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FrancoAngeli Journals

Saggi, Studi e Ricerche

No. 56 (2020)

Possible eradication of HCV hepatitis in users belonging to Ser.D: experience of collaboration between a Ser.D of the Province of Foggia and the U.O.C. Infectious Diseases of Foggia

DOI
https://doi.org/10.3280/mis56-2020oa12631
Submitted
settembre 28, 2021
Published
2021-12-30

Abstract

The eradication of HCV hepatitis in users belonging to Ser.D. should be encouraged not only with respect to the care of these patients but also for global health, today they represent the main reservoir of infection in industrialized countries. Field experiences and scientific evidence are trying to identify the essential elements in order to facilitate access to treatment for taking care of the consumer of substances with HCV. The use of the new drugs, the DAA (Direct-Acting Antivirals), able to cure more than 95% of people with chronic HCV infection, is certainly an encouraging element for the limited treatment time and for the few side effects, but the enrollment of consumers of substances is still difficult. In the Ser.D. of the province of Foggia, a collaboration is underway with the U.O.C. Infectious Diseases Policlinico Riuniti of Foggia.
The usefulness of this protocol lies in its ability to integrate the activities carried out within the Addiction Service with those of the Infectious Diseases Treatment Center, which is responsible for completing the initial diagnosis made by the Ser.D, prescribing patients specific therapy. The Ser.D. is responsible for the complete virological screening, the diagnosis of liver disease activity, the monitoring through laboratory tests during therapy as well as the supervision of the assumption of the therapy entrusted.
The experience carried out so far has led to the following results: the activity of the addictive disease did not represent a factor of non-adherence to the treatment nor of non-inclusion in the treatment itself; the employees in the service who tested positive for Ab-HCV and with positive HCV-RNA are all addicted to drugs with active or previous use by injection, even the two positive alcoholics were both former drug abusers; the side effects recorded were not such as to determine the interruption of the antiviral treatment in progress, except for a patient in whom psoriasis emerged and, in any case, those recorded are related to therapy with interferon and ribavirin; the stay in the service represents a protective factor not only for the treatment of addiction but also for the treatment of diseases related to addiction, in fact as many as 72.3% of those who did not take the HCV-RNA had stopped treatment for the addiction treatment; the percentage lost during treatment was 3.7%; compared to the pathology of addiction, 16.7% showed disease activity with positivity to drugs, but this was neither a reason for exclusion nor for interruption of antiviral therapy. The follow-up as of May 31, 2021, post SVR-12, was characterized by no recurrence or reinfection.

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