177 / 290
subjects compared to the general population. In particular, epidemio-
logical studies mainly performed in the
“
90s in rural towns of
the South of the country found a HCV prevalence up to 42% in over
65-year-old individuals.
Aim of the study:
To evaluate the prevalence of HBV and HCV
infections in a population of elderly residents in nursing homes of a
Sicilian urban area.
Methods:
A total number of 316 subjects (mean age 83.5 ± 7.5 SD;
63.6% female) hosted in two nursing homes in Messina from June 2014
to December 2015, were consecutively tested for HBV and HCV serum
markers (namely, HBsAg, anti-HBs, anti-HBc, anti-HCV).
Results:
Three/316 individuals (0.95%) tested HBsAgpositive.
Serological markers of HBV previous infection (anti-HBs and/or anti-
HBc) were found in 80/316 cases (25.3%). Nine/316 cases (2.3%) tested
positive for anti-HCV. Neither the HBsAg nor the anti-HCV positive
subjects had any laboratory or clinical evidence of liver disease.
Key conclusions:
Prevalence of HCV infections in elderly subjects
living in nursing homes of a Southern Italian city is low, in contrast
to what expected on the basis of the previous epidemiological studies.
On the contrary, prevalence of HBsAg positivity appears to be constant
over time. Lack of liver disease in both HBsAg and anti-HCV positive
subjects suggests that development of a virus-related hepatic illness is
generally incompatible with reaching an old age.
P-538
No age limits on HIV infection
E. Campôa, L. Pedro, F. Azevedo, R. Pinho, D. Faria, C. Santos, L. Arez.
Algarve Hospital Center, Portimão Hospital Unit, Department of Medicine
Introduction:
Throughout a long period the human immunodefi-
ciency virus (HIV) was considered a disease of the youth. The number
of elder HIV infected people is increasing, factor that can be correlated
with the perception of a diminishing risk of HIV infection, lack of
sexual transmitted diseases tests and the non-use of contagious
protection measures. This case demonstrates that doesn
′
t exists age
limit for HIV transmission.
Clinical Case:
A 73 year-old man, married, autonomous, without
relevant medical history and without regular medication, was sent to a
medical appointment due to non-intentional weight loss already with
a 4 month duration period. The patient presented a 19% weight loss
with no other associated symptoms
’
. Through physical exam it was
found three round papular whitish lesions at the glans. Analytically
there were no significant alterations. A test for venereal infections
demonstrated a negative RPR and positive for HIV. The patient, when
questioned about the origin of the infection, assumed a sexual relation
with a sex worker 7 months earlier. The patient presented an initial
immunological status of CD4 146 cells/μL and a viral HIV load of
238.285 copies. Started antiviral therapy with Efavirenz, Emtricitabine
and Tenofovir and prophylatic cotrimoxazole which resulted in a good
immune and viral response.
Conclusion:
With this age group increasing, it
’
s important the
attention of all medical professionals in screening, early detection
and health education. The elderly may not be aware of the risks and
therefore they require more information, education and behaviour
adjustments.
P-539
Efficacy of the Multidimensional Prognostic Index (MPI) in
predicting clinical outcomes in older outpatients treated with
parenteral antimicrobial therapies in a Geriatric Home-care Service
A. Cella
1
, S. Dini
1
, D. Torriglia
1
, N. Vello
1
, R. Custureri
1
, C. Musacchio
1
,
A.M. Mello
1
, E. Zigoura
1
, S. Garaboldi
1
, M. Pomata
1
, C. Prete
1
, A. Pilotto
1
.
1
Department Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O.
Galliera Hospital, National Relevance and High Specialization, Genoa,
Italy
Introduction:
Outpatient parenteral antimicrobial therapy (OPAT)
has become a routine recommendation in many infections, despite
some concerns about feasibility and toxicity in elderly frail patients.
Therefore we need clinical tools to assess the risk-benefit ratio in
elderly patients on OPAT.
Methods:
We evaluated 48 consecutive elderly patients (+60 years)
during OPAT, followed-up by our Home-care Service for acute
infections. The Multidimensional Prognostic Index (MPI) was mea-
sured at the beginning (T0), at the end of treatment (EOT), and 14 days
after EOT (FUP14); a telephone call was made 28 days after EOT
(FUP28). Statistical analysis: T-test.
Results:
We studied 14 men and 34 women (mean age 86.6 ± 9.8
years), with a baseline MPI value of 0.68 ± 0.20. OPAT was not
completed in 8 patients (16.7%): 5 died before EOT (3 due to the
infection); 2 were hospitalized (non-infective diseases); one case of
treatment failure. We observed a significant decrease in EOT-MPI
(0.62 ± 0.22, p < 0.001). Thirty-nine patients were evaluated at FUP14
(one patient re-hospitalized due to a leg fracture). The mean FUP14-
MPI (0.57 ± 0.22) was significantly lower than both T0-MPI (p < 0.001)
and EOT-MPI (p = 0.001). At FUP28 three patients had died and 4
required a new antibiotic therapy. The dead or hospitalized patients
(12) had higher values of T0-MPI compared to those who completed
OPAT (0.80 ± 0.8 and 0.64 ± 0.21 respectively, p = 0.015), even though
they were not older.
Key conclusions:
Our study demonstrated the efficacy of MPI to
predict clinical outcomes of older outpatients treated with parenteral
antimicrobial therapies in a Geriatric Home-care Service.
P-540
Clinical development of the Takeda norovirus vaccine candidate in
adults
J.P. Cramer
1
, F. Baehner
1
, A. Borkowski
1
, P.M. Mendelman
2
.
1
Takeda
Pharmaceuticals International AG, Zurich, Switzerland;
2
Takeda Vaccines
Inc., Deerfield, IL, USA
Introduction:
Norovirus (NoV) is the world
’
s leading cause of acute
gastroenteritis. NoV infections can be particularly severe in older
adults, especially those with co-morbidities. As NoV outbreaks are
unpredictable, and there is no effective treatment, vaccination may be
the best option to avoid moderate and severe illness. Takeda Vaccines
are developing an intramuscular bivalent virus-like particle (VLP)
vaccine candidate.
Methods and results:
Proof of concept studies in NoV human
challenge trials have shown that NoV VLPs can reduce the severity
of NoV disease. The two component VLPs of the Takeda vaccine
candidate, against genotype GI.1 and a consensus sequence of three
GII.4 viruses, are designed to provide broad protection against the
most common disease-causing genotypes. Ongoing Phase II studies
to assess the best formulation in terms of antigen content and the
necessity of adjuvantation with Al(OH)3 or MPL, have demonstrated
robust immune responses when measured as IgG or IgA antibodies,
histo-blood group binding antigen blocking antibodies (a possible
correlate for protection), and cell-mediated immunity. Such responses
persist above baseline for at least a year. Vaccination is generally
well tolerated, the most frequent adverse reactions consisting of
mild and transient pain at the injection site, or mild to moderate
headache.
Key conclusions:
Currently available data suggest the Takeda noro-
virus vaccine candidate is immunogenic and well-tolerated, and may
prove to be a useful tool to prevent norovirus illness that is frequent in
older adults living in long-term care facilities that can have severe
consequences in those with underlying medical conditions.
P-541
Pneumococcal serotype distribution: a snapshot of recent data in
adult populations around the world, 2014
–
15
Y. Cui
1
, H. Patel
2
, W.M. O
’
Neil
2
, S. Li
1
, P. Saddier
1
.
1
Merck,
2
LASER
Analytica
Background and aims:
Pneumococcal disease remains a global health
problem despite availability of vaccines, including pneumococcal
polysaccharide (PPV23), and conjugate vaccines (PCV). Non-vaccine
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S171