Tailored screening and dedicated funding for direct acting antiviral drugs: how to keep Italy on the road to hepatitis C virus elimination?

Open Access

Abstract

Background and aims. Hepatitis C virus (HCV) elimination for Italy is an ambitious,but achievable goal. In Italy, there is political will, which aims to achieve the World HealthOrganization (WHO) elimination goals recognizing the need to identify undiagnosed individuals in key high-risk groups and in the general population, however there is concernregarding HCV treatment implementation in Italian Regions.Methods. A modelling analysis was conducted, using the "Italy Polaris" model, to forecastthe impact of different HCV treatment rates in achieving the HCV elimination goals inItaly. The model assessed two treatment scenarios: 2018 Scenario and 2019 Scenario, usingthe annually HCV treatment rate in Italy.Results. Considering a high treatment rate, as assumed by the 2018 Scenario, all HCVelimination targets would be achieved. Considering the 2019 Scenario, in which a decreasingnumber of newly diagnosed individuals and as consequence, a decline in thenumber of treated patients, were assumed, only the 65% HCV mortality reduction wouldbe an achievable goal in Italy. The other elimination targets could be achievable over 7years later than the year 2030.Conclusions. Establishing an ad hoc fund for DAAs for each Italian Region, binding resourcesboth for case finding, through active screening and activities for rapid linkage tocare and treatment, is of paramount importance, in order to keep Italy on track to achievethe WHO elimination targets by 2030.