Current practice of hepatitis C treatment in Southern Italy

Stroffolini, Tommaso; Spadaro, A.; Guadagnino, Vincenzo; Cosentino, Stefano; Fatuzzo, Filippo; Galdieri, Antonio; Cacopardo, Bruno; Scalisi, I.; Sapienza, Mauro; Russello, Maurizio; Scifo, G.; Frugiuele, P.; Almasio, Piero Luigi

doi:10.1016/j.dld.2010.03.020

Cited by 8 publications

(15 citation statements)

References 14 publications

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“…Recently, we have evaluated the effectiveness of hepatitis C virus (HCV) treatment in Southern Italy [5]. It has allowed us a good opportunity to evaluate in the same area even the current practice of HBV infection treatment.…”

Section: Introductionmentioning

confidence: 99%

Current practice of chronic hepatitis B treatment in Southern Italy

Stroffolini

Spadaro²,

Marco

et al. 2012

European Journal of Internal Medicine

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Background: Treatment choice for chronic HBV infection is a continuously evolving issue, with a wide range of options. We aimed to evaluate the current practice of HBV therapies in the real world in Southern Italy. Methods: A prospective study enrolling over a six month period (February-July 2010) all consecutive HBsAg positive subjects, never previously treated, referred to 16 liver units in two Southern Italy regions (Calabria and Sicily). Results: Out of 247 subjects evaluated, 116 (46.9%) had HBV-DNA undetectable or lower than 2000 UI/ml. There were 108 (43.7%) inactive carriers, 103 (41.7%) chronic hepatitis, and 36 (14.6%) liver cirrhosis. Antiviral treatment was planned in 94 (38.0%) patients (26 cases with Interferon or Pegylated Interferon and 68 with nucleos(t)ides analogues). As many as 49.5% of subjects with chronic hepatitis did not receive antiviral treatment. Discussion: The majority of chronic HBsAg carrier referring centres for evaluation were not considered suitable for antiviral treatment. Nucleos(t)ides analogues are the preferred first choice for therapy. A longlasting period of observation may be needed to make appropriate therapeutic decisions in several cases.

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Section: Introductionmentioning

confidence: 99%

Current practice of chronic hepatitis B treatment in Southern Italy

Stroffolini

Spadaro²,

Marco

et al. 2012

European Journal of Internal Medicine

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“…Overall, 469 studies were identified, of which 454 were captured by the search strategy and 15 by hand searching. The inclusion criteria were fulfilled in 25 studies , from which data were extracted and analysed. The studies flow is shown in Figure .…”

Section: Studies Flowmentioning

confidence: 99%

“…Included studies were heterogeneous, with a variety of designs and aims. The vast majority of studies were from Western Europe (22/25 or 88%) , of which six were from France and six from Italy . Two studies were from Eastern Europe and one pan‐European .…”

Section: Studies Characteristicsmentioning

confidence: 99%

“…Two studies were from Eastern Europe and one pan‐European . There were eight single centre , 13 multicentre , two regional and two nationwide studies . Four studies reported the results of surveys , of which one was on primary care physicians , two on secondary care physicians and one on patients .…”

Section: Studies Characteristicsmentioning

confidence: 99%

“…Four studies reported the results of surveys , of which one was on primary care physicians , two on secondary care physicians and one on patients . Six studies reported on patients with chronic HBV infection and 19 on patients with chronic HCV infection . Of the 19 studies on patients with chronic HCV infection, six were on parenteral drug users (PDU) and four on HCV–HIV co‐infection .…”

Section: Studies Characteristicsmentioning

confidence: 99%

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Barriers to care and treatment for patients with chronic viral hepatitis in Europe: a systematic review

Papatheodoridis

Tsochatzis

Hardtke

et al. 2014

Liver International

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Background & Aims: Despite the availability of effective therapies for hepatitis B (HBV) and C virus (HCV), only a minority of these patients receive treatment. We systematically reviewed published data on barriers to management for chronic HBV/HCV patients in Europe. Methods: Literature search to identify studies including adult patients with chronic HBV/HCV infection from European countries and data on barriers to treatment. Results: Twenty-five studies including 6253 chronic HBV and 19 014 HCV patients were identified, of which only two were from Eastern Europe. The mean rate of no treatment in HBV patients was 42% being higher in North-Western European countries than Italy (56% vs. 39%, P < 0.001). Immigrants represented the most common barrier to HBV treatment. The mean rate of no treatment in HCV RNA-positive patients was 57%, being highest in Romania (89%), intermediate in France (79%) and lower though still high in other European countries (52%, P < 0.001). The predominant barriers to HCV treatment were lack of financial resources in Romania and direct/indirect limitations of interferon-alfa and/or parenteral drug and alcohol abuse in other countries. The mean rate of no treatment was highest in HCV RNA-positive parenteral drug users (72%) and intermediate in those with HCV-HIV co-infection (64%). Conclusions: A substantial proportion of diagnosed chronic HBV and the majority of diagnosed HCV patients remain untreated. The rates and most importantly the reasons of barriers to treatment in chronic HBV/HCV patients vary widely among European countries supporting the need for country-specific national strategies, resource allocation and implementation of global management policies.Hepatitis B (HBV) and C viruses (HCV) are leading causes of chronic liver disease worldwide and responsible for 1.2-1.5 million deaths annually (1, 2). In particular in Europe, according to the estimations of the European Region of the World Health Organization, there are approximately 14 and 9 million people chronically infected with HBV and HCV and around 36 000 and 86 000 related deaths each year, respectively, with the number of deaths reported to be increasing (3).Over the last 15 years, the efficacy of the therapeutic options for chronic HBV and HCV infections has dramatically improved. Practically all chronic HBV infection can now achieve at least on-therapy virological remission which is associated with improved liver histology and often even reversion of pre-existing histological cirrhosis, reduction in need for liver transplantation and eventually improved survival (4, 5). In patients with chronic HCV infection, sustained virological response, which is equivalent to viral eradication and has been shown to improve survival (6, 7), can be currently achieved in the majority of cases without contraindication for interferon-alfa-based therapies (8, 9), while emerging and future treatment options are expected to further improve the sustained virological response rates to over 90-95% extending the treatment indications ...

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Costi diretti e indiretti assorbiti dalle patologie HCV-indotte in Italia: stima basata su una metodologia probabilistica di Cost of Illness

Marcellusi

Viti

Capone

et al. 2014

PharmacoEcon Ital Res Artic

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Background The hepatitis C virus (HCV) induces several pathological conditions worldwide with a substantial medical and economic burden. The objective of this study was to estimate the average annual cost incurred by the National Health Service (NHS) as well as society due to HCV in Italy. Methods A probabilistic incidence-based cost of illness model was developed to estimate an aggregate measure of the economic burden associated with HCV-induced diseases either in terms of direct or indirect costs. Indirect costs were calculated on the basis of productivity lost according to the human capital approach. A systematic literature review was carried out to identify epidemiological and economic data which were subsequently used to inform the model. Furthermore, a one-way probabilistic sensitivity analysis with 5,000 Monte Carlo simulations was performed, in order to test the robustness of results and define the proper 95% CI.

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Current practice of hepatitis C treatment in Southern Italy

Cited by 8 publications

References 14 publications

Current practice of chronic hepatitis B treatment in Southern Italy

Current practice of chronic hepatitis B treatment in Southern Italy

Barriers to care and treatment for patients with chronic viral hepatitis in Europe: a systematic review

Costi diretti e indiretti assorbiti dalle patologie HCV-indotte in Italia: stima basata su una metodologia probabilistica di Cost of Illness

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