Publications by authors named "Ravasi G"

Article Synopsis
  • The prevalence of pretreatment drug resistance (PDR) to certain HIV medications is high in Belize, particularly among those with previous treatment exposure, posing a challenge for effective antiretroviral therapy (ART).
  • WHO recommends dolutegravir-based ART regimens for their effectiveness and low resistance risk, which is crucial for reaching UNAIDS' target of 95% viral suppression.
  • Recent surveys show that while 79.6% of adults achieved viral suppression on ART, only 50% of children and adolescents did, highlighting the need for better support and adherence to treatment.
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International migrants, especially those belonging to key populations, face a considerable HIV burden. However, continuity of HIV care for this group is often challenged along the migration route. We assess the available evidence on the existing interventions that aim to strengthen community and health systems to ensure the continuity of HIV care for international migrants.

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More than 62,000 individuals are currently on antiretroviral treatment within the public health system in Argentina. In 2019, more than 50% of people on ART received non-nucleoside reverse transcriptase inhibitors (NNRTIs). In this context, the second nationwide HIV-1 pretreatment drug resistance surveillance study was carried out between April and December 2019 to assess the prevalence of HIV-1 drug resistance in Argentina using the World Health Organization guidelines.

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The first nationally representative cross-sectional HIV drug resistance (HIVDR) survey was conducted in Uruguay in 2018-2019 among adults diagnosed with HIV and initiating or reinitiating antiretroviral therapy (ART). , , and genes of HIV-1 were sequenced. A total of 206 participants were enrolled in the survey; 63.

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Article Synopsis
  • A study in El Salvador assessed the prevalence of HIV drug resistance (HIVDR) among individuals starting antiretroviral therapy (ART) and those receiving ART for 12 and 48 months.* -
  • Findings showed that 27% of new ART users had pretreatment drug resistance, with viral load (VL) suppression rates of 88.8% at 12 months and 80.5% at 48 months.* -
  • The results indicate a need for improvements in ART delivery to address the high drug resistance to efavirenz or nevirapine and the low VL suppression rates in the population.*
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Prioritisation of elderly people in COVID-19 vaccination campaigns aimed at reducing severe outcomes in this group. Using EU/EEA surveillance and vaccination uptake, we estimated the risk ratio of case, hospitalisation and death notifications in people 80 years and older compared with 25-59-year-olds. Highest impact was observed for full vaccination uptake 80% or higher with reductions in notification rates of cases up to 65% (IRR: 0.

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Background: Several inherited diseases cause hyperferritinemia with or without iron overload. Differential diagnosis is complex and requires an extensive work-up. Currently, a clinical-guided approach to genetic tests is performed based on gene-by-gene sequencing.

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Since December 2019, over 1.5 million SARS-CoV-2-related fatalities have been recorded in the World Health Organization European Region - 90.2% in people ≥ 60 years.

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Article Synopsis
  • - From 2016 to 2019, the adoption of WHO PrEP guidelines saw significant growth, with 67% of surveyed countries implementing these recommendations, increasing the number of PrEP users from around 370,000 to 626,000 in just one year.
  • - By analyzing data from various regions, it was forecasted that global PrEP users could reach between 2.4 million and 5.3 million by the end of 2023, although potential disruptions from COVID-19 could lower this estimate to between 2.1 million and 3 million.
  • - The findings highlight the successful uptake of PrEP in many countries but also underline the uncertainty introduced by the pandemic, emphasizing the need for
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Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines.

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HFE-related hereditary hemochromatosis (HH) is characterized by marked phenotypic heterogeneity. Homozygosity for p.C282Y is a low penetrance genotype suggesting that the HFE-HH is a multifactorial disease resulting from a complex interaction involving a major gene defect, genetic background and environmental factors.

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Objective: To inform about the most recent epidemiological trends and integrated programmatic response to tuberculosis (TB) and HIV coinfection in Latin America and the Caribbean (LAC).

Methods: A descriptive review analyzed the most relevant indicators on TB/HIV coinfection in 33 countries in LAC with a cross-sectional and time-trend approach. Data were obtained from publicly available databases and analyzed through simple proportions, weighted means, and risk ratios.

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Article Synopsis
  • Pre-treatment HIV drug resistance (HIVDR) to NNRTIs has increased significantly over the past decade in low and middle-income countries, including Honduras.
  • A nationwide survey found that 26.9% of individuals starting antiretroviral therapy (ART) had pre-treatment HIVDR, with a notable prevalence of 25.9% specifically for NNRTIs.
  • The findings suggest a need for alternative first-line ART regimens and improved monitoring and support strategies for individuals living with HIV in Honduras.*
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Article Synopsis
  • A national survey in Nicaragua assessed pretreatment and acquired HIV drug resistance among people starting antiretroviral therapy (ART) and those on ART for different durations.
  • Out of 638 participants, 23.4% had pretreatment resistance to any HIV drug, with a higher rate in those previously exposed to antiretrovirals, especially non-nucleoside reverse transcriptase inhibitors (NNRTIs).
  • The study also found viral load suppression rates of 77.8% for those on ART for around 12 months but lower at 70.3% for those on ART for over 48 months, highlighting challenges in managing HIV resistance and treatment efficacy.
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: Use of dolutegravir-based first-line antiretroviral therapy (ART) in response to rising levels of pretreatment HIV drug resistance (PDR) to non-nucleoside reverse transcriptase inhibitors (NNRTIs) may be limited, given safety concerns for birth defects in women of child-bearing potential. Pooled data from 11 nationally representative surveys show that NNRTI PDR in women is nearly twice that in men, exceeding 10% in 8 of 11 countries monitored, suggesting the urgent need for a non-NNRTI-based ART regimen in this population.

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Objective: To identify and summarize existing literature on the burden of HIV, sexually transmitted infections (STIs), and viral hepatitis (VH) in indigenous peoples and Afro-descendants in Latin America to provide a broad panorama of the quantitative data available and highlight problematic data gaps.

Methods: Published and grey literature were systematically reviewed to identify documents published in English, Spanish, or Portuguese with data collected between January 2000 and April 2016 on HIV, STI, and VH disease burden among indigenous peoples and Afro-descendants in 17 Latin American countries.

Results: Sixty-two documents from 12 countries were found.

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Objective: During hypoxia, hepcidin expression is inhibited to allow iron mobilization to sustain erythropoietic expansion. We analyzed molecular mechanisms underlying hypoxia-induced hepcidin inhibition in an in vivo model of acute hypoxia.

Methods: Mice were kept under normal or hypoxic conditions for 6 hours and 15 hours and treated with α-PDGF-BB antibody or PDGF-BB receptor inhibitor.

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Introduction: Aceruloplasminemia is an ultra-rare hereditary disorder characterized by iron-restricted microcytic anemia and tissue iron overload associated with diabetes, retinal and progressive neurological degeneration. We describe genotypes and phenotypes at diagnosis, and disease evolution of seven Italian patients.

Methods: Anagraphical, biochemical, genetic, clinical and instrumental data were collected at diagnosis and during a long-term follow-up.

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In diverse global regions with significant human immunodeficiency virus (HIV) burden, programmatic, cultural, and provider-, patient-, and virus-related factors may result in HIV drug resistance, with global implications. This article reviews such common and unique challenges in Russia, Latin America and the Caribbean, China, and India, to suggest potential solutions.

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