Publications by authors named "Muccini C"

Background: Major adverse cardiovascular events (MACEs) may contribute to the high morbidity in people with four-class drug-resistant HIV (4DR-PWH).

Objectives: To explore the probability of MACEs in 4DR-PWH compared with non-4DR controls.

Methods: This was a retrospective, propensity score-matched cohort study on 4DR-PWH (cases) and non-4DR-PWH (controls), on ART, without previous MACEs.

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Article Synopsis
  • Virological failure (VF) of first-line second-generation INSTI-based HIV treatments is uncommon, typically presenting with low viral loads and no drug resistance mutations.
  • A retrospective study examined the effectiveness of rescue treatments for patients who experienced VF while on SG-INSTI therapy between 2016 and 2021, focusing on their viral load outcomes.
  • Results showed that 75.6% of patients achieved virological success during follow-up, regardless of whether they switched medications or remained on their failing regimen, suggesting spontaneous suppression in many cases.
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Introduction: The combination of bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) represents a valid option of antiretroviral therapy (ART) as first line regimen both in ART-naïve and -experienced people with HIV (PWH). This review evaluates the pharmacokinetic profiles of these drugs and their clinical implications.

Areas Covered: This article discusses the pharmacokinetics and pharmacodynamics of BIC/FTC/TAF.

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Objectives: We report longitudinal trends in alcohol and recreational drug use, and their associations with sexual behaviors and clinical outcomes in a Thai cohort of predominantly men who have sex with men (MSM) living with HIV.

Methods: From 2017 to 2019, participants in the RV254/SEARCH010 acute HIV cohort answered questions every 24 weeks about drug use and sexual behaviors. Longitudinal trends were assessed using the χ2 test for trend.

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  • The study analyzed the CD4+/CD8+ ratio in people with HIV who switched from a standard treatment to a long-acting combination of cabotegravir and rilpivirine.
  • Over the course of one year, participants showed a notable improvement in their CD4+/CD8+ ratio, indicating better immune health.
  • The results suggest that using long-acting therapy could help improve immune recovery in those already experienced with HIV treatment.
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Background: Reducing the number of active compounds for lifelong HIV treatment is of interest, especially to reduce potential long-term side effects. So far, available data assessing viral control, support the robustness and safety of 2DR (2-drug regimen) ART compared to 3DR. However, further in-depth investigations of the viral reservoirs are mandatory to guarantee long-term safety of these regimens regarding stable intact HIV-1 DNA copies, HIV-1 RNA transcripts and sustained immunological control.

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Article Synopsis
  • - The introduction of antiretroviral therapy (ART) has greatly improved the lives of individuals with HIV, but it can lead to significant side effects, particularly cardiometabolic complications, especially in children and adolescents.
  • - A literature review was conducted to gather current knowledge on metabolic issues (like dyslipidemia and insulin resistance) and diseases (such as prediabetes and cardiovascular diseases) linked to ART in the pediatric population with HIV.
  • - Close monitoring of these metabolic complications is crucial as they heighten the risk of developing serious health conditions later in life. Addressing these challenges requires better access to treatments, technology advancements, and a focus on reducing healthcare disparities.
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Background: Implementation level of long-acting injectable agents cabotegravir/rilpivirine (LAI CAB/RPV) for human immunodeficiency virus (HIV) treatment in Italy is still not known. The aim of this study is to identify the status of implementation of LAI CAB-RPV and its barriers.

Materials And Methods: A cross-sectional online survey was conducted among infectious diseases (ID) physicians and nurses belonging to the ICONA network in Italy.

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Background: The aim of the study was to evaluate the 12-month cumulative probability of treatment discontinuation (TD) in people with human immunodeficiency virus (HIV; PWH) and a long exposure to antiretroviral therapy (ART) switching to long-acting cabotegravir and rilpivirine (CAB/RPV).

Methods: SCohoLART is a single-center, prospective, cohort study designed to collect both samples and clinical data from PWH with virological suppression who switched to bimonthly long-acting CAB/RPV. TD occurred at switch to another regimen for any reason including virological failure (VF); VF was defined as HIV RNA levels ≥50 copies/mL at 2 consecutive measurements or a single HIV RNA level ≥1000 copies/mL.

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Objectives: In this study, we compared the performance of a self-administered point-of-care test (POCT) for anal human papillomavirus (HPV) screening with laboratory gold-standard test in pre-exposure prophylaxis (PrEP) users and evaluated its feasibility.

Methods: We enrolled PrEP users from a local community-based PrEP service. Each participant self-collected an anal swab to test anal HPV with a PCR POCT capable of detecting 14 high-risk HPV genotypes.

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Italian guidelines recommend HIV pre-exposure prophylaxis (PrEP) only upon satisfying strict eligibility criteria. The objective of this study is to evaluate if PrEP candidates attending a community-based service comply with these criteria and whether these prescribing conditions affect retention in care and sexually transmitted infections (STIs) acquisition. A retrospective analysis was performed on PrEP candidates evaluated from January 2019 to June 2022.

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Objective: Analysis of bictegravir/emtricitabine/tenofovir alafenamide (BFTAF) efficacy and safety in virologically suppressed people living with HIV (PLWH) in clinical practice.

Patients And Methods: The retrospective cohort study, which included adult treatment-experienced and virologically suppressed PLWH, switched to BFTAF from June 2019 to June 2021. Efficacy and safety were evaluated as virological failure (VF=2 consecutive HIV-RNA>50 copies/mL or a single HIV-RNA>400 copies/mL) and treatment failure (TF=VF or discontinuation for any reason) until data freezing (August 2022).

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Article Synopsis
  • - The study investigates how the HLA class I genotype influences the size of the HIV viral reservoir in individuals on antiretroviral therapy (ART), highlighting the significant roles of HLA-B and -C genes in this process.
  • - Using advanced bioinformatic tools, the researchers assessed the relationship between HLA alleles and HIV antigen presentation, finding that certain HLA types, like HLA-B*57:01 and HLA-B*58:01, may enhance immune responses against HIV.
  • - The research suggests a potential interaction between specific HLA-peptide complexes and factors like the CCR5 ∆32 mutation in regulating HIV replication and controlling the size of the viral reservoir, proposing a multifaceted approach to understanding HIV management
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Introduction: Darunavir (DRV)/cobicistat (COBI)/emtricitabine (FTC)/tenofovir alafenamide (TAF) is the only protease inhibitor-based single-tablet regimen (STR) approved for the treatment of HIV infection of adults and pediatric patients weighing at least 40 kg. DRV/COBI/FTC/TAF has demonstrated to be an effective regimen, to have a high genetic barrier to resistance, and to be well tolerated.

Areas Covered: The authors summarize the chemistry and pharmacology of DRV, COBI, FTC, and TAF and discuss trials conducted on antiretroviral therapy (ART)-naïve and -experienced people living with HIV designed to evaluate safety, tolerability, and efficacy of the STR.

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Introduction: The aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH).

Methods: This cohort study included PLWH followed at the IRCCS San Raffaele, Milan, Italy, with at least one body mass index (BMI) determination during the pre-pandemic period (1 December 2018 to 29 February 2020) and the pandemic period (1 March 2020 to 31 May 2021). MS diagnosis was based on NCEP ATP III 2005 criteria.

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Despite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006-2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders.

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Article Synopsis
  • * The rapid spread of mpox has been linked to sexual transmission among men who have sex with men (MSM), and the potential role of asymptomatic carriers remains under discussion, with estimates suggesting about 6.5% of infections might be asymptomatic.
  • * In a study involving 72 high-risk asymptomatic MSM participants, none tested positive for mpox infection or developed symptoms over a 21-day follow-up, indicating potential challenges for epidemic management and contact tracing in similar populations.
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Objectives: Few data on management of two-drug regimen (2DR) failure in people living with HIV (PLWH) are available.

Methods: Retrospective study of treatment-experienced PLWH on a 2DR who experienced virological failure (VF) [two consecutive viral loads (VLs) ≥50 copies/mL, single VL ≥1000 copies/mL, or antiretroviral therapy (ART) switch after single VL ≥50 copies/mL with previous blips] or discontinuation for toxicity (baseline). Integrase strand transfer inhibitor (INSTI)-based [one INSTI plus one nucleoside reverse transcriptase inhibitor (NRTI) (n = 78) or one non-NRTI (n = 20)] or boosted protease inhibitor (PI/b)-based [one PI/b plus one NRTI (n = 116) or one INSTI (n = 12)] 2DRs were included.

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