0000000001227778

AUTHOR

K. Falasca

showing 9 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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Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

2014

a b s t r a c t Background: Data on the efficacy of Peg-interferon/ribavirin therapy for chronic hepatitis C are mostly derived from treatment of selected patients enrolled in clinical trials. This study aimed to assess the effectiveness of Peg-interferon/ribavirin therapy in “real world” chronic hepatitis C patients in Italy. Methods: Independent observational multicentre study including consecutive patients receiving Peginterferon/ribavirin in the 18 months before (retrospective phase) and after (prospective phase) the start of the study. Results: 4176 patients were eligible. The final study population consisted of 2051 patients in the retrospective and 2073 in the prospective phase. Sust…

RegistrieMaleCirrhosismedicine.disease_causePolyethylene GlycolGastroenterologyPolyethylene Glycolschemistry.chemical_compoundHepatitis VirusesHepatitis ViruseProspective StudiesViralRegistriesChronicProspective cohort studyDrug CarrierDrug CarriersSettore MED/12 - GastroenterologiaMedicine (all)GastroenterologyRecombinant ProteinMiddle AgedHepatitis CRecombinant ProteinsTreatment OutcomeItalyCombinationRNA ViralPopulation studyDrug Therapy CombinationFemaleHumanmedicine.medical_specialtyGenotypeHepatitis C virusAlpha interferonRibavirin; Sustained virological response (SVR); TreatmentAntiviral AgentsFollow-Up StudieRibavirin; Sustained virological response (SVR); Treatment; Hepatology; GastroenterologyDrug TherapyInternal medicineRibavirinmedicineHumansAntiviral AgentHepatologybusiness.industryRibavirinInterferon-alphaHCV therapyHepatitis C ChronicHepatologymedicine.diseaseClinical trialTreatmentProspective StudiechemistryImmunologyRNARibavirin; Sustained virological response (SVR); Treatment; Antiviral Agents; Drug Carriers; Drug Therapy Combination; Female; Follow-Up Studies; Genotype; Hepatitis C Chronic; Hepatitis Viruses; Humans; Interferon-alpha; Italy; Male; Middle Aged; Polyethylene Glycols; Prospective Studies; RNA Viral; Recombinant Proteins; Ribavirin; Treatment Outcome; RegistriesbusinessRibavirin; Sustained virological response (SVR); Treatment; Antiviral Agents; Drug Carriers; Drug Therapy Combination; Female; Follow-Up Studies; Genotype; Hepatitis C Chronic; Hepatitis Viruses; Humans; Interferon-alpha; Italy; Male; Middle Aged; Polyethylene Glycols; Prospective Studies; RNA Viral; Recombinant Proteins; Ribavirin; Treatment Outcome; Registries; Gastroenterology; Hepatology; Medicine (all)Follow-Up StudiesSustained virological response (SVR)
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Virological response and retention in care according to time of starting ART in Italy: data from the Icona Foundation Study cohort

2020

Abstract Objectives To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year from ART initiation according to timing of start in a real-life setting. Methods All individuals in the Icona cohort diagnosed with HIV in 2016–17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, ≤7 days; Group 2, 8–14 days; Group 3, 15–30 days; Group 4, 31–120 days; and Group 5, >120 days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed…

0301 basic medicinediagnosishivcommunicable diseasesHIV InfectionsLogistic regressionVirological responseCohort Studies0302 clinical medicineRetention in CareMedicinePharmacology (medical)HIV Infection030212 general & internal medicineProspective cohort studycd4 count determination proceduredrugsuppressionViral LoadCD4 Lymphocyte Count; Cohort Studies; Humans; Italy; Viral Load; Anti-HIV Agents; HIV Infections; Retention in CarevirologyInfectious DiseasesItalyblood hiv rnaCohorthiv cd4 count determination procedure communicable diseases incomeitaly diagnosis virology blood hiv rna retention in careincomeitalyViral loadHIV ARTCohort studyHumanMicrobiology (medical)medicine.medical_specialtyAnti-HIV Agentsantiretroviral therapySettore MED/17 - MALATTIE INFETTIVENO03 medical and health sciencesHIV viral loadInternal medicineHumansHIV CD4 ARTPharmacologybusiness.industrydouble blindAnti-HIV AgentHIV viral load antiretroviral therapy double blind initiation suppression infectionRetention in care030112 virologyinfectioninitiationCD4 Lymphocyte CountObservational studyCohort Studiebusiness
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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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The impact of DAA-mediated HCV eradication on CD4+ and CD8+ T lymphocyte trajectories in HIV/HCV coinfected patients: Data from the ICONA Foundation …

2021

HCV infection has been hypothesized as a contributor of poor CD4+ recovery in patients living with HIV (PLWHIV). Aim of this study was to evaluate CD4+, CD8+ cells and CD4/CD8 ratio trends before and after HCV treatment with direct acting agents (DAA) in PLWHIV. HIV/HCV patients enrolled in ICONA and HepaICONA cohorts with HIV-RNA≤50 copies/ml who achieved a sustained viral response after DAA treatment were studied. A linear regression model was used to investigate CD4+, CD8+ and CD4/CD8 changes 12 months before and after DAA treatment. A total of 939 HIV/HCV patients were included, 225 (24.0%) female, median age: 53 years (IQR 50–56). At DAA initiation, CD4+ T cell count was <350 cells/…

CD4-Positive T-LymphocytesHIV InfectionsHepacivirusCD8-Positive T-LymphocytesGastroenterologySettore MED/07chemistry.chemical_compound0302 clinical medicineCd8 t lymphocyteHIV Infection030212 general & internal medicineCoinfectionCD4; CD8; DAA; HCV/HIV; immune activationHcv clearancevirus diseasesMiddle AgedHepatitis CInfectious Diseasesmedicine.anatomical_structureCD4-Positive T-LymphocyteCohort030211 gastroenterology & hepatologyFemaleCD4 CD8 DAA HCV/HIV immune activationHumanImmune activationmedicine.medical_specialtyHCV/HIVT cellAntiviral Agentsimmune activationNO03 medical and health sciencesVirologyInternal medicinemedicineHumansIn patientimmune activation.DAAAntiviral AgentHepaciviruHepatologybusiness.industryRibavirinCD8-Positive T-LymphocyteCD8CD4CD4 Lymphocyte CountchemistryCD4; CD8; DAA; HCV/HIV; immune activation; Antiviral Agents; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Female; Hepacivirus; Humans; Middle Aged; Coinfection; HIV Infections; Hepatitis CbusinessCD8
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Human Immunodeficiency Virus Continuum of Care in 11 European Union Countries at the End of 2016 Overall and by Key Population: Have We Made Progress?

2020

Abstract Background High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed …

Male0301 basic medicinePsychological interventionHuman immunodeficiency virus (HIV)MedizinContinuum of care; Europe; HIV infection; Key population; Sex; Anti-Retroviral Agents; Continuity of Patient Care; European Union; HIV; Humans; Male; HIV InfectionsHIV InfectionsContinuum of care; Europe; HIV infection; Key population; Sexmedicine.disease_causekey population0302 clinical medicineContinuum of careHIV Infection030212 general & internal medicineMen having sex with menContinuum of caremedia_commoneducation.field_of_study[SDV.MHEP] Life Sciences [q-bio]/Human health and pathologyTransmission (medicine)Continuity of Patient CareEuropeInfectious DiseasesAcademicSubjects/MED00290Anti-Retroviral AgentsHIV infection continuum of care sex key population EuropeSexMicrobiology (medical)PopulationSocio-culturale03 medical and health sciencesAcquired immunodeficiency syndrome (AIDS)SDG 3 - Good Health and Well-beingmedicinemedia_common.cataloged_instanceHumansEuropean UnionEuropean unioneducationPandemicsHIV infection ; continuum of care ; sex ; key population ; Europebusiness.industrySARS-CoV-2COVID-19HIVmedicine.diseaseHIV infectioncontinuum of care030112 virologyMajor Articles and CommentariesKey populationAnti-Retroviral Agentbusiness[SDV.MHEP]Life Sciences [q-bio]/Human health and pathologyDemography
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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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