TY - JOUR
T1 - Hepatitis C Elimination in the Netherlands (CELINE)
T2 - How nationwide retrieval of lost to follow-up hepatitis C patients contributes to micro-elimination
AU - Isfordink, Cas J
AU - van Dijk, Marleen
AU - Brakenhoff, Sylvia M
AU - Kracht, Patricia A M
AU - Arends, Joop E
AU - de Knegt, Robert J
AU - van der Valk, Marc
AU - Drenth, Joost P H
AU - CELINE Study Group
AU - Hoebe, Christian
AU - Heil, Jeanne
AU - Koc, Özgür
AU - Ackens, Robin
AU - van Oorschot, Eva
N1 - Copyright © 2022. Published by Elsevier B.V.
PY - 2022/7
Y1 - 2022/7
N2 - BACKGROUND & AIMS: The number of chronic hepatitis C virus (HCV)-infected patients who have been lost to follow-up (LTFU) is high and threatens HCV elimination. Micro-elimination focusing on the LTFU population is a promising strategy for low-endemic countries like the Netherlands (HCV prevalence 0.16%). We therefore initiated a nationwide retrieval project in the Netherlands targeting LTFU HCV patients.METHODS: LTFU HCV-infected patients were identified using laboratory and patient records. Subsequently, the Municipal Personal Records database was queried to identify individuals eligible for retrieval, defined as being alive and with a known address in the Netherlands. These individuals were invited for re-evaluation. The primary endpoint was the number of patients successfully re-linked to care.RESULTS: Retrieval was implemented in 45 sites in the Netherlands. Of 20,183 ever-diagnosed patients, 13,198 (65%) were known to be cured or still in care and 1,537 (8%) were LTFU and eligible for retrieval. Contact was established with 888/1,537 (58%) invited individuals; 369 (24%) had received prior successful treatment elsewhere, 131 (9%) refused re-evaluation and 251 (16%) were referred for re-evaluation. Finally, 219 (14%) were re-evaluated, of whom 172 (79%) approved additional data collection. HCV-RNA was positive in 143/172 (83%), of whom 38/143 (27%) had advanced fibrosis or cirrhosis and 123/143 (86%) commenced antiviral treatment.CONCLUSION: Our nationwide micro-elimination strategy accurately mapped the ever-diagnosed HCV population in the Netherlands and indicates that 27% of LTFU HCV-infected patients re-linked to care have advanced fibrosis or cirrhosis. This emphasizes the potential value of systematic retrieval for HCV elimination.
AB - BACKGROUND & AIMS: The number of chronic hepatitis C virus (HCV)-infected patients who have been lost to follow-up (LTFU) is high and threatens HCV elimination. Micro-elimination focusing on the LTFU population is a promising strategy for low-endemic countries like the Netherlands (HCV prevalence 0.16%). We therefore initiated a nationwide retrieval project in the Netherlands targeting LTFU HCV patients.METHODS: LTFU HCV-infected patients were identified using laboratory and patient records. Subsequently, the Municipal Personal Records database was queried to identify individuals eligible for retrieval, defined as being alive and with a known address in the Netherlands. These individuals were invited for re-evaluation. The primary endpoint was the number of patients successfully re-linked to care.RESULTS: Retrieval was implemented in 45 sites in the Netherlands. Of 20,183 ever-diagnosed patients, 13,198 (65%) were known to be cured or still in care and 1,537 (8%) were LTFU and eligible for retrieval. Contact was established with 888/1,537 (58%) invited individuals; 369 (24%) had received prior successful treatment elsewhere, 131 (9%) refused re-evaluation and 251 (16%) were referred for re-evaluation. Finally, 219 (14%) were re-evaluated, of whom 172 (79%) approved additional data collection. HCV-RNA was positive in 143/172 (83%), of whom 38/143 (27%) had advanced fibrosis or cirrhosis and 123/143 (86%) commenced antiviral treatment.CONCLUSION: Our nationwide micro-elimination strategy accurately mapped the ever-diagnosed HCV population in the Netherlands and indicates that 27% of LTFU HCV-infected patients re-linked to care have advanced fibrosis or cirrhosis. This emphasizes the potential value of systematic retrieval for HCV elimination.
KW - Antiviral Agents/therapeutic use
KW - Hepacivirus/genetics
KW - Hepatitis C/epidemiology
KW - Hepatitis C, Chronic/drug therapy
KW - Humans
KW - Liver Cirrhosis/drug therapy
KW - Lost to Follow-Up
KW - Netherlands/epidemiology
U2 - 10.1016/j.ejim.2022.04.024
DO - 10.1016/j.ejim.2022.04.024
M3 - Article
C2 - 35527178
SN - 0953-6205
VL - 101
SP - 93
EP - 97
JO - European journal of internal medicine
JF - European journal of internal medicine
ER -