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

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
• micro-elimination
• lost to follow-up
• direct-acting antivirals
• retrieval

Acknowledgments

The authors thank nurses Trine Sølund Bager and Mie Rønnebæk in the hepatitis outpatient clinic, Department of Infectious Disease, Odense University Hospital, and Department of Medicine, Sygehus Lillebælt, Kolding, for their great commitment.

Disclosure statement

SD has received speaker fees from Gilead, Abbott, and AbbVie, travel support from Gilead and AbbVie, and research grants from Gilead. PBC has received research grants from Gilead, AbbVie, and MSD. ALHØ has received research grants from Gilead and speaker fees and travel support from Gilead, AbbVie, and MSD. JFH has received travel support from Gilead, AbbVie, and MSD. BTR has no conflicts of interest.

Additional information

Funding

The C-Free South Project is funded by the C.H.I.M.E. grant by Gilead Sciences [ISR-DK-18-10469]. The Region of Southern Denmark and the University of Southern Denmark, Odense, have supported the work. The financial supporters have not been involved in this work.