Biomedical subjects

V Giannini

Publications and source records attributed to V Giannini.

At least 19 recordsLinked to original sources

PubMed1997

A randomized trial (ISS 902) of didanosine versus zidovudine in previously untreated patients with mildly symptomatic human immunodeficiency virus infection.

In this multicenter study (ISS 902), 554 previously untreated patients with <500 CD4 cells/mm3 and mildly symptomatic human immunodeficiency virus disease were randomized to receive zidovudine or didanosine (ddI). After a mean follow-up of 20 months, 80 patients (40 zidovudine, 40 ddI) had died and 146 had at least one AIDS-defining event (73 zidovudine, 73 ddI). Overall, no difference was found between treatments with respect to progression to AIDS or death. The analysis of relative risk (RR) of progression over time, however, showed an initially minor risk for zidovudine patients and an inversion in the zidovudine-ddI RR in the second and third years of follow-up. Didanosine showed a greater effect on CD4 cell count response. The two drugs confirmed the toxicity patterns already reported in other trials, with a low occurrence of pancreatitis (ddI 1.3%, zidovudine 0.4%). The overall results suggest that, in this population, zidovudine and ddI monotherapies have comparable long-term clinical efficacy and that more powerful regimens should be preferred.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Clinical and mycological evaluation of fluconazole in the secondary prophylaxis of esophageal candidiasis in AIDS patients. An open, multicenter study.

A prospective, multicenter, open study of fluconazole prophylaxis was performed in AIDS patients to evaluate the efficacy and toxicity of the drug in preventing relapses of esophageal candidiasis. To this aim, 99 AIDS patients who presented a first episode of clinically and microbiologically confirmed esophageal candidiasis were enrolled in eleven clinical centers scattered throughout the Italian territory. After resolution of this initial esophagitis, all subjects were given fluconazole, 100 mg/die, and followed up for a 6 month period. Only 7 out of the 99 patients enrolled had a relapse of Candida esophagitis, during a mean follow-up period of 138.5 days. All relapsing patients had CD4+ cell number < 100/microliters at baseline. Mild side effects were reported in only eight patients. However, 14 of the 27 subjects from whom serial serum samples were available became (12) or remained (2) antigenemic during fluconazole prophylaxis, independently from relapse, suggesting the persistence of tissue-invasive, proliferating Candida cells. Overall, the data of this study suggest a beneficial effect of prophylactic maintenance therapy with fluconazole against Candida esophagitis, particularly in the population with > 100 CD4+/microliters. However, the data on Candida antigenemia in these patients invite the consideration of a relative inefficiency of the drug to eradicate the microrganism from the esophageal tissue.

AIDS-Related Opportunistic Infections↗

PubMed1994

[Changed etiopathogenic and clinical features of infective endocarditis].

The authors report their experience on etiological and clinical aspects of infective endocarditis (IE). A series of 182 consecutive patients, including 83 cases of medical IE, 73 cases of IE in intravenous drug abusers (DA), 22 cases of IE on late prosthetic valves and 4 cases of IE on early prosthetic valves were evaluated since 1976. Medical IE occurred frequently in the elderly patients and in most of the cases (80%) involved natural valves with underlying abnormalities, either rheumatic (42%) or degenerative (33%) or malphormative (25%). Pre-existing valvular pathology was not needed for IE in DA, occurring in 13%, mainly due to a previous IE. In most of the cases IE in DA was a staphylococcal IE (80%) and a right-sided IE (77%). Streptococci were frequent agent both in medical and late prosthetic valves IE (55%): however, a wide pattern of microorganisms, including "unusual" pathogens like nutritionally variant Streptococci, Haemophylus parainfluenzae, Haemophylus paraphrophylus, Coxiella burnetii and the so-called "non pathogen microorganisms" (e.g. Neisseria sicca) was identified as etiological agent. As regards the clinical approach and diagnosis, the Authors underline some atypical clinical presentations of IE: the pulmonary presentation, occurring in right-sided IE, mainly in DA; the neurological presentation, suggesting staphylococcal etiology and left-sided IE; the vasculitis presentation, miming connective tissue diseases; the cardiac presentation, observed in aortic localization (1 case). One or more severe complications occurred in 65% of the patients, contributing to adverse outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Counselling and testing for HIV infection in Rome 1985-1990: analysis of client characteristics and seroprevalence.

To analyze the characteristics of persons seeking HIV testing, and to evaluate the potential effectiveness of a regional program of confidential counselling and testing for HIV infection, we reviewed data on 5127 clients seen from July 1985 to December 1990 in a major counselling and testing site of the city of Rome. During the study period, the number of clients attending the service increased without a parallel rise of the number of newly identified HIV seropositive subjects. Consequently, the seroprevalence rate decreased from 27.6% in the second half of 1985, to 4.3% in the second half of 1990 (p < 0.001). This decrease appears to be associated with the increasing attendance of low risk subjects and of those referred for testing by family practitioner. The study suggests the need for more efficient strategies to reach persons at higher risk for HIV infection.

AIDS Serodiagnosis↗

PubMed1992

Prevalence of hepatitis B and C viruses and human immunodeficiency virus infections in women of reproductive age.

OBJECTIVE: To determine the prevalence of hepatitis B and C viruses, and human immunodeficiency virus infections in women of reproductive age attending a health care system. DESIGN: Prospective cross-sectional study. SETTING: Public Obstetric Clinic and Service for Pre- and Perinatal Prevention of Infectious Diseases, Rome, Latium Region, Italy. SUBJECTS: 1142 women attending our centres consecutively for delivery, miscarriage, voluntary interruption of pregnancy or screening for pre- and perinatal prevention of infectious diseases. INTERVENTIONS: Serum samples, collected after informed consent over a period of 2 months, were tested for hepatitis B virus markers (anti-HBc and HBsAg) by enzyme linked immunosorbent assay (ELISA), for antibodies against hepatitis C virus (by ELISA and, if positive, by RIBA) and for human immunodeficiency virus antibodies (by ELISA and, if positive by Western blot). RESULTS: The seroprevalence of hepatitis B virus was 14.4% (95% CI Poisson distribution 12.2-16.5) for anti-HBc and 1.6% (95% CI, 0.9-2.5) for HBsAg. Antibodies against hepatitis C virus were detected by ELISA in 2.4% (CI 1.6-3.5) and by first generation RIBA in 0.9% (CI 0.4-1.6). Human immunodeficiency virus seroprevalence was 1.0% (CI 0.5-1.7). No significant differences were observed by age or by reason for attending. CONCLUSIONS: Women attending our centres have a higher prevalence of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection than those observed in our country in larger national surveys of newborn babies, in reproductive-aged women or in other selected low-risk groups such as blood donors. This could be due to the attendance of women at increased risk such as drug addicts. The information has the additional value of emphasizing the need for adherence by health care personnel, to the recommendations issued for the prevention of occupational infections.

Adult↗

PubMed1972