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

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

Risultato della ricerca: Articlepeer review


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.
Lingua originaleEnglish
pagine (da-a)7024-7033
Numero di pagine10
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

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