Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model
Introduction: Taiwan has several hepatitis C virus (HCV) hyper-endemic areas. We aimed to evaluate the effectiveness and safety of a collaborative HCV care system with an outreach decentralized strategy among the resource-constrained rural/remote areas of Taiwan. Methods: The pilot study was conduct...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118223000336 |
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| author | Ching-Chu Lo Wei-Yi Lei Ying-Che Huang Jow-Jyh Hwang Chen-Yu Lo Chien-hung Lin Hsu-sheng Cheng Yee-Tam Liao Po-Cheng Liang Meng-Jau Chiou Ming-Jong Bair Chia-Yen Dai Ming-Lung Yu |
| author_facet | Ching-Chu Lo Wei-Yi Lei Ying-Che Huang Jow-Jyh Hwang Chen-Yu Lo Chien-hung Lin Hsu-sheng Cheng Yee-Tam Liao Po-Cheng Liang Meng-Jau Chiou Ming-Jong Bair Chia-Yen Dai Ming-Lung Yu |
| author_sort | Ching-Chu Lo |
| collection | DOAJ |
| description | Introduction: Taiwan has several hepatitis C virus (HCV) hyper-endemic areas. We aimed to evaluate the effectiveness and safety of a collaborative HCV care system with an outreach decentralized strategy among the resource-constrained rural/remote areas of Taiwan. Methods: The pilot study was conducted in four high HCV-endemic townships in the rural/remote areas of Taoyuan, Alishan, Zhuoxi and Xiulin. Registered residents who worked or lived in the four areas and were aged 30–75 years were invited to participate in this program. Multidisciplinary HCV care teams provided outreach decentralized services of anti-HCV screening, link-to-diagnosis, and link-to-treatment with direct-acting antiviral agents (DAA). The primary end-point was sustained virological response (SVR). Results: Of 8291 registered residents who were invited as the target population, 7807 (94.2%) subjects received anti-HCV screening, with the average anti-HCV prevalence rate of 14.2% (1108/7807) (range among four areas: 11.8%–16.7%). The rate of link-to-diagnosis was 94.4% (1046/1108) of anti-HCV-positive subjects (range: 90.9%–100%) with an average HCV-viremic rate of 55.1% (576/1046) (range: 50.0%–64.3%). The link-to-treat rate was 94.4% (544/576) in HCV-viremic subjects (range from 92.7% to 97.2%). Overall, 523 (96.1%) patients achieved an SVR (range: 94.7%–97.6%). Eventually, the overall effectiveness was 80.7% (range: 74.6%–93.1%). The presence of hepatocellular carcinoma at baseline was the only factor associated with DAA failure. The DAA regimens were well-tolerated. Conclusion: The outreach decentralized community-based care system with DAA therapy was highly effective and safe in the achievement of HCV micro-elimination in the resource-constrained rural and remote regions, which could help us to tackle the disparity. |
| first_indexed | 2024-03-12T16:15:51Z |
| format | Article |
| id | doaj.art-ccf76717e93e4e2c88dfeab2fdf7f592 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-03-12T16:15:51Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-ccf76717e93e4e2c88dfeab2fdf7f5922023-08-09T04:32:14ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822023-08-01564680687Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care modelChing-Chu Lo0Wei-Yi Lei1Ying-Che Huang2Jow-Jyh Hwang3Chen-Yu Lo4Chien-hung Lin5Hsu-sheng Cheng6Yee-Tam Liao7Po-Cheng Liang8Meng-Jau Chiou9Ming-Jong Bair10Chia-Yen Dai11Ming-Lung Yu12Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, TaiwanDepartment of Medicine, Hualien Tzu Chi Hospital, Buddihist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital Yuli Branch, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, Taiwan; Eberly College of Science, Department of Biology, Schreyer Honors College, Pennsylvania State University, United StatesDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Martin De Porres Hospital, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, TaiwanHepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung, TaiwanTaoyuan District Public Health Center, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan; Department of Medicine, Mackay Medical College, New Taipei, Taiwan; Corresponding author. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mackay Memorial Hospital-Taitung Branch, Taiwan.Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung, Taiwan; School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan; Corresponding author. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung, Taiwan; School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanIntroduction: Taiwan has several hepatitis C virus (HCV) hyper-endemic areas. We aimed to evaluate the effectiveness and safety of a collaborative HCV care system with an outreach decentralized strategy among the resource-constrained rural/remote areas of Taiwan. Methods: The pilot study was conducted in four high HCV-endemic townships in the rural/remote areas of Taoyuan, Alishan, Zhuoxi and Xiulin. Registered residents who worked or lived in the four areas and were aged 30–75 years were invited to participate in this program. Multidisciplinary HCV care teams provided outreach decentralized services of anti-HCV screening, link-to-diagnosis, and link-to-treatment with direct-acting antiviral agents (DAA). The primary end-point was sustained virological response (SVR). Results: Of 8291 registered residents who were invited as the target population, 7807 (94.2%) subjects received anti-HCV screening, with the average anti-HCV prevalence rate of 14.2% (1108/7807) (range among four areas: 11.8%–16.7%). The rate of link-to-diagnosis was 94.4% (1046/1108) of anti-HCV-positive subjects (range: 90.9%–100%) with an average HCV-viremic rate of 55.1% (576/1046) (range: 50.0%–64.3%). The link-to-treat rate was 94.4% (544/576) in HCV-viremic subjects (range from 92.7% to 97.2%). Overall, 523 (96.1%) patients achieved an SVR (range: 94.7%–97.6%). Eventually, the overall effectiveness was 80.7% (range: 74.6%–93.1%). The presence of hepatocellular carcinoma at baseline was the only factor associated with DAA failure. The DAA regimens were well-tolerated. Conclusion: The outreach decentralized community-based care system with DAA therapy was highly effective and safe in the achievement of HCV micro-elimination in the resource-constrained rural and remote regions, which could help us to tackle the disparity.http://www.sciencedirect.com/science/article/pii/S1684118223000336HCVDAASVRRural area |
| spellingShingle | Ching-Chu Lo Wei-Yi Lei Ying-Che Huang Jow-Jyh Hwang Chen-Yu Lo Chien-hung Lin Hsu-sheng Cheng Yee-Tam Liao Po-Cheng Liang Meng-Jau Chiou Ming-Jong Bair Chia-Yen Dai Ming-Lung Yu Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model Journal of Microbiology, Immunology and Infection HCV DAA SVR Rural area |
| title | Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model |
| title_full | Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model |
| title_fullStr | Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model |
| title_full_unstemmed | Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model |
| title_short | Micro-elimination of hepatitis C virus infection in the rural and remote areas of Taiwan – A multi-center collaborative care model |
| title_sort | micro elimination of hepatitis c virus infection in the rural and remote areas of taiwan a multi center collaborative care model |
| topic | HCV DAA SVR Rural area |
| url | http://www.sciencedirect.com/science/article/pii/S1684118223000336 |
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