Exploration of a Model for Elimination of Hepatitis C in Women of Childbearing Age in Primary Hospitals in Southern China

Abstract

Hepatitis C virus (HCV) can be transmitted from mother to child, although data on HCV elimination in women of childbearing age remain limited. This study aimed to evaluate an intervention model aligning with the ‘treatment as prevention’ strategy. The ‘Hepatitis C Prevention and Treatment Project for Women of Childbearing Age (15–49 years)’, launched in October 2022, strengthened the use of HCV-Ab screening, RNA testing, and treatment referral through multidisciplinary hospital collaborations. Key indicators (screening, RNA testing, and treatment rates) were compared between the pre-intervention (October 2021–September 2022) and post-intervention (October 2022–September 2023) periods. Additionally, a retrospective analysis of 503 HCV-Ab-positive women diagnosed between 2015 and 2024 was performed, together with a recall of the patients for RNA testing and treatment. The post-intervention rates for screening rose from 41.5% to 66.2%, while those for RNA testing increased from 45.9% to 97.9%, and treatment from 52.6% to 97.3% (all p < 0.001). Among the 503 historical cases, 337 (67.0%) returned for follow-up, with 92.5% completing RNA testing (312/337), 65.1% found to be RNA-positive (203/312) and 91.3% began treatment (185/203). Of these, 98.9% (183/185) achieved SVR12 after direct-acting antiviral therapy. Another 124 (24.7%) agreed to future testing. These findings demonstrated that targeted interventions significantly improve the rates of HCV diagnosis and treatment in women of childbearing age, enabling early detection and reducing the risk of transmission. This model offered a practical approach to eliminating HCV in this population, fulfilling the ‘treatment as prevention’ goal.