Management care improvement of people living with HIV: definition of a targeted clinical pathway in a University Hospital of South Italy

Management care improvement of people living with HIV: definition of a targeted clinical pathway in a University Hospital of South Italy

Authors

  • Smeralda D'Amato Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy
  • Giovanni Francesco Pellicanò Department of Adult and Childhood Human Pathology “Gaetano Barresi”, University of Messina, Messina, Italy
  • Giuseppe Nunnari Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
  • Franco Fedele Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy
  • Raffaele Squeri Igiene Ospedaliera, University of Messina, Italy
  • Francesco Mazzitelli Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy
  • Flavia D'Andrea Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
  • Daniele Maisano Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy
  • Raffaele Squeri Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy
  • Cristina Genovese Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy

Keywords:

people living with HIV, AIDS, vaccination, guidelines

Abstract

Background and aim: : In the world 37,9 billions live with Human Immunodeficiency Virus and, despite the availability of retroviral therapy, they have an higher risk to acquire other infectious diseases and to develop severe complications. According to several guidelines their immunization is crucial but only some center have developed a specific scheduled pathway and vaccination coverage is very low.  Aim of this study is: a)incentivize the active and free of charge offer of vaccines and increase of immunization coverage; b) application and implementation of a shared clinical pathway avoiding reluctance, embarrassment or shame by patients for their condition; d) instauration of an empathic relationship between doctor and patient; e) evaluation of side effects.

Methods: A prospective study was conducted from October 2019 to February 2020 at the University Hospital G. Martino of Messina. Inclusion criteria were: age over 18; absence of other diseases; absence of immunization against HBV or HAV; CD4 count for live attenuated viral vaccines of 350/uL and for other vaccine 200/uL. A specific scheduled pathway was adopted for every patient. Statistical analysis was performed with Excel software.

Results: 86 patients were enrolled (74.4% were males, 79.1% were Italian; mean age=4013.3 SD).  An increase in administration was observed between 2018 and 2019 (+164.3% for flu and for other vaccines +370%).  The higher increase was observed for HPV one. No-one received DTpa, MMRV or Zoster vaccine.

Conclusions: The undertook clinical pathway showed the relevance of specific management of these patients and the need to increase the vaccination offer.

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02-09-2021

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Management care improvement of people living with HIV: definition of a targeted clinical pathway in a University Hospital of South Italy. Acta Biomed [Internet]. 2021 Sep. 2 [cited 2024 Mar. 29];92(4):e2021244. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/11425