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Barbara Suligoi

Publications and source records attributed to Barbara Suligoi.

23 records · Page 2Linked to original sources

Precision and accuracy of a procedure for detecting recent human immunodeficiency virus infections by calculating the antibody avidity index by an automated immunoassay-based method.

We evaluated the precision and accuracy of a procedure for detecting recent human immunodeficiency virus (HIV) infections, specifically, the avidity index (AI) calculated using a method based on an automated AxSYM HIV 1/2gO assay (Abbott). To evaluate precision, we performed multiple replicates on eight HIV-positive serum samples. To evaluate the accuracy in identifying recent infections (i.e., within 6 months of seroconversion), we used 216 serum samples from 47 persons whose dates of seroconversion were known. To evaluate the sensitivity and specificity of the procedure for different AI cutoff values, we performed receiver operating characteristic (ROC) analysis. To determine the effects of antiretroviral treatment, advanced stage of the disease (i.e., low CD4-cell count), and low HIV viral load on the AI, we analyzed 15 serum samples from 15 persons whose dates of seroconversion were unknown. The precision study showed that the procedure was robust (i.e., the total variance of the AI was lower than 10%). Regarding accuracy, the mean AI was significantly lower for samples collected within 6 months of seroconversion, compared to those collected afterwards (0.68 +/- 0.16 versus 0.99 +/- 0.10; P < 0.0001), with no overlap of the 95% confidence intervals. The ROC analysis revealed that an AI lower than 0.6 had a sensitivity of 33.3% and a specificity of 98.4%, compared to 87.9 and 86.3%, respectively, for an AI lower than 0.9. Antiretroviral treatment, low CD4-cell count, and low viral load had no apparent effect on the AI. In conclusion, this procedure is reproducible and accurate in identifying recent infections; it is automated, inexpensive, and easy to perform, and it provides a quantitative result with different levels of sensitivity and specificity depending on the selected cutoff.

AIDS Serodiagnosis↗

No protective effect of acyclovir on HIV disease progression in a cohort of HSV-2-HIV-infected individuals.

The efficacy of anti-herpetic drugs in decreasing HIV disease progression has not been clarified. We studied a cohort of 126 HIV-positive individuals with known date of seroconversion who were HSV-2-seropositive to determine if progression to AIDS was influenced by treatment with acyclovir. In the multivariate analysis, being homosexual and low CD4 count were associated with a faster progression to AIDS, whereas treatment with acyclovir showed a 37.0% protective effect compared to those who did not receive it when antiretroviral treatment was not included in the model. When including antiretroviral therapy, the protective effect of acyclovir decreased to 9.0% and that of antiretroviral therapy was 43.0% for monotherapy and 36.0% for double therapy, suggesting that most of the protective effect of acyclovir in the previous model was due to antiretroviral therapy. In conclusion, treatment with acyclovir does not seem to prolong significantly survival to AIDS among HIV-positive individuals who are HSV-2-infected.

Acyclovir↗

[Epidemiology of HIV infection in Italy].

AIDS surveillance systems, which have provided for many years useful information on HIV epidemic dynamics, are no longer useful for estimating the evolution of the HIV epidemic due to the effect of anti-retroviral treatments that have strongly improved survival of HIV-infected persons. To obtain reliable data on the HIV epidemic, some Italian provinces and regions (Lazio, Veneto, Friuli Venezia-Giulia, Trento, Modena) have set up local surveillance systems of the new HIV diagnoses. Aggregated data collected by these systems since 1988, show that the rapid spread of the infection in the eighties has been followed by a progressive decrease in the number of new diagnoses during the nineties; in more recent years this trend has levelled-off. The composition of cases by exposure category has greatly changed over time: in 1988 75.2% of cases were injecting drug users, whereas in 2000 58.5% of cases acquired the infection through sexual contacts. HIV incidence for the considered areas decreased from 19.2 per 100.000 inhabitants in 1992, to 6.7 per 100.000 inhabitants in 2000. Median age at diagnosis increased over time, from 27 years in 1988 to 34 years in 2000. The changed pattern of the HIV epidemic in Italy stresses the need of a nation-wide surveillance system for HIV infections aimed at allocation of adequate economic resources and planning specific prevention programmes.

Adult↗

[The HIV epidemiology in province of Modena: use of two different sources of data].

OBJECTIVE: to analyse demographic characteristics and risk factors of people living with HIV and to compare data from the surveillance system for new HIV diagnoses with those from the National AIDS Registry (RAIDS). DESIGN: comparison of two surveillance systems. SETTING: province of Modena. PARTICIPANTS: cases reported to the RAIDS and to the HIV surveillance system, from 1985 to 2004 regarding residents in the province of Modena. MAIN OUTCOMES: number of cases and incidence, by exposure categories, age, and gender. RESULTS: from 1985 to 2004, 615AIDS cases and 1731 new HIV diagnoses were reported among residence in the province of Modena. The incidence of AIDS progressively decreased after 1995, whereas incidence of new HIV diagnoses remained stable since 1994 with annual rates up to three-fold higher than those reported for the AIDS cases. Individuals with a new HIV diagnosis were younger (<30 years of age), with a higher proportion of females and heterosexuals compared to AIDS cases. The most represented age group among AIDS cases was 30-49 years whereas it was <30 years for newly diagnosed HIV cases. The proportion of intravenous drug users decreased over time both among new AIDS cases and new HIV diagnoses, whereas the proportion of cases attributed to sexual transmission increased. The proportion of foreigners among newly diagnosed HIV cases was twice as high as among AIDS cases. CONCLUSIONS: this study shows that, especially after the introduction of highly active antiretroviral therapies, information on AIDS cases has become less representative of the trends to HIV epidemic. Therefore, AIDS surveillance systems should be combined with local surveillance systems on new HIV diagnoses.

Acquired Immunodeficiency Syndrome↗