{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T22:30:11Z","timestamp":1781908211818,"version":"3.54.5"},"reference-count":55,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Epidemics"],"published-print":{"date-parts":[[2021,3]]},"DOI":"10.1016\/j.epidem.2021.100442","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T16:34:09Z","timestamp":1613061249000},"page":"100442","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":47,"special_numbering":"C","title":["Estimated prevalence of undiagnosed HCV infected individuals in Italy: A mathematical model by route of transmission and fibrosis progression"],"prefix":"10.1016","volume":"34","author":[{"given":"Loreta A.","family":"Kondili","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Andreoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Alberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Lobello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7291-8687","authenticated-orcid":false,"given":"Sergio","family":"Babudieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Saverio","family":"Roscini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Merolla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Marrocco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-9544","authenticated-orcid":false,"given":"Antonio","family":"Crax\u00ec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.epidem.2021.100442_bib0005","series-title":"42 Congreso AEEH | AEEH","author":"42 Congreso AEEH","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0010","unstructured":"Aggiornamento dati Registri AIFA DAAs - Epatite C cronica. 4."},{"key":"10.1016\/j.epidem.2021.100442_bib0015","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/0272989X09353194","article-title":"Markov decision processes: a tool for sequential decision making under uncertainty","volume":"30","author":"Alagoz","year":"2010","journal-title":"Med. Decis. Making"},{"key":"10.1016\/j.epidem.2021.100442_bib0020","first-page":"1473","article-title":"HIV-HCV co-infection: epidemiology, pathogenesis and therapeutic implications","volume":"16","author":"Andreoni","year":"2012","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"10.1016\/j.epidem.2021.100442_bib0025","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.ejim.2018.02.015","article-title":"Declining prevalence and increasing awareness of HCV infection in Italy: a population-based survey in five metropolitan areas","volume":"53","author":"Andriulli","year":"2018","journal-title":"Eur. J. Intern. Med."},{"key":"10.1016\/j.epidem.2021.100442_bib0030","series-title":"AIFA Agenzia Italiana Del Farmaco","author":"Archivio aggiornamenti","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0035","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/hep.510240201","article-title":"An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group","volume":"24","author":"Bedossa","year":"1996","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0040","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1136\/gut.44.6.874","article-title":"Clinical course and risk factors of hepatitis C virus related liver disease in the general population: report from the Dionysos study","volume":"44","author":"Bellentani","year":"1999","journal-title":"Gut"},{"key":"10.1016\/j.epidem.2021.100442_bib0045","series-title":"Epidemiologia Delle Epatiti Virali Acute I.N","author":"Bollettino Seieva","year":"2019"},{"issue":"Suppl 1","key":"10.1016\/j.epidem.2021.100442_bib0050","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/jvh.12247","article-title":"Historical epidemiology of hepatitis C virus (HCV) in selected countries","volume":"21","author":"Bruggmann","year":"2014","journal-title":"J. Viral Hepat."},{"key":"10.1016\/j.epidem.2021.100442_bib0055","doi-asserted-by":"crossref","first-page":"377","DOI":"10.2147\/CEOR.S106769","article-title":"Financial and feasibility implications of the treatment of hepatitis C virus in Italy: scenarios and perspectives","volume":"8","author":"Croce","year":"2016","journal-title":"Clinicoecon. Outcomes Res."},{"issue":"513\u2013521","key":"10.1016\/j.epidem.2021.100442_bib0060","first-page":"521","article-title":"Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression","volume":"138","author":"Davis","year":"2010","journal-title":"Gastroenterology"},{"key":"10.1016\/j.epidem.2021.100442_bib0065","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1002\/hep.510290528","article-title":"Modeling the hepatitis C virus epidemic in France","volume":"29","author":"Deuffic","year":"1999","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0070","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1053\/j.gastro.2012.05.054","article-title":"Predicted effects of treatment for HCV infection vary among European countries","volume":"143","author":"Deuffic-Burban","year":"2012","journal-title":"Gastroenterology"},{"key":"10.1016\/j.epidem.2021.100442_bib0075","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1002\/hep.24370","article-title":"A prospective study of the rate of progression in compensated, histologically advanced chronic hepatitis C","volume":"54","author":"Dienstag","year":"2011","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0080","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12879-017-2908-5","article-title":"Estimating the scale of chronic hepatitis C virus infection in the EU\/EEA: a focus on migrants from anti-HCV endemic countries","volume":"18","author":"Falla","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"10.1016\/j.epidem.2021.100442_bib0085","first-page":"7","article-title":"HCV - Estimation of the number of diagnosed patients eligible to the new anti-HCV therapies in Italy","volume":"20","author":"Gardini","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"10.1016\/j.epidem.2021.100442_bib0090","first-page":"7","article-title":"HCV - Estimation of the number of diagnosed patients eligible to the new anti-HCV therapies in Italy","volume":"20","author":"Gardini","year":"2016","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"10.1016\/j.epidem.2021.100442_bib0095","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1002\/hep.510260431","article-title":"Prevalence, risk factors, and genotype distribution of hepatitis C virus infection in the general population: a community-based survey in southern Italy","volume":"26","author":"Guadagnino","year":"1997","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0100","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.dld.2012.10.014","article-title":"Hepatitis C virus infection in an endemic area of Southern Italy 14 years later: evidence for a vanishing infection","volume":"45","author":"Guadagnino","year":"2013","journal-title":"Dig. Liver Dis."},{"key":"10.1016\/j.epidem.2021.100442_bib0105","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1038\/nrgastro.2013.107","article-title":"Epidemiology and natural history of HCV infection","volume":"10","author":"Hajarizadeh","year":"2013","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0110","doi-asserted-by":"crossref","DOI":"10.1111\/jvh.13063","article-title":"Monitoring the hepatitis C epidemic in England and evaluating intervention scale-up using routinely collected data","author":"Harris","year":"2019","journal-title":"J. Viral Hepat."},{"key":"10.1016\/j.epidem.2021.100442_bib0115","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/hep.20836","article-title":"Modeling the current and future disease burden of hepatitis C among injection drug users in Scotland","volume":"42","author":"Hutchinson","year":"2005","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0120","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1002\/hep.29399","article-title":"Modeling cost-effectiveness and health gains of a \u201cuniversal\u201d versus \u201cprioritized\u201d hepatitis C virus treatment policy in a real-life cohort","volume":"66","author":"Kondili","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.epidem.2021.100442_bib0125","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0185728","article-title":"Incidence of DAA failure and the clinical impact of retreatment in real-life patients treated in the advanced stage of liver disease: interim evaluations from the PITER network","volume":"12","author":"Kondili","year":"2017","journal-title":"PLoS One"},{"key":"10.1016\/j.epidem.2021.100442_bib0130","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1111\/liv.13901","article-title":"Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?","volume":"38","author":"Kondili","year":"2018","journal-title":"Liver Int."},{"key":"10.1016\/j.epidem.2021.100442_bib0135","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1111\/liv.14408","article-title":"Optimization of hepatitis C virus screening strategies by birth cohort in Italy","volume":"40","author":"Kondili","year":"2020","journal-title":"Liver Int."},{"key":"10.1016\/j.epidem.2021.100442_bib0140","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/MEG.0000000000000785","article-title":"Hepatitis C virus infection: opportunities for an earlier detection in primary care","volume":"29","author":"Lapi","year":"2017","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0145","first-page":"227","article-title":"Value of expanding HCV screening and treatment policies in the United States","volume":"22","author":"Linthicum","year":"2016","journal-title":"Am. J. Manag. Care"},{"key":"10.1016\/j.epidem.2021.100442_bib0150","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/S0168-8278(00)80167-1","article-title":"Hepatitis C virus infection and alanine transaminase levels in the general population: a survey in a southern Italian town","volume":"33","author":"Maio","year":"2000","journal-title":"J. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0155","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.meegid.2014.06.006","article-title":"Back to the origin of HCV 2c subtype and spreading to the Calabria region (Southern Italy) over the last two centuries: a phylogenetic study","volume":"26","author":"Marascio","year":"2014","journal-title":"Infect. Genet. Evol."},{"key":"10.1016\/j.epidem.2021.100442_bib0160","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1186\/1471-2334-14-S5-S2","article-title":"Update on epidemiology of HCV in Italy: focus on the Calabria region","volume":"14","author":"Marascio","year":"2014","journal-title":"BMC Infect. Dis."},{"key":"10.1016\/j.epidem.2021.100442_bib0165","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.dld.2008.11.011","article-title":"Antiviral treatment for hepatitis C virus infection: effectiveness at general population level in a highly endemic area","volume":"41","author":"Mariano","year":"2009","journal-title":"Dig. Liver Dis."},{"key":"10.1016\/j.epidem.2021.100442_bib0170","doi-asserted-by":"crossref","DOI":"10.1111\/jvh.13375","article-title":"Innovative procedures for micro-elimination of HCV infection in persons who use drugs","author":"Messina","year":"2020","journal-title":"J. Viral Hepat."},{"key":"10.1016\/j.epidem.2021.100442_bib0175","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1016\/j.jhep.2016.07.012","article-title":"HCV epidemiology in high-risk groups and the risk of reinfection","volume":"65","author":"Midgard","year":"2016","journal-title":"J. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0180","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.jhep.2018.11.013","article-title":"Epidemiology and natural history of hepatitis C virus infection among children and young people","volume":"70","author":"Modin","year":"2019","journal-title":"J. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0185","series-title":"National Demographic Balance 2018","author":"National demographic balance","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0190","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1111\/liv.14166","article-title":"HCV point-of-care screening programme and treatment options for people who use drugs in a metropolitan area of Southern Italy","volume":"39","author":"Persico","year":"2019","journal-title":"Liver Int."},{"key":"10.1016\/j.epidem.2021.100442_bib0195","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S2468-1253(16)30181-9","article-title":"Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study","volume":"2","author":"Polaris Observatory HCV Collaborators","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0200","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s12072-020-10034-0","article-title":"Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort","volume":"14","author":"Quaranta","year":"2020","journal-title":"Hepatol. Int."},{"issue":"Suppl 1","key":"10.1016\/j.epidem.2021.100442_bib0205","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/jvh.12248","article-title":"The present and future disease burden of hepatitis C virus (HCV) infection with today\u2019s treatment paradigm","volume":"21","author":"Razavi","year":"2014","journal-title":"J. Viral Hepat."},{"key":"10.1016\/j.epidem.2021.100442_bib0210","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/cld.376","article-title":"HCV testing and linkage to care: expanding access","volume":"4","author":"Reau","year":"2014","journal-title":"Clin. Liver Dis"},{"key":"10.1016\/j.epidem.2021.100442_bib0215","series-title":"71 Milioni Di Euro Stanziati in Italia Per Screening Gratuiti. Osservatorio Malattie Rare","author":"Redazione. Epatite C","year":"2020"},{"key":"10.1016\/j.epidem.2021.100442_bib0220","series-title":"Statistiche Istat","author":"Statistiche Istat","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0225","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jclinepi.2005.06.008","article-title":"Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment","volume":"59","author":"Sweeting","year":"2006","journal-title":"J. Clin. Epidemiol."},{"key":"10.1016\/j.epidem.2021.100442_bib0230","doi-asserted-by":"crossref","first-page":"41","DOI":"10.7150\/ijms.3.41","article-title":"Epidemiology of hepatitis C virus (HCV) infection","volume":"3","author":"Sy","year":"2006","journal-title":"Int. J. Med. Sci."},{"key":"10.1016\/j.epidem.2021.100442_bib0235","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.epidem.2018.01.002","article-title":"A Bayesian evidence synthesis approach to estimate disease prevalence in hard-to-reach populations: hepatitis C in New York City","volume":"23","author":"Tan","year":"2018","journal-title":"Epidemics"},{"key":"10.1016\/j.epidem.2021.100442_bib0240","series-title":"The Italian Liver Patients\u2019 Association (EpaC)","author":"The Italian Liver Patients\u2019 Association (EpaC)","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0245","doi-asserted-by":"crossref","first-page":"538","DOI":"10.4254\/wjh.v6.i8.538","article-title":"Vertical hepatitis C virus transmission: main questions and answers","volume":"6","author":"Tosone","year":"2014","journal-title":"World J. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0250","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.jval.2011.06.006","article-title":"Structural frameworks and key model parameters in cost-effectiveness analyses for current and future treatments of chronic hepatitis C","volume":"14","author":"Townsend","year":"2011","journal-title":"Value Health"},{"key":"10.1016\/j.epidem.2021.100442_bib0255","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1136\/jech.2006.051599","article-title":"Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis","volume":"62","author":"Vescio","year":"2008","journal-title":"J. Epidemiol. Commun. Health"},{"key":"10.1016\/j.epidem.2021.100442_bib0260","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1016\/j.jhep.2014.07.012","article-title":"Natural history of hepatitis C","volume":"61","author":"Westbrook","year":"2014","journal-title":"J. Hepatol."},{"key":"10.1016\/j.epidem.2021.100442_bib0265","series-title":"Global Health Sector Strategy on Viral Hepatitis 2016-2021","author":"WHO","year":"2019"},{"key":"10.1016\/j.epidem.2021.100442_bib0270","series-title":"World Health Organization, Global Hepatitis Programme. Global Hepatitis Report, 2017","author":"World Health Organization","year":"2017"},{"key":"10.1016\/j.epidem.2021.100442_bib0275","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta10210","article-title":"Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation","volume":"10","author":"Wright","year":"2006","journal-title":"Health Technol. Assess."}],"container-title":["Epidemics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1755436521000050?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1755436521000050?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:40:15Z","timestamp":1761698415000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1755436521000050"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":55,"alternative-id":["S1755436521000050"],"URL":"https:\/\/doi.org\/10.1016\/j.epidem.2021.100442","relation":{},"ISSN":["1755-4365"],"issn-type":[{"value":"1755-4365","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Estimated prevalence of undiagnosed HCV infected individuals in Italy: A mathematical model by route of transmission and fibrosis progression","name":"articletitle","label":"Article Title"},{"value":"Epidemics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.epidem.2021.100442","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"100442"}}