Achieving hepatitis C virus (HCV) elimination as a global health threat has been a priority of many countries since the World Health Organisation published their elimination targets. In low-endemic countries, like the Netherlands (prevalence 0.16%), micro-elimination may be a favourable approach.
In the Netherlands, HCV is restricted to key populations such as people who inject(ed) drugs, migrants from HCV endemic countries, men who have sex with men and people with inherited bleeding disorders. These key populations are commonly identified as targets for HCV micro-elimination initiatives. A population worthy of attention are people with HCV who have been lost to follow-up (LTFU). Despite earlier diagnosis they dropped out of the continuum of care before adequate management had been delivered or after antiviral treatment without formal proof of HCV eradication.
Several Dutch regional projects demonstrated that the LTFU rate in people with HCV runs up to 30%. These pilot studies drove the development of a micro-elimination project “Hepatitis C Elimination in the Netherlands (CELINE)”, that aimed to retrieve and re-evaluate LTFU HCV patients in a nationwide manner. Successful implementation would support the concept of micro-elimination in the LTFU HCV population as a tool towards achieving the World Health Organisation hepatitis C elimination targets in low-endemic countries.
A study, published in the European Journal of Internal Medicine, described the implementation of CELINE project in the Netherlands.
Full study results can be accessed here.