1,721,112 research outputs found
Letter to the Editor on "Bonafè M, Prattichizzo F, Giuliani A, Storci G, Sabbatinelli J, Olivieri F. Inflamm-aging: Why older men are the most susceptible to SARS-CoV-2 complicated outcomes. Cytokine Growth Factor Rev"
No full text
The Impact of Immune System Aging on Infectious Diseases
No full textImmune system aging is becoming a field of increasing public health interest because of prolonged life expectancy, which is not paralleled by an increase in health expectancy. As age progresses, innate and adaptive immune systems undergo changes, which are defined, respectively, as inflammaging and immune senescence. A wealth of available data demonstrates that these two conditions are closely linked, leading to a greater vulnerability of elderly subjects to viral, bacterial, and opportunistic infections as well as lower post-vaccination protection. To face this novel scenario, an in-depth assessment of the immune players involved in this changing epidemiology is demanded regarding the individual and concerted involvement of immune cells and mediators within endogenous and exogenous factors and co-morbidities. This review provides an overall updated description of the changes affecting the aging immune system, which may be of help in understanding the underlying mechanisms associated with the main age-associated infectious diseases
Female sexual dysfunction: prevalence and risk factors in a cohort of women living with HIV in Italy
No full textBackground: Female sexual dysfunction (FSD) has an impact on the lives of many women, and it is inadequately investigated by medical professionals in women living with HIV (WLWH). Aim: In the present study, the aim was to investigate the prevalence and risk factors of sexual dysfunction (SD) in a cohort of WLWH using the Female Sexual Function Index (FSFI) questionnaire. Methods: This monocentric cross-sectional study was conducted at the ASST Spedali Civili of Brescia, Italy, between April 2023 and August 2023. To assess SD, the FSFI questionnaire was administered in accordance with current European AIDS Clinical Society guidelines to all consecutive cisgender adult WLWH who presented to our unit of Infectious Diseases. We used FSFI < 26.55 to identify participants at risk of SD. Participants were divided into two groups based on the pathological cut-off of FSFI score. Outcome: Comparison of demographic characteristics, menopausal status, and comorbidities among the two different groups of WLWH. Results: The questionnaire was offered to 371 women and 179 (48.2%) completed it. Of the 192 (51,8%) excluded, there were 129 women who declined to participate and 63 who were unable to do so due to a language barrier. Two-thirds (117/179) of individuals declared sexual intercourse in the previous month and were considered. Among those who completed the questionnaire, 36% scored below the FSFI total cut-off, indicating increased risk of SD. The most frequently impaired domains were desire (56.4%) and lubrication (52.1%). The correlation between age and total FSFI score was significant (P = .008), as well as menopausal women obtained lower FSFI scores (P = .0004). Clinical Implications: Age and menopausal status are substantial factors influencing sexual functionality. Strengths and Limitations: This study is limited by its reliance on self-reported data and a sample size that may be insufficient for detecting subtle effects. However, it leverages the well-validated FSFI tool and benefits from trusted questionnaire administration by HIV healthcare providers. Conclusion: Sexual dysfunction in menopausal WLWH has a high prevalence (36%). Interestingly, around 67% of women declined to investigate and deal with sexual issues
Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection
No full textBackgroundOrf virus (ORFV) is the pathogen responsible for Orf, a zoonotic viral infection that can be spread to humans from sheep and goats. Here, we present a case of human Orf complicated by an immune-related reaction, to raise awareness of this under-recognized disease avoiding unnecessary investigations and overtreatment.Case reportA 51-year-old woman with no previous medical history presented with a one-week history of three asymptomatic swelling nodules with a grey necrotic center and red outer halo on her index finger. At physical examination there was also a pruritic papulovesicular eruption on her hands and feet. She reported a recent contact with a goat which had a similar nodular lesion in its mouth. A biopsy of the lesions was performed and a diagnosis of Orf complicated by widespread erythema multiforme was made based on the clinical and histopathological features. The lesions spontaneously resolved within the next 2 weeks.ConclusionsOrf is not very prevalent in our region, so we performed a biopsy of the lesion to guide us toward a diagnosis. However, we should remember that the diagnosis of ecthyma relies on clinical evaluation and epidemiological criteria
An exploratory pilot study on the involvement of APOE, HFE, C9ORF72 variants and comorbidities in neurocognitive and physical performance in a group of HIV-infected people
Full text linkCognitive decline of aging is modulated by chronic inflammation and comorbidities. In people with HIV-infection (PWH) it may also be affected by HIV-induced inflammation, lifestyle and long-term effects of antiretroviral therapies (ART). The role of genetics in the susceptibility to HIV-associated neurocognitive disorders (HAND) is not fully understood. Here we explored the possible relations among variants in 3 genes involved in inflammation and neurodegenerative disorders (APOE: epsilon 2/epsilon 3/epsilon 4; HFE: H63D; C9ORF72: hexanucleotide expansions >= 9 repeats), cognitive/functional impairment (MiniMental State Examination MMSE, Clock Drawing Test CDT, Short Physical Performance Battery SPPB), comorbidities and HIV-related variables in a cohort of > 50 years old PWH (n = 60) with at least 10 years efficient ART. Patients with diabetes or hypertension showed significantly lower MMSE (p = .031) or SPPB (p = .010) scores, respectively, while no relations between HIV-related variables and cognitive/functional scores were observed. Patients with at least one APOE epsilon 3 allele had higher CDT scores (p = .019), APOE epsilon 2/epsilon 4 patients showing the lowest scores in all tests. Patients with HFE-H63D variant showed more frequently hypertriglyceridemia (p = .023) and those harboring C9ORF72 expansions > 9 repeats had higher CD4(+)-cell counts (p = .032) and CD4% (p = .041). Multiple linear regression analysis computed to verify possible associations among cognitive/functional scores and all variables further suggested positive association between higher CDT scores and the presence of at least one APOE epsilon 3 allele (2,2; 95% CI [0,03 0,8]; p = .037), independent of other variables, although the model did not reach the statistical significance (p = .14). These data suggest that in PWH on efficient ART cognitive abilities and physical performances may be partly associated with comorbidities and genetic background. However, further analyses are needed to establish whether they could be also dependent and influenced by comorbidities and genetic background
Lopinavir/ritonavir: Repurposing an old drug for HIV infection in COVID-19 treatment
Full text linkCurrently, there is no specific antiviral treatment for COVID-19. However, drugs previously
developed to treat other viral infections are being tested to verify if they might also be effective
against SARS-CoV-2, the virus that causes COVID-19. Twenty years ago, the F.D.A. approved
Lopinavir/ritonavir (LPV/r) to treat HIV infection. LPV and ritonavir were initially purposed to inhibit
3-chymotrypsin-like protease (3CLpro) of SARS-CoV and MERS-CoV and preliminary promising data
on its efficacy for treating people infected with those viruses were available. Therefore, due to the
high genetic similarities among those viruses and SARS-CoV-2, early during COVID-19 pandemic
LPV/r was also proposed as one emergency treatment.
We reviewed data from the literature about LPV/r treatment and SARS-CoV-2 infection, mainly
focused on the efficacy and safety of this drugs for COVID-19 treatment. We can conclude that
although up to date no clear benefit has been observed with the LPV/r treatment beyond standard
care, its efficacy against SARS-COV-2 infection deserves further evaluations, particularly during the
very early phase of the disease
Sexual dysfunction in women living with HIV: an updated narrative review
No full textIntroduction: Female sexual dysfunction is a significant concern for many women worldwide, with chronic health conditions such as HIV infection contributing to its prevalence. However, there is a paucity of studies focusing this subject in the available literature. Objectives: This narrative review aimed to provide a comprehensive and updated overview of the current state of knowledge regarding sexual dysfunction in women living with HIV (WLWH). Methods: References for this review were identified from MEDLINE, Embase, and Cochrane databases using the search terms “sexual dysfunction” AND “HIV” AND “female” OR “woman.” The final reference list was generated based on the timeline, originality, and relevance to the scope of this narrative review. Results: In the general population, female sexual function is influenced by various factors, including biological, psychological, physiological, sociocultural, and relational ones. In WLWH, the role of antiretroviral therapy in female sexual dysfunction is controversial. Although current international guidelines recommend collecting a thorough sexual life anamnesis during routine outpatient visits, sexual difficulties are often inadequately addressed. Conclusion: A tailored clinical approach that focuses on the multidimensional domains of sexual dysfunction may improve the sexual health and quality of life in WLWH
The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
No full textPurposeOral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a range of new, returning, or ongoing symptoms after SARS-CoV-2 infection. Little is known about the impact of such therapies on long COVID.MethodsThis is a retrospective observational study, including all outpatients evaluated from April 2021 to March 2022 in Brescia, Lombardy, northern Italy. Patients were stratified in three groups: (a) treated with mAbs, (b) treated with antivirals drugs and (c) controls (patients eligible for a or b who refused treatment). Data were collected at baseline and at month 1 and 3 (data on self-reported symptoms were collected using a telephone-administered questionnaire). We assessed early COVID-19 therapies effectiveness in preventing hospitalization, death at 1 or 3 months and persisting symptoms at 3 months after the onset of SARS-CoV-2 infection.ResultsA total of 649 patients were included in the study, of which 242 (37.3%) were treated with mAbs, 197 (30.3%) with antiviral drugs and 210 (32.4%) were not treated. Patients most frequently reported cerebro-cardiovascular diseases (36.7%) followed by obesity (22%). Overall, 29 patients (4.5%) died or were hospitalized at 1 or 3-month follow-up. Death or hospitalization was positively associated with older ages, with a significant linear trend (OR 3.05; 95% CI 1.16-8.06, for patients aged 80 or more years compared to those aged less than 65). Data on long COVID at 3 months were available for 323 (49.8%) patients. A positive association emerged for females compared to men, with an OR of 2.14 (95% CI 1.30-3.53) for any symptoms. Conversely, inverse associations were found for treatment groups as compared to the control one, with significant estimates among patients treated with antiviral drugs for any symptoms (OR 0.43, 95% CI 0.21-0.87) and patients treated with mAbs for any neuro-behavioral symptoms (OR 0.48, 95% CI 0.25-0.92).ConclusionsWe report beneficial effect of early use of anti-SARS-CoV-2 antivirals and mAbs on long COVID
Impact of COVID-19 pandemic on HIV viremia: a single-center cohort study in northern Italy
No full textBackground Brescia Province, northern Italy, was one of the worst epicenters of the COVID-19 pandemic. The division of infectious diseases of ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili Hospital of Brescia had to face a great number of inpatients with severe COVID-19 infection and to ensure the continuum of care for almost 4000 outpatients with HIV infection actively followed by us. In a recent manuscript we described the impact of the pandemic on continuum of care in our HIV cohort expressed as number of missed visits, number of new HIV diagnosis, drop in ART (antiretroviral therapy) dispensation and number of hospitalized HIV patients due to SARS-CoV-2 infection. In this short communication, we completed the previous article with data of HIV plasmatic viremia of the same cohort before and during pandemic. Methods We considered all HIV-patients in stable ART for at least 6 months and with at least 1 available HIV viremia in the time window March 01-November 30, 2019, and another group of HIV patients with the same two requisites but in different time windows of the COVID-19 period (March 01-May 31, 2020, and June 01-November 30, 2020). For patients with positive viremia (PV) during COVID-19 period, we reported also the values of viral load (VL) just before and after PV. Results: the percentage of patients with PV during COVID-19 period was lower than the previous year (2.8% vs 7%). Only 1% of our outpatients surely suffered from pandemic in term of loss of previous viral suppression. Conclusions Our efforts to limit the impact of pandemic on our HIV outpatients were effective to ensure HIV continuum of care
- …
