No abstract

Natural resistance-associated substitutions (RASs) are reported with highly variable prevalence across different HCV genotypes (GTs). Frequency of natural RASs in a large Italian real-life cohort of patients infected with the 4 main HCV-GTs was investigated. NS3, NS5A and NS5B sequences were analysed in 1445 HCV-infected DAA-naïve patients. Sanger-sequencing was performed by home-made protocols on 464 GT1a, 585 GT1b, 92 GT2c, 199 GT3a, 16 GT4a and 99 GT4d samples. Overall, 20.7% (301/1455) of patients showed natural RASs, and the prevalence of multiclass-resistance was 7.3% (29/372 patients analysed). NS3-RASs were particularly common in GT1a and GT1b (45.2-10.8%, respectively), mainly due to 80K presence in GT1a (17%). Almost all GTs showed high prevalence of NS5A-RASs (range: 10.2–45.4%), and especially of 93H (5.1%). NS5A-RASs with fold-change >100x were detected in 6.8% GT1a (30H/R-31M-93C/H), 10.3% GT1b (31V-93H), 28.4% GT2c (28C-31M-93H), 8.5% GT3a (30K-93H), 45.5% GT4a (28M-30R-93H) and 3.8% GT4d (28V-30S-93H). Sofosbuvir RAS 282T was never detected, while the 159F and 316N RASs were found in GT1b (13.4–19.1%, respectively). Natural RASs are common in Italian patients infected with HCV-GTs 1–4. High prevalence of clinically-relevant RASs (such as Y93H) supports the appropriateness of HCV resistance-test to properly guide DAA-based therapy.

No abstract

HCV-NS3 sequencing provides reliable results and at the same time gives two clinically relevant pieces of information: a correct subtype/genotype assignment and the detection of variants that may interfere with the efficacy of PI.

The COVID-19 outbreak in Italy saturated the public hospitals' intensive care units in March 2020. The Ministry of Health asked for the Military Health Unit's intervention to deal with the emergency. The first COVID-19 Army field hospital in the world was thus built in Piacenza, Italy, to address the emergency. We describe the architecture of the hospital and the preventive measures adopted to reduce COVID-19 contagion among the medical personnel. The hospital project with the "H" shape divides the "dirty path" of entry for operators and patients from the "clean path" of exit for operators. Hypochloritebased and alcohol-based solutions were used for personal protective equipment (PPE) decontamination before reuse. Although exposed to 50 confirmed COVID-19 patients, all primary care personnel tested negative to COVID-19, before the operation, 14 days after the first patient and 30 days after the closure of the military field hospital. Due to the reported discomfort and its potential toxicity, the hypochlorite-based disinfection method was substituted with alcohol-based disinfection solution, which displayed comparable effective results. The results of the present study pave the way for the creation of a protocol for future validation in larger studies aimed at providing guidelines in emergency conditions.