Claudio Galli
Associate Director Medical Scientific Liaison Europe,Abbott Diagnostics, Italy
Title: New insights in the diagnosis and monitoring of HCV infection
Biography
Biography: Claudio Galli
Abstract
Several direct antiviral agents (DAAs) for the treatment of chronic hepatitis due to the hepatitis C virus (HCV) have been recently approved. Since these drugs allow to achieve a sustained response rate >95%, there is an enhanced need for the implementation of screening strategies aimed to the identification of “silent” HCV carriers in order to obtain a clearer picture on the real burden of infection and to plan for therapeutic interventions. While more than 65% of cases of chronic hepatitis, cirrhosis and hepatocellular carcinoma are linked to a chronic HCV infection, the modes of acquisition over time and the routes of infection show profound differences. Incidence data, when available, show a decrease over the last decades; prevalence data are not reliable since most studies have been carried out several years ago and in small population samples. Surveillance systems are mostly based on the reporting of symptomatic cases and rely on the detection of anti-HCV antibodies alone or on the combination of anti-HCV and HCV-RNA. Since the rate of active infections among anti-HCV positive, asymptomatic subjects ranges from 60% to 80% and usually decreases with age, the former strategy will overestimate the number of HCV-infected individuals and also underestimate the total number of subjects who encountered HCV, because a spontaneous clearance of HCV followed by the negativization of anti-HCV has been reported. Several screening algorithms that include HCVAg testing have been proposed; the sensitivity of current assays corresponds to about 1,000 UI/mL of HCV-RNA, a level usually attained in untreated subjects