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, 14 (10), e0223668

Estimation of the Number of HCV-positive Patients in Italy


Estimation of the Number of HCV-positive Patients in Italy

Ivan Gardini et al. PLoS One.


Background: HCV is one of the main causes of cirrhosis, hepatocellular carcinoma (HCC) and liver transplantation.

Aim: The aim of this study was to estimate the number of living individuals diagnosed with hepatitis C in Italy. This study also aimed to stratify these subjects as diagnosed and cured, diagnosed awaiting a cure, and undiagnosed (individuals who were not diagnosed, living or lived with hepatitis C).

Methods: To quantify the number of ill patients in Italy, an inquiry was conducted based on questionnaires submitted to three nationally representative regions, namely, Campania, Lazio and Piemonte, as representatives of the three main areas of Italy (North, Centre and South regions). The data were collected through a questionnaire to acquire demographic and clinical information on patients in the participating hospitals. The questionnaires contained 6 questions on sex, age, region of residence, disease condition, type of exemption and category. The questionnaires were administered individually to consecutive patients through face-to-face interviews conducted by specialised personnel in each centre. Data were collected between September 2017 and January 2018.

Results: In total, 2,860 questionnaires were analysed. They were completed by the patients (55% male), who had an average age of 61 years (64 years for women and 59 years for men). In total, 54% of the sample declared that they were still infected with HCV (1,548 patients out of 2,860 respondents), while the remaining subjects declared that they had been cured. The inquiry showed that 46.6% of the sample had at least a 016 exemption (chronic hepatitis), while more than 51% (1,469 interviewed patients out of 2,860 respondents) had a different type of exemption. Only 2% of the respondents declared that they had no exemption. Assuming that the analysed sample is representative of the actual HCV-positive population in Italy and considering the number of 016 exempt patients in the regional data, the model estimates that there are 443,491 cured and HCV-positive living patients and 240,043 ill patients who have yet to be treated.

Conclusions: Although this study has limitations, it represents a considerable improvement over the previously available studies. This study can help decision-makers implement more effective strategic planning to eliminate hepatitis C.

Conflict of interest statement

The authors have declared that no competing interests exist.


Fig 1
Fig 1. Results of the estimation of the HCV-positive population with known diagnoses–EpaC inquiry into 2018 exemptions.
Fig 2
Fig 2. One-way deterministic sensitivity analysis–estimated number of HCV-positive patients estimated for the base-case analysis (black-line) and each simulated scenario (± 20%).
Fig 3
Fig 3. One-way deterministic sensitivity analysis–estimated number of HCV-infected patients who had yet to be treated as of 1 January 2018 estimated for the base-case analysis (black-line) and each simulated scenario (± 20%).

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Grant support

This study was supported by EpaC Onlus, Italian Liver Patient Association, Rome, Italy