Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?

Antonio Craxi, Sarah Robbins, Pietro Andreone, Mario Melazzini, Maurizia R. Brunetto, Pierluigi Blanc, Andrea Gori, Francesco P. Russo, Donatella Ieluzzi, Alessandra Orlandini, Elke M. Erne, Stefano Vella, Antonio Gasbarrini, Salvatore Madonia, Maria Vinci, Sarah Blach, Massimo Zuin, Luchino Chessa, Antonio Gasbarrini, Mario MelazziniGiovanni Raimondo, Maria G. Rumi, Ivane Gamkrelidze, Teresa A. Santantonio, Homie Razavi, Massimo Puoti, Marco Massari, Giuseppina Brancaccio, Maria G. Quaranta, Maria G. Quaranta, Marco Massari, Homie Razavi, Simona Montilla, Loreta A. Kondili, Mario Strazzabosco, Alessia Ciancio, Andrea Iannone, Massimo Puoti, Carmine Coppola, Maria G. Rumi, Angelo Andriulli, Marco Massari, Anna L. Zignego, Gloria Taliani, Pietro Lampertico, Guglielmo Borgia, Marcello Persico, Nicola Caporaso, Alessandro Federico

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Background & Aims: Advances in direct-acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked-to-care individuals on overallHCV burden estimates and identified a possible strategy to achieve the WHO targetsby 2030.Methods: Using a modelling approach grounded in Italian real-life data of diagnosedand treated patients, different linkage-to-care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals.Results: Under the 40% linked-to-care scenario, viraemic burden would decline(60%); however, eligible patients to treat will be depleted by 2025. Increased casefinding through a targeted screening strategy in 1948-1978 birth cohorts couldsupplement the pool of diagnosed patients by finding 75% of F0-F3 cases. Underthe 60% linked-to-care scenario, viraemic infections would decline by 70% by2030 but the patients eligible for treatment will run out by 2028. If treatment is tobe maintained, a screening strategy focusing on 1958-1978 birth cohorts couldcapture 55% of F0-F3 individuals. Under the 80% linked-to-care scenario, screening limited in 1968-1978 birth cohorts could sustain treatment at levels required toachieve the HCV elimination goals.Conclusion: In Italy, which is an HCV endemic country, the eligible pool of patients totreat will run out between 2025 and 2028. To maintain the treatment rate and achievethe HCV elimination goals, increased case finding in targeted, high prevalence groupsis required.
Original languageEnglish
Pages (from-to)2190-2198
Number of pages9
JournalLiver International
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Hepatology


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