Beekmans N, Klemt-Kropp M
Department of Gastroenterology and Hepatology, Northwest Clinics, Alkmaar, The Netherlands.
Hepatol Med Policy. 2018 Jan 31;3:5. doi: 10.1186/s41124-018-0032-9. eCollection 2018.
Many persons infected with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) in the past are now lost to follow-up. The aim of the Northern Holland Hepatitis Retrieval Project (NHHRP) is to retrieve and re-evaluate persons previously diagnosed with HBV or HCV and bring them back into care. Chronic HBV infection was defined as two positive Hepatitis B surface antigen (HBsAg) tests within 6 months and chronic HCV infection with 2 positive HCV RNA tests by polymerase chain reaction (PCR).
Data files of the local public health services and microbiology laboratory were explored to identify all registered HBV and HCV cases in the Alkmaar region, the Netherlands, for the past 15 years. Identified cases were compared with patients currently known in our hospital. Patients without follow-up in primary or hospital care were approached via their primary health care physician and invited for evaluation at our hospital.
In total, 552 cases of HBV were identified. 356 (64.5%) had no follow-up. Only 113/356 (31.7%) were eligible for retrieval and 44.2% were evaluated in our hospital resulting in a change of management in 22/50 (44%) of patients. Four hundred ninety nine cases of HCV were identified, 150/499 (30.1%) were lost to follow-up. Only 20/150 (13.3%) were eligible for retrieval and 4/20 (20%) were evaluated at our clinic. Resulting in a change of management in 3/4 (75%).
Only a limited part of HBV and HCV persons lost to follow-up is eligible for retrieval, nonetheless re-evaluation of these persons will lead to a change of management in the majority of persons.
过去许多感染乙肝病毒（HBV）和丙肝病毒（HCV）的人现在已失访。北荷兰肝炎检索项目（NHHRP）的目的是找回并重新评估先前诊断为HBV或HCV的人，并使他们重新接受治疗。慢性HBV感染定义为6个月内两次乙肝表面抗原（HBsAg）检测呈阳性，慢性HCV感染定义为通过聚合酶链反应（PCR）检测两次HCV RNA呈阳性。
对当地公共卫生服务机构和微生物实验室的数据文件进行了梳理，以确定过去15年荷兰阿尔克马尔地区所有登记的HBV和HCV病例。将识别出的病例与我们医院目前已知的患者进行比较。通过他们的初级保健医生联系在初级保健或医院护理中未接受随访的患者，并邀请他们到我们医院进行评估。
共识别出552例HBV病例。356例（64.5%）未接受随访。只有113/356例（31.7%）符合找回条件，44.2%在我们医院接受了评估，结果50例患者中有22例（44%）的治疗方案发生了改变。识别出499例HCV病例，150/499例（30.1%）失访。只有20/150例（13.3%）符合找回条件，20例中有4例（20%）在我们诊所接受了评估。结果4例中有3例（75%）的治疗方案发生了改变。
失访的HBV和HCV感染者中只有有限一部分符合找回条件，尽管如此，对这些人的重新评估将导致大多数人的治疗方案发生改变。
