Prevalence of Hepatitis C in the Emilia-Romagna Region of Italy: Population-Wide Screening

TL;DR

A large HCV screening program in Italy found more infections in high-risk groups and showed the effectiveness of targeted outreach.

Contribution

The study demonstrates the success of a population-wide HCV screening program in Italy with high participation and treatment rates.

Findings

72.8% of high-risk individuals and 36.9% of the general population were screened for HCV.

The HCV detection rate was significantly higher in high-risk groups (23.8‰) than in the general population (1.2‰).

74.3% of infected individuals started antiviral therapy after being identified through the screening.

Abstract

In agreement with WHO recommendations, the Emilia-Romagna Region, Italy, implemented a population-wide HCV screening program for the treatment of the large asymptomatic infected population. From January 2022, the free-of-charge screening targeted all residents born between 1969 and 1989, prison inmates, and injection drug users. Participants were recruited using phone messages, electronic health record notifications, public advertisement, and direct contact with general practitioners. A single blood sample was collected for anti-HCV IgG testing and, if positive, for reflex HCV–RNA testing. Infected subjects were offered an evidence-based therapeutic pathway. By June 2024, 72.8% of high-risk subjects (n = 19,732), and 36.9% of the general population (n = 488,065) had been screened. A total of 1032 individuals were positive based on the HCV–RNA test, and the detection rate widely differed between the high-risk and the general population (23.8‰ vs. 1.2‰, respectively). Of the infected individuals, 88.1% were seen by a specialist physician, and 74.3% (n = 767) started antiviral therapy. Thanks to multiple recruitment approaches, over one third of the general population participated in HCV screening. The program performance was substantially greater among high-risk individuals compared to the general population. To achieve WHO targets, policymakers might consider expanding the screening to other high-risk subgroups and/or adapting birth cohorts.

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