Close the circle. Or rather, achieve the ambitious goal of eliminating HCV infection (the hepatitis C virus) by 2030, as sanctioned by the World Health Organization. Mantova is making an effort to do so, putting its energies and skills into the field. In an area where much has already been done in terms of screening, we wanted to organize a proximity service, which brings the test where it is most needed, reaching those populations that have remained outside the previous campaigns. “The collaboration with the complex structure of Infectious Diseases of the Mantua Hospital has always worked very well and in recent years there have been many people who, after taking the Hcv test at the SerD and having tested positive, have been treated with new generation drugs, obtaining healing in the vast majority of cases”, says Marco Degli Esposti, Director of the Mantua SerD. Despite this close collaboration, some users of the SerD sent to the Infectious Diseases clinic to be taken care of did not show up or did not continue with the checks and treatments, mainly due to their condition of discomfort.
Therefore, EpatoSerD was born in April 2022, a clinic dedicated to the study of liver diseases aimed precisely at SerD users. “Within a few months we went from the idea to its realization, thanks to the Company Management who believed in the project: we acquired an ultrasound, HCV-reflex tests and the possibility of administering the treatments directly in our structure”, says Giorgio Perboni, SerD doctor, responsible for this project: three very important factors. Thanks to the ultrasound, in fact, it is possible to evaluate the state of liver impairment and therefore, on the one hand, to guide the choice of therapy, on the other, to identify the most seriously ill, who need periodic monitoring if not taking charge gastroenterological; thanks to the HCV reflex test, then, with a single blood sample, the complete diagnosis is obtained and the patient, if a candidate for therapy, can begin treatment as early as the next visit; lastly, a therapy which can be administered directly to the SerD thanks to the presence of an expert doctor who has the possibility of prescribing specific drugs. All facilitated by the direct supply of drugs to the SerD, thanks to the collaboration with the hospital pharmacy. “We have already treated 31 patients, starting in the summer of 2021 and we have about ten left on the list, so on average we treat about two patients a month. Most SerD users with hepatitis C have already been treated but we continue to find new cases of infection, albeit in small numbers. And this demonstrates that the project works: there are people who attend our center for whom going to the hospital represents a barrier”, underlines Perboni.
From surveys conducted at a national level it is known that only 20% of drug addicts take the HCV test. This is why the SerDs represent a key place to complete the screening that the Ministry of Health launched in 2020 and which is aimed at the entire population born between 1969 and 1989 and at risk populations with no age limit, such as drug addicts , prison population, sex workers. “Always with the intention of going to find the still undetected cases of HCV infection, we have established a connection with the Mantua Prison, thanks to the collaboration with Laura Mannarini, Medical Manager, where the HCV test is offered and, in case of positivity, the prisoner is taken to the SerD for ultrasound and, if indicated, for therapy”, Perboni continues. In short, the local health and social care agency of Mantua has taken the WHO objective seriously and has decided to go towards potential patients rather than waiting for them to turn to the service. “Users who frequent our facilities are very loyal, they even come several times a week, and it is therefore easier for us to be able to offer the service and obtain a good result”, concludes Perboni. “For the clinic to work, however, it is essential that there are the necessary skills to be able to do ultrasound scans and administer therapies”. 2030 is approaching and if we want to reach the goal, it is time for the formidable opportunity guaranteed by the new antiviral drugs to be seized thanks to an organization capable of reaching those who have not yet been reached. And thus close the circle.