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Dig Liver Dis. 2017 Jul;49(7):731-741. doi: 10.1016/j.dld.2017.03.027. Epub 2017 Apr 12.

Treatment of Hepatitis C virus infection in Italy: A consensus report from an expert panel.

Author information

1
Hepatology Unit, Ospedale San Giuseppe, University of Milan, Milan, Italy. Electronic address: mvigano72@gmail.com.
2
Virology Unit, Department of Experimental Medicine and Surgery, "Tor Vergata" University of Rome, Rome, Italy.
3
Department of Gastroenterology, DiBiMIS, University of Palermo, Palermo, Italy.
4
Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
5
Department of Molecular Medicine, University of Padua, Padua, Italy.
6
Department of Medical and Surgical Sciences, Bologna University, Bologna, Italy.
7
Department of Infectious Diseases, University of Rome Tor Vergata, Rome, Italy.
8
Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy.
9
Hepatology Unit, University Hospital of Pisa, Pisa, Italy.
10
Unit of Infectious and Tropical Diseases, University of Pavia, Pavia, Italy.
11
Department of Internal Medicine, Humanitas University Medicine, Rozzano, Italy.
12
Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Naples, Italy.
13
Department of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital and Department of Medical Sciences, University of Turin, Turin, Italy.
14
Unit of Infectious Diseases and Hepatology, INMI "Lazzaro Spallanzani" Rome, Italy.
15
Department of Gastroenterology, Hepatology and Liver Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.
16
Unit of Infectious Diseases and Hepatology, AOU di Parma, Parma, Italy.
17
Section of Infectious Diseases, Department of Internal Medicine, Second University of Naples, Naples, Italy.
18
Liver Unit, San Camillo Forlanini Hospital, Rome, Italy.
19
Division of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
20
Division of Clinical and Molecular Hepatology, Department of Internal Medicine, University Hospital of Messina, Messina, Italy.
21
Section of Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy.
22
Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
23
UOD 08 (Politica del Farmaco) della Regione Campania, Italy.
24
Division of Gastroenterology, AOU Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
25
Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Abstract

Hepatitis C virus (HCV) infection remains one of the main causes of chronic liver disease worldwide. The advent of direct-acting antivirals (DAAs) has significantly improved the course of patients with chronic HCV infection (CHC), due to the ability of these drugs to achieve high rates of sustained virological response (SVR). These exceedingly high rates of SVR and the excellent safety data have been confirmed in real life practice. Evolving guidelines have been issued by national and international scientific societies in accordance with the progression of clinical knowledge and the availability of new DAAs. These recommendations, however, may not be applied universally because of delays in drugs reimbursability in different countries and because some National Health Systems identify only patients with advanced disease as a treatment priority. Italy in this regard is a prototype about DAAs treatment of CHC patients. With the aim to assess the Italian treatment experience with DAAs and to respond to unmet needs in treatment optimization of antiviral therapy in specific settings of CHC patients, a group of Italian experts met in Stresa in February 2017. The summary of the considerations arising from this two-day meeting and some statements regarding a few open issues are reported in this position paper.

KEYWORDS:

Antiviral treatment; Cirrhosis; Direct-acting antiviral agents; Hepatitis C; RAV; Treatment failure

PMID:
28456519
DOI:
10.1016/j.dld.2017.03.027
[Indexed for MEDLINE]

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