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Nerlander L, Champezou L, Gomes Dias J, Aspelund G, Berlot L, Constantinou E, Díaz A, Epštein J, Fogarassy E, Hernando V, Hoffmann P, Igoe D, Klavs I, Pinto Leite P, Liitsola K, McIntyre A, Molnár Z, Olsen AO, Pires-Afonso Y, Putniņa R, Rudaitis K, Siakallis G, de Stoppelaar S, Suligoi B, Hannila-Handelberg T, Velicko I, Cabral Veríssimo V, Visser M, Wessman M, Mårdh O. Sharp increase in gonorrhoea notifications among young people, EU/EEA, July 2022 to June 2023. Euro Surveill 2024; 29:2400113. [PMID: 38456219 PMCID: PMC10986672 DOI: 10.2807/1560-7917.es.2024.29.10.2400113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/06/2024] [Indexed: 03/09/2024] Open
Abstract
Gonorrhoea cases increased steeply in women aged 20 to 24 years across 15 EU/EEA countries in July to December 2022 and January to June 2023 with, respectively, 73% and 89% more cases reported than expected, based on historical data from 2015 to 2019. Smaller increases among men due to heterosexual transmission were observed in nine EU/EEA countries. Interventions to raise awareness among young people about sexually transmitted infection risks are needed, emphasising the benefit of safe sexual practices and testing.
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Affiliation(s)
- Lina Nerlander
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Lydia Champezou
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Gudrun Aspelund
- Centre for Health Security and Communicable Disease Control, Directorate of Health, Reykjavik, Iceland
| | - Lina Berlot
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | | | - Asunción Díaz
- National Centre of Epidemiology, CIBER in Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Jevgenia Epštein
- Department of Communicable Diseases Epidemiology Health Board, Tallinn, Estonia
| | - Erika Fogarassy
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Victoria Hernando
- National Centre of Epidemiology, CIBER in Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Patrick Hoffmann
- Health Directorate Luxembourg, Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Derval Igoe
- HSE Public Health: National Health Protection Office, Dublin, Ireland
| | - Irena Klavs
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Pedro Pinto Leite
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Kirsi Liitsola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Angeline McIntyre
- HSE Public Health: National Health Protection Office, Dublin, Ireland
| | - Zsuzsanna Molnár
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Anne Olaug Olsen
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| | - Yolanda Pires-Afonso
- Health Directorate Luxembourg, Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Renāte Putniņa
- The Centre for Disease Prevention and Control, Riga, Latvia
| | | | | | | | - Barbara Suligoi
- National AIDS Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Inga Velicko
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Vítor Cabral Veríssimo
- Public Health Unit Cascais, Western Lisbon Local Health Unit, Lisbon, Portugal
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Maartje Visser
- Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, the Netherlands
| | - Maria Wessman
- Department of Infectious Disease Epidemiology and Prevention Statens Serum Institut, Copenhagen, Denmark
| | - Otilia Mårdh
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Thomadakis C, Gountas I, Duffell E, Gountas K, Bluemel B, Seyler T, Pericoli FM, Kászoni-Rückerl I, El-Khatib Z, Busch M, Schmutterer I, Vanwolleghem T, Klamer S, Plettinckx E, Mortgat L, Van Beckhoven D, Varleva T, Kosanovic Licina ML, Nemeth Blazic T, Nonković D, Theophanous F, Nemecek V, Maly M, Christensen PB, Cowan S, Rüütel K, Brummer-Korvenkontio H, Brouard C, Steffen G, Krings A, Dudareva S, Zimmermann R, Nikolopoulou G, Molnár Z, Kozma E, Gottfredsson M, Murphy N, Kondili LA, Tosti ME, Ciccaglione AR, Suligoi B, Nikiforova R, Putnina R, Jancoriene L, Seguin-Devaux C, Melillo T, Boyd A, van der Valk M, Op de Coul E, Whittaker R, Kløvstad H, Stępień M, Rosińska M, Valente C, Marinho RT, Popovici O, Avdičová M, Kerlik J, Klavs I, Maticic M, Diaz A, del Amo J, Lundberg Ederth J, Axelsson M, Nikolopoulos G. Prevalence of chronic HCV infection in EU/EEA countries in 2019 using multiparameter evidence synthesis. Lancet Reg Health Eur 2024; 36:100792. [PMID: 38188273 PMCID: PMC10769889 DOI: 10.1016/j.lanepe.2023.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/09/2024]
Abstract
Background Epidemiological data are crucial to monitoring progress towards the 2030 Hepatitis C Virus (HCV) elimination targets. Our aim was to estimate the prevalence of chronic HCV infection (cHCV) in the European Union (EU)/European Economic Area (EEA) countries in 2019. Methods Multi-parameter evidence synthesis (MPES) was used to produce national estimates of cHCV defined as: π = πrecρrec + πexρex + πnonρnon; πrec, πex, and πnon represent cHCV prevalence among recent people who inject drugs (PWID), ex-PWID, and non-PWID, respectively, while ρrec, ρex, and ρnon represent the proportions of these groups in the population. Information sources included the European Centre for Disease Prevention and Control (ECDC) national operational contact points (NCPs) and prevalence database, the European Monitoring Centre for Drugs and Drug Addiction databases, and the published literature. Findings The cHCV prevalence in 29 of 30 EU/EEA countries in 2019 was 0.50% [95% Credible Interval (CrI): 0.46%, 0.55%]. The highest cHCV prevalence was observed in the eastern EU/EEA (0.88%; 95% CrI: 0.81%, 0.94%). At least 35.76% (95% CrI: 33.07%, 38.60%) of the overall cHCV prevalence in EU/EEA countries was associated with injecting drugs. Interpretation Using MPES and collaborating with ECDC NCPs, we estimated the prevalence of cHCV in the EU/EEA to be low. Some areas experience higher cHCV prevalence while a third of prevalent cHCV infections was attributed to PWID. Further efforts are needed to scale up prevention measures and the diagnosis and treatment of infected individuals, especially in the east of the EU/EEA and among PWID. Funding ECDC.
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Affiliation(s)
| | - Ilias Gountas
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Benjamin Bluemel
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Thomas Seyler
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | | | - Irene Kászoni-Rückerl
- VII/A/11 Communicable Diseases and Disease Control, Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria
| | - Ziad El-Khatib
- Institute for Surveillance & Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Martin Busch
- Addiction Competence Center, Austrian National Public Health Institute, Vienna, Austria
| | - Irene Schmutterer
- Addiction Competence Center, Austrian National Public Health Institute, Vienna, Austria
| | - Thomas Vanwolleghem
- Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - Sofieke Klamer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Els Plettinckx
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laure Mortgat
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Tonka Varleva
- Scientific Research Institute, Medical University, Pleven, Bulgaria
| | | | - Tatjana Nemeth Blazic
- Department for HIV, Sexual and Blood Transmitted Diseases, Reference Center of the Epidemiology of the Ministry of Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Diana Nonković
- Teaching Institute of Public Health Split and Dalmatia County, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | | | - Vratislav Nemecek
- National Reference Laboratory for Viral Hepatitis, National Institute of Public Health, Prague, Czech Republic
| | - Marek Maly
- Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic
| | - Peer Brehm Christensen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Susan Cowan
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Kristi Rüütel
- National Institute of Health Development, Tallinn, Estonia
| | | | - Cécile Brouard
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Gyde Steffen
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Amrei Krings
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sandra Dudareva
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Ruth Zimmermann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Zsuzsanna Molnár
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Emese Kozma
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Magnús Gottfredsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- Landspitali University Hospital, Reykjavík, Iceland
| | - Niamh Murphy
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Loreta A. Kondili
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
- UniCamillus-Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Anna Rita Ciccaglione
- Viral Hepatitis, Oncovirus and Retrovirus Disease Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- National AIDS Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Renate Putnina
- The Centre for Disease Prevention and Control, Riga, Latvia
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Carole Seguin-Devaux
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Department of Health Regulation, Ministry for Health, Gwardamangia, Malta
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- stichting hiv monitoring, Amsterdam, the Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Marc van der Valk
- stichting hiv monitoring, Amsterdam, the Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Robert Whittaker
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Hilde Kløvstad
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Małgorzata Stępień
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Magdalena Rosińska
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Cristina Valente
- Department of Infectious Diseases, Hospitais da Universidade de Coimbra, Directorate General of Health, Coimbra, Portugal
| | - Rui Tato Marinho
- Centro Hospitalar Universitário Lisboa Norte, Medical School of Lisbon, Directorate General of Health, Ministry of Health, Lisbon, Portugal
| | - Odette Popovici
- National Centre for Surveillance and Control of Communicable Diseases, National Institute of Public Health Romania, Bucharest, Romania
| | - Mária Avdičová
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | - Jana Kerlik
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mojca Maticic
- Clinic for Infectious Diseases, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Asuncion Diaz
- National Centre of Epidemiology, Carlos III Health Institute, CIBER in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Julia del Amo
- Division for HIV, STI, Viral Hepatitis and Tuberculosis Control, Ministry of Health, Madrid, Spain
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Dorrucci M, Regine V, Pugliese L, Suligoi B. Impact of COVID-19 epidemic on temporal pattern of new HIV diagnoses in Italy, 2021 database. Eur J Public Health 2023; 33:1171-1176. [PMID: 37651709 PMCID: PMC10710354 DOI: 10.1093/eurpub/ckad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND New HIV diagnoses in Italy decreased drastically in 2020 due to COVID-19 related effects: 50% fewer diagnoses were reported by the National HIV Surveillance System. COVID-19 pandemic impact on HIV surveillance is unclear. We estimated the expected number of new HIV diagnoses in 2020 in order to isolate the impact of the COVID-19 pandemic. METHODS We analyzed 29 697 new HIV infections diagnosed from 2012 to 2020, reported to the National HIV Surveillance System. We assessed temporal trends of new HIV diagnoses applying negative binomial mixed effects models. We estimated the COVID-19 impact as the difference between the model-estimated slopes from 2012 to 2019 and the change reported in the diagnoses. The expected number of new HIV diagnoses in 2020 was also estimated and compared with the reported count. RESULTS Based on the historical trend, we expected a 15% (95% CI: 5-25%) decline of new HIV diagnoses in 2020. We reported, however, a 49% decrease, yielding to a 34% net decrease in the number of new diagnoses. The strongest impact was estimated in northern regions (-40%) and MSM (-38%). We estimated 761 (95% prediction interval: 350-1277) missed diagnoses during 2020, the majority of them occurring in the North (465 cases), among MSM (416) and heterosexual males (217). CONCLUSIONS In 2020, when excluding 15% decrease of new diagnoses attributable to the expected reduction, an additional 34% decrease was observed, representing a large decline in new HIV diagnoses associated with the COVID-19 pandemic.
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Affiliation(s)
- Maria Dorrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenza Regine
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Pugliese
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Regine V, Pugliese L, Simonetti A, Marchionni F, Briola G, Saturni V, Suligoi B. Knowledge and behaviours associated with HIV infection and other sexually transmitted infections in blood donors in Italy. Ann Ist Super Sanita 2023; 59:180-186. [PMID: 37712234 DOI: 10.4415/ann_23_03_02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Sexually transmitted infections (STIs) represent a group of widespread infectious diseases. The objective of this study is to investigate the knowledge on HIV and STIs as well as sexual risk behaviours among blood donors in Italy. MATERIALS AND METHODS The study was carried out in 2017 among blood donors who accessed social media of the Italian Association of Blood Donors (Associazione Volontari Italiani del Sangue, AVIS), and answered to a questionnaire posted online. RESULTS Participating blood donors were 9,021, median age 36 years (IQR 26-47), 53.9% males, 94.3% heterosexual, and 2.7% reported having a current occasional partner. Unprotected sex in the last 4 months was reported by 54.1% of participants. About half of the participants were not informed of most STIs, 11.0% reported never having searched for information on HIV and STIs, one third considered unlikely acquiring HIV through unprotected sex with a known person, 21.3% would stop having sex with a partner found to be HIV-positive, and 15.8% would be afraid to hug or kiss a person with HIV. DISCUSSION Our results show that most blood donors have a stable partner and search actively for information on HIV and STIs. However, there is a proportion of them who engage in high-risk behaviours, have misconceptions on HIV and STIs transmission, reporting a stigmatising attitude towards people with HIV. CONCLUSION A more comprehensive and updated information on various STIs, transmission modes and safe sex should be provided to blood donors, not only to prevent the spread of these infections but also to avoid unjustified discrimination.
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Affiliation(s)
- Vincenza Regine
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Pugliese
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Simonetti
- Associazione Volontari Italiani del Sangue (AVIS), Milan, Italy
| | | | | | | | - Barbara Suligoi
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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Taborelli M, Suligoi B, Serraino D, Frova L, Grande E, Toffolutti F, Regine V, Pappagallo M, Pugliese L, Grippo F, Zucchetto A. Increased kidney disease mortality among people with AIDS versus the general population: a population-based cohort study in Italy, 2006-2018. BMJ Open 2022; 12:e064970. [PMID: 36456002 PMCID: PMC9716863 DOI: 10.1136/bmjopen-2022-064970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES This study aimed to assess whether an excess mortality related to kidney and other urinary tract diseases exists among Italian people with AIDS (PWA), as compared with the general population without AIDS (non-PWA). DESIGN Population-based, retrospective cohort study. SETTING AND PARTICIPANTS We conducted a nationwide study including 9481 Italian PWA, aged 15-74 years, reported to the National AIDS Registry between 2006 and 2018. METHODS Vital status and causes of death were retrieved by record linkage with the National Register of Causes of Death up to 2018. Excess mortality for PWA versus non-PWA was estimated through sex-standardised and age-standardised mortality ratios (SMRs) with corresponding 95% CIs. RESULTS Among 2613 deceased PWA, 262 (10.0%) reported at least one urinary tract disease at death, including 254 (9.7%) non-cancer diseases-mostly renal failures (225 cases, 8.6%)-and 9 cancers (0.3%). The overall SMR for non-cancer urinary tract diseases was 15.3 (95% CI 13.4 to 17.3) with statistically significant SMRs for acute (SMR=22.3, 95% CI 18.0 to 27.4), chronic (SMR=8.4, 95% CI 6.0 to 11.3), and unspecified renal failure (SMR=13.8, 95% CI 11.2 to 16.8). No statistically significant excess mortality was detected for urinary tract cancers (SMR=1.7, 95% CI 0.8 to 3.3). The SMRs were particularly elevated among PWA aged <50 years, injecting drug users, or those with the first HIV-positive test >6 months before AIDS diagnosis. CONCLUSIONS The excess mortality related to non-cancer kidney and other urinary tract diseases reported among PWA highlights the importance of implementing the recommendation for screening, diagnosis and management of such conditions among this population.
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Affiliation(s)
- Martina Taborelli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Roma, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Luisa Frova
- Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy
| | - Enrico Grande
- Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Vincenza Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, Roma, Italy
| | - Marilena Pappagallo
- Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy
| | - Lucia Pugliese
- Centro Operativo AIDS, Istituto Superiore di Sanità, Roma, Italy
| | - Francesco Grippo
- Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy
| | - Antonella Zucchetto
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Chinelli A, Torri E, Martinelli D, Farinella M, Rancilio L, Galipò R, Meli P, Ubbiali M, Suligoi B, Tavoschi L. Development and early results of a comprehensive sexuality education experience in Italian schools. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Comprehensive sexuality education (CSE) is an integrated approach to sexual health and wellbeing promotion, especially effective when performed in school settings, but it is not included in Italian school curricula. This study describes the creation and early results of a pilot experience targeting students attending 20 lower secondary schools (LSS) in 4 Italian regions within EduForIST project, funded by the Ministry of Health.
Methods
A literature review and a national survey were used to collect guidelines and best practices in the field of sexuality education (SE), along with focus groups and multisectorial expert consultations. The results informed the development of 4 modules of 2 hours each, addressing: changes in adolescence; emotions and relationships; sexual identities and diversity; sexual consent, pregnancy and sexually transmitted infection (STI) prevention, sexual health services. A final session was dedicated to evaluation.
Results
The pre-test results referred to 14 classrooms of 5 schools within 2 Regions, for a total of 266 students. A high level of uncertainty was reported, regarding the topics of personal identity development (37,4%), experiencing intense emotions during adolescence (18,1%), the definitions of gender identity, sexual orientation and stereotype (42,1%), STI symptoms (58,7%) and prevention (43,4%). The post-test results were available for 153 students. Pre/post analysis showed an increase of correct answers (p<.05) for 12/15 items investigated. A total of 102 students responded to the satisfaction questionnaire, with positive results.
Conclusions
Preliminary results revealed knowledge gaps and high levels of uncertainty among LSS students. Early pre/post evaluation suggested that the pilot activity was effective in enhancing knowledge and decreasing uncertainty in all domains. Evidence collected through this study will foster awareness among policy makers on the value and urgency of introducing CSE in Italian school curricula.
Key messages
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Affiliation(s)
- A Chinelli
- Translational Research, University of Pisa , Pisa, Italy
| | - E Torri
- Translational Research, University of Pisa , Pisa, Italy
| | - D Martinelli
- Medical and Surgical Sciences, University of Foggia , Foggia, Italy
| | | | | | | | | | - M Ubbiali
- Human Sciences, University of Verona , Verona, Italy
| | - B Suligoi
- Infectious Diseases, Italian National Institute of Health , Rome, Italy
| | - L Tavoschi
- Translational Research, University of Pisa , Pisa, Italy
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7
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Martinelli D, Galipò R, Meli P, Farinella M, Chinelli A, Palamara AT, Suligoi B, Oldrini M, Colaprico L, Tavoschi L. Implementing a school-based comprehensive sexual health education intervention in Italy: experiences from the field. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
This study describes the preliminary results of a School-based sexuality education (SBSE) pilot activity developed and implemented within EduForIST project, funded by the Italian Ministry of Health.
Methods
The pilot activity (5 modules of 2 hours each delivered per classroom) targeted lower secondary schools students. A total of 20 schools located in 4 different Italian regions participated. The educators were staff of several HIV/AIDS civil society organisations operating in Italy. A 2-days intensive workshop for educators was performed. Pre and post tests were conducted.
Results
At the time of submission, pre-test results were available from 14 classrooms of 5 schools within 2 Italian Regions, for a total of 266 students. Among these, 37,4% were unsure that personal identity is built through social comparison; 21,8% reported that emotions don't get more intense during adolescence, while 18,1% were unsure about the response; 42,1% reported a higher level of uncertainty concerning the definitions of gender identity, sexual orientation and stereotype. The highest level of uncertainty were reported for STIs symptoms (58,7%), impact of treatment on HIV+ people (61,9%) and efficacy of contraceptive pills in preventing STIs (43,4%). The post-test results were available for 153 students. Pre/post analysis showed an increase of correct answers (p < 0.05) for 12 of 15 items investigated. A total of 102 students responded to the satisfaction questionnaire, with preliminary positive results.
Conclusions
Since activities are ongoing, further data will be soon available for more exhaustive analyses. Early pre/post evaluations suggested that the pilot experience was effective in enhancing knowledge and decreasing uncertainty in the different domains addressed in the pilot. Evidence collected through this study shall raise awareness among decision makers on the urgency of introducing CSE in Italian school curricula and inform future policy options.
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Affiliation(s)
| | - R Galipò
- Associazione Nazionale per la Lotta control' , Rome, Italy
| | - P Meli
- Coordinamento Italiano Case Alloggio/AIDS , Bergamo, Italy
| | - M Farinella
- Circolo di Cultura Omosessuale Mario Mieli , Rome, Italy
| | | | - AT Palamara
- Università La Sapienza , Rome, Italy
- National Institute of Health , Rome, Italy
| | - B Suligoi
- National Institute of Health , Rome, Italy
| | - M Oldrini
- Lega Italiana Lotta all'AIDS , Rome, Italy
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Romaní Vidal A, Vaughan A, Innocenti F, Colombe S, Nerlander L, Rachwal N, Ciancio BC, Mougkou A, Carvalho C, Delgado E, Mook P, de Muylder G, Peeters M, Tenev T, Golkocheva-Markova E, Vorobieva Solholm Jensen V, Koch A, Figoni J, Brouard C, Nikolopoulou G, Zisouli A, Murphy N, Broderick A, Goldberg L, Rich R, Hecht Sagie L, Tosti ME, Suligoi B, Joosten R, Pijnacker R, Fjeldheim I, Heen E, Stępień M, Polański P, Tato Marinho R, Vieira Martins J, Varela C, Avellón A, Andersson E, Jansson Mörk M, Mandal S, Watson C, Coughlan L, Chand M, Neill C, Bradley DT, Li K, O'Leary M, McInnes N, Williams CJ, Moore C, Gjini A, Duffell E, Pebody R. Hepatitis of unknown aetiology in children - epidemiological overview of cases reported in Europe, 1 January to 16 June 2022. Euro Surveill 2022; 27. [PMID: 35929429 PMCID: PMC9358403 DOI: 10.2807/1560-7917.es.2022.27.31.2200483] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18–3.74) and transplanted (OR = 3.36; 95% CI: 1.19–9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.
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Affiliation(s)
| | - Aisling Vaughan
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Soledad Colombe
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Natalia Rachwal
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Aikaterini Mougkou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Carlos Carvalho
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Enrique Delgado
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Piers Mook
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Michael Peeters
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre for Hepatitis Viruses, Brussels, Belgium
| | - Tencho Tenev
- National Reference Laboratory Hepatitis viruses, NCIPD-Virology, Sofia, Bulgaria
| | | | | | - Anders Koch
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Julie Figoni
- Santé Publique France, the National Public Health Agency, Saint-Maurice, France
| | - Cécile Brouard
- Santé Publique France, the National Public Health Agency, Saint-Maurice, France
| | | | | | - Niamh Murphy
- Health Service Executive HPSC surveillance scientist on the National IMT for hepatitis, Dublin, Ireland
| | | | | | - Rivka Rich
- Israel Ministry of Health, Jerusalem, Israel
| | | | - Maria Elena Tosti
- National Centre for Global Health - Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- Infectious Disease Department - Istituto Superiore di Sanità, Rome, Italy
| | - Rosa Joosten
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Roan Pijnacker
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Ingvild Fjeldheim
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Eli Heen
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Małgorzata Stępień
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Piotr Polański
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Rui Tato Marinho
- Gastroenterology and Hepatology Department, Hospital S. Maria; Medical School of Lisbon; National Programme for Viral Hepatitis, Portugal Ministry of Health, Lisbon, Portugal
| | - João Vieira Martins
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Carmen Varela
- National Centre of Epidemiology, Carlos III Institute of Health, CIBERESP, Madrid, Spain
| | - Ana Avellón
- National Centre of Microbiology, Carlos III Institute of Health, CIBERESP, Madrid, Spain
| | | | | | - Sema Mandal
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Conall Watson
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Laura Coughlan
- United Kingdom Health Security Agency Epidemiology Cell, London, United Kingdom
| | - Meera Chand
- United Kingdom Health Security Agency Incident Director, London, United Kingdom
| | - Claire Neill
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | | | - Kathy Li
- Regional Virology Laboratory Belfast Health and Social Care Trust, Northern Ireland, Belfast, United Kingdom
| | - Maureen O'Leary
- Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, United Kingdom
| | - Neil McInnes
- West of Scotland Specialist Virology Centre, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | | | | | | | - Erika Duffell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Richard Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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9
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Grippo F, Grande E, Zucchetto A, Frova L, Pappagallo M, Pugliese L, Regine V, Serraino D, Taborelli M, Suligoi B. Mortality of people with AIDS in Italy: comparison of AIDS surveillance and multiple cause-of-death registries. Ann Ist Super Sanita 2022; 58:139-145. [PMID: 35722801 DOI: 10.4415/ann_22_02_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIMS To assess whether the use of multiple cause-of-death data could improve reporting of AIDS mortality in Italy. METHOD Population-based, record-linkage study, on 3,975,431 deaths recorded in the National Registry of Causes of Death (RCoD) and 4,530 deaths recorded in the National AIDS Registry (RAIDS), during 2006-2012. RESULTS The record-linkage identified 3,646 AIDS-related deaths present in both registries, 884 deaths in the RAIDS without mention of HIV/AIDS in the RCoD, and 3,796 deaths in the RCoD with mention of HIV/AIDS that were not present in the RAIDS. In the latter, in-depth analysis of multiple cause-of-death allowed the identification of 1,484 deaths that were AIDS-related. On these results, we estimated 6,014 deceased people with AIDS. Of them, 14.7% (884) were not present in the RCoD and 24.7% (1,484) derived from the RCoD only. CONCLUSIONS The integration of different nationwide registries allowed a more comprehensive estimate of the impact of AIDS-associated mortality in Italy.
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Affiliation(s)
- Francesco Grippo
- Servizio Sistema integrato salute, assistenza e previdenza, Istituto Nazionale di Statistica, Rome, Italy
| | - Enrico Grande
- Servizio Sistema integrato salute, assistenza e previdenza, Istituto Nazionale di Statistica, Rome, Italy
| | | | - Luisa Frova
- Servizio Sistema integrato salute, assistenza e previdenza, Istituto Nazionale di Statistica, Rome, Italy
| | - Marilena Pappagallo
- Servizio Sistema integrato salute, assistenza e previdenza, Istituto Nazionale di Statistica, Rome, Italy
| | - Lucia Pugliese
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenza Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
| | - Diego Serraino
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Martina Taborelli
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
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10
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Chinelli A, Salfa MC, Cellini A, Rancilio L, Farinella M, Galipò R, Ceccarelli L, Caraglia A, Suligoi B, Tavoschi L. School-based sexuality education in Italy 2016-2020: a highly heterogeneous scenario. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In Italy, sexuality education (SE) is not part of school curricula. SE and, specifically, comprehensive SE (CSE), as defined by UNESCO, is one of the most important means of promoting sexual well-being among young people and a key component for sexually transmitted infections' (STI) prevention. School-based SE has the potential to reach most young people, is cost-effective and valued by students. The aim of this study was to describe school-based SE educational activities (EA) implemented in Italy during 2016-2020.
Methods
An online survey was developed and piloted to collect information on duration, content and methods used to implement the EA. The survey was disseminated at national and regional level between August-October 2020. IBM SPSS Statistics 26 was used to perform descriptive analysis of the data, while a framework from UNESCO was adapted to perform a qualitative analysis.
Results
A total of 219 reported EA were carried out in secondary schools. The analysis describes a highly heterogeneous scenario in terms of EA geographical coverage across the country (most EA delivered in 4/20 regions), providers (70% private, 30% public) and objectives. The qualitative analysis of content, objectives, and methodology identified 62 EA (29%) classifiable as CSE, with median duration of 3 days. The remainder EA had a risk-based approach, largely focussing on STI prevention (35%). Many EA (29%) were single-session interventions. Limited time availability for extra-curricular activities was reported as a key challenge. Only 97 EA performed evaluation (44%). In 53 EA (24%) both pre and post knowledge assessment were delivered and in 114 (52%) satisfaction was evaluated.
Conclusions
Italy is one of a few European countries still lacking a dedicated policy for school-based SE. According to available data, SE is not systematically and equally delivered across the country. Action is urgently needed to incorporate SE in school curricula. (Funding: Italian Ministry of Health)
Key messages
This study shows the absence of a comprehensive and shared approach to SE in Italy, with heterogeneous geographical coverage and providers and a lack of systematic objectives and evaluation. The results highlight the need to develop theoretical and practical guidelines for the implementation of CSE in Italy and the integration of sexuality education in school curricula.
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Affiliation(s)
- A Chinelli
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - MC Salfa
- Italian National Institute of Health, Rome, Italy
| | - A Cellini
- Sapienza University of Rome, Rome, Italy
| | | | | | | | - L Ceccarelli
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - A Caraglia
- Department of Prevention, Ministry of Health, Rome, Italy
| | - B Suligoi
- Italian National Institute of Health, Rome, Italy
| | - L Tavoschi
- Department of Translational Research, University of Pisa, Pisa, Italy
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11
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Suligoi B, Luzi AM, Salfa MC, Esposito G. [The professional skills of the nurse involved in the care of individuals with sexually transmitted infections]. Prof Inferm 2021; 74:241-247. [PMID: 35363960 DOI: 10.7429/pi.2021.744241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Accurate pain assessment and management in critically ill patients withcognitive alterations who are unable to communicate constitute a major challenge for themedical and nursing staff of Intensive Care Units (ICUs). This study want assess the impact of Critical Care Pain Observation Tool (CCPOT) scale in ICU practice and evaluate the effects on pain assessment and management in brain-injured critically ill adult patients. METHODS This before-and-after study was carried out in an Italian ICU, where data were collected before (T0) and after (T1) implementation of the CCPOT in brain-injured critically ill adults. RESULTS The study population consisted of 81 patients (35 before and 46 after intervention). The use of propofol fell significantly (propofol: t(80) = 1.83) and at the same time the use of morphine increase significantly (morphine: t(80) = 1.51) after intervention.Analysis of the data with respect to pain relief and prevention during some nursing care activities revealed a significant increase in the use of fentanyl citrate (x2(1)= 4.04, p =.04) and paracetamol (x2(1)= 5.30, p =.02). Pain management was in line with the protocol, which envisaged administration of pain medications to patients with CCPOT scores > 3 in 76.8% of cases. CONCLUSION The present findings strongly support the value of the CCPOT scale in managing ICU patient pain in conjunction with medical and nursing staff training. However, further studies of larger patient samples should be performed.
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Affiliation(s)
- Barbara Suligoi
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Istituto Superiore di Sanita', Roma. Corresponding Author
| | - Anna Maria Luzi
- Gia' Dipartimento Malattie Infettive, Istituto Superiore di Sanita', Roma; Professore a contratto M-PSI/05, Universita' degli Studi di Roma Tor Vergata, Roma
| | - Maria Cristina Salfa
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Istituto Superiore di Sanita', Roma.
| | - Giuseppe Esposito
- Professore a contratto MED/45, Universita' degli Studi di Roma Tor Vergata, Roma
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12
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Yin Z, Brown AE, Rice BD, Marrone G, Sönnerborg A, Suligoi B, Sasse A, Van Beckhoven D, Noori T, Regine V, Delpech VC. Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016. ACTA ACUST UNITED AC 2021; 26. [PMID: 34414881 PMCID: PMC8380976 DOI: 10.2807/1560-7917.es.2021.26.33.2000161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundThe assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common.AimWe assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data.MethodsUsing CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition.ResultsBetween 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34-59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87-95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21-37) among those 1-5 years prior. Younger age at arrival was a predictor: 15-18 years (81%; IQR: 74-86), 19-25 years (53%; IQR: 45-63), 26-35 years (37%; IQR: 30-46) and 36 years and older (25%; IQR: 21-33).ConclusionsMigrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities.
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Affiliation(s)
- Zheng Yin
- HIV and STI Department, CIDSC, Public Health England, Colindale, London, United Kingdom
| | - Alison E Brown
- HIV and STI Department, CIDSC, Public Health England, Colindale, London, United Kingdom
| | - Brian D Rice
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gaetano Marrone
- Department of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Sönnerborg
- Department of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Barbara Suligoi
- National AIDS Unit, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Andre Sasse
- Scientific Institute of Public Health, Brussels, Belgium
| | | | - Teymur Noori
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Vincenza Regine
- National AIDS Unit, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Valerie C Delpech
- HIV and STI Department, CIDSC, Public Health England, Colindale, London, United Kingdom
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13
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Vourli G, Noori T, Pharris A, Porter K, Axelsson M, Begovac J, Cazein F, Costagliola D, Cowan S, Croxford S, d'Arminio Monforte A, Delpech V, Díaz A, Girardi E, Gunsenheimer-Bartmeyer B, Hernando V, Leierer G, Lot F, Nunez O, Obel N, Op de Coul E, Paraskeva D, Patrinos S, Reiss P, Schmid D, Sonnerborg A, Suligoi B, Supervie V, van Sighem A, Zangerle R, Touloumi G. 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? Clin Infect Dis 2021; 71:2905-2916. [PMID: 32960957 PMCID: PMC7778352 DOI: 10.1093/cid/ciaa696] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
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 who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.
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Affiliation(s)
- Georgia Vourli
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | | | | | - Josip Begovac
- Department of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Francoise Cazein
- Santé publique France, the French national public health agency, Saint-Maurice, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | | | | | | | | | - Asunción Díaz
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrico Girardi
- Istituto Nazionale Malattie Infettive 'L. Spallanzani, Roma, Italy
| | | | - Victoria Hernando
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Florence Lot
- Santé publique France, the French national public health agency, Saint-Maurice, France
| | - Olivier Nunez
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Niels Obel
- Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Eline Op de Coul
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Dimitra Paraskeva
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Stavros Patrinos
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, The Netherlands.,Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Anders Sonnerborg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Barbara Suligoi
- National AIDS Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | | | | | - Giota Touloumi
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
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14
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Dorrucci M, Regine V, Pezzotti P, Mammone A, Girardi E, Suligoi B. Demographic and socio-economic determinants of poor HIV-risk perception at first HIV diagnosis: analysis of the HIV Surveillance data, Italy 2010-2016. Ann Ist Super Sanita 2020; 56:267-276. [PMID: 32959792 DOI: 10.4415/ann_20_03_04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION HIV infections in Italy has not undergone a substantial decline over recent years. For this reason, we analysed risk-factors and socio-economic indicators of HIV-risk perception in HIV surveillance data. METHODS An observational study was conducted and HIV-risk perception was estimated on the basis of reasons for undergoing testing. Ordinal logistic models were applied with three groups of response corresponding to three ordered levels of HIV-risk perception. RESULTS The study included 18 055 individuals: 27% with low, 40% moderate and 33% with high perception. A low risk perception was estimated in both areas, least deprived and highly deprived [Adjusted Odds Ratio (AOR) = 1.58, CI: 1.14-2.18 and AOR = 2.33, CI: 1.39-3.90]; for heterosexuals (AOR = 1.96, CI: 1.83-2.11), Injecting Drug Users (IDU) (AOR =1.82, CI: 1.59-2.08), low education (AOR = 1.74. CI: 1.20-2.54), age > 40 years (AOR = 1.59, CI: 1.50-1.69), males (AOR = 1.30, CI: 1.20-1.40). CONCLUSIONS In Italy there is a high percentage of HIV-infected people with poor HIV-risk perception. Poorer HIV-risk perception was associated with both, least and high deprivation, low education, older age, male gender, heterosexual and IDU groups. Our results could be relevant to address targeted HIV testing policies at both local and national levels.
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Affiliation(s)
- Maria Dorrucci
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenza Regine
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Alessia Mammone
- Istituto Nazionale Malattie Infettive "L. Spallanzani", Rome, Italy
| | - Enrico Girardi
- Istituto Nazionale Malattie Infettive "L. Spallanzani", Rome, Italy
| | - Barbara Suligoi
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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15
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Taborelli M, Suligoi B, Toffolutti F, Frova L, Grande E, Grippo F, Pappagallo M, Pugliese L, Regine V, Serraino D, Zucchetto A. Excess liver-related mortality among people with AIDS compared to the general population: an Italian nationwide cohort study using multiple causes of death. HIV Med 2020; 21:642-649. [PMID: 32876382 DOI: 10.1111/hiv.12937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Liver diseases have become a leading cause of death among people with AIDS (PWA). This study aimed to investigate whether PWA experienced excess mortality related to liver diseases as compared to the general population (non-PWA), using a multiple cause of death (MCoD; i.e. all conditions reported on death certificates) approach. METHODS A population-based, nationwide, retrospective cohort study was conducted among Italian people, aged 15-74 years, who had been diagnosed with AIDS since 2006. Date of death and MCoD data were retrieved, up to December 2015, by individual record linkage with national mortality data. Sex- and age-standardized mortality ratios (SMRs), with 95% confidence intervals (CIs), were estimated by dividing the observed number of deaths related to a specific condition among PWA to the expected number, based on non-PWA mortality rates. RESULTS Among 7912 PWA (34 184 person-years), 2076 deaths occurred. The number of death certificates reporting liver diseases among MCoDs was 583 (28.1%), including 382 (18.4%) reporting viral hepatitis, 370 (17.8%) reporting nonviral liver diseases, and 41 (2.0%) reporting liver cancers. The corresponding SMRs were 40.4 (95% CI 37.2-43.8) for all liver diseases, 131.1 (95% CI 118.3-145.0) for viral hepatitis, 29.9 (95% CI 27.0-33.1) for nonviral liver diseases, and 11.2 (95% CI 8.1-15.3) for liver cancers. Particularly elevated SMRs emerged among PWA aged 15-49 years and those infected by injecting drug use. CONCLUSIONS The high excess liver-related mortality observed among PWA warrants preventive actions to limit the burden of viral hepatitis coinfections, alcohol abuse, and metabolic disorders, especially among younger PWA and injecting drug users.
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Affiliation(s)
- M Taborelli
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - B Suligoi
- National AIDS Unit, National Health Institute, Rome, Italy
| | - F Toffolutti
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - L Frova
- Integrated System for Health, Social Assistance, Welfare and Justice, National Institute of Statistics, Rome, Italy
| | - E Grande
- Integrated System for Health, Social Assistance, Welfare and Justice, National Institute of Statistics, Rome, Italy
| | - F Grippo
- Integrated System for Health, Social Assistance, Welfare and Justice, National Institute of Statistics, Rome, Italy
| | - M Pappagallo
- Integrated System for Health, Social Assistance, Welfare and Justice, National Institute of Statistics, Rome, Italy
| | - L Pugliese
- National AIDS Unit, National Health Institute, Rome, Italy
| | - V Regine
- National AIDS Unit, National Health Institute, Rome, Italy
| | - D Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - A Zucchetto
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Sabbatucci M, Salfa MC, Regine V, Pezzotti P, Suligoi B. Estimated burden of Chlamydia trachomatis female infection and consequent severe pelvic inflammatory disease, Italy, 2005-2016. Ann Ist Super Sanita 2020; 55:217-223. [PMID: 31553313 DOI: 10.4415/ann_19_03_04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Chlamydia trachomatis (Ct) is the leading sexually transmitted infection (STI) across Europe. In Italy, Ct prevalence is low in general population, but predominance of asymptomatic infections, passive voluntary reporting, variable diagnostic criteria and coding practices can lead to considerable underestimation, preventing assessment of real burden of disease and health intervention. We analysed data on female genital Ct infection registered in STI sentinel surveillance systems in Italy from 2005 through 2016 and found 3305 women. Among them, those aged 20-24 years had the highest disability-adjusted life years (DALYs) estimation equal to 106.77 DALYs per 100 000-stratum specific population. Through the study period, incidence rate (IR) for female Ct infection increased significantly from 2.9 to 7.1 per 100 000 resident population. Besides, we analysed data on pelvic inflammatory disease (PID) reported from the National Hospital Information system (NHIS) in the same period. We found 287 women hospitalised with concurrent PID and Ct infection. We recommend targeted screening programmes in women aged 20-24, definition of nationwide active surveillance system, standardisation of diagnostic criteria and ICD-9CM coding practices.
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Affiliation(s)
- Michela Sabbatucci
- Dipartimento Malattie Infettive,Istituto Superiore di Sanità, Rome, Italy - European Programme for Public Health Microbiology (EUPHEM) Training, Stockholm, Sweden
| | | | - Vincenza Regine
- Dipartimento Malattie Infettive,Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Dipartimento Malattie Infettive,Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- Dipartimento Malattie Infettive,Istituto Superiore di Sanità, Rome, Italy
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17
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Mirandola M, Gios L, Sherriff N, Marcus U, Toskin I, Rosinska M, Schink S, Kühlmann-Berenzon S, Suligoi B, Folch C, Nöstlinger C, Dias S, Stanekova D, Klavs I, Caplinskas S, Rafila A, Marin C, Alexiev I, Zohrabyan L, Noori T, Menel-Lemos C, On Behalf Of The Sialon Ii Network. Quantifying unmet prevention needs among MSM in Europe through a multi-site bio-behavioural survey. ACTA ACUST UNITED AC 2019; 23. [PMID: 30621823 PMCID: PMC6290532 DOI: 10.2807/1560-7917.es.2018.23.49.1800097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction The HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic. Methods The Sialon II study, implemented in 13 European cities (2013-14), was a complex multi-centre integrated bio-behavioural cross-sectional survey targeted at MSM, with a concomitant collection of behavioural and biological (oral fluid or blood specimens) data. Rigorous sampling approaches for hard-to-reach populations were used (time-location sampling and respondent-driven sampling) and GAM indicators were calculated; sampling frames were adapted to allow weighted estimates of GAM indicators. Results 4,901 MSM were enrolled. HIV prevalence estimates ranged from 2.4% in Stockholm to 18.0% in Bucharest. When exploring city-level correlations between GAM indicators, prevention campaigns significantly correlated with levels of condom use and level of HIV testing among MSM. Conclusion The Sialon II project has made an important contribution to the monitoring and evaluation of the HIV epidemic across Europe, integrating the use of GAM indicators within a second generation HIV surveillance systems approach and in participatory collaboration with MSM communities. It influenced the harmonisation of European data collection procedures and indicators via GAM country reporting and contributed essential knowledge informing the development and implementation of strategic, evidence-based HIV prevention campaigns for MSM.
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Affiliation(s)
- Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Nigel Sherriff
- School of Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Igor Toskin
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Magdalena Rosinska
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Susanne Schink
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sharon Kühlmann-Berenzon
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - Barbara Suligoi
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya / CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Christiane Nöstlinger
- Faculty of Psychology, University of Vienna, Austria.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sonia Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública & GHTM, Universidade NOVA de Lisboa, Portugal
| | - Danica Stanekova
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Saulius Caplinskas
- Centre for Communicable Diseases and AIDS, Mykolas Romeris University, Vilnius, Lithuania
| | - Alexandru Rafila
- National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest, Romania
| | | | - Ivailo Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Lev Zohrabyan
- Regional Support Team Joint United Nations Programme on HIV/AIDS (UNAIDS), Moscow, Russia
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Cinthia Menel-Lemos
- Consumers, Health, Agriculture and Food Executive Agency (Chafea), Luxembourg
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Regine V, Dorrucci M, Pezzotti P, Mammone A, Quinten C, Pharris A, Suligoi B, The Regional Representatives Of The National Hiv Surveillance System. People living with undiagnosed HIV infection and a low CD4 count: estimates from surveillance data, Italy, 2012 to 2014. ACTA ACUST UNITED AC 2019; 23. [PMID: 29667577 PMCID: PMC6836199 DOI: 10.2807/1560-7917.es.2018.23.15.17-00240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background and aims Late HIV diagnosis is associated with onward HIV transmission, higher morbidity, mortality and healthcare costs. In Italy, more than half of people living with HIV were diagnosed late during the last decade, with a CD4 count < 350 cells/mm3 at diagnosis. We aimed to determine the number and characteristics of people living with undiagnosed HIV infection and low CD4 counts in Italy. Methods Data on newly reported HIV diagnoses from 2012 –2014 were obtained from the national HIV surveillance system. We used the European Centre for Disease Prevention and Control HIV modelling tool to calculate the undiagnosed prevalence and yearly diagnosed fraction (YDF) in people with low CD4 count. Results The estimated annual number undiagnosed HIV infections with low CD4 count was on average 6,028 (95% confidence interval (CI): 4,954–8,043) from 2012–2014. In 2014, most of the undiagnosed people with low CD4 count were men (82.8%), a third acquired HIV through sex between men (MSM) (35.0%), and heterosexual transmission (33.4%), respectively. The prevalence of undiagnosed HIV infection was 11.3 (95% CI: 9.3–14.9) per 100,000 residents ranging from 0.7 to 20.8 between Italian regions. Nationally the prevalence rate was 280.4 (95% CI: 173.3–450.2) per 100,000 MSM, 8.3 (95% CI: 4.9–13.6) per 100,000 heterosexual men, and 3.0 (95% CI: 1.4–5.6) per 100,000 women. The YDF was highest among heterosexual women (27.1%; 95% CI: 16.9–45.2%). Conclusions These findings highlight the importance of improving efforts to identify undiagnosed HIV infections primarily among men, both MSM and heterosexual men.
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Affiliation(s)
- Vincenza Regine
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Maria Dorrucci
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Patrizio Pezzotti
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Alessia Mammone
- National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
| | - Chantal Quinten
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Barbara Suligoi
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
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Sacchetti M, Regine V, Mantelli F, Chini L, Moschese V, Bonini M, Pugliese L, Suligoi B, Lambiase A. Allergy screening in a schoolchildren-based population. Pediatr Allergy Immunol 2019; 30:289-295. [PMID: 30681199 DOI: 10.1111/pai.13024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Schoolchildren screening for allergic diseases may improve early identification and management of atopic children. The aim of this study was to perform a schoolchildren screening program for identification of children with allergic diseases. METHODS All parents of children attending to 13 primary schools in the city of Rome were requested to fill in a demographic data form and the ChAt questionnaire. Allergological evaluation was performed in the children with suspect of allergy (ChAt score > 2). Ocular examination was performed to identify signs of allergic conjunctivitis. The presence of allergic symptoms was related to demographic and environmental variables. RESULTS A total of 2667 children (mean age: 7.1 ± 1 years) were included, and 2489 (93.3%) parents completed the ChAt questionnaire. Results of ChAt questionnaire showed a previous diagnosis of allergic disease in 637 (25.6%) children and the potential presence of an allergic disease (ChAt score > 2) in 35.1%. Multivariate analysis showed that older age, male gender, and having less than two siblings were associated with higher risk of allergic disease. Visual screening showed the presence of clinical signs of allergic conjunctivitis in 2% of children. Allergologic evaluation in 334 children confirmed the diagnosis of allergic disease in 324 (97%) cases. Among them, 97 (29.9%) did not refer to a previous formal diagnosis of allergic condition. CONCLUSIONS This study confirmed that schoolchildren screening using ChAt questionnaire could represent a useful tool for early identification of yet undiagnosed atopic children.
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Affiliation(s)
- Marta Sacchetti
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy.,Cornea and Ocular Surface Unit, San Raffaele Hospital, Milan, Italy
| | - Vincenza Regine
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Flavio Mantelli
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, Pennsylvania
| | - Loredana Chini
- Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Viviana Moschese
- Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Matteo Bonini
- National Heart and Lung Institute, Royal Brompton Hospital & Imperial College, London, UK
| | - Lucia Pugliese
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Barbara Suligoi
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
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Zanotta N, Campisciano G, Morassut S, Castro-Silva E, Luksa V, Zito G, Luppi S, Martinelli M, Colli C, De Seta F, Ricci G, Suligoi B, Comar M. Emerging role for Ureaplasma parvum serovar 3: Active infection in women with silent high-risk human papillomavirus and in women with idiopathic infertility. J Cell Physiol 2019; 234:17905-17911. [PMID: 30883747 DOI: 10.1002/jcp.28423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 12/17/2022]
Abstract
Recently, there are controversial opinions on the presence of Mycoplasmas/Ureaplasmas as colonizers or pathogens, and on the use of a targeted therapy. This study aimed to characterize Mycoplasmas/Ureaplasmas infections in reproductive age women, including the acquisition of sexually transmitted (ST) pathogens and poor birth outcomes. A total of 646 healthy Italian women fulfilled the inclusion criteria including 521 infertile women, 65 pregnant women, and 60 fertile women with identified risk factors and symptomatic for vaginitis/cervicitis. Multiplex and quantitative molecular techniques and direct automatic DNA sequencing were performed to assess the genome structure of Mycoplasma/Ureaplasma species and ST infected pathogens. Ureaplasma parvum serovar 3 represented the predominant colonizer of the urogenital tract of this series and the unique species significantly associated with ST pathogens coinfection (p < 0.01). U. parvum load >104 bacteria/ml, suggestive of active infection, has been measured only in asymptomatic high-risk human papillomavirus infected women (24.3%) and in 40% of women with idiopathic infertility. To note, 16% of the follicular fluid from these idiopathic women resulted infected with U. parvum. In conclusion, the present study focused the attention on U. parvum serovar 3 as emerging microorganism in sexually active women that may have the benefit of targeted therapy.
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Affiliation(s)
- Nunzia Zanotta
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Sara Morassut
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Viviana Luksa
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Gabriella Zito
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Stefania Luppi
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Monica Martinelli
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Francesco De Seta
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
| | | | - Manola Comar
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
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Regine V, Pugliese L, Suligoi B. [Regional HIV Surveillance in Italy: a starting point for the future national system]. Epidemiol Prev 2019; 42:235-242. [PMID: 30066525 DOI: 10.19191/ep18.3-4.p235.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND the Italian National HIV Surveillance, instituted by the Ministerial Decree of March 31st, 2008, is based on 21 regional surveillance systems and adopts an essential data collection form with a definite data flow. The unification of HIV and AIDS surveillance systems and the implementation of an identical data collection form are priorities of the Italian National HIV/AIDS Action Plan 2017 (PNAIDS). OBJECTIVES to describe the 21 regional HIV surveillance systems and to verify the feasibility of their unification. METHODS in March 2017, a questionnaire containing 13 questions was sent to all the regional representatives of the 21 surveillance systems. The main questions were about timeliness, data flow, and quality of the system. The quality was measured through a subjective evaluation expressed by the regional referent through scores from 1 (minimum) to 10 (maximum) regarding four indicators (regional coverage, timeliness, correctness, and completeness of the data). RESULTS more than half of the regional systems use a computerized data collection method. Some of these regions have not completely adapted to the data collection form contained in the Decree and other regions declare a undernotification of the system. The majority of the regions record a slight notification delay by the reporting centres. Some regions report gaps in the completeness of the data received by the reporting centres. CONCLUSIONS the main strengths of the HIV surveillance system are computerization of the systems and slightly reporting delay. Regarding the quality of the regional systems and its data, the study reports a good self-evaluation. This study also showed useful indications to improve the national HIV surveillance system, such as the unification of HIV surveillance with the AIDS surveillance and the implementation of a unique national system, as suggested by guidelines of the PNAIDS 2017.
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Affiliation(s)
- Vincenza Regine
- Dipartimento malattie infettive, Centro operativo AIDS, Istituto superiore di sanità, Roma.
| | - Lucia Pugliese
- Dipartimento malattie infettive, Centro operativo AIDS, Istituto superiore di sanità, Roma
| | - Barbara Suligoi
- Dipartimento malattie infettive, Centro operativo AIDS, Istituto superiore di sanità, Roma
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Suligoi B, Virdone S, Taborelli M, Frova L, Grande E, Grippo F, Pappagallo M, Regine V, Pugliese L, Serraino D, Zucchetto A. Excess mortality related to circulatory system diseases and diabetes mellitus among Italian AIDS patients vs. non-AIDS population: a population-based cohort study using the multiple causes-of-death approach. BMC Infect Dis 2018; 18:428. [PMID: 30153797 PMCID: PMC6114052 DOI: 10.1186/s12879-018-3336-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 08/15/2018] [Indexed: 12/21/2022] Open
Abstract
Background Chronic diseases, chiefly cancers and circulatory system diseases (CSDs), have become the leading non-AIDS-related causes of death among HIV-infected people, as in the general population. After our previous report of an excess mortality for several non-AIDS-defining cancers, we now aim to assess whether people with AIDS (PWA) experience also an increased mortality for CSDs and diabetes mellitus (DM), as compared to the non-AIDS general population (non-PWA). Methods A nationwide, population-based, retrospective cohort study was conducted including 5285 Italians, aged 15−74 years, who were diagnosed with AIDS between 2006 and 2011. Multiple cause-of-death (MCoD) data, i.e. all conditions reported in death certificates, were retrieved through record-linkage with the National Register of Causes of Death up to 2011. Using MCoD data, sex- and age-standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) were calculated by dividing the observed number of PWA reporting a specific disease among MCoD to the expected number, estimated on the basis of mortality rates (based on MCoD) of non-PWA. Results Among 1229 deceased PWA, CSDs were mentioned in 201 (16.4%) certificates and DM in 46 (3.7%) certificates among the various causes of death. These values corresponded to a 13-fold higher mortality related to CSDs (95% CI 10.8–14.4) and DM (95% CI: 9.5–17.4) as compared to 952,019 deceased non-PWA. Among CSDs, statistically significant excess mortality emerged for hypertension (23 deaths, SMR = 6.3, 95% CI: 4.0–9.4), ischemic heart diseases (39 deaths, SMR = 6.1, 95% CI: 4.4–8.4), other forms of heart diseases (88 deaths, SMR = 13.4, 95% CI: 10.8–16.5), and cerebrovascular diseases (42 deaths, SMR = 13.4, 95% CI: 9.7–18.2). The SMRs were particularly elevated among PWA aged < 50 years and those infected through drug injection. Conclusions The use of MCoD data disclosed the fairly high mortality excess related to several CSDs and DM among Italian PWA as compared to non-PWA. Study findings also indicate to start preventive strategies for such diseases at a younger age among AIDS patients than in the general population and with focus on drug users.
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Affiliation(s)
- Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, via Regina Elena 299, 00161, Rome, Italy
| | - Saverio Virdone
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, via Gallini 2, 33081, Aviano, PN, Italy
| | - Martina Taborelli
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, via Gallini 2, 33081, Aviano, PN, Italy
| | - Luisa Frova
- Integrated system for health, social assistance, welfare and justice, Istituto Nazionale di Statistica, viale Liegi 13, 00198, Rome, Italy
| | - Enrico Grande
- Integrated system for health, social assistance, welfare and justice, Istituto Nazionale di Statistica, viale Liegi 13, 00198, Rome, Italy
| | - Francesco Grippo
- Integrated system for health, social assistance, welfare and justice, Istituto Nazionale di Statistica, viale Liegi 13, 00198, Rome, Italy
| | - Marilena Pappagallo
- Integrated system for health, social assistance, welfare and justice, Istituto Nazionale di Statistica, viale Liegi 13, 00198, Rome, Italy
| | - Vincenza Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, via Regina Elena 299, 00161, Rome, Italy
| | - Lucia Pugliese
- Centro Operativo AIDS, Istituto Superiore di Sanità, via Regina Elena 299, 00161, Rome, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, via Gallini 2, 33081, Aviano, PN, Italy
| | - Antonella Zucchetto
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano, IRCCS, via Gallini 2, 33081, Aviano, PN, Italy.
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Suligoi B, Regine V, Raimondo M, Rodella A, Terlenghi L, Caruso A, Bagnarelli P, Capobianchi MR, Zanchetta N, Ghisetti V, Galli C. HIV avidity index performance using a modified fourth-generation immunoassay to detect recent HIV infections. Clin Chem Lab Med 2017; 55:2010-2019. [PMID: 28672745 DOI: 10.1515/cclm-2016-1192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 05/05/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Detecting recent HIV infections is important to evaluate incidence and monitor epidemic trends. We aimed to evaluate the diagnostic performance and accuracy of the avidity index (AI) for discriminating for recent HIV infections. METHODS We collected serum samples from HIV-1 positive individuals: A) with known date of infection (midpoint in time between last HIV-negative and first HIV-positive test); B) infected for >1 year. Samples were divided into two aliquots: one diluted with phosphate buffered saline (PBS) and the other with 1 M guanidine. Both aliquots were assayed by the Architect HIV Ag/Ab Combo 4th generation assay (Abbott). We compared AI found in recent (RI=<6 months from seroconversion) and established (EI) infections. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curve analysis. The proportion of samples misclassified as recent (FRR) was calculated. RESULTS In total, 647 samples were collected: 455 in group A (51.6% RI and 48.4% EI) and 192 in group B. Among these, sixteen samples were from elite controllers, 294 from treated patients, 328 from patients infected with non-B subtypes. Samples before antiretroviral initiation showed a mean AI significantly lower among RI compared to EI (0.66+0.28 vs. 1.00±0.12; p<0.000). The FRR was 0% using a cut-off of ≤0.70. An extremely low FRR was observed among elite controllers, samples with low VL or CD4. HIV subtype had no impact on AI misclassifications. All individuals in group A reached the AI threshold of 0.80 within 24 months after seroconversion. CONCLUSIONS The AI is an accurate serological marker for discriminating recent from established HIV infections and meets WHO requirements for HIV incidence assays.
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Camoni L, Raimondo M, Urciuoli R, Iacchini S, Suligoi B, Pezzotti P. People diagnosed with HIV and in care in Italy in 2014: results from the second national survey. AIDS Care 2017; 30:760-764. [PMID: 29134815 DOI: 10.1080/09540121.2017.1400639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We conducted a second National survey in all Italian Infectious Disease clinics to assess the number of people diagnosed and linked to care and, among these, the number of people on antiretroviral therapy and viral load suppressed. In 2014, 100,049 (0.16 per 100 residents) people diagnosed and linked to care were estimated, corresponding to an increase of 6.3% compared to the survey conducted in 2012. Among people diagnosed and linked to care, 91.9% were on antiretroviral therapy (increase of 11.4% compared to 2012), and among these, 87.7% were viral load suppressed. Overall, the majority were males (72.1%), Italians (82.7%), aged 25-49 years (45.6%); the most common HIV mode of transmission was reported to be in heterosexual contact (37.9%) and men who had sex with men (31.3%); 8.8% had less than 350 CD4 cells/μL, 82.4% had VL <50 copies and 22.9% had a CDC stage C. In conclusion, the number of people diagnosed and linked to care was increasing. The vast majority of them was receiving ART but the percentage of people still with a detectable viral load was lower than the 90-90-90 WHO target.
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Affiliation(s)
- Laura Camoni
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
| | - Mariangela Raimondo
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
| | - Roberta Urciuoli
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
| | - Simone Iacchini
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
| | - Barbara Suligoi
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
| | - Patrizio Pezzotti
- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
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- a Dipartimento Malattie Infettive , Istituto Superiore di Sanità , Rome , Italy
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Gourlay A, Noori T, Pharris A, Axelsson M, Costagliola D, Cowan S, Croxford S, d'Arminio Monforte A, Del Amo J, Delpech V, Díaz A, Girardi E, Gunsenheimer-Bartmeyer B, Hernando V, Jose S, Leierer G, Nikolopoulos G, Obel N, Op de Coul E, Paraskeva D, Reiss P, Sabin C, Sasse A, Schmid D, Sonnerborg A, Spina A, Suligoi B, Supervie V, Touloumi G, Van Beckhoven D, van Sighem A, Vourli G, Zangerle R, Porter K. The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges. Clin Infect Dis 2017; 64:1644-1656. [PMID: 28369283 PMCID: PMC5447871 DOI: 10.1093/cid/cix212] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/13/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. METHODS. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. RESULTS. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. CONCLUSIONS. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.
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Affiliation(s)
| | - Teymur Noori
- European Centre for Disease Prevention and Control, and
| | | | | | - Dominique Costagliola
- Sorbonne Universites, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (IPLESP UMR_S 1136), Paris, France
| | | | | | | | - Julia Del Amo
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Asunción Díaz
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrico Girardi
- Istituto Nazionale Malattie Infettive 'L. Spallanzani', Rome, Italy
| | | | - Victoria Hernando
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Georgios Nikolopoulos
- Medical School, University of Cyprus, Nicosia
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Niels Obel
- Rigshospitalet, Copenhagen University, Denmark
| | - Eline Op de Coul
- National Institute for Public Health and the Environment, Bilthoven
| | - Dimitra Paraskeva
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, and
- Academic Medical Center, Amsterdam, The Netherlands
| | | | - André Sasse
- Scientific Institute of Public Health, Brussels, Belgium
| | | | - Anders Sonnerborg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | | | - Barbara Suligoi
- National AIDS Unit, Istituto Superiore di Sanita, Rome, Italy; and
| | - Virginie Supervie
- Sorbonne Universites, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (IPLESP UMR_S 1136), Paris, France
| | - Giota Touloumi
- Medical School, National and Kapodistrian University of Athens, Greece
| | | | | | - Georgia Vourli
- Medical School, National and Kapodistrian University of Athens, Greece
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Raimondo M, Camoni L, Suligoi B, Pezzotti P, CARPHA Study Group. HIV-Positive Individuals on Antiretroviral Therapy and with Viral Load Suppressed in 12 Infectious Diseases Clinics in Italy: Successes and Disparities in the HIV Continuum of Care. AIDS Res Hum Retroviruses 2017; 33:575-582. [PMID: 28135809 DOI: 10.1089/aid.2016.0256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The HIV care continuum is a tool that describes the quality of HIV care for people living with HIV and assesses the extent to which the goal of viral suppression has been achieved. In 2014, we conducted a retrospective cross-sectional study to assess the characteristics associated with three steps of the HIV continuum of care in Italy [i.e., most recent diagnoses, people diagnosed and in care who are on therapy, and people with viral load (VL) suppressed among those on therapy]. Among the 10,262 individuals diagnosed and linked to care, 9,810 (95.6%) were on therapy and among these 8,383 (85.7%) had VL suppressed. The comparison between people diagnosed in 2013 to those diagnosed before 2013 shows that they were more likely to be male [adjusted odds ratios (AOR) = 1.46; 95% confidence interval (95% CI): 1.18-1.79], <25 years of age (AOR = 7.59; 95% CI: 4.17-13.79), and born in Italy (AOR = 1.33; 95% CI: 1.09-1.62). Factors significantly associated with not being in therapy were as follows: age <35 years (AOR = 4.03; 95% CI: 2.50-6.51), age 35-55 years (AOR = 1.85; 95% CI: 1.19-2.87), being migrants (AOR = 1.25; 95% CI: 1.13-1.39), being men who have sex with men (MSM) (AOR = 1.54; 95% CI: 1.22-1.95), have been diagnosed in 2010-2012 (AOR = 4.51; 95% CI: 3.03-6.73), or before 2010 (AOR = 3.18; 95% CI: 2.41-4.21), and not had previous clinical AIDS (AOR = 8.24; 95% CI: 3.33-20.23), whereas factors significantly associated with not having VL suppressed were as follows: age <35 years (AOR = 1.56; 95% CI: 1.13-2.13) and age 35-55 years (AOR = 1.23; 95% CI: 1.10-1.38), being migrants (AOR = 1.38; 95% CI: 1.11-1.70), have been diagnosed in 2010-2012 (AOR = 1.34; 95% CI: 1.14-1.57), in 2013 (AOR = 4.35; 95% CI: 2.47-7.68), and not having had previous clinical AIDS (AOR = 0.74; 95% CI: 0.63-0.86). Despite this we observed significant disparities for young people, MSM, and migrants, overall in Italy the vast majority of people diagnosed with HIV and in care in 2013 received therapy and the percentage of people who are VL suppressed is near the Joint United Nations Programme on HIV/AIDS goal.
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Affiliation(s)
- Mariangela Raimondo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Laura Camoni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Barbara Suligoi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - CARPHA Study Group
- Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy
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Grande E, Zucchetto A, Suligoi B, Grippo F, Pappagallo M, Virdone S, Camoni L, Taborelli M, Regine V, Serraino D, Frova L. Multiple cause-of-death data among people with AIDS in Italy: a nationwide cross-sectional study. Popul Health Metr 2017; 15:19. [PMID: 28521797 PMCID: PMC5437492 DOI: 10.1186/s12963-017-0135-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 05/04/2017] [Indexed: 12/12/2022] Open
Abstract
Background Multiple cause-of-death (MCOD) data allow analyzing the contribution to mortality of conditions reported on the death certificate that are not selected as the underlying cause of death. Using MCOD data, this study aimed to fully describe the cause-specific mortality of people with AIDS (PWA) compared to people without AIDS. Methods We conducted a nationwide investigation based on death certificates of 2,515 Italian PWA and 123,224 people without AIDS who had died between 2006 and 2010. The conditions most frequently associated with PWA mortality, compared to people without AIDS, were identified using an age-standardized proportion ratio (ASPR) calculated as the ratio between the age-standardized proportion of a specific cause among PWA and the same proportion among people without AIDS. Results The most frequently reported conditions at death among PWA were infectious/parasitic diseases (52%), digestive (36%), respiratory (33%), and circulatory (32%) system diseases, and neoplasms (29%). All AIDS-defining conditions resulted highly associated (ASPR significantly greater than unity) with PWA deaths. Significant associations also emerged for leishmaniasis (ASPR = 188.0), encephalitis/myelitis/encephalomyelitis (ASPR = 14.3), dementia (ASPR = 13.1), chronic viral hepatitis (ASPR = 13.1), liver fibrosis/cirrhosis (ASPR = 4.4), pneumonia (ASPR = 4.4), anal (ASPR = 12.1) and liver (ASPR = 1.9) cancers, and Hodgkin’s disease (ASPR = 3.1). Conclusions Study findings identified the contribution of several non-AIDS-defining conditions on PWA mortality, emphasizing the need of preventive public health interventions targeting this population.
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Affiliation(s)
- Enrico Grande
- Servizio Sistema integrato salute, assistenza, previdenza e giustizia, Istituto Nazionale di Statistica, Viale Liegi 13, 00198, Rome, Italy
| | - Antonella Zucchetto
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Via Gallini 2, 33081, Aviano, PN, Italy
| | - Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesco Grippo
- Servizio Sistema integrato salute, assistenza, previdenza e giustizia, Istituto Nazionale di Statistica, Viale Liegi 13, 00198, Rome, Italy
| | - Marilena Pappagallo
- Servizio Sistema integrato salute, assistenza, previdenza e giustizia, Istituto Nazionale di Statistica, Viale Liegi 13, 00198, Rome, Italy
| | - Saverio Virdone
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Via Gallini 2, 33081, Aviano, PN, Italy
| | - Laura Camoni
- Centro Operativo AIDS, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Martina Taborelli
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Via Gallini 2, 33081, Aviano, PN, Italy
| | - Vincenza Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Via Gallini 2, 33081, Aviano, PN, Italy.
| | - Luisa Frova
- Servizio Sistema integrato salute, assistenza, previdenza e giustizia, Istituto Nazionale di Statistica, Viale Liegi 13, 00198, Rome, Italy
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Comar M, Monasta L, Seraceni S, Colli C, Luska V, Morassut S, Clemente L, Drabeni M, Moise G, Fontana F, Suligoi B. Chlamydia trachomatis and HPV co-infections in HIV negative men from a multi-ethnic area of Northern Italy at high prevalence of cervical malignancies. J Med Virol 2017; 89:1654-1661. [PMID: 28316071 DOI: 10.1002/jmv.24811] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/08/2017] [Indexed: 01/09/2023]
Abstract
Chlamydia trachomatis and HPV coinfections in the male population are often a disregarded issue. We performed a study to evaluate the prevalence of such infections in heterosexual HIV negative men from a Northern Italy multi-ethnic area at high prevalence for cervical malignancies. Urethral swabs (US) or first-voided urine were evaluated retrospectively from 1317 patients attending Sexually Transmitted Infections (STI) clinic and from 3388 outpatients attending private clinics. Informations about participants' demographic characteristics and attributes of C. trachomatis, including chronic infection, and HPV genotypes testing, were collected. Exact Fisher test, bivariate, and multivariate logistic regressions were carried out. The prevalence of C. trachomatis was 1.7% in the outpatients and 16.9% in the STI group (P < 0.0001) in which the highest frequency was observed in men of age ≤25 years. Among patients with C. trachomatis, asymptomatic HPV co-infection was detected in 33% of men from the STI clinic and in 2% of the outpatients. Out of all coinfections, 56% were due to single HPV, with a prevalence of 73% in young STI men. The distribution of HPV genotypes confirmed the increased circulation of LR-HPV42, HR-HPV51, HR-HPV52 and prHR-HPV82, and the decreasing of HR-HPV16. African nationalities and leucorrhea were significantly associated risk factors, while the regular condom use offered an effective protection. This study highlights the high prevalence of C. trachomatis and HPV asymptomatic co-infection in young HIV negative men attending the STI clinic, representing a reservoir of new HPV genotypes with potential oncogenic risk.
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Affiliation(s)
- Manola Comar
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.,University of Trieste, Trieste, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Silva Seraceni
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Viviana Luska
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sara Morassut
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Libera Clemente
- Laboratory of Clinical Chemistry and Microbiological Analysis AAS2 "Bassa Friulana-Sontina"-S. Polo General Hospital, Monfalcone (GO), Italy
| | - Marina Drabeni
- Dermatology Center, MST/AIDS, AAS2, "Bassa Friulana-Isontina", Gorizia, Italy
| | - Gianmichele Moise
- Dermatology Center, MST/AIDS, AAS2, "Bassa Friulana-Isontina", Gorizia, Italy
| | - Francesco Fontana
- Laboratory of Clinical Chemistry and Microbiological Analysis AAS2 "Bassa Friulana-Sontina"-S. Polo General Hospital, Monfalcone (GO), Italy
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Suligoi B, Vittori G, Salfa MC, Timelli L, Corsini D, Fattorini G, Mariani L. Prevalence and incidence of external genital warts in a sample of Italian general female population. BMC Infect Dis 2017; 17:126. [PMID: 28166736 PMCID: PMC5294736 DOI: 10.1186/s12879-017-2202-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 01/12/2017] [Indexed: 12/02/2022] Open
Abstract
Background The Human papillomavirus is the most common sexually transmitted virus worldwide. The objective of this study was to estimate: 1) the prevalence and the incidence of external genital warts (eGW) in a sample of women attending community outpatient clinics and 2) the total number of eGW cases in the Italian female population aged 15–64 years. Methods A prospective study was performed for a 12-month period between 2009 and 2010, among a sample of women attending community gynecological outpatient clinics located throughout Italy. Demographic data, for every woman aged 15–64 years, were collected. For women diagnosed with eGW, behavioral and clinical data were recorded. Prevalence of eGW was calculated as the proportion between the number of women with eGW and that of women visiting any of the participating gynecologists; incidence of eGW was calculated as the proportion between the number of women with a new diagnosis of eGW and that of women visiting any of the participating gynecologists. Standardized prevalence by age was used to estimate the number of eGW cases occurring in the Italian female population aged 15–64 years. Results In 2009–2010, 44 community gynecologists were included in the network. In one-year period, 16,410 women visited any of the participating gynecologists; 63 women were diagnosed with eGW, corresponding to a prevalence of 3.8 cases per 1,000 women per year (95%CI: 2.9-4.9). The incidence of eGW was 3.0 cases per 1,000 women per year (95%CI: 2.2-3.9). Women aged 15–24 years showed both the highest prevalence and incidence. Prevalence and incidence significantly decreased by increasing age group (p <0.001), and were higher in Southern Italy compared to Central-Northern Italy. The estimated number of women with eGW among women aged 15–64 years in Italy, in 2010, was approximately 69,000. Conclusions These data show a high prevalence and incidence of eGW among young women in Italy, stress the effectiveness of community clinical networks in investigating STI epidemiology among women from the general population, confirm the relevance of HPV vaccination programs among adolescents, and underscore the need of promoting safe sex, implementing early diagnosis, treatment and prevention of genital warts.
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Affiliation(s)
- Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
| | | | - Maria Cristina Salfa
- Centro Operativo AIDS, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy
| | | | | | - Giovanni Fattorini
- Associazione ginecologi territoriali (AGITE), Via G. Abamonti 1, Milan, Italy
| | - Luciano Mariani
- HPV-unit, Istituto Nazionale Tumori Regina Elena, Via Elio Chianesi 53, Rome, Italy
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Taborelli M, Virdone S, Camoni L, Regine V, Zucchetto A, Frova L, Grande E, Boros S, Dal Maso L, De Paoli P, Serraino D, Suligoi B. The persistent problem of late HIV diagnosis in people with AIDS: a population-based study in Italy, 1999-2013. Public Health 2016; 142:39-45. [PMID: 28057195 DOI: 10.1016/j.puhe.2016.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/30/2016] [Accepted: 10/13/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Despite the wide accessibility to free human immunodeficiency virus (HIV) testing and combined antiretroviral therapy (cART), late HIV diagnosis remains common with severe consequences at individual and population level. This study aimed to describe trends of late HIV testing and to identify their determinants in the late cART era in Italy. STUDY DESIGN We conducted a population-based, nationwide analysis of the Italian National AIDS Registry data (AIDS - acquired immune deficiency syndrome) for the years 1999-2013. METHODS Late testers (LTs) were defined as people with AIDS (PWA) whose first HIV-positive test preceded AIDS diagnosis by 3 months or less. Odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were estimated to examine factors associated with being LTs. Joinpoint analysis was used to estimate annual percent changes (APCs) of LTs' proportion over time. RESULTS Among 20,753 adult PWA, 50.8% were LTs. Italian PWA showed a lower proportion of LTs than non-Italian PWA (46.5% vs 68.2%). Among Italian PWA, the odds of being LTs was higher in men than in women (OR = 2.62, 95% CI: 2.38-2.90); in the age groups below 35 years and over 49 years at diagnosis (OR = 1.24, 95% CI: 1.12-1.37 and OR = 1.51, 95% CI: 1.38-1.67, respectively) vs PWA aged 35-49 years; and in those infected through sexual contact as compared with injecting drug use (OR = 13.34, 95% CI: 12.06-14.76 for heterosexual contact and OR = 8.13, 95% CI: 7.30-9.06 for male-to-male sexual contact). The proportion of LTs increased over time among Italians, especially in the latest period (APC2006-2013 = 5.3, 95% CI: 3.8-6.9). The LTs' proportion resulted higher, though stable, among PWA aged ≥50 years. Conversely, an increasing trend was observed among PWA aged 18-34 years (APC = 5.3, 95% CI: 4.5-6.1). The LTs' proportion was persistently higher among PWA who acquired HIV infection through sexual contact, even if a marked increase among injecting drug users was observed after 2005 (APC = 11.4, 95% CI: 5.7-17.5). CONCLUSIONS The increasing trend of LTs' proportion in the late cART era highlights the need of new strategies tailored to groups who may not consider themselves to be at a high risk of infection. Active promotion of early testing and continuous education of infection, especially among young people, need to be implemented.
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Affiliation(s)
- M Taborelli
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy.
| | - S Virdone
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - L Camoni
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
| | - V Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
| | - A Zucchetto
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - L Frova
- Servizio Sanità, Salute ed Assistenza, Istituto Nazionale di Statistica, Rome, Italy
| | - E Grande
- Servizio Sanità, Salute ed Assistenza, Istituto Nazionale di Statistica, Rome, Italy
| | - S Boros
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
| | - L Dal Maso
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - P De Paoli
- Scientific Directorate, CRO Aviano National Cancer Institute, Aviano, Italy
| | - D Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - B Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy
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32
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Camoni L, Regine V, Raimondo M, Salfa MC, Boros S, Suligoi B. The continued ageing of people with AIDS in Italy: recent trend from the national AIDS Registry. Ann Ist Super Sanita 2016; 50:291-7. [PMID: 25292277 DOI: 10.4415/ann_14_03_12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction. In industrialized countries, the availability of highly active antiretroviral therapy (HAART) caused a slow but substantial ageing of the AIDS epidemic mainly due to the longer survival of persons with HIV/AIDS which has turned HIV into a manageable, chronic disease. The number of older people with AIDS is growing in many European countries. We described the impact of AIDS among persons aged 50 years or more in Italy and compared the characteristics of these cases with those of persons diagnosed with AIDS at an age younger than 50. Methods. The source of data was the Italian AIDS Registry, from 1982 to 2011. We defined "older" persons those aged 50 years or more, and younger individuals those aged less than 50 years. We built two multivariate logistic regression models: the first one to identify factors associated with being older, and the second one to identify AIDS-defining diseases correlated with being older. Variables with a P value of <0.05 were entered in the model. Results. Of the total AIDS cases, 10.5% were among persons older than 49 years. This proportion progressively increased from 0.0% in 1983 to 26.4% in 2011. Among older cases, the incidence of AIDS was 2.0 per 100 000 residents in 1996, then decreased to 1.4 per 100 000 in 2000 and levelled off around 1 per 100 000 residents until 2011. Compared to younger cases, older cases were more frequently males, Italians, diagnosed with AIDS in recent years, residing in Northern or Central Italy, non-injecting drug users, and late testers. Discussion. These findings stress the need for physicians to consider carefully the possibility of HIV infection among older individuals not to miss the opportunity to deliver prevention messages, offer HIV testing, and make an early diagnosis.
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Affiliation(s)
- Laura Camoni
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy. E mail:
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Gios L, Mirandola M, Toskin I, Marcus U, Dudareva-Vizule S, Sherriff N, Breveglieri M, Furegato M, Folch C, Ferrer L, Montoliu A, Nöstlinger C, Vanden Berghe W, Kühlmann-Berenzon S, Velicko I, Dias S, Suligoi B, Regine V, Stanekova D, Rosińska M, Caplinskas S, Klavs I, Alexiev I, Rafila A. Bio-behavioural HIV and STI surveillance among men who have sex with men in Europe: the Sialon II protocols. BMC Public Health 2016; 16:212. [PMID: 26935752 PMCID: PMC4776381 DOI: 10.1186/s12889-016-2783-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/26/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach. METHODS/DESIGN Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for 'hard-to-reach' populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection. DISCUSSION Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.
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Affiliation(s)
- Lorenzo Gios
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Massimo Mirandola
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy. .,Department of Pathology, Infectious Diseases Section, the Verona University Hospital - Veneto Region, Verona, Italy.
| | - Igor Toskin
- Department of Reproductive Health & Research, World Health Organization, Geneva, Switzerland.
| | - Ulrich Marcus
- Department for Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany.
| | - Sandra Dudareva-Vizule
- Department for Infectious Diseases Epidemiology, Robert Koch-Institute, Berlin, Germany.
| | - Nigel Sherriff
- Centre for Health Research, University of Brighton, Brighton, UK.
| | - Michele Breveglieri
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Martina Furegato
- Veneto Region - Department of Health, CReMPE - Regional Coordination Centre for European Project Management, the Verona University Hospital, Verona, Italy.
| | - Cinta Folch
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | - Laia Ferrer
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | - Alexandra Montoliu
- Institut Catala d'Oncologia (ICO), Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
| | | | - Wim Vanden Berghe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | | | - Inga Velicko
- Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
| | - Sónia Dias
- Institute of Hygiene and Tropical Medicine & GHTM, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Barbara Suligoi
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy.
| | - Vincenza Regine
- Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy.
| | - Danica Stanekova
- NRC for HIV/AIDS, Slovak Medical University, Bratislava, Slovak Republic.
| | - Magdalena Rosińska
- Department of Epidemiology, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland.
| | | | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia.
| | - Ivailo Alexiev
- National Reference Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
| | - Alexandru Rafila
- National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest, Romania
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Raimondo M, Facco G, Regine V, Pupella S, Grazzini G, Suligoi B. HIV-positive blood donors unaware of their sexual at-risk behaviours before donation in Italy. Vox Sang 2015; 110:134-42. [PMID: 26414961 DOI: 10.1111/vox.12328] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 07/23/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite the procedures adopted for the selection of blood donors, in Italy the HIV prevalence per 100 000 repeat tested donors (RTD) and first-time tested donors (FTD) is high compared to most other Council of Europe member states. To evaluate the effectiveness of predonation procedures, we studied both the characteristics and the undisclosed risk behaviours of HIV-positive donors. MATERIALS AND METHODS We analysed the data from the Italian blood donor surveillance system in 2009, 2010 and 2011. Based on the postdonation interview, HIV-positive donors were classified by risk behaviour (heterosexual, MSM, 'non-sexual' and 'not determined') and by time elapsed from risk behaviour to donation. In Italy, the temporary deferral for exposure to behaviour at risk is 4 months. RESULTS In the postdonation interview, 113 HIV-positive donors (32·4%), who denied at-risk behaviours in the predonation selection, reported sexual risk behaviours <4 months prior to donation; they were predominantly males (84·1%) and RTD (63·7%). The main reason for not having reported the risk behaviour in the predonation selection was 'not realizing having engaged in at-risk behaviour' (66·4%). CONCLUSION These findings underline the need for more comprehensible educational material, a clearer predonation questionnaire, and effective information campaigns to improve the awareness of HIV sexual risk behaviours among blood donors.
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Affiliation(s)
- M Raimondo
- National AIDS Unit, National Institute of Health, Rome, Italy
| | - G Facco
- National Blood Centre, National Institute of Health, Rome, Italy
| | - V Regine
- National AIDS Unit, National Institute of Health, Rome, Italy
| | - S Pupella
- National Blood Centre, National Institute of Health, Rome, Italy
| | - G Grazzini
- National Blood Centre, National Institute of Health, Rome, Italy
| | - B Suligoi
- National AIDS Unit, National Institute of Health, Rome, Italy
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Suligoi B, Zucchetto A, Grande E, Camoni L, Dal Maso L, Frova L, Virdone S, Boros S, Pappagallo M, Taborelli M, Regine V, De Paoli P, Serraino D. Risk factors for early mortality after AIDS in the cART era: A population-based cohort study in Italy. BMC Infect Dis 2015; 15:229. [PMID: 26067992 PMCID: PMC4464724 DOI: 10.1186/s12879-015-0960-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the dramatically improved survival due to combination antiretroviral therapies (cART), life expectancy of people with HIV/AIDS remains lower than that of the general population. This study aimed to estimate, at a population level, the survival experience of Italian people with AIDS (PWA) and to quantify the prognostic role of selected factors at diagnosis in the risk of early mortality (i.e., within six months from AIDS diagnosis). METHODS A population-based, retrospective-cohort study was conducted among Italian PWA diagnosed between 1999 and 2009 and recorded in the national AIDS registry. The vital status, up to December 2010, of 14,552 PWA was ascertained through a record linkage procedure with the Italian mortality database. Survival probabilities were estimated through Kaplan-Meier method. To identify risk factors for early mortality from any cause, odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for major confounders, were computed using multivariate logistic regression models. RESULTS Of the 5,706 deaths registered among the 14,552 PWA included in the study, 2,757 (18.9%) occurred within six months from AIDS diagnosis. The probability of surviving six months increased from 81.2% in PWA diagnosed in 1999-2000 to 82.9% in 2009, while the 5-year survival augmented from 60.7% in PWA diagnosed in 1999-2000 to 65.4% for PWA diagnosed in 2005-2006. Elevated risks of early mortality were associated to older age (OR = 5.28; 95% CI: 4.41-6.32 for age ≥60 vs. <35 years), injecting drug use (OR = 1.71; 95% CI: 1.53-1.91 vs. heterosexual intercourse), and CD4 count <50 cells/mm(3) at AIDS diagnosis (OR = 1.87, 95% CI: 1.55-2.27 vs. ≥350). Elevated ORs for early mortality also emerged for PWA diagnosed with primary brain lymphoma (OR = 11.66, 95% CI: 7.32-18.57), or progressive multifocal leukoencephalopathy (OR = 4.21, 95% CI: 3.37-5.27). CONCLUSIONS Our study documented, among Italian PWA, the high - though slightly decreasing - frequency of early mortality in the full cART era. These findings indicate the need for enduring and ameliorating preventive actions aimed at timely HIV testing among all individuals at risk for HIV infection and/or those who present diseases known to be related with HIV infection.
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Affiliation(s)
- Barbara Suligoi
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy.
| | - Antonella Zucchetto
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via Gallini 2, 33081, Aviano, Italy.
| | - Enrico Grande
- Health and social care Section, National Institute of Statistics, Rome, Italy.
| | - Laura Camoni
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy.
| | - Luigino Dal Maso
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via Gallini 2, 33081, Aviano, Italy.
| | - Luisa Frova
- Health and social care Section, National Institute of Statistics, Rome, Italy.
| | - Saverio Virdone
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via Gallini 2, 33081, Aviano, Italy.
| | - Stefano Boros
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy.
| | - Marilena Pappagallo
- Health and social care Section, National Institute of Statistics, Rome, Italy.
| | - Martina Taborelli
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via Gallini 2, 33081, Aviano, Italy.
| | - Vincenza Regine
- Centro Operativo AIDS, Istituto Superiore di Sanità, Rome, Italy.
| | - Paolo De Paoli
- Scientific Directorate, CRO Aviano National Cancer Institute, Aviano, Italy.
| | - Diego Serraino
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via Gallini 2, 33081, Aviano, Italy.
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Cruciani M, Wiessing L, Serpelloni G, Genetti B, Andreotti A, Iulia C, Zermiani M, Suligoi B. Increasing prevalence of HIV infection among first time clients in Italian drug treatment services - is it sexual transmission? BMC Infect Dis 2015; 15:201. [PMID: 25925747 PMCID: PMC4431036 DOI: 10.1186/s12879-015-0940-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 04/23/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Over the last two decades, the proportion of people who inject drugs among newly reported HIV cases in Italy has been continuously declining. This trend is reflected in the prevalence of HIV infection among problem drug users followed in drug treatment services. We report nationwide trends in the prevalence of HIV and HCV among tested clients in charge to drug addiction services from 2005 to 2011. METHODS Data on the prevalence of HIV and HCV among drug users from public drug treatment services across Italy were collected and analyzed for the period from 2005 to 2011. Prevalence of HIV and HCV were compared between clients returning to treatment and those entering treatment for the first time, and by gender. Due to the high percentage of missing data, the "inverse probability weight" method was used. Trends in testing uptake were also analysed. RESULTS A significant decrease of HIV and HCV prevalence is observed among all PDUs entering treatment (from 14.7% to 11.1% and from 61.6% to 50%, respectively, in 2005-2011). By contrast, among those entering the services for the first time, after an initial decline the prevalence of HIV infection steadily increased in both sexes, from 2.2% in 2009 to 5.3% in 2011. Self-reported injecting rates in this group decreased over time, and in 2011 the proportion reporting drug injecting was lower among new clients than in people returning to services (14.5 vs. 34.4%). We also observed a progressive and significant reduction in HIV and HCV testing in drug treatment services. CONCLUSIONS Changes in injection practice and type of drugs used, coupled with a concurrent reduction in HCV prevalence, do not support drug injection as the main explanation for an increased HIV transmission in people entering drug treatment services for the first time. While reductions in testing rates raise concerns over data quality, the possibility of increased sexual transmission needs to be considered.
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Affiliation(s)
- Mario Cruciani
- Center of Community Medicine and HIV Outpatient Clinic, Via Germania, 20, Verona, Italy.
| | - Lucas Wiessing
- European Monitoring Centre for Drugs and Drug Addiction (EMCCDA), Cais do Sodré, 1249-289, Lisboa, Portugal.
| | - Giovanni Serpelloni
- Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Via dei Laterani, 34, 00184, Roma, Italy.
| | - Bruno Genetti
- Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Via dei Laterani, 34, 00184, Roma, Italy.
| | - Alessandra Andreotti
- Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Via dei Laterani, 34, 00184, Roma, Italy.
| | - Carpignano Iulia
- Dipartimento Politiche Antidroga, Presidenza del Consiglio dei Ministri, Via dei Laterani, 34, 00184, Roma, Italy.
| | - Monica Zermiani
- Center of Community Medicine and HIV Outpatient Clinic, Via Germania, 20, Verona, Italy.
| | - Barbara Suligoi
- Istituto Superiore di Sanità (ISS), Viale Regina Elena, 299, 00161, Roma, Italy.
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Camoni L, Raimondo M, Dorrucci M, Regine V, Salfa MC, Suligoi B. Estimating minimum adult HIV prevalence: a cross-sectional study to assess the characteristics of people living with HIV in Italy. AIDS Res Hum Retroviruses 2015; 31:282-7. [PMID: 25432098 DOI: 10.1089/aid.2014.0154] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.
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Affiliation(s)
- Laura Camoni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Mariangela Raimondo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Dorrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenza Regine
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Barbara Suligoi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Mariani L, Vici P, Suligoi B, Checcucci-Lisi G, Drury R. Early direct and indirect impact of quadrivalent HPV (4HPV) vaccine on genital warts: a systematic review. Adv Ther 2015; 32:10-30. [PMID: 25620536 PMCID: PMC4311067 DOI: 10.1007/s12325-015-0178-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Since 2007, many countries have implemented national human papillomavirus (HPV) vaccination programs with the quadrivalent HPV (4HPV) vaccine that has been shown to be efficacious in clinical trials involving 25,000 subjects. Two vaccine serotypes, HPV16 and 18, are responsible for cervical cancer and other HPV-related cancers, but the impact of the 4HPV vaccine on these cancers cannot be seen immediately as there is a considerable lag between infection with HPV and cancer development. The other two serotypes, HPV6 and 11, are responsible for genital warts (GWs), which develop within a few months after infection, making GWs an early clinical endpoint for the assessment of the impact of 4HPV vaccination. METHODS We performed a systematic literature search in PubMed to identify all published studies on 4HPV vaccination, including those that assessed the impact of 4HPV vaccination programs on the incidence of GWs at a population level around the world. RESULTS A total of 354 records were identified in the PubMed search. After screening and obtaining full papers for 56 publications, 16 publications presenting data on the impact or effectiveness of 4HPV vaccination on GWs were identified. These reported data on the impact or effectiveness of 4HPV in six countries [Australia (n = 6), New Zealand (n = 2), United States (n = 3), Denmark (n = 2), Germany (n = 1), and Sweden (n = 2)]. In Australia, no GWs were diagnosed in women aged <21 years who reported being vaccinated. A 92.6% reduction in GWs incidence was reported for all women in this age group, where the vaccine uptake rate (VUR) was 70% for 3 doses. The highest reductions were reported in countries with high VURs, mostly through school-based vaccination programs, although high VURs were obtained with some non-school-based programs. CONCLUSION The results are coherent with the GWs incidence reduction reported in clinical trials and are an early indicator of what can be expected for the long-term clinical impact on vaccine-type HPV-related cancers.
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Affiliation(s)
- Luciano Mariani
- HPV-UNIT, Department of Gynecologic Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Department of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
| | - Barbara Suligoi
- AIDS Unit, Department of Infectious, Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy
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Dal Maso L, Suligoi B, Franceschi S, Braga C, Buzzoni C, Polesel J, Zucchetto A, Piselli P, Falcini F, Caldarella A, Zanetti R, Vercelli M, Guzzinati S, Russo A, Tagliabue G, Iachetta F, Ferretti S, Limina RM, Mangone L, Michiara M, Stracci F, Pirino DR, Piffer S, Giacomin A, Vitarelli S, Mazzoleni G, Iannelli A, Contrino ML, Fusco M, Tumino R, Fanetti AC, De Paoli P, Decarli A, Serraino D. Survival after cancer in Italian persons with AIDS, 1986-2005: a population-based estimation. J Acquir Immune Defic Syndr 2014; 66:428-35. [PMID: 24798769 DOI: 10.1097/qai.0000000000000184] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cancer survival in persons with AIDS (PWA) after introduction of antiretroviral therapies remains poorly characterized. The aim is to provide population-based estimates of cancer survival, overall and for the most important cancer types in PWA, and a comparison with persons without AIDS (non-PWA) affected by the same cancer. METHODS PWA with cancer at AIDS diagnosis or thereafter were individually matched with non-PWA by type of cancer, sex, age, year of diagnosis, area of living, and, for lymphomas, histological subtype. Five-year observed survival and hazard ratios (HRs) of death in PWA versus non-PWA with 95% confidence intervals (CIs) were estimated. RESULTS We included 2262 Italian PWA and 4602 non-PWA with cancer diagnosed during 1986-2005. Between 1986 and 1995, and 1996 and 2005, 5-year survival for all cancers in PWA improved from 12% to 41% and the corresponding HR versus non-PWA decreased from 5.1 (95% CI: 4.3 to 6.1) to 2.9 (95% CI: 2.6 to 3.3). During 1996-2005, HRs were 2.0 (95% CI: 1.4 to 2.9) for Kaposi sarcoma, 3.4 (95% CI: 2.9 to 4.1) for non-Hodgkin lymphoma, and 2.4 (95% CI: 1.4 to 4.0) for cervical cancer. HRs were 2.5 (95% CI: 2.1 to 3.1) for all non-AIDS-defining cancers, 5.9 (95% CI: 3.1 to 11.2) for Hodgkin lymphoma, and 7.3 (95% CI: 2.8 to 19.2) for nonmelanoma skin cancer. A ≤3-fold survival difference was found for cancers of the stomach, liver, anus, lung, brain, and the most aggressive lymphoma subtypes. CONCLUSIONS The persisting, although narrowing, gap in cancer survival between PWA and non-PWA indicates the necessity of enhancing therapeutic approaches, so that PWA can be provided the same chances of survival observed in the general population, and improving cancer prevention and screening.
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Affiliation(s)
- Luigino Dal Maso
- *Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, Italy; †Istituto Superiore di Sanità, Rome, Italy; ‡International Agency for Research on Cancer, Lyon, France; §AIRTUM database, Florence, Italy; ‖Tuscany Cancer Registry, UO di epidemiologia clinica e descrittiva, Istituto per lo studio e la prevenzione oncologica, Florence, Italy; ¶Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; #Department of Epidemiology, INMI "L Spallanzani" IRCCS, Rome, Italy; **Romagna Cancer Registry, Cancer Institute of Romagna IRCCS, Meldola, Italy; ††Piedmont Cancer Registry, Oncology Prevention Center (CPO), Torino, Italy; ‡‡Registro Tumori Regione Liguria, IRCSS Azienda Università Ospedale San Martino-IST Istituto nazionale ricerca sul cancro e Dipartimento di scienze della salute, Genoa University, Genoa, Italy; §§Registro Tumori del Veneto, Istituto Oncologico Veneto IRCCS, Padua, Italy; ‖‖Milan Cancer Registry, Milan Health Authority, Epidemiology Unit, Milan, Italy; ¶¶Lombardia Cancer Registry, Varese Province, National Cancer Institute, Milan, Italy; ##Modena Cancer Registry, Department of Oncology, Hematology, and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy; ***Ferrara Cancer Registry, Ferrara University, Ferrara, Italy; †††Brescia Health Unit, Cancer Registry, Brescia, Italy; ‡‡‡S.C. Statistica, qualità e studi clinici IRCCS, Arcispedale S. Maria Nuova, Reggio Emilia, Italy; §§§Parma Province Cancer Registry, University Hospital Parma, Parma, Italy; ‖‖‖Umbria Cancer Registry, Department of Medical and Surgical Specialties, and Public Health, Section of Public Health, Perugia University, Perugia, Italy; ¶¶¶Cancer Registry of Sassari, Sassari, Italy; ###Registro Tumori della Provincia di Trento, Servizio di Epidemiologia Clinica e Valutativa, Trento, Italy; ****Registro Tumori Piemonte, Provincia di Biella CPO, Biella, Italy; †††
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Hall HI, Halverson J, Wilson DP, Suligoi B, Diez M, Le Vu S, Tang T, McDonald A, Camoni L, Semaille C, Archibald C. Late diagnosis and entry to care after diagnosis of human immunodeficiency virus infection: a country comparison. PLoS One 2013; 8:e77763. [PMID: 24223724 PMCID: PMC3818378 DOI: 10.1371/journal.pone.0077763] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/04/2013] [Indexed: 12/12/2022] Open
Abstract
Background Testing for HIV infection and entry to care are the first steps in the continuum of care that benefit individual health and may reduce onward transmission of HIV. We determined the percentage of people with HIV who were diagnosed late and the percentage linked into care overall and by demographic and risk characteristics by country. Methods Data were analyzed from national HIV surveillance systems. Six countries, where available, provided data on two late diagnosis indicators (AIDS diagnosis within 3 months of HIV diagnosis, and AIDS diagnosis within 12 months before HIV diagnosis) and linkage to care (≥1 CD4 or viral load test result within 3 months of HIV diagnosis) for people diagnosed with HIV in 2009 or 2010 (most recent year data were available). Principal Findings The percentage of people presenting with late stage disease at HIV diagnosis varied by country, overall with a range from 28.7% (United States) to 8.8% (Canada), and by transmission categories. The percentage of people diagnosed with AIDS who had their initial HIV diagnosis within 12 months before AIDS diagnosis varied little among countries, except the percentages were somewhat lower in Spain and the United States. Overall, the majority of people diagnosed with HIV were linked to HIV care within 3 months of diagnosis (more than 70%), but varied by age and transmission category. Conclusions Differences in patterns of late presentation at HIV diagnosis among countries may reflect differences in screening practices by providers, public health agencies, and people with HIV. The percentage of people who received assessments of immune status and viral load within 3 months of diagnosis was generally high.
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Affiliation(s)
- H. Irene Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Jessica Halverson
- Public Health Agency of Canada/Agence de la santé publique du Canada, Ontario, Canada
| | - David P. Wilson
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Mercedes Diez
- Secretaría del Plan Nacional sobre el Sida/Centro Nacional de Epidemiología, Madrid, Spain
| | | | - Tian Tang
- ICF Marcro International, Atlanta, Georgia, United States of America
| | - Ann McDonald
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Chris Archibald
- Public Health Agency of Canada/Agence de la santé publique du Canada, Ontario, Canada
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Suligoi B, Salfa MC, Mariani L, Corsini D, Timelli L, Fattorini G, Vittori G. A new surveillance gynecological network to assess the incidence and prevalence of genital warts in the Italian female population: lessons learned. Minerva Ginecol 2013; 65:577-585. [PMID: 24096294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Human papillomavirus (HPV) is the etiologic agent of genital warts. Genital warts are transmitted through sexual contacts and caused in about 90% of the cases by HPV types 6 and 11. Worldwide, several million cases of genital warts occur each year both in females and males. In Italy, genital warts are not subject to mandatory notification; the only available data come from the sentinel surveillance system for sexually transmitted infections (STI), which show that external genital warts represent the most frequent STI in Italy. However, these data are not suitable for estimates of incidence and prevalence of single STI in the general population. To obtain more reliable data on the epidemiology of genital warts in the female population at large, we implemented a network of local gynecologists reporting essential data on all women visited throughout one year and detailed data on women who were diagnosed with genital warts. In order to organize and create this network, a partnership between the Italian National Institute of Health and the Italian Society of Gynecology and Obstetrics was constituted to implement the start-up and management of this pilot and unique project in Europe. The present paper intends to present the methods used to build and implement this surveillance network of local gynecologists.
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Affiliation(s)
- B Suligoi
- Centro Operativo AIDS Istituto Superiore di Sanità, Rome, Italy -
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Salfa M, Regine V, Camoni L, Raimondo M, Suligoi B. P3.142 Epidemiology of STI in Men Having Sex with Men in Italy, 1991–2010. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mariani L, Salfa M, Timelli L, Vittori G, Fattorini G, Suligoi B. P3.037 High Prevalence of Genital Warts Among Young Women in Italy. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Camoni L, Raimondo M, Regine V, Salfa MC, Suligoi B. Late presenters among persons with a new HIV diagnosis in Italy, 2010-2011. BMC Public Health 2013; 13:281. [PMID: 23537210 PMCID: PMC3616982 DOI: 10.1186/1471-2458-13-281] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 03/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Western Europe, about 50% of newly diagnosed HIV-positive individuals are diagnosed at a late stage disease and enter in care late (i.e. with a CD4 count ≤350 μL/μL). The aim of the present study is to analyze the characteristics and the factors associated with being diagnosed late or at an advanced stage of disease among persons with a new HIV diagnosis in Italy, in the period 2010-2011. METHODS We used individual data on new HIV diagnoses reported by the HIV surveillance system in 2010 and in 2011. Persons with CD4 ≤350 cells/μL or diagnosed with AIDS (regardless of the CD4 cell count) were defined as late presenters (LP); persons with CD4 ≤ 200 cells/μL or AIDS (regardless of the CD4 cell count) were defined as presenting with advanced HIV disease (AHD). RESULTS Of the 7,300 new diagnoses reported in 2010-2011 by the included regions, 55.2% were LP; among these, 37.9% was diagnosed with AIDS. Persons presenting with AHD were 37.8%. The median age of LP was 40 years (IQR 33-48), significantly higher (p < 0.001) than that of non-LP (35 years); 73.9% were males; 30.7% were non-nationals. The median age of AHD was 42 years (IQR 35-50), 74.5% were males; 31.1% were non-nationals. The proportion of LP among IDUs was 59.8%, among heterosexuals (HET) 61.1% and among MSM 44.3%. The proportion of AHD among IDUs was 43.6%, among HET 43.2% and among MSM 27.4%. Factors significantly associated with being LP were: age older than 50 years (OR = 4.6 [95% CI 3.8-5.6]); having been diagnosed in Southern Italy (Southern vs Northern Italy OR = 1.5 [95% CI 1.3-1.7]) having been diagnosed in Central Italy (Central vs Northern Italy OR = 1.3 [95% CI 1.1-1.6]); being HET (HET vs MSM, OR = 1.7 [95% CI 1.5-2.0]), being non-national (Non-national vs Italian, OR 1.7 (95% CI 1.5-2.0); being IDU (IDU vs MSM, OR = 1.6 [95% CI 1.2-2.1]). The same factors were significantly associated with being AHD. CONCLUSIONS Older people, people diagnosed in Central and Southern Italy, non nationals, and persons who acquired the infection through injecting drug use or heterosexual contact showed a higher risk of being diagnosed late. A more active offer of HIV testing and targeted interventions focussed on these populations are needed to optimize early access to care and treatment.
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Affiliation(s)
- Laura Camoni
- AIDS Unit, Department of Infectious, Parasitic and Immunomediated Diseases, National Institute of Health, Rome, Italy.
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Casari S, Suligoi B, Camoni L, Pavan A, Macchi L, Capelli M, Paraninfo G, Compostella S, Castelli F, Carosi G, Donato F. Epidemiological and clinical characteristics and behaviours of individuals with newly diagnosed HIV infection: a multicentre study in north Italy. J Prev Med Hyg 2012; 53:190-194. [PMID: 23469586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION We aimed to investigate socio-demographic, clinical and epidemiological characteristics and behaviours of subjects with new HIV diagnosis. METHODS We carried out a multi-centre cross-sectional study comprising 17 infectious diseases units in the Lombardy Region, North Italy. All subjects with a first positive test for HIV infection examined in 2008-09 were interviewed using a structured questionnaire. RESULTS 472 patients were enrolled (mean age 39.8 years, standard deviation [SD] 11.5), mostly males (78%), and born in Italy (77%). The most common routes of HIV transmission were heterosexual intercourse (49%) and sex among men who have sex with men (MSM) (40%). Never/sometimes use of a condom with occasional partners was associated with male gender, heterosexual transmission route, and with >10 sexual partners in their lifetime. 47% had previous HIV negative tests. Having had more than 2 previous HIV negative tests was associated with younger age, MSM transmission route, CD4+ lymphocyte count >350/microl and self-perception of risk. DISCUSSION This study shows that there is a large portion of the adult population, especially heterosexual men aged 45 years and over, who are at high risk of acquiring and transmitting HIV infection and undergoing the HIV diagnostic test late, due to risk behaviours combined with a low perception of being at risk. Compared to people infected by heterosexual contacts, MSM show a greater awareness of being at risk of infection, but this knowledge has a low impact in reducing at-risk behaviours.
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Affiliation(s)
- S Casari
- Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy.
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Pasqua A, Salfa M, Pecchioli S, Pasciullo G, Brignoli O, Costa S, Suligoi B. O153 EPIDEMIOLOGY OF GENITAL WARTS REPORTED BY GENERAL PRACTITIONERS IN ITALY. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60583-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mariani L, Salfa M, Timelli L, Biasio L, Vittori G, Fattorini G, Suligoi B. W052 PREVALENCE OF EXTERNAL GENITAL WARTS IN THE ITALIAN GENERAL FEMALE POPULATION. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61778-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Camoni L, Regine V, Boros S, Salfa MC, Raimondo M, Suligoi B. AIDS patients with tuberculosis: characteristics and trend of cases reported to the National AIDS Registry in Italy--1993-2010. Eur J Public Health 2012; 23:658-63. [DOI: 10.1093/eurpub/cks122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tavoschi L, Bernasconi D, Chiappi M, Suligoi B, Galli C, Regine V, Kityo C, Buttò S. Performance of V3-based HIV-1 sero subtyping in HIV endemic areas. Ann Ist Super Sanita 2011; 47:424-8. [PMID: 22194078 DOI: 10.4415/ann_11_04_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
HIV-1 serosubtyping based on reactivity to peptides from the V3 region of gp120 is a low-cost and easy to perform procedure often used in geographical areas with high prevalence and incidence of HIV infection. We evaluated the performance of V3-based serotyping on 148 sera from 118 HIV-1-infected individuals living in Uganda, with estimated dates of seroconversion. Of the 148 tested samples, 68 (46.0%) specifically reacted with only one of the V3 peptides included in the test (SP), 64 (43.2%) did not react with any peptide (NR) and 16 (10.8%) reacted with two or more peptides (CR). According to the estimated seroconversion date, the large majority of samples collected early after infection belonged to the NR group. These samples had also a low Avidity Index. In contrast, samples collected later after infection belonged mainly to CR and SP groups and had also a higher avidity index. These results indicate that the performance of V3-based assays depends on maturation of HIV-specific immune response and can be significantly lowered when these tests are carried out on specimens collected from recently infected individuals.
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Affiliation(s)
- Lara Tavoschi
- Centro Nazionale AIDS, Istituto Superiore di Sanità, Rome, Italy
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