0000000000181371

AUTHOR

A Gasbarrini

showing 9 related works from this author

Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?

2018

Abstract Background & Aims Advances in direct‐acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked‐to‐care individuals on overall HCV burden estimates and identified a possible strategy to achieve the WHO targets by 2030. Methods Using a modelling approach grounded in Italian real‐life data of diagnosed and treated patients, different linkage‐to‐care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals. Results Under the 40% linked‐to‐care scenario, viraemic burden would decline (60%); however, eligible patients to treat w…

HCV; WHO; chronic infection; linkage to careLiver Cirrhosismedicine.medical_specialtyCarcinoma HepatocellularSustained Virologic ResponseViral HepatitisSettore MED/12 - GASTROENTEROLOGIAWorld Health OrganizationAntiviral AgentsNO03 medical and health sciencesLiver diseaseWHO0302 clinical medicinePharmacotherapyCost of IllnessCause of DeathHealth caremedicineHumans030212 general & internal medicineViremiachronic infection HCV linkage to care WHODisease EradicationMortalityIntensive care medicineCause of deathlinkage to carechronic infection; HCV; linkage to care; WHODisease EradicationHepatologybusiness.industryPublic healthCarcinomaLiver NeoplasmsHepatocellularHepatitis Cmedicine.diseasechronic infectionHepatitis CMarkov Chainschronic infection; HCV; linkage to care; WHO; Antiviral Agents; Carcinoma Hepatocellular; Cost of Illness; Disease Eradication; Hepatitis C; Humans; Italy; Liver Cirrhosis; Liver Neoplasms; Markov Chains; Mortality; Sustained Virologic Response; Viremia; World Health Organization; Cause of DeathItalychronic infection;HCV;linkage to care;WHOHCVchronic infection; HCV; linkage to care; WHO; Hepatology030211 gastroenterology & hepatologybusinessViral hepatitis
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Modeling cost-effectiveness and health gains of a “universal” versus “prioritized” hepatitis C virus treatment policy in a real-life cohort

2017

We evaluated the cost-effectiveness of two alternative direct-acting antiviral (DAA) treatment policies in a real-life cohort of hepatitis C virus–infected patients: policy 1, “universal,” treat all patients, regardless of fibrosis stage; policy 2, treat only “prioritized” patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and health care system perspective, was applied to the PITER cohort (representative of Italian hepatitis C virus–infected patients in care). Specifically, 8,125 patients naive to DAA treatment, without clinical, sociodemographic, or insurance restrictions, were us…

hepatitis C virusPediatricsCost effectivenessViral HepatitisAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models Economic; HepatologyCost-Benefit AnalysisDirect-acting antiviralAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models EconomicCohort StudiesLiver disease0302 clinical medicineModelsHealth careantiviral therapy80 and overincremental cost-effectiveness ratiohealth care economics and organizationsHCV cost -effectivenessAged 80 and overDirect-acting antiviral hepatocellular carcinoma hepatitis C virus incremental cost-effectiveness ratio interferon quality-adjusted life-years sustained virological response willingness to payCost–benefit analysis030503 health policy & servicesquality-adjusted life-yearsHealth PolicyHepatitis Chepatocellular carcinomainterferonMiddle AgedHepatitis CModels EconomicAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models Economic; Hepatology; HCV; antiviral therapy; cost-effectiveness; real-life cohortCohortHCV030211 gastroenterology & hepatologyOriginal Articlesustained virological response0305 other medical scienceCohort studyHumanAdultmedicine.medical_specialtyEconomicAntiviral AgentsNO03 medical and health sciencesYoung Adultreal-life cohortmedicineHumansCost-Benefit Analysicost-effectivenessHealth policyAgedAntiviral AgentHepatologybusiness.industryOriginal Articlesmedicine.diseaseSurgeryCohort Studiebusinesswillingness to pay
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Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting.

2010

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies.

Liver CirrhosisANTIVIRAL TREATMENTHuman immunodeficiency virus (HIV)HIV InfectionsHepacivirusANTIVIRAL THERAPY; PEGYLATED INTERFERON-ALPHA-2B; LIVER-TRANSPLANTATION; PEGINTERFERON ALPHA-2A; HIV-INFECTED PATIENTS; VIRUS-COINFECTED PATIENTS; RAPID VIROLOGICAL RESPONSEAntiviral therapymedicine.disease_causeGastroenterologyPolyethylene GlycolsHBVguidelinesAcute hepatitisChronic hepatitisSettore MED/12 - Gastroenterologialiver transplantationGastroenterologyAntiviral therapyHepatitis CVIRUS-COINFECTED PATIENTSLIVER-TRANSPLANTATIONHepatitis CRecombinant Proteinsacute hepatitis; antiviral therapy; chronic hepatitis; cirrhosis; elderly patients; hbv; hcv; hdv; hiv; liver transplantationCLINICAL PRACTICE GUIDELINESCirrhosisHCVDrug Therapy CombinationAntiviral therapy Acute hepatitis Chronic hepatitisCirrhosis Elderly patients HBV HCV HDV HIV Liver transplantationElderly patientAcute hepatitiAcute hepatitismedicine.medical_specialtyGenotypePEGINTERFERON ALPHA-2AAlpha interferonHIV-INFECTED PATIENTSInterferon alpha-2CHRONIC HEPATITIS CAntiviral AgentsHepatitis B ChronicChronic hepatitisInternal medicineHDVDrug Resistance ViralRibavirinmedicineHumansPEGYLATED INTERFERON-ALPHA-2BCirrhosiHepatologybusiness.industrySettore MED/09 - MEDICINA INTERNAInterferon-alphaHIVHepatitis C Chronicmedicine.diseaseElderly patientsFamily medicineExpert opinionAntiviral therapy; Acute hepatitis; Chronic hepatitis; Cirrhosis; Elderly patients; HBV; HCV; HDV; HIV; liver transplantationChronic hepatitiRAPID VIROLOGICAL RESPONSEbusinessCHRONIC HEPATITIS C; ANTIVIRAL TREATMENT; CLINICAL PRACTICE GUIDELINES
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HCV NS3 sequencing as a reliable and clinically useful tool for the assessment of genotype and resistance mutations for clinical samples with differe…

2016

OBJECTIVES: This study aims to evaluate the reliability and clinical utility of NS3 sequencing in hepatitis C virus (HCV) 1-infected patients who were candidates to start a PI-containing regimen. METHODS: NS3 protease sequencing was performed by in-house-developed HCV-1 subtype-specific protocols. Phylogenetic analysis was used to test sequencing reliability and concordance with previous genotype/subtype assignment by commercial genotyping assays. RESULTS: Five hundred and sixty-seven HCV plasma samples with quantifiable HCV-RNA from 326 HCV-infected patients were collected between 2011 and 2014. Overall, the success rate of NS3 sequencing was 88.9%. The success rate between the two subtype…

0301 basic medicinens3Genotyping TechniquesvirusesDrug ResistanceHepacivirusViral Nonstructural Proteinsmedicine.disease_causeGastroenterologyTelaprevirchemistry.chemical_compoundgenotype; genotyping techniques; hepacivirus; hepatitis C; humans; RNA viral; retrospective studies; sequence analysis; DNA; viral nonstructural proteins; drug resistance viral; mutation; pharmacology; infectious diseases0302 clinical medicineRetrospective StudieGenotypePharmacology (medical)ViralGenotype; Genotyping Techniques; Hepacivirus; Hepatitis C; Humans; RNA Viral; Retrospective Studies; Sequence Analysis DNA; Viral Nonstructural Proteins; Drug Resistance Viral; MutationProteolytic enzymesvirus diseasesSettore MED/07 - Microbiologia e Microbiologia ClinicaHepatitis Chcv-rna levelsInfectious DiseasesHCV-RNARNA Viral030211 gastroenterology & hepatologySequence Analysismedicine.drugHumanMicrobiology (medical)medicine.medical_specialtyGenotypeHepatitis C virusConcordanceSettore MED/12 - GASTROENTEROLOGIAGenotype; Genotyping Techniques; Hepacivirus; Hepatitis C; Humans; RNA Viral; Retrospective Studies; Sequence Analysis DNA; Viral Nonstructural Proteins; Drug Resistance Viral; Mutation; Pharmacology; Pharmacology (medical); Infectious DiseasesBiology03 medical and health sciencesBoceprevirInternal medicineDrug Resistance ViralmedicinehcvHumansGenotypingGenotyping TechniquesRetrospective StudiesPharmacologyHepaciviruViral Nonstructural ProteinSettore MED/09 - MEDICINA INTERNASequence Analysis DNADNAVirologydigestive system diseases030104 developmental biologychemistrySequence AnalysiMutationRNAGenotyping TechniqueRNA viral
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Overview of Prognostic Systems for Hepatocellular Carcinoma and ITA.LI.CA External Validation of MESH and CNLC Classifications

2021

Simple Summary This review proposes a comprehensive overview of the main prognostic systems for HCC classified as prognostic scores, staging systems, or combined systems. Prognostic systems for HCC are usually compared in terms of homogeneity, monotonicity of gradients, and discrimination ability. However, despite the great number of published studies comparing HCC prognostic systems, it is rather difficult to identify a system that could be universally accepted as the best prognostic scheme for all HCC patients encountered in clinical practice. In order to give a contribute in this topic, we conducted a study aimed at externally validate the MESH score and the CNLC classification using the…

Cancer Researchmedicine.medical_specialtyReviewlcsh:RC254-282Prognostic score03 medical and health sciences0302 clinical medicinemedicineIn patientMedical physicsStaging systemmonotonicity of gradientsSettore MED/12 - Gastroenterologiadiscrimination ability; hepatocellular carcinoma; homogeneity; monotonicity of gradients; prognostic performance; prognostic systembusiness.industryprognostic systemExternal validationMono-tonicity of gradienthepatocellular carcinomamedicine.diseaselcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogensSettore MED/18homogeneityOncology030220 oncology & carcinogenesisHepatocellular carcinomaPopulation data030211 gastroenterology & hepatologyGeneral healthdiscrimination abilityLiver dysfunctionbusinessprognostic performanceCancers
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Restaging Patients With Hepatocellular Carcinoma Before Additional Treatment Decisions: A Multicenter Cohort Study

2018

Prognostic assessment of patients with hepatocellular carcinoma (HCC) at the time of diagnosis remains controversial and becomes even more complex at the time of restaging when new variables need to be considered. The aim of the current study was to evaluate the prognostic utility of restaging patients before proceeding with additional therapies for HCC. Two independent Italian prospective databases were used to identify 1,196 (training cohort) and 648 (validation cohort) consecutive patients with HCC treated over the same study period (2008-2015) who had complete restaging before decisions about additional therapies. The performance of the Italian Liver Cancer (ITA.LI.CA) prognostic score …

MaleOncologyDatabases FactualLiver cancer; non surgical therapy; prognostic system; surgical therapy; survivalhepatocellular carcinoma stage treatmentKaplan-Meier EstimateCohort StudiesLiver disease0302 clinical medicineMiddle AgedSorafenibPrognosisItaly030220 oncology & carcinogenesisCatheter AblationDisease ProgressionFemale030211 gastroenterology & hepatologysurgical therapyLiver cancerLiver cancermedicine.drugCohort studySorafenibmedicine.medical_specialtyCarcinoma HepatocellularSettore MED/12 - GASTROENTEROLOGIAClinical Decision-MakingRisk AssessmentsurvivalDisease-Free SurvivalStatistics Nonparametric03 medical and health sciencesnon surgical therapyInternal medicinemedicineHepatectomyHumansInfusions Intra-ArterialNeoplasm InvasivenessSurvival analysisAgedNeoplasm StagingRetrospective StudiesAnalysis of VarianceHepatologybusiness.industryprognostic systemReproducibility of ResultsCancerRetrospective cohort studymedicine.diseaseSurvival AnalysisbusinessProgressive disease
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Comparison of prognostic models in advanced hepatocellular carcinoma patients undergoing Sorafenib: A multicenter study

2021

Background: Sorafenib is the gold standard therapy for the advanced hepatocellular carcinoma (HCC). No scoring/staging is universally accepted to predict the survival of these patients. Aims: To evaluate the accuracy of the available prognostic models for HCC to predict the survival of advanced HCC patients treated with Sorafenib included in the Italian Liver Cancer (ITA.LI.CA.) multicenter cohort. Methods: The performance of several prognostic scores was assessed through a Cox regression-model evaluating the C-index and the Akaike Information Criterion (AIC). Results: Data of 1129 patients were analyzed. The mean age of patients was 61.6 years, and 80.8% were male. During a median follow-u…

OncologyMaleSurvivalHepatocellular carcinomaCohort study Hepatocellular carcinoma Prognosis Sorafenib SurvivalSeverity of Illness IndexAntineoplastic Agent0302 clinical medicineProspective StudiesLiver NeoplasmsGastroenterologyMiddle AgedSorafenibPrognosisTreatment OutcomeItalyLiver Neoplasm030220 oncology & carcinogenesisHepatocellular carcinomaCohort030211 gastroenterology & hepatologyFemaleLiver cancerCohort studymedicine.drugCohort studySorafenibCohort study; Hepatocellular carcinoma; Prognosis; Sorafenib; Survivalmedicine.medical_specialtyCarcinoma HepatocellularPrognosiSettore MED/12 - GASTROENTEROLOGIAAntineoplastic AgentsRisk Assessment03 medical and health sciencesInternal medicinemedicineHumansneoplasmsPrognostic modelsNeoplasm StagingProportional Hazards ModelsRetrospective StudiesHepatologybusiness.industrySettore MED/09 - MEDICINA INTERNAGold standardmedicine.diseasedigestive system diseasesMulticenter studybusiness
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HCC management with Sorafenib and TACE: Italian experience from GIDEON (Global Investigational Of Therapeutic Decisions in HCC and of its Treatment w…

2014

Hepatocellular carcinomaSorafenibManagement
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Effectiveness and safety of glecaprevir/pibrentasvir in chronic hepatitis C patients: Results of the Italian cohort of a post-marketing observational…

2021

Abstract Background and Aims The MARS post-marketing, observational study evaluates glecaprevir/pibrentasvir in a large population of Italian patients who are infected with HCV. Patients and Methods Achievement of SVR12 was the primary endpoint in the overall population and by subpopulations of interest (treatment-naive and treatment-experienced patients, subjects infected with different HCV genotype/sub-genotype, cirrhotic and non-cirrhotic patients, patients with different severity of fibrosis, patients with an APRI score ≥1, subjects with comorbidities, HIV-coinfected patients, elderly patients and people who use drugs). Safety and quality of life (assessed by SF-36 and Work Productivity…

MaleAdultmedicine.medical_specialtyPyrrolidinesQuinoxalineSustained Virologic ResponseSettore MED/12 - GASTROENTEROLOGIAPopulationAntiviral AgentselderlyBenzimidazoleGLE/PIBQuinoxalinesInternal medicineDrug CombinationClinical endpointmedicineProduct Surveillance PostmarketingHumansProspective StudieseducationAdverse effectAgedAntiviral AgentSulfonamideseducation.field_of_studyHepatologybusiness.industrySettore MED/09 - MEDICINA INTERNAGastroenterologyPWUDGlecaprevirMiddle Agedelderly; GLE/PIB; HCV; PWUDHepatitis C ChronicPibrentasvirDiscontinuationDrug CombinationsGLE/PIB; HCV; PWUD; elderlyItalyCohortHCVQuality of LifeBenzimidazolesFemaleObservational studybusiness
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