HIV infection newly diagnosed in Northern Italy; evolving trends

Abstract

Results From June 2006 up to December 2008 (31 months), 162 patients were first diagnosed with HIV disease (mean 5.2 novel cases per month), and 78 of them were judged to have a recent infection (as established on the ground of a specific “avidity” serologic testing). Males greatly prevailed over females (93 versus 69 cases), while homosexual exposure (53 cases) was prevalent over heterosexual one (38 patients), and only two novel cases were registered among i.v. drug users. The median age at diagnosis was 36.2 years, while the main laboratory parameters showed a mean CD4+ count of 502 cells/μL, and a mean HIV-RNA load of 8.21 × 10 copies/mL. Although subtype B of HIV greatly prevailed (141 cases: 87%), also subtypes A-A1, and recombinant HIV virions were found among newly infected patients. When conducting a genotypic resistance assay including all available antiretroviral agents, the overall prevalence of primary mutations accounted for 13% of newly infected patients: 11.1% of them had one or more mutations of the reverse transcriptase gene, and 9.3% of subjects had one or more mutations of the protease inhibitor gene (including one case of multiple mutations, probably conferring resistance extended to the third-generation protease inhibitor tipranavir). The majority of patients with recent infection (50 out of 78: 64.1%) were asymptomatic or paucisymptomatic, while a full-blown AIDS or a symptomatic disease were present in 18 and 10 cases respectively.