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Papers by Marco Gentile

BMC infectious diseases, Jan 8, 2018

HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore,... more HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore, prevalence and patterns of HPV infection at different anatomical sites, as well as theoretical protection of nonavalent vaccine should be investigated. Aim was to describe prevalence and predictors of oral HPV detection in HIV-positive men, with attention to nonavalent vaccine-targeted HPV types. Further, co-occurrence of HPV DNA at oral cavity and at anal site was assessed. This cross-sectional, clinic-based study included 305 HIV-positive males (85.9% MSM; median age 44.7 years; IQR: 37.4-51.0), consecutively observed within an anal cancer screening program, after written informed consent. Indication for anal screening was given by the HIV physician during routine clinic visit. Paired oral rinse and anal samples were processed for the all HPV genotypes with QIASYMPHONY and a PCR with MY09/MY11 primers for the L1 region. At the oral cavity, HPV DNA was detected in 64 patients (20.9%), ...

Infection and Immunity, 2003

Vγ9Vδ2 T lymphocytes strongly respond to phosphoantigens from Plasmodium parasites. Thus, we anal... more Vγ9Vδ2 T lymphocytes strongly respond to phosphoantigens from Plasmodium parasites. Thus, we analyzed the changes in Vγ9Vδ2 T-cell function and repertoire during the paroxysm phase of nonendemic malaria infection. During malaria paroxysm, Vγ9Vδ2 T cells were early activated but rapidly became anergic and finally loose Jγ1.2 Vγ9 complementarity-determining region 3 transcripts.

Journal of Medical Case Reports, 2011

Introduction: The influenza virus infection may be severe in non-immune people. Common complicati... more Introduction: The influenza virus infection may be severe in non-immune people. Common complications of influenza virus include upper and lower respiratory tract infections, otitis media, myocarditis, acute respiratory distress syndrome and multi-organ failure. There have been cases of vasculitis following influenza vaccination, and rash and acute purpura may occur in certain viral infections. To the best of our knowledge, there are no reports concerning cases of systemic vasculitis associated with pandemic 2009 (H 1 N 1) infection. Case presentation: A 23-year-old Caucasian woman was hospitalized at the "L. Spallanzani" National Institute for Infectious Diseases in Rome, Italy. Clinical and radiological features including laboratory findings of this case are illustrated. Notably, the patient had fever, severe abdominal pain, hematuria, arthritis, and purpuric manifestations associated with a normal platelet count. Nasopharyngeal and rectal swabs revealed pandemic 2009 (H 1 N 1) virus by reverse-transcriptase-polymerase-chain-reaction assay. Routine laboratory analyses showed elevated inflammatory parameters. The autoimmune panel tests were normal. Steroid therapy associated with oseltamivir achieved an evident and rapid improvement. On day seven the patient chose to leave the hospital against medical advice. Conclusion: Complications related to influenza infection can be life threatening, particularly in immunocompromised patients. Henoch-Schönlein purpura triggered by the novel influenza virus infection could be an attractive pathogenetic hypothesis. We have discussed both the diagnosis and the challenge of therapy protocols. Steroid therapy is part of the management of severe vasculitis. Our case suggests that steroid therapy associated with antivirals can prevent the risk of further complications such as hemorrhage and multi-organ failure during severe vasculitis, without enhancing the virulence of the influenza virus. The possible role of pandemic 2009 (H 1 N 1) in the pathogenesis of hemorrhagic manifestations should be further investigated.

The Journal of Infectious Diseases, 2000

A multicenter analysis of 57 consecutive human immunodeficiency virus-positive patients with prog... more A multicenter analysis of 57 consecutive human immunodeficiency virus-positive patients with progressive multifocal leukoencephalopathy (PML) was performed, to identify correlates of longer survival. JC virus (JCV) DNA was quantified in the cerebrospinal fluid (CSF) by polymerase chain reaction. Two months after therapy, 4% of the patients without highly active antiretroviral therapy (HAART) and 26% with HAART showed neurologic improvement or stability (), and 8% and 57%, respectively, reached undetectable JCV DNA levels in P p .03 the CSF (). One-year probability of survival was .04 without HAART and .46 with P p .04 HAART. HAART and lack of neurologic progression 2 months after diagnosis were independently associated with longer survival. Among HAART-treated patients, a baseline JCV DNA !4.7 log, and reaching undetectable levels after therapy predicted longer survival. Survival of AIDS-related PML is improved by HAART when JCV replication is controlled. Progressive multifocal leukoencephalopathy (PML), the demyelinating brain disease caused by JC virus (JCV), is an important cause of morbidity and mortality in patients with AIDS. The introduction of highly active antiretroviral therapy (HAART) into clinical practice has led to fewer opportunistic infections during human immunodeficiency virus (HIV) disease [1], but PML has been reduced less than other opportunistic diseases [2, 3]. Although potent antiretroviral therapies significantly prolong survival of patients affected by AIDS-related PML, even in large cohort studies [4-7], not all HIV-infected patients with this neurologic disorder receive significant benefit from HAART. Indeed, some case series have shown very poor prognosis, despite aggressive antiretroviral treatments [8], and

International Journal of STD & AIDS, 2011

Detecting acute HIV infection is important, but often the infection is difficult to recognize. We... more Detecting acute HIV infection is important, but often the infection is difficult to recognize. We report the case of a 23-year-old man with persistent genital ulceration; all microbiological examinations from the ulcers were negative. HIV-1/2 antibodies were positive, but the HIV-1 Western blot (WB) was indeterminate and HIV-1 p24 antigen was persistently negative, with a low HIV-1 RNA level. One month later, the genital ulcerations disappeared and the WB test showed complete seroconversion; nonetheless HIV p24 antigen remained negative and HIV-RNA was persistently low. HIV-1 proviral DNA was detected by nested polymerase chain reaction (PCR) from the initial ulcers swabs. This case was notable due to genital ulceration being the only sign of primary HIV infection. Furthermore, the serological pattern was unusual, and HIV-RNA was unexpectedly low. This underlines the importance of screening for HIV being infection in the setting of sexually transmitted infections (STIs), and also in...

BMC infectious diseases, Jan 8, 2018

HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore,... more HIV-positive patients carry an increased risk of HPV infection and associated cancers. Therefore, prevalence and patterns of HPV infection at different anatomical sites, as well as theoretical protection of nonavalent vaccine should be investigated. Aim was to describe prevalence and predictors of oral HPV detection in HIV-positive men, with attention to nonavalent vaccine-targeted HPV types. Further, co-occurrence of HPV DNA at oral cavity and at anal site was assessed. This cross-sectional, clinic-based study included 305 HIV-positive males (85.9% MSM; median age 44.7 years; IQR: 37.4-51.0), consecutively observed within an anal cancer screening program, after written informed consent. Indication for anal screening was given by the HIV physician during routine clinic visit. Paired oral rinse and anal samples were processed for the all HPV genotypes with QIASYMPHONY and a PCR with MY09/MY11 primers for the L1 region. At the oral cavity, HPV DNA was detected in 64 patients (20.9%), ...

Infection and Immunity, 2003

Vγ9Vδ2 T lymphocytes strongly respond to phosphoantigens from Plasmodium parasites. Thus, we anal... more Vγ9Vδ2 T lymphocytes strongly respond to phosphoantigens from Plasmodium parasites. Thus, we analyzed the changes in Vγ9Vδ2 T-cell function and repertoire during the paroxysm phase of nonendemic malaria infection. During malaria paroxysm, Vγ9Vδ2 T cells were early activated but rapidly became anergic and finally loose Jγ1.2 Vγ9 complementarity-determining region 3 transcripts.

Journal of Medical Case Reports, 2011

Introduction: The influenza virus infection may be severe in non-immune people. Common complicati... more Introduction: The influenza virus infection may be severe in non-immune people. Common complications of influenza virus include upper and lower respiratory tract infections, otitis media, myocarditis, acute respiratory distress syndrome and multi-organ failure. There have been cases of vasculitis following influenza vaccination, and rash and acute purpura may occur in certain viral infections. To the best of our knowledge, there are no reports concerning cases of systemic vasculitis associated with pandemic 2009 (H 1 N 1) infection. Case presentation: A 23-year-old Caucasian woman was hospitalized at the "L. Spallanzani" National Institute for Infectious Diseases in Rome, Italy. Clinical and radiological features including laboratory findings of this case are illustrated. Notably, the patient had fever, severe abdominal pain, hematuria, arthritis, and purpuric manifestations associated with a normal platelet count. Nasopharyngeal and rectal swabs revealed pandemic 2009 (H 1 N 1) virus by reverse-transcriptase-polymerase-chain-reaction assay. Routine laboratory analyses showed elevated inflammatory parameters. The autoimmune panel tests were normal. Steroid therapy associated with oseltamivir achieved an evident and rapid improvement. On day seven the patient chose to leave the hospital against medical advice. Conclusion: Complications related to influenza infection can be life threatening, particularly in immunocompromised patients. Henoch-Schönlein purpura triggered by the novel influenza virus infection could be an attractive pathogenetic hypothesis. We have discussed both the diagnosis and the challenge of therapy protocols. Steroid therapy is part of the management of severe vasculitis. Our case suggests that steroid therapy associated with antivirals can prevent the risk of further complications such as hemorrhage and multi-organ failure during severe vasculitis, without enhancing the virulence of the influenza virus. The possible role of pandemic 2009 (H 1 N 1) in the pathogenesis of hemorrhagic manifestations should be further investigated.

The Journal of Infectious Diseases, 2000

A multicenter analysis of 57 consecutive human immunodeficiency virus-positive patients with prog... more A multicenter analysis of 57 consecutive human immunodeficiency virus-positive patients with progressive multifocal leukoencephalopathy (PML) was performed, to identify correlates of longer survival. JC virus (JCV) DNA was quantified in the cerebrospinal fluid (CSF) by polymerase chain reaction. Two months after therapy, 4% of the patients without highly active antiretroviral therapy (HAART) and 26% with HAART showed neurologic improvement or stability (), and 8% and 57%, respectively, reached undetectable JCV DNA levels in P p .03 the CSF (). One-year probability of survival was .04 without HAART and .46 with P p .04 HAART. HAART and lack of neurologic progression 2 months after diagnosis were independently associated with longer survival. Among HAART-treated patients, a baseline JCV DNA !4.7 log, and reaching undetectable levels after therapy predicted longer survival. Survival of AIDS-related PML is improved by HAART when JCV replication is controlled. Progressive multifocal leukoencephalopathy (PML), the demyelinating brain disease caused by JC virus (JCV), is an important cause of morbidity and mortality in patients with AIDS. The introduction of highly active antiretroviral therapy (HAART) into clinical practice has led to fewer opportunistic infections during human immunodeficiency virus (HIV) disease [1], but PML has been reduced less than other opportunistic diseases [2, 3]. Although potent antiretroviral therapies significantly prolong survival of patients affected by AIDS-related PML, even in large cohort studies [4-7], not all HIV-infected patients with this neurologic disorder receive significant benefit from HAART. Indeed, some case series have shown very poor prognosis, despite aggressive antiretroviral treatments [8], and

International Journal of STD & AIDS, 2011

Detecting acute HIV infection is important, but often the infection is difficult to recognize. We... more Detecting acute HIV infection is important, but often the infection is difficult to recognize. We report the case of a 23-year-old man with persistent genital ulceration; all microbiological examinations from the ulcers were negative. HIV-1/2 antibodies were positive, but the HIV-1 Western blot (WB) was indeterminate and HIV-1 p24 antigen was persistently negative, with a low HIV-1 RNA level. One month later, the genital ulcerations disappeared and the WB test showed complete seroconversion; nonetheless HIV p24 antigen remained negative and HIV-RNA was persistently low. HIV-1 proviral DNA was detected by nested polymerase chain reaction (PCR) from the initial ulcers swabs. This case was notable due to genital ulceration being the only sign of primary HIV infection. Furthermore, the serological pattern was unusual, and HIV-RNA was unexpectedly low. This underlines the importance of screening for HIV being infection in the setting of sexually transmitted infections (STIs), and also in...