Position paper on the role of Internal Medicine in the management of hepatitis C virus infection (screening, diagnosis, linkage-to-care, treatment)

  • Giorgio Ballardini Internal Medicine Department, Ospedale degli Infermi, Rimini, Italy.
  • Francesco Bandiera Internal Medicine Department, SS. Annunziata Hospital, Sassari, Italy.
  • Luca Fontanella Internal Medicine Department, Buonconsiglio Fatebenefratelli Hospital, Napoli, Italy.
  • Antonio Mancini Internal Medicine Department, Careggi Hospital, Firenze, Italy.
  • Giancarlo Parisi Internal Medicine Department, Feltre Hospital (BL), Italy.
  • Paola Piccolo Internal Medicine Department, Fatebenefratelli Hospital, Roma, Italy.
  • Claudio Puoti Epatology Center, INI Institute Grottaferrata (RM), Italy.
  • Giuseppe Zaccala Internal Medicine Department, Ospedale Maggiore della Carità, Novara, Italy.
  • Elisa Zagarrì | elisa.zagarri@fadoi.org FADOI Study Center, Milano, Italy.
  • Giovanni Pappagallo Epidemiology & Clinical Trials Office, General Hospital, Mirano (VE), Italy.
  • Andrea Fontanella Internal Medicine Department, Buonconsiglio Fatebenefratelli Hospital, Napoli, Italy.

Abstract

Since Internal Medicine (IM) is the most frequent setting of hospitalization for both patients with advanced liver disease and those with comorbidities and risk factors for infection, through this position paper FADOI aims to promote and disseminates its vision regarding the current and potential role of IM in managing hepatitis C virus (HCV) infection (screening, diagnosis, linkage-to-care, treatment). The Internist plays an important role in identifying new cases, in selecting the appropriate diagnostic work-up for liver disease staging and prognosis, and in initiating antiviral therapy, coordinating care and communication with other specialists, the Hepatology outpatient clinic and General Practitioners. Since the Internist is naturally accustomed to the management of multiple comorbidities, he has a fundamental role in the identification of extrahepatic diseases associated with HCV infection and in the diagnosis of comorbidities, some of which are potential factors of liver disease progression. Moreover, in the prescription of the antiviral therapy, it is important to consider the possible drug interactions, and this ideally fits the role of the Internist who can weigh the risk/benefit ratio of possible alternatives, by considering the patient’s clinical situation, especially in case of multiple comorbidities. Moreover, it seems appropriate that the ability to prescribe antiviral therapy is guaranteed to all IM hepatology clinics, favoring a spread of awareness as well as an increase in national coverage and therefore patient access to therapies. The network of IM can also contribute to homogenizing the management policies of HCV treatment, which sometimes differ between Italian Regions.

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Published
2020-03-19
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Section
FADOI Position Statement
Keywords:
Internal medicine, hepatitis C virus, hepatitis, infections, FADOI, nominal group technique.
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How to Cite
Ballardini, G., Bandiera, F., Fontanella, L., Mancini, A., Parisi, G., Piccolo, P., Puoti, C., Zaccala, G., Zagarrì, E., Pappagallo, G., & Fontanella, A. (2020). Position paper on the role of Internal Medicine in the management of hepatitis C virus infection (screening, diagnosis, linkage-to-care, treatment). Italian Journal of Medicine, 14(1), 36-42. https://doi.org/10.4081/itjm.2020.1214