title: Current practice of hepatitis C treatment in Southern Italy.
abstract: BACKGROUND
  Only a small proportion of subjects referring to hospitals for hepatitis C virus (HCV) positivity receives antiviral therapy.
  
  
  OBJECTIVE
  To evaluate the rate of antiviral treatment and the causes for no treatment in HCV-RNA positive subjects seen in hospital settings.
  
  
  METHODS
  A prospective study enrolling over a 6-month period (February-July 2009) all consecutive anti-HCV positive subjects initially referred (naïve patients) to 12 liver units in Southern Italy for HCV treatment.
  
  
  RESULTS
  Out of 608 subjects evaluated, 74 (12.2%) had no detectable HCV-RNA in the serum and thus were excluded. Of the remaining 534 HCV-RNA positive subjects, 357 (66.9%) were not treated for the following reasons: 49.9% were older than 65 years of age (75% of them >70 years), 14.3% had normal liver enzymes, 13.2% had compensated/decompensated cirrhosis, 10.4% refused treatment, 9.8% had ongoing substance or alcohol abuse. Multivariate analysis showed that females (O.R. 2.27; C.I. 95% 1.05-4.90) and subjects with low educational level (O.R. 4.38; C.I. 95% 1.27-15.11) were more likely to decline therapy.
  
  
  CONCLUSIONS
  The majority of patients with HCV infection does not receive antiviral treatment. The effectiveness of the current standard therapy for HCV infection is low despite its good efficacy.
authors.affiliation: Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy. tommaso.stroffolini@iss.it
authors.forename: Tommaso
authors.initials: T
authors.lastname: Stroffolini
authors.forename: Aldo
authors.initials: A
authors.lastname: Spadaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Guadagnino
authors.forename: Stefano
authors.initials: S
authors.lastname: Cosentino
authors.forename: Filippo
authors.initials: F
authors.lastname: Fatuzzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Galdieri
authors.forename: Bruno
authors.initials: B
authors.lastname: Cacopardo
authors.forename: Ignazio
authors.initials: I
authors.lastname: Scalisi
authors.forename: Mauro
authors.initials: M
authors.lastname: Sapienza
authors.forename: Maurizio
authors.initials: M
authors.lastname: Russello
authors.forename: Gaetano
authors.initials: G
authors.lastname: Scifo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Frugiuele
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Foti
authors.forename: Piero Luigi
authors.initials: PL
authors.lastname: Almasio
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism; D000998:Antiviral Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D004522:Educational Status; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D012737:Sex Factors; D016896:Treatment Outcome; D016312:Treatment Refusal
chemical_list: D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000410:Alanine Transaminase; C417083:peginterferon alfa-2b