Thanks to the modern ARV regimens and the fact that the morbidity and mortality of metabolic syndrome increases with age, clinicians are continuously researching effective and safe antiretroviral regimens with low impact on the lipid profile. Doravirine (DOR) is the latest non-nucleoside reverse-transcriptase inhibitor (NNRTI) that shows long-term safety and tolerability and a favorable lipid profile. The aim of this study is to assess the impact of DOR-based three-drug regimens on the lipid profile in clinical practice. We retrospectively analyzed a cohort of 38 treatment-experienced, virologically suppressed people living with HIV (PLWH) switching to this regimen, following the eligibility criteria. We carried out comparison analysis of immunological and metabolic parameters between baseline and 48 weeks of follow up. In our cohort of treatment-experienced, virologically suppressed PLWH, three-drug regimens with DOR showed good efficacy and a positive profile on lipid metabolism at 48 weeks of follow up.

Background: In May 2022, a new case of Monkeypox Virus (MPX) was reported in a non-endemic area, the United Kingdom, and since then, the number of confirmed cases in Europe has been increasing until WHO, on May 10 2023, declared that MPOX is no longer a public health emergency of international concern. We aimed to describe the clinical and microbiological characteristics of sixteen patients with a confirmed diagnosis of MPX followed by a single Italian clinical centre, the Fondazione Policlinico Universitario Agostino Gemelli, between May 20 and August 30. Materials and methods: A prospective observational study has been conducted, collecting microbiological samples during the time of the infection, as well as epidemiological and clinical data of the patients. All patients provided written informed consent. Results: During clinical practice, 16 individuals presenting with consistent symptoms tested positive for MPX on a polymerase chain reaction. All patients were men having sex with men (MSM). The most frequent clinical presentation was a vesicular erythematous cutaneous rash, mainly distributed on the genital and perianal area, but also regarding limbs, face, neck, chest and back in some of the patients. Systemic symptoms, such as fever or lymphadenopathy, involved eight patients. The symptom most frequently reported by patients was pruritus in the area of the vesicles. Thirteen patients also reported pain. Nine patients were HIV-1 coinfected, but no significant differences have been observed compared to other cohort patients. The median time between the onset of symptoms and the healing was 19.5 days (IQR 14.0–20.3). Conclusions: Our cohort of patients presented a mild manifestation of the disease with no complications and no need for antiviral therapy nor hospitalization. This population seems different from the ones reported in the literature during the previous outbreaks in endemic areas in epidemiological data and clinical manifestations but also from a cohort of patients described in the literature from the 2022 outbreak, suggesting the importance for healthcare workers to keep in mind the possibility of an MPX infection in the differential diagnosis of patients presenting with consistent symptoms, even in non-endemic areas, to ensure efficient isolation of the patient for infection control purposes and effective management of the infection preventing the development of MPOX-related complications.

Dengue, traditionally confined to endemic regions, is now emerging in non-endemic areas, including Italy. This manuscript describes the 2023 Italian autochthonous dengue outbreak, reporting the clinical and demographic characteristics of 19 patients followed by the Fondazione Policlinico Universitario Gemelli IRCCS in Rome, Italy.

Long-acting injectable cabotegravir/rilpivirine (CAB/RPV-LA) is currently approved as a maintenance therapy for people with HIV (PWH) who are virologically suppressed. However, growing real-world evidence highlights its potential role in more complex viremic populations traditionally considered ineligible. We present a case series of eight PWH treated at two tertiary centers in Italy, all of whom faced persistent viremia, adherence difficulties, malabsorption syndromes, or psychosocial barriers. Following the switch to CAB/RPV-LA, all patients, despite heterogeneous clinical profiles and baseline virological status, achieved and maintained virologic suppression, demonstrated improved adherence, and experienced no serious adverse events.

Objectives: This study aimed to evaluate the HIV virological efficacy of two‐drug regimens (2DR) with lamivudine (3TC) and dolutegravir (DTG) in people with HIV (PWH), classified by their hepatitis B virus (HBV) serological status. Specifically, it explored whether isolated anti‐hepatitis B core (anti‐HBc) positivity impacts virological outcomes.Methods: A retrospective observational study was conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, enrolling 606 virologically suppressed (HIV‐RNA < 50 copies/mL) PWH who switched to a 2DR regimen with 3TC/DTG. Participants were categorized into four groups based on their HBV serological status: hepatitis B surface antibody (HBsAb)‐positive/hepatitis B core antibody (HBcAb)‐positive, HBsAb‐negative/HBcAb‐negative, HBsAb‐positive/HBcAb‐negative, and isolated HBcAb positivity. Viral failure (VF) was defined as two consecutive HIV viral loads above 50 copies/mL or a single HIV viral load above 1000 copies/mL, and viral blips (VBs) as a single HIV‐RNA measurement between 50 and 200 copies/mL followed by suppression.Results: During 2216.4 patient‐years of follow‐up (PYFU), we observed 30 VFs (1.3 per 100 PYFU) and 63 VBs (2.9 per 100 PYFU). No statistically significant differences in VF or VB were noted between the serological groups. Additionally, no significant alanine aminotransferase (ALT) flares or HBV‐DNA breakthroughs were observed, with HBV‐DNA remaining undetectable throughout.Conclusions: The study supports the virological efficacy of 3TC/DTG‐based 2DR in PWH, regardless of HBV serological status. Isolated anti‐HBc positivity did not influence virological outcomes independently. Larger studies are warranted to further investigate HIV–HBV interactions in this context.

Objectives: The aim of this study was to assess sleep quality in people living with HIV (PLWH), and to examine how the sleep sphere interacts with mental health, quality of life and internalized stigma. Methods: A total of 250 PLWH were consecutively enrolled during routine outpatient visits. Each participant completed a 67-item questionnaire. Sleep disturbances were measured using the Pittsburgh Sleep Quality Index (PSQI). The Depression, Anxiety and Stress Scale (DASS-21) was used to measure the mental health status. The Short Form 12 (SF-12) questionnaire was used to measure participants’ quality of life. Internalized HIV-related stigma was evaluated using the modified six-item internalized AIDS-related stigma scale. Results: Many of the PLWH were male (69.2%) and the time between HIV diagnosis and first antiretroviral therapy (ART) was over 10 years (69.2% and 64%, respectively). The PSQI component most-cited as problematic by PLWH was habitual sleep efficiency (52.4%). In multivariate analysis models, a higher mean in the PSQI total score was significantly associated with internalized stigma (mean change 1.10), depression (mean change 6. 20), anxiety (mean change 12.15), stress (mean change 6.24), physical (mean change 7.54) and mental (mean change 3.56) quality of life, health status (mean change −6.04), ART adherence (mean change −5.08) and physical activity (mean change −6.20). Conclusions: Our results confirm the role of sleep quality in both mental and physical health and suggest that sleep disorders might also be a significant indicator of psychosocial challenges faced by PLWH.