Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships

Abstract

Screening and linkage to care are essential to achieve viral hepatitis elimination before 2030. The accurate identification of endemic areas is important for controlling diseases with geographic aggregation. Viral activity drives prognosis of chronic hepatitis B and hepatitis C virus infection. This screening was conducted in Chiayi County from 2018–2019. All residents aged 30 years or older were invited to participate in quantitative HBsAg (qHBsAg) and HCV Ag screening. Among the 4010 participants (male: female = 1630: 2380), the prevalence of qHBsAg and HCV Ag was 9.9% (396/4010) and 4.1% (163/4010), respectively. High-prevalence townships were identified, three for qHBsAg >15% and two for HCV Ag >10%. The age-specific prevalence of qHBsAg was distributed in an inverse U-shape with a peak (16.0%, 68/424) for subjects in their 40 s; for HCV, prevalence increased with age. Concentrations of qHBsAg <200 IU/mL were found in 54% (214/396) of carriers. The rate of oral antiviral treatment for HCV was 75.5% (114/151), with subjects younger than 75 years tending to undergo treatment (85.6% vs. 57.4%, p < 0.001). QHBsAg and HCV Ag core antigens can reflect the concentration of the viral load, which serves as a feasible screening tool. Using quantitative antigen screening for hepatitis B and C in community-based screening, two hyperendemic townships were identified from an endemic county.

Screening of hepatitis B and C viral infection, recognition of risk factors, and immunization of patients against hepatitis B virus: a module developed for effective hepatitis control

“…Another study reported a higher HCV prevalence (42.7%) than HBV (8.4%) in Punjab, Pakistan (25). A high frequency of 9.9% of HBV in comparison to 4.1% of HCV was noted in the Taiwan population (26).…”

Above-Standard Survival of Hepatocellular Carcinoma as the Final Outcome of Comprehensive Hepatology Care Programs in a Remote HCV-Endemic Area

“…Up to 95.7% of residents with HCV in this program achieved a sustained virological response (SVR), defined as undetectable HCV viremia, for at least 12 weeks after the end of treatment [ 32 ]. Since 2018, YLCGMH has coordinated with the Nursing Department of Chiayi Chang Gung University of Science and Technology to improve villagers’ health in nearby townships [ 12 , 16 , 17 , 18 , 19 , 20 ]. Outreach health checkups, including liver disease screening, have been conducted in five surrounding townships.…”

“…Mailiao and Taihsi are rural indigenous townships with a high risk of HCC mortality in the Yunlin county, with high priorities for HCC detection and treatment programs [ 14 ]. The two townships were endemic for HCV infection due to limited medical recourses, low socioeconomic status, poor hygiene practices and inadequate sanitary conditions [ 12 , 17 , 20 ]. It is served by the Chang Gung Memorial Hospital Yunlin Branch (YLCGMH), a 100-bed local hospital located near Mailiao and Taihsi.…”

“…As a local hospital, the routine daily medical work of YLCGMH includes multidisciplinary outpatient, inpatient and emergency services. This local hospital works to improve their patients’ health from nearby townships in coordination with the Nursing Department of Chiayi Chang Gung University of Science and Technology [ 12 , 16 , 17 , 18 , 19 , 20 ]. In addition to annual checkups for Mailiao and Taihsi, outreach health checkups, including liver disease screening, were also conducted in five surrounding townships (Sihhu, Baojhong, Dacheng, Dongshih and Lunbei Townships), as depicted in Figure 1 The outreach health checkups were conducted in up to sixty-five villages between 2018 and 2022.…”

State-of-the-Art Chronic Hepatitis Viruses Research in Asia

“…Hence, implementing a nationwide screening program is the way to identify the undiagnosed HCV-infected patients. In this issue, Huang et al reported a community-based screening program using two quantitative antigens to identify both hepatitis B and C infectivity [ 15 ] and demonstrated its feasibility as a screening tool.…”