“The elimination of hepatitis C by 2030 remains a hope and a goal for now. Obviously an important step is the screening of subjects who use drugs by injection, in which the prevalence of the Hcv virus is very high. Certainly the availability of drugs with high efficacy and short duration of administration is an important point in the treatment of these patients. However, despite the state finances screening for all subjects who use intravenous drugs, in Italy too few control tests are still performed “. Massimo Puoti, professor of infectious diseases at the University of Milan-Bicocca and director of the complex structure of infectious diseases of the large metropolitan hospital Niguarda in Milan, says this to Adnkronos Health.
Puoti infectious disease specialist, ‘in Italy 21% Serd users screened for HCV’ (VIDEO)
“From the latest annual report on drug addiction in Italy – he underlines – it emerges that, out of 123,871 users of the Serd (Service for pathological addictions), only 26,576 were screened for hepatitis C, about 21% of the total. So we have to intervene on the remaining 79% who have not yet joined the National Screening Program. Once the screening is done, the subjects who use intravenous drugs must be treated and by treating these subjects, transmission is also prevented. So far in the Italian clinics we have treated more than 200 thousand people with antivirals, now the goal is to find those who have hepatitis C and do not yet know they have it “.
The World Health Organization, “thanks to the availability of the new short therapy (glecaprevir / pibrentesvir) lasting 8 weeks able to cure more than 97% of viral hepatitis C in patients with or without cirrhosis, for 2030 has entered as The goal is to eliminate HCV infection – Puoti remembers – which means reducing mortality in 65% of cases, cutting down new infections by 90% and treating 80% of patients. However, the national screening program remains fundamental. bring out the undeclared. Obviously there are differences from one region to another: we go from 0.1% screening in Sardinia to 93% in Emilia Romagna, precisely because of the heterogeneity of the national health system “.
A phenomenon “which is emerging in the United States” and which “is of particular concern – reports the infectious disease specialist – is the injecting use of opioid drugs prescribed for pain therapy, including oxycodone and fentanyl, which potentially could interact with hepatitis C treatments. Even in Italy, although there is no such alarm, this phenomenon is growing: only 1.5% of Serd users report using these substances; however, if we go to see the analysis of the 2022 Report on waste water in 33 cities, as many as 26 show traces of fentanyl anilidopiperidine, taken for therapeutic use as a painkiller, but probably also for non-therapeutic use “.
The good news is that the data presented at the 2022 Congress of the EASL (European Association for the Study of the Liver), of the “Grand Plan study that supports the use of glecaprevir and pibrentesvir in drug addicts, including those using opiates or amphetamines – remarks Puoti – showed a lower number of adverse events or deaths. Not only that: the study shows that the combination of the two drugs heals in just 8 weeks with percentages higher than 95% even in patients who use fentanyl “. They are drugs “safe even for people with addictions”, assures the specialist. The short-term treatment “even in patients who use intravenous drugs have an undoubted advantage over other longer therapies”.
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