0000000001227789

AUTHOR

P. Blanc

showing 7 related works from this author

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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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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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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