Hepatitis C Elimination in the Netherlands (CELINE): How nationwide retrieval of lost to follow-up hepatitis C patients contributes to micro-elimination.
Linkage to care
Micro-elimination
People who inject drugs
Viral hepatitis
Journal
European journal of internal medicine
ISSN: 1879-0828
Titre abrégé: Eur J Intern Med
Pays: Netherlands
ID NLM: 9003220
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
25
02
2022
revised:
24
04
2022
accepted:
28
04
2022
pubmed:
9
5
2022
medline:
24
6
2022
entrez:
8
5
2022
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 35527178
pii: S0953-6205(22)00168-6
doi: 10.1016/j.ejim.2022.04.024
pii:
doi:
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
93-97Investigateurs
M van den Berg
(M)
P Honkoop
(P)
S Abraham
(S)
S Bosman
(S)
P van Wijngaarden
(P)
K Steenhuisen
(K)
P Friederich
(P)
A S M Dofferhoff
(ASM)
J Berkhout
(J)
F Ter Borg
(F)
J M da Silva
(JM)
M A M T Verhagen
(MAMT)
X Vos
(X)
K Vlaar
(K)
R Douma
(R)
W G Erkelen
(WG)
M den Reijer
(M)
C J P A Hoebe
(CJPA)
J Heil
(J)
M Baven
(M)
H van Soest
(H)
K Sebib Korkmaz
(KS)
G Bezemer
(G)
A J J Lammers
(AJJ)
S B Debast
(SB)
H J M de Jong
(HJM)
P Bus
(P)
P Sturm
(P)
J den Hollander
(J)
P Friederich
(P)
L M Kampschreur
(LM)
N Venneman
(N)
F Bosma
(F)
O M Koc
(OM)
R Ackens
(R)
E van Oorschot
(E)
M Klemt-Kropp
(M)
L C Baak
(LC)
J T Brouwer
(JT)
B W M Spanier
(BWM)
C Swanink
(C)
H Blokzijl
(H)
M Knoester
(M)
P Liedorp
(P)
J van Bergeijk
(J)
A van Nunen
(A)
Informations de copyright
Copyright © 2022. Published by Elsevier B.V.