Testing for hepatitis C virus and hepatitis B virus/hepatitis D virus: Current scenarios and perspectives in Italy

Liver disease accounts for approximately 4% of all deaths worldwide, and viral hepatitis affects more than 300 million people.The World Health Organization aims to reduce new hepatitis infections by 90% and deaths by 65% by 2030 through vaccination and screening programs.In Italy, screening for hepatitis C virus (HCV) benefits from dedicated government funding, whereas testing for hepatitis B virus (HBV) and hepatitis D virus (HDV) is supported by recommendations from scientific societies but does not benefit from dedicated national public health programmes.This expert-opinion review summarises the experience of tertiary-level Italian centres actively engaged in hospitalbased testing for HCV, HBV, and HDV and identifies practical pathways to improve testing and linkage to care.This article presents proposals to improve the effectiveness of viral hepatitis management in Italy by: (1) Strengthening coordination between hospital units and integrating information systems between general practitioners and hospitals;(2) Implementing a centralised reporting system and a structured referral network to ensure that patients with positive test results receive appropriate therapies in a timely manner; (3) Providing the resources needed to increase testing in public addiction treatment services (Servizi per le Dipendenze) and prisons; (4) Promoting screening in high-risk populations, including vulnerable and older populations; and (5) Implementing a national awareness campaign on viral hepatitis.These measures could help Italy make concrete progress towards eliminating HCV infection and controlling HBV/HDV infection within the next decade.