Retrieval of patients with hepatitis C who were lost to follow-up in Southern Denmark

Infect Dis (Lond). 2023 May;55(5):361-369. doi: 10.1080/23744235.2023.2189298. Epub 2023 Mar 17.

Abstract

Background: The goal of the C-Free-South project is to eliminate hepatitis C (HCV) in the Region of Southern Denmark (1.2 million inhabitants). One target group consists of people with HCV who had received care but were lost to follow-up. The study aim was to evaluate program efficacy in locating these patients and getting them into care.

Methods: Patients were contacted if they were HCV-RNA positive and age 18+ years, registered in the clinical hepatitis database as of November 1, 2019, and had no scheduled HCV-related appointment. They were contacted at 2-month intervals by phone or letter. For patients who did not respond, we asked their general practitioner to refer them, if possible.

Results: We identified 69 (7%) patients in the database who were listed as untreated and not being followed up. We successfully contacted 54 (78%), and the remaining 15 (22%) did not respond to our contacts. To date, 45 (65%) had initiated treatment, one (1%) had rejected treatment, and eight (12%) did not show up to their appointments. Among those receiving treatment, 20 (44%) responded after the first contact, 18 (40%) after the second contact, and 7 (16%) after informing the general practitioner.

Conclusion: An intensified and persistent effort made it possible to reach most HCV patients lost to follow-up. All new contact attempts increased the possibility that patients would receive treatment. Nevertheless, 22% of HCV patients lost to follow-up did not respond to repeated contact attempts.

Keywords: Hepatitis C; direct-acting antivirals; lost to follow-up; micro-elimination; retrieval.

MeSH terms

  • Adolescent
  • Antiviral Agents / therapeutic use
  • Denmark / epidemiology
  • Hepacivirus / genetics
  • Hepatitis C* / drug therapy
  • Hepatitis C* / epidemiology
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / epidemiology
  • Humans
  • Lost to Follow-Up

Substances

  • Antiviral Agents