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<p>Chronic hepatitis C virus (HCV) infection remains a major cause of liver disease worldwide and requires effective strategies to achieve elimination targets. Taiwan has a substantial HCV burden, with prevalence varying by region; in Changhua County, prevalence was 4.3% before large-scale intervention. In 2019, Changhua launched a county-wide micro-elimination program—the Changhua Integrated Program to Stop Hepatitis C Infection (CHIPS-C)—which combined existing population screening with targeted outreach to higher-risk groups and decentralized delivery of curative direct-acting antiviral (DAA) treatment. Using individual-level data from a population-based cohort, we compared care cascade performance before and after CHIPS-C implementation. The program was associated with increased screening coverage (53.7% to 90.2%) and fewer individuals screened to achieve similar numbers of diagnosed infections. Improvements were driven by streamlined confirmatory testing and coordinated care delivery. Here we show that CHIPS-C substantially increased the adjusted treatment completion rate (83.9% vs 38.7% before implementation). Model-based projections indicate that these gains could reduce HCV-related liver cancer and mortality to levels meeting World Health Organization elimination targets by 2030. These findings demonstrate that integrating risk-based targeting with existing health systems can markedly improve efficiency and outcomes, providing a scalable model for accelerating HCV elimination in diverse settings.</p>

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Towards hepatitis C elimination with integrated risk-based screening and decentralized care in Taiwan

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月15日

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  • Yen-Po Yeh,
  • Abbie Ting-Yu Lin,
  • Wei-Wen Su,
  • Chih-Chao Yang,
  • Sheng-Lei Yan,
  • Yu-Chin Yao,
  • Hsiao-Chi Wang,
  • Ming-Ling Hsieh,
  • Li-Chen Shih,
  • Hui-Chun Liu,
  • Hui-Hua Chen,
  • Amy Ming-Fang Yen,
  • Sam Li-Sheng Chen,
  • Chen-Yang Hsu,
  • Chao-Chih Lai,
  • Dih-Ling Luh,
  • Rong-Nan Chien,
  • Chien-Jen Chen,
  • Philippa Easterbrook,
  • John W. Ward,
  • Tsung-Hui Hu,
  • Tony Hsiu-Hsi Chen

摘要

Chronic hepatitis C virus (HCV) infection remains a major cause of liver disease worldwide and requires effective strategies to achieve elimination targets. Taiwan has a substantial HCV burden, with prevalence varying by region; in Changhua County, prevalence was 4.3% before large-scale intervention. In 2019, Changhua launched a county-wide micro-elimination program—the Changhua Integrated Program to Stop Hepatitis C Infection (CHIPS-C)—which combined existing population screening with targeted outreach to higher-risk groups and decentralized delivery of curative direct-acting antiviral (DAA) treatment. Using individual-level data from a population-based cohort, we compared care cascade performance before and after CHIPS-C implementation. The program was associated with increased screening coverage (53.7% to 90.2%) and fewer individuals screened to achieve similar numbers of diagnosed infections. Improvements were driven by streamlined confirmatory testing and coordinated care delivery. Here we show that CHIPS-C substantially increased the adjusted treatment completion rate (83.9% vs 38.7% before implementation). Model-based projections indicate that these gains could reduce HCV-related liver cancer and mortality to levels meeting World Health Organization elimination targets by 2030. These findings demonstrate that integrating risk-based targeting with existing health systems can markedly improve efficiency and outcomes, providing a scalable model for accelerating HCV elimination in diverse settings.