TOPIC

Infectious diseases, HIV

HIV/AIDS

The Italian National Institute of Health (ISS) is at the forefront in the fight against infectious agents which, constantly changing over time, make it necessary the frequent updating  of priority actions.

The ISS implements surveillance, prevention and control measures against emerging diseases such as those deriving from the spread of antibiotic-resistant biological agents commonly found in hospital environment, and those transmitted by vectors, such as chikungunya, dengue and West Nile.

Vaccine preventable diseases, although they have been reduced due to effective interventions, represent a significant burden of diseases which require to maintain a high level of attention.

Viral hepatitis and sexually transmitted infections, as human papillomavirus (HPV) infection, are a paradigmatic example of how chronic infections can result in degenerative diseases and even cancers. A vaccine is available for hepatitis B virus (HBV) and HPV infection.

Infectious diseases include also neglected tropical diseases, as intestinal parasitosis and echinococcosis, found in many parts of the world.

With regard to HIV / AIDS, the antiretroviral therapy (ART), although it has saved millions of lives, does not eliminate the HIV from the body nor restore the immune system completely back to normal. Furthermore, it has limited effects if started late or not taken regularly.

In order to stop the HIV epidemic and assure those living with the infection (about 38 million people with HIV / AIDS in the world, including 20.6 million in Africa) better quality of life and life expectancy, the ISS develops surveillance, prevention and treatment strategies, working in cooperation with the National Health Service (SSN), Regions, developing countries and international bodies.

General aims of ISS research activities on HIV/AIDS include:

  • study and surveillance of the spread of HIV and its variants, and of co-infections in general and vulnerable populations
  • study of the mechanisms of infection, of development of AIDS and associated diseases
  • facilitating ART adherence by improving its effectiveness and reducing its side effects
  • development of new strategies capable of preventing infection, reducing its progression and enhancing the effectiveness of ART, in particular preventive and therapeutic vaccines
     

Markers of HIV infection progression

Understanding the progression of HIV infection in the Italian and immigrant population.
Immigrants residing in Italy are often infected with HIV subtypes different from subtype B which is predominant in our country. The identification of viral or immunological "markers" able to predict the evolution of the disease in the general population compared to the immigrant population is a key aspect to set up more effective therapeutic strategies. CNAIDS is committed to identifying these aspects in immigrants who have a different genetic, immunological, and virological background.
In this context, people of different ethnicities may, in fact, represent key populations to understand which viral and immunological markers are important for disease progression. A number of immune activation markers have been associated with morbidity and mortality in HIV-infected persons. Cytokines and chemokines play a central role in the immune response to HIV infection, and proviral DNA (measurement of viral reservoirs) is considered a key marker for monitoring infection. As HIV strains may differ in terms of pathogenicity, thus influencing disease progression, CNAIDS is committed to identify possible relationships among biomarkers of inflammation, immunological status, and virological status in ART patients.
The study may, therefore, provide important data for the clinical management of patients, including effective therapeutic strategies in controlling the progression of HIV infection.