Current status of HCV elimination in Taiwan

Area of Science:

• Hepatology
• Public Health
• Infectious Disease Epidemiology

Background:

• Hepatitis C virus (HCV) prevalence in Taiwan is estimated at 2.86%, with iatrogenic transmission noted in geriatric patients.
• High-risk groups for HCV include those with end-stage renal disease on hemodialysis, HIV infection, people who inject drugs (PWID), and individuals on opioid substitution therapy.
• An estimated 188,126 individuals in Taiwan have chronic hepatitis C (CHC; HCV RNA positive) requiring treatment.

Purpose of the Study:

• To evaluate Taiwan's progress towards the World Health Organization's (WHO) 2025 HCV elimination targets.
• To assess the impact of national strategies implemented by the Ministry of Health and Welfare (MOHW) between 2017 and 2024.
• To determine the diagnostic and treatment rates for CHC in Taiwan's general population.

Main Methods:

• Analysis of national HCV prevalence data and estimated CHC patient numbers.
• Review of government-led initiatives including national screening, harm reduction, expanded treatment capacity, and linkage-to-care programs.
• Calculation of diagnostic and treatment rates based on program data and WHO criteria.

Main Results:

• Taiwan has demonstrated strong government commitment, crucial for successful HCV elimination efforts.
• National programs successfully addressed barriers to diagnosis and care, including financial support, harm reduction, and expanded treatment access.
• Diagnostic and treatment rates reached 90.6% and 92.8% respectively, meeting WHO's HCV elimination programmatic targets (diagnostic rate >90%, treatment rate >80%).

Conclusions:

• Taiwan is on track to achieve WHO's HCV elimination goals by 2025, largely due to robust government-led strategies.
• The comprehensive approach, encompassing screening, harm reduction, and accessible treatment, has been highly effective.
• Sustained political will and strategic program implementation are key factors in achieving public health targets for infectious disease elimination.