Changhua Integrated Program to Stop HCV Infection (CHIPS-C): A county-wide model for integrated HCV elimination in...

Hepatitis C virus (HCV) infection remains a global health challenge. The Changhua Integrated Program to Stop HCV Infection (CHIPS-C), launched in 2019, aimed to achieve HCV elimination in alignment with Taiwan's 2025 national target by combining general population testing with targeted micro-elimination strategies.

Antecedent anti-HCV data were used to estimate viremic HCV prevalence to set diagnostic and treatment targets. HCV testing was embedded into services for marginalized populations, chronic disease management, and community-based multiple screening through collaboration among gastroenterologists and various specialties. Program performance was assessed using HCV care cascade indicators, and population-level impact was evaluated by care delivery channels, age, gender, geographic areas, and changes in HCV viremia prevalence.

Marginalized populations had an average HCV prevalence of 54.9 %, with moderate rates (5.8 %-7.4 %) in chronic disease groups and the lowest prevalence (2.6 %) in the general population. From 2005 to 2024, 513897 individuals were screened through the extensive, county-wide participation of all relevant care settings. High care cascade performance was consistently achieved across all care settings. Overall, 98.5 % (16675) of the estimated viremic cases were diagnosed, and 90.5 % (15098) of those diagnosed received treatment, exceeding the WHO's programmatic target. HCV viremia prevalence declined from 2.43 % in 2003 to 0.39 % in 2024, marking an 84.1 % reduction.

The CHIPS-C program demonstrated that integrating HCV elimination within diverse communicable and noncommunicable disease programs can effectively accelerate progress toward elimination goals. This locally led, collaborative, and multi-channel strategy provides a scalable model for other regions with comparable HCV burdens.