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New Microbiol. 2016 Oct;39(4):241-246. Epub 2016 Sep 13.

HIV-1 early and late diagnosis in the Emilia Romagna Region (Italy): a three year study.

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Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Microbiology Section, University of Bologna, Bologna, Italy.
Department of Infectious Diseases, S. Maria Nuova IRCCS Hospital, Reggio Emilia, Italy.
Department of Infectious Diseases and Hepatology, Parma Hospital, Parma, Italy.
Department of Infectious Diseases and Microbiology, Arcispedale S. Anna, Ferrara, Italy.
Malattie Infectious Disease Unit, Piacenza, Italy.
The Greater Romagna Hub Laboratory, Unit of Microbiology, Pievesestina, Cesena and Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Microbiology Section, University of Bologna.
Department of Infectious Diseases, S. Anna Hospital, Ferrara, Italy.
Clinical Immunology, Allergy, and Advanced Biotechnologies Unit, Diagnostic Imaging and Laboratory Medicine Department, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
Department of Medical and Surgical Sciences, Section of Infectious Diseases, S. Orsola-Malpighi Hospital, University of Bologna.
Public Health Service - Directorate General for Health and Social Policy - Emilia-Romagna Region, Italy.


It is crucial to establish the timing of infection and distinguish between early and long-lasting HIV-1 infections not only for partner notification and epidemiological surveillance, but also to offer early drug treatment and contain the spread of infection. This study analyzed serum and/or plasma samples with a first positive HIV antibody/antigen result coming from different Medical Centers in the Emilia Romagna Region, North East Italy, using the avidity assay, Western Blotting, RNA viral load, CD4 cell counts and genotyping assay. From May 2013 to May 2016, we certified 845 new HIV-1 infections, 18.7% of which were classified on the basis of avidity index as recent infections and 81.3% as long-lasting infections, with an estimated conversion time exceeding six months at the time of study. Western Blotting showed reactivity to only one or two HIV-1 proteins in recently infected patients (RIPs), while a complete pattern to gag, env and pol proteins was observed in most long-lasting infected patients (LLIPs). The median age, gender, nationality and risk transmission factors were comparable in RIPs and LLIPs. Phylogenetic analysis performed in available plasma disclosed B strains, non-B subtypes and circulating recombinant forms (CRFs) in both groups of patients, with a major presence of CRFs in non-Italian HIV subjects. The large number of patients unaware of their HIV status makes it crucial to discover hidden epidemics and implement appropriate targeted public health interventions.


HIV; Long-lasting infection; Recent infection; Viral strains

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