INTRODUCTION: Prevalence of infection with HIV-1 non-B subtypes in Italy has been reported to raise, due to increased migration flows and travels. HIV-1 variants show different biological and immunological properties that impact on disease progression rate, response to antiretroviral therapy (ART) and sensitivity of diagnostic tests with important implications for public health. Therefore, a constant surveillance of the dynamics of HIV variants in Italy should be a high public health priority. Organization of surveillance studies requires building up a platform constituted of a network of clinical centers, laboratories and institutional agencies, able to properly collect samples for the investigation of HIV subtypes heterogeneity and to provide a database with reliable demographic, clinical, immunological and virological data. AIM: We here report our experience in building up such a platform, co-ordinated by the National AIDS Center of the Istituto Superiore di Sanita, taking advantage of a pilot study aimed at evaluating HIV subtypes diversity in populations of HIV-infected migrant people in Italy. MATERIALS AND METHODS: Four hundred and thirty four HIV-infected migrants were enrolled in 9 Italian clinical centers located throughout the Italian territory. Standard Operating Procedures (SOPs) for sample collection were provided by the National AIDS Center to each clinical center. In addition, clinical centers were required to fill up a case report form (crf) for each patient, which included demographic, clinical, immunological and virological information. RESULTS: All centers properly collected and stored samples from each enrolled individual. Overall, the required information was correctly provided for more than 90% of the patients. However, some fields of the crf, particularly those including information on the last HIV-negative antibody test and presence of co-infections, were properly filled up in less than 80% of the enrolled migrants. Centers from Northern and Central Italy showed a better tendency to report correct information in the crf than centers from the South. These results provide evidence that procedures for establishing a platform for the surveillance of HIV subtype heterogeneity are affordable by all the components of the network and lay the ground for the organization of a broader HIV subtypes surveillance in Italy.

Italy has adhered to international declarations regarding the prevention, care, and treatment of HIV/AIDS and has adopted the fundamental interventions for surveillance and control; access to testing is defined by Law 135 of 5 June 1990. At the time, the Ministry of Health issued decrees to define national epidemiological surveillance systems for new HIV infections. The decree provides indications on the data to be collected, data flow, the modes of data transmission respecting security measures and some recommendations regarding access to HIV testing. It is thus necessary to develop national recommendations on appropriate methods for considering the diverse phases of access to testing in relation to the level of awareness of the minor, the outcome and divulging of the test.

L'Italia ha aderito alle dichiarazioni internazionali in materia di prevenzione, cura e trattamento dell'HIV/AIDS e ha adottato gli interventi fondamentali per la sorveglianza e il controllo; l'accesso ai test è definito dalla legge 135 del 5 giugno 1990. Il Ministero della Salute ha diramato il decreto per la sorveglianza epidemiologica delle nuove infezioni da HIV. Il decreto fornisce indicazioni sui dati da raccogliere, il flusso di dati, le modalità di trasmissione dei dati nel rispetto delle misure di sicurezza e alcune raccomandazioni riguardo l'accesso al test HIV. È necessario sviluppare raccomandazioni nazionali riguardo ai metodi adeguati per poter valutare le diverse fasi di accesso al test in relazione al livello di consapevolezza del minore, l'esito e la divulgazione dello stesso.