**1. Introduction**

Chronic viral hepatitis, if left untreated, leads to considerable morbidity and liverrelated mortality [1]. Therefore, the World Health Organization (WHO) set ambitious hepatitis B (HBV) and C virus (HCV) elimination targets in 2016. The goal is to eliminate viral hepatitis as a public health threat by 2030, which is defined by the following targets: (1) 80% reduction in incidence, (2) 65% reduction in hepatitis-related mortality, (3) 90% diagnosis coverage, and (4) 80% treatment coverage [2]. The year 2015 serves as baseline for these targets. Many countries aim to reach these goals in time and elaborate efforts have been made to monitor progress towards elimination, often using mathematical models [3,4].

With regard to hepatitis C, it appears that only few countries are on track to meeting the WHO targets in time [5]. A recent modelling study, using the latest data on chronic HCV prevalence, and annual diagnosis and treatment levels in 45 high-income countries, suggests that only Australia, Canada, France, Germany, Iceland, Italy, Japan, Spain, Sweden, Switzerland, and the United Kingdom are currently on track [5]. Tailored HCV-specific national strategies, regional or national guidelines, national expert advisory groups and/or decentralized HCV screening likely keep these countries on a trajectory towards elimination.

The situation is different in The Netherlands. While there is a national plan that is endorsed by the Ministry of Health, the governmen<sup>t</sup> has not allocated funds to aid its execution, and the plan itself lacks specific targets and accompanying interventions. Furthermore, The Netherlands does not ye<sup>t</sup> have a nationwide hepatitis registry, complicating the ability to track our progress. However, physicians took the initiative to establish a national collaboration group (HepNed) to create the necessary infrastructure to eliminate HCV. HepNed has initiated several HCV elimination projects, such as CELINE and CAC.

CELINE, which stands for hepatitis C elimination in The Netherlands, is a nationwide retrieval project aiming to re-engage lost to follow-up HCV patients with care [6]. The project uses laboratory and patient records dating back 15 years from virtually all hepatitis treatment centers in The Netherlands. CAC, which stands for hepatitis C Chain of Addiction Care, is a project that aims to decentralize HCV care for people visiting addiction care services, one of the few remaining risk groups for chronic HCV infection in The Netherlands, even though transmission is very low [7]. Patients in several facilities all over The Netherlands are screened and linked to care, and data is collected throughout this process. These projects have provided us with high quality data on the current epidemiology of HCV in The Netherlands.

A recent study estimated that The Netherlands will reach the WHO HCV elimination targets by 2035 [5]. However, this study did not have access to the detailed epidemiologic data yielded from recent elimination projects. A previous Dutch modelling study from the pre-DAA era investigated various strategies to reduce the future HCV disease burden [8]. Many changes from their most effective strategy have since been implemented, including unrestricted access to direct-acting antivirals (DAA). Furthermore, various efforts to achieve viral hepatitis elimination have since been initiated. The aim of the present modelling study is therefore to evaluate the current timeline towards HCV elimination in The Netherlands.
