# Italian screening protocol and genotypes characterization for HCV elimination (2022–2023) in Ferrara’s province: a real-world study

## TL;DR

This study evaluates an HCV screening program in Italy's Ferrara province from 2022–2023, showing high compliance and mapping HCV genotypes among different population groups.

## Contribution

The study introduces a novel double invitation model and screening protocol that significantly improved compliance with HCV testing.

## Key findings

- A total of 51,283 individuals were screened, with 447 and 88 testing positive in the first and second screening rounds respectively.
- The highest compliance rate (51.83%) was achieved in Italy using the new protocol, particularly among those born between 1969 and 1989.
- HCV genotype 1a was the most prevalent (35.06%), followed by 1b (27.27%) and 3a (22.08%).

## Abstract

Hepatitis C virus (HCV) is a worldwide health hazard, and in chronic form (nowadays affecting 50 million people – World Health Organization data) can be lethal. To forestall it, preventive screening is a mandatory approach. Since 2021, Italy conducts a national-wide screening program to eliminate the virus from its population. The team perfected an innovative method throughout the period between 2022 and 2023, to answer that medical necessity and map HCV genotypes. The medical protocol has introduced a dedicated double invitation model for the adherents, with consequential pre-prepared medical consumables allocated. The population was divided in three separate groups: born between 1969 and 1989, addiction services, and prison. Two screening levels were carried out: anti-HCV antibodies (indirect chemiluminescence immunoassay) and quantitative HCV RNA reverse transcription. 51,283 adherents were registered: 447 resulted positive to the first screening round, and 88 to the second (393 and 77 patients respectively from population born between 1969 and 1989). The medical protocol introduced allowed to substantially increase patients and medical staff compliance to HCV screening (adherence: 51.83%, the highest in Italy). HCV genotypes’ distribution was mapped by patients’ age, biological sex and origin over five groups comprehending subtypes 1a(35.06% of the positive population), 1b(27.27%), 2a/2c(10.39%), 3a(22.08%), 4a/4c/4d(5.19%).

The online version contains supplementary material available at 10.1038/s41598-025-92654-w.