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

Isfordink, Cas J; Dijk, Marleen van; Brakenhoff, Sylvia M.; Kracht, Patricia A. M.; Arends, Joop E.; Knegt, Robert J. de; Valk, Marc van der; Drenth, Joost P.H.; Berg, M. van den; Honkoop, P.; Abraham, S.; Bosman, S.; Wijngaarden, Paulien van; Steenhuisen, K.; Dofferhoff, A.S.M.; Berkhout, J.J.; Borg, F. ter; Silva, J.M. da; Verhagen, M. A. M. T.; Vos, X.; Vlaar, K.; Douma, R.; Erkelen, W.G.; Reijer, M. den; Hoebe, Christian J. P. A.; Heil, Jeanne; Baven, M.; Soest, Hanneke van; Korkmaz, Kerem Sebib; Bezemer, G.; Lammers, A.J.J.; Debast, S.B.; Jong, H.J.M. de; Bus, P.; Sturm, P.; Hollander, J.; Friederich, Philip W.; Kampschreur, L.M.; Venneman, N.; Bosma, F.; Koç, Orhan; Ackens, Robin; Oorschot, E. van; Klemt-Kropp, Michael; Baak, L.C.; Brouwer, J.T.; Spanier, B.W.M.; Swanink, C.; Blokzijl, Hans; Knoester, Marjolein; Liedorp, P.; Bergeijk, J. van; Nunen, A. van

doi:10.1016/j.ejim.2022.04.024

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…In our study, we described a high proportion of patients LTFU with advanced fibrosis. Similar results were described by a nationwide retrieval project, CELINE study, were 27% of the retrieved patients presented advanced liver fibrosis 20 . These findings highlight the importance of retrieving patients with chronic HCV to prevent liver‐related complications such as cirrhosis and hepatocellular carcinoma.…”

Section: Discussionsupporting

confidence: 83%

“…Similar results were described by a nationwide retrieval project, CELINE study, were 27% of the retrieved patients presented advanced liver fibrosis. 20 These findings highlight the importance of retrieving patients with chronic HCV to prevent liver-related complications such as cirrhosis and hepatocellular carcinoma. National and regional authorities should commit to this task by providing contact details to enhance case-finding and implementing methods to contact individuals who are LTFU.…”

Section: Discussionmentioning

confidence: 95%

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Implementation of a re‐linkage to care strategy in patients with chronic hepatitis C who were lost to follow‐up in Latin America

Mendizábal

Thompson

Gonzalez‐Ballerga

et al. 2022

Journal of Viral Hepatitis

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To achieve WHO's goal of eliminating hepatitis C virus (HCV), innovative strategies must be designed to diagnose and treat more patients. Therefore, we aimed to describe an implementation strategy to identify patients with HCV who were lost to follow-up (LTFU) and offer them re-linkage to HCV care. We conducted an implementation study utilizing a strategy to contact patients with HCV who were not under regular follow-up in 13 countries from Latin America. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or equivalent. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined by anti-HCV+ and detectable HCV-RNA. Identified patients who were not under follow-up by a liver specialist were contacted by telephone or email, and offered a medical reevaluation. A total of 10,364 patients were classified to have HCV. After reviewing their medical charts, 1349 (13%) had undetectable HCV-RNA or were wrongly coded.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 95%

Implementation of a re‐linkage to care strategy in patients with chronic hepatitis C who were lost to follow‐up in Latin America

Mendizábal

Thompson

Gonzalez‐Ballerga

et al. 2022

Journal of Viral Hepatitis

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“…CAC is a project that is part of the portfolio that is offered by HepNed, a collaboration between hepatologists and infectious disease physicians. HepNed coordinated the nationwide hepatitis C retrieval program CELINE [ 22 ]. During the CAC project, as addiction care teams are familiarized with HCV care, a HepNed expert is available for advice and instruction.…”

Section: Methodsmentioning

confidence: 99%

Implementation of a decentralized hepatitis C care pathway for people who use drugs in Dutch addiction care. Study protocol for the Hepatitis C: chain of addiction care (CAC) project

Hoff

Berden

Drenth

et al. 2022

Addict Sci Clin Pract

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Background People who use drugs (PWUD) are at high risk for hepatitis C virus (HCV) infection and its complications. Given the high prevalence rate of HCV in PWUD, the World Health Organization (WHO) emphasizes PWUD as a target population for HCV elimination. The introduction of pangenotypic direct acting antivirals (DAAs) greatly simplifies HCV treatment, which encourages integration of HCV treatment in primary care. Facilitating low threshold HCV care for PWUD by implementing decentralized models is crucial for HCV elimination. Aims With this study we aim to (1) eliminate 90% of identified HCV infections in Dutch addiction care, using a decentralized PWUD-HCV care model, and (2) identify facilitators and barriers for successful implementation of the model using interviews. Methods We will perform a multicenter mixed-method study on HCV treatment in addiction care. In a prospective observational study we will examine HCV-related outcomes in PWUD receiving HCV treatment as part of addiction care. The primary outcome is viral elimination, defined as percentage of identified HCV positive patients cured with DAAs. In parallel, we will perform a qualitative study to explore facilitators and barriers for implementation of fully decentralized HCV-PWUD care. We will interview addiction care professionals and board members about their experience with HCV-care as part of addiction care. Discussion This study will show effectiveness of integration of HCV care within addiction care, and provide insight in facilitators and barriers to implement integrated HCV-addiction care. The results will provide recommendations for implementation and maintenance of the decentralized HCV pathway, which can facilitate scaling-up to contribute to reaching WHO HCV elimination goals. Trial registration NCT05401136.

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“…Therefore, re‐linkage to care and treatment of these individuals should be a pivotal part of the micro‐elimination strategy. In the Netherlands, the nationwide project CELINE has demonstrated that retrieval of individuals with HCV who were LTFU is feasible and can contribute to HCV elimination 3 …”

Section: Introductionmentioning

confidence: 99%

Socio‐economic factors associated with loss to follow‐up among individuals with HCV: A Dutch nationwide cross‐sectional study

van Dijk,

Boyd,

Brakenhoff

et al. 2023

Liver International

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Background and AimsThe path to hepatitis C virus (HCV) elimination is complicated by individuals who become lost to follow‐up (LTFU) during care, particularly before receiving effective HCV treatment. We aimed to determine factors contributing to LTFU and whether LTFU is associated with mortality.MethodsIn this secondary analysis, we constructed a database including individuals with HCV who were either LTFU (data from the nationwide HCV retrieval project, CELINE) or treated with directly acting antivirals (DAA) (data from Statistics Netherlands) between 2012 and 2019. This database was linked to mortality data from Statistics Netherlands. Determinants associated with being LTFU versus DAA‐treated were assessed using logistic regression, and mortality rates were compared between groups using exponential survival models. These analyses were additionally stratified on calendar periods: 2012–2014, 2015–2017 and 2018–2019.ResultsAbout 254 individuals, LTFU and 5547 DAA‐treated were included. Being institutionalized (OR = 5.02, 95% confidence interval (CI) = 3.29–7.65), household income below the social minimum (OR = 1.96, 95% CI = 1.25–3.06), receiving benefits (OR = 1.74, 95% CI = 1.20–2.52) and psychiatric comorbidity (OR = 1.51, 95% CI = 1.09–2.10) were associated with LTFU. Mortality rates were significantly higher in individuals LTFU compared to those DAA‐treated (2.99 vs. 1.15/100 person‐years (PY), p < .0001), while in those DAA‐treated, mortality rates slowly increased between 2012–2014 (.22/100PY) and 2018–2019 (2.25/100PY).ConclusionIn the Netherlands, individuals who are incarcerated/institutionalized, with low household income, or with psychiatric comorbidities are prone to being LTFU, which is associated with higher mortality. HCV care needs to be adapted for these vulnerable individuals.

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

Cited by 11 publications

References 12 publications

Implementation of a re‐linkage to care strategy in patients with chronic hepatitis C who were lost to follow‐up in Latin America

Implementation of a re‐linkage to care strategy in patients with chronic hepatitis C who were lost to follow‐up in Latin America

Implementation of a decentralized hepatitis C care pathway for people who use drugs in Dutch addiction care. Study protocol for the Hepatitis C: chain of addiction care (CAC) project

Socio‐economic factors associated with loss to follow‐up among individuals with HCV: A Dutch nationwide cross‐sectional study

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