The point on the occasion of the World Day announced for 28 July.
The University Hospital Company deploys four operational STD panel test units for prevention and combat, and the USL Company has screened 30,031 citizens from February 2022 to today. An information campaign on social media and the HPV direct testimony of those who were tested and saved from the disease
From left Cavicchioli, Romagnoli, Vagnini, Abbati, Cuomo and Khafian
Every day in Modena, a highly complex activity is undertaken to prevent and, when necessary, combat the onset of hepatitis. Tomorrow, Friday, 28 July, marks World STD Day, proclaimed by the World Health Test Organization (WHO). This date is significant as it coincides with the birth of Baruch Blumberg in 1925; the American biochemist awarded the Nobel Prize for discovering the Hepatitis B virus and developing the first vaccine.
This occasion is a chance to give you an overview of the ongoing efforts at the hospital level in the city area. The Polyclinic and the Civil Hospital of Baggiovara are directly engaged in the HPV diagnostic testing and treatment fields. Meanwhile, the USL company handles screening campaigns for the general population and specific categories of citizens.
The University Hospital of Modena
The University Hospital of Modena has four operational units. These include the Internal Medicine of the Polyclinic, directed by Professor Antonello Pietrangelo. Additionally, there’s Internal Medicine with a Metabolic Nutritional focus based in Baggiovara, directed by Professor Pietro Andreone. Furthermore, the Gastroenterology of the Polyclinic is directed by Professor Antonio Colecchia. Lastly, the HPV Clinic of Infectious Diseases is directed by Professor Cristina Mussini.
The Internal Medicine Operating Unit of the Polyclinic hosts a hepatitis clinic that receives approximately 4,000 visits every year. This program enables the detection of undiagnosed infections. And the initiation of evaluations for therapy with the new direct antiviral drugs. The STD screening targets citizens born between 1969 and 1989, including all patients tested and treated at the Serdp and those in the Modena detention centres.
Metabolic-Nutritional Internal Medicine of the Baggiovara Civil Hospital
In a year, the Metabolic-Nutritional Internal Medicine of the Baggiovara Civil Hospital follows approximately 500 STD patients suffering from HBV-related chronic liver disease. Among them, 160 are cirrhotic, and another 60 suffer from delta liver disease, half of whom are cirrhotic. Additionally, approximately 1,500 people with a previous infection from hepatitis C are monitored, with around twenty having recovered from 2019 to today. The Infectious Diseases Clinic receives approximately 400 patients with chronic HBV hepatitis.
These patients range from inactive carriers who undergo annual check-ups to those undergoing chronic and prolonged treatment with nucleotide (s)ide analogues. In Gastroenterology, between 2018 and 2019, doctors treated over 400 HCV+ patients with direct antiviral drugs (DAAs). This treatment attracted significant attention both within and outside the region.
The General Director of the Modena University Hospital, Claudio Vagnini, emphasises that these numbers represent the collaborative effort of a multidisciplinary team. Each team member contributes to providing adequate testing and support to individuals facing HPV illnesses of this magnitude. Often, this crucial work goes unnoticed, making it important to highlight this issue on World Hepatitis Day. Vagnini commends all professionals for their coordination and dedication to local healthcare.
World Hepatitis Day
On World Hepatitis Day, the Information and Communication Office of the AOU of Modena has designed a mini-social campaign. This campaign features two awareness reels scheduled for publication in the next few hours. It includes an interview with Luca Ferrari, a patient from Tellaro (Hamlet of Lerici, in the province of La Spezia). He has chosen treatment at the Polyclinic and the Civil Hospital of Baggiovara for years after contracting both hepatitis B and hepatitis C. In full form, the video will always be visible in the next few hours on the company’s YouTube channel.
As mentioned, the hospital activity is also accompanied by the territorial activity conducted by the Modena Local Health Authority. Since February 2022, the hepatitis C screening program has been active in the provincial territory. This STD program enables the detection of undiagnosed infections and the initiation of evaluations for therapy with the new direct antiviral drugs. The screening targets citizens born between 1969 and 1989. It also includes all patients treated at the Serdp and those in the Modena detention centres.
The invitation
We sent the invitation to join the entire target population via an SMS and detailed communication on the electronic health record. To stimulate participation, citizens who have any exam scheduled at the 29 sampling points in the Modena area receive a reminder via SMS a few days before. This reminder informs them that if they still need to take the exam, they can join the screening during the appointment without the need to book.
In the province of Modena, health authorities have screened 30,031 citizens. This screening effort has detected 19 cases of active STI infection. Following specialist consultations by AOU colleagues, therapy was initiated with new direct-acting antiviral drugs. The established therapy allowed these citizens to eradicate the HPV infection by eliminating the viral load. All information on screening is available on the AUSL website: www.ausl.mo.it/screening-patia-c. We would also like to remind you that screening for hepatitis B and C is active in the province of Modena. This screening is specifically for migrants, refugees, and those seeking international protection who arrive in the provincial territory.
Gianluca Abbati, Internal Medicine Doctor, AOU of Modena
The Internal Medicine Unit of the Polyclinic, directed by Professor Antonello Pietrangelo, has dealt with liver diseases for over 50 years from both clinical and research perspectives. The research aspect involves the Center for Genomic Medicine and Rare Diseases ‘Mario Coppo,’ with which the structure is associated. The clinical STI activity focuses on patients afflicted by a wide range of liver diseases, particularly hepatitis. This includes autoimmune, viral hepatitis (B and C), and alcoholic and non-alcoholic hepatitis, also known as steatohepatitis.
Non-alcoholic steatohepatitis represents a significant part of the activity due to the high prevalence of obesity and sedentary lifestyles in the population. In recent years, the hepatitis clinic has increasingly treated STD cases caused by drugs, alcohol, supplements, and herbal products, posing an emerging problem in the field. As the professional in charge of the hepatitis clinic, I focus primarily on managing home therapies and conducting periodic instrumental evaluations of patients with viral hepatitis. This includes HPV tests, ultrasound, liver biopsies, and elastometry/fibroscan.
Viral Hepatitis
Regarding viral hepatitis, doctors treat patients with hepatitis C using direct antivirals, which currently achieve recovery rates of around 100%. Patients with hepatitis B benefit from therapies that are less effective at present but require close monitoring due to the high risk of cirrhosis, hepatocellular carcinoma, and liver transplantation. Those with autoimmune hepatitis can now benefit from effective immunosuppressive drugs. However, early diagnosis is crucial to prevent rapidly progressive diseases, necessitating careful clinical surveillance. Those with autoimmune hepatitis can now benefit from effective immunosuppressive drugs. However, early diagnosis is crucial to prevent rapidly progressive diseases, necessitating careful clinical surveillance.
Alessia Cavicchioli, Metabolic Nutritional Medicine Doctor, AOU of Modena. “I collaborate with Professor Pietro Andreone and his team in the U.O. of Metabolic Medicine hepatology clinic at Baggiovara Hospital, where we conduct clinical practice and carry out phase 2B and 3 pharmacological activities.”
Clinical Trials
We are conducting STD clinical trials on viral, autoimmune, and dysmetabolic hepatitis. Specifically, for hepatitis B, we have initiated phase 2B and 3 protocols involving 34 patients. We also plan two further pharmacological protocols to control hepatitis B virus infection definitively.
Regarding the delta virus, we contributed to the study on Bulevertide. The study yielded satisfactory results, leading to its approval for treating delta hepatitis through the NHS. Conducting these STI trials provides our patients with access to innovative drugs before they are available on the market, which offers an excellent therapeutic opportunity.
Gianluca Cuomo, Infectious Diseases Doctor, AOU of Modena
The hepatitis clinic of the Infectious Diseases Clinic of the Modena Polyclinic provides comprehensive care for patients. Those with STI viral hepatitis, including HPV diagnosis, treatment, and follow-up. Patients with chronic hepatitis B or hepatitis B/delta co-infection receive thorough diagnostics. And therapeutic processes, including antiviral treatment and instrumental follow-up.
Diagnostic and Therapeutic Excellence in Chronic Diseases
Dante Romagnoli, Gastroenterology Doctor, AOU of Modena
The Complex Gastroenterology Structure, under the direction of Professor Antonio Colecchia, offers advanced diagnosis and treatment for Chronic Liver Diseases. It also specialises in Liver Cirrhosis and Hepatocarcinoma. It serves as a provincial reference point for the Regional Screening Campaign for HCV. The outpatient activity focuses on specialised care for various liver diseases, including viral hepatitis C.
Infectious disease specialist, Hepatitis Coordinator,
“I want to emphasise the importance of participating in the free screening. This is available to citizens throughout the province born between 1969 and 1989. You can undergo the screening alone or during any other STD test at our sampling points.” It is an opportunity to quickly and easily identify a pathology that can have serious outcomes if not intervened early. Most people with chronic Hepatitis C have no symptoms or general symptoms such as chronic fatigue and depression. Screening, therefore, is the only way to identify it. At the same time, the STI therapy available for some years is simple, safe, and extremely effective. Over 95% of treated people recover completely, eliminating the HPV infection.