Italian Consensus Recommendations for the management of hepatitis C infection in patients with rheumatoid arthritis

OBJECTIVES: The recent itroduction of direct-acting antiviral agents (DAAs) which can eliminate Hepatitis C virus (HCV) had revoluzionized the treatment of HCV infections also in a complex clinical setting such as the patients with rheumatoid arthritis (RA). HCV elimination is also opportune due to the availability of more efficient immunosuppressive drugs, whose effect on the course of HCV infection is largely unknown. METHODS: Consensus process was endorsed by the Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) to review the available evidences and produce practical, hospital-wide recommendations. The consensus panel consisted of 18 infectious diseases consultants, 20 rheumatologists and one clinical epidemiologist, who used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidences and the strength of their recommendations. RESULTS: A core-set of statements about management of patients with RA and infection by HCV have been developed to help clinicians in their clinical practice. CONCLUSIONS: A screening for HCV should be performed in all RA patients and it is mandatory before starting an immunsuppressive therapy. Finally, a DAA treatment should be considered in all HCV-infected patients.