The Netherlands Is on Track to Meet the World Health Organization Hepatitis C Elimination Targets by 2030

Abstract

Background: The Netherlands strives for hepatitis C virus (HCV) elimination, in accordance with the World Health Organization targets. An accurate estimate when HCV elimination will be reached is elusive. We have embarked on a nationwide HCV elimination project (CELINE) that allowed us to harvest detailed data on the Dutch HCV epidemic. This study aims to provide a well-supported timeline towards HCV elimination in The Netherlands. Methods: A previously published Markov model was used, adopting published data and unpublished CELINE project data. Two main scenarios were devised. In the Status Quo scenario, 2020 diagnosis and treatment levels remained constant in subsequent years. In the Gradual Decline scenario, an annual decrease of 10% in both diagnoses and treatments was implemented, starting in 2020. WHO incidence target was disregarded, due to low HCV incidence in The Netherlands (≤5 per 100,000). Results: Following the Status Quo and Gradual Decline scenarios, The Netherlands would meet WHO’s elimination targets by 2027 and 2032, respectively. From 2015 to 2030, liver-related mortality would be reduced by 97% in the Status Quo and 93% in the Gradual Decline scenario. Compared to the Status Quo scenario, the Gradual Decline scenario would result in 12 excess cases of decompensated cirrhosis, 18 excess cases of hepatocellular carcinoma, and 20 excess cases of liver-related death from 2020–2030. Conclusions: The Netherlands is on track to reach HCV elimination by 2030. However, it is vital that HCV elimination remains high on the agenda to ensure adequate numbers of patients are being diagnosed and treated.

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

“…CELINE results must be placed in the greater context of HCV elimination. A recent modelling study predicting the Netherlands' progress towards the WHO HCV elimination targets concluded that the Netherlands is currently on track to meet these targets by 2030 [11]. However, this was only met under the assumption that annual HCV diagnosis and treatment rates were maintained at the 2019 levels.…”

The Role of the Microbiota Gut–Liver Axis during HCV Chronic Infection: A Schematic Overview

“…Since 2011, the introduction of direct-acting antiviral (DAA) drugs in clinical practice has significantly increased the rate of people who have eradicated the virus, although a small percentage of positive patients are still difficult to treat [ 2 ]. The HCV eradication program is ongoing, even if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has created a delay in the diagnosis and cure of patients with HCV infection due to a reallocation of public health measures and resources [ 3 , 4 ]. Van Dijk and co-authors, by applying a mathematical model, have shown an increased number of hepatic diseases during the COVID-19 pandemic scenario [ 4 ].…”

“…The HCV eradication program is ongoing, even if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has created a delay in the diagnosis and cure of patients with HCV infection due to a reallocation of public health measures and resources [ 3 , 4 ]. Van Dijk and co-authors, by applying a mathematical model, have shown an increased number of hepatic diseases during the COVID-19 pandemic scenario [ 4 ]. However, timely diagnosis and DAA treatment has reduced the pathogenic effects of a persistent HCV infection, in both hepatic and extra-hepatic diseases [ 5 ].…”

Against All Odds? Addiction History Associated with Better Viral Hepatitis Care: A Dutch Nationwide Claims Data Study

“…In 2016, the World Health Organization (WHO) set ambitious goals for the elimination of HBV and HCV by 2030 [5]. Key to the target in this elimination strategy are specific populations, where the prevalence rates are higher, in particular migrants from endemic countries and people who inject(ed) drugs (PWID) [4,6]. For instance, in the Netherlands prevalence rates for HBV and HCV among PWID are up to 4% and 59%, respectively [4].…”