A pilot sentinel surveillance system to monitor treatment and treatment outcomes of chronic hepatitis B and C infections in European centres in 2019

Introduction: The European 2020 targets for Hepatitis B (HBV) and hepatitis C (HCV) elimination require 75% of eligible people with chronic HBV or HCV infection should be treated. We report on a pilot study of sentinel surveillance of individuals with chronic HBV and HCV infections that aimed to monitor progress in achieving treatment targets. Methods:We undertook retrospective enhanced data collection of patients presenting at seven participating clinics in three countries (Croatia, Romania and Spain).Clinical records of patients that conformed to the European definition of chronic viral hepatitis and who presented for the first time between 1 January 2019 and 30 June 2019 were reviewed from date of first attendance through to 31 December 2019. Data were collected on socio-demography, clinical history, laboratory results, and treatment and treatment outcomes. Univariate analysis was performed to describe treatment eligibility, uptake and outcomes for viral hepatitis cases. Results:Of the 229 chronic HBV infections, treatment status was reported for 203 (89%), 80(35%) were reported as eligible for treatment of whom 41(18%) were treated. The majority of treated cases were reported as achieving viral suppression (89% ; 33/37) and all but one was continuing treatment. Of the 240 chronic HCV infections, treatment status was reported for 231 (96%), 179(75%) were reported as being treated and 165 (69%) had achieved sustained virological response. The majority of treated HCV cases received Direct Acting Antivirals (99% ; 174/176) and had ended treatment (99% ; 177/178). Treatment uptake for both HBV and HCV varied between countries. Conclusion:Treatment targets for the elimination of hepatitis were missed for HBV but not for HCV, although there was variation in achieving these targets between countries. The pilot demonstrated the feasibility of implementing a hepatitis sentinel surveillance to monitor the progress in achieving European hepatitis treatment targets.