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5. Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

Author

Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L. A., Vella, S., Quaranta, M. G., Rosato, S., Tosti, M. E., Weimer, L. E., Ferrigno, L., D’Angelo, F., Falzano, L., Benedetti, A., Schiadà, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Di Leo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, Peter, Rimenti, G., Rossini, A., Contessi, G. B., Castelli, Fulvio, Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, Lucia, Quintieri, F., De Siena, Martina, Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall’Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., DelundefinedPin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, Francesca, Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., DiundefinedBiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, Chiara, Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D’ArminioundefinedMonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, Margherita, D’Ambrosio, R., Degasperi, E., Vinci, Maria Rosaria, Villa, E., Bernabucci, V., Bristot, Luca, Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, Alex, Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D’Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, Enrico, Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, Maria Chiara, Montalto, G., Licata, A., Capitano, A. R., Craxì, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, Paolo, Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, Antonio, Siciliano, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D’Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, Roberto, Cingolani, Antonella, Lamonica, S., D’Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, Antonio, D’Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, Patrizia, Dell’Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, Monia, Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, A, Viti, R, Kondili, L, Rosato, S, Vella, S, Mennini, F, Quaranta, M, Tosti, M, Weimer, L, Ferrigno, L, D'Angelo, F, Falzano, L, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Drenaggi, D, Mazzaro, C, Angarano, G, Milella, M, Dileo, A, Rendina, M, Contaldo, A, Iannone, A, La Fortezza, F, Rizzi, M, Cologni, G, Bolondi, L, Benevento, F, Serio, I, Andreone, P, Caraceni, P, Guarneri, V, Margotti, M, Simonetti, G, Mazzella, G, Verucchi, G, Donati, V, Mian, P, Rimenti, G, Rossini, A, Contessi, G, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Leandro, G, Cozzolongo, R, Zappimbulso, M, Russello, M, Benigno, R, Coco, C, Torti, C, Costa, C, Greco, G, Mazzitelli, M, Pisani, V, Cosco, L, Quintieri, F, Desiena, M, Giancotti, F, Vecchiet, J, Falasca, K, Mastroianni, A, Apuzzo, G, Chidichimo, L, Foschi, F, Dall'Aglio, A, Libanore, M, Segala, D, Sighinolfi, L, Bartolozzi, D, Salomoni, E, Blanc, P, Baragli, F, Delpin, B, Mariabelli, E, Mazzotta, F, Poggi, A, Zignego, A, Monti, M, Madia, F, Xheka, A, Cela, E, Santantonio, T, Bruno, S, Viscoli, C, Alessandrini, A, Curti, C, Dibiagio, A, Nicolini, L, Balletto, E, Mastroianni, C, Blerta, K, Prati, D, Raffaele, L, Andreoletti, M, Perboni, G, Costa, P, Manzini, L, Raimondo, G, Filomia, R, Lazzarin, A, Morsica, G, Salpietro, S, Puoti, M, Baiguera, C, Vassalli, S, Rumi, M, Labanca, S, Zuin, M, Giorgini, A, Orellana, D, D'Arminiomonforte, A, Debona, A, Solaro, S, Fargion, S, Valenti, L, Periti, G, Pelusi, S, Galli, M, Calvi, E, Milazzo, L, Peri, A, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Vinci, M, Villa, E, Bernabucci, V, Bristot, L, Pereira, F, Chessa, L, Pasetto, M, Loi, M, Gori, A, Beretta, I, Pastore, V, Soria, A, Strazzabosco, M, Ciaccio, A, Gemma, M, Borgia, G, Foggia, A, Zappulo, E, Gentile, I, Buonomo, A, Abrescia, N, Maddaloni, A, Caporaso, N, Morisco, F, Camera, S, Donnarumma, L, Coppola, C, Amoruso, D, Staiano, L, Saturnino, M, Coppola, N, Martini, S, Monari, C, Federico, A, Dallio, M, Loguercio, C, Gaeta, G, Brancaccio, G, Nardone, G, Sgamato, C, D'Adamo, G, Alberti, A, Gonzo, M, Piovesan, S, Chemello, L, Buggio, A, Cavalletto, L, Barbaro, F, Castelli, E, Floreani, A, Cazzagon, N, Franceschet, I, Russo, F, Zanetto, A, Franceschet, E, Madonia, S, Cannizzaro, M, Montalto, G, Licata, A, Capitano, A, Craxi, A, Petta, S, Calvaruso, V, Rini, F, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Bruno, R, Lombardi, A, Zuccaro, V, Gulminetti, R, Asti, A, Villaraggia, M, Mondelli, M, Ludovisi, S, Baldelli, F, Di Candilo, F, Parruti, G, Di Stefano, P, Sozio, F, Gizzi, M, Brunetto, M, Colombatto, P, Coco, B, Surace, L, Foti, G, Pellicano, S, Fornaciari, G, Schianchi, S, Vignoli, P, Massari, M, Corsini, R, Garlassi, E, Ballardini, G, Andreoni, M, Cerva, C, Angelico, M, Gasbarrini, A, Siciliano, M, De Siena, M, Nosotti, L, Taliani, G, Biliotti, E, Santori, M, Spaziante, M, Tamburini, F, Vullo, V, D'Ettorre, G, Cavallari, E, Gebremeskel, T, Pavone, P, Cauda, R, Cingolani, A, Lamonica, S, D'Offizi, G, Lionetti, R, Visco Comandini, U, Grieco, A, D'Aversa, F, Picardi, A, De Vincentis, A, Galati, G, Gallo, P, Dell'Unto, C, Aghemo, A, Gatti Comini, A, Persico, M, Masarone, M, Anselmo, M, De Leo, P, Marturano, M, Brunelli, E, Ridolfi, F, Schimizzi, A, Ayoubi Khajekini, M, Framarin, L, Di Perri, G, Cariti, G, Boglione, L, Cardellino, C, Marinaro, L, Saracco, G, Ciancio, A, Toniutto, P, Alterini, G, Capra, F, Ieluzzi, D, Kondili LA, Vella S, Quaranta MG, Rosato S, Tosti ME, Weimer LE, Ferrigno L, D'Angelo F, Falzano L, Benedetti A, Schiadà L, Cucco M, Giacometti A, Brescini L, Castelletti S, Drenaggi D, Mazzaro C, Angarano G, Milella M, Di Leo A, Rendina M, Contaldo A, Iannone A, La Fortezza F, Rizzi M, Cologni G, Bolondi L, Benevento F, Serio I, Andreone P, Caraceni P, Guarneri V, Margotti M, Simonetti G, Mazzella G, Verucchi G, Donati V, Mian P, Rimenti G, Rossini A, Contessi GB, Castelli F, Zaltron S, Spinetti A, Odolini S, Leandro G, Cozzolongo R, Zappimbulso M, Russello M, Benigno R, Coco C, Torti C, Costa C, Greco G, Mazzitelli M, Pisani V, Cosco L, Quintieri F, De Siena M, Giancotti F, Vecchiet J, Falasca K, Mastroianni A, Apuzzo G, Chidichimo L, Foschi FG, Dall'Aglio AC, Libanore M, Segala D, Sighinolfi L, Bartolozzi D, Salomoni E, Blanc P, Baragli F, Del Pin B, Mariabelli E, Mazzotta F, Poggi A, Zignego AL, Monti M, Madia F, Xheka A, Cela EM, Santantonio TA, Bruno SR, Viscoli C, Alessandrini AI, Curti C, Di Biagio A, Nicolini LA, Balletto E, Mastroianni C, Blerta K, Prati D, Raffaele L, Andreoletti M, Perboni G, Costa P, Manzini L, Raimondo G, Filomia R, Lazzarin A, Morsica G, Salpietro S, Puoti M, Baiguera C, Vassalli S, Rumi MG, Labanca S, Zuin M, Giorgini A, Orellana D, D'Arminio Monforte A, Debona A, Solaro S, Fargion S, Valenti L, Periti G, Pelusi S, Galli M, Calvi E, Milazzo L, Peri A, Lampertico P, Borghi M, D'Ambrosio R, Degasperi E, Vinci M, Villa E, Bernabucci V, Bristot L, Pereira F, Chessa L, Pasetto MC, Loi M, Gori A, Beretta I, Pastore V, Soria A, Strazzabosco M, Ciaccio A, Gemma M, Borgia G, Foggia A, Zappulo E, Gentile I, Buonomo AR, Abrescia N, Maddaloni A, Caporaso N, Morisco F, Camera S, Donnarumma L, Coppola C, Amoruso DC, Staiano L, Saturnino MR, Coppola N, Martini S, Monari C, Federico A, Dallio M, Loguercio C, Gaeta GB, Brancaccio G, Nardone G, Sgamato C, D'Adamo G, Alberti A, Gonzo M, Piovesan S, Chemello L, Buggio A, Cavalletto L, Barbaro F, Castelli E, Floreani A, Cazzagon N, Franceschet I, Russo FP, Zanetto A, Franceschet E, Madonia S, Cannizzaro M, Montalto G, Licata A, Capitano AR, Craxì A, Petta S, Calvaruso V, Rini F, Ferrari C, Negri E, Orlandini A, Pesci M, Bruno R, Lombardi A, Zuccaro V, Gulminetti R, Asti A, Villaraggia M, Mondelli M, Ludovisi S, Baldelli F, Di Candilo F, Parruti G, Di Stefano P, Sozio F, Gizzi MC, Brunetto MR, Colombatto P, Coco B, Surace L, Foti G, Pellicano S, Fornaciari G, Schianchi S, Vignoli P, Massari M, Corsini R, Garlassi E, Ballardini G, Andreoni M, Cerva C, Angelico M, Gasbarrini A, Siciliano M, De Siena M, Nosotti L, Taliani G, Biliotti E, Santori M, Spaziante M, Tamburini F, Vullo V, D'Ettorre G, Cavallari EN, Gebremeskel TS, Pavone P, Cauda R, Cingolani A, Lamonica S, D'Offizi G, Lionetti R, Visco Comandini U, Grieco A, D'Aversa F, Picardi A, De Vincentis A, Galati G, Gallo P, Dell'Unto C, Aghemo A, Gatti Comini A, Persico M, Masarone M, Anselmo M, De Leo P, Marturano M, Brunelli E, Ridolfi F, Schimizzi AM, Ayoubi Khajekini M, Framarin L, Di Perri G, Cariti G, Boglione L, Cardellino C, Marinaro L, Saracco GM, Ciancio A, Toniutto P, Alterini G, Capra F, Ieluzzi D., Marcellusi, A., Viti, R., Kondili, L. A., Rosato, S., Vella, S., Mennini, F. S., Quaranta, M. G., Tosti, M. E., Weimer, L. E., Ferrigno, L., D'Angelo, F., Falzano, L., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Dileo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, P., Rimenti, G., Rossini, A., Contessi, G. B., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, L., Quintieri, F., Desiena, M., Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall'Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., Delpin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, F., Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., Dibiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, C., Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D'Arminiomonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Vinci, M., Villa, E., Bernabucci, V., Bristot, L., Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, A., Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D'Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, E., Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, M., Montalto, G., Licata, A., Capitano, A. R., Craxi, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, P., Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, A., Siciliano, M., De Siena, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D'Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, R., Cingolani, A., Lamonica, S., D'Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, A., D'Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, P., Dell'Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, M., Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L.A., Quaranta, M.G., Tosti, M.E., Weimer, L.E., D’Angelo, F., Schiadà, L., Di&nbsp, Leo, A., Contessi, G.B., De&nbsp, Siena, M., Foschi, F.G., Dall’Aglio, A.C., Del&nbsp, Pin, B., Zignego, A.L., Cela, E.M., Santantonio, T.A., Bruno, S.R., Alessandrini, A.I., Biagio, A., Nicolini, L.A., Rumi, M.G., D’Arminio&nbsp, Monforte, A., D’Ambrosio, R., Pasetto, M.C., Buonomo, A.R., Amoruso, D.C., Saturnino, M.R., Gaeta, G.B., D’Adamo, G., Russo, F.P., Capitano, A.R., Craxì, A., Gizzi, M.C., Brunetto, M.R., D’Ettorre, G., Cavallari, E.N., Gebremeskel, T.S., D’Offizi, G., D’Aversa, F., Dell’Unto, C., Schimizzi, A.M., Saracco, G.M., Cosco, Alfredo, Dall’Aglio, A. C., Salomoni, Valentina, Nicolini, Elvira, Calvi, Marta, Soria, Giovanni, D'Adamo, Danilo, ALONSO ALBERTI, MARIA PALOMA CARMEN, Orlandini, Giovanni, DE ASTIS, Fabio, Sozio, Concetta, Terzini, Angelico, DE SIENA, ANDREA URIEL, Taliani, Sabrina, Spaziante, Agata, Lamonica, Emilia, and Capra, Carlo

Subjects
Liver Cirrhosis, Pediatrics, Time Factors, Settore MED/09 - Medicina Interna, National Health Programs, ERADICATION, OUTBREAK, antiviral treatment, anti HCV, economic consequences, Hepacivirus, LIVER FIBROSIS, Severity of Illness Index, Health Services Accessibility, COST-EFFECTIVENESS, Indirect costs, 0302 clinical medicine, Epidemiology, virus infection, 030212 general & internal medicine, health care economics and organizations, cost effectiveness, 030503 health policy & services, Health Policy, Health services research, health, Hepatitis C, Markov Chains, chronic hepatitis C, virus infection, fibrosis progression, cost effectiveness, liver fibrosis, Italy, Pharmacology, Public Health, Environmental and Occupational Health, Cohort, Settore SECS-P/03 - Scienza delle Finanze, Disease Progression, Public Health, 0305 other medical science, Viral hepatitis, Anti-HCV antiviral treatment, CHRONIC HEPATITIS-C, medicine.medical_specialty, Genotype, Settore MED/12 - GASTROENTEROLOGIA, VIRUS-INFECTION, Antiviral Agents, NO, 03 medical and health sciences, Cost Savings, Humans, medicine, MANAGEMENT, chronic hepatitis C, INDUCED DISEASES, METAANALYSIS, Health economics, business.industry, Public health, Environmental and Occupational Health, medicine.disease, FIBROSIS PROGRESSION, business
Abstract

OBJECTIVE:\ud We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.\ud \ud METHODS:\ud A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.\ud \ud RESULTS:\ud The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively.\ud \ud CONCLUSIONS:\ud This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV.

Published
2019

6. Missed opportunities to prevent mother-to-child transmission of HIV in Italy

Author

Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, Tk., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E, De Martino, M, Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Chiappini, E., Gervaso, P., Montagnani, C., De Martino, M., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, Pa., Silvestro, E., Virano, S., Portelli, V., Pellegatta, A., Di Biagio, A., Taramasso, L., Gustinetti, G., Burastero, G., Giacomet, V., La Rovere, D., Genovese, O., Giaquinto, C., Rampon, O., Carloni, I., Hyppolite, T. K., Palandri, L., Bernardi, S., Bruzzese, E., Badolato, R., Gabiano, C., Chiappini, E., De Martino, M., Galli, L., Osimani, P., Larovere, D., Ruggeri, M., Pession, A., Faldella, G., Capra, F., Pulcini, S., Zattoni, V., Dotta, L., Aliffi, A., Anastasio, E., Fiumana, E., Gervaso, P., Montagnani, C., Viscoli, C., Erba, P., Zuccotti, G., Benincaso, A., Salvini, F., Lipreri, R., Esposito, S., Plebani, A., Tagliabue, C., Giubbarelli, F., Nicastro, E., Lo Vecchio, A., Buffolano, W., Agnese, M., Romano, A., Marcello, S., Pennazzato, M., Consolini, R., Dodi, I., Zanaboni, D., Palma, P., Pontrelli, G., Tchidjou, H., Mazza, A., Tovo, P. A., Silvestro, E., Virano, S., Portelli, V., and Pellegatta, A.

Subjects
Male, 0301 basic medicine, Pediatrics, newborns, medicine.medical_treatment, children, HIV, missed opportunities, mothers, pregnancy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Health Services Accessibility, Health Policy, Infectious Diseases, Pharmacology (medical), 0302 clinical medicine, newborn, Childbirth, Registries, 030212 general & internal medicine, Pregnancy Complications, Infectious, Transmission (medicine), mother, virus diseases, Settore MED/38, children, HIV, missed opportunities, mothers, newborns, pregnancy, Italy, Female, medicine.medical_specialty, Mother to child transmission, Anti-HIV Agents, Prenatal care, Risk Assessment, 03 medical and health sciences, medicine, Humans, Caesarean section, Peripartum Period, Pregnancy, Cesarean Section, business.industry, Infant, Newborn, Infant, medicine.disease, 030112 virology, Infectious Disease Transmission, Vertical, missed opportunitie, business
Abstract

OBJECTIVES: Vertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother-to-child transmission of HIV. METHODS: The Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. RESULTS: We found 79 HIV-1-infected children newly diagnosed after birth in Italy. Thirty-two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty-one newborns received antiretroviral prophylaxis and 39 received infant formula. CONCLUSIONS: We found an unacceptable number of missed opportunities to prevent mother-to-child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns.

Published
2019

17. Treatment of 320 genotype 3 cirrhotic patients with 12 weeks Sofosbuvir/Velpatasvir with or without ribavirin: real life experience from Italy

Author

Pasulo, L., primary, Gambato, M., additional, Spinetti, A., additional, D’Ambrosio, R., additional, Puoti, M., additional, Ciancio, A., additional, Di Marco, V., additional, Calvaruso, V., additional, Colombatto, P., additional, Brunetto, M., additional, Schiavini, M., additional, Fabris, P., additional, Sacchi, P., additional, Gulminetti, R., additional, Carolo, G., additional, Scotton, P., additional, Pozzan, C., additional, Vinci, M., additional, Viganò, M., additional, Lombardi, A., additional, Bello, S. Lo, additional, Zuin, M., additional, Aghemo, A., additional, Rumi, M.G., additional, Carrara, M., additional, Manfrin, V., additional, Uberti-Foppa, C., additional, Panese, S., additional, Paon, V., additional, Pan, A., additional, Spinelli, O., additional, D’Arminio Monforte, A., additional, Colli, A., additional, Spinzi, G., additional, Russo, F.P., additional, Chemello, L., additional, Vincenzi, V., additional, Grossi, P., additional, Buscarini, E., additional, Cardaci, G., additional, Soria, A., additional, Menzaghi, B., additional, Mendeni, M., additional, Soffredini, R., additional, Colpani, M., additional, Zaltron, S., additional, Gori, A., additional, Del Poggio, P., additional, Giorgini, A., additional, Cologni, G., additional, Cartabellotta, F., additional, Di Lorenzo, F., additional, Cacciola, I., additional, Albanese, A., additional, Di Rosolini, M.A., additional, Digiacomo, A., additional, Capretti, A., additional, Memoli, M., additional, Rossi, C., additional, Cavalletto, L., additional, Capra, F., additional, Colombo, A.E., additional, Dibenedetto, C., additional, Magni, C.F., additional, Noventa, F., additional, Lampertico, P., additional, Castelli, F., additional, Alberti, A., additional, and Fagiuoli, S., additional

Published
2019
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18. Efficacy and safety of Elbasvir/Grazoprevir in a large real-life cohort of HCV-infected patients

Author

Gambato, M., primary, Spinetti, A., additional, Pasulo, L., additional, D’ambrosio, R., additional, Puoti, M., additional, Schiavini, M., additional, Fabris, P., additional, Sacchi, P., additional, Gulminetti, R., additional, Carolo, G., additional, Scotton, P., additional, Franceschet, I., additional, Vinci, M., additional, Viganò, M., additional, Lobello, S., additional, Zuin, M.G., additional, Aghemo, A., additional, Rumi, M., additional, Carrara, M., additional, Manfrin, V., additional, Uberti-Foppa, C., additional, Panese, S., additional, Cattelan, F., additional, Paon, V., additional, Pan, A., additional, Spinelli, O., additional, Monforte, A. D’arminio, additional, Colli, A., additional, Spinzi, G., additional, Russo, F.P., additional, Chemello, L., additional, Vincenzi, V., additional, Grossi, P.A., additional, Buscarini, E., additional, Cardaci, G., additional, Soria, A., additional, Menzaghi, B., additional, Mendeni, M., additional, Degasperi, E., additional, Soffredini, R., additional, Colpani, M., additional, Comi, L., additional, Zuccaro, V., additional, Zaltron, S., additional, Gori, A., additional, Del Poggio, P., additional, Giorgini, A., additional, Capretti, A., additional, Memoli, M., additional, Pigozzi, M.G., additional, Rossi, M.C., additional, Cavalletto, L., additional, Capra, F., additional, Colombo, A., additional, Dibenedetto, C., additional, Landonio, S., additional, Noventa, F., additional, Lampertico, P., additional, Castelli, F., additional, Alberti, A., additional, and Fagiuoli, S., additional

Published
2019
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19. Effectiveness and safety of Sofosbuvir/Velpatasvir/Voxilaprevir for retreatment of chronic hepatitis C patients with a previous failure to direct-acting antivirals: a real-life study from the Navigatore Lombardia and Veneto Networks

Author

Degasperi, E., primary, Spinetti, A., additional, Lombardi, A., additional, Landonio, S., additional, Scotton, P., additional, Pasulo, L., additional, Carlotto, A., additional, Giorgini, A., additional, Pozzoni, P., additional, Angeli, P., additional, Carrara, M., additional, Puoti, M., additional, Gatti, F., additional, Carolo, G., additional, Vinci, M., additional, Zoncada, A., additional, Bonfanti, P., additional, Aghemo, A., additional, Soria, A., additional, Centenaro, R., additional, Maggiolo, F., additional, Russo, F.P., additional, Rovere, P., additional, Piovesan, S., additional, Capra, F., additional, Viviani, F., additional, Morini, L., additional, Soffredini, R., additional, Carriero, C., additional, Paolucci, S., additional, Noventa, F., additional, Alberti, A., additional, Lampertico, P., additional, and Fagiuoli, S., additional

Published
2019
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24. Non-alcoholic fatty liver disease is omega-6 fatty acids diet dipendent in a group of obese children

Author

Dalbeni, A., primary, Mantovani, A., additional, Tagetti, A., additional, Bonafini, S., additional, Paon, V., additional, Gaudino, R., additional, Montagnana, M., additional, Danese, E., additional, Donato, A., additional, Minuz, P., additional, Maffeis, C., additional, Antoniazzi, F., additional, Capra, F., additional, and Fava, C., additional

Published
2018
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25. HCC recurrence under all-oral DAAs-based antiviral therapy in HCV-infected patients: data from Navigatore web platform

Author

Gambato, M., primary, Russo, F.P., additional, Piovesan, S., additional, Romano, A., additional, Zanetto, A., additional, Anastassopoulos, G., additional, Capra, F., additional, Paon, V., additional, Franceschet, I., additional, Carlotto, A., additional, Storato, S., additional, De Bona, M., additional, Rovere, P., additional, Manuppelli, C., additional, Giordani, M.T., additional, Lomonaco, L., additional, Angeli, P., additional, Alberti, A., additional, and Burra, P., additional

Published
2018
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27. Effectiveness and safety of DAA treatment for recurrent hepatitis C after liver transplantation: The NAVIGATOR Lombardia-Veneto network

Author

Invernizzi, F., primary, Pasulo, L., additional, Aghemo, A., additional, Puoti, M., additional, Zaltron, S., additional, Maggiolo, F., additional, Rizzardini, G., additional, Fargion, S., additional, Sacchi, P., additional, Gulminetti, R., additional, Zuin, M., additional, Quirino, T., additional, Rumi, M.G., additional, Pan, A., additional, Grossi, P., additional, Rossini, A., additional, Corbellini, A., additional, Uberti Foppa, C., additional, Belli, L., additional, Piovesan, S., additional, Angeli, P., additional, Chemello, L., additional, Russo, F.P., additional, Burra, P., additional, Vincenzi, V., additional, Cattelan, A.M., additional, Carolo, G., additional, Capra, F., additional, Carlotto, G., additional, Rovere, P.A., additional, Lobello, S., additional, Scotton, P., additional, Panese, S., additional, Fabris, P., additional, Alberti, A., additional, Lampertico, P., additional, and Fagiuoli, S., additional

Published
2018
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28. Evolution of HCV treatments with direct acting antivirals between 2014 and 2017 in 8637 HCV patients in a real world setting: A report from the Lombardia Network and Navigator Study Group

Author

Degasperi, E., primary, Pasulo, L., additional, Aghemo, A., additional, Puoti, M., additional, Zaltron, S., additional, Maggiolo, F., additional, Rizzardini, G., additional, Fargion, S., additional, Sacchi, P., additional, Gulminetti, R., additional, Zuin, M., additional, Quirino, T., additional, Rumi, M.G., additional, Pan, A., additional, Grossi, P., additional, Rossini, A., additional, Corbellini, A., additional, Uberti Foppa, C., additional, Colli, A., additional, Piovesan, S., additional, Angeli, P., additional, Chemello, L., additional, Russo, F.P., additional, Burra, P., additional, Vincenzi, V., additional, Cattelan, A.M., additional, Carolo, G., additional, Capra, F., additional, Carlotto, G., additional, Rovere, P.A., additional, Lobello, S., additional, Scotton, P., additional, Panese, S., additional, Fabris, P., additional, Alberti, A., additional, Lampertico, P., additional, and Fagiuoli, S., additional

Published
2018
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29. Effect of an exercise programme for the prevention of back and neck pain in poultry slaughterhouse workers

Author

BERTOZZI, LUCIA, Villafañe JH, Capra F, Reci M, PILLASTRINI, PAOLO, Bertozzi L, Villafañe JH, Capra F, Reci M, and Pillastrini P

Subjects
Adult, Male, Neck Pain, neck pain work, Middle Aged, Poultry, Exercise Therapy, Occupational Diseases, Disability Evaluation, Treatment Outcome, Occupational Therapy, Animals, Humans, prevention and control, Female, Musculoskeletal Diseases, MUSCULOSKELETAL DISORDERS, Exercise, Low Back Pain, Abattoirs, Pain Measurement, Program Evaluation
Abstract

The objectives of this study were to determine the effectiveness of a programme of prevention exercises conducted in a corporate environment in poultry industry slaughterers suffering from musculoskeletal disorders. Forty workers, 70% female (mean ± SD age: 44.4 ± 8.4 years) were consecutively, in an alternative way, assigned to one of two groups receiving either set of 10 sessions (experimental or control group). The experimental group followed an exercise programme for a period of five weeks and a protocol of home exercises. The control group performed the exercise protocol only at home. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) to measure disability, the Visual Analogue Scale (VAS) score and the Pain Drawing to measure pain were used as outcome evaluations. A significant effect of time interaction (all P

Published
2014

32. Refined histopathological predictors of BRCA1\ud and BRCA2 mutation status: a large-scale analysis\ud of breast cancer characteristics from the BCAC,\ud CIMBA, and ENIGMA consortia

Author

Spurdle, A.B., Couch, F.J., Parsons, M.T., McGuffog, L., Barrowdale, D., Bolla, M.K., Wang, Q., Healey, S., Schmutzler, R.K., Wappenschmidt, B., Rhiem, K., Hahnen, E., Engel, C., Meindl, A., Ditsch, N., Arnold, N., Plendl, H., Niederacher, D., Sutter, C., Wang-Gohrke, S., Steinemann, D., Preisler-Adams, S., Kast, K., Varon-Mateeva, R., Ellis, S., Frost, D., Platte, R., Perkins, J., Evans, D.G., Izatt, L., Eeles, R., Adlard, J., Davidson, R., Cole, T., Scuvera, G., Manoukian, S., Bonanni, B., Mariette, F., Fortuzzi, S., Viel, A., Pasini, B., Papi, L., Varesco, L., Balleine, R., Nathanson, K.L., Domchek, S.M., Offitt, K., Jakubowska, A., Lindor, N., Thomassen, M., Jensen, U.B., Rantala, J., Borg, A., Andrulis, I.L., Miron, A., Hansen, T.V.O., Caldes, T., Neuhausen, S.L., Toland, A.E., Nevanlinna, H., Montagna, M., Garber, J., Godwin, A.K., Osorio, A., Factor, R.E., Terry, M.B., Rebbeck, T.R., Karlan, B.Y., Southey, M., Rashid, M.U., Tung, N., Pharoah, P.D.P., Blows, F.M., Dunning, A.M., Provenzano, E., Hall, P., Czene, K., Schmidt, M.K., Broeks, A., Cornelissen, S., Verhoef, S., Fasching, P.A., Beckmann, M.W., Ekici, A.B., Slamon, D.J., Bojesen, S.E., Nordestgaard, B.G., Nielsen, S.F., Flyger, H., Chang-Claude, J., Flesch-Janys, D., Rudolph, A., Seibold, P., Aittomaki, K., Muranen, T.A., Heikkila, P., Blomqvist, C., Figueroa, J., Chanock, S.J., Brinton, L., Lissowska, J., Olson, J.E., Pankratz, V.S., John, E.M., Whittemore, A.S., West, D.W., Hamann, U., Torres, D., Ulmer, H.U., Rudiger, T., Devilee, P., Tollenaar, R.A.E.M., Seynaeve, C., Van Asperen, C.J., Eccles, D.M., Tapper, W.J., Durcan, L., Jones, L., Peto, J., dos-Santos-Silva, I., Fletcher, O., Johnson, N., Dwek, M., Swann, R., Bane, A.L., Glendon, G., Mulligan, A.M., Giles, G.G., Milne, R.L., Baglietto, L., McLean, C., Carpenter, J., Clarke, C., Scott, R., Brauch, H., Bruning, T., Ko, Y-D., Cox, A., Cross, S.S., Reed, M.W.R., Lubinski, J., Jaworska-Bieniek, K., Durda, K., Gronwald, J., Dork, T., Bogdanova, N., Park-Simon, T-W., Hillemanns, P., Haiman, C.A., Henderson, B.E., Schumacher, F., Le Marchand, L., Burwinkel, B., Marme, F., Surovy, H., Yang, R., Anton-Culver, H., Ziogas, A., Hooning, M.J., Collee, J.M., Martens, J.W.M., Tilanus-Linthorst, M.M.A., Brenner, H., Dieffenbach, A.K., Arndt, V., Stegmaier, C., Winqvist, R., Pylkas, K., Jukkola-Vuorinen, A., Grip, M., Lindblom, A., Margolin, S., Joseph, V., Robson, M., Rau-Murthy, R., Gonzalez-Neira, A., Arias, J.I., Zamora, P., Benitez, J., Mannermaa, A., Kataja, V., Kosma, V-M., Hartikainen, J.M., Peterlongo, P., Zaffaroni, D., Barile, M., Capra, F., Radice, P., Teo, S.H., Easton, D.F., Antoniou, A.C., Chenevix-Trench, G., Goldgar, D.E., Investigators, ABCTB, Group, EMBRACE, Network, GENICA, Group, HEBON, and Investigators, KConFab

Subjects
endocrine system diseases, skin and connective tissue diseases
Abstract

Introduction: The distribution of histopathological features of invasive breast tumors in BRCA1 or BRCA2 germline\ud mutation carriers differs from that of individuals with no known mutation. Histopathological features thus have\ud utility for mutation prediction, including statistical modeling to assess pathogenicity of BRCA1 or BRCA2 variants of\ud uncertain clinical significance. We analyzed large pathology datasets accrued by the Consortium of Investigators of\ud Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC) to reassess histopathological\ud predictors of BRCA1 and BRCA2 mutation status, and provide robust likelihood ratio (LR) estimates for statistical\ud modeling.\ud Methods: Selection criteria for study/center inclusion were estrogen receptor (ER) status or grade data available for\ud invasive breast cancer diagnosed younger than 70 years. The dataset included 4,477 BRCA1 mutation carriers, 2,565\ud BRCA2 mutation carriers, and 47,565 BCAC breast cancer cases. Country-stratified estimates of the likelihood of\ud mutation status by histopathological markers were derived using a Mantel-Haenszel approach.\ud Results: ER-positive phenotype negatively predicted BRCA1 mutation status, irrespective of grade (LRs from 0.08 to\ud 0.90). ER-negative grade 3 histopathology was more predictive of positive BRCA1 mutation status in women 50 years\ud or older (LR = 4.13 (3.70 to 4.62)) versus younger than 50 years (LR = 3.16 (2.96 to 3.37)). For BRCA2, ER-positive grade 3\ud phenotype modestly predicted positive mutation status irrespective of age (LR = 1.7-fold), whereas ER-negative grade 3\ud features modestly predicted positive mutation status at 50 years or older (LR = 1.54 (1.27 to 1.88)). Triple-negative tumor\ud status was highly predictive of BRCA1 mutation status for women younger than 50 years (LR = 3.73 (3.43 to 4.05)) and\ud 50 years or older (LR = 4.41 (3.86 to 5.04)), and modestly predictive of positive BRCA2 mutation status in women 50 years\ud or older (LR = 1.79 (1.42 to 2.24)).\ud Conclusions: These results refine likelihood-ratio estimates for predicting BRCA1 and BRCA2 mutation status by using\ud commonly measured histopathological features. Age at diagnosis is an important variable for most analyses, and grade is\ud more informative than ER status for BRCA2 mutation carrier prediction. The estimates will improve BRCA1 and BRCA2\ud variant classification and inform patient mutation testing and clinical management.

Published
2014

33. Effectiveness of a physiotherapy program in the management of musculoskeletal disorders in hairdressers

Author

BERTOZZI, LUCIA, PILLASTRINI, PAOLO, Capra F., Barducci C., Bertozzi L., Capra F., Barducci C., and Pillastrini P.

Subjects
WORK-RELATED MUSCULOSKELETAL DISORDERS, HAIRDRESSERS, LOW BACK PAIN, NECK PAIN, EXERCISE PROGRAM
Abstract

Background. Hairdressers are considered a high risk category to develop musculoskeletal disorders. Some studies suggest that these musculoskeletal disorders are mainly located in the upper limbs, the lumbar and cervical spine. Objective. The aim of the study was to determine the effectiveness of physiotherapy exercise program in the prevention and management of musculoskeletal disorders in hairdressers. Study design. A Cluster Randomized Controlled Trial was utilized. Methods. Twenty-eight hairdressers working in nine shops were randomly divided into two groups, with each shop as a unit of randomization. All the hairdressers in both groups received an ergonomic brochure; the exercise program was conducted by a physical therapist. Data were collected at baseline and at a six weeks follow-up. The primary and secondary outcome measure recorded was the level of disability (Roland Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI) and the pain using a Visual Analogue Scale (VAS). Results. The comparison between the two groups (Experimental vs Control) at baseline and at follow-up report no significant differences regarding RMDQ; we found a more positive response in the control group in ODI evaluation, while the 42.86% of patients treated reported an improvement in the VAS for lumbar pain and the 28,58% of them reported an improvement in the VAS for neck pain. Conclusions. This study seems to suggest that exercise program, conducted in the occupational setting by a physiotherapist, can be useful in the prevention and management in reducing LBP among hairdressers.

Published
2011

34. Acute Hepatitis Caused by Green Tea Infusion: A Case Report

Author

Capra F, R Leone, Paon, Guzzo F, L Magro, Conforti A, E. Arzenton, and Apostoli P

Subjects
Abdominal pain, medicine.diagnostic_test, business.industry, Bilirubin, Metabolite, food and beverages, Catechin, Pharmacology, chemistry.chemical_compound, chemistry, Polyphenol, Liver biopsy, General Earth and Planetary Sciences, Medicine, Camellia sinensis, medicine.symptom, business, Liver function tests, General Environmental Science
Abstract

The green tea is obtained by an unfermented process of leaves of Camellia sinensis and the main chemical components are polyphenols, particularly epigallocatechin-3-gallate and epicatechin-3-gallate that could be associated to adverse hepatic reactions. We present a case of acute hepatitis caused by the use of green tea.A 62-year-old woman was hospitalized because of the persistent high levels of liver function tests. After the hospitalization a lot of instrumental exams and blood checks were performed. The search of metallic elements in the used green tea infusions was performed using an inductively coupled-plasma mass spectrometry; high performance liquid chromatography-electro spray ionization-mass spectrometry analysis was done to characterize the metabolite profiles of the infusions of green tea. The blood check showed in particular alanine aminotransferase (780 U/L) and total bilirubin (1.15 mg/dL) levels abnormal. The abdominal echography and other blood parameters were normal, but liver biopsy described a “drug toxic damage”. Every day over the previous 9 months the patient drank two or three cups of several brands of green tea infusions and she stopped this behavior when abdominal pain was persistent. Her medical history didn’t report the use of other drugs or toxic products. After four months of stopping the use of green tea infusions, the liver function tests were normalized. The presence of metallic elements in tea infusion cannot justify the observed liver toxicity in our patient. Instead, the highest levels of epigallo catechin methyl gallate derived from epigallocatechin-3-gallate observed in one of the samples consumed by the patient, arise a possible correlation between some of the catechins in green tea and the hepatotoxic effect. It is conceivable that the mechanism of damage can be idiosyncratic-metabolic or allergic.

Published
2014

35. Chronic hepatitis B in Italy: New features of an old disease - Approaching the universal prevalence of hepatitis B e antigen-negative cases and the eradication of hepatitis D infection

Author

Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Imparato, Michele, Almasio, Piero L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Imparato, Michele, Almasio, Piero L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M.

Subjects
Liver Cirrhosis, Adult, Male, Microbiology (medical), medicine.medical_specialty, Cirrhosis, Adolescent, Hepatitis D, Chronic, Hepatitis C virus, Hepacivirus, Liver Cirrhosi, medicine.disease_cause, Gastroenterology, Virus, Flaviviridae, Hepatitis B, Chronic, Seroepidemiologic Studies, Internal medicine, medicine, Humans, Hepatitis B e Antigens, Aged, Aged, 80 and over, Cross-Sectional Studie, Hepaciviru, biology, business.industry, Seroepidemiologic Studie, Hepatitis Delta Viru, Hepatitis B, Middle Aged, medicine.disease, biology.organism_classification, Hepatitis D, Virology, Alcoholism, Cross-Sectional Studies, Infectious Diseases, Italy, Disease Progression, Female, Hepatitis B e Antigen, Hepatitis D virus, Hepatitis Delta Virus, business, Human
Abstract

We evaluated 1336 hepatitis B surface antigen-positive subjects consecutively observed in 79 Italian hospitals over a 6-month period. The proportion of hepatitis B e antigen-negative cases was 86.4%, that of patients coinfected with hepatitis D virus was 9.7%, and the rate of patients coinfected with hepatitis C virus was 16.8%. Multiple logistic regression analysis showed that age >49 years, alcohol abuse, and anti-hepatitis D virus and anti-hepatitis C virus positivity were independent predictors of progression to liver cirrhosis. © 2007 by the Infectious Diseases Society of America. All rights reserved.

Published
2008

36. The importance of HCV on the burden of chronic liver disease in Italy: a multicenter prevalence study of 9,997 cases

Author

Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Almasio, Piero, Coppola, Nicola, Ferrigno, Luigina, Scolastico, Carlo, Onofrio, Mirella, Imparato, Michele, Filippini, Pietro, Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Comandino, U. Visco, Gallo, A. I., Festi, D., Sabusco, G., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Furgiuele, P. L., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioni, S., Lai, M., Spanneda, M., SAGNELLI E, STROFFOLINI T, MELE A, ALMASIO PL, COPPOLA N, FERRIGNO L, SCOLASTICO C, ONOFRIO M, IMPARATO M, FILIPPINI P, Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Almasio, Piero, Coppola, Nicola, Ferrigno, Luigina, Scolastico, Carlo, Onofrio, Mirella, Imparato, Michele, Filippini, Pietro, Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Comandino, U. Visco, Gallo, A.I., Festi, D., Sabusco, G., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Furgiuele, P.L., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioni, S., Lai, M., and Spanneda, M.

Subjects
Adult, Liver Cirrhosis, Male, Hepatitis B virus, HBsAg, Carcinoma, Hepatocellular, Cirrhosis, alcohol abuse, Hepatitis C virus, Hepacivirus, Chronic liver disease, medicine.disease_cause, Risk Factors, Virology, Prevalence, medicine, HBV, Humans, Aged, business.industry, Incidence, Liver Diseases, Liver Neoplasms, Hepatitis C, Middle Aged, Hepatitis B, medicine.disease, Alcoholism, Infectious Diseases, Italy, Hepatocellular carcinoma, Chronic Disease, HCV, Female, Viral hepatitis, business
Abstract

Knowledge of the current epidemiology of chronic liver disease in Italy is mostly obsolete and fragmentary for the lack of up-to-date consistent data. In 2001, a 6-month prevalence study was undertaken in 79 hospitals to assess the characteristics of chronic liver disease in Italy. Both prevalent and incident cases were enrolled. A total of 9,997 patients were recruited, of whom 939 (9.4%) had normal liver biochemistry, 6,210 (62.1%) had chronic hepatitis, 1,940 (19.4%) had liver cirrhosis, and 341 (3.4%) had hepatocellular carcinoma (HCC). In 567 patients (5.7%) the diagnosis was not established. Hepatitis C virus (HCV) was found in 69.9% of the patients and was the only etiological factor in 56.3% of all the patients. Hepatitis B surface antigen (HBsAg) was present in the serum of 13.4% of the cases (in 10% it was the only etiological factor). A history of alcohol abuse was found in 23% of the cases (9.4% without viral infection). The prevalence of HCV-related cases was significantly lower in incident than in prevalent cases (44.9% vs. 59.9%, P < 0.0001), while the proportion of patients with alcohol abuse was much higher in incident than in prevalent cases (18.1% vs. 6.6%, P < 0.0001). These findings indicate that nearly one quarter of patients with chronic liver diseases in Italy have a severe disease such as liver cirrhosis and HCC represents a not negligible burden for the national health system. Hepatitis B fell in importance as an etiological factor. Hepatitis C is the important pathogenic factor for chronic liver disease in Italy. However, a comparison between the prevalent and incident cases suggests that in future HCV infection will also play a progressively decreasing role, in part as a consequence of treatment. © 2005 Wiley-Liss, Inc.

Published
2005

37. The aetiology of chronic hepatitis in Italy: results from a multicentre national study

Author

Stroffolini, T., Sagnelli, E., Mele, A., Craxi, A., Almasio, P., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, Sacchini, Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Pratico, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, Marino, De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frigiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Stroffolini, T, Sagnelli, E, Mele, A, Crax, A, Almasio, P, Coppola, Nicola, Italian Hospitals Collaborating, Group, Filippini, Pietro, Sagnelli, Caterina, STROFFOLINI T, SAGNELLI E, MELE A, CRAXI A, ALMASIO PL, ITALIAN HOSPITALS, COLLABORATING GROUP, Stroffolini, T., Sagnelli, E., Mele, A., Craxì, A., Almasio, P., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frigiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M.

Subjects
Adult, Male, medicine.medical_specialty, HBsAg, Hepatitis D, Chronic, Epidemiology, Hepatitis C virus, Autoimmune hepatitis, medicine.disease_cause, Autoimmune Diseases, Hepatitis B, Chronic, Internal medicine, medicine, Prevalence, Humans, Hepatitis B virus, Hepatology, business.industry, Gastroenterology, Hepatitis C, Hepatitis B, Hepatitis C, Chronic, Middle Aged, medicine.disease, Hepatitis D, HBeAg, Italy, Immunology, Chronic hepatiti, Female, chronic hepatitis, epidemiology, italy, business
Abstract

Background: No recent national-level data on the aetiology of chronic hepatitis are available in Italy. Aim: To evaluate the current aetiology of chronic hepatitis in Italy. Patients: A total of 6210 chronic hepatitis patients (both prevalence and incident cases) consecutively admitted to 79 hospitals located throughout Italy were enrolled over a 6-month period in 2001. The hospitals were randomly selected through systematic cluster sampling. Results: The main agent associated with chronic hepatitis was hepatitis C virus, which was found in 76.5% of the patients (in 62.6% it was the only aetiologic factor). Hepatitis B surface antigen was present in the serum of 12.2% of the cases (in 9.2% it was the only aetiologic factor). Hepatitis B e antigen and hepatitis Delta were detected in 16.6% and 7.0%, respectively, of hepatitis B surface antigen-positive patients. A history of alcohol abuse was found in 19.2% of the cases (5.5% without viral infection). Autoimmune hepatitis and inborn metabolic disorders were extremely rare. The prevalence of hepatitis C virus-related cases was significantly lower in incident cases, compared to prevalent cases (55.1% versus 65.0%; p < 0.01). The mean alanine aminotransferase level was significantly higher in hepatitis B surface antigen-positive patients, compared to hepatitis B surface antigen-negative patients. The histology was less severe in non-viral-related cases. Conclusions: Hepatitis C virus is the most important pathogenic factor for chronic hepatitis in Italy; however, the comparison between prevalent and incident cases suggests that this infection will play a less important role in the future. A comparison with previous reports shows that both hepatitis B virus-related and hepatitis Delta virus-related cases are decreasing. © 2004 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Published
2004

41. Rare variants in XRCC2 as breast cancer susceptibility alleles

Author

Hilbers, F.S., Wijnen, J.T., Hoogerbrugge, N., Oosterwijk, J.C., Collee, M.J., Peterlongo, P., Radice, P., Manoukian, S., Feroce, I., Capra, F., Couch, F.J., Wang, X.S., Guidugli, L., Offit, K., Shah, S., Campbell, I.G., Thompson, E.R., James, P.A., Trainer, A.H., Gracia, J., Benitez, J., Asperen, C.J. van, Devilee, P., Damage and Repair in Cancer Development and Cancer Treatment (DARE), Targeted Gynaecologic Oncology (TARGON), Internal Medicine, and Clinical Genetics

Subjects
Hereditary cancer and cancer-related syndromes [ONCOL 1], MUTATIONS, Hereditary cancer and cancer-related syndromes Genetics and epigenetic pathways of disease [ONCOL 1], Breast Neoplasms, BRCA1, DNA-Binding Proteins, MICE, Open Reading Frames, SDG 3 - Good Health and Well-being, SUBSTITUTIONS, Translational research [ONCOL 3], Mutation, Humans, Female, Genetic Predisposition to Disease, skin and connective tissue diseases, Alleles
Abstract

Item does not contain fulltext BACKGROUND: Recently, rare germline variants in XRCC2 were detected in non-BRCA1/2 familial breast cancer cases, and a significant association with breast cancer was reported. However, the breast cancer risk associated with these variants needs further evaluation. METHODS: The coding regions and exon-intron boundaries of XRCC2 were scanned for mutations in an international cohort of 3548 non-BRCA1/2 familial breast cancer cases and 1435 healthy controls using various mutation scanning methods. Predictions on functional relevance of detected missense variants were obtained from three different prediction algorithms. RESULTS: The only protein-truncating variant detected was found in a control. Rare non-protein-truncating variants were detected in 20 familial cases (0.6%) and nine healthy controls (0.6%). Although the number of variants predicted to be damaging or neutral differed between prediction algorithms, in all instances these categories were evenly represented among cases and controls. CONCLUSIONS: Our data do not confirm an association between XRCC2 variants and breast cancer risk, although a relative risk smaller than two could not be excluded. Variants in XRCC2 are unlikely to explain a substantial proportion of familial breast cancer.

Published
2012

47. Pancolitis with Ischemic Injury as a Complication of Immunosuppressive Treatment in a Patient with Autoimmune Hepatitis: A Case Report

Author

Dalbeni, A., Capoferro, E., Bernardoni, L., Capelli, P., Caliò, A., Gabbrielli, A., and Capra, F.

Subjects
Article Subject
Abstract

Ischemic colitis is a serious drug-induced adverse event. There are only few cases of immunosuppression-associated ischemic colitis described in the literature, but none with a pancolitis-like manifestation. We report the case of a 72-year-old female patient who developed a pancolitis with ischemic injury on immunosuppressive treatment with steroids and azathioprine for autoimmune hepatitis. The patient presented with massive rectal bleeding. Colonoscopy confirmed the diagnosis of pancolitis. The results of histological examination indicated drug-induced ischemic colitis involving the entire colon. This is the first case of ischemic pancolitis mimicking an inflammatory bowel disease (IBD) in a patient with immunosuppressive therapy.

Published
2012
Full Text
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48. HCV infection is a risk factor for gallstone disease in liver cirrhosis: an Italian epidemiological survey. J Viral Hepat

Author

Stroffolini, T., Sagnelli, E., Mele, A., Cottone, C., Almasio, Pl, Traverso, ., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Marino PAROLI, Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Sabusco, D. G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M.

Published
2007

49. Characteristics of HCV positive subjects referring to hospitals in Italy: a multicentre prevalence study on 6,999 cases

Author

Stroffolini, T., Sagnelli, E., Mariano, A., Craxí, A., Almasio, P., Traverso, ., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Marino PAROLI, Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Sabusco, D. G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, Nicola, Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M.

Published
2006

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