Tue, May 21, 2024 page2

• INTERVIEW: Nation on track to eliminate hepatitis C by next year: liver disease expert

  MORE ON HORIZON: After meeting the WHO’s hepatitis C goal, Taiwan next needs to focus on eliminating hepatitis B and MASH, the renowned hepatologist said

  • By Lin Chi-yi / Staff reporter
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  Taiwan is likely to eliminate hepatitis C by next year, renowned hepatologist Yu Ming-lung (余明隆) said.

  Yu, who is vice president of National Sun Yat-sen University, made the remarks in a recent interview with the Chinese-language Liberty Times (the sister paper of the Taipei Times).

  The WHO’s global hepatitis elimination goal is to by 2030 diagnose 90 percent of people with active hepatitis C infections and treat at least 80 percent of them with the aim of curing them.

  

  Hepatologist Yu Ming-lung gestures during an interview with the Liberty Times (the sister paper of the Taipei Times) in Taipei on May 9.

  Photo: Liao Chen-huei, Taipei Times

  Taiwan has been accelerating its efforts to eliminate hepatitis C and is on track to reach the WHO’s goal by next year.

  Last year, the WHO updated its hepatitis C elimination target, using the 2015 level as a basis for comparison, Yu said.

  Under the new target formula, it would only consider those taking direct-acting antivirals as undergoing treatment and would no longer include those taking interferons.

  As a result the Health Promotion Administration (HPA) has to recalculate and revise its data, but a preliminary calculation shows that Taiwan is “very likely” to achieve the goal by next year, although some details need to be addressed, Yu said.

  The HPA would invite WHO official and experts on hepatitis C to Taiwan toward the end of the year for discussions on changes in the prevalence rate of the virus and the agency’s data processing method, he said.

  If the discussions confirm that the government’s direction is correct, it would stay the course, run a statistical analysis in 2026 and officially announce that it had reached its goal, he said.

  In the next year and a half, Taiwan needs to achieve two goals, Yu said.

  First, it must accelerate screenings of prisoners, with at least 90 percent of inmates receiving a hepatitis C test, he said.

  Second, it must increase screenings of people born before 1980, who are eligible for government-funded free health examinations, he said.

  Taiwan has about 45,000 to 50,000 prisoners, 30,000 to 40,000 of whom are long-term prisoners, while more than half of all inmates have at one time been a drug addict, which increases their risk of hepatitis C infection, he said.

  The most effective method of hepatitis C prevention is to cure those with infections to prevent transmission, so the screening and treatment of prisoners should not be ignored, he said.

  If Taiwan can eliminate hepatitis C, the government’s liver disease prevention efforts should then focus on hepatitis B and metabolic dysfunction-associated steatohepatitis (MASH), Yu said.

  Regarding hepatitis B, Taiwanese aged 40 and younger were likely vaccinated during infancy and have lower infection risk, so the target group for hepatitis B prevention should be people older than 40, he said.

  However, the National Health Insurance-covered drug payment standard for hepatitis B treatment is complicated, making it difficult for patients to access the drug, he said.

  The government should simplify the process to prevent people from delaying treatment due to long waits or because they find it too troublesome, he said.

  MASH more often occurs in people with obesity, Yu said.

  The condition has become one of the main causes of cirrhosis and liver cancer in some European countries and the US, and that as Western diets have become popular, the same situation could be expected to develop in Taiwan in the next 10 years, he said.

  Obesity and metabolic syndrome prevention are crucial to avoiding MASH, he said.

  If Taiwan can eliminate hepatitis C by next year, it would be the first “non-hepatitis C country” in the world, but it would not be the end of Taiwan’s fight against liver diseases, Yu said.

  The challenge of hepatitis B and MASH elimination is also likely to become a decades-long battle, so the HPA’s hepatitis B and hepatitis C prevention office, cross-ministerial collaboration and other government resources would be needed to win that fight, he said.
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