Optimising management of patients with hepatitis C virus in the age of direct-acting antivirals: results of a Delphi consensus.

Antonio Craxi, Vito Di Marco, Massimo Colombo, Alfredo Alberti, Giovanni Battista Gaeta, Di Perri, Angarano, Mangia, Pasqualetti, Mangia, Ippolito

Research output: Contribution to journalArticle


OBJECTIVE: To optimize the management of patients with chronic hepatitis C virus (HCV).MATERIALS AND METHODS: We developedtwo questionnaires to determine Italian healthcare professionals’ opinions on the overall management of HCV chronic liver disease and theuse of direct-acting antivirals (DAAs) in the treatment of HCV. A Delphi consensus method usingthe RAND/UCLA appropriateness method wasused to determine opinions of an expert panel(EP) of specialists.RESULTS: Overall 443 physicians from 167Italian centres completed the two questionnaires. The EP confirmed the importance of collaboration with general practitioners (GPs) andHCV testing in high-risk groups, but did notagree on treating patients over 80 years of agewith DAAs. Over 90% agreed that it was important to quantify HCV-RNA, determine genotype,and test for anti-HIV and HBsAg before startingDAAs. Transient elastography (FibroScan®) wasused by >90% to evaluate the stage of liver fibrosis while serum biomarkers were used by <20%.Adherence to therapy, drug-drug interactionsand the possibility of treating advanced liverdisease were decisive factors in therapy choice.Monthly monitoring during therapy was considered appropriate and 80% were in favor of HCVRNA testing 24 weeks after the end of the therapy to confirm sustained virological response(SVR). Over 80% agreed that it was necessary tocontinue follow-up of patients with advanced fibrosis/cirrhosis.CONCLUSIONS: Scientific organizations shouldreview their guideline recommendations to facilitate access to DAAs.
Original languageEnglish
Pages (from-to)7024-7033
Number of pages10
Publication statusPublished - 2018


All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this