Hepatitis C epidemiology and treatment outcomes in Italy: Impact of the DAA era and the COVID-19 pandemic

J Viral Hepat. 2024 Oct;31(10):623-632. doi: 10.1111/jvh.13983. Epub 2024 Jul 27.

Abstract

HCV infection poses a global health threat, with significant morbidity and mortality. This study examines HCV trends in a large Italian region from 2015 to 2022, considering demographic changes, evolving clinical profiles, treatment regimens and outcomes, including the impact of the COVID-19 pandemic. This multicentre retrospective study analysed demographics, clinical histories and risk factors in 6882 HCV patients. The study spanned before and after the direct-acting antiviral (DAA) era, and the COVID-19 period, focusing on treatment outcomes (SVR12, non-SVR12 and patients lost to follow-up). Statistical methods included ANOVA, multinomial logistic regression, Kruskal-Wallis test and chi-square analysis, and were conducted adhering to the intention-to-treat (ITT) principle. The cohort, mainly Italian males (average age 58.88), showed Genotype 1 dominance (56.6%) and a high SVR12 rate (97.5%). The pandemic increased follow-up losses, yet SVR12 rates remained stable, influenced by factors like age, gender, cirrhosis and comorbidities. Despite COVID-19 challenges, the region sustained high SVR12 rates in HCV care, emphasising the importance of sustained efforts in HCV care. Continuous screening and targeted interventions in high-risk populations are crucial for achieving WHO elimination targets. The study highlights the resilience of HCV care during the pandemic and provides insights for future public health strategies.

Keywords: COVID‐19; DAA; HCV; SVR12; high‐risk population; loss to follow‐up.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents* / therapeutic use
  • COVID-19* / epidemiology
  • Female
  • Hepacivirus / drug effects
  • Hepacivirus / genetics
  • Hepatitis C / drug therapy
  • Hepatitis C / epidemiology
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antiviral Agents