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Long-acting injectable antiretroviral therapy (LAI-ART) could increase adherence to therapy, while maintaining excellent viro-immunologic control, reduce the risk of toxicity and drug interactions, and improve the overall quality of life of people living with HIV. The purpose of this study is to assess knowledge and acceptability to this new therapeutic modality in PLWH and their readiness to change their current treatment regimen in favour of the injectable one. An anonymous, multiple-choice self-completion questionnaire was offered at the Infectious and Tropical Diseases Unit of the ASST Spedali Civili of Brescia from June 2022 to June 2023 to every PLWH. We enrolled 500 subjects. Although just a few people are aware of the availability of LAI-ART (only 281 subjects, 56.2%), the acceptability toward this new therapeutic modality is quite good (432 subjects, 86.4%) and more than half of the study population have declared that they would like to replace oral therapy with intramuscular injections (320, 63%). Duration of HIV infection, gender and number of concomitant medications were not related to the cumulative propensity to LAI-ART, while age appeared to be an independent predictor (OR 0.97, 95%CI 0.95–0.98, p-value < 0.001). The selection of motivated patients seems critical to establish LAI-ART in clinical practice.

People living with HIV (PLWH) have a higher risk of herpes zoster (HZ) reactivation and postherpetic neuralgia (PHN) compared to general population. Our study aims to evaluate prevalence of HZ reactivation and PHN after vaccination with recombinant vaccine (RZV) in a population living with HIV, and to identify risk factors associated with recurrence. We conducted an observational study, enrolling all PLWH ≥18 years old vaccinated with RZV from January 2022 to December 2023. A questionnaire was proposed to the subjects at least 6 months after vaccination, inquiring about previous history of HZ and PHN, and recurrence after vaccination. We collected demographic characteristics, comorbidities, viro-immunological status, and medications. We performed a descriptive analysis and univariate logistic regressions to investigate risk factors associated with HZ reactivation and PHN persistence. We included 223 subjects. We estimated the prevalence of events among 145 subjects: we recorded 54 subjects with pre-vaccination HZ (prevalence 37.24 % [IC 95 %: 29.36% – 45.65 %]) and 13 with post-vaccination HZ (prevalence 8.97 % [IC 95 %: 4.86 % - 14.84 %]). The prevalence of pre-vaccination PHN was 19.23 % [IC 95 %: 11.18 % - 29.73 %], with mean NRS 6.33 [IC 95 %: 4.9–7.76]; no case of PHN was recorded after vaccination. Evaluating risk factors related to post-vaccination HZ, we didn't find any association with viro-immunological status, clinical history of HIV infection, or concomitant medications. We correlate HZ and age (OR 1.06, CI 95 % 1.01–1.13, p-value 0.031), haematological (OR 9.60, CI 95 % 1.70–49.9, p-value 0.007), oncological (OR 5.36, CI 95 % 1.04–22.8, p-value 0.028), and hepatic comorbidities (OR 3.67, CI 95 % 1.10–12.0, p-value 0.030). This is the first real-world study that highlights the excellent clinical response to RZV, with a low prevalence of HZ reactivation and complete resolution of PHN after the vaccination. Moreover, we identified clinical conditions promoting the recurrence HZ after vaccination.

The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18–40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations.