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Loss to follow-up in the hepatitis C care cascade: A substantial problem but opportunity for micro-elimination

Marleen van Dijk1, Joost P H Drenth1,

  • 1Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands.

Journal of Viral Hepatitis
|September 23, 2020
PubMed

Insights

Hepatitis C elimination is achievable, but patient loss to follow-up (LTFU) hinders progress. Retrieving and re-engaging these patients is a feasible micro-elimination strategy to meet global hepatitis C targets.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Direct-acting antivirals have advanced Hepatitis C Virus (HCV) elimination goals.
  • Suboptimal patient progression through the HCV cascade of care remains a significant barrier.
  • Loss to follow-up (LTFU) is a critical issue impeding HCV elimination efforts.

Purpose of the Study:

  • To review the scale of the LTFU problem in HCV care.
  • To propose a micro-elimination strategy for retrieving LTFU patients.
  • To assess the feasibility of re-engaging LTFU patients in HCV treatment.

Main Methods:

  • Literature review summarizing the scope of LTFU in HCV care.
  • Analysis of strategies for patient retrieval and re-engagement.
  • Case study from the Netherlands demonstrating feasibility.

Main Results:

  • LTFU represents a major obstacle to achieving HCV elimination targets.
  • Patient retrieval and re-engagement programs have proven feasible.
  • Successful re-engagement contributes to the overall goal of HCV elimination.

Conclusions:

  • Micro-elimination through patient retrieval is a viable strategy.
  • This approach can help achieve the World Health Organization's 2030 viral hepatitis elimination targets.
  • Targeted interventions are crucial for overcoming LTFU and completing HCV elimination.

Keywords:
cascade of carehepatitis Clost to follow-upmicro-elimination

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