Micro-elimination of hepatitis C in patients with chronic kidney disease and diabetes in Taiwan

Abstract

National governments across the globe are devising strategies to achieve the World Health Organization (WHO) goal of hepatitis C virus (HCV) elimination by 2030. The Taiwan government has also set an ambitious target of reaching 80 % treatment coverage for HCV by 2025. The HCV micro-elimination approach, which focuses on treating smaller, targeted high-risk subpopulations-such as people who inject drugs (PWID), individuals co-infected with HIV/HCV, prisoners, and patients with end-stage renal disease (ESRD)-has been proposed as an effective strategy for achieving global HCV elimination. Patients with CKD and DM exhibit a higher prevalence of HCV infection compared to the general population. Treating HCV in these individuals can improve glycemic control, slow CKD progression, and reduce both hepatic and extrahepatic complications and mortality. A novel finding from the Changhua Integrated Program to Stop HCV Infection (CHIPS-C) in Changhua County, revealed that patients with DM and CKD comprise at least 45 % of all HCV-infected individuals. Screening for HCV in patients with DM and CKD can identify more cases easily when integrated into Taiwan's well-established shared care system. Micro-elimination targeting HCV in patients with CKD and DM have been designated as a national policy priority for HCV elimination in Taiwan.

Keywords: CHISPS–C; Chronic kidney disease (CKD); Diabetes (DM); Hepatitis C; Micro-elimination.