Meet–Test–Treat for HCV management: patients’ and clinicians’ preferences in hospital and drug addiction services in Italy

Abstract

Background It has been estimated that the incidence of chronic hepatitis C virus (HCV) will not decline over the next 10 years despite the improved efficacy of antiviral therapy because most patients remain undiagnosed and/or untreated. This study aimed to investigate the opinion of relevant target populations on the practicability, effectiveness and best modalities of the test-and-treat approach in the fight against HCV in Italy. Methods A survey was delivered to patients with HCV from the general population, patients from drug addiction services, hospital physicians and healthcare providers for drug addiction services. Results For both hospital clinicians and SerD HCPs, tolerability is shown as the most important feature of a suitable treatment. Time to treatment (the time from first contact to initiation of treatment) is deemed important to the success of the strategy by all actors. While a tolerable treatment was the main characteristic in a preferred care pathway for general patients, subjects from drug addiction services indicated that a complete Meet–Test–Treat pathway is delivered within the habitual care center as a main preference. This is also important for SerD HCPs who are a strong reference for their patients; hospital clinicians were less aware of the importance of the patient-HCP relationship in this process. Conclusion The health system is bound to implement suitable pathways to facilitate HCV eradication. A Meet–Test–Treat program within the drug addiction services may provide good compliance from subjects mainly concerned with virus transmission.

The tolerability of sofosbuvir/velpatasvir for 12 weeks in patients treated in the ASTRAL 1, 2 and 3 studies: A pooled safety analysis

“…The results showed a sustained virologic response rate of 95.0% (95% CI, 92.4–96.7); 4% of patients reported SAEs, none of which were considered related to treatment 23 . Assessing patient and clinician opinions on HCV treatment has shown a clear preference for treatments with minimal pretreatment testing and fewer side effects 24 …”

“…23 Assessing patient and clinician opinions on HCV treatment has shown a clear preference for treatments with minimal pretreatment testing and fewer side effects. 24 One limitation of this analysis is the small size of the placebo group, which derives from ASTRAL-1 only, and which compromises the ability to determine the relatedness of rare events with treatment. Another potential limitation is that the ASTRAL studies excluded patients with active (within 12 months) drug use, although those on stable opioid substitution therapy (OST) were eligible.…”

HCV RNA Quantification by a Domestic Commercial Assay: A Case Study among People Who Inject Drugs in Vietnam

“…Meta-analyses showed that these solutions perform as well as the techniques used in central laboratories with a sensitivity rate and diagnosis accuracy above 90% [19]. This is particularly true for the diagnosis of chronic hepatitis C, since the final aim is to adopt a test and treat strategy on the same day to reach elimination [20,21]. Nonetheless, this strategy will require significant resources and so will not rule out the use of "domestic" techniques in LMIC.…”

Hepatitis C virus burden: Treating and educating people without prejudice

“…In Italy, approximately 50% of the population receiving assistance for substance use disorder is positive for HCV infection. These services in Italy could be considered a “hot spot” for HCV screening and treatment because they avoid the typical health care pattern, create a dedicated link to a care strategy for patient retention, curing the condition, and improving adherence to therapy and follow-up[ 11 , 17 ].…”