Large Disparity between Prevalence and Treatment Rates for Hepatitis C in Western China

Abstract

Background and Aims: Recently, the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030. However, the epidemiology and treatment rates of hepatitis C virus (HCV) infection in Western China are still unknown. Methods: A total of 111,916 adult individuals (15-96 years) who underwent the HCV-antibody (HCV-Ab) test in the Second Affiliated Hospital of Chongqing Medical University between 2013 and 2015 were included in this study. We retrospectively analyzed the electronic medical records' data for each, and the positivity of HCV-Ab and the treatment of HCV RNA-positive patients were evaluated. Results: During 2013-2015, the crude prevalence of HCV-Ab was 1.4% (95%CI: 1.4-1.5; 1,611/111,916) and the adjusted prevalence of HCV-Ab was 1.7% (95%CI: 1.6-1.8), which was higher than in the 2006 national study (0.43%). The prevalence was 2-times higher in males than females (2.0% vs. 1.1%, p < 0.01). Notably, only 46% (434/951) of the HCV RNA-positive patients received standard peg-interferon plus ribavirin treatment, with 370 (82%) that completed treatment, of whom 272 (74%) achieved sustained virologic response (SVR). Particularly, 11% (32/292) of HCV RNA-positive patients were HBsAg-positive, and the SVR rate for them was lower than for the HBsAg-negative patients, but no significant difference was observed. Conclusions: HCV infection may have increased since 2006 in Western China. The SVR rate of peg-interferon plus ribavirin treatment was high, but the proportion of untreated HCV patients was large. Thus, more efforts need to be made by the government to create a scientific-based policy for HCV treatment and prevention.

Keywords: Epidemiology; Hepatitis C virus; Hospital-based population study; Treatment.

Fig. 1.. Overall prevalence (A) and age-specific prevalence of HCV-Ab stratified by sex (B) in this 2013–15 study and the 2006 national study^*.

^* Prevalence of HCV-Ab of the age 55–64 group in 2006 national study was used for data from the patients age 55–59 group because the data of the age ≥60 group were unavailable in the national study. Abbreviations: Ab, antibody; HCV, hepatitis C virus.

Fig. 2.. Percentages for 1611 HCV-Ab-positive patients, showing cascade of care.

Abbreviations: Ab, antibody; HCV, hepatitis C virus; SVR, sustained virologic response.

Fig. 3.. Prevalence of HBsAg-positive (A) and the SVR rate of P/R treatment between HBsAg-positive and -negative groups (B) in HCV-infected patients.

Abbreviations: HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; P/R, pegylated-interferon plus ribavirin; SVR, sustained virologic response.