Testing for hepatitis C virus and hepatitis B virus/hepatitis D virus: Current scenarios and perspectives in Italy

Table 1 Estimates of the absolute number and percentage of individuals with viremic hepatitis C virus infection in Italy according to macroarea up to January 2021

Macroarea	Absolute number and 95%CI[25]	Prevalence and 95%CI (%)[25]
Italy	398610 (396960-400260)	0.66 (0.66-0.67)
North	150983 (149557-152410)	0.54 (0.53-0.54)
Centre	105351 (104188-106513)	0.88 (0.87-0.89)
South	98928 (87623-100233)	0.72 (0.71-0.73)
Isles	43348 (42513-44183)	0.67 (0.66-0.68)

95%CI: 95% confidence interval.

Table 2 Prioritisation of hepatitis C virus testing in different hospital departments

	Based on expected prevalence	Based on clinical risk/need for care
Routine testing departments	Hepatology; infectious diseases	Hepatology; infectious diseases
High-priority departments	Emergency department; internal medicine; gastroenterology/endoscopy; ophthalmology; geriatrics; psychiatry	Gynaecology/obstetrics; oncology/haematology
Medium-priority departments	Cardiology; nephrology; surgery	Rheumatology; neurology
Low-priority departments	Paediatrics; infectious diseases1; gastroenterology/hepatology1; internal medicine/hepatology1

¹Classified as low-priority departments because hepatitis C virus testing is part of their routine activity.

Table 3 Examples of intra-hospital screening and linkage to care programmes for hepatitis C virus infection

Study	Study design	Study period	Area	Setting	No. of subjects tested	No. of anti-HCV-positive subjects	No. of previously unknown HCV-positive subjects	Rate of linkage to care
Telepass study[39]	Retrospective/prospective	March 2017 to March 2018	Rome, Italy	Surgical units at a university hospital	12260	224	93	35/93 (37.6%)
Caserta model[40]	Prospective	January to December 2019	Caserta, Italy	Tertiary-level hospital	14396	529	276	276/276 (100%)
ICEberg project[38]	Retrospective phase	January 2018 to June 2022	Castellammare di Stabia, Italy	Local health unit	49287	4415	Not available	3344/4415 (75.7%)
ICEberg project[38]	Prospective phase	September 2021 to October 2022	Castellammare di Stabia, Italy	Local health unit	856	54	Not available	54/54 (100%)

HCV: Hepatitis C virus.

Table 4 Characteristics of hepatology departments in level I, II, and III centres

Level	I	II	III
Type of facility	Community care/single operating unit	Specialised hospital facility	Highly specialised healthcare facility
Level of complexity	Low	Medium-high	High
Position	Basic hepatology care management	Intermediate between community care (general practitioner or outpatient specialist) and highly specialised centres	Highly specialised care management
Multidisciplinary approach	No	Yes	Yes
Advanced technology	No	Yes	Yes
Liver transplant centre	No	No	Yes
Regional/national reference	No	Possibly	Yes
Research/clinical trials	No	Possibly	Yes