Re-engaging individuals who are lost to follow-up (LTFU) is needed to achieve hepatitis C virus (HCV) elimination in the United States. The CDAF-Relink grant funds programs which use data management systems like patient registries to identify and re-engage individuals with HCV who are LTFU.

This study aims to assess the follow-up eligibility of individuals with HCV presumed LTFU. Pre-contact investigation (PCI) to assess ineligibility, including due to death or outdated contact information, was encouraged.  Data came from the patient registries of 23 of 30 grant-funded organizations in different clinical, community and geographical settings. Data sources included patient, state, prison, and public records.

PCI was completed for 28,600 individuals between January 2024 and September 2025. The most common data sources were patient (64%) and state health records (30%). Fifty-one percent of presumed LTFU individuals were ineligible for follow-up (Table 1). Undocumented ongoing care, cure, or death, and outdated contact information were the most common ineligibility reason, occurring in over 80% of ineligible individuals (Table 2). Meanwhile, 30% of individuals ineligible due to outdated contact information were aged 30-39, and 23% were aged 40-49.

The number of presumed LTFU individuals found to be in care or cured suggests poorly integrated patient tracking systems may be obscuring the impact of HCV programs. Meanwhile, outdated contact information is a notable barrier to re-engagement. Given the labor and time costs of PCI, improved patient tracking systems will optimize resource utilization for HCV patient re-engagement and overall care coordination.