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

Introduction Chronic hepatitis B (HBV) and hepatitis C (HCV) infections cause approximately 64, 000 deaths annually within the European Union and Economic Area [Mardh 2020] Treatment is a core components of the WHO Global Health Sector Strategy for the elimination of viral hepatitis [WHO 2016] European targets for hepatitis elimination by 2020 require 75% of eligible patients to be treated and 90% to have achieved viral suppression [WHO 2017] Objectives Pilot the feasibility of establishing a European sentinel surveillance for viral hepatitis Assess treatment and treatment outcomes against international targets Results 229 HBV and 240 HCV cases reported by the 7 sites in three countries 37% of chronic HBV cases reported Amino Alanine Transferase (ALT) above upper limit normal (ULN) and 29% stage F2 fibrosis or greater 68% of chronic HCV cases reported ALT above ULN and 55% stage F2 fibrosis or greater Of the 240 chronic HCV infections: treatment status was reported for 231 179 (75%) were reported as being treated 96% were treated with Direct Acting Antivirals 98% had achieved sustained virological response 178 had ended treatment Of the 229 chronic HBV infections: treatment status was reported for 203 80 were reported as eligible for treatment according to either local or EASL criteria 41 of the 80 eligible cases were treated 37 achieving viral suppression (89% ; 33/37) and all were continuing treatment. Conclusions and recommendations: The WHO 2020 targets of 75% treatment of eligible cases was missed for HBV cases (51%) and achieved for HCV cases (77%) 90% viral suppression of treated cases was just missed for HBV cases (89%) and achieved for HCV cases (98%) Further research is needed to address the low uptake of HBV treatment reported here and in other studies The insights gained from this pilot justify its future expansion to monitor the progress in achieving hepatitis control targets such as treatment uptake as these are currently not available in many countries