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ABSTRACT: In recent years an increase in the number of sexually transmitted infections (STIs) in men who have sex with men (MSM) has been reported in different industrialised countries. Because few epidemiological data on the STls/MSM population in Sicily are available, a survey was conducted to assess the prevalence of STls/enteric protozoa and risky sexual behaviours among MSM in western Sicily.
In 2010, 74 MSM with median age of 30 years old, were recruited via networks. All participants to the study were interviewed by anonymous self-administered questionnaire in order to collect social/demographic information, clinic data and STI-related risky sexual behaviours. After completing the questionnaire, blood samples were collected to determine HIV, HCV, HHV8 and Treponema pallidum antibodies; presence of Giardia duodenalis and Cryptosporidium parvum was also investigated in faecal samples by immunofluorescence assay.
HIV, HHV8, T. pallidum and Giardia prevalence were 8.1%, 16.2%, 21.6% and 16.4% respectively; all patients were negative for HCV and Cryptosporidium infections. The median values of sexual anal intercourse and oral sex per week were 2 and 1, respectively. 7% of participants always had unprotected anal sex, 50.7% sometimes used condom during sexual anal intercourse and 42.3% always had protected anal sex. All MSM-HIV+ and 7 (43.7%) syphilis seropositives were unaware of their own infection.
MSM in western Sicily are a high risk group for important STIs. It seems necessary that continuous interventions for preventing HIV/AIDS and other STls and for improving the level of knowledge of symptoms are needed.
Journal of preventive medicine and hygiene 12/2012; 53(4):181-5.
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ABSTRACT: The aim of this paper is to improve the feasibility perception of policymakers, health care workers and target population about the cost-effectiveness of the implementation of colorectal screening as Public Health strategy.
Retrospective study by application of a three-step model designed for a local setting in Sicily (Palermo and its Province) in order to distribute Fecal Occult Blood Tests (FOBTs), offer colonoscopy and surgery, by district allocation of pharmacies, public digestive endoscopic centres and oncologic and general surgery units. Mean adherence to consolidated colorectal screening programs in Italy was applied in order to evaluate the feasibility of an operative model in our area.
Applying the model to the target population (269,368 individuals of both sexes), it can be expected a mean percentage of 79% delivered invitation and a mean participation rate of 46.3% accounting for a total of 213,070 invited individuals and 98,651 participating in the first round of the program. Furthermore, considering the national mean of 6% positive FOBT, 82% of colonscopy adhesion and 7% CRC detection rate, it can be scheduled a burden for health care structures involved in the program accounting for 49,325 FOBTs, 2,338 colonscopies and 141 surgeries for each year.
This work demonstrates the feasibility of a colorectal screening project in our area, showing a sustainable impact for local health care involved structures. Furthermore, this program may be spread as an applicative model to other areas, adapting the project to the needs of the local setting in which the colorectal screening will be organized.
Journal of preventive medicine and hygiene 12/2011; 52(4):191-5.
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International Journal of Cancer 03/2001; 91(4):588-91. · 5.44 Impact Factor
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ABSTRACT: To evaluate whether or not human herpesvirus 8 (HHV8) can be transmitted through a non-sexual route a serological survey was carried out in a group of 51 catholic nuns. The seroprevalence rate and the geometrical mean antibody titre to anti-latent HHV8 antigen were similar in nuns and in a group of 60 women, matched by age, in the general population (27 vs. 24%; 1028 vs. 1575, respectively). Moreover, by using nested polymerase chain reaction (PCR), HHV8 DNA sequences were detected in 7 of 16 (43.8%) saliva and peripheral blood mononuclear cells (PBMC) from patients with classical Kaposi's sarcoma (KS) and in 3 out of 7 (42%) AIDS-KS patients. None of 5 HIV positive persons who did not have KS tested positive for HHV8 DNA. HHV8 DNA sequences were also detected in 2 of 12 (17%) saliva and 1 PBMC sample out of 12 healthy HHV8 positive individuals (age range: 30-80 years old). This paper suggests that non-sexual transmission of HHV8 is operating in our geographical setting and saliva may be a potential source of HHV8 spreading in the general population.
Epidemiology and Infection 01/2001; 125(3):671-5. · 2.84 Impact Factor
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ABSTRACT: This study in intravenous drug users (IVDUs) investigated differences in serum soluble tumor necrosis factor types I and II (sTNFR-I and II) concentrations in HIV-1-infected IVDUs and controls. This study also investigated whether changes of sTNFRs concentration affect the risk of death among patients with AIDS. A cross-sectional study of 54 subjects with AIDS, 47 HIV-seropositive IVDUs, 47 HIV-seronegative IVDUs, and 21 healthy subjects showed that sTNFRs concentration increases from healthy controls to AIDS patients through HIV-seronegative and HIV-seropositive subjects (p < 0.01). sTNFR-I concentration, however, was shown to be similar in HIV-seronegative IVDUs and healthy controls. In the longitudinal study, serum concentration of sTNFRs was determined near AIDS diagnosis in 21 IVDUs and 1 year later (start for the survival study). Cox proportional hazards regression was performed to assess the prognostic value of percent change of sTNFR level alone and in combination with T lymphocyte subsets, HIV-p24 antigenemia and opportunistic infections for death within 240 days. Uni- and multivariate Cox modelling for dichotomised variables according to its median showed an increase of sTNFR-II by at least 30% to be single significant predictor of death: crude relative risk 3.69, p = 0.03; adjusted relative risk 5.67, p = 0.02. Mean survival was 126 days in 11 patients whose sTNFR-II level increased by at least 30%, and 176 days in 10 patients with less change in sTNFR-II (p = 0.02). CONCLUSIONS: sTNFRs concentration is higher in IVDUs than in healthy controls and is highest in AIDS patients. Survival of patients with AIDS is associated with variation in the concentration of sTNFR-II.
European Journal of Epidemiology 03/2000; 16(3):209-16. · 4.71 Impact Factor
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A M Perna,
F Bonura,
F Vitale,
E Viviano,
M A Di Benedetto,
F Ajello,
M R Villafrate,
T Prestileo,
S Mancuso,
J J Goedert, N Romano
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ABSTRACT: Human herpes virus 8 (HHV8) appears to be the primary aetiologic agent of Kaposi sarcoma (KS). To study the distribution of HHV8, a seroepidemiological study was carried out in western Sicily, where a high incidence rate of classical KS is well documented.
A total of 970 sera of healthy human immunodeficiency virus (HIV) negative individuals of general population (1-70 years old) and 742 sera of individuals in different risk groups for HIV infection were evaluated by means of an indirect immunofluorescence assay able to detect antibodies to lytic and latent HHV8 antigens.
Crude seroprevalence to HHV8 antigens was 11.5% in the general population, and it increased significantly with age from 6% under age 16 to 22% after age 50. Significantly higher HHV8 seroprevalence rates were detected among HIV positive and negative homosexual men (62% and 22%, respectively), men who had sex with prostitutes (40% and 29%, respectively); female prostitutes (42% and 30%, respectively), and clients at a sexually transmitted disease clinic (male: 60% and 33%, respectively, female: 63% and 43%, respectively). In contrast, heterosexual intravenous drug users had seroprevalence rates comparable to those found in the general population.
The results suggest that HHV8 infection is widespread in Western Sicily. The high seroprevalence in individuals with high risk sexual activity point to the role of sexual behaviour in the transmission of the infection in adults, whereas the detection of antibodies in younger population (under 16 years old) is suggestive of a non-sexual route of transmission, probably occurring during childhood by close personal contact.
International Journal of Epidemiology 03/2000; 29(1):175-9. · 6.41 Impact Factor
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ABSTRACT: Four HHV-6 strains were initially isolated during attempts to observe HIV-1 replication in cultured primary lymphocytes from 48 patients with AIDS. HHV-6 DNA from each strain was extracted from primary cell cultures and amplified using specific primers in a nested polymerase chain reaction (PCR) assay. All HHV-6 strains were classified as B variants by submitting the PCR products to the digestion of two restriction enzymes (Hind III and Bgl II). Since in primary cultures, the appearance of HHV-6 cytopathic effect was followed by a progressive reduction of HIV-1 replication, we tried to reproduce the observed inhibition in vitro. Two HHV-6 strains, used throughout the experiments, showed their ability to suppress HIV-1 replication when the viruses co-infected CD4+T lymphocyte cultures. While the intrinsic mechanism of this finding still remains unclear, the inhibition of HIV-1 replication was observed only when a high multiplicity of infection (m.o.i.) of HHV-6 and a low m.o.i. of HIV-1 were used in dually infected cell cultures. By using a semiquantitative determination of HIV-1 cDNA by PCR, it appears that the inhibition begins in infected cell cultures and, once established, does not allow any further HIV-1 replication.
The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 08/1999; 22(3):161-71. · 1.00 Impact Factor
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ABSTRACT: A cross-sectional study was carried out on the sera of 88 active intravenous drug users (IVDU) collected between 1985 and 1986 to evaluate the circulation of HCV genotypes in Western Sicily. The patients were grouped by age and classified by their HIV status. Genotype 3a (48.8% of all cases) was most frequently detected, followed by genotype 1a (20.4%) and type 1b (17.0%). No significant differences in HCV genotype distribution were observed between HIV positive and negative individuals. Next, the HCV genotype distribution found in sera samples of IDVUs drawn between 1985 and 1986 was studied and divided into three age groups. The genotype distribution in the younger group was then compared with samples collected ten years later, between 1995 and 1996, from young HIV negative IVDU individuals. A different distribution between HCV genotypes 3a and 1a was found with a relative, though not significant, increase in the detection of genotype 1a (38%). Finally, sera from six IVDUs obtained at three different times over a ten-year period were genotyped for HCV. None of the subjects showed any change in the genotype found at the first sampling throughout the ten years. The results suggest that a) genotype 1a and 3a are the most common among IVDUs in Western Sicily, b) concurrent HIV infection does not seem to influence HCV genotype and c) infected IVDUs harbor almost exclusively one genotype.
The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 11/1998; 21(4):335-42. · 1.00 Impact Factor
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JNCI Journal of the National Cancer Institute 08/1998; 90(13):1013-4. · 13.76 Impact Factor
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Journal of Clinical Microbiology 12/1997; 35(11):3010. · 4.15 Impact Factor
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Infection 10/1997; 25(6):381-382. · 2.66 Impact Factor
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ABSTRACT: To evaluate the circulation of a new human herpesvirus (HHV), HHV-8 or Kaposi's sarcoma (KS)-associated herpesvirus in a geographical area where a high incidence rate of classical KS was already present before the appearance of the AIDS epidemic.
The study was carried out by analysing: (i) bioptic samples from classic, AIDS-associated KS, and controls; (ii) peripheral blood mononuclear cells (PBMC) from classic KS, HIV-positive subjects with and without KS and healthy HIV-negative individuals; (iii) semen samples from heterosexual HIV-positive and HIV-negative individuals affected or not by KS; and (iv) cervical swabs from HIV-negative healthy heterosexual females. All specimens were tested for the presence of HHV-8 DNA sequences by a two-step polymerase chain reaction.
Positive results were obtained in 90% of bioptic samples of classic KS and in 100% of AIDS-associated KS. Viral sequences were also present in 50% of PBMC of subjects with classic KS and AIDS-associated KS, in 10% of AIDS patients without the angiosarcoma and in 11% of healthy HIV-negative individuals. Finally, HHV-8 DNA was detected in 13% of semen of HIV-negative heterosexual individuals and in 10% of AIDS patients without KS. Both PBMC and ejaculates from the same individual gave positive results. No HHV-8 sequences were found in cervical swabs.
HHV-8 is widespread in the general population in Sicily since it was detected in PBMC and semen of heterosexual HIV-negative individuals and is not found only in high-risk groups. The viral load appears to be more elevated in a high-risk population and it may be ascribed to a viral reactivation. The higher incidence rates of KS in Sicily compared with northern Italy and other European countries might be related to the presence of HHV-8 in the general population.
AIDS 05/1997; 11(5):607-12. · 6.24 Impact Factor
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ABSTRACT: We investigated by nested PCR the possible association of human herpesvirus 6 (HHV-6) and human papillomavirus (HPV) genomes in the cervixes of 109 women with normal and abnormal cytological smears. HPV DNA was detected in 8.33% of 24 women with normal cytologies and in 41.1% of 85 women with abnormal cytologies; the proportion of HPV DNA was directly related to the severity of the lesions. HHV-6 DNA was found in only one patient, who had a cytological pattern of koilocytosis. The HHV-6 genome was classified by restriction enzyme analysis as variant B. The study indicates that detection of the HHV-6 genome in the cervixes of women with a wide spectrum of gynecological complaints is a rare event and rules out the possible association between HHV-6 and HPV genomes in cervical cancer lesions.
Journal of Clinical Microbiology 07/1996; 34(6):1589-91. · 4.15 Impact Factor
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ABSTRACT: A cross-sectional seroepidemiologic study was carried out between 1985 and 1990 in 1,567 heterosexual intravenous drug users who had been seen at the AIDS Regional Reference Center in Palermo, Italy, to evaluate the rate of human immunodeficiency virus type 1 (HIV-1) seroprevalence in this group and its long-term trend. Sixty serum samples collected from drug users in 1980 and 1983, before the founding of the Center (1985), were tested as well. Some demographic and behavioral risk factors were studied in a subgroup of intravenous drug users enrolled in 1985, 1987, and 1990 for their possible association with HIV-1. These factors were also studied in relation to hepatitis B virus infection, since both viruses share the same modes of spread. These drug users had a higher prevalence of markers for hepatitis B virus than of HIV-1 antibodies, and the prevalence rates in sera collected declined over time for both infections. The presence of both antibodies to HIV-1 and markers for hepatitis B virus was independently associated with the age of the drug user, the duration of drug use, and the year of serum collection. Antibodies to HIV-1 were observed more frequently in females than in males. No relation was found between education or employment status and the presence of HIV-1 antibodies or hepatitis B virus markers. Although new HIV-1 infections still occur, the decline in seroprevalence observed at the end of the 1980s might be related to modifications in social behavior among newer drug users, partial exhaustion of the susceptible population, and increasing risk awareness in more experienced users.
American Journal of Epidemiology 07/1992; 135(11):1189-96. · 5.22 Impact Factor
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ABSTRACT: A strain of HIV 1 (PA 40), isolated from a patient with AIDS, showed a size variation of its external glycoprotein. This glycoprotein had an estimated molecular weight of 105 Kd and differed from that of both HIV 1 IIIb and HIV 2 Rod strains. The protein was derived from a bigger (140 Kd) precursor, detectable only in the infected cells and could incorporate labeled glucose in its prosthetic portion. The change in size of the external glycoprotein may be the result of envelope sequence variations since the unglycosylated form of the envelope precursor of PA 40 strain, detected in tunicamycin treated cells, was smaller than that of the HIV 1 IIIb strain. The different size of the external glycoprotein is a further aspect of the variability of the biological characteristic of HIV 1 strains and might be correlated with the emergence of more virulent variants which arose during the progression of the clinical disease.
Microbiologica 02/1991; 14(1):15-20.
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ABSTRACT: The pattern of free and antibody-complexed HIV antigen and the antibody profile were investigated retrospectively in 305 serum samples taken from 22 AIDS patients before and during the development of AIDS and from 40 apparently healthy seropositive individuals. Most AIDS patients were found positive for both free and complexed antigen and had high gp41 antibody titres but low or undetectable p24 antibody. Four different patterns of HIV antigenaemia were observed: 1) positive for both free and complexed antigen; 2) negative for free HIV antigen at first, but always positive for complexed antigen; 3) positive for free antigen without complexed antigen; and 4) negative for both free and complexed antigen. The development of immune complexes preceded the appearance of free antigen and might reflect the ongoing viral replication with antigen excess and binding of anticore antibodies. No correlation was found between the development of AIDS symptoms and either the duration of free antigen positivity or the level of antigenaemia. A different pattern was observed in apparently healthy seropositive individuals: 90% of whom had high antibody titres to p24 and gp41 and were persistently negative for free and complexed HIV antigen. This study demonstrates that testing HIV markers in sequentially collected serum samples from HIV seropositive individuals is a useful and simple tool for early identification of persons at risk of developing AIDS.
Journal of Medical Virology 02/1990; 30(1):30-5. · 2.82 Impact Factor
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ABSTRACT: A seroepidemiological survey was carried out with the aim of establishing whether or not HIV 2 infection could be detected in Western Sicily. Two groups of sera were tested by EIA and WB assay against HIV 1 and HIV 2. 200 sera taken from North African immigrants in the Mazara del Vallo area, and 297 samples taken from AIDS-high risk groups individuals living in Palermo. None of the North African sera was positive to HIV 1 and/or HIV 2 by either techniques. 118 of the 297 sera from Palermo were HIV 1 positive by both techniques; 69 thereof also reacted to HIV 2 by EIA. Only six of these were confirmed by WB assay, showing a clear reactivity against the 140 and 105 HIV 2 glycoproteins. However, all six sera were considered merely cross-reactive to HIV 2, since none of them had neutralizing antibody to HIV 2 and the cross reactivity to glycoproteins of HIV 2 could be removed by absorbing them with HIV 1 infected cells. It seems therefore that HIV 2 has not yet reached our area. Early detection of the possible presence of this virus in our country could be obtained by improving both the surveillance and the effectiveness of laboratory tools for HIV 2 diagnosis.
Microbiologica 08/1989; 12(3):195-201.
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ABSTRACT: An assay based on inhibition of cytopathic effect of human immunodeficiency virus (HIV) strains in Molt 4 cells was developed to quantitate neutralizing antibodies (NA) in sera of HIV-infected individuals. The assay was specific and gave results comparable to those obtained by the inhibition of immunofluorescence (IFI) and reverse transcriptase (RT) activity. Attempts were made to correlate the presence and the antibody titres with the clinical status of HIV-infected individuals classified according to Walter Reed staging classification scheme. NA titres correlated inversely with the stage of HIV infection: Compared with acquired immunodeficiency syndrome (AIDS) patients, HIV-infected subjects at stage WR1 had significantly higher NA titres. Moreover, a decrease in NA titre in relation to clinical deterioration was noted in sequential sera of eight of 11 AIDS patients, retrospectively examined, for NA. The symptomless subjects showed either the same level of NA or a trend towards an increasing antibody titre with time. Different isolates of HIV strains showed a variability in the extent of sensitivity to neutralization by sera obtained from different HIV-infected individuals.
Journal of Medical Virology 02/1989; 27(1):7-12. · 2.82 Impact Factor
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ABSTRACT: 21 HIV strains were isolated from peripheral mononuclear cells of 31 adult and pediatric patients with AIDS or ARC and 10 apparently healthy HIV seropositive individuals. Viral isolation rate was correlated to the clinical status of patients, being very high in patients with AIDS or ARC, and lower in apparently healthy individuals. 4 isolates were propagated in cultures of a T-cell continuous line (Molt 4) and their biological properties were compared. The capacity to establish a chronic infection on Molt 4 cells and the extent of cytopathic effect of the infected cultures varied among the different strains. Moreover, differences in endpoint titrations of the supernatants and variable effects on cell multiplication and viability of Molt 4 cells were also observed. Our results further substantiate the existence of a wide heterogeneity of HIV strains.
Microbiologica 11/1988; 11(4):329-37.
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ABSTRACT: A cross-sectional seroepidemiologic study was carried out on household contacts and sexual partners of human immunodeficiency virus (HIV) antibody-positive intravenous drug abusers in Palermo, Italy, in 1985 to evaluate factors that influenced HIV transmission. A total of 43 index cases, 36 spouses or heterosexual partners, 28 children, and 55 adult household members were enrolled. None of the household members without sexual contact, who had shared items and facilities and had interacted with the index cases, contracted HIV infection. However, six of 36 sexual partners had antibodies to HIV. It was observed that the risk of HIV infection was significantly associated with the frequency of sexual intercourse with the seropositive partner. Four children were also found to be infected: two had acquired immunodeficiency syndrome-related complex, and the other two were clinically and immunologically normal. Furthermore, one other child had evidence of passive transfer of maternal antibodies. The infection was confined to the younger children (ranging in age from eight months to three years). The data support a high rate of vertical transmission from mother to infant, an intermediate rate of transmission to sexual partners, and no transmission attributable to household contact.
American Journal of Epidemiology 09/1988; 128(2):254-60. · 5.22 Impact Factor
