Since the relatively recent discovery of the virus (1989), all medical-surgical procedures undergone prior to that period must be considered as potential risk factors.
Recently, I was offered to perform the anti-Hcv test as part of a screening campaign. Honestly, I was taken aback: I have never used drugs, I have no symptoms. What do you think of it?
He answers Roberta D’AmbrosioHead of Outpatient Activities Center AM and A. Migliavacca for the study of liver diseases, Gastroenterology and Hepatology Operating Unit, IRCCS Ca ‘Granda Foundation, Maggiore Policlinico Hospital, Milan (GO TO THE FORUM)
Infection with hepatitis C virus (Hcv) it is transmitted mainly through infected blood and runs asymptomatically up to the most advanced stages of the disease (cirrhosis). Since the discovery of the virus is relatively recent (1989), all medical-surgical procedures undergone before that period (blood transfusions, surgery, dental procedures) must be considered as potential risk factors. The idea that this disease is transmitted exclusively through the use of drugs in the wrong vein. Extremely effective antiviral therapies (Daa) have been available since 2014: these are tablets that must be taken for only 2-3 months, without side effects and whose use is associated with cure rates above 98%. The development of these powerful and safe drugs has led the World Health Organization (WHO) to define among its objectives that of the elimination of HCV infection worldwide. by 2030.
Screening for those born between 1969 and 1989
Precisely for this reason, in recent years, numerous programs have been launched aimed atidentification of infected subjects and to the optimization of treatment paths by specialist and care centers. At the end of May 2022, in Italy, they were launched overall 240 thousand antiviral therapies, a number that places us in seventh place in the world ranking for the number of treatments. However, there is an important share of subjects with an undiagnosed infection: the Istituto Superiore di Sanit (ISS) estimates that this is 200 – 300 thousand individuals. These people (the so-called submerged) must be identified early, before the infection can evolve, and must be treated. Definitive recovery from the virus has a positive impact on survival and quality of life. For all these reasons, in 2019 the Milleproroghe decree allocated over 71 million euros to be allocated to screening for Hcv in Italy. Based on the results of complex analyzes, screening was found to be cost-effective from subjects born between 1969 and 1989: this age group is targeted by the screening plans of the individual regions.
Participation could be extended
These are relatively young individuals, who can involuntarily favor the circulation of the virus after coming into contact with it medical, cosmetic or other procedures, especially before the 1990s. In Lombardy, for example, free screening for Hcv is currently offered to all subjects of age between 32 and 62 years who go to any public or private-accredited health facility to perform blood tests or on the occasion of hospitalizations. Soon the age for participation in screening could be extended to those born before 1969. At the same time, the screening of subjects related to SerD continues (Public addiction services) and prisons, in this case without personal limitations. In light of this data, I find that there is no reason to refuse the test run.
June 19, 2022 (change June 19, 2022 | 19:38)
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