Background: Malaysia has been fully committed to the global endeavor to eliminate hepatitis C virus (HCV) infection by 2030. In early 2018, the Ministry of Health (MOH) embarked on a “one-size-fits-all strategy” by introducing generic versions of sofosbuvir and daclatasvir as the standard treatment for HCV infection in public hospitals nationwide. Objectives: To evaluate the outcomes of such an initiative in multiple aspects, including the number and characteristics of patients treated, the extent of evidence-based drug use, the treatment completion status, individual responses to treatment, common side effects of treatment, and its economic implications. Methods: The findings were generated from the data compiled by the MOH, capturing the information regarding the treatment provided to adult HCV-infected patients in 16 selected hospitals between April 2018 and March 2020, along with the drug costs incurred. Results: A total of 1,797 patients were treated, nearly four times more than the patients receiving interferon-based treatment across the country in the preceding two years. Approximately one-third of them had liver cirrhosis, and the main HCV genotypes were 3 (46.9%) and 1a (20.0%). Dosing, treatment duration and the addition of ribavirin to the treatment generally agreed with the recommendations of the MOH. More than 90% of the patients completed the treatment course, and a sustained virologic response (SVR) rate of 95.4% (95% CI: 94.2, 96.7%) was recorded in those with a known treatment outcome (n = 1,163). The SVR achievement did not vary across HCV genotypes and cirrhosis status, but those ≥ 50 years of age (adjusted OR: 2.13; 95% CI: 1.16, 3.92) were more likely to fail the treatment. Side effects were rare. Anemia and fatigue caused treatment discontinuation in only 0.3% of the patients. The total drug expenditure reached US$678,258.20, and the mean cost of a 12-week treatment course of sofosbuvir and daclatasvir (US$235.16) was lower than the cost expected by the MOH (US$300). Conclusions: The findings demonstrate a high degree of real-world effectiveness, safety, and affordability of the standard treatment, suggesting that such a government-led initiative was reasonable and timely and could be extended to include more public health institutions.

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Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.

Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.