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Page Background

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.


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).


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.


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


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.


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



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


, S. Dini


, D. Torriglia


, N. Vello


, R. Custureri


, C. Musacchio



A.M. Mello


, E. Zigoura


, S. Garaboldi


, M. Pomata


, C. Prete


, A. Pilotto




Department Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O.

Galliera Hospital, National Relevance and High Specialization, Genoa,



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.


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.


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.


Clinical development of the Takeda norovirus vaccine candidate in


J.P. Cramer


, F. Baehner


, A. Borkowski


, P.M. Mendelman





Pharmaceuticals International AG, Zurich, Switzerland;


Takeda Vaccines

Inc., Deerfield, IL, USA


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


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.


Pneumococcal serotype distribution: a snapshot of recent data in

adult populations around the world, 2014


Y. Cui


, H. Patel


, W.M. O



, S. Li


, P. Saddier








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