Hepatitis C Elimination in the Netherlands (CELINE): How nationwide retrieval of lost to follow-up hepatitis C patients contributes to micro-elimination

Cas J. Isfordink, Marleen van Dijk, on behalf of CELINE Study Group, Sylvia M. Brakenhoff, Patricia A.M. Kracht, Joop E. Arends, Robert J. de Knegt, Marc van der Valk, Joost P.H. Drenth*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)93-97
Number of pages5
JournalEuropean Journal of Internal Medicine
Early online date5 May 2022
Publication statusPublished - 1 Jul 2022

Bibliographical note

Funding Information:
CELINE was supported with an unrestricted grant from Gilead Sciences. The funder did not have any role in study design, data collection, management, analysis and/or interpretation. Wherever possible, CELINE included and expanded on data from regional retrieval projects. The REtrieval And cure of Chronic Hepatitis C (REACH) project was supported with unrestricted grants from Gilead Sciences, Merck Sharpe & Dohme (MSD), AbbVie and Bristol-Myers Squibb (BMS). The Zuyderland project was financially supported by grants from Gilead Sciences and MSD. The Track Trace & Treat project was financially supported by a grant from MSD. Projects from the Leiden University Medical Centre, Haga Teaching Hospital and Medical Centre Leeuwarden were financially unsupported.

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© 2022


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