title: Correlates of infection and molecular characterization of blood-borne HIV, HCV, and HBV infections in HIV-1 infected inmates in Italy: An observational cross-sectional study.
abstract: Coinfection of blood-borne hepatitis B and hepatitis C viruses (HBV and HCV, respectively) in human immunodeficiency virus type 1 (HIV-1)-positive individuals frequently occurs in inmate population and peculiar viral strains and patterns of virological markers may be observed.Plasma from 69 HIV-1-positive inmates was obtained from 7 clinical centers connected with correctional centers in different towns in Italy. HIV, HBV, and HCV markers were tested by commercial assays. Virus genotyping was carried out by sequencing the protease and reverse transcriptase-encoding region (PR-RT region) for HIV and a region encompassing the NS5B gene for HCV and subsequent phylogenetic analysis.Twelve over 14 HIV-subtyped inmates were infected with HIV-1 subtype B strains. The 2 non-B strains belonged to subtype G and CRF02_AG, in an Italian and a Gambian patient, respectively. Variants carrying the K103N and Y181C resistance mutations to non-nucleoside reverse transcriptase inhibitors (NNRTIs) were found in 2 out of 9 patients naive for combined antiretroviral therapy (cART) (22.2%). Most HIV-positive patients (92.8%) showed evidence of past or present HBV and/or HCV infection. Prevalence of HBV and HCV was 81.2% for both viruses, whereas prevalence of HBV/HCV coinfection was 69.6%. A significantly higher presence of HCV infection was found in Italians [odds ratio (OR) 11.0; interval 1.7-80.9] and in drug users (OR 27.8; interval 4.9-186.0). HCV subtypes were determined in 42 HCV or HBV/HCV-coinfected individuals. HCV subtypes 1a, 3a, 4d, and 1b were found in 42.9%, 40.5%, 14.3%, and 2.4% of inmates, respectively. Low titers of HBV DNA in HBV DNA positive subjects precluded HBV subtyping.The high prevalence of HBV and HCV coinfections in HIV-infected inmates, as well as the heterogeneity of HIV and HCV subtypes suggest the need to adopt systematic controls in prisons to monitor both the burden and the genetic forms of blood-borne viral infections, in order to apply targeted therapeutic interventions.
authors.affiliation: National AIDS Center, Istituto Superiore di Sanità, Rome Italian Ministry of Health, Rome Department of Infectious Diseases, Istituto Superiore di Sanità, Rome ASL 3 Genovese and Department of Infectious Diseases, Galliera Hospital, Genova Spedali Civili, Brescia Infectious Diseases Unit, University of Bari, Bari Centro Medicina del Viaggiatore e delle Migrazioni, Presidio Ospedaliero di Lamezia Terme, Giovanni Paolo II Hospital, Lamezia Terme Department of Primary Care AUSL, Modena Belcolle Hospital, ASL Viterbo University of Sassari, Sassari, Italy.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Sanarico
authors.forename: Stefania
authors.initials: S
authors.lastname: D'Amato
authors.forename: Roberto
authors.initials: R
authors.lastname: Bruni
authors.forename: Claudia
authors.initials: C
authors.lastname: Rovetto
authors.forename: Emanuela
authors.initials: E
authors.lastname: Salvi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Di Zeo
authors.forename: Paola
authors.initials: P
authors.lastname: Chionne
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Madonna
authors.forename: Giulio
authors.initials: G
authors.lastname: Pisani
authors.forename: Angela
authors.initials: A
authors.lastname: Costantino
authors.forename: Michele
authors.initials: M
authors.lastname: Equestre
authors.forename: Maria E
authors.initials: ME
authors.lastname: Tosti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cenci
authors.forename: Maria T
authors.initials: MT
authors.lastname: Maggiorella
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sernicola
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pontali
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pansera
authors.forename: Rocco
authors.initials: R
authors.lastname: Quattrocchi
authors.forename: Sergio
authors.initials: S
authors.lastname: Carbonara
authors.forename: Fabio
authors.initials: F
authors.lastname: Signorile
authors.forename: Lorenzo Antonio
authors.initials: LA
authors.lastname: Surace
authors.forename: Guido
authors.initials: G
authors.lastname: Federzoni
authors.forename: Elisa
authors.initials: E
authors.lastname: Garlassi
authors.forename: Giulio
authors.initials: G
authors.lastname: Starnini
authors.forename: Roberto
authors.initials: R
authors.lastname: Monarca
authors.forename: Sergio
authors.initials: S
authors.lastname: Babudieri
authors.forename: Maria
authors.initials: M
authors.lastname: Rapicetta
authors.forename: Maria G
authors.initials: MG
authors.lastname: Pompa
authors.forename: Anna
authors.initials: A
authors.lastname: Caraglia
authors.forename: Barbara
authors.initials: B
authors.lastname: Ensoli
authors.forename: Anna R
authors.initials: AR
authors.lastname: Ciccaglione
authors.forename: Stefano
authors.initials: S
authors.lastname: Buttò
mesh_terms: D000328:Adult; D000368:Aged; D017848:Blood-Borne Pathogens; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D016174:Hepacivirus / Q000235:genetics*; D006509:Hepatitis B / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics*; D006526:Hepatitis C / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence