (n = 3), ST11 (n = 2), ST17 (n = 1), ST29 (n = 1), ST307 (n = 1) and the newly identified ST4853 (n = 1). Genetic relationships were further investigated by the WGS-based core genome MLST (cgMLST) scheme, and 5 cluster types (CTs) were identified. Whereas a substantial overall heterogeneity among isolates was detected (8 different STs were identified out of 17 isolates), the strains within each cluster showed a very high level of genome similarity. Discussion Our study highlights the key role of surveillance, which allowed taking a picture of a part of the NDM-Kpn strains circulating in Italy, adding further insight into their molecular features.
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Affiliation(s)
- Martina Spaziante
- Emerging Infection Unit and Regional Service for Surveillance and Control of Infectious Diseases (SeRESMI), National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Carolina Venditti
- Laboratory of Microbiology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Ornella Butera
- Laboratory of Microbiology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Francesco Messina
- Laboratory of Microbiology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Antonino Di Caro
- Laboratory of Microbiology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Gilda Tonziello
- Emerging Infection Unit and Regional Service for Surveillance and Control of Infectious Diseases (SeRESMI), National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Simone Lanini
- Emerging Infection Unit and Regional Service for Surveillance and Control of Infectious Diseases (SeRESMI), National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Maria Adriana Cataldo
- Emerging Infection Unit and Regional Service for Surveillance and Control of Infectious Diseases (SeRESMI), National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - Vincenzo Puro
- Emerging Infection Unit and Regional Service for Surveillance and Control of Infectious Diseases (SeRESMI), National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
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Spaziante M, Taliani G, Marchetti G, Tavelli A, Lichtner M, Cingolani A, Cicalini S, Biliotti E, Girardi E, Antinori A, Puoti M, d’Arminio Monforte A, Cozzi-Lepri A. Impact of HCV Eradication on Lipid Metabolism in HIV/HCV Coinfected Patients: Data from ICONA and HepaICONA Foundation Cohort Study. Viruses 2021; 13:v13071402. [PMID: 34372608 PMCID: PMC8310285 DOI: 10.3390/v13071402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES HCV shows complex interactions with lipid metabolism. Our aim was to examine total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) changes in HIV/HCV coinfected patients, after achieving sustained virological response (SVR), according to different HCV genotypes and specific antiretroviral use. METHODS HIV/HCV coinfected patients, enrolled in the ICONA and HepaICONA cohorts, who achieved DAA-driven SVR were included. Paired t-tests were used to examine whether the pre- and post-SVR laboratory value variations were significantly different from zero. ANCOVA regression models were employed to estimate the causal effect of SVR and of PI/r use on lipid changes. The interaction between the effect of eradication and HCV genotype was formally tested. RESULTS six hundred and ninety-nine HIV/HCV coinfected patients were enrolled. After HCV eradication, a significant improvement in liver function occurred, with a significant decrease in AST, ALT, GGT, and total plasmatic bilirubin. TC and LDL-C significantly increased by 21.4 mg/dL and 22.4 mg/dL, respectively (p < 0.001), after SVR, whereas there was no evidence for a change in HDL-C (p = 0.45) and triglycerides (p = 0.49). Notably, the TC and LDL-C increase was higher for participants who were receiving darunavir/ritonavir, and the TC showed a more pronounced increase among HCV genotype 3 patients (interaction-p value = 0.002). CONCLUSIONS complex and rapid changes in TC and LDL-C levels, modulated by HCV genotype and PI/r-based ART combinations, occurred in HIV/HCV coinfected patients after SVR. Further studies are needed to evaluate the clinical impact of these changes on the long-term risk of cardiovascular disease.
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Affiliation(s)
- Martina Spaziante
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (M.S.); (E.G.)
| | - Gloria Taliani
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy;
- Task Force Anti-COVID, AORN San Giuseppe Moscati, 83100 Avellino, Italy
- Correspondence:
| | - Giulia Marchetti
- ASST Santi Paolo e Carlo, Clinic of Infectious and Tropical Diseases, Department of Health Sciences, University of Milan, 20122 Milan, Italy; (G.M.); (A.d.M.)
| | | | - Miriam Lichtner
- Department of Infectious Diseases, La Sapienza University, Polo Pontino, 04100 Latina, Italy;
| | - Antonella Cingolani
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Stefania Cicalini
- HIV/AIDS Clinical Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (A.A.)
| | - Elisa Biliotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | - Enrico Girardi
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (M.S.); (E.G.)
| | - Andrea Antinori
- HIV/AIDS Clinical Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (A.A.)
| | - Massimo Puoti
- Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy;
| | - Antonella d’Arminio Monforte
- ASST Santi Paolo e Carlo, Clinic of Infectious and Tropical Diseases, Department of Health Sciences, University of Milan, 20122 Milan, Italy; (G.M.); (A.d.M.)
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London WC1N 1EH, UK;
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7
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Russini V, Spaziante M, Zottola T, Fermani AG, Di Giampietro G, Blanco G, Fabietti P, Marrone R, Parisella R, Parrocchia S, Bossù T, Bilei S, De Marchis ML. A Nosocomial Outbreak of Invasive Listeriosis in An Italian Hospital: Epidemiological and Genomic Features. Pathogens 2021; 10:pathogens10050591. [PMID: 34066208 PMCID: PMC8150339 DOI: 10.3390/pathogens10050591] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Listeria monocytogenes (L. monocytogenes) is a widespread opportunistic pathogen that causes the listeriosis foodborne disease. This bacterium has become a common contaminant of handled food, and a relevant public health issue. Here we describe a nosocomial outbreak of listeriosis caused by an ST451 strain of L. monocytogenes involving three cancer and one immunocompromised patients hospitalized in different units from the same hospital during September and October 2020. The epidemiological investigation was conducted using traditional microbiological methodology combined with a whole genome sequencing approach. The source of contamination was identified in the kitchen hospital, where a meat slicer used to prepare patients’ meals was tested positive to the same sequence type (ST) of L. monocytogenes. This is the first report of an outbreak of listeriosis caused by ST451 in Italy.
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Affiliation(s)
- Valeria Russini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Martina Spaziante
- Regional Service Surveillance and Control for Infectious Diseases (SERESMI), National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, Italy;
| | - Tiziana Zottola
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Latina, 04100 Latina, Italy;
| | | | - Gina Di Giampietro
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Giovanni Blanco
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Paolo Fabietti
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Riccardo Marrone
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Roberta Parisella
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Sergio Parrocchia
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Teresa Bossù
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Stefano Bilei
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Maria Laura De Marchis
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
- Correspondence:
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8
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Fontanelli Sulekova L, Spaziante M, Vita S, Zuccalà P, Mazzocato V, Spagnolello O, Lopalco M, Pacifici LE, Bello L, Borrazzo C, Angeletti S, Ciccozzi M, Ceccarelli G. The Pregnancy Outcomes Among Newly Arrived Asylum-Seekers in Italy: Implications of Public Health. J Immigr Minor Health 2020; 23:232-239. [PMID: 33278011 PMCID: PMC7914189 DOI: 10.1007/s10903-020-01126-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 11/30/2022]
Abstract
Background Migration has a significant impact on overall health and pregnancy outcome. Despite the fact that growing volume of migration flows significantly engaging the public health system of European host countries, there is a lack of evidence concerning pregnancy outcomes of newly arrived asylum-seeking women. Methods Data about pregnant asylum seekers hosted in the Italian Reception Centers between the 1 st June 2016 and the 1st June 2018 were retrospectively collected and analysed in the present study. We examined the following pregnancy outcomes: miscarriage, self-induced abortion, voluntary pregnancy termination, live-birth; and studied potentially related socio-demographic factors. Results Out of the 110 pregnant women living in the reception centers, 44 (40%) had eutocic delivery, 8 (7.3%) dystocic delivery, 15 (13.6%) miscarriage, 17 (15.5%) self-induced abortion and 26 (23.6%) underwent voluntary pregnancy termination. Nigerian women were at a significantly higher risk of abortive outcomes for voluntary pregnancy termination (p < 0.001), miscarriage (p = 0.049) and self-induced abortion (p < 0.001). Being unmarried was significantly associated with voluntary pregnancy termination and self-induced abortion. Women who chose to undergo unsafe abortion did not result to have significantly lower educational levels, compared to women who preferred medical abortion. Conclusion This study offers first insights into pregnancy outcomes among asylum-seeking women in Italy. The country of origin and marital status seem to significantly impact on pregnancy outcome. We identified sub-groups of migrant women at increased risk of abortive outcomes, and highlight the need to improve care in order to promote migrant women’s reproductive health.
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Affiliation(s)
- Lucia Fontanelli Sulekova
- Department of Public Health and Infectious Diseases, Policlinico Umberto I Hospital. University of Rome Sapienza, Rome, Italy. .,Migrant and Global Health Organization (Mi-HeRO), Rome, Italy. .,Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy.
| | - Martina Spaziante
- Department of Public Health and Infectious Diseases, Policlinico Umberto I Hospital. University of Rome Sapienza, Rome, Italy.,Migrant and Global Health Organization (Mi-HeRO), Rome, Italy.,Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy
| | - Serena Vita
- Department of Public Health and Infectious Diseases, Policlinico Umberto I Hospital. University of Rome Sapienza, Rome, Italy.,Migrant and Global Health Organization (Mi-HeRO), Rome, Italy.,Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy
| | - Paola Zuccalà
- Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy.,Italian Red Cross, Sanitary Bureau of) Extraordinary Reception Centers for Migrants "ENEA", "Pietralata" and "Penelope" of Rome, Rome, Italy
| | - Valentina Mazzocato
- Italian Red Cross, Sanitary Bureau of) Extraordinary Reception Centers for Migrants "ENEA", "Pietralata" and "Penelope" of Rome, Rome, Italy
| | - Ornella Spagnolello
- Department of Public Health and Infectious Diseases, Policlinico Umberto I Hospital. University of Rome Sapienza, Rome, Italy.,Emergency NGO, Milan, Italy.,Emergency Department, Policlinico Umberto I Hospital, University of Rome Sapienza, Rome, Italy
| | - Maurizio Lopalco
- Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy
| | - Laura Elena Pacifici
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Luca Bello
- Unit of Gynecology, Department of Obstetrics and Gynecology, University of Turin, Maria Vittoria Hospital, Turin, Italy
| | - Cristian Borrazzo
- Statistical Unit, Department of Public Health and Infectious Diseases, University of Rome Sapienza, Rome, Italy
| | - Silvia Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Rome, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Policlinico Umberto I Hospital. University of Rome Sapienza, Rome, Italy.,Migrant and Global Health Organization (Mi-HeRO), Rome, Italy.,Auxilium Soc Coop. Sanitary Bureau of Asylum Seeker Center of Castelnuovo di Porto, Senise, Italy.,Italian Red Cross, Sanitary Bureau of) Extraordinary Reception Centers for Migrants "ENEA", "Pietralata" and "Penelope" of Rome, Rome, Italy.,Italian Red Cross, Metropolitan Area of Rome Committee, Sanitary Direction of Reception Centers for Migrants, Rome, Italy
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9
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Volpicelli L, Biliotti E, Milito C, Cruciata A, Spaziante M, Rivano Capparuccia M, Taliani G, Mezzaroma I. Glecaprevir/pibrentasvir ultra-short treatment to cure HCV infection: case report and literature review. Infez Med 2020; 28:616-620. [PMID: 33257639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Shortening therapy duration with direct-acting antiviral agents (DAAs) is desirable to pursue the WHO target of HCV eradication by 2030. We report two cases of HCV-infected women who achieved sustained virologic response after an ultra-short treatment with glecaprevir/pibrentasvir (G/P), discontinued due to cutaneous adverse events, and analyze similar cases reported in the literature. Female gender seems to be a prevailing characteristic in this group of patients. G/P, due to its pangenotypic and strong antiviral activity, may represent a candidate for a shortened DAA regimen in non-cirrhotic treatment-naive subjects.
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Affiliation(s)
- Lorenzo Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Elisa Biliotti
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Cinzia Milito
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Alessia Cruciata
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Martina Spaziante
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | - Gloria Taliani
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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10
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Spaziante M, Oliva A, Ceccarelli G, Venditti M. What are the treatment options for resistant Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria? Expert Opin Pharmacother 2020; 21:1781-1787. [DOI: 10.1080/14656566.2020.1779221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
- IRCCS INM Neuromed, Pozzilli, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy
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11
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Spaziante M, Giuliano S, Ceccarelli G, Alessandri F, Borrazzo C, Russo A, Venditti M. Gram-negative septic thrombosis in critically ill patients: A retrospective case-control study. Int J Infect Dis 2020; 94:110-115. [PMID: 32126323 DOI: 10.1016/j.ijid.2020.02.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Data on septic thrombosis caused by Gram-negative bacilli (GN-ST) in intensive care unit (ICU) patients are currently limited. METHODS The aim of this retrospective case-control study (matched 1:3) performed over a 15-month period on ICU patients with bacteraemia, associated (cases) or not (controls) with GN-ST, was to assess 30-day mortality and clinical/microbiological features of GN-ST. RESULTS During the study period, 16 patients with GN-ST and 48 controls were analyzed. Polytrauma was the cause of ICU admission in 12 (75%) cases and 22 (46%) controls (p = 0.019). In no case of septic thrombosis was surgical debridement performed. The site of venous thrombosis was more frequently in the lower limbs, associated with bone fracture in nine out of 12 (75%) cases. The median duration of bacteraemia (22 days vs 1 day; p < 0.001) and time to clinical improvement (15 days vs 4 days; p < 0.001) were significantly longer in cases than in controls. On analysis of the receiver operating characteristics (ROC) curve, bacteraemia >72 h was significantly associated with GN-ST (area under the curve (AUC) 0.95, sensitivity 0.996 and specificity 0.810; p < 0.001). Finally, 30-day mortality was 20% in cases and 67% in controls (p < 0.001). CONCLUSIONS Critically ill patients with GN-ST showed specific clinical features. Despite delayed bacteraemia clearance, targeted antibiotic therapy plus anticoagulation usually provided clinical improvement and a low 30-day mortality rate.
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Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | | | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Francesco Alessandri
- Department of Anaesthesia and Intensive Care Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Cristian Borrazzo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Alessandro Russo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
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12
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Spaziante M, Oliva A, Ceccarelli G, Alessandri F, Pugliese F, Venditti M. Follow-up blood cultures in Gram-negative bacilli bacteremia: are they needed for critically ill patients? Minerva Anestesiol 2020; 86:498-506. [PMID: 32100514 DOI: 10.23736/s0375-9393.20.14040-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Gram-negative bacilli bacteremias (GNB-Bs) represent a major cause of morbidity and mortality in Intensive Care Unit (ICU) patients. Aim of this study was to investigate the role of follow-up blood cultures (FUBCs) and the clinical significance of persistent bacteremia (PB) in these settings. METHODS We retrospectively analyzed clinical data and outcome of GNB-Bs that occurred in ICU patients over a span of 1 year. In particular we sought information on development and clinical details of PB, defined as repeatedly positive FUBCs after ≥96 hours of appropriate antibiotic treatment and ≥48 hours after removal of endovascular devices. RESULTS Among 307 ICU patients, 69 (22.4%) developed 107 GNB-Bs. Of these, 78 (73%) could be eventually analyzed: 50 of 78 (64.1%) were non-PBs from 26 patients and 28 of 78 (35.9%) were PBs from 23 patients. Duration of fever and bacteremia, time to procalcitonin normalization and weaning from vasopressors were longer in episodes of PBs than non-PBs (P=0.04, P<0.001, P=0.02 and P=0.004, respectively). Primary bacteremia was more frequent in non-PBs than in PBs (29 of 50, 58% vs. 3/28, 10.7%, P=0.0001), whereas septic thrombus infection (STI) was the source of infection in 14 of 28 (50%). Finally, clinical features and 30-day mortality did not differ between patients with PB and those who developed only non-PB episodes. CONCLUSIONS Among our ICU patients, more than one third of GNB-Bs for which FUBCs were performed resulted PB. This condition is often associated with the presence of STI; therefore, FUBCs seem useful for the optimal management of GNB in this clinical setting.
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Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.,IRCCS INM Neuromed, Pozzilli, Isernia, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Francesco Alessandri
- Department of Anesthesia and Intensive Care Medicine, Sapienza University, Rome, Italy
| | - Francesco Pugliese
- Department of Anesthesia and Intensive Care Medicine, Sapienza University, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy -
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13
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Vita S, Sinopoli MT, Fontanelli Sulekova L, Morucci L, Lopalco M, Spaziante M, Pacifici LE, Bazzardi R, Angeletti S, Ciccozzi M, Ceccarelli G. Vaccination campaign strategies in recently arrived migrants: experience of an Italian reception centre. J Infect Dev Ctries 2019; 13:1159-1164. [PMID: 32088704 DOI: 10.3855/jidc.11815] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/22/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Control of vaccine preventable diseases, while constituting a priority of European health policies, is challenged by migrations from countries with suboptimal levels of immunization coverage. We report here two different types of vaccination campaign strategy in one of the bigger Italian asylum seekers' centres. The vaccination service staff of the local national health institute came monthly during the first three years of observation, while in the last year, the vaccinations were offered directly upon arrival of migrants in the asylum seekers' centre. METHODOLOGY we performed a descriptive cross-sectional study that analysed data collected from the database of the internal healthcare facility and ARVA Target tool, regarding vaccinations performed from 2013 to 2017 in the asylum seekers' centre. RESULTS In the four years of observation period the asylum seekers centre hosted 3941 migrants. Among them, 85% were vaccinated during their stay, for a total of 4252 vaccinations administered, covering 95% of minors and 85% of adults. During the study period, there was an important increase from an average of 10.5% of migrants vaccinated in the first three years to 66% in the last year, when vaccines were delivered directly upon arrival in the centre. CONCLUSIONS To improve the rate of immunization in migrants, the first requirement is a strong collaboration with the local vaccine services and the second,vaccinations must be carried out when migrants arrive at the asylum seekers' centre, avoiding any delay.
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Affiliation(s)
- Serena Vita
- Migrant and global Health Research Organization (Mi-HeRO), Rome, Italy.
| | | | | | - Luca Morucci
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
| | - Maurizio Lopalco
- Sanitary Bureau of Asylum Seekers Centre of Castelnuovo di Porto, Rome, Italy.
| | - Martina Spaziante
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - Laura Elena Pacifici
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy.
| | - Riccardo Bazzardi
- Microbiology Laboratory, Experimental Zooprophylactic Institute of Sardinia "G.Pegreffi", Sassari, Italy.
| | - Silvia Angeletti
- Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Italy.
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Italy.
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14
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Ceccarelli G, Alessandri F, Sargentini V, D'Alessandro MD, Spaziante M, Bachetoni A, Morabito S, Venditti M. Impact of continuous renal replacement therapy (CRRT) and other extracorporeal support techniques on procalcitonin guided antibiotic therapy in critically ill patients with septic shock. Clin Chem Lab Med 2019; 57:e86-e87. [PMID: 30204588 DOI: 10.1515/cclm-2018-0685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/13/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesco Alessandri
- Department of Anaesthesiology and Intensive Care, Sapienza University of Rome, Rome, Italy
| | - Valeria Sargentini
- Clinical Pathology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Martina Spaziante
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandra Bachetoni
- Clinical Pathology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Santo Morabito
- Department of Nephrology and Urology, Hemodialysis Unit, Policlinico di Roma, 'Sapienza' University, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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15
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Spaziante M, Ceccarelli G, Venditti M. Procalcitonin as guide to therapy in endovascular infections: caveat emptor! Clin Chem Lab Med 2019; 57:e52-e53. [PMID: 30157028 DOI: 10.1515/cclm-2018-0653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/25/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Rome, Italy.,Azienda Policlinico Umberto I, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Rome, Italy.,Azienda Policlinico Umberto I, Rome, Italy
| | - Mario Venditti
- Azienda Policlinico Umberto I, Rome, Italy.,Department of Public Health and Infectious Diseases, University of Rome Sapienza, Viale del Policlinico 155, Rome, Italy
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16
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Spaziante M, Franchi C, Taliani G, D'Avolio A, Pietropaolo V, Biliotti E, Esvan R, Venditti M. Serum Bactericidal Activity Levels Monitor to Guide Intravenous Dalbavancin Chronic Suppressive Therapy of Inoperable Staphylococcal Prosthetic Valve Endocarditis: A Case Report. Open Forum Infect Dis 2019; 6:ofz427. [PMID: 31737736 PMCID: PMC6847610 DOI: 10.1093/ofid/ofz427] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Here we describe a case of a methicillin-resistant coagulase-negative staphylococci prosthetic valve endocarditis in a patient considered not eligible for valve replacement due to high perioperative mortality risk and who did not tolerate oral antibiotic treatment. Under these circumstances, intravenous long-term chronic suppressive antibiotic therapy with dalbavancin, scheduling the doses using the serum bactericidal activity titers, proved to be safe and effective.
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Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Cristiana Franchi
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Gloria Taliani
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Antonio D'Avolio
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Elisa Biliotti
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Rozenn Esvan
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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17
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Mazzuti L, Melengu T, Falasca F, Calabretto M, Cella E, Ciccozzi M, Mezzaroma I, Iaiani G, Spaziante M, d'Ettorre G, Fimiani C, Vullo V, Antonelli G, Turriziani O. Transmitted drug resistance mutations and trends of HIV-1 subtypes in treatment-naïve patients: A single-centre experience. J Glob Antimicrob Resist 2019; 20:298-303. [PMID: 31518723 DOI: 10.1016/j.jgar.2019.08.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/12/2019] [Accepted: 08/28/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Transmitted drug resistance (TDR) and HIV-1 genetic diversity may affect treatment efficacy and clinical outcomes. Here we describe the circulating viral subtypes and estimate the prevalence of drug resistance among antiretroviral therapy (ART)-naïve patients attending Sapienza University Hospital (Rome, Italy) from 2006-2017. METHODS Genotypic resistance testing (GRT) was performed on 668 ART-naïve patients for integrase (n = 52), protease and reverse transcriptase (n = 668) sequences. RESULTS Twenty-one different HIV-1 subtypes and circulating recombinant forms (CRFs) were identified. Subtype B was the most common (67.1%), followed by CRF02_AG (8.4%), and subtypes C and F (both 6.0%). A significantly increase in the proportion of non-B strains (P < 0.001) and the rate of non-Italian patients was observed over time. The overall prevalence of TDR was 9.4% (NRTI, 4.2%; NNRTI, 5.8%; and PI, 1.0%) and was higher in subtype B strains. Transmitted INSTI mutations (Q148H and G140S) responsible for high-level resistance to raltegravir and elvitegravir and intermediate resistance to dolutegravir and bictegravir were found, for the first time, in two individuals. Minor or accessory INSTI mutations were detected in 17.3% of patients. No significant decrease in the prevalence of TDR was documented over time. CONCLUSION The significant increase in non-B subtypes suggests that the molecular epidemiology of HIV-1 is changing. Detection of a major INSTI mutation in two ART-naïve patients highlights the importance of performing GRT before commencing treatment. This finding and the lack of a significant reduction in TDRs underline the importance of continuous surveillance of resistance mutations.
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Affiliation(s)
- Laura Mazzuti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Taulant Melengu
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesca Falasca
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Eleonora Cella
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Ivano Mezzaroma
- Department of Translational and Precision Medicine, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Martina Spaziante
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - Gabriella d'Ettorre
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | | | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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18
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Palazzo D, Biliotti E, Esvan R, Volpicelli L, Franchi C, Fontanelli Sulekova L, Spaziante M, Santori M, Rugova A, Rucci P, Taliani G. Vitamin D deficiency and health-related quality of life in chronic hepatitis C. J Viral Hepat 2019; 26:774-777. [PMID: 30739371 DOI: 10.1111/jvh.13076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/11/2019] [Indexed: 12/09/2022]
Affiliation(s)
- Donatella Palazzo
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Elisa Biliotti
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Rozenn Esvan
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Volpicelli
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Cristiana Franchi
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Martina Spaziante
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Marta Santori
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Alban Rugova
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Gloria Taliani
- Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
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Spaziante M, Ceccarelli G, Al Moghazi S, Alessandri F, Venditti M. Specific dynamic of serum procalcitonin in critically ill patients affected by Gram-negative bacilli septic thrombophlebitis. Crit Care 2018; 22:178. [PMID: 30037337 PMCID: PMC6057063 DOI: 10.1186/s13054-018-2116-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/03/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Martina Spaziante
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Viale del Policlinico 155, Rome, Italy.,Azienda Policlinico Umberto I, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Viale del Policlinico 155, Rome, Italy.,Azienda Policlinico Umberto I, Rome, Italy
| | - Samir Al Moghazi
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Viale del Policlinico 155, Rome, Italy.,Azienda Policlinico Umberto I, Rome, Italy
| | - Francesco Alessandri
- Azienda Policlinico Umberto I, Rome, Italy.,Department of Anesthesia and Intensive Care Medicine, University of Rome Sapienza, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, Viale del Policlinico 155, Rome, Italy. .,Azienda Policlinico Umberto I, Rome, Italy.
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20
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Iacovelli A, Spaziante M, Al Moghazi S, Giordano A, Ceccarelli G, Venditti M. Correction to: A challenging case of carbapenemase-producing Klebsiella pneumoniae septic thrombophlebitis and right mural endocarditis successfully treated with ceftazidime/avibactam. Infection 2018; 46:743. [PMID: 29992522 DOI: 10.1007/s15010-018-1172-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The given names and family names of all authors were transposed in the original publication. The original article has been corrected.
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Affiliation(s)
- Alessandra Iacovelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Martina Spaziante
- Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Samir Al Moghazi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Alessandra Giordano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
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21
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Iacovelli A, Spaziante M, Al Moghazi S, Giordano A, Ceccarelli G, Venditti M. A challenging case of carbapenemase-producing Klebsiella pneumoniae septic thrombophlebitis and right mural endocarditis successfully treated with ceftazidime/avibactam. Infection 2018; 46:721-724. [PMID: 29926399 DOI: 10.1007/s15010-018-1166-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/18/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The emergence of carbapenemase-producing Klebsiella pneumonia (KPC-Kp) has become a significant problem in terms of public health and clinical outcome in many hospitals in Southern Europe. Treatment options are usually limited and effective treatment of infections caused by these pathogens is a considerable challenge for clinicians. Ceftazidime-avibactam has been recently approved for the treatment of difficult-to-treat infections due to aerobic Gram-negative organisms in patients with limited treatment options. CASE REPORT We reported the first case of KPC-Kp septic thrombophlebitis and right atrial endocarditis associated with metastatic lung abscesses successfully treated with a prolonged ceftazidime/avibactam plus ertapenem treatment course, suggesting that this combination therapy could be safe and effective for serious Gram-negative infections. Interestingly, we also observed an apparent discrepancy between clinical and microbiological courses: the patient became rapidly afebrile; hemodynamically stable and his procalcitonin levels showed a prompt decreasing trend. Nevertheless, blood cultures remained persistently positive for a prolonged period. CONCLUSION In conclusion, ceftazidime-avibactam plus ertapenem was a safe and effective therapy of serious endovascular infection due to KPC-Kp. Moreover, in this setting, follow-up blood cultures might represent an irreplaceable tool to guide the therapy.
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Affiliation(s)
- Alessandra Iacovelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Martina Spaziante
- Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Samir Al Moghazi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Alessandra Giordano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
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22
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Biliotti E, Palazzo D, Serani M, Silvestri AM, Volpicelli L, Esvan R, Franchi C, Spaziante M, Sorrentino F, Taliani G. Interferon free antiviral treatment of chronic hepatitis C in patients affected by β-thalassemia major. Ann Hematol 2017; 96:1043-1045. [PMID: 28378040 DOI: 10.1007/s00277-017-2986-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/29/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Elisa Biliotti
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy.
| | - Donatella Palazzo
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Serani
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandro M Silvestri
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Lorenzo Volpicelli
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Rozenn Esvan
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Cristiana Franchi
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | - Martina Spaziante
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
| | | | - Gloria Taliani
- Department of Clinical Medicine, Sapienza University of Rome, viale del Policlinico 155, 00161, Rome, Italy
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23
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Spaziante M, Biliotti E, Grieco S, Palazzo D, Esvan R, Taliani G. Anti-HBs seroconversion during treatment with entecavir in a patient with chronic hepatitis B virus infection on hemodialysis. J Med Virol 2013; 86:139-43. [PMID: 24136393 DOI: 10.1002/jmv.23795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2013] [Indexed: 11/07/2022]
Abstract
Hepatitis B (HBV) virus infection is one of the most important causes of liver disease in patients with end-stage renal failure on hemodialysis. The natural history of chronic HBV infection acquired in childhood starts with an immune tolerant phase, followed by an immune clearance phase that may lead to the inactive carrier state or the development of chronic liver disease. Information on antiviral therapy administered very early during the immune clearance phase are lacking and no data exist on the treatment of early immune activation in the hemodialysis setting. This report describes the case of a patient affected by end-stage renal failure and HBeAg-positive chronic HBV virus infection treated very early during the immune clearance phase of HBV infection with an adjusted-dose of nucleoside analogue entecavir. The patient achieved a very rapid HBV-DNA undetectability, anti-HBe, and anti-HBs seroconversion. This is the first report of antiviral therapy with entecavir started during the immune reactive phase of HBV infection in a patient on hemodialysis and it suggests that antiviral treatment can enhance the effects of host immune activation resulting in biochemical, serological, and viral response, even in end-stage renal failure patients with partial immunodeficiency. Antiviral therapy with entecavir in the setting of hemodialysis was safe and well tolerated.
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Affiliation(s)
- Martina Spaziante
- Clinica Malattie Infettive e Tropicali, Sapienza University of Rome, Rome, Italy
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24
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Arnaud C, Pradat P, Spaziante M, Berthillon P, Maynard M, Taliani G, Chemin I, Trépo C, Petit MA. Pretreatment predictive factors for hepatitis C therapy outcome: relevance of anti-E1E2 antibodies compared to IP-10 and IL28B genotypes. Antivir Ther 2013; 18:1027-32. [PMID: 23948510 DOI: 10.3851/imp2671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Unique serum anti-E1E2 antibodies were shown to be associated with spontaneous recovery or predictive of sustained virological response (SVR) in patients with chronic hepatitis C receiving pegylated interferon/ribavirin (PEG-IFN/RBV) therapy. The objectives were to establish the relationship between pretreatment anti-E1E2 titres and HCV RNA kinetics during PEG-IFN/RBV therapy, and to examine whether the combined determination of interleukin (IL)28B rs12979860 and rs8099917, pretreatment inducible protein (IP)-10 levels and/or anti-E1E2 improved the prediction of SVR. METHODS Sera from 26 treatment-naive consecutive HCV patients treated with PEG-IFN/RBV for 48 weeks were analysed. Serum anti-E1E2 titres and pretreatment IP-10 levels were measured by enzyme-linked immunosorbent assays. The IL28B variants were determined using genotyping real-time polymerase chain reaction method. Viral decline was measured at weeks (W) 4 and 12 and SVR assessed 6 months after the end of therapy. RESULTS Baseline anti-E1E2 titres were correlated with HCV RNA decline at W4 and W12 and were highly predictive of SVR with 100% of patients negative for anti-E1E2 failing to achieve SVR. Receiver operating characteristic curve analyses indicate that the best prediction of SVR (AUC 0.990) was obtained with the combination of anti-E1E2 and IP-10 levels. Predictive values were better than those obtained with IP-10 alone or in combination with IL28B variants. CONCLUSIONS Pretreatment serum anti-E1E2 response predicts HCV RNA clearance kinetics and treatment outcome. The combination of anti-E1E2 and IP-10 significantly improved the prediction of treatment response. This warrants further investigation and validation on larger cohorts of patients in the context of new therapeutic strategies.
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Affiliation(s)
- Clémence Arnaud
- Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052/CNRS UMR5286, Lyon, France
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25
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Taliani G, Spaziante M, Biliotti E, Borro M, Palazzo D, Grieco S, Franchi C, Iaiani G, Furlan C, Gallinaro V, Simmaco M. IL28B gene polymorphisms and US liver fatty changes in patients who spontaneously cleared hepatitis C virus infection. PLoS One 2013; 8:e67301. [PMID: 23936294 PMCID: PMC3731327 DOI: 10.1371/journal.pone.0067301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/16/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recent clinical studies have shown that the presence of CC genotype in the rs12979860 region of IL28B gene is associated with an increase in the probability of spontaneous clearance of hepatitis C virus (HCV). Moreover, IL28B polymorphism seems to influence the probability of developing liver steatosis in chronic HCV patients. AIMS The aims of our clinical study were 1) to verify the distribution of IL28B genotypes (CC, CT or TT) among subjects with spontaneous clearance of HCV infection and 2) to examine the correlation between IL28B polymorphism and hepatic steatosis among these subjects. METHODS AND PATIENTS We enrolled 41 subjects with spontaneous resolution of HCV infection (detectable serum anti-HCV but undetectable HCV-RNA) and 134 healthy controls from the same geographical area. The IL28B single-nucleotide polymorphism (SNP) rs12979860 was genotyped by using a Pyrosequencing™ technique. The presence of steatosis was assessed by liver biopsy or ultrasound examination in the 41 study subjects. RESULTS CC, CT and TT-genotypes of the SNP rs1979860 were found in 66%, 24% and 10% of the subjects who spontaneously cleared HCV and in 31%, 54% and 15% of controls, respectively (p = 0.0003). Among the study subjects, females with CC-genotype were significantly more represented (p = 0.02). Hepatic steatosis did not correlate with IL28B genotype (p = 0,14) but only with a high body mass index (BMI) value (p = 0.03). CONCLUSIONS Female subjects carrying IL28B CC-genotype are significantly more represented among Italian patients who spontaneously cleared HCV infection. In addition, among these subjects, the presence of liver steatosis does not correlate with IL28B genotype but is solely related to the occurrence of high BMI. Thus, the association between IL28B polymorphism and steatosis in chronic HCV patients requires the presence of active HCV replication to occur, while in subjects who have cleared the infection, the mechanism(s) inducing liver steatosis are independent from IL28B profile.
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Affiliation(s)
- Gloria Taliani
- Clinica Malattie Infettive e Tropicali, Department of Clinical Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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Biliotti E, Zacharia S, Grieco S, Spaziante M, Giusto M, Merli M, Gallinaro V, Taliani G. Acute hepatitis B in a patient with OLT during treatment with peg-interferon and ribavirin for hepatitis C recurrence. J Chemother 2012; 24:369-72. [PMID: 23174103 DOI: 10.1179/1973947812y.0000000046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The course and outcome of acute viral hepatitis in liver transplanted patients with hepatitis C recurrence are unknown. Here we describe a patient who presented with acute hepatitis B infection while on treatment with peg-interferon and ribavirin for hepatitis C recurrence after liver transplantation. A nucleoside analogue was added (entecavir) and the patient cleared hepatitis C virus (HCV) infection and seroconverted to anti-HBs. In this case, the acute hepatitis B virus (HBV) infection might have contributed to the clearance of HCV, the concomitant immunosuppression might have lead to the slow clearance of HBV infection, and the combined antiviral therapy has helped in the resolution of both infections. Hepatitis B vaccination should be recommended in susceptible patients waiting for liver transplantation.
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Affiliation(s)
- Elisa Biliotti
- Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
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