OBJECTIVES:

To evaluate the results of the first three years of the HCV Sicilia network experience both in terms of adherence to the recommended diagnostic procedures and therapeutic guidelines, and in terms of quantity and quality of data collected in hub and spoke centers by gastroenterologists, infectivologists and general practitioners.

METHODS:

In Sicily, the Direct Antiviral Agents (DAAs) therapeutic revolution for the treatment of hepatitis C has been accompanied and supported by the HCV Regional Network, an important technical-organizational innovation for connecting hub and spoke centres and general practitioners to optimize the diagnosis and treatment of HCV chronic diseases. This synergy was implemented through a web-based platform designed and implemented by CINECA Interuniversity Consortium, which allows direct communication between GPs and Hospital Specialists. Through the website, the GP can directly book outpatient visits, fibroscan and therapies at the specialized centers of the network and follow the patients diagnostic-therapeutic pathway.

RESULTS:

Since March 2015, over 5,000 patients per year (57% male, median age 64 years) have been recorded in the web system; almost 60% of patients was included in the Registry for Chronic hepatitis and genotype 1b has been the most frequent observed in the population (65%); 7,858 patients completed the first-line treatment, and the Sustained Virological Response (SVR) was achieved in 6,071 patients (94.0%); 273 patients underwent second-line therapy thus increasing the SVR rate to 97.9% of treated patients.

CONCLUSIONS:

The HCV Sicily Network has proved to be an excellent model for the complicated management of chronic HCV diseases. The synergy between all the stakeholders involved in the diagnostic-therapeutic pathway facilitated continuity of care and equity of access to innovative medicines, it moreover led a very high degree of completeness in the eCRF compilation which generated a huge amount of data for outcome research, clinical evaluations and regulatory purposes in a real-world setting.