Volume 29, Issue 2, 2021
Review
Immunopathogenesis and immunobiology of SARS-CoV-2
Rabaan AliA.,
Al-Ahmed Shamsah H.,
Al Mutair Abbas,
Alhumaid Saad,
Sule Anupam A.,
Tirupathi Raghavendra,
Fawzy Mohamed,
Muhammad Javed,
Khan Amjad,
Hasan Abdulkarim,
Shrestha Dhan Bahadur ,
Sah Ranjit,
Dhawan Manish,
Tiwari Ruchi,
Bilal Muhammad,
Ahmad Tauseef,
Dhama Kuldeep
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome virus 2 (SARS-CoV-2), in a very short span of thirteen months has taken a considerable toll on humanity, resulting in over 3 million deaths with more than 150 million confirmed cases as on May 1, 2021. In the scarcity of a potential antiviral and protective vaccine, COVID-19 has posed high public health concerns, panic, and challenges to limit the spread of this pandemic virus. Only recently have a few vaccine candidates been developed, and vaccination programs have started in some countries. Multiple clinical presentations of COVID-19, animal spillover, cross-species jumping, zoonotic concerns, and emergence of virus variants have altogether created havoc during this ongoing pandemic. Several bodies of research are continuously working to elucidate the exact molecular mechanisms of the pathogenesis. To develop a prospective antiviral therapy/vaccine for SARS-CoV-2, it is quite essential to gain insight into the immunobiology and molecular virology of SARS-CoV-2. A thorough literature search was conducted up to 28th February 2021 in the PubMed and other databases for the articles describing the immunopathology and immune response of SARS-CoV-2 infection, which were critically evaluated and used to compile this article to present an overall update. Some of the information was drawn from studies on previous MERS and SARS viruses. Innate as well as adaptive immunity responses are elicited by exposure to SARS-CoV-2. SARS-CoV-2 establishes a successful infection by escaping the host immunity as well as over activating the innate immune mechanisms that result in severe disease outcomes, including cytokine storm. This review summarizes the immunopathology and molecular immune mechanisms elicited during SARS-CoV-2 infection, and their similarities with MERS-CoV and SARS-CoV.
Molecular and serological prevalence of Coronavirus in Chiropterans: A systematic review with meta-analysis
Bonilla-Aldana D. Katterine,
Acevedo-López Doménica,
Aristizábal-Carmona Brayan Stiven,
Díaz-García Fabio Andrés,
Sarmiento-Cano CristianCamilo,
Gutiérrez-Soleibe Samuel,
Del Mar España-Cerquera María,
Obando-Cardona Diego Mauricio,
Castrillón-Correa Laura Paulina,
Castro-Henao Juliana,
Suárez-Muñoz Juan Esteban,
Serna-Suárez SaraCristina,
Mora-Hernández Mateo Alejandro,
Álvarez-Amaya Valeria,
Rodriguez-Morales Alfonso J.,
Pecho-Silva Samuel ,
Paniz-Mondolfi Alberto,
Mattar Salim
In recent years, and now especially with the arrival of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), there has been increased interest in understanding the role of bats in the dynamics of transmission and origin of this pandemic agent. To date, no systematic reviews have been published on this topic. This systematic review aimed to summarize and highlight the frequency of bat infections reported in currently available observational studies for coronavirus. The purpose of this study was also to examine the differences between the pool prevalence by technique and country. We performed a systematic literature review with meta-analysis, using three databases to assess coronavirus (CoV) infection in bats and its diagnosis by serological and molecular tests. We carried out random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In all, 824 articles were retrieved (1960-2021). After screening by abstract/title, 43 articles were selected for full-text assessment. Of these, 33 were finally included for qualitative and quantitative analyses. From the total of studies, the pool prevalence by RT-PCR (n=14,295 bats) for CoV was 9.8% (95% CI 8.7-10.9%); Italy reported the highest pooled prevalence (44.9%, 95% CI 31.6-58.1%), followed by the Philippines (29.6%). Regarding the ELISA, the pool prevalence for coronavirus from 15 studies, including 359 bats, was 30.2% (95% CI 14.7-45.6%). The results for coronaviruses with the MIF were significantly lower, 2.6% (95% CI 1.5-3.7%). A considerable proportion of infected bats tested positive, particularly by molecular tests. This essential condition highlights the relevance of bats and the need for future studies to detail their role as potential reservoirs of SARS-CoV-2. In this meta-analysis, bats were positive in almost 10% by RT-PCR, suggesting their relevance and the need to understand their potential participation in maintaining wild zoonotic transmission.
Clinical and epidemiological aspects of sporotrichosis: an overview of the cases reported in Europe and in Italy
Monno Rosa,
Giannelli Giorgia,
Fumarola Luciana
Sporotrichosis is a fungal infection occurring worldwide, especially in tropical and sub-tropical areas. We present a brief review of clinical and epidemiological aspects of sporotrichosis, as well as its treatment. Sporotrichosis is rarely reported in Europe and the European Centre of Disease Control does not track its infection rate. To fill this gap, we report a survey of clinical cases described over the past forty years in Europe and in Italy.
Human visceral leishmaniasis prevalence by different diagnostic methods in Latin America: a systematic review and meta-analysis
Gutiérrez-Ocampo Estefanía,
Villamizar-Peña Rhuvi,
Cortes-Bonilla Isabella,
García-Zuluaga Luisa M.,
Holguin-Rivera Yeimer,
Ospina-Arzuaga Harrison D.,
Cardona-Trujllo Maria Camila,
Trejos-Mendoza Adrián E.,
Perez-Vargas Soffia,
Arteaga-Livias Kovy,
Zambrano Lysien I.,
Bonilla-Aldana D. Katterine,
Perez-Garcia Luis A.,
Hernandez-Pereira Carlos E.,
Rodriguez-Morales Alfonso J.,
Paniz-Mondolfi Alberto,
Delgado Olinda M.
Visceral leishmaniasis is a neglected zoonotic disease that affects animals and humans in different tropical and subtropical regions and even beyond, with variable prevalence among infected hosts. To date, there have been no systematic reviews on human visceral leishmaniasis prevalence in Latin America. We therefore performed a systematic literature review with meta-analysis, using six databases to assess prevalence of visceral leishmaniasis in human patients in Latin American countries. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). In all, 10,435 articles were retrieved for the time frame (1950-2019). After initial screening, 120 articles were selected for full-text assessment, 97 being finally included for qualitative and quantitative analyses. Overall, VL pooled prevalence was estimated at 38.8% (95% CI 33.8-43.8%), derived from 97 studies, including 44,986 individuals. Many aspects of the transmission dynamics of Leishmania and the exact burden of this parasitosis on public health remain largely unknown. Although the elimination of zoonotic VL in the Americas appears an unrealistic goal, additional efforts need to be put in place to achieve better diagnosis, treatment, and prevention of VL.
Original article
Use of renin-angiotensin system inhibitors and clinical predictors of COVID-19 severity in a tertiary hospital in the city of Buenos Aires
Barochiner Jessica,
Martínez Rocío,
Roxana Patricia,
Marín Marcos José,
Ko Ery Ayelén,
Osorno María Sol
Information regarding predictors of a worse COVID-19 prognosis in the South American population is scarce. We aimed to determine whether the blockade of the renin-angiotensin system is associated with a worse clinical course of COVID-19, and to evaluate what clinical variables are associated with COVID severity in our population. We included adult subjects with rtPCR-confirmed COVID-19. The use of renin system inhibitors was defined according to its registration in the electronic medical record or the hospital pharmacy registry during the previous three months. Our endpoint was a composite of death or mechanical ventilation requirement. Patients were followed up until discharge or death. A multiple logistic regression model was used to determine the predictors of the composite endpoint. In all, we included 4930 COVID+ patients, the median age was 52 years, and 48.1% were male. The endpoint occurred in 488 patients (9.9%). In adjusted analysis, neither angiotensin converting enzyme inhibitors nor angiotensin receptor blockers were associated with the outcome. Independent predictors of mortality and/or mechanical ventilation requirement were age, male sex, a history of diabetes and/or chronic kidney disease, smoking and dementia. To conclude, renin system inhibitors seem to be unrelated to COVID-19 severity, whereas prognosis is independently associated with age, male sex and comorbidities.
Long-term clinical and serological follow-up of paediatric patients infected by SARS-CoV-2
Calitri Carmelina,
Fantone Francesca,
Benetti Stefania,
Lupica Maria Maddalena,
Ignaccolo Maria Giovanna,
Banino Elena,
Viano Alice,
Pace Mariella,
Castella Annalisa,
Gaido Flavio,
Garofalo Franco,
ASLTO3 Study Groupon Paediatric COVID-19
Studies concerning Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in paediatrics are limited to children mainly selected from hospitals, where patients with complications and co-morbidities are managed. We aimed to describe the course of the Coronavirus Disease 2019 (COVID-19) in a population of children enrolled by place of residence, from diagnosis to recovery, with a long-term clinical and serological follow-up. We identified patients aged <14 years old living in the Turin Health District 3 who had SARS-CoV-2 detected in at least one nasopharyngeal swab from 1st March to 1st June 2020. Epidemiological and clinical features of SARS-CoV-2 infection were collected by way of a telephone inquiry. Enrolled patients were tested for SARS-CoV-2 serology in order to provide evidence of seroconversion and persistence of specific antibodies some time after infection. A total of 46 patients with SARS-CoV-2 infection/COVID-19 were identified. The main pattern of viral transmission was intra-family. Eleven children were totally asymptomatic. If symptoms appeared, the disease had a mild course. A single case of COVID-19-related respiratory insufficiency was registered. Among children who underwent serological evaluation, 84% had seroconversion. No significant differences in antibody development were found according to the age and the burden of the disease. Children tested farther from the primary infection had lower antibody index titre values than the others. In conclusion, COVID-19 has a good prognosis in paediatric age. Children are able to develop a valid immune response, although their index titres seem to decrease a long time after the disease.
Vitamin D plasma levels in patients with COVID-19: a case series
Lagadinou Maria,
Zorbas Basileios,
Velissaris Dimitrios
Vitamin D deficiency has been associated to respiratory tract infections. We aimed to investigate plasma vitamin D levels in patients with chest infection with and without COVID-19 in a hospitalized population during the second pandemic wave. A prospective study was conducted in a Mediterranean tertiary center referring to 80 patients suffering from chest infection, who were divided into two groups according to a positive test for SARS-CoV-2 infection. The hospitalized COVID-19 patients had a high prevalence of vitamin D deficiency, and these patients also exhibited higher levels of plasma inflammatory markers. Intensive research is required to identify the role and mechanisms of vitamin D in patients with SARS-CoV-2 infection and its possible role as a prognostic factor of the disease.
QuantiFERON-TB and tuberculin skin test in patients with active tuberculosis: the experience of a single medium-sized Italian University Hospital
Pasticci Maria Bruna,
Papalini Chiara,
Murgia Nicola,
Papili Rita,
Bucaneve Giampaolo,
Malincarne Lisa,
Bozza Silvia,
Francisci Daniela,
Cenci Elio
Interferon-γ releasing assays (IGRAs) are currently widely employed in the initial work up of Mycobacterium tuberculosis infection, as well as in suspected tuberculosis (TB). These assays are commonly utilized over the Tuberculin Skin Test (TST) in high resource and low TB burden settings, despite the unclear benefits shown in such contexts. The debate on the use of TST and IGRAs is of current interest also in Italy due to the increasing presence of immigrants from countries with a high incidence of TB and the rising attention of health care institutions to economic costs. The aim of this study was to compare QuantiFERON-TB (QFT) and TST results in active TB. We evaluated QFT results and TST reactions from 245 consecutive patients having both tests, registered among 411 patients admitted for TB at the Infectious Disease Clinic, Department of Medicine of the University of Perugia (Italy). We compared the rates of positive QFT and TST tests and noted no statistically significant differences overall or in relation to age, gender, HIV status and TB localization. Among foreign-born patients with confirmed TB, we observed a lower rate of positive TST results. The results of our study indicated that both QFT and TST can be used in the work up of TB having special attention when evaluating foreign-born patients..
Outcome of HBV screening and vaccination in a migrant population in southern Italy
Mazzitelli Maria,
Greco Giuseppe,
Serapide Francesca,
Scaglione Vincenzo,
Morrone Helen,
Marascio Nadia,
Giancotti Aida,
Liberto Maria Carla,
Matera Giovanni,
Trecarichi Enrico Maria,
Torti Carlo
Chronic hepatitis B virus (HBV) infection is a major health problem worldwide. Although Italy is considered a low prevalence setting for HBV infection, following significant migration in recent years there has been an increase in the occurrence of the disease. Italian guidelines recommend that all migrants be screened, vaccinated and treated for HBV, as required. Unfortunately, screening and vaccination in this population can be challenging for several reasons. We therefore conducted an analysis to evaluate the efficacy and outcome of the pathways of care (from screening to treatment) for HBV in a population of migrants. We evaluated 330 migrants who came to our centre between August 2015 and October 2018, and who were residing in seven different centres for refugees and asylum seekers. At the first evaluation, only 30% of them had already received screening for HBV. After our intervention, 23 (6.9%) were diagnosed as HBsAg carriers, whereas 204 (61.8%) were potentially eligible for vaccination. At a follow-up evaluation of the latter group, only 56.9% had by then been vaccinated, 17.6% had the vaccination course ongoing, and 17.1% had not started their vaccination course. Among those who were HBsAg positive, 73.9% were still in care at month 6 of follow-up, and only 43.3% were in care one year later. Our results demonstrated that both screening and vaccination strategies for HBV need to be improved in migrant populations. Similarly, a reinforcement of the network to keep in care migrants who initiated treatment or deserve clinical monitoring is necessary.
Prevalence of resistance-associated substitutions to NS3, NS5A and NS5B inhibitors at DAA-failure in hepatitis C virus in Italy from 2015 to 2019
Rossetti Barbara,
Paglicci Lorenzo,
Di Maio Velia C.,
Cassol Chiara,
Barbaliscia Silvia,
Paolucci Stefania,
Bruzzone Bianca,
Coppola Nicola,
Montagnani Francesca,
Micheli Valeria,
Monno Laura,
Zanelli Giacomo,
Santantonio Teresa,
Cuomo Nunzia,
Caudai Cinzia,
Zazzi Maurizio,
Ceccherini-Silberstein Francesca,
Despite the high efficacy of direct-acting antivirals (DAAs), the selection of resistance-associated substitutions (RASs) after virological failure of hepatitis C virus (HCV) DAAs can impair the cure of chronic HCV. The aim of the study was to characterize RASs after virological failure of DAAs in Italy over the years. Within the Italian network VIRONET-C, the change in prevalence of NS3/4A-NS5A-NS5B RASs was retrospectively evaluated in patients who failed a DAA regimen over the years 2015-2019. NS3, NS5A and NS5B Sanger sequencing was performed using homemade protocols and the geno2pheno system was used to define HCV-genotype/subtype and predict drug resistance. The changes in the prevalence of RASs over time were evaluated using the chi-square test for trend. Predictors of RASs at failure were analysed by logistic regression. Among 468 HCV-infected patients, HCV genotype 1 was the most prevalent (1b in 154, 33% and 1a in 109, 23%). DAA regimens were: ledipasvir (LDV)/sofosbuvir (SOF) in 131 patients (28%), daclatasvir (DCV)/SOF in 109 (23%), ombitasvir/paritaprevir/ritonavir+dasabuvir (3D) in 89 (19%), elbasvir (EBR)/grazoprevir (GRZ) in 52 (10.5%), velpatasvir (VEL)/SOF in 53 (11%), glecaprevir (GLE)/pibrentasvir (PIB) in 27 (6%) and ombitasvir/paritaprevir/ritonavir (2D) in 7 (1.5%); ribavirin was administered in 133 (28%). The NS5A fasta sequence was available for all patients, NS5B and NS3/4A both for 93%. The prevalence of NS5A and NS3/4A RASs significantly declined from 2015 to 2019; NS5B RAS remained stable. Independent predictors of any RASs included older age and genotype 1a (vs G2 and vs G4). Notably, at least partial susceptibility to all the agents included in the GLE/PIB and VEL/SOF/Voxilaprevir (VOX) combinations was predicted in >95% of cases. As RASs remain common at the failure of DAAs, their identification could play a crucial role in optimizing re-treatment strategies. In Italy RAS prevalence has been decreasing over the years and susceptibility to the latest developed drug combinations is maintained in most cases.
Lesson learned from the 2017 measles outbreak in Italy: report from an emergency department
Spagnolello Ornella,
Russo Alessandro,
Borrazzo Cristian,
D’Ettorre Gabriella,
Ceccarelli Giancarlo
Measles is a preventable disease still responsible for a number of outbreaks worldwide. Although most adults with measles recover uneventfully, measles-related complications may occur. However, as to whether every complicated case requires hospital management is still a point of debate. In this study we described the rate, clinical features and severity of measles complications in patients admitted to the ED of a tertiary-care teaching hospital during the outbreak that took place in 2017. Some insights into the impact on the health care system are reported as well. A retrospective cohort study was performed. Medical records of adults discharged from January to December 2017 with diagnosis of “measles” were collected and analyzed. Out of 58,579 of ED admissions, 162 measles cases were enrolled. Acute measles infection was laboratory confirmed in 71.6% and deemed as possible/probable in 24.0% of cases. Three percent of patients were immunocompromised while 1.2% of cases occurred in pregnant women. Of all complications reported (37%), hepatitis was the most frequent (29%) followed by pneumonia (10.4%), keratitis (3.8%), thrombocytopenia (3.8%) and otitis media (0.6%). No significant clinical and laboratory difference emerged between complicated and non-complicated cases besides antibiotic prescription (80.0% vs 66.3%; p=0.039). The course of the disease was mild, and no life-threatening measles-related complications or critical care support were reported. One out of three measles cases may experience at least one measles-related complication. However, the course of the disease seems to be rather benign in young adults, and the widespread use of the ED and hospitalization observed seem an inappropriate approach to the issue.
Case report
Severe systemic thrombosis in a young COVID-19 patient with a rare homozygous prothrombin G20210A mutation
Ramon Jose,
Ciarallo Marianna,
Di Stefano Mariantonietta,
Sica Salvatore,
Scarale Mariagrazia,
D’Errico Maria,
Corallo Fabio,
Lo Caputo Sergio,
Margaglione Maurizio,
Santantonio Teresa
COVID-19 patients may experience a hypercoagulable condition, leading to thrombotic events. We describe a patient with COVID-19, carrying a rare homozygous mutation of the prothrombin gene, who developed a severe systemic vein thrombosis. In COVID-19 patients with hypercoagulability disorders the most common inherited and acquired risk factors should be investigated.
Cutaneous tuberculosis on the scalp: a case report
Hassunuma Carneiro Bruno,
Palone André Gama,
Celeira Zanlorenzi Carine Andrade,
Bochnia Küster João Guilherme,
Abreu Ducroquet Marcelo,
de Barros João Adriano
Tuberculosis is a disease that usually affects the lungs, although other systems may also be infected, resulting in atypical clinical presentations. We report the case of a 76-year-old man who was admitted to the hospital in Brazil with a 3-week history of a painful, enlarging ulcer on the scalp and cough. His medical history was notable for non-metastatic prostatic adenocarcinoma and esophageal squamous cell carcinoma. On physical examination, the ulcer measured 10 cm in diameter and was tender, with a firm border and yellow crusts. A punch-biopsy specimen of the edge of the ulcer showed acute and chronic non-specific inflammation and neutrophilic infiltrates. Acid-fast bacilli were seen on microscopic examination, molecular testing detected Mycobacterium tuberculosis DNA and pan-sensitive M. tuberculosis was cultured. Computed tomography (CT) scan of the head showed a frontoparietal osteolytic lesion under the ulcer, chest CT revealed areas of consolidation in the lower lobes and M. tuberculosis was also identified in a bronchoalveolar lavage specimen. After one month of combination therapy with rifampin, isoniazid, pyrazinamide and ethambutol his symptoms were found to be improving and the size of the ulcer was markedly reduced.
Oligosymptomatic diphtheria infection in adults: two contacts of the Peruvian index case after 20 years without disease report
Montenegro-Idrogo Juan José,
Resurrección-Delgado Cristhian,
Sánchez-Álvarez César,
Villarreal-Zerpa Marcelo,
Morales-López Freddy,
Vargas-Matos Iván,
Chiappe-Gonzalez Alfredo Juan
In Peru, diphtheria infection was eradicated in the last two decades. However, recently, diphtheria pharyngeal infection was confirmed and reported in a 5-year-old boy (index case). We report two more cases of this outbreak (in the index case parents) with confirmed diphtheria infection and tox gene identified by molecular assay, who were in close contact with the index case and never presented any symptoms. Both parents had a congestive pharynx with erythematous plaques at the back of it. In adults, diphtheria infection can be oligosymptomatic or mimic viral pharyngitis, which could lead to misdiagnosis and, furthermore, an increased risk of transmission in regions with lower immunization rates.
Elbasvir/Grazoprevir combination therapy in a B-NHL patient with HCV genotype 1 infection
Sica Antonello,
Spada Alessandro,
Sagnelli Caterina,
Verolino Pasquale,
Mazzocca Annalisa,
Sagnelli Evangelista,
Colella Giuseppe,
Guastafierro Salvatore,
Marrone Aldo
Patients with indolent non-Hodgkin lymphomas (NHL) may often be followed up only with observation, reserving chemotherapy in case of spread. Patients with chronic HCV infection and B cell NHL frequently undergo regression of lymphoproliferative disease once HCV infection is eradicated by treatment. Interferon (IFN)-based therapy has been the treatment of choice for years, remaining unclear whether it is effective in B cell NHL directly or through HCV eradication, since IFN is effective in both HCV infection and B cell NHL. IFN therapy for HCV infection became obsolete with the advent of the well tolerated direct-acting antiviral agents (DAAs), whose excellent efficacy in treating patients with chronic HCV infection and B cell NHL has been recently highlighted. We treated a 53-year-old woman with chronic HCV infection and marginal zone lymphoma (MZL) with elbasvir plus grazoprevir in 2018, with complete remission and persisting excellent results: sustained virological response 24 weeks after treatment (SVR24). The exclusive role of HCV eradication in B cell NHL regression is also underlined.
The Infections in the History of Medicine
Historical pearls of HPV research: from condyloma to cervical cancer
Mavrommatis Evangelos,
Lytsikas-Sarlis Pavlos,
Troupis Theodoros
The oldest discovered human papilloma virus (HPV) infection in an ancient Egyptian mummy testifies that there is still much to unearth in its history. The Graeco-Roman world recognized venereal infections, and its nomenclature is still valid concerning HPV lesions. Western Europeans, eons later, created various theories for HPV evolution. Animal experiments during the 19th century had a profound impact for the understanding of HPV. In the late 20th century the carcinogenic properties of the virus had been clarified. This historical review presents the most important figures and discoveries in HPV research
Controversies and lessons from the history of smallpox: the case of massive vaccination in British Corfu (1852)
Tsiamis Costas,
Vrioni Georgia,
Dimopoulou Chryssa,
Poulakou-Rebelakou Effie,
Anoyatis-Pelè Dimitrios,
Tsakris Athanassios
The study presents an anti-vaccination action in the 19th century involving both scientific and political motivation. The research is based on an unpublished archive, namely the registries of the British Executive Police during the massive vaccination campaign in Corfu, the capital of the British possession in the Ionian Islands-Greece (1815-1864), after the smallpox outbreak of 1852. The archival material provides information about the number of vaccinated people, namely their sex, age, nationality, the year of the previous vaccination, along with the last year when a citizen “had smallpox”. The records indicated 40,858 citizens and of these, a total 21,845 (53.46%) were vaccinated. Despite the impressive organization, the vaccination project caused a great controversy at both the scientific and political level between the British authorities and the Greek Ionian Assembly. The archival material gives a diachronic message in the fields of public health, infectious disease control, and health crisis management. The lack of control by a State or local authority, combined with political instability and the public’s ignorance or distrust of scientific matters, are the main factors behind the failure to prevent, restrict or eradicate infectious diseases even nowadays.
Letters to the editor
Covid-19 pandemic and bats: a lucky symbol of evil fortune
Tsoucalas Gregory,
Michaleas SpyrosN.,
Papaioannou TheodoreG.,
Karamanou Marianna
Not available
Universal screening for SARS-CoV-2 in pregnant women using a combination of antigen and RT-PCR testing
Kumar Anil,
Kunjukutty Radhamany,
Thaha Ameena,
Srikumar Saranya,
Madhusoodanan Haritha,
David Sachin,
Biswas Lalitha,
Sathyapalan Dipu
Not available
How could Italy reach the HCV elimination by 2030?
Kondili Loreta A.
Not available
Valacyclovir for prevention and treatment of fetal CMV infection: inclusion in the Law 648/96 list and launch of the Italian multicentre observational prospective study “MEGAL-ITALI
Zammarchi Lorenzo,
Lazzarotto Tiziana,
Di Tommaso Mariarosaria,
Tomasoni Lina,
Pasquini Lucia,
Galli Luisa,
Simonazzi Giuliana,
Castelli Francesco,
Borchi Beatrice,
Campolmi Irene,
Ornaghi Sara,
Bartoloni Alessandro,
Andreoni Massimo,
Pagano Immacolata,
Petraglia Sandra,
Ramenghi Luca,
Clerici Pierangelo,
Tavio Marcello,
Trotta Michele
Not available
