REtrieval And cure of Chronic Hepatitis C (REACH): Results of micro‐elimination in the Utrecht province

Kracht, Patricia A. M.; Arends, Joop E.; Erpecum, Karel J. van; Thijsen, Steven; Vlaminckx, Bart J. M.; Weersink, A. J. L.; Wensing, A. M. J.; Deege, M.; Dimmendaal, Marieke; Stadhouders, P.H.G.M.; Friederich, Philip W.; Verhagen, M. A. M. T.; Boland, Greet J.; Hoepelman, Andy I. M.

doi:10.1111/liv.13959

Cited by 35 publications

(59 citation statements)

References 14 publications

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“…Moreover, they should not be considered the target of HCV elimination strategies themselves, but rather a brick in the achievement of HCV eradication in the entire population. Evidence supporting feasibility and effectiveness of micro‐elimination strategies is mounting, both in developed countries and LMICs and in different target populations …”

Section: Eradication and Eliminationmentioning

confidence: 99%

“…b IFN-based regimens.achievement of HCV eradication in the entire population. Evidence supporting feasibility and effectiveness of micro-elimination strategies is mounting, both in developed countries and LMICs and in different target populations [44][45][46][47][48]. 6 | S PECIAL P OPUL ATIONSTargeting HCV eradication in specific high-risk populations appears to be a highly effective strategy to reduce disease burden.…”

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confidence: 99%

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Hepatitis C: Is eradication possible?

Lombardi

Mondelli

2019

Liver International

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Hepatitis C has a relevant global impact in terms of morbidity, mortality and economic costs, with more than 70 million people infected worldwide. In the resolution, “Transforming our world: the 2030 Agenda for Sustainable Development” was included as a focus area in the health‐related goal with world leaders pledging to “combat” it by 2030. In response, WHO drafted the Global Viral Hepatitis Strategy carrying the ambitious targets to reduce the number of deaths by two‐thirds and to increase treatment rates up to 80%. Despite the availability of highly effective therapeutic regimens based on direct‐acting antivirals many barriers to HCV eradication still remain. They are related to awareness of the infection, linkage to care, availability of the therapeutic drug regimens and reinfection. Overall, if an effective prophylactic vaccine will not be available, HCV eradication appears difficult to achieve in the future.

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Section: Eradication and Eliminationmentioning

confidence: 99%

mentioning

confidence: 99%

Hepatitis C: Is eradication possible?

Lombardi

Mondelli

2019

Liver International

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“…In 2018, the Polaris Observatory reported that only 12 countries were on the track of achieving this result, and Italy is among these . Notably, many countries have already started special programmes to meet this challenge . In this optics, the European Association for the Study of Liver (EASL) International Liver Foundation proposed “micro‐elimination” as a way to eliminate HCV infection.…”

Section: Introductionmentioning

confidence: 99%

HCV point‐of‐care screening programme and treatment options for people who use drugs in a metropolitan area of Southern Italy

Persico

Masarone

Aglitti

et al. 2019

Liver International

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Background and aims People who use drugs (PWUD) represent an active reservoir of HCV infection. The prevalence of chronic HCV infection in PWUD in Italy remains unknown because of the lack of systematic screening. Thanks to direct‐acting antiviral agents (DAAs), hepatitis C can now be cured in most patients. Thus, the next challenge is to provide linkage‐to‐care for these patients. Methods In this scenario, we conducted a screening programme in PWUD attending seven Addiction Centers in Southern Italy, as well as a treatment programme in the Liver Unit of the University Hospital of Salerno. We used the OraQuick HCV antibody test to screen the PWUD (from 1 April to 30 September 2018). Results 593 subjects were consecutively enrolled in the programme; 250 (41.8%) were HCV‐Ab‐positive. 143 (24.1%) were aware of their infection and had been HCV‐RNA‐tested: 83 were positive and 60 negative. The remaining 107 subjects (18.1%) had never previously been tested and were unaware of their infection. A total of 160 (26.9%) HCV RNA‐positive patients were found and offered antiviral therapy with DAAs. The sustained virological response rate was 98.5% and no adverse events were recorded. Two patients voluntarily discontinued treatment. No reinfections have been recorded to date. Conclusions The prevalence of HCV‐Ab positivity was high in the PWUDs enrolled in this study, and almost half the patients were unaware of being HCV‐positive. The linkage‐to‐care provided was safe and effective, and no case of reinfection was recorded.

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“…In order to achieve the World Health Organization (WHO) 2030 elimination targets [3], focus in the field of HCV healthcare has shifted towards increasing the diagnosis rate, improving linkage to care but also promoting adherence and preventing loss to follow-up [4]. Next to those undiagnosed, patients with HCV who are lost to follow-up (LFU) are an important source of untreated individuals with HCV [5].…”

Section: Introductionmentioning

confidence: 99%

“…Following several small Dutch pilot retrieval projects, the REACH (REtrieval And cure of Chronic Hepatitis C) study aimed to bring LFU patients with HCV back into care, describing that over the past 15 years up to 14% of all individuals with HCV were LFU and eligible for retrieval [5][6][7][8]. The REACH-study achieved the highest retrieval yield with 28% of all local LFU patients with HCV traced but this final turnout was still moderate at most.…”

Section: Introductionmentioning

confidence: 99%

The balancing perspective of hard-to-reach hepatitis C patients who were lost to follow-up: A qualitative study

et al. 2020

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Background In the foreseeable future, patients with hepatitis C virus (HCV) with good healthcare access will all have been cured and the lost to follow-up (LFU) HCV-population will increasingly exist of hard-to-reach patients. Efforts to retrieve these individuals with HCV have been moderately successful so far. A deeper understanding of the reasons for loss to follow-up and the underlying processes is lacking. Aims To explore reasons for previous loss to follow-up in patients with HCV who have been brought back into care. Methods In 2017, fifteen patients with HCV who were evaluated at the University Medical Center Utrecht (UMCU) Infectious diseases outpatient clinic as part of the "REtrieval And cure of Chronic Hepatitis C" (REACH)-project were included in this study through convenience sampling. Face-to-face semi-structured in-depth interviews were conducted and a qualitative analysis based on the grounded theory was applied. Results A basic socio-psychological process named "maintaining the achieved balance" was uncovered in patients with HCV who were LFU. This "achieved balance" is the result of a transformative process following the initial HCV diagnosis. It is a steadfast stance in which participants keep HCV out of sight and in the margin of their lives in order to reestablish an optimal state of well-being. The balancing perspective is subsequently defended by repeated evasive behavioral patterns to avoid confrontation with the disease.

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REtrieval And cure of Chronic Hepatitis C (REACH): Results of micro‐elimination in the Utrecht province

Cited by 35 publications

References 14 publications

Hepatitis C: Is eradication possible?

Hepatitis C: Is eradication possible?

HCV point‐of‐care screening programme and treatment options for people who use drugs in a metropolitan area of Southern Italy

The balancing perspective of hard-to-reach hepatitis C patients who were lost to follow-up: A qualitative study

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