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

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 Health
Organization (WHO) elimination goals recognizing the need to identify undiagnosed individuals in key high-risk groups and in the general population, however there is concern
regarding HCV treatment implementation in Italian Regions.
Methods. A modelling analysis was conducted, using the “Italy Polaris” model, to forecast
the impact of different HCV treatment rates in achieving the HCV elimination goals in
Italy. The model assessed two treatment scenarios: 2018 Scenario and 2019 Scenario, using
the annually HCV treatment rate in Italy.
Results. Considering a high treatment rate, as assumed by the 2018 Scenario, all HCV
elimination targets would be achieved. Considering the 2019 Scenario, in which a decreasing
number of newly diagnosed individuals and as consequence, a decline in the
number of treated patients, were assumed, only the 65% HCV mortality reduction would
be an achievable goal in Italy. The other elimination targets could be achievable over 7
years later than the year 2030.
Conclusions. Establishing an ad hoc fund for DAAs for each Italian Region, binding resources
both for case finding, through active screening and activities for rapid linkage to
care and treatment, is of paramount importance, in order to keep Italy on track to achieve
the WHO elimination targets by 2030.