0000000000455542

AUTHOR

F. Baldelli

showing 6 related works from this author

Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

2019

AbstractBackgroundAlcohol consumption is a known risk factor for liver disease in HIV-infected populations. Therefore, knowledge of alcohol consumption behaviour and risk of disease progression associated with hazardous drinking are important in the overall management of HIV disease. We aimed at assessing the usefulness of routine data collected on alcohol consumption in predicting risk of severe liver disease (SLD) among people living with HIV (PLWHIV) with or without hepatitis C infection seen for routine clinical care in Italy.MethodsWe included PLWHIV from two observational cohorts in Italy (ICONA and HepaICONA). Alcohol consumption was assessed by physician interview and categorized ac…

Male030508 substance abuseHIV InfectionsSeverity of Illness IndexCohort StudiesLiver disease0302 clinical medicineRisk FactorsEpidemiologyMedicineHIV InfectionAlcohol consumptionAlcohol consumption HIV-infected HIV/HCV co-infection Severe liver disease030212 general & internal medicineeducation.field_of_studyCoinfectionLiver Diseaselcsh:Public aspects of medicineLiver DiseasesHazard ratioHepatitis CMiddle AgedHepatitis CItalyalcohol consumption; HIV-infected; HIV/HCV co-infection; severe liver diseaseCoinfectionFemale0305 other medical scienceHumanCohort studyResearch ArticleAdultmedicine.medical_specialtyAlcohol DrinkingPopulationSevere liver diseaseHIV/HCV co-infectionNO03 medical and health sciencesEnvironmental healthHumansRisk factorAlcohol consumption; HIV-infected; HIV/HCV co-infection; Severe liver disease; Adult; Alcohol Drinking; Cohort Studies; Female; HIV Infections; Hepatitis C; Humans; Italy; Liver Diseases; Male; Middle Aged; Risk Factors; Severity of Illness Index; CoinfectioneducationHIV-infectedbusiness.industryRisk FactorPublic Health Environmental and Occupational Healthlcsh:RA1-1270medicine.diseaseCohort StudiebusinessBMC Public Health
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Evolution of transmitted HIV-1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016

2018

Objectives: The aim was to evaluate the evolution of transmitted HIV-1 drug resistance (TDR) prevalence in antiretroviral therapy (ART)-naïve patients from 2006 to 2016. Methods: HIV-1 sequences were retrieved from the Antiviral Response Cohort Analysis (ARCA) database and TDR was defined as detection of at least one mutation from the World Health Organization (WHO) surveillance list. Results: We included protease/reverse transcriptase sequences from 3573 patients; 455 had also integrase sequences. Overall, 68.1% of the patients were Italian, the median CD4 count was 348 cells/μL [interquartile range (IQR) 169–521 cells/μL], and the median viral load was 4.7 log 10 HIV-1 RNA copies/mL (IQR …

0301 basic medicineMaleantiretroviral therapy; HIV; recent HIV infection; resistance epidemiology; transmitted HIV drug resistance; Adult; Anti-HIV Agents; CD4 Lymphocyte Count; Female; HIV Infections; HIV-1; Humans; Italy; Male; Middle Aged; Mutation; Odds Ratio; Prevalence; Viral Proteins; Drug Resistance Viralantiretroviral therapy; HIV; recent HIV infection; resistance epidemiology; transmitted HIV drug resistance; Health Policy; Infectious Diseases; Pharmacology (medical)Drug ResistanceHIV InfectionsDrug resistanceGastroenterologyInterquartile rangeOdds RatioPrevalenceHIV InfectionPharmacology (medical)ViralbiologyHealth PolicyMiddle AgedIntegraseInfectious DiseasesItalyFemaleViral loadHumanresistance epidemiologyAdultmedicine.medical_specialtytransmitted HIV drug resistanceAnti-HIV AgentsHIV; antiretroviral therapy; recent HIV infection; resistance epidemiology; transmitted HIV drug resistance030106 microbiologyantiretroviral therapySettore MED/17 - MALATTIE INFETTIVEVirus03 medical and health sciencesrecent HIV infectionViral ProteinsInternal medicineDrug Resistance ViralmedicineViral ProteinHumansbusiness.industryAnti-HIV AgentHIVOdds ratioReverse transcriptaseConfidence intervalCD4 Lymphocyte CountMutationbiology.proteinHIV-1business
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Risk for non-AIDS-defining and AIDS-defining cancer of early versus delayed initiation of antiretroviral therapy

2021

BACKGROUND: Immediate initiation of antiretroviral therapy (ART) regardless of CD4 cell count reduces risk for AIDS and non-AIDS-related events in asymptomatic, HIV-positive persons and is the standard of care. However, most HIV-positive persons initiate ART when their CD4 count decreases below 500 × 10 9 cells/L. Consequences of delayed ART on risk for non-AIDS-defining and AIDS-defining cancer, one of the most common reasons for death in HIV, are unclear. OBJECTIVE: To estimate the long-term risk difference for cancer with the immediate ART strategy.DESIGN: Multinational prospective cohort study.SETTING: The D:A:D (Data collection on Adverse events of anti-HIV Drugs) study, which included…

MaleHIV AIDSHIV Infections0302 clinical medicineInterquartile rangeRisk FactorsNeoplasmsMedicine030212 general & internal medicineProspective StudiesProspective cohort study0303 health sciencesIncidenceAbsolute risk reductionDrugsGeneral MedicineMiddle AgedViral LoadAntiretroviral therapy3. Good healthAIDSCancer treatmentPrevention policy and public healthCohortInfectious diseasesCohort studiesFemaleViral loadAdultmedicine.medical_specialtyAnti-HIV AgentsHIV Infections/drug therapySocio-culturaleTime-to-Treatment03 medical and health sciencesAcquired immunodeficiency syndrome (AIDS)SDG 3 - Good Health and Well-beingInternal medicineInternal MedicineHumansAdverse effect030306 microbiologybusiness.industryHIVCancermedicine.diseaseCD4 Lymphocyte CountCancer.Anti-HIV Agents/therapeutic use[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologiebusinessNeoplasms/epidemiologyAnnals of Internal Medicine
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Effectiveness of dolutegravir-based regimens as either first-line or switch antiretroviral therapy: data from the Icona cohort

2019

Introduction: Concerns about dolutegravir (DTG) tolerability in the real-life setting have recently arisen. We aimed to estimate the risk of treatment discontinuation and virological failure of DTG-based regimens from a large cohort of HIV-infected individuals. Methods: We performed a multicentre, observational study including all antiretroviral therapy (ART)-naïve and virologically suppressed treatment-experienced (TE) patients from the Icona (Italian Cohort Naïve Antiretrovirals) cohort who started, for the first time, a DTG-based regimen from January 2015 to December 2017. We estimated the cumulative risk of DTG discontinuation regardless of the reason and for toxicity, and of virologica…

Maleadverse eventadverse events; antiretroviral therapy; cohort study; discontinuation; dolutegravir; toxicity; Adult; Anti-HIV Agents; Cohort Studies; Dideoxynucleosides; Female; HIV Infections; Heterocyclic Compounds 3-Ring; Humans; Italy; Male; Middle Aged; Prospective Studies; Retrospective Studies; Tenofovir; Treatment Outcomeadverse events; antiretroviral therapy; cohort study; discontinuation; dolutegravir; toxicity;HIV InfectionsPiperazinesCohort Studies0302 clinical medicineHeterocyclic CompoundsAbacavirRetrospective StudieMedicineHIV InfectionProspective Studies030212 general & internal medicineProspective cohort studyResearch Articlesadverse events; antiretroviral therapy; cohort study; discontinuation; dolutegravir; toxicityHazard ratioMiddle AgedDideoxynucleosidedolutegravirTreatment OutcomeInfectious DiseasesTolerabilityItalyCohortFemalePublic Health0305 other medical scienceHeterocyclic Compounds 3-RingResearch Articlemedicine.drugHumanAdultmedicine.medical_specialtyAnti-HIV AgentsPyridonesantiretroviral therapySettore MED/17 - MALATTIE INFETTIVE3-RingLower riskNO03 medical and health sciencesInternal medicineOxazinescohort studyHumansTenofovirRetrospective Studies030505 public healthbusiness.industryEnvironmental and Occupational HealthPublic Health Environmental and Occupational HealthAnti-HIV AgenttoxicityRetrospective cohort studyantiretroviral therapy; dolutegravir; cohort study; discontinuation; toxicity; adverse eventsDideoxynucleosidesadverse eventsDiscontinuationProspective Studieadverse events; antiretroviral therapy; cohort study; discontinuation; dolutegravir; toxicity; Public Health Environmental and Occupational Health; Infectious DiseasesCohort Studiebusinessdiscontinuation
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Switching to dual/monotherapy determines an increase in CD8+ in HIV-infected individuals: An observational cohort study

2018

Background The CD4/CD8 ratio has been associated with the risk of AIDS and non-AIDS events. We describe trends in immunological parameters in people who underwent a switch to monotherapy or dual therapy, compared to a control group remaining on triple antiretroviral therapy (ART). Methods We included patients in Icona who started a three-drug combination ART regimen from an ART-naïve status and achieved a viral load ≤ 50 copies/mL; they were subsequently switched to another triple or to a mono or double regimen. Standard linear regression at fixed points in time (12-24 months after the switch) and linear mixed model analysis with random intercepts and slopes were used to compare CD4 and CD8…

0301 basic medicineMaleCD4-CD8 Ratiolcsh:MedicineHIV InfectionsCD8-Positive T-LymphocytesCD4/CD8 ratio; CD8; Chronic inflammation; Dual therapy; Monotherapy; Adult; Anti-HIV Agents; CD4-CD8 Ratio; CD8-Positive T-Lymphocytes; Cohort Studies; Emtricitabine; Female; HIV Infections; Humans; Male; Middle Aged; Reverse Transcriptase Inhibitors; Tenofovir; Medicine (all)Cohort Studies0302 clinical medicineEmtricitabineHIV Infection030212 general & internal medicineMedicine (all)General MedicineChronic inflammationCD4/CD8 ratio; CD8; Chronic inflammation; Dual therapy; Monotherapy; Medicine (all)Middle AgedSettore MED/07 - Microbiologia e Microbiologia ClinicaReverse Transcriptase InhibitorReverse Transcriptase InhibitorsFemalecd4/cd8 ratio; cd8; chronic inflammation; dual therapy; monotherapy; medicine (all)Research Articlemedicine.drugCohort studyHumanAdultmedicine.medical_specialtyDual therapyCD4/CD8 ratio; CD8; Chronic inflammation; Dual therapy; Monotherapy; Adult; Anti-HIV Agents; CD4-CD8 Ratio; CD8-Positive T-Lymphocytes; Cohort Studies; Emtricitabine; Female; HIV Infections; Humans; Male; Middle Aged; Reverse Transcriptase Inhibitors; TenofovirAnti-HIV Agents030106 microbiologyCD4-CD8 RatioEmtricitabineSettore MED/17 - MALATTIE INFETTIVENO03 medical and health sciencesCD4/CD8 ratioInternal medicineLinear regressionmedicineHumansDual therapyTenofovirbusiness.industrylcsh:RAnti-HIV AgentCD8CD8-Positive T-LymphocyteMonotherapyConfidence intervalRegimenCD4/CD8 ratio; CD8; Chronic inflammation; Dual therapy; MonotherapyCD8; CD4/CD8 ratio; Chronic inflammation; Monotherapy; Dual therapyCohort StudiebusinessCD8
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Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

2019

OBJECTIVE:\ud We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.\ud \ud METHODS:\ud A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulativ…

Liver CirrhosisPediatricsTime FactorsSettore MED/09 - Medicina InternaNational Health ProgramsERADICATIONOUTBREAKantiviral treatment anti HCV economic consequencesHepacivirusLIVER FIBROSISSeverity of Illness IndexHealth Services AccessibilityCOST-EFFECTIVENESSIndirect costs0302 clinical medicineEpidemiologyvirus infection030212 general & internal medicinehealth care economics and organizationscost effectiveness030503 health policy & servicesHealth PolicyHealth services researchhealthHepatitis CHepatitis CMarkov Chainschronic hepatitis C virus infection fibrosis progression cost effectiveness liver fibrosisItalyPharmacology; Health Policy; Public Health Environmental and Occupational HealthCohortSettore SECS-P/03 - Scienza delle FinanzeDisease ProgressionPublic Health0305 other medical scienceViral hepatitisAnti-HCV antiviral treatmentCHRONIC HEPATITIS-Cmedicine.medical_specialtyGenotypeSettore MED/12 - GASTROENTEROLOGIAVIRUS-INFECTIONAntiviral AgentsNO03 medical and health sciencesCost SavingsAntiviral Agents; Cost Savings; Disease Progression; Genotype; Health Policy; Health Services Accessibility; Hepacivirus; Hepatitis C; Humans; Italy; Liver Cirrhosis; Markov Chains; National Health Programs; Severity of Illness Index; Time FactorsmedicineMANAGEMENTHumanschronic hepatitis CINDUCED DISEASESMETAANALYSISPharmacologyHealth economicsbusiness.industryPublic healthEnvironmental and Occupational HealthPublic Health Environmental and Occupational Healthmedicine.diseaseFIBROSIS PROGRESSIONbusiness
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