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Article ; Online: HIV-1 Tat Protein Enters Dysfunctional Endothelial Cells via Integrins and Renders Them Permissive to Virus Replication

Aurelio Cafaro / Giovanni Barillari / Sonia Moretti / Clelia Palladino / Antonella Tripiciano / Mario Falchi / Orietta Picconi / Maria Rosaria Pavone Cossut / Massimo Campagna / Angela Arancio / Cecilia Sgadari / Claudia Andreini / Lucia Banci / Paolo Monini / Barbara Ensoli

International Journal of Molecular Sciences, Vol 22, Iss 317, p

2021 Volume 317

Abstract: Previous work has shown that the Tat protein of Human Immunodeficiency Virus (HIV)-1 is released by acutely infected cells in a biologically active form and enters dendritic cells upon the binding of its arginine-glycine-aspartic acid (RGD) domain to the ...

Abstract	Previous work has shown that the Tat protein of Human Immunodeficiency Virus (HIV)-1 is released by acutely infected cells in a biologically active form and enters dendritic cells upon the binding of its arginine-glycine-aspartic acid (RGD) domain to the α5β1, αvβ3, and αvβ5 integrins. The up-regulation/activation of these integrins occurs in endothelial cells exposed to inflammatory cytokines that are increased in HIV-infected individuals, leading to endothelial cell dysfunction. Here, we show that inflammatory cytokine-activated endothelial cells selectively bind and rapidly take up nano-micromolar concentrations of Tat, as determined by flow cytometry. Protein oxidation and low temperatures reduce Tat entry, suggesting a conformation- and energy-dependent process. Consistently, Tat entry is competed out by RGD-Tat peptides or integrin natural ligands, and it is blocked by anti-α5β1, -αvβ3, and -αvβ5 antibodies. Moreover, modelling–docking calculations identify a low-energy Tat-αvβ3 integrin complex in which Tat makes contacts with both the αv and β3 chains. It is noteworthy that internalized Tat induces HIV replication in inflammatory cytokine-treated, but not untreated, endothelial cells. Thus, endothelial cell dysfunction driven by inflammatory cytokines renders the vascular system a target of Tat, which makes endothelial cells permissive to HIV replication, adding a further layer of complexity to functionally cure and/or eradicate HIV infection.
Keywords	integrins ; endothelial cells ; inflammatory cytokines ; HIV-1 Tat protein ; cellular uptake ; HIV-1 target cells ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
Subject code	571 ; 570
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Anti-Tat Immunity in HIV-1 Infection

Aurelio Cafaro / Antonella Tripiciano / Orietta Picconi / Cecilia Sgadari / Sonia Moretti / Stefano Buttò / Paolo Monini / Barbara Ensoli

Vaccines, Vol 7, Iss 3, p

Effects of Naturally Occurring and Vaccine-Induced Antibodies Against Tat on the Course of the Disease

2019 Volume 99

Abstract: HIV-1 Tat is an essential protein in the virus life cycle, which is required for virus gene expression and replication. Most Tat that is produced during infection is released extracellularly and it plays a key role in HIV pathogenesis, including residual ...

Abstract	HIV-1 Tat is an essential protein in the virus life cycle, which is required for virus gene expression and replication. Most Tat that is produced during infection is released extracellularly and it plays a key role in HIV pathogenesis, including residual disease upon combination antiretroviral therapy (cART). Here, we review epidemiological and experimental evidence showing that antibodies against HIV-1 Tat, infrequently occurring in natural infection, play a protective role against disease progression, and that vaccine targeting Tat can intensify cART. In fact, Tat vaccination of subjects on suppressive cART in Italy and South Africa promoted immune restoration, including CD4+ T-cell increase in low immunological responders, and a reduction of proviral DNA even after six years of cART, when both CD4+ T-cell gain and DNA decay have reached a plateau. Of note, DNA decay was predicted by the neutralization of Tat-mediated entry of Env into dendritic cells by anti-Tat antibodies, which were cross-clade binding and neutralizing. Anti-Tat cellular immunity also contributed to the DNA decay. Based on these data, we propose the Tat therapeutic vaccine as a pathogenesis-driven intervention that effectively intensifies cART and it may lead to a functional cure, providing new perspectives and opportunities also for prevention and virus eradication strategies.
Keywords	HIV-1 Tat ; anti-Tat antibodies ; natural vs. vaccine-induced antibody response ; crossclade antibodies ; HIV-1 vaccine development ; HIV-1 Tat therapeutic vaccine ; HIV reservoir ; cART intensification ; functional cure ; perspective for clinical implications ; Medicine ; R
Subject code	570
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of Inositol Hexaphosphate and Myo-Inositol Administration in Breast Cancer Patients during Adjuvant Chemotherapy

Maria Ida Amabile / Alessandro De Luca / Domenico Tripodi / Elena D’Alberti / Rossella Melcarne / Giovanni Imbimbo / Orietta Picconi / Vito D’Andrea / Massimo Vergine / Salvatore Sorrenti / Alessio Molfino

Journal of Personalized Medicine, Vol 11, Iss 756, p

2021 Volume 756

Abstract: Background: Treatment of breast cancer (BC) includes locoregional and systemic therapies depending on tumor and patient’s characteristics. Inositol hexaphosphate (IP6) is known as a strong antioxidant agent, able to improve local (i.e., breast region) ... ...

Abstract	Background: Treatment of breast cancer (BC) includes locoregional and systemic therapies depending on tumor and patient’s characteristics. Inositol hexaphosphate (IP6) is known as a strong antioxidant agent, able to improve local (i.e., breast region) side effects, functional status and quality-of-life. We investigated some potential beneficial effects, including hematological and local, of the combined therapy with oral myo-inositol administration and topical IP6 application in patients undergoing surgery for BC and eligible to adjuvant chemotherapy. Methods: We considered BC patients randomly assigned to the Inositol Group (oral myo-inositol + IP6 local application for the entire neoadjuvant treatment period) and to the Control Group (standard of care). The EORTC QLQ-BR23 and QLQ-C30 questionnaires were administered to both groups and blood parameters were assessed as per clinical routine practice at baseline (before starting adjuvant chemotherapy), T1 (after the first two doses of epirubicin-cyclophosphamide regimen), T2 (at the end of epirubicin-cyclophosphamide regimen), T3 (after the first six doses of paclitaxel regimen), and T4 (at the end of the paclitaxel treatment). Results: A total of 36 BC patients were considered, 18 in the Inositol Group and 18 in the Control Group. The Inositol Group showed a lower decrease in red blood cells, hemoglobin levels and white blood cells with respect to controls ( p ≤ 0.02), as well as amelioration in scores related to breast and arm local symptoms ( p ≤ 0.02), body image ( p = 0.04) and quality-of-life related symptoms ( p ≤ 0.04). Conclusions: In our cohort of BC patients, a combined treatment with oral myo-inositol + IP6 local application was able to improve local symptoms and quality-of-life related symptoms which represent clinically relevant aspects associated with patient’s prognosis.
Keywords	inositol hexaphosphate ; myo-inositol ; breast cancer ; breast surgery ; adjuvant chemotherapy ; quality of life ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Short- and Long-Term Immunological Responses in Chronic HCV/HIV Co-Infected Compared to HCV Mono-Infected Patients after DAA Therapy

Stefania Farcomeni / Sonia Moretti / Caterina Fimiani / Lucia Fontanelli Sulekova / Fenicia Vescio / Leonardo Sernicola / Maria T. Maggiorella / Anna Lisa Remoli / Orietta Picconi / Luciana Mosca / Rozenn Esvan / Elisa Biliotti / Massimo Ciccozzi / Marco Sgarbanti / Gloria Taliani / Alessandra Borsetti

Pathogens, Vol 10, Iss 1488, p

2021 Volume 1488

Abstract: Background: Direct-acting antivirals (DAAs) treatment, although highly efficacious for the treatment of hepatitis C virus (HCV) infection, may not completely reconstitute the HCV-mediated dysregulated immune system, especially in patients co-infected ... ...

Abstract	Background: Direct-acting antivirals (DAAs) treatment, although highly efficacious for the treatment of hepatitis C virus (HCV) infection, may not completely reconstitute the HCV-mediated dysregulated immune system, especially in patients co-infected with human immunodeficiency virus (HIV) and HCV. Objectives: We aimed to evaluate the impact of HCV eradication following DAA therapy on the immune system and liver disease improvement through comparative monitoring of 10 HCV mono-infected and 10 HCV/HIV co-infected patients under combined antiretroviral therapy (cART). Early and late longitudinal phenotypic changes in peripheral blood mononuclear cell (PBMC) subsets, T-cell activation, differentiation and exhaustion, as well as inflammatory biomarkers, indoleamine 2-3 dioxygenase (IDO) activity, and liver stiffness, APRI and FIB-4 scores were assessed. Materials and Methods: Samples were obtained at baseline (T0), week 1 (T1), week 2 (T2), week 12 (T3, end of treatment, EOT), and month 9 (T4, end of follow-up, 36 weeks post EOT). Results: All patients achieved a sustained virological response (SVR 12) after DAA treatment. Overall, changes of the T-cell immune phenotypes were greater in HCV/HIV co-infected than in HCV mono-infected, due to an increase in CD4+ and CD8+ T-cell percentages and of CD8+ T-cell activation and memory markers, in particular at the end of follow-up. On the other end, HCV mono-infected showed changes in the activation profile and in the memory CD4+ T-cell compartment. In HCV/HIV co-infected, a decrease in the IDO activity by DAA treatment was observed; conversely, in HCV mono-infected, it resulted unmodified. Regarding inflammatory mediators, viral suppression was associated with a reduction in IP-10 levels, while interferon regulatory factor (IRF)-7, interferon (IFN)-β, and interferon (IFN)-γ levels were downregulated during therapy and increased post therapy. A decrease in liver stiffness, APRI, and FIB-4 scores was also observed. Conclusions: Our study suggests that, although patients ...
Keywords	HCV infection ; HCV/HIV coinfection ; DAA direct-acting antivirals ; interferon-stimulated gene (ISG) expression ; indoleamine 2-3 dioxygenase (IDO) activity ; immune activation ; Medicine ; R
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Building up a collaborative network for the surveillance of HIV genetic diversity in Italy

Nunzia Sanarico / Stefania D'Amato / Orietta Picconi / Barbara Ensoli / Stefano Butto

Annali dell'Istituto Superiore di Sanità, Vol 51, Iss 4, Pp 321-

A pilot study

2015 Volume 326

Abstract: INTRODUCTION: Prevalence of infection with HIV-1 non-B subtypes in Italy has been reported to raise, due to increased migration flows and travels. HIV-1 variants show different biological and immunological properties that impact on disease progression ... ...

Abstract	INTRODUCTION: Prevalence of infection with HIV-1 non-B subtypes in Italy has been reported to raise, due to increased migration flows and travels. HIV-1 variants show different biological and immunological properties that impact on disease progression rate, response to antiretroviral therapy (ART) and sensitivity of diagnostic tests with important implications for public health. Therefore, a constant surveillance of the dynamics of HIV variants in Italy should be a high public health priority. Organization of surveillance studies requires building up a platform constituted of a network of clinical centers, laboratories and institutional agencies, able to properly collect samples for the investigation of HIV subtypes heterogeneity and to provide a database with reliable demographic, clinical, immunological and virological data. AIM: We here report our experience in building up such a platform, co-ordinated by the National AIDS Center of the Istituto Superiore di Sanita, taking advantage of a pilot study aimed at evaluating HIV subtypes diversity in populations of HIV-infected migrant people in Italy. MATERIALS AND METHODS: Four hundred and thirty four HIV-infected migrants were enrolled in 9 Italian clinical centers located throughout the Italian territory. Standard Operating Procedures (SOPs) for sample collection were provided by the National AIDS Center to each clinical center. In addition, clinical centers were required to fill up a case report form (crf) for each patient, which included demographic, clinical, immunological and virological information. RESULTS: All centers properly collected and stored samples from each enrolled individual. Overall, the required information was correctly provided for more than 90% of the patients. However, some fields of the crf, particularly those including information on the last HIV-negative antibody test and presence of co-infections, were properly filled up in less than 80% of the enrolled migrants. Centers from Northern and Central Italy showed a better tendency to report correct information in the crf than centers from the South. These results provide evidence that procedures for establishing a platform for the surveillance of HIV subtype heterogeneity are affordable by all the components of the network and lay the ground for the organization of a broader HIV subtypes surveillance in Italy.
Keywords	HIV ; variability ; surveillance ; network ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2015-12-01T00:00:00Z
Publisher	Istituto Superiore di Sanità
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Anti-Tat immunity defines CD4+ T-cell dynamics in people living with HIV on long-term cART.

EBioMedicine, Vol 66, Iss , Pp 103306- (2021)

2021

Abstract: Background: Low-level HIV viremia originating from virus reactivation in HIV reservoirs is often present in cART treated individuals and represents a persisting source of immune stimulation associated with sub-optimal recovery of CD4+ T cells. The HIV-1 ... ...

Abstract	Background: Low-level HIV viremia originating from virus reactivation in HIV reservoirs is often present in cART treated individuals and represents a persisting source of immune stimulation associated with sub-optimal recovery of CD4+ T cells. The HIV-1 Tat protein is released in the extracellular milieu and activates immune cells and latent HIV, leading to virus production and release. However, the relation of anti-Tat immunity with residual viremia, persistent immune activation and CD4+ T-cell dynamics has not yet been defined. Methods: Volunteers enrolled in a 3-year longitudinal observational study were stratified by residual viremia, Tat serostatus and frequency of anti-Tat cellular immune responses. The impact of anti-Tat immunity on low-level viremia, persistent immune activation and CD4+ T-cell recovery was investigated by test for partitions, longitudinal regression analysis for repeated measures and generalized estimating equations. Findings: Anti-Tat immunity is significantly associated with higher nadir CD4+ T-cell numbers, control of low-level viremia and long-lasting CD4+ T-cell recovery, but not with decreased immune activation. In adjusted analysis, the extent of CD4+ T-cell restoration reflects the interplay among Tat immunity, residual viremia and immunological determinants including CD8+ T cells and B cells. Anti-Env immunity was not related to CD4+ T-cell recovery. Interpretation: Therapeutic approaches aiming at reinforcing anti-Tat immunity should be investigated to improve immune reconstitution in people living with HIV on long-term cART. Trial registration: ISS OBS T-002 ClinicalTrials.gov identifier: NCT01024556 Funding: Italian Ministry of Health, special project on the Development of a vaccine against HIV based on the Tat protein and Ricerca Corrente 2019/2020.
Keywords	HIV immune activation ; HIV reservoirs ; HIV residual viremia ; CD4+ T cells ; HIV-1 Tat ; Anti-Tat antibodies ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	570
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Non-Conventional MRI Techniques as an Alternative Role to the Clinical Diagnosis in Alzheimer’s Disease

Elisabetta Giugni / Rita Vadalà / Francesca Romana Pezzella / Giuseppe Bomboi / Stefano Galletti / Giacomo Luccichenti / Carmela Colica / Orietta Picconi / Stefano Bastianello

Health, Vol 06, Iss 19, Pp 2712-

2014 Volume 2723

Abstract: Improved methods for early diagnosis and non-invasive surrogates for the diagnosis of disease severity in Alzheimer’s disease (AD) are becoming the new challenge. Dementia can now be accurately determined through clinical evaluation, cognitive screening, ...

Abstract	Improved methods for early diagnosis and non-invasive surrogates for the diagnosis of disease severity in Alzheimer’s disease (AD) are becoming the new challenge. Dementia can now be accurately determined through clinical evaluation, cognitive screening, basic laboratory evaluation and structural imaging. Magnetic resonance (MRI) techniques are being evaluated as possible surrogate measures to monitor disease progression. The purpose of this work is to correlate the results of combined advanced MR techniques with neuropsychological performance in order to identify a sensible and sensitive imaging approach to quantify neurodegenerative disease progression. One of the most relevant evidences in our study is the degeneration of the fibers of the corpus callosum in the pathogenesis of cognitive disorders in AD patients, as demonstrated by the relationship between altered neuropsychological tests and reduced FA (Fractional Anisotrophy) values of the corpus callosum in such patients. This data is also integrated by the evidence of anatomic reduction of the total volume of the corpus callosum assessed by FreeSurfer, thus supporting the hypothesis that the “brain disconnects” play a key role in the pathogenesis of AD. Statistical evaluation of regression consisting in the identification of different numerical coefficients that are multiplied by the thickness of the right fusiform value or by the volume of left inferoparietal region and left middle-temporal region, allows us to obtain the predictive numeric value of the related neuropsychological test. Combination of non-conventional magnetic resonance imaging, including morphometry, spectroscopy, MD (mean diffusivity) and FA evaluation, could be an alternative to clinic in the evaluation of neurodegeneration in AD.
Keywords	Alzheimer’s Disease (AD) ; Non Conventional MRI Technique ; MRI Reproducible Marker ; Medicine (General) ; R5-920 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-11-01T00:00:00Z
Publisher	Scientific Research Publishing
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Article ; Online: Subcutaneous interferon β-1a may protect against cognitive impairment in patients with relapsing-remitting multiple sclerosis

Francesco Patti / Vincenzo Brescia Morra / Maria Pia Amato / Maria Trojano / Stefano Bastianello / Maria Rosalia Tola / Salvatore Cottone / Andrea Plant / Orietta Picconi / COGIMUS Study Group

PLoS ONE, Vol 8, Iss 8, p e

5-year follow-up of the COGIMUS study.

2013 Volume 74111

Abstract: Objective To assess the effects of subcutaneous (sc) interferon (IFN) -1a on cognition over 5 years in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS). Methods Patients aged 18-50 years with RRMS (Expanded Disability Status ... ...

Abstract	Objective To assess the effects of subcutaneous (sc) interferon (IFN) -1a on cognition over 5 years in mildly disabled patients with relapsing-remitting multiple sclerosis (RRMS). Methods Patients aged 18-50 years with RRMS (Expanded Disability Status Scale score ≤4.0) who had completed the 3-year COGIMUS study underwent standardized magnetic resonance imaging, neurological examination, and neuropsychological testing at years 4 and 5. Predictors of cognitive impairment at year 5 were identified using multivariate analysis. Results Of 331 patients who completed the 3-year COGIMUS study, 265 participated in the 2-year extension study, 201 of whom (75.8%; sc IFN β-1a three times weekly: 44 µg, n = 108; 22 µg, n = 93) completed 5 years' follow-up. The proportion of patients with cognitive impairment in the study population overall remained stable between baseline (18.0%) and year 5 (22.6%). The proportion of patients with cognitive impairment also remained stable in both treatment groups between baseline and year 5, and between year 3 and year 5. However, a significantly higher proportion of men than women had cognitive impairment at year 5 (26.5% vs 14.4%, p = 0.046). Treatment with the 22 versus 44 µg dose was predictive of cognitive impairment at year 5 (hazard ratio 0.68; 95% confidence interval 0.48-0.97). Conclusions This study suggests that sc IFN β-1a dose-dependently stabilizes or delays cognitive impairment over a 5-year period in most patients with mild RRMS. Women seem to be more protected against developing cognitive impairment, which may indicate greater response to therapy or the inherently better prognosis associated with female sex in MS.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Molecular characterization of HIV-1 subtype C gp-120 regions potentially involved in virus adaptive mechanisms.

Alessandra Cenci / Giuseppe D'Avenio / Lara Tavoschi / Michele Chiappi / Simone Becattini / Maria Del Pilar Narino / Orietta Picconi / Daniela Bernasconi / Emanuele Fanales-Belasio / Eftyhia Vardas / Hosea Sukati / Alessandra Lo Presti / Massimo Ciccozzi / Paolo Monini / Barbara Ensoli / Mauro Grigioni / Stefano Buttò

PLoS ONE, Vol 9, Iss 4, p e

2014 Volume 95183

Abstract: The role of variable regions of HIV-1 gp120 in immune escape of HIV has been investigated. However, there is scant information on how conserved gp120 regions contribute to virus escaping. Here we have studied how molecular sequence characteristics of ... ...

Abstract	The role of variable regions of HIV-1 gp120 in immune escape of HIV has been investigated. However, there is scant information on how conserved gp120 regions contribute to virus escaping. Here we have studied how molecular sequence characteristics of conserved C3, C4 and V3 regions of clade C HIV-1 gp120 that are involved in HIV entry and are target of the immune response, are modulated during the disease course. We found an increase of "shifting" putative N-glycosylation sites (PNGSs) in the α2 helix (in C3) and in C4 and an increase of sites under positive selection pressure in the α2 helix during the chronic stage of disease. These sites are close to CD4 and to co-receptor binding sites. We also found a negative correlation between electric charges of C3 and V4 during the late stage of disease counteracted by a positive correlation of electric charges of α2 helix and V5 during the same stage. These data allow us to hypothesize possible mechanisms of virus escape involving constant and variable regions of gp120. In particular, new mutations, including new PNGSs occurring near the CD4 and CCR5 binding sites could potentially affect receptor binding affinity and shield the virus from the immune response.
Keywords	Medicine ; R ; Science ; Q
Subject code	570
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: High HIV-1 diversity in immigrants resident in Italy (2008–2017)

Maria Teresa Maggiorella / Nunzia Sanarico / Gaetano Brindicci / Laura Monno / Carmen Rita Santoro / Nicola Coppola / Nunzia Cuomo / Annalisa Azzurri / Francesco Cesario / Filippo Luciani / Issa El-Hamad / Gabriella D’Ettorre / Ombretta Turriziani / Laura Mazzuti / Alessandra Poggi / Francesca Vichi / Elisa Mariabelli / Lorenzo Surace / Giuseppina Berardelli /

Scientific Reports, Vol 10, Iss 1, Pp 1-

2020 Volume 14

Abstract: Abstract The proportion of new diagnoses of HIV infection in immigrants residing in Italy raised from 11% in 1992 to 29.7% in 2018. To investigate the HIV clades circulating in this community a retrospective study was performed in 557 HIV-infected ... ...

Abstract	Abstract The proportion of new diagnoses of HIV infection in immigrants residing in Italy raised from 11% in 1992 to 29.7% in 2018. To investigate the HIV clades circulating in this community a retrospective study was performed in 557 HIV-infected immigrants living in 12 Italian cities. Immigrants originated from East-Europe and Central-Asia (11.7%), North Africa and Middle East (7.3%), South and South-East Asia (7.2%), Latin America and the Caribbean (14.4%), and sub-Saharan Africa (59.4%). More than 87% of immigrants were on antiretroviral therapy (ART), although 26.6% of them were viremic. A 22.0% of immigrants had hepatitis (HBV and/or HCV) and/or tuberculosis. HIV phylogenetic analysis on sequences from 192 immigrants showed the presence of clades B (23.4%), G (16.1%), C (10.4%), A1 (9.4%), F1 (5.2%), D (1.6%) and Circulating Recombinant Forms (CRFs) (33.9%). CRF02_AG represented 72.3% of the total CRFs. Clusters between immigrants and Italian natives were also present. Drug resistance mutations to NRTI, NNRTI, and PI drug classes occurred in 29.1% of ART-treated and in 12.9% of ART-naïve individuals. These data highlight the need for tailored public health interventions in immigrants to avoid spreading in Italy of HIV genetic forms and ART-resistant variants, as well as HIV co-morbidities.
Keywords	Medicine ; R ; Science ; Q
Subject code	306
Language	English
Publishing date	2020-02-01T00:00:00Z
Publisher	Nature Portfolio
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