Nationwide hepatitis C virus microelimination in uremic patients undergoing maintenance hemodialysis in Taiwan

The anti-hepatitis C virus (HCV) seropositivity rate among hemodialysis patients in Taiwan was reported to be 10.6 %-17.3 % in the last decade. HCV treatment uptake in patients undergoing hemodialysis has tremendously improved with the innovation reimbursement of direct-acting antiviral agents (DAAs) since 2017 in Taiwan. Two successful models of HCV microelimination using DAAs for patients undergoing hemodialysis, one local public health bureau-led strategy (CHIPS-C) and one investigator-initiated campaign (ERASE-C), have been successfully established in Taiwan. Based on data through December 2024, official data of the Ministry of Health and Welfare of Taiwan retrieved from 108,116 patients undergoing hemodialysis indicated that almost all patients undergoing hemodialysis across the country were screened for anti-HCV antibodies (ranging from 99.9 % to 100 % among 22 counties and cities). Among the patients who were anti-HCV seropositive, the HCV RNA diagnostic rate was 97.4 %. Finally, the treatment rate of viremic patients was 97.0 %. With respect to prevention, the seroconversion rate from anti-HCV seronegativity to anti-HCV seropositivity decreased gradually from 0.36 % in 2011 to 0.08 % in 2021 according to the report of the Taiwan Renal Data System (TWRDS). We now believe that Taiwan has achieved HCV microelimination in the hemodialysis population in 2025.