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

J Viral Hepat. 2020 Dec;27(12):1270-1283. doi: 10.1111/jvh.13399. Epub 2020 Sep 22.

Abstract

Since the advent of direct-acting antivirals, elimination of hepatitis C viral (HCV) infections seems within reach. However, studies on the HCV cascade of care show suboptimal progression through each step for all patient groups. Loss to follow-up (LTFU) is a major issue and is a barrier to HCV elimination. This review summarizes the scale of the LTFU problem and proposes a micro-elimination approach. Retrieving LTFU patients and re-engaging them with care again has shown to be feasible in the Netherlands. Micro-elimination through retrieval can contribute to reaching the World Health Organization's viral hepatitis elimination targets by 2030.

Keywords: cascade of care; hepatitis C; lost to follow-up; micro-elimination.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Follow-Up Studies
  • Hepacivirus
  • Hepatitis C* / drug therapy
  • Hepatitis C* / epidemiology
  • Hepatitis C* / prevention & control
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / epidemiology
  • Humans

Substances

  • Antiviral Agents