Epidemiology of HCV Infection in the General Population: A Survey in a Southern Italian Town

Cozzolongo, Raffaele; Osella, Alberto Rubén; Elba, Silvana; Petruzzi, Josè; Buongiorno, G; Giannuzzi, Vito; Leone, Giuseppe; Bonfiglio, Caterina; Lanzilotta, Elsa; Manghisi, O. G.; Leandro, Gioacchino

doi:10.1038/ajg.2009.428

Cited by 79 publications

(68 citation statements)

References 20 publications

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“…The spontaneous clearance of HCV in 17% of untreated subjects found positive for anti-HCV and HCV RNA in an open population study has ben reported 18 and cross-sectional surveys on HCV infection indicate that only a proportion of anti-HCV positive subjects show signs of viral replication. [18][19][20] This is relevant also in high-risk populations, since it has been shown that a previous humoral response towards HCV, albeit not protective against reinfections, may lead to a shorter course of active infection with clearance of RNA within 150 days in the majority of reinfected subjects. 21 Determining the presence of an active HCV infection is clinically relevant, and in this respect the automated assay for HCV Ag evaluated in this study is more suitable than HCV-RNA methods, that are more expensive and require a dedicated sample and skilled personnel.…”

Section: Discussionmentioning

confidence: 96%

“…The results obtained on anti-HCV positives indicate that almost 50% are negative for HCV antigen, thus excluding the presence of active HCV replication. 20 A potential bias is that HCV Ag is less sensitive than HCV-RNA: in this study the sensivitity of the new HCV Ag assay corresponds to about 1000 IU/mL of HCV RNA, in accord with the estimated equivalency between pg/mL of HCV Ag and IU/mL of HCV-RNA 9,22 and with another recent experience on the ARCHITECT assay that reported an HCV Ag threshold corresponding to 428-2700 IU/mL of HCV-RNA. 11 This has limited relevance in untreated, chronically infected subjects with HCV-RNA levels usually ranging from 10 4 to 10 7 IU/mL.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Hepatitis C virus core antigen: Analytical performances, correlation with viremia and potential applications of a quantitative, automated immunoassay

Medici

Furlini

Rodella

et al. 2011

Journal of Clinical Virology

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Hepatitis C virus core antigen: Analytical performances, correlation with viremia and potential applications of a quantitative, automated immunoassay

Medici

Furlini

Rodella

et al. 2011

Journal of Clinical Virology

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“…27,28 The extraordinary high prevalence in some areas of southern Italy is due to the frequent use of glass multiuse syringes for intravenous therapies in the past. 29,30 A continued high iatrogenic transmission rate in Europe is observed in rural areas with limited medical care, such as in parts of Romania, Crete, or Turkey. [31][32][33] Nevertheless, IDU has outpaced other risk factors of HCV transmission in most European countries, and individuals with IDU will form the future major HCV cohort on the continent.…”

Section: Iatrogenic Transmissionmentioning

confidence: 99%

Hepatitis C Virus

Dultz

Zeuzem

2015

Gastroenterology Clinics of North America

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“…Furthermore, the predictive model included a redistribution of prevalence data by age and sex. With reference to this parameter, an American model was adjusted to the Italian context using national literature data 17,18. Hence, the model was calibrated by comparing the output trend with the age-specific prevalence of HCV infection (Figure 2).…”

Section: Epidemiological Datamentioning

confidence: 99%

Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy

Mennini

Marcellusi²,

Andreoni³

et al. 2014

CEOR

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BackgroundAt present, there are no specific nationwide epidemiological studies representing the whole Italian population. This study is aimed at describing the epidemiological and economic burden that HCV will generate in the next few years in Italy. Furthermore, the impact that future anti-HCV treatments may have on the burden of disease was considered. This analysis was developed for the period 2012–2030 from the perspective of the Italian National Health Service (NHS).MethodsA published system dynamic model was adapted for Italy in order to quantify the HCV-infected population in terms of disease progression and the associated costs from 1950 to 2030. The model structure was based on transition probabilities reflecting the natural history of the disease. In order to estimate the efficacy of current anti-HCV treatment strategies for genotypes 1 and 4, the sustained virological response (SVR) rate in registration clinical trials for both boceprevir and telaprevir was estimated. It was assumed that the efficacy for patients treated with peginterferon + ribavirin was equal to the placebo arm of a randomized clinical trial (RCT) relating to boceprevir and telaprevir. For genotypes 2/3 patients it was assumed that treatment efficacy with dual therapy was equal to a SVR rate from the literature. According to the aim of this study, only direct health care costs (hospital admissions, drugs, treatment, and care of patients) incurred by the Italian NHS have been included in the model. Costs have been extrapolated using the published scientific literature available in Italy and actualized with the 2012 ISTAT (Istituto Nazionale di Statistica) Price Index system for monetary revaluation. Three different scenarios were assumed in order to evaluate the impact of future anti-HCV treatments on the burden of disease.ResultsOverall, in Italy, 1.2 million infected subjects were estimated in 2012. Of these, about 211,000 patients were diagnosed, while only about 11,800 subjects were actually being treated with anti-HCV drugs. A reduction of health care costs is associated with a prevalence decrease. Indeed, once the spending peak is reached during this decade (about €527 million), the model predicts a cost reduction in the following 18 years. In 2030, based on the more effective treatments currently available, the direct health care cost associated with the management of HCV patients may reach €346 million (−34.3% compared to 2012). The first scenario (new treatment in 2015 with SVR =90% and same number of treated patients) was associated with a significant reduction in HCV-induced clinical consequences (prevalence =−3%) and a decrease in direct health care expenses, corresponding to €11.1 million. The second scenario (increase in treated patients to 12,790) produced an incremental cost reduction of €7.3 million, reaching a net decrease equal to €18.4 million. In the third scenario (treated patients =16,770), a higher net direct health care cost decrease versus the base-case (€44.0 million) was estimated.ConclusionOur model showed...

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Epidemiology of HCV Infection in the General Population: A Survey in a Southern Italian Town

Cited by 79 publications

References 20 publications

Hepatitis C virus core antigen: Analytical performances, correlation with viremia and potential applications of a quantitative, automated immunoassay

Hepatitis C virus core antigen: Analytical performances, correlation with viremia and potential applications of a quantitative, automated immunoassay

Hepatitis C Virus

Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy

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