Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2016; 22(44): 9829-9835
Published online Nov 28, 2016. doi: 10.3748/wjg.v22.i44.9829
Attempt to calculate the prevalence and features of chronic hepatitis C infection in Tuscany using administrative data
Caterina Silvestri, Simone Bartolacci, Pasquale Pepe, Mirko Monnini, Fabio Voller, Francesco Cipriani, Cristina Stasi
Caterina Silvestri, Simone Bartolacci, Pasquale Pepe, Mirko Monnini, Fabio Voller, Francesco Cipriani, Cristina Stasi, Observatory of Epidemiology, Regional Health Agency of Tuscany, 50141 Florence, Italy
Cristina Stasi, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
Author contributions: Silvestri C drafted the initial manuscript, participated in study design, in interpretation of the data, revised the article critically for important intellectual content; Bartolacci S, Pepe P and Monnini M participated in the acquisition and analysis of the data; Voller F and Cipriani F participated in study design and they were the guarantor of the methods used, revised the article critically for important intellectual content; Stasi C participated in study design, wrote the paper, interpreted the data, revised the article critically for important intellectual content; all authors have reviewed and approved the final manuscript.
Conflict-of-interest statement: The Authors have no conflict of interest to disclose.
Institutional review board statement: The study complied with the Declaration of Helsinki and with the protection of personal data. No identifiable human data were used for this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cristina Stasi, MD, PhD, Observatory of Epidemiology, Regional Health Agency of Tuscany, Via P. Dazzi 1, 50141 Florence, Italy. cristina.stasi@gmail.com
Telephone: +39-055-4624385
Received: July 14, 2016
Peer-review started: July 16, 2016
First decision: September 12, 2016
Revised: September 21, 2016
Accepted: October 19, 2016
Article in press: October 19, 2016
Published online: November 28, 2016
Processing time: 135 Days and 1.7 Hours
Abstract
AIM

To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in 2015.

METHODS

Tuscan Health administrative data were used to evaluate hepatitis C virus (HCV) infected people known to the Regional Health Service. Residents in Tuscany with a HCV exemption code (070.54) were identified. Using the universal code attributed to each resident, these patients were matched with hospital admission codes identified by the International Classification of Diseases, Ninth Revision (ICD-9), Clinical Modification, and with codes for dispensing drugs to patients by local and hospital pharmacies. Individuals were considered only once. Capture-recapture analysis was used to evaluate the HCV-infected population unknown to the Regional Health Service.

RESULTS

In total, 14526 individuals were living on 31/12/2015 with an exemption code for HCV. In total, 9524 patients were treated with pegylated interferon + ribavirin and/or direct-acting antiviral drugs during the last 10 years, and 13879 total hospital admissions were noted in the last 15 years. After data linkage, the total number was 25918. After applying the Capture-Recapture analysis, the number of unknown HCV-infected people was 23497. Therefore, the total number of chronic HCV-infected people was 38643, excluding those achieved sustained virological response to previous treatment.

CONCLUSION

Our results show a prevalence of HCV infected people of 1%. Tuscan administrative data could be useful for calculating health care costs and health planning in the coming years.

Keywords: Hepatitis C; Public health; Fibrosis; Antiviral treatment; Epidemiology

Core tip: Given the considerable differences among the world regions, the calculation of hepatitis C virus (HCV) prevalence through administrative flows seems to be essential for intervention policy strategies. Currently, these data are highly interesting given that the introduction of direct-acting antiviral drugs has highlighted the problem of sustainability due to the high costs of new drugs in low and middle income countries. Therefore, given the high number of chronic HCV-infected patients and the high costs of these drugs, the administrative data could be useful for calculating health care costs and health planning in the coming years.