Publications by authors named "Andrea Calcagno"

Background: Alzheimer's disease (AD) is the most common neurodegenerative dementia, with diagnosis traditionally reliant on clinical criteria. Cerebrospinal fluid (CSF) biomarkers like pTau181 and Aβ/Aβ ratio significantly improve diagnostic accuracy but are invasive. Plasma biomarkers measured by automated assays offer a non-invasive alternative.

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During antiretroviral therapy (ART), most people living with HIV-1 have undetectable HIV-1 RNA in their plasma. However, they occasionally present with new or progressive neurologic deficits and detectable HIV-1 RNA in the cerebrospinal fluid (CSF), a condition defined as neurosymptomatic HIV-1 CSF escape (NSE). We explored the source of neuropathogenesis and HIV-1 RNA in the CSF during NSE by characterizing HIV-1 populations and inflammatory biomarkers in CSF from 25 individuals with NSE.

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People living with HIV (PLWH) may present atypical neurological complications. Recently, autoimmune manifestations of the central nervous system (CNS) have been described. We retrospectively described the features of PLWH presenting with acute neurological symptoms with positive anti-CNS antibodies.

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Purpose: Non-tuberculous mycobacteria (NTM) account for high clinical burden, and treatment can be challenging. Moreover, accessibility of NTM medications varies across centers. These challenges may lead to unplanned therapeutic changes, discontinuations, potentially affecting patient outcomes.

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Article Synopsis
  • The study investigated the impact of switching to a less neurotoxic antiretroviral therapy (ARV) on neurocognitive performance in people living with HIV who have cognitive impairments.
  • Participants were randomly assigned to either continue their current treatment or switch to a less harmful ARV regimen (MARAND-X) for 24 weeks, with results measured using various cognitive tests and electroencephalography.
  • While the overall neurocognitive scores improved modestly, significant improvements were only seen in specific memory functions for those in the MARAND-X group with better CNS penetration, indicating that the effectiveness of ARVs in the central nervous system may influence cognitive health.
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  • Researchers are studying if the brain gets affected early during HIV infection even if patients don't show symptoms.
  • They looked at different drug combinations to see if they help in treating patients with HIV by measuring certain brain-related proteins in their blood and spinal fluid over time.
  • The study found that some brain protein levels decreased after treatment, but no big differences were seen between the different drug treatments.
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Mycobacterium abscessus complex is a group of rapidly growing non-tuberculous mycobacteria (NTM), increasingly emerging as opportunistic pathogens. Current treatment options for these microorganisms are limited and associated with a high rate of treatment failure, toxicity and recurrence. In search of new therapeutic strategies, interest has grown in dual β-lactam (DBL) therapy, as research recently discovered that M.

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We assessed whether symptomatic neurocognitive impairment (NCI) and asymptomatic NCI -of which the clinical relevance is debated- affect HIV control and the role of ART adherence in this relationship. Observational study on the relationship between NCI and viral control during the 2 years before and the 2 after the neurocognitive evaluation (NCE) of 322 PLWH on ART. Viral load (VL) was defined as undetectable, very low-level (VLLV), low-level (LLV), or high-level viremia (HLV), and classified overtime as persistent (p; ≥2 consecutive values in the same worst category), viral failure (VF; ≥1 HLV requiring ART changes), or optimal control.

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Noma, or Cancrum oris, is a severe and rapidly progressing gangrenous infection that primarily affects the face. It is most commonly observed in children living in impoverished conditions, especially in sub-Saharan Africa. Rapid diagnosis and early management are crucial to prevent devastating consequences, such as functional limitations and serious psychological repercussions.

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With the advancement of artificial intelligence(AI), platforms like ChatGPT have gained traction in different fields, including Medicine. This study aims to evaluate the potential of ChatGPT in addressing questions related to HIV prevention and to assess its accuracy, completeness, and inclusivity. A team consisting of 15 physicians, six members from HIV communities, and three experts in gender and queer studies designed an assessment of ChatGPT.

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Despite its effectiveness, combination antiretroviral treatment (cART) has a limited effect on HIV DNA reservoir, which establishes early during primary HIV infection (PHI) and is maintained by latency, homeostatic T-cells proliferation, and residual replication. This limited effect can be associated with low drug exposure in lymphoid tissues and/or suboptimal adherence to antiretroviral drugs (ARVs). The aim of this study was to assess ARV concentrations in plasma, peripheral blood mononuclear cells (PBMCs) and lymph nodes (LNs), and their association to HIV RNA and HIV DNA decay during PHI.

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Background: HIV-associated neurocognitive disorders (HAND) still affects persons with HIV (PWH) and their pathogenesis is not completely understood. We aimed to explore the association between plasma and cerebrospinal fluid (CSF) markers of blood-brain barrier (BBB) impairment and HAND in untreated PWH.

Design: Cross-sectional study.

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Objectives: Blood-brain barrier impairment is frequent in people living with human immunodeficiency virus (PLWHIV), affecting the penetration of target cells and antiretrovirals into the central nervous system, through transporters (e.g. ABCB1), leading to neuroinflammation.

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Article Synopsis
  • Many people living with HIV (PLHIV) have poor knowledge about sexually transmitted infections (STIs) and HIV transmission, which can negatively affect their quality of life.
  • A study was conducted with 200 PLHIV in Italy using an anonymous questionnaire to assess their understanding of HIV and STIs, with a focus on disclosure and the concept of undetectable = untransmittable (U=U).
  • Results showed that only 25% of participants knew how HIV is transmitted, and while a majority disclosed their status to healthcare providers and friends, there are significant gaps in understanding U=U, highlighting the need for better education to reduce stigma and improve life quality.
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  • The study aimed to analyze the effects of drug-drug interactions (DDIs) between antiretrovirals (ARVs) and other medications, including over-the-counter (OTC) drugs, on treatment outcomes in real-world settings.
  • Between March 2019 and May 2023, 139 clinical cases were reviewed, revealing that most interactions involved common ARV boosters and highlighted frequent DDI issues with CNS and cardiovascular drugs as well as OTC medications.
  • The findings emphasize the need for careful medication reconciliation, as OTC drugs often led to reduced efficacy of ARVs and toxicity in certain cases, making real-world case data a vital tool for understanding DDIs in clinical practice.
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  • The study aimed to evaluate the relationship between the plasma levels of efavirenz (EFV) and its metabolite 8-hydroxy-EFV (8-OH-EFV) with neurocognitive impairment and central nervous system (CNS) side effects in patients switching from EFV to rilpivirine.
  • Analysis of 104 patients showed that although higher levels of 8-OH-EFV were significantly linked to more CNS side effects, EFV levels only showed a marginal association with cognitive performance, particularly in executive and language functions.
  • The findings suggest that 8-OH-EFV may have a more pronounced impact on CNS side effects, while EFV's influence on cognitive function is less clear, indicating differing
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Introduction: Impairment of the gastrointestinal barrier leads to microbial translocation and peripheral immune activation, which are linked to disease progression. Data in the setting of primary HIV/SIV infection suggest that gut barrier damage is one of the first events of the pathogenic cascade, preceding mucosal immune dysfunction and microbial translocation. We assessed gut structure and immunity as well as microbial translocation in acutely and chronically-infected, combination antiretroviral therapy (cART)-naive individuals.

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Objective: HIV and Epstein-Barr virus (EBV) co-infection has been linked to increased immune activation and larger HIV reservoir. We assessed whether anti-EBV humoral responses are associated with increased cerebrospinal fluid (CSF) inflammation and with neurocognitive impairment (NCI) in people with HIV (PWH).

Design: Cross-sectional analysis in 123 EBV-seropositive PWH either on antiretroviral therapy ( n  = 70) or not.

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The prevalence of neurocognitive impairment in people living with HIV is estimated between 30 and 50%. The pathogenesis of HIV-associated neurocognitive disorders is complex and multifactorial. Aim of the study was to measure the change in CSF biomarkers, Fibroscan and IMT measurements in PLWH with HAND randomized to a less neurotoxic regimen, or continuing their treatment.

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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.

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