Publications by authors named "Ivan Gentile"

Background: The combination of antivirals and monoclonal antibodies (mAbs) in the first phase of COVID-19 has demonstrated to reduce time to viral clearance, but the superiority of combination compared to antiviral monotherapy is still debated.

Research Design And Methods: In an observational, prospective study, we enrolled immunocompromised outpatients with mild-to-moderate COVID-19 treated with one antiviral monotherapy within 7 days from symptoms onset, with or without sotrovimab from January 1, 2024 to October 31, 2024, and we compared them to an identical cohort of patients treated with a combination of one antiviral and sotrovimab, from May 1, 2023 to December 30, 2023. 1st of May 2023 and 31st of October 2024.

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Background And Aims: Hepatitis B (HBV) and Hepatitis Delta virus (HDV) infection have undergone significant changes in Italy over the past few decades, but reliable and updated prevalence of chronic hepatitis B (CHB) and Delta (CHD) data are lacking. The aim of the study was to describe the epidemiology of CHB and CHD in Italy in 2024, based on real-world data.

Methods: The number of patients with a healthcare expenditure exemption for CHB (016.

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Objectives: Doxycycline postexposure prophylaxis (DoxyPEP) has emerged as a promising tool for reducing bacterial sexually transmitted infections (bSTIs), particularly among men who have sex with men. This study aims to investigate the attitudes and prescribing practices of Italian infectious disease (ID) physicians regarding DoxyPEP for the prevention of bSTIs.

Methods: This is a cross-sectional survey conducted between October 2024 and March 2025 among ID specialists registered with the Italian Society of Infectious and Tropical Diseases.

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This study aims to investigate the clinical impact of Omicron Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection on the clinical presentation of Coronavirus Disease 2019 (COVID-19) in the very old (≥80 years old) population. All patients aged 80 years or older, hospitalized from March 2020 to June 2023 with a SARS-CoV-2 infection in one of the 17 COVID-19 units in eight cities of Campania, southern Italy, were enrolled in a multicenter, observational, retrospective study. 341 patients ≥ 80 years of age were included: 80 of them in the Omicron and 261 in the non-Omicron period.

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Invasive fungal infections (IFIs) are a major complication in patients with acute myeloid leukemia (AML), particularly during chemotherapy-induced neutropenia. Posaconazole is the standard drug for primary antifungal prophylaxis (PAP), but its use is limited by oral bioavailability and CYP3A4 interactions. This study aims to evaluate the clinical efficacy and safety of intravenous caspofungin versus oral posaconazole as PAP in AML patients during their first cycle of chemotherapy and assess their subsequent impact on clinical outcomes.

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West Nile Virus (WNV) infection is endemic in Italy, but it has rarely reported in humans in Southern Italy. We report the first human outbreak of WNV infection in the Campania region, Italy. Five confirmed and seven probable cases of WNV were identified from August to September 2024.

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Objective: To evaluate the impact of multidrug resistance (MDR) on the mortality of cancer patients with bloodstream infection (BSI) by Gram-negative bacilli (GNB).

Patients And Methods: This was a prospective observational multicentre study including cancer patients with BSI caused by GNB (June 2018-January 2020). The primary outcome was 30-day mortality.

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Background: Urinary tract infections (UTIs) in kidney transplant patients are a challenge.

Aim: To evaluate epidemiology, clinical status, therapeutic management, and clinical outcome of kidney transplant patients in a university hospital for UTI.

Methods: We conducted a retrospective observational study, enrolling all kidney transplant patients hospitalized for UTI, with the objective to evaluate the epidemiology, clinical status, therapeutic management, and clinical outcome of kidney transplant patients.

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HDV infection has long been, and continues to be, a significant challenge. Chronic liver disease related to HDV is one of the most aggressive forms of liver disease, carrying a high risk of progression to cirrhosis and decompensated liver disease. Although an estimated 12 to 72 million people worldwide have been exposed to HDV, the prevalence of HDV-related conditions is believed to be underreported, and further epidemiological studies are needed to better understand its scope.

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Refractory and resistant cytomegalovirus infections remain significant challenges in solid-organ transplant recipients. In this context, maribavir is a valuable therapeutic option for management of cytomegalovirus infection. Although the clinical efficacy and safety of maribavir are well established, the optimal approach for assessment of viremic response, which is defined as the clearance of viremia, still requires further clarification.

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We conducted a real-life case-control study among outpatients with Omicron SARS-CoV-2 infection to assess the effectiveness of molnupiravir (MNP) in reducing hospital admission, admission to the intensive care unit, and death at day 28. Cases were SARS-CoV-2-positive patients seeking medical care within five days of symptom onset from 1 January to 31 December 2022, who received MNP. Controls were selected from a regional database among positive subjects who did not receive antiviral treatment for SARS-CoV-2.

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Background: Chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease, and bronchiectasis, are significant global health concerns associated with recurrent exacerbations, hospitalization, and increased mortality. Preventive strategies, particularly vaccination, play a crucial role in managing these diseases by reducing infection-related exacerbations and stabilizing lung function.

Summary: This review summarizes the recommendations provided by four major Italian scientific societies on vaccination against key respiratory pathogens, including respiratory syncytial virus, influenza, SARS-CoV-2, Streptococcus pneumoniae, and varicella zoster virus, which pose serious risks to individuals with chronic respiratory conditions.

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Introduction: Community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) are major global health challenges, with high morbidity and mortality rates. The increasing prevalence of multidrug-resistant (MDR) bacteria may diminish the effectiveness of standard empirical antibiotics, highlighting the need for broader-spectrum agents that target also MDR organisms.

Areas Covered: This review summarizes findings from a PubMed search on the use of ceftobiprole in CAP and HAP.

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Background: Risk of herpes zoster (HZ) infection increases with age and immunosuppression. We estimated the impact of HZ and post-herpetic neuralgia (PHN) on direct costs and health care resource utilization (HCRU) in patients ≥50 years, including those with comorbidities, as limited information exists in Italy.

Methods: This retrospective analysis used reimbursement data from local health authorities in Italy (January 2009-June 2022).

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Background And Aim: Ceftobiprole, an advanced-generation cephalosporin with broad bactericidal activity, is approved for community-acquired and hospital-acquired pneumonia (excluding ventilator-associated pneumonia). We aimed to evaluate, in a real-world setting, the safety profile of ceftobiprole in patients with risk conditions (severe renal impairment, hepatic impairment, and immunocompromised status), groups excluded from clinical trials.

Methods: In this retrospective study (NCT04170309), 396 consecutive charts of patients treated with ceftobiprole during 2016-2022 in 15 centres in France, Italy, and Spain were analysed: 62 had severe renal impairment, 51 had a hepatic impairment, 120 were immunocompromised, and 203 had no predefined risk condition (controls).

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Background: Ritonavir-boosted nirmatrelvir (N/r) is an antiviral which targets the main viral protease, administered to prevent the progression of SARS-CoV-2 infection in patients at high risk for severe COVID-19. We present a real-life case-control study evaluating the efficacy of N/r therapy in SARS-CoV-2 omicron variants positive outpatients in Campania region, Italy, with the aim of assessing the occurrence of three outcomes (hospital admission, admission in ICU and death) in cases and controls.

Methods: We enrolled SARS-CoV-2 positive subjects that came to our attention in Early antiviral treatment ambulatory of Infectious Diseases ward of University Federico II of Naples, Italy from January 1st, 2022, to December 31st, 2022, during the first five days from symptoms occurrence.

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Purpose: To describe the clinical characteristics and outcomes of patients with nosocomial pneumonia (NP) caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) and to compare them to patients with NP caused by carbapenem-susceptible (CS)-GNB.

Methods: Prospective observational multicenter study including patients with bacteremic NP caused by GNB from the ALARICO Network (June 2018-January 2020). The primary outcome measure was 30-day mortality.

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Urinary tract infections are one of the main complications in kidney transplant patients, with a significant impact on graft function and survival. In fact, it is estimated that up to 74% of kidney transplant patients experience at least one episode of UTIs in the first year after transplantation, with an increased risk of graft loss and an increased risk of mortality. Several risk factors have been identified, such as female gender, old age, diabetes mellitus, immunosuppression, pre-transplant UTIs, urinary tract abnormalities, and prolonged dialysis.

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Carbapenem-resistant (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. We enrolled 45 patients. Cefiderocol was administered to 40% of patients, often (38.

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Objectives: Hepatitis delta virus infection poses a significant challenge in solid-organ transplant recipients due to its aggressive nature and limited therapeutic options. Bulevirtide is a novel antiviral agent approved by the European Medicines Agency in 2020 for the treatment of hepatitis delta virus infection, but limited data are available on its use in solid-organ transplant recipients.

Materials And Methods: We present a case report of a 42-year-old male kidney transplant patient with coinfection of hepatitis B virus and hepatitis delta virus who was treated with bulevirtide over a 6-month period.

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Article Synopsis
  • Pre-exposure prophylaxis with Tixagevimab/Cilgavimab has effectively reduced COVID-19 risks in immunocompromised patients, but its efficacy is limited against the Kraken variant (XBB.1.5).
  • A study involving kidney transplant patients on this treatment showed only one asymptomatic infection during a six-month follow-up, with no hospitalizations or COVID-related deaths.
  • The results suggest Tixagevimab/Cilgavimab may still be a beneficial preventive option for immunocompromised individuals, underlining the need for further clinical research on this topic.
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The emergence of COronaVIrus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presented a global health challenge since its identification in December 2019. With clinical manifestations ranging from mild respiratory symptoms to severe multi-organ dysfunction, COVID-19 continues to affect populations worldwide. The complex interactions between SARS-CoV-2 variants and the human immune system are crucial for developing effective therapies, vaccines, and preventive measures.

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