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Cascade of care among hepatitis B patients in Maastricht, the Netherlands, 1996 to 2018

Eva van Oorschot1,2, Özgür M Koc3,4,5, Astrid Ml Oude Lashof3,6

  • 1Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.

Journal of Virus Eradication
|July 5, 2022
PubMed

Insights

A significant number of hepatitis B virus (HBV) patients in the Netherlands are not linked to care or are lost to follow-up. Caucasian ethnicity was linked to not being linked to care, while older age and Asian ethnicity were predictors for loss to follow-up.

Area of Science:

  • Hepatology
  • Public Health
  • Infectious Diseases

Background:

  • Chronic hepatitis B virus (HBV) infection affects 0.34% of the Dutch population.
  • Linkage to care and follow-up rates in HBV patients are not well-defined.
  • This study investigated the cascade of care for HBV patients in Maastricht, Netherlands.

Purpose of the Study:

  • To determine the cascade of care for hepatitis B surface antigen (HBsAg)-positive patients.
  • To identify predictors for not being linked to care.
  • To identify predictors for loss to follow-up (LTFU) among HBV patients.

Main Methods:

  • Retrospective identification of HBsAg-positive patients between December 1996 and September 2018.
  • Analysis of linkage to care and LTFU rates.
  • Statistical analysis to identify predictors for not being linked to care and LTFU.

Main Results:

  • Out of 569 individuals with chronic/unknown HBV status, 23.6% were not linked to care and 58.7% experienced LTFU.
  • Caucasian ethnicity was a predictor for not being linked to care (OR=2.76).
  • Older age (OR=0.97), high HBV DNA levels (OR=0.44), and Asian ethnicity (OR=0.46) were predictors for LTFU.
  • Rates of not being linked to care and LTFU decreased significantly over time.

Conclusions:

  • A substantial proportion of HBsAg-positive individuals are not linked to care or are lost to follow-up.
  • Ethnicity appears to influence linkage to care and follow-up in HBV patients.
  • Further research is necessary to understand these ethnic disparities in HBV care.
Abstract

Keywords:
Cascade of careEthnicityHepatitis BLinkage to careLoss to follow-upThe Netherlands

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