Retrieval of HCV patients lost to follow-up as a strategy for Hepatitis C Microelimination: results of a Brazilian multicentre study

• Published in: BMC infectious diseases 2023-07, Vol.23 (1), p.468-468, Article 468
• Main Authors: Ferraz, Maria Lucia Gomes, de Andrade, Antonio Ricardo Cardia Ferraz, Pereira, Gustavo Henrique Santos, Codes, Liana, Bittencourt, Paulo Lisboa
• Format: Article
• Language: English
• Subjects: Adult; Antiviral agents; Antiviral Agents - therapeutic use; Brazil - epidemiology; Care and treatment; DAA treatment; Diagnosis; Dosage and administration; Female; Hepacivirus - genetics; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C virus; Hepatitis C, Chronic - drug therapy; Humans; Infections; Infectious diseases; Liver cancer; Liver cirrhosis; Lost to Follow-Up; Male; Medical consultation; Medical diagnosis; Medical records; Methods; Micro-elimination; Middle Aged; Non-SVR; Outpatient care facilities; Patients; Questionnaires; Retrieval; Retrospective Studies; Short message service; Statistical analysis
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08169-0

Several HCV patients in Brazil were lost to follow-up (LTFU) in the last two decades before achievement of sustained virological response (SVR). Strategies to recall those diagnosed but untreated patients have been used elsewhere with different success rates. To identify and retrieve LTFU patients in order to offer them the treatment with the current highly effective direct acting antiviral agents (DAAs). Registries ofall HCV patients from three large reference centers in Brazil were retrospectively reviewed to identify those with no registry of SVR. Reasons for non-achievement of SVR were elicited in HCV-RNA + patients. All patients who were not treated or cured were contacted to offer the therapy with DAAs. 10,289 HCV patients (50% males, mean age 52 ± 11 years) were identified. Only 4,293 (41.7%) had been successfully treated previously. From the remaining 5,996 most were LTFU (59%), were not treated for other reasons (14.7%) or were non-responders (26.3%). After revision of the charts 3,559 were considered eligible to be retrieved. The callback success of phone calls was 18%, 13% to cellphone messages (SMS or WhatsApp) and 7% to regular mail. Five-hundred sixty patients had been already treatedor were on treatment and 234 were reported to be dead or transplanted. Finally, 201 had made an appointment and initiated antiviral treatment. Even considering the low callback rate, retrieval of LTFU patients was shown to be an important strategy forhepatitis C micro-elimination in Brazil.