{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:19:02Z","timestamp":1777576742599,"version":"3.51.4"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-related liver cancer in Europe. Although direct-acting antivirals (DAA) were initially restricted to persons with advanced fibrosis, their use has since been extended to all infected individuals; more than 244 000 persons have been treated to date. HCV liver-related mortality is expected to decline by 75% by 2030, achieving the World Health Organization target for mortality. However, Italy risks failing to meet the overall goal of eliminating HCV infection by 2030. In this light, \u20ac71.5 million have been allocated for screening initially specific target populations (persons who inject drugs, prison inmates, and the 1969\u20131989 birth cohort). Herein, we outline the challenges and recommendations for how to move Italy toward HCV elimination, including expanding screening programs in other populations, increasing awareness through strategic communication, sustaining DAA access, and tailoring care models to meet the needs of key populations.<\/jats:p>","DOI":"10.1093\/infdis\/jiad038","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T17:00:37Z","timestamp":1694624437000},"page":"S211-S220","source":"Crossref","is-referenced-by-count":15,"title":["From Prioritization to Universal Treatment: Successes and Challenges of Hepatitis C Virus Elimination in Italy"],"prefix":"10.1093","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-224X","authenticated-orcid":false,"given":"Loreta A","family":"Kondili","sequence":"first","affiliation":[{"name":"Center for Global Health, Istituto Superiore di Sanita , Rome , Italy"},{"name":"Degree Course in Dentistry and Dental Prosthetics, UniCamillus\u2013Saint Camillus International University of Health Sciences , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Crax\u00ec","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo , Palermo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felice","family":"Nava","sequence":"additional","affiliation":[{"name":"Health Care and Drug Abuse Unit in Prison, Public Health Agency , Padua , Italy"},{"name":"Federazione Italiana degli Operatori dei Dipartimenti e dei Servizi delle Dipendenze , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Babudieri","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit, University Hospital of Sassari , Sassari , Italy"},{"name":"Italian Society of Penitentiary Health Medicine , Viterbo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"D\u2019Ambrosio","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Marcellusi","sequence":"additional","affiliation":[{"name":"Economic Evaluation and Health Technology Assessment, Centre for Economic and International Studies, Faculty of Economics, University of Rome Tor Vergata , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco Saverio","family":"Mennini","sequence":"additional","affiliation":[{"name":"Economic Evaluation and Health Technology Assessment, Centre for Economic and International Studies, Faculty of Economics, University of Rome Tor Vergata , Rome , Italy"},{"name":"Institute of Leadership and Management in Health, Kingston Business School, Kingston University , London , United Kingdom"},{"name":"Italian Society of Health Technology Assessment , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Valle","sequence":"additional","affiliation":[{"name":"General Directorate for Health Prevention, Prevention of Communicable Diseases and International Prophylaxis, Italian Ministry of Health , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Russo","sequence":"additional","affiliation":[{"name":"Health Economic Evaluations Office, Italian Medicines Agency , Rome , Italy"},{"name":"Monitoring Registers Office, Italian Medicines Agency , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pier Paolo","family":"Olimpieri","sequence":"additional","affiliation":[{"name":"Monitoring Registers Office, Italian Medicines Agency , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Andreoni","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, University Hospital Tor Vergata , Rome , Italy"},{"name":"Italian Society of Infectious and Tropical Diseases , Prato , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Aghemo","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Hepatology, Department of Gastroenterology, Isituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital , 20089, Rozzano , Italy"},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele , Italy"},{"name":"Italian Association for the Study of the Liver , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"2023091317000126500_jiad038-B1","author":"Associazione Italiana Per Lo Studio Del Fegato"},{"key":"2023091317000126500_jiad038-B2","author":"Eurostat. Over 6 600 deaths from hepatitis in the EU"},{"key":"2023091317000126500_jiad038-B3","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":"2023091317000126500_jiad038-B4","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":"2023091317000126500_jiad038-B5","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1080\/00365540903095358","article-title":"Estimating the incidence, prevalence and clinical burden of hepatitis C over time in Italy","volume":"41","author":"Mariano","year":"2009","journal-title":"Scand J Infect Dis"},{"key":"2023091317000126500_jiad038-B6","first-page":"5758","article-title":"Impact of reimbursement limits on patient access to direct-acting antivirals in Italy: analysis of data from national registries","volume":"24","author":"Russo","year":"2020","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2023091317000126500_jiad038-B7","author":"Italian Medicine Agency"},{"key":"2023091317000126500_jiad038-B8","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":"2023091317000126500_jiad038-B9","first-page":"325","article-title":"Tailored screening and dedicated funding for direct acting antiviral drugs: how to keep Italy on the road to hepatitis C virus elimination?","volume":"56","author":"Kondili","year":"2020","journal-title":"Ann Ist Super Sanita"},{"key":"2023091317000126500_jiad038-B10","author":"Mennini"},{"key":"2023091317000126500_jiad038-B11","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/liv.14779","article-title":"Progress towards hepatitis C virus elimination in high-income countries: an updated analysis","volume":"41","author":"Gamkrelidze","year":"2021","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B12","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.dld.2020.07.008","article-title":"Assessing the impact of COVID-19 on the management of patients with liver diseases: a national survey by the Italian association for the study of the liver","volume":"52","author":"Aghemo","year":"2020","journal-title":"Dig Liver Dis"},{"key":"2023091317000126500_jiad038-B13","first-page":"249","article-title":"Prevalence of hepatitis C virus estimates of undiagnosed individuals in different Italian regions: a mathematical modelling approach by route of transmission and fibrosis progression with results up to January 2021","volume":"45","author":"Kondili","year":"2022","journal-title":"New Microbiol"},{"key":"2023091317000126500_jiad038-B14"},{"key":"2023091317000126500_jiad038-B15","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1111\/liv.14808","article-title":"The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four European countries","volume":"41","author":"Mennini","year":"2021","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B16","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":"2023091317000126500_jiad038-B17","author":"Coalition for Global Hepatitis Elimination"},{"key":"2023091317000126500_jiad038-B18","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.dld.2021.03.026","article-title":"Milestones to reach hepatitis C virus (HCV) elimination in Italy: from free-of-charge screening to regional roadmaps for an HCV-free nation","volume":"54","author":"Kondili","year":"2022","journal-title":"Dig Liver Dis"},{"key":"2023091317000126500_jiad038-B19","doi-asserted-by":"crossref","DOI":"10.1016\/j.epidem.2021.100442","article-title":"Estimated prevalence of undiagnosed HCV infected individuals in Italy: a mathematical model by route of transmission and fibrosis progression","volume":"34","author":"Kondili","year":"2021","journal-title":"Epidemics"},{"key":"2023091317000126500_jiad038-B20","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12879-022-07042-w","article-title":"A mathematical model by route of transmission and fibrosis progression to estimate undiagnosed individuals with HCV in different Italian regions","volume":"22","author":"Kondili","year":"2022","journal-title":"BMC Infect Dis"},{"key":"2023091317000126500_jiad038-B21","author":"Ministero della Salute (Italian Ministry of Health)."},{"key":"2023091317000126500_jiad038-B22"},{"key":"2023091317000126500_jiad038-B23","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1093\/ndt\/gfab190","article-title":"Prevalence of hepatitis C virus infection in non-dialysis CKD patients: a multicentre study in renal clinics","volume":"36","author":"Minutolo","year":"2021","journal-title":"Nephrol Dial Transplant"},{"key":"2023091317000126500_jiad038-B24","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.3390\/v14051096","article-title":"Elimination of hepatitis C in southern Italy: a model of HCV screening and linkage to care among hospitalized patients at different hospital divisions","volume":"14","author":"Rosato","year":"2022","journal-title":"Viruses"},{"key":"2023091317000126500_jiad038-B25","first-page":"E359","article-title":"Screening, linkage to care and treatment of hepatitis C infection in primary care setting in the south of Italy","volume":"10","author":"Citarella","year":"2020","journal-title":"Life (Basel)"},{"key":"2023091317000126500_jiad038-B26","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1056\/NEJMc2106143","article-title":"Extrahepatic manifestations of chronic HCV infection","volume":"385","author":"Ferri","year":"2021","journal-title":"N Engl J Med"},{"key":"2023091317000126500_jiad038-B27","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1111\/liv.15243","article-title":"Opportunistic co-screening for HCV and COVID-19-related services: a creative response with a need for thoughtful reflection","volume":"42","author":"Kondili","year":"2022","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B28","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/S0140-6736(18)31734-3","article-title":"The Lancet-EASL commission on liver diseases in Europe: overcoming unmet needs, stigma, and inequities","volume":"392","author":"Manns","year":"2018","journal-title":"Lancet"},{"key":"2023091317000126500_jiad038-B29","author":"European Centre for Disease Prevention and Control","year":"2016"},{"key":"2023091317000126500_jiad038-B30","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jhep.2021.09.038","article-title":"Population-level estimates of hepatitis C reinfection post scale-up of direct-acting antivirals among people who inject drugs","volume":"76","author":"Yeung","year":"2022","journal-title":"J Hepatol"},{"key":"2023091317000126500_jiad038-B31","doi-asserted-by":"crossref","first-page":"n332","DOI":"10.1136\/bmj.n332","article-title":"Changing behaviour: an essential component of tackling health inequalities","volume":"372","author":"Marteau","year":"2021","journal-title":"BMJ"},{"key":"2023091317000126500_jiad038-B32","author":"European Centre for Disease Prevention and Control"},{"key":"2023091317000126500_jiad038-B33","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1111\/liv.14998","article-title":"Management of liver disease in Italy after one year of the SARS-CoV-2 pandemic: a web-based survey","volume":"41","author":"Ponziani","year":"2021","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B34","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1111\/liv.15273","article-title":"Hepatitis C screening during SARS-CoV-2 testing or vaccination. Experience in an area of southern Italy in the province of Salerno","volume":"42","author":"Torre","year":"2022","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B35","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1111\/liv.15216","article-title":"Implementation of HCV screening in the 1969\u20131989 birth-cohort undergoing COVID-19 vaccination","volume":"42","author":"D\u2019Ambrosio","year":"2022","journal-title":"Liver Int"},{"key":"2023091317000126500_jiad038-B36"},{"key":"2023091317000126500_jiad038-B37","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1111\/dar.12978","article-title":"Barriers to effective management of hepatitis C virus in people who inject drugs: evidence from outpatient clinics","volume":"38","author":"Molinaro","year":"2019","journal-title":"Drug Alcohol Rev"},{"key":"2023091317000126500_jiad038-B38","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.14309\/ajg.0000000000001147","article-title":"Factors enhancing treatment of hepatitis C virus-infected Italian people who use drugs: the CLEO-GRECAS experience","volume":"116","author":"Rinaldi","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"2023091317000126500_jiad038-B39","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1111\/jvh.13375","article-title":"Innovative procedures for micro-elimination of HCV infection in persons who use drugs","volume":"27","author":"Messina","year":"2020","journal-title":"J Viral Hepat"},{"key":"2023091317000126500_jiad038-B40","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":"2023091317000126500_jiad038-B41","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugpo.2020.103055","article-title":"HCV Testing and treatment initiation in an Italian prison setting: a step-by-step model to micro-eliminate hepatitis C","volume":"90","author":"Fiore","year":"2021","journal-title":"Int J Drug Policy"},{"key":"2023091317000126500_jiad038-B42","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1111\/jvh.13376","article-title":"HCV micro-elimination in two prisons in Milan, Italy: a model of care","volume":"27","author":"Giuliani","year":"2020","journal-title":"J Viral Hepat"},{"key":"2023091317000126500_jiad038-B43","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.drugpo.2018.06.017","article-title":"Treatment with direct-acting antivirals in a multicenter cohort of HCV-infected inmates in Italy","volume":"59","author":"Pontali","year":"2018","journal-title":"Int J Drug Policy"},{"key":"2023091317000126500_jiad038-B44","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.dld.2020.02.012","article-title":"Hepatitis C virus infection in jail: difficult-to-reach, not to-treat. Results of a point-of-care screening and treatment program","volume":"52","author":"Masarone","year":"2020","journal-title":"Dig Liver Dis"},{"key":"2023091317000126500_jiad038-B45","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1370\/afm.2245","article-title":"Forces for integration","volume":"16","author":"Stange","year":"2018","journal-title":"Ann Fam Med"},{"key":"2023091317000126500_jiad038-B46","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40249-019-0528-6","article-title":"Epidemiology and management of hepatitis C virus infections in immigrant populations","volume":"8","author":"Coppola","year":"2019","journal-title":"Infect Dis Poverty"},{"key":"2023091317000126500_jiad038-B47","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.dld.2021.08.024","article-title":"Effectiveness of a screening program for HBV, HCV, and HIV infections in African migrants to Sicily","volume":"54","author":"Prestileo","year":"2022","journal-title":"Dig Liver Dis"},{"key":"2023091317000126500_jiad038-B48","author":"World Health Organization"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/228\/Supplement_3\/S211\/51544060\/jiad038.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/228\/Supplement_3\/S211\/51544060\/jiad038.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T17:00:52Z","timestamp":1694624452000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/228\/Supplement_3\/S211\/7273018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,13]]},"references-count":48,"journal-issue":{"issue":"Supplement_3","published-online":{"date-parts":[[2023,9,13]]},"published-print":{"date-parts":[[2023,9,13]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiad038","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9,15]]},"published":{"date-parts":[[2023,9,13]]}}}