Introduction: It is currently believed that Southern Italy (Calabria in particular) is less affected by the HIV epidemics than the rest of Italy. Detailed regional analyses are very important to define characteristics of HIV epidemics, across Italy and among different Italian regions. The impact of migration and socio-economical conditions may contribute to differences in prevalence and characteristics of new HIV diagnoses. This study aimed to describe the prevalence and the features of HIV-infected patients diagnosed in 2014-2015 in the Calabria Region and one nearby centre in Messina.— Patients and Methods: All new HIV diagnoses in all 7 Centers in the Calabria Region and 1 Centre in Messina, occurring between January 2014 and December 2015 were reviewed. Main demographical, virological, immunological and clinical data were recorded, as well as first-line antiretroviral regimens if prescribed.— Results: Ninety patients were selected. Most patients were males (78%) and Italians (73%). Migrants came more frequently from Africa (51%) and were concentrated in 3/7 Centers in the Calabria Region. Median age was 40 years (range: 20-71). More frequent risk factors for HIV acquisition were sexual intercourses(heterosexual [41%] or homosexual [39%]). Median CD4+ T-cell count at diagnosis was 342/mm3 (range: 7-1163). Twenty-seven percent of patients had ≥1 AIDS events at or before HIV diagnosis; 49% were late presenters. Combination antiretroviral therapy (cART) was prescribed to 82% patient, whereas 14 patients who are currently on follow-up (all with CD4+ ≥500/mm3 at diagnosis) have not yet started therapy. Twelve patients with an acute or recent infection received antiretroviral therapy. Conclusions: Ninety new HIV diagnoses were found in 2014-2015. Importantly, we found a high prevalence of AIDS/late presenters. Centers acted with immediate cART for acute or recently infected patients, while the test-and-treat strategy recently recommended for patients with chronic HIV infection has not been appliedyet in all cases. Southern Italy (Calabria in particular) merits attention as the burden of HIV is significant and clinical problems require maintenance and optimization of skills and resources.
Number and characteristics of new HIV diagnoses in the Calabria Region and in one nearby centre in Messina: a resurgent or still hidden epidemic in Southern Italy?
G. Nunnari;
2016-01-01
Abstract
Introduction: It is currently believed that Southern Italy (Calabria in particular) is less affected by the HIV epidemics than the rest of Italy. Detailed regional analyses are very important to define characteristics of HIV epidemics, across Italy and among different Italian regions. The impact of migration and socio-economical conditions may contribute to differences in prevalence and characteristics of new HIV diagnoses. This study aimed to describe the prevalence and the features of HIV-infected patients diagnosed in 2014-2015 in the Calabria Region and one nearby centre in Messina.— Patients and Methods: All new HIV diagnoses in all 7 Centers in the Calabria Region and 1 Centre in Messina, occurring between January 2014 and December 2015 were reviewed. Main demographical, virological, immunological and clinical data were recorded, as well as first-line antiretroviral regimens if prescribed.— Results: Ninety patients were selected. Most patients were males (78%) and Italians (73%). Migrants came more frequently from Africa (51%) and were concentrated in 3/7 Centers in the Calabria Region. Median age was 40 years (range: 20-71). More frequent risk factors for HIV acquisition were sexual intercourses(heterosexual [41%] or homosexual [39%]). Median CD4+ T-cell count at diagnosis was 342/mm3 (range: 7-1163). Twenty-seven percent of patients had ≥1 AIDS events at or before HIV diagnosis; 49% were late presenters. Combination antiretroviral therapy (cART) was prescribed to 82% patient, whereas 14 patients who are currently on follow-up (all with CD4+ ≥500/mm3 at diagnosis) have not yet started therapy. Twelve patients with an acute or recent infection received antiretroviral therapy. Conclusions: Ninety new HIV diagnoses were found in 2014-2015. Importantly, we found a high prevalence of AIDS/late presenters. Centers acted with immediate cART for acute or recently infected patients, while the test-and-treat strategy recently recommended for patients with chronic HIV infection has not been appliedyet in all cases. Southern Italy (Calabria in particular) merits attention as the burden of HIV is significant and clinical problems require maintenance and optimization of skills and resources.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
