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Update sul ruolo infettivo della saliva

Update sul ruolo infettivo della saliva. Francesco Barchiesi Istituto di Malattie Infettive e Medicina Pubblica Università Politecnica delle Marche Roma, 19-21 ottobre 2006. MMBR 2002; 66: 486-505. modalità di trasmissione dei. microrganismi emessi con le secrezioni. respiratorie. FONTE.

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Update sul ruolo infettivo della saliva

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  1. Update sul ruolo infettivo della saliva Francesco Barchiesi Istituto di Malattie Infettive e Medicina Pubblica Università Politecnica delle Marche Roma, 19-21 ottobre 2006

  2. MMBR 2002; 66: 486-505

  3. modalità di trasmissione dei microrganismi emessi con le secrezioni respiratorie FONTE 1 METRO TRASMISSIONE DA DROPLET TRASMISSIONE AEREA

  4. HBV HIV Herpesviridae HCV

  5. Estimated number of people living with HIV and adult HIV prevalence Global HIV epidemic, 1990‒2005* HIV epidemic in sub-Saharan Africa, 1985‒2005* Number of people living with HIV (millions) % HIV prevalence, adult (15‒49) Number of people living with HIV (millions) % HIV prevalence, adult (15‒49) 50 5.0 30 15.0 12.5 25 40 4.0 20 10.0 30 3.0 7.5 15 20 2.0 5.0 10 10 1.0 2.5 5 0 0.0 0 0.0 1990 1995 2000 2005 1985 1990 1995 2000 2005 *Even though the HIV prevalence rates have stabilized in sub-Saharan Africa, the actual number of people infected continues to grow because of population growth. Applying the same prevalence rate to a growing population will result in increasing numbers of people living with HIV. Number of people living with HIV % HIV prevalence, adult (15-49) This bar indicates the range around the estimate 2.2

  6. A global view of HIV infection 38.6 million people [33.4‒46.0 million] living with HIV, 2005 2.4

  7. Casi di AIDS in Italia per semestre di diagnosi, corretti per ritardo di notifica e tasso annuale di incidenza al 30 giugno 2005

  8. Distribuzione dei casi di AIDS in adulti per categoria di esposizione e per anno di diagnosi

  9. Analysis of HIV-1 viral load in blood, semen and saliva: evidence for different viral compartments in a cross-sectional and longitudinal studyAIDS 1996,10:F51-F56 HIV RNA (copies/ml) Plasma Semen Saliva

  10. HIV- inhibitory activity of different body fluids Shugars et al., 2002, Oral Dis. 8(Suppl. 2):169-175

  11. Campo et al., 2006, Oral Dis. 12:219-228

  12. Campo et al., 2006, Oral Dis. 12:219-228

  13. Distribution of Acute Viral Hepatitis in Italy(SEIEVA 2000-2001) Total cases = 4071

  14. Geographic distribution of chronic HBV infection

  15. National Immunization Programs (WHO)

  16. Incidence rate of acute HBV in Italy Mass Hepatitis B Vaccination introduced Cases / 100,000 Stroffolini et al., 2000 ISS, 2003

  17. Risk factors among hepatitis B cases in Italy Stroffolini et al., J. Hepatol., 2000

  18. Paired measurements of quantitative hepatitis B virus DNA in saliva and serum of chronic hepatitis B patients: implications for saliva as infectious agent J. Clin. Virol., 2004; 29:92-94

  19. Transmission of hepatitis B by human bite—Confirmation by detection of virus in saliva and full genome sequencing J. Clin. Virol., 2005; 33:254-256 Resident A Index patient

  20. Infezione da HCV: prevalenza globale WHO. Wkly Epidemiol Rec. 2000;75:18-19

  21. High serum hepatitis C virus RNA load predicts the presence of HCV RNA in saliva from individuals with chronic and acute HCV infectionJID 2006; 193:672-6

  22. Indicazioni per la gestione delle esposizioni a materiale biologico

  23. Gestione post-esposizione occupazionale ad HIV, HBV ed HCV

  24. Gestione post-esposizione occupazionale ad HIV, HBV ed HCV

  25. Protocollo riassuntivo degli esami da effettuare nel soggetto esposto

  26. Profilassi post-esposizione (PPE) ad HIV • Inizio il più presto possibile (entro 1-4 ore) dall’esposizione • E’ sconsigliata se sono trascorse oltre 72 ore • Se dopo la somministrazione delle prima dose di PPE, l’esposizione si rivela non a rischio la profilassi viene interrotta • Regime a tre farmaci (es.: AZT + 3TC + IP) • Durata 4 settimane

  27. Profilassi post-esposizione (PPE) ad HBV

  28. Herpesviridae

  29. Periodontology 2000, June 2005

  30. Periodontitis lesions are a source of salivarycytomegalovirus and Epstein–Barr virus Journal of Periodontal ResearchVolume 40 Page 187  - April 2005

  31. High prevalence of multiple human herpesviruses in saliva from human immunodeficiency virus-infected persons in the era of highly active antiretroviral therapy. J. Clin. Microbiol.,2006; 44:2409-15

  32. Candida albicans 50% • Candida tropicalis 15-30% • Candida glabrata 15-30% • Candida parapsilosis 15-30% • Candida krusei ~ 1% • Candida lusitaniae ~ 1% • Candida dubliniensis < 1%

  33. Genotyping and antifungal susceptibility of human subgingival Candida albicans isolates Arch. Oral Biol., 2002; 3:189-196

  34. Transmission of fluconazole-resistant Candida albicans between patients with AIDS and oropharyngeal candidiasis documented by pulsed-field gel electrophoresis FLU MIC ITC MIC A A A B A g/ml g/ml Male A 0.5 0.06 A 4.0 1.0 A >64 4.0 Female B 0.125 <0.03 A >64 2.0 Clin Infect Dis. 1995;21:561-4

  35. Grazie

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