Taiwan accelerates its efforts to eliminate hepatitis C

Chien, Rong‐Nan; Lu, Sheng–Nan; Pwu, Raoh‐Fang; Wu, Grace; Yang, Wei; Liu, Chia-Ling

doi:10.35772/ghm.2021.01064

Cited by 27 publications

(28 citation statements)

References 23 publications

(25 reference statements)

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“…Administration (HPA). 20 The current study can provide exact information for decision-making to overcome the gaps in each care cascade in HCV-hyperendemic areas as well as in the general population.…”

Section: Discussionmentioning

confidence: 97%

“…Taiwan has implemented many efforts to accelerate the elimination of HCV since 2017, aiming to achieve the goal of the WHO by 2025. The Ministry of Health and Welfare has set several key success strategies, including financial commitment of DAA reimbursement by National Health Insurance and programs to improve awareness and scale up national screening programs by the Taiwan Centers for Disease Control (CDC) and the Health Promotion Administration (HPA) 20 . The current study can provide exact information for decision‐making to overcome the gaps in each care cascade in HCV‐hyperendemic areas as well as in the general population.…”

Section: Discussionmentioning

confidence: 99%

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Low disease awareness as a contributing factor to the high prevalence of hepatitis C infection in Tzukuan, a hyperendemic area of southern Taiwan

Tsai

Dai

Huang

et al. 2022

The Kaohsiung J of Med Scie

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Low disease awareness as a contributing factor to the high prevalence of hepatitis C infection in Tzukuan, a hyperendemic area of southern Taiwan

Tsai

Dai

Huang

et al. 2022

The Kaohsiung J of Med Scie

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“…Starting in 2017, the National Health Insurance only reimbursed DAA treatment at hepatology clinics for those who had documented chronic HCV infection with moderate to severe liver fibrosis. As the DAA treatment became more accessible to PLWH after these restrictions were gradually lifted by involving HIV-treating physicians to provide DAA treatments to PLWH regardless of the chronicity of HCV viremia between 2017 and 2019 [ 20 ], our study demonstrated the prevalence of HCV viremia began to decrease after 2018 and the reduction of HCV incidence after 2019. The findings suggest that unrestricted access to DAA treatments is crucial for the success of HCV elimination to be achieved.…”

Section: Discussionmentioning

confidence: 99%

“…In Taiwan, the National Health Insurance started to reimburse DAA treatments in January 2017, which initially covered only HCV-infected patients with moderate to severe fibrosis; patients who were reinfected with HCV or had relapses after DAA treatments were not reimbursed. In 2018, the government published Taiwan Hepatitis C Policy Guidelines, aiming to reach the WHO HCV elimination targets by 2025 [ 20 , 21 ]. As of 2021, restrictions on DAA treatment have been gradually lifted to increase the coverage of treatments and all patients with HCV viremia, regardless of chronicity, could have access to DAA treatment [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Hepatitis C microelimination among people living with HIV in Taiwan

Chen

et al. 2022

Emerging Microbes & Infections

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To reach the WHO target of hepatitis C virus (HCV) elimination by 2025, Taiwan started to implement free-of-charge direct-acting antiviral (DAA) treatment programme in 2017. Evaluating the progress of HCV microelimination among people living with HIV (PLWH) is a critical step to identify the barriers to HCV elimination. PLWH seeking care at a major hospital designated for HIV care in Taiwan between January 2011 and December 2021 were retrospectively included. For PLWH with HCV-seropositive or HCV seroconversion during the study period, serial HCV RNA testing was performed using archived samples to confirm the presence of HCV viremia and estimate the prevalence and incidence of HCV viremia. Overall, 4199 PLWH contributed to a total of 27,258.75 person-years of follow-up (PYFU). With the reimbursement of DAAs and improvement of access to treatments, the prevalence of HCV viremia has declined from its peak of 6.21% (95% CI, 5.39–7.12%) in 2018 to 2.09% (95% CI, 1.60–2.77%) in 2021 (decline by 66.4% [95% CI, 55.4–74.7%]); the incidence has declined from 25.94 per 1000 PYFU (95% CI, 20.44–32.47) in 2019 to 12.15% per 1000 PYFU (95% CI, 8.14–17.44) (decline by 53.2% [95% CI, 27.3–70.6%]). However, the proportion of HCV reinfections continued to increase and accounted for 82.8% of incident HCV infections in 2021. We observed significant declines of HCV viremia among PLWH with the expansion of the DAA treatment programme in Taiwan. Further improvement of the access to DAA retreatments is warranted to achieve the goal of HCV microelimination.

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Direct‐acting antiviral therapy for chronic hepatitis C among incarcerated people who inject drugs

Mao

Chen

2022

Adv in Digestive Medicine

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Hepatitis C virus (HCV) infection is an important public health problem, causing significant morbidity and mortality worldwide. The prevalence of HCV infections is especially high among people who inject drugs (PWID). The efficacy of direct‐acting antiviral (DAA) therapy was evaluated herein. During 2019‐2021, a total of 321 cases who received a full course of DAA therapy and completed a 12‐week follow‐up observation were studied. The most frequent genotype (GT) was GT6 (34.9%), followed by GT1a (23.4%), GT1b (14.6%), GT2 (12.1%), and GT3 (11.8%). Increase was observed in GT6 (from 29.8% in 2019 to 44.9% in 2021) and GT3 (from 9.9% in 2019 to 16.3% in 2021) over the study years. GT2 was more likely found in patients >50 years old, while GT3 was more in younger patients (both P < .05). GT3 was also more frequently associated with moderate scores of fibrosis‐4 index (FIB‐4) (1.45 ≤ FIB‐4 ≤ 3.25, 13/38 vs 49/283; P < .05). High viral loads (>1 500 000 IU/mL) were found in 65.7% of the patients, including 21.5% showing a very high level (>6 000 000 IU/mL). Compared to other genotypes, viral loads were significantly higher in GT6 (P < .005) and lower in GT1b (P < .01). The end of treatment virologic response rate and the sustained virologic response rate at 12 weeks (SVR12) post‐treatment were both 100%. Two recurrent infections with GT6 and GT2 were noted at 16‐month and 3‐month, respectively, after achieving SVR12. The present report provides a solid evidence for the effectiveness of DAA therapy in the treatment of hepatitis C among incarcerated PWID. We believe that appropriate DAA therapy, when incorporated with active universal screening, can achieve micro‐elimination of chronic hepatitis C in incarcerated persons. Hence, the strategies should be applied to all custodial settings, especially for PWID, as an important step to eliminate hepatitis C by 2025, a goal set by the Taiwan government.

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Taiwan accelerates its efforts to eliminate hepatitis C

Cited by 27 publications

References 23 publications

Low disease awareness as a contributing factor to the high prevalence of hepatitis C infection in Tzukuan, a hyperendemic area of southern Taiwan

Low disease awareness as a contributing factor to the high prevalence of hepatitis C infection in Tzukuan, a hyperendemic area of southern Taiwan

Hepatitis C microelimination among people living with HIV in Taiwan

Direct‐acting antiviral therapy for chronic hepatitis C among incarcerated people who inject drugs

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