Precision Screening Helps Close Hepatitis C Diagnosis and Treatment Gaps

Although highly effective antiviral therapies are available, persistent gaps in screening, confirmatory testing, and linkage to care continue to limit disease control. New findings show that a countywide precision screening program combined with decentralized treatment substantially improved case detection, treatment initiation, and projected health outcomes.

National Taiwan University and collaborating institutions developed an integrated hepatitis C elimination program across Changhua County, Taiwan, combining risk-based screening with decentralized, community-based care. Rather than relying solely on population-wide screening, the model prioritizes high-risk groups, including people with chronic kidney disease, diabetes, human immunodeficiency virus (HIV), individuals who inject drugs, incarcerated populations, and dialysis patients. Services are embedded within existing community health resources and integrate targeted screening, rapid diagnosis, confirmatory RNA testing, and locally delivered treatment.

In a study involving more than 1.27 million residents, published in Nature Communications, the program increased hepatitis C screening coverage from 53.7% to 90.2%. Confirmatory RNA testing doubled, treatment initiation reached 91.6%, and modern antiviral therapy achieved a 99% cure rate. Advanced statistical modeling projected reductions in liver cancer incidence and liver-related mortality sufficient to meet World Health Organization (WHO) hepatitis C elimination targets by 2030.

For clinical laboratories, the targeted approach increased demand for confirmatory RNA testing while directing diagnostic resources toward populations with the highest pretest probability. The Changhua program demonstrates how precision public health, integrated care networks, and data-driven decision-making can improve progression from screening through treatment and accelerate hepatitis C elimination.

“Our study demonstrates that hepatitis C elimination depends not only on effective medicines but also on delivering the right care to the right people at the right time. By integrating precision risk-based screening with community-based health care, we provide a practical model that can help countries worldwide accelerate progress toward hepatitis C elimination,” said co-corresponding author Tony Hsiu-Hsi Chen of the Institute of Health Data Analytics and Statistics at National Taiwan University.

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