{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:27:13Z","timestamp":1767968833115,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Gilead Sciences and Bando di Ateno Universit\u00e0 degli Studi della Campania Luigi Vanvitelli","award":["This work was in part supported by Gilead for the study \u201cEvaluation of an innovative model to eliminate HCV infection in a high-risk population of undocumented immigrants and low-income refugees\u201d and by the Bando di Ateneo per progetti competitivi, University of Campania, 2019, for the study \u201cAwareness of Sexually-Transmitted Infections among immigrant population in Southern Italy (SexTImP study)\u201d."],"award-info":[{"award-number":["This work was in part supported by Gilead for the study \u201cEvaluation of an innovative model to eliminate HCV infection in a high-risk population of undocumented immigrants and low-income refugees\u201d and by the Bando di Ateneo per progetti competitivi, University of Campania, 2019, for the study \u201cAwareness of Sexually-Transmitted Infections among immigrant population in Southern Italy (SexTImP study)\u201d."]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Poverty"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Migrants, mainly undocumented and low-income refugees, are at high risk of hepatitis C virus (HCV) infection, but are a difficult-to-reach and to-treat population. The aim of the study was to evaluate the effectiveness of a test and treat model with direct-acting antiviral for HCV infection in these migrants coming from low-income and living in southern Italy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A prospective, multicenter, collaborative study based on a four-phase-program (educational counseling, screening, linkage-to-care and treatment) was designed in southern Italy; the study started in June 2018, was stopped in February 2020 because of the outbreak of SARS-CoV2 infection in Italy and was resumed in February 2021 until November 2021.<\/jats:p>\n                <jats:p>After educational counseling on infectious diseases that are transmitted through blood or sexually pseudonymized HCV screening was offered to all undocumented migrants and low-income refugees observed at one of the 1st level clinical centers. The HCV-RNA-positive subjects were referred to one of the 3rd level units of Infectious Diseases (ID) and treated with a 12-week course of sofosbuvir-velpatasvir and observed for 12 weeks after the end of direct antiviral agents (DAA) treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Statistical analysis<\/jats:title>\n                <jats:p>For the descriptive analysis, the categorical variables were reported as absolute numbers and relative frequencies. Continuous variables were summarized as mean and standard deviation (<jats:italic>SD<\/jats:italic>) if normally distributed, or as a median and interquartile range (IQR) if not normally distributed. We used Pearson chi-square or Fisher\u2019s exact test for categorical variables and Student\u2019s <jats:italic>t<\/jats:italic> test or Mann\u2013Whitney test for continuous variables. A <jats:italic>P<\/jats:italic> value\u2009&lt;\u20090.05 was considered to be statistically significant. Analyses were performed with SPSS 21.0.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 3501migrants observed in the study period, 3417 (97.6%) agreed to be screened; 185 (4.7%) were anti-HCV-positive and, of these, 53 (28.6%) were HCV-RNA-positive. Of these 53 subjects, 48 (90.5%) were referred to an ID unit and started DAA treatment.<\/jats:p>\n                <jats:p>The HCV-RNA-positive-subjects were older [median 36 years (IQR: 32\u201321) vs 27.19 (IQR: 30.5\u201319.25); <jats:italic>P<\/jats:italic> = 0.001], and less frequently males [35 (66.03 %) vs 119 (90.1%), <jats:italic>P<\/jats:italic> &lt; 0 .0001] than seronegative participants. They more frequently came from Eastern Europe (70.8%) stayed longer in Italy [months of stay in Italy, mean \u00b1 <jats:italic>SD<\/jats:italic>: 51.02\u00a0\u00b1\u00a052.84 vs 25.7 \u00b1 42.65, <jats:italic>P<\/jats:italic> = 0.001], and had more years of schooling [years of schooling, mean \u00b1 <jats:italic>SD<\/jats:italic>: 9.61\u00b12.81 vs 7.10 \u00b1 4, <jats:italic>P<\/jats:italic> = 0.0001]. HCV-RNA-positive-subjects less frequently reported piercing, tattoos and tribal scars as risk factors (23.6%). Of these 48 HCV RNA positive subjects who started DAA, 47 (97.9%) showed a sustained virological response and one dropped-out in follow-up after DAA treatment. No subject had any adverse event.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This model of HCV screening and linkage to care seems effective to eliminate HCV infectionin a difficult-to-reach and to-treat population, such as undocumented migrants and low-income refugees. The participation of cultural mediators in the study made possible a better interaction between migrants and physicians, as is evident from the large number of subjects enrolled. Eliminating HCV among migrants will have a long-term positive impact from a public health and healthcare perspective by reducing the number of individuals who potentially develop HCV-related complications such as liver cirrhosis and hepatocellular carcinoma and reducing the circulation of HCV in the regions that host them which often, as in the case of Italy, are low endemic for HCV infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s40249-024-01200-9","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T03:54:34Z","timestamp":1716868474000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effectiveness of test-and-treat model with direct-acting antiviral for hepatitis C virus infection in migrants: a prospective interventional study in Italy"],"prefix":"10.1186","volume":"13","author":[{"given":"Nicola","family":"Coppola","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loredana","family":"Alessio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"De Pascalis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Macera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Di Caprio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Messina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Onorato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"Minichini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Stanzione","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranca","family":"Stornaiuolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Starace","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Monari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Cal\u00f2","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Sagnelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5870-0956","authenticated-orcid":false,"given":"Mariantonietta","family":"Pisaturo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"issue":"5","key":"1200_CR1","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/S2468-1253(21)00472-6","volume":"7","author":"Polaris Observatory HCV Collaborators","year":"2022","unstructured":"Polaris Observatory HCV Collaborators. 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All procedures performed in this study were in accordance with the ethics standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethics standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors give consent for publication of the manuscript","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"39"}}