Publications by authors named "Loreta A Kondili"
Background And Aims: We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility.
Methods: This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model.
The treatment of hepatitis C virus (HCV) with direct-acting antivirals (DAA) leads to high sustained virological response (SVR) rates, but hepatocellular carcinoma (HCC) risk persists in people with advanced liver disease even after SVR. We weighted the HCC risk in people with cirrhosis achieving HCV eradication through DAA treatment and compared it with untreated participants in the multicenter prospective Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. Propensity matching with inverse probability weighting was used to compare DAA-treated and untreated HCV-infected participants with liver cirrhosis.
View Article and Find Full Text PDFBackground And Aims: Italy has the greatest burden of hepatitis C virus (HCV) infection in Western Europe. The screening strategy represents a crucial prevention tool to achieve HCV elimination in Italy. We evaluated the cost-consequences of different screening strategies for the diagnosis of HCV active infection in the birth cohort 1948-1968 to achieve the HCV elimination goal.
View Article and Find Full Text PDFGiven the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socio-economic and educational levels and are the most affected by liver cancer risk factors.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to estimate the prevalence of chronic Hepatitis C Virus (cHCV) infections in EU/EEA countries for the year 2019, using a method called multi-parameter evidence synthesis (MPES) to analyze data from various sources.
- - In 29 out of 30 EU/EEA countries, the overall cHCV prevalence was found to be 0.50%, with notably higher rates in the eastern EU/EEA (0.88%), and over a third of cases were linked to people who inject drugs (PWID).
- - The findings indicate that while cHCV prevalence is generally low, targeted efforts are needed, particularly in eastern regions and among PWID, to
Background & Aims: Sustained virological response (SVR) by direct-acting antivirals (DAAs) may reverse the hypercoagulable state of HCV cirrhosis and the portal vein thrombosis (PVT) risk. We evaluated the incidence and predictive factors of de novo, non-tumoral PVT in patients with cirrhosis after HCV eradication.
Methods: Patients with HCV-related cirrhosis, consecutively enrolled in the multi-center ongoing PITER cohort, who achieved the SVR using DAAs, were prospectively evaluated.
Background: Italy has a high HCV prevalence, and despite the approval of a dedicated fund for 'Experimental screening' for 2 years, screening has not been fully implemented. We aimed to evaluate the long-term impact of the persisting delay in HCV elimination after the Coronavirus disease 2019 (COVID-19) pandemic in Italy.
Methods: We used a mathematical, probabilistic modelling approach evaluating three hypothetical 'Inefficient', 'Efficient experimental' and 'WHO Target' screening scenarios differing by treatment rates over time.
Article Synopsis
- Italy has the highest rates of hepatitis C virus (HCV) infection and liver cancer deaths in Europe, but new treatments have expanded access, with over 244,000 people treated.
- While HCV-related deaths are expected to drop by 75% by 2030, Italy is at risk of not eliminating HCV completely by that time.
- To improve HCV elimination efforts, recommendations include expanding screening to more populations, raising awareness, ensuring continued access to direct-acting antivirals, and customizing care for high-risk groups.
Article Synopsis
- - Chronic liver diseases, particularly hepatocellular carcinoma (HCC), exhibit a notable gender disparity, with men showing higher incidence rates than women due to factors like risk distribution.
- - The liver demonstrates sexual dysmorphism, highlighting its sensitivity to sex hormones (androgens and estrogens), which influence the development, aggressiveness, and treatment response of HCC.
- - This review aims to explore the factors contributing to the gender differences in HCC incidence, focusing on the significant role of sex hormones in the disease's pathophysiology.
Despite maximizing techniques and patient selection, liver resection and ablation for HCC are still associated with high rates of recurrence. To date, HCC is the only cancer with no proven adjuvant or neoadjuvant therapy used in association to potentially curative treatment. Perioperative combination treatments are urgently needed to reduce recurrence rates and improve overall survival.
View Article and Find Full Text PDFHepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021.
View Article and Find Full Text PDFArticle Synopsis
- - The study assesses a local program aimed at eliminating Hepatitis C virus (HCV) in regions with high infection rates through retrospective and prospective data analysis from a southern Italy health unit (2018-2022).
- - Findings showed that out of nearly 50,000 tested individuals, 2.2% were positive for HCV antibodies without prior RNA testing, and a notable percentage of hospital admissions involved patients with active infections and advanced liver disease.
- - The results highlight the necessity of implementing an active case-finding strategy in hospitals to improve diagnosis and link patients to care, suggesting this approach should be adopted as a standard practice in areas heavily impacted by HCV.
Article Synopsis
- The study analyzed trends in chronic hepatitis B patients in Italy through a multicenter observational cohort (PITER) from 2019-2021, comparing it to an earlier cohort (MASTER) from 2012-2015.
- Key findings revealed that the PITER cohort had older patients and a higher percentage of females, with a significant decline in HBeAg prevalence compared to MASTER, while rates of anti-HD virus remained stable.
- The study concludes that while chronic hepatitis B infection is becoming better managed in Italy, HDV remains a concern, particularly among patients with cirrhosis and non-Italian migrants.
Background And Aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis.
Methods: HCC occurrence was evaluated by Kaplan-Meier analysis.
Article Synopsis
- In 2016, a group called HepBCPPA created a plan called the HCV Elimination Manifesto to try to get rid of Hepatitis C in Europe by 2030.
- Even though some countries have made progress, many are still not on track, especially after COVID-19 slowed down diagnoses and treatments.
- To reach the goal, it's really important for government leaders to work together and support new actions, which was the purpose of the EU Policy Summit in March 2021.
Background: Italy has witnessed high levels of COVID-19 deaths, mainly at the elderly age. We assessed the comorbidity and the biochemical profiles of consecutive patients ≤65 years of age to identify a potential risk profile for death.
Methods: We retrospectively analyzed clinical data from consecutive hospitalized-for-COVID-19 patients ≤65 years, who were died (593 patients) or discharged (912 patients) during February-December 2020.
This study provides an update on hepatitis C virus (HCV) estimates across Italy up to January 2021. A mathematical probabilistic modelling approach, including a Markov chain for liver disease progression, was used to estimate current HCV viraemic burden. Prevalence was defined by geographic area using an estimated annual historical HCV incidence by age, treatment, and migration rate from the Italian National database (ISTAT).
View Article and Find Full Text PDFBackground & Aims: The World Health Organization (WHO) HBV and HCV elimination targets, set in 2016 and based on projections to 2030, were unable to consider the impact of intervening factors. To evaluate the impact of the COVID-19 pandemic on viral hepatitis elimination programs, the European Association for the Study of the Liver (EASL) conducted a survey in liver centers worldwide in 2021.
Methods: A web-based questionnaire was distributed (May-July 2021) to all EASL members representing clinical units providing HBV and HCV hepatitis care.
Free-of-charge HCV screening in some key populations and in 1969-1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linkage to care. A hospital-based HCV screening was conducted as a routine test for in-patients admitted to the Evangelical Hospital Betania of Naples from January 2020 to May 2021.
View Article and Find Full Text PDFBackground: Although an increase in hepatitis C virus (HCV) prevalence from Northern to Southern Italy has been reported, the burden of asymptomatic individuals in different Italian regions is currently unknown.
Methods: A probabilistic approach, including a Markov chain for liver disease progression, was applied to estimate current HCV viraemic burden. The model defined prevalence by geographic area using an estimated annual historical HCV incidence by age, treatment rate, and migration rate from the Italian National database.