Italian consensus recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis.

The recent introduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revolutionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown. Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidence and produce practical, hospital-wide recommendations.

Italian consensus Guidelines for the management of hepatitis B virus infections in patients with rheumatoid arthritis.

Objectives: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations.

Methods: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Center for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations.

Interferon gamma release assays and tubercolin skin test performance in different settings of HIV immunodeficiency.

Background/aim: HIV infection is a risk factor for re-activation of latent tubercolosis infection (LTBI). In recent years new blood tests for the detection of TB infection have been developed: Quantiferon TB Gold in Tube and TSPOT TB, which are interferon-γ releasing assays (IGRAs), have improved the identification of LTBI. In our study we have compared IGRAs and TST in HIV-positive patients with different settings of immunodeficiency.

Different impact of anti-retroviral regimen containing protease inhibitors on development of HIV-related Kaposi sarcoma.

Background: The incidence of Kaposi's sarcoma (KS), an AIDS-related malignancy, has dramatically decreased in the Highly Active Anti-retroviral Therapy (HAART) era. However, KS remains the second most frequent tumor in HIV-infected patients worldwide and has become the most common cancer in the sub-Saharan Africa. Experimental studies have demonstrated a direct anti-neoplastic effect of HAART, and overall of protease inhibitors (PIs), on KS.

Novel antiretroviral drugs and renal function monitoring of HIV patients.

Chronic kidney disease is a major comorbidity in patients affected by HIV infection. In addition, the introduction of new antiretroviral agents that interact with creatinine transporters is raising some concerns. In this review we analyze the currently available data about three new antiretroviral drugs and one new pharmacokinetic enhancer.

Inconsistent condom use among HIV-positive women in the "Treatment as Prevention Era": data from the Italian DIDI study.

Introduction: Translation of the evidence regarding the protective role of highly active antiretroviral therapy (HAART) on HIV sexual transmission rates into sexual behaviour patterns of HIV-infected subjects remains largely unexplored. This study aims to describe frequency of self-reported condom use among women living with HIV in Italy and to investigate the variables associated with inconsistent condom use (ICU).

Methods: DIDI (Donne con Infezione Da HIV) is an Italian multicentre study based on a questionnaire survey performed during November 2010 and February 2011.

Role of FAP48 in HIV-associated lipodystrophy.

The highly active antiretroviral therapy (HAART) can cause a metabolic syndrome consisting of lipodystropy/lipoatrophy, dyslipidemia, and type 2 diabetes mellitus with an increased cardiovascular risk. The pathogenetic bases of HAART-associated lipodystrophy are poorly known. A genetic screen was used to evaluate proteins that are modulated in HIV-1-infected patients with or without lipodystrophy syndrome, that are routinely treated with HAART regimens.

Suppression of pre adipocyte differentiation and promotion of adipocyte death by anti-HIV drugs.

In the present study, we investigated the ability of anti-HIV drugs to interfere with normal cell cycle progression and to induce oxidative stress by perturbing the redox environment. Our results provide evidence that anti-HIV drugs have a differential effect on adipocyte cell cycle and differentiation, being able to modify the response to oxidative stress through an increase of reactive oxygen species (ROS) that compromises the induction of phase-2 and antioxidant enzymes. In detail, saquinavir, efavirenz, and stavudine exert antiadipogenic influences on the model 3T3-L1 cell line, perturbing the oxidative response and inducing of apoptosis.

Comparative transcriptional profiling in HIV-infected patients using human stress arrays: clues to metabolic syndrome.

Highly active antiretroviral therapy (HAART therapy) for HIV-1 infection has significantly increased the survival and quality of life of patients with this disease. However, in several epidemiological studies the onset of metabolic syndrome is a phenomenon reported to be extremely frequent. In the present study, genes involved in the molecular cascade responsible for the alteration of fat tissue and of lipid and glucose metabolism in patients with HIV-1 infection treated with antiretroviral therapy were identified.

Safety of fosamprenavir in a cohort of HIV-1-infected patients with co-morbidities.

Background: The hypothesis that fosamprenavir-including highly active antiretroviral therapy (HAART) regimens would be associated with few metabolic and hepatic side-effects was investigated.

Patients And Methods: An observational single-arm retrospective study was set up on a cohort of 139 human immunodeficiency virus (HIV)-infected patients, followed up at A.O.

[Effect of antiretroviral therapy on carotid intima-media thickness in HIV-infected patients].

Background: The introduction of highly active antiretroviral therapy reduced HIV-associated morbidity and mortality, at the cost of adverse metabolic effects that increase cardiovascular risk. The aim of this study was to evaluate the impact of exposure to protease inhibitors (PI) compared with exposure to non-nucleoside reverse transcriptase inhibitors (NNRTI) on carotid intima-media thickness (IMT) and blood flow velocity and to measure vascular involvement over a 2-year follow-up in HIV-infected patients treated with PI.

Methods: Thirty-five HIV-infected patients treated with PI (group I) and 15 patients treated with NNRTI (group II) underwent epiaortic vessel ultrasonography.

Role of NEDD8 in HIV-associated lipodystrophy.

The pathogenetic bases of HAART-associated lipodystrophy are still poorly known, even if it is clear that adipose tissue and its metabolism are sensitive to antiretroviral therapy alone and/or in combination with HIV infection. The NEDD8 system is essential for the regulation of protein degradation pathways involved in cell cycle progression, morphogenesis and tumorigenesis. We investigated the possible involvement of NEED8 in adipogenesis and, consequently, in HIV-related lipodystrophy.

A color Doppler ultrasound-based comparative study between stavudine and non-stavudine regimens in the onset of vascular lesions in HIV-1-positive patients.

Background: The present study aimed to investigate the role of stavudine in the onset of premature vascular lesions using an ultrasound color Doppler evaluation of the carotid vessels.

Patients And Methods: A total of 266 patients were evaluated: 149 were treated with stavudine (group I) and 117 without stavudine (group II).

Results: Of the patients in group I, 41% exhibited vascular lesions vs.

Rapid progression of carotid lesions in HAART-treated HIV-1 patients.

To obtain data on the evolution of carotid lesions, we evaluated 133 patients at their first antiretroviral regimen, followed for at least 2 years; 77 treated with protease inhibitors (PIs): Group A and 56 with non-nucleosidic reverse transcriptase inhibitors (NNRTIs): Group B. All patients were subjected to carotid ultrasonography. In Group A, among the previously normal patients 22.

Role of chlamydia infection in the pathogenesis of atherosclerotic plaques in HIV-1-positive patients.

Background: Various authors have hypothesized a role of Chlamydia pneumoniae infection in the pathogenesis of atherosclerosis. To better understand the possible role of this infection in the pathogenesis of epi-aortic lesions in HIV-1-positive patients, the presence of anti-Chlamydia pneumoniae antibodies was evaluated in a group of individuals subjected to ultrasonography of the epi-aortic vessels.

Patients And Methods: The presence of specific antibodies in 129 subjects was determined; 59 patients were HIV-1-positive, of whom 30 had carotid plaques and 29 were without lesions.