Publications by authors named "Clara Gabiano"
Background: Intravenous administration of zidovudine (ZDV) during labour is a key step for vertical HIV transmission (VT) prevention, but there is no evidence of benefit when maternal HIV-RNA at delivery is <50 copies/mL. The aim of this study is evaluating the appropriateness of intrapartum ZDV use in Italy.
Methods: Observational study including mother-infant pairs with perinatal HIV exposure during 2002-2019, enrolled in the Italian Register for HIV Infection in Children.
Background: Early start of highly active antiretroviral therapy (HAART) in perinatally HIV-1 infected children is the optimal strategy to prevent immunological and clinical deterioration. To date, according to EMA, only 35% of antiretroviral drugs are licenced in children < 2 years of age and 60% in those aged 2-12 years, due to the lack of adequate paediatric clinical studies on pharmacokinetics, pharmacodynamics and drug safety in children.
Methods: An observational retrospective study investigating the rate and the outcomes of off-label prescription of HAART was conducted on 225 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018.
Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited. An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018.
View Article and Find Full Text PDFBackground: Human Parechovirus (HPeVs), along with human enteroviruses is associated with gastrointestinal and respiratory infections. The aim of this study was to assess the performance characteristics of two nucleic acid extraction for HPeV-RNA quantitation, the RNAlev Extraction Kit associated with Maxwell automated nucleic acid extractor (Promega, Milan, Italy) and RNAzol manually protocol.
Methods: A total of 137 fecal specimens previously routinely screened for Rotavirus and Adenovirus were tested for HPeV virus.
Background: Strategies for prevention of HIV-1 mother-to-child transmission (PMTCT) have been continuously optimized. However, cases of vertical transmission continue to occur in high-income countries.
Objectives: To investigate changes in PMTCT strategies adopted by Italian clinicians over time and to evaluate risk factors for transmission.
Background: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae.
Methods: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy.
Gastroenteritis is a common disease in children. It is characterized by diarrhea, vomiting, abdominal pain, and fever. Sapovirus (SaV) is a causative agent of acute gastroenteritis, but it causes milder illness than do rotavirus and norovirus.
View Article and Find Full Text PDFBackground: Currently, RT-PCR is used widely and considered to be a convenient, useful, and powerful method for molecular diagnosis, to detect pathogens from clinical specimens.
Objectives: In this work we describe the development of an in-house Real-time Taqman PCR assay for quantification of HPeV in stool specimens.
Study Designs: A total of 137 fecal specimens previously screened for rotavirus and adenovirus were tested for HPeV virus.
Article Synopsis
- The prevalence of hepatitis C virus (HCV) in children varies significantly, with 0.05%-0.4% in developed countries and 2%-5% in resource-limited settings, often due to unsafe medical practices.
- Mother-to-child transmission (MTCT) is the main cause of pediatric HCV infection, with a 5% transmission rate, influenced by factors like maternal HIV co-infection and high maternal viral load.
- Most children with chronic HCV show mild symptoms, and about 25% may naturally clear the virus by age six; severe complications are rare, although some children exhibit autoimmune responses.
Tuberculosis (TB) is a re-emerging health problem in developed countries. This paper is part of large guidelines on the global management of TB in children, by a group of scientific societies. It describes the indications to hospitalization of children with suspected or diagnosed TB, the isolation measures, hospital discharge, and re-admission into the community.
View Article and Find Full Text PDFPurpose: This article describes the recommendations of a group of scientific societies concerning the therapeutic approach to immunocompromised children with tuberculosis (TB).
Methods: Using the Consensus Conference method, relevant publications in English were identified by a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception until December 31, 2014.
Findings: On the basis of their clinical experience and the published evidence, the group of experts concluded that, although immunosuppressed subjects are at greater risk of developing TB, none of the signs or symptoms is sensitive or specific enough to enable a diagnosis.
Article Synopsis
- The study aimed to assess how effective the seasonal influenza vaccine is in preventing Emergency Department visits and hospitalizations for influenza-like illnesses in children.
- Data was collected from 704 children visiting EDs during the 2011-2012 and 2012-2013 influenza seasons, with 262 testing positive for influenza and 442 negative.
- The overall vaccine effectiveness was found to be 38%, with a higher effectiveness of 53% in hospitalized children, though both results lacked statistical significance and highlighted a need for further research on vaccine recommendations for children.
Background: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.
Methods: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.
Results: Twenty-three women had 29 pregnancies.
Article Synopsis
- The study followed untreated children with vertically acquired Hepatitis C virus (HCV) infection to analyze its natural progression, including rates of viral clearance and autoimmune disorders.
- Among 45 children studied, 26.7% achieved spontaneous viral clearance, mostly associated with genotype 3, while most displayed increased liver enzyme levels but no symptoms of liver disease.
- Autoantibodies were found in over half of the children, with some developing rare complications like type-1 diabetes, indicating that while chronic HCV infection is often asymptomatic, there can be mild liver damage and autoimmune responses.
Objective: To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population.
Methods: This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres.
Background: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown.
Methods: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis.
Background: Growth impairment and bone toxicity due to tenofovir disoproxil fumarate (TDF) fetal exposure has been described mainly in animals. We evaluated growth pattern and bone health in TDF-exposed HIV-uninfected children born to HIV-infected mothers, defined as seroreverters (SR).
Methods: This was a multicentre observational cross-sectional cohort study enrolling 68 SR who were in utero exposed to an antiretroviral regimen including (TDF+) or not including (TDF-) tenofovir.
Objectives: Because of the spread of drug-resistant Gram-positive bacteria, the use of linezolid for treating severe infections is increasing. However, clinical experience in the paediatric population is still limited. We undertook a multicentre study to analyse the use of linezolid in children.
View Article and Find Full Text PDFClinical features and outcome of 2009 H1N1 influenza virus in the paediatric setting is ill-defined. The epidemiologic and clinical features of children with confirmed H1N1 influenza virus infection admitted to an Italian tertiary paediatric hospital from August through December 2009 were evaluated. A total of 63 children (mean age 4.
View Article and Find Full Text PDFReduced bone mass measurements are often found in HIV-infected youths. Both in vitro and human studies demonstrated a role of antiretroviral treatment in determining bone mass alteration. Nevertheless, the data regarding the responsibility of different antiretroviral drugs on bone health in children and adolescents are highly controversial.
View Article and Find Full Text PDFBackground: Early highly active antiretroviral therapy (HAART), started within the first months of age, has been proven to be the optimal strategy to prevent immunological and clinical deterioration in perinatally HIV-infected children. Nevertheless, data about long-term follow-up of early treated children are lacking.
Methods: We report data from 40 perinatally HIV-infected-children receiving early HAART, with a median follow-up period of 5.
Objective: To assess applicability of quantitative ultrasonography (QUS) for bone health assessment in HIV-infected youths.
Methods: QUS measurements of the radius and tibia and dual-energy x-ray absorptiometry (DXA) measurements of the lumbar spine and whole skeleton were obtained in 88 HIV-infected children and adolescents (aged 4.8-22.
Article Synopsis
- * Out of 937 pregnant women with HIV-1, a small percentage interrupted ART, with a notable increase in mother-to-child transmission rates during these interruptions: 4.9% when interrupted in the first trimester and 18.2% in the third trimester.
- * The findings indicate that discontinuing ART during pregnancy significantly raises the risk of transmission, emphasizing the need for consistent treatment throughout pregnancy to minimize this risk.