From Prioritization to Universal Treatment: Successes and Challenges of Hepatitis C Virus Elimination in Italy

Author:

Kondili Loreta A12ORCID,Craxì Lucia3,Nava Felice45,Babudieri Sergio67,D’Ambrosio Roberta8,Marcellusi Andrea9,Mennini Francesco Saverio91011,Valle Sabrina12,Russo Pierluigi1314,Olimpieri Pier Paolo14,Andreoni Massimo1516,Aghemo Alessio171819

Affiliation:

1. Center for Global Health, Istituto Superiore di Sanita , Rome , Italy

2. Degree Course in Dentistry and Dental Prosthetics, UniCamillus–Saint Camillus International University of Health Sciences , Rome , Italy

3. Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo , Palermo , Italy

4. Health Care and Drug Abuse Unit in Prison, Public Health Agency , Padua , Italy

5. Federazione Italiana degli Operatori dei Dipartimenti e dei Servizi delle Dipendenze , Milan , Italy

6. Infectious and Tropical Disease Unit, University Hospital of Sassari , Sassari , Italy

7. Italian Society of Penitentiary Health Medicine , Viterbo , Italy

8. Division of Gastroenterology and Hepatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan , Italy

9. Economic Evaluation and Health Technology Assessment, Centre for Economic and International Studies, Faculty of Economics, University of Rome Tor Vergata , Rome , Italy

10. Institute of Leadership and Management in Health, Kingston Business School, Kingston University , London , United Kingdom

11. Italian Society of Health Technology Assessment , Rome , Italy

12. General Directorate for Health Prevention, Prevention of Communicable Diseases and International Prophylaxis, Italian Ministry of Health , Rome , Italy

13. Health Economic Evaluations Office, Italian Medicines Agency , Rome , Italy

14. Monitoring Registers Office, Italian Medicines Agency , Rome , Italy

15. Infectious Diseases Clinic, University Hospital Tor Vergata , Rome , Italy

16. Italian Society of Infectious and Tropical Diseases , Prato , Italy

17. Division of Internal Medicine and Hepatology, Department of Gastroenterology, Isituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital , 20089, Rozzano , Italy

18. Department of Biomedical Sciences, Humanitas University , Pieve Emanuele , Italy

19. Italian Association for the Study of the Liver , Rome , Italy

Abstract

Abstract Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-related liver cancer in Europe. Although direct-acting antivirals (DAA) were initially restricted to persons with advanced fibrosis, their use has since been extended to all infected individuals; more than 244 000 persons have been treated to date. HCV liver-related mortality is expected to decline by 75% by 2030, achieving the World Health Organization target for mortality. However, Italy risks failing to meet the overall goal of eliminating HCV infection by 2030. In this light, €71.5 million have been allocated for screening initially specific target populations (persons who inject drugs, prison inmates, and the 1969–1989 birth cohort). Herein, we outline the challenges and recommendations for how to move Italy toward HCV elimination, including expanding screening programs in other populations, increasing awareness through strategic communication, sustaining DAA access, and tailoring care models to meet the needs of key populations.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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