Changing epidemiology of hepatitis A in the Bologna metropolitan area, northern Italy: importance of counselling and prophylactic measures for the male homo/bisexual population

Manfredi, Roberto; Calza, Leonardo; Chiodo, Francesco

doi:10.1111/j.1469-0691.2005.01219.x

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…Several countries, such as those in Southeast Asia, have presented socioeconomic improvements in recent decades. In those countries, a significant decline in HAV seroprevalence has been seen among the youngest individuals (Chen 2003, Kang et al 2004, Tosun et al 2004, Letaief et al 2005, Manfredi et al 2005, Sacy et al 2005.…”

Section: The Impact Of Socioeconomic Improvements On the Prevalence Omentioning

confidence: 99%

Epidemiological pattern and mortality rates for hepatitis A in Brazil, 1980-2002: a review

Vitral¹,

Gaspar

Souto

2006

Mem. Inst. Oswaldo Cruz

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Section: The Impact Of Socioeconomic Improvements On the Prevalence Omentioning

confidence: 99%

Epidemiological pattern and mortality rates for hepatitis A in Brazil, 1980-2002: a review

Vitral¹,

Gaspar

Souto

2006

Mem. Inst. Oswaldo Cruz

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“…However, surveillance is based on symptomatic cases, and seroprevalence studies have only been conducted in small areas or among certain age-classes or risk groups, and the results of these studies cannot be generalized to the entire population [5,[9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study

et al. 2007

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To define the pattern of HAV infection in Italy and to study the differences among geographic areas (northern, central and southern Italy) and age-classes, we performed HAV antibody testing on sera collected in 1996-1997 from a large sample of the Italian population and compared the results with those of other seroprevalence studies and with incidence data for the period 1985-2005, calculated by a surveillance system specific for acute viral hepatitis based on symptomatic cases. A total of 3,561 sera, collected by hospital-based reference laboratories in 18 out of 20 Italian Regions, were tested; 1,138 (32%, 95% CI: 30.5-33.5) were positive. The age-adjusted prevalence was 60.1% and the age-specific rates were among the highest rates reported in Europe in the 1990s. The age-adjusted seroprevalence showed a significant north-south gradient, increasing from 55% in northern Italy to 68% in southern Italy. Age and area of residence were found to be strong predictors of previous HAV infection: the marked increase in prevalence with increasing age represents a strong cohort effect. In northern Italy, a marked increase with age was observed beginning with the 20- to 29-year age-class, whereas in southern Italy, such an increase was observed beginning with the 12- to 19-year age-class, indicating that northern Italy preceded southern Italy by 10-20 years in terms of improvements in hygiene and sanitation. The incidence of HAV infection shows an evident peak in 1997, when an outbreak occurred in southern Italy, mainly affecting 15- to 24-year-old individuals. In the period from 1998 to 2005, the incidence drastically decreased (average of 3.2/100,000 inhabitants), reaching a minimum of 2/100,000 inhabitants in 2005.

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“…As anticipated, the direct effects of HIV infection on the kidney sum up with a varied genetic background and an extremely broad spectrum of immune-mediated factors, physiological conditions like pregnancy [75], and especially underlying comorbidities, immune recovery due to cART itself [10,21,22,63], and especially overwhelming (also non-HIV associated) diseases, the frequent chronic co-infections (i.e. chronic hepatitis B, D, and especially C) [90][91][92], but also an increasing prevalence of sexually-transmitted diseases including syphilis [24,[99][100][101] (as in our case), and even hepatitis A [102]. As expected, the extremely different medications prescribed (or self-prescribed, or taken in a not appropriate, even "heterodox" mode by HIV-infected patients themselves) [28,83,[96][97][98]103] have their intrinsic toxicities but they also have potential, varied drug-drug interactions among an almost endless list of drugs potentially used (or useful, or needed, or taken as "recreational" ones) by individuals living with HIV, even more in the years 2010-2011, when the life expectancy of HIV-infected individuals is approaching that of the general population (Table I) [5,8,18,27,36,42,67].…”

Section: Hiv Acute Nephropathymentioning

confidence: 78%

Kidney failure during HIV disease treated with tenofovir, multiple concurrent diseases and drug therapies

Manfredi¹,

Calza

Colangeli

et al. 2012

RHC

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A significant case report of a HIV infected patient in his fifties who experienced an excellent virological and immunological response to antiretroviral therapy (which has been modified just to prevent or avoid some adverse events), but developed a severe, sudden acute kidney failure while under a polypharmacy due to some underlying and overwhelming disorders (i.e. arterial hypertension, non-insulin-dependent diabetes mellitus, a recent acute heart infarction with remarkable remnants, and finally an anecdotal muscle-joint pain with self-prescription of non-steroideal anti-inflammatory drugs), represents the key point for a debate around the increasing frequency of "polypharmacy" in the field of HIV infection, even when HIV resistance to antiretroviral is not a concern. The continuing increase of mean age of HIV-infected population, plus the existing, sometimes unmodifiable risk factors for cardiovascular, dysmetabolic, and renal disorders, plus the adjunct of anecdotal illnesses prompting the resort to different drugs and medications, either prescribed for HIV infection itself, or taken for concurrent or subsequent diseases, or self-prescribed occasionally due to an intercurrent, trivial disorders per se, may prompt a complicated scenario culminating with a lifethreatening acute renal failure of tubular origin. Our report gives us the opportunity to revise and discuss the expected interactions between antiretroviral therapy and the even growing exposure to multiple different drug and drug classes, which may be responsible for relevant drug interactions and direct or adjunctive end-organ impairment, up to life-threatening conditions, which may be avoided or prevented by considering carefully all comorbidites and co-treatments potentially administered to HIV infected patients, thirty years after the discovery of AIDS.

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Changing epidemiology of hepatitis A in the Bologna metropolitan area, northern Italy: importance of counselling and prophylactic measures for the male homo/bisexual population

Cited by 11 publications

References 10 publications

Epidemiological pattern and mortality rates for hepatitis A in Brazil, 1980-2002: a review

Epidemiological pattern and mortality rates for hepatitis A in Brazil, 1980-2002: a review

Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study

Kidney failure during HIV disease treated with tenofovir, multiple concurrent diseases and drug therapies

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