In the Kashi region of Xinjiang, China, the prevalence of chronic hepatitis C virus (HCV) infection and challenges in antiviral treatment have come to light in a comprehensive study conducted between 2018 and 2022. The research reveals an alarming increase in HCV positivity rates, highlighting significant barriers to effective healthcare in this area.
Chronic hepatitis C is a major global health concern, contributing to severe liver diseases and numerous fatalities. According to a 2020 assessment, about 56.8 million people worldwide were infected with the virus. In China alone, the burden is severe, with approximately 9.487 million individuals affected. The Kashi region reflects this crisis acutely, with the incidence rate of hepatitis C reaching 61 per 100,000 residents in 2019, significantly above the nationwide average.
The study presented a retrospective analysis of HCV antibody (HCV-Ab) testing results at the First People’s Hospital of Kashi, which is the primary medical facility equipped to conduct comprehensive HCV testing and treatment in the region. Research findings show that the HCV-Ab positivity rate rose from 1.7% in 2018 to 2.9% in 2022.
Out of 4,928 individuals with confirmed HCV-Ab positivity, only 2,174 underwent HCV RNA testing—about 44% of the total. Among these, 1,088 were confirmed HCV RNA positive, with a genotype distribution revealing that GT1b was the most prevalent, accounting for 70.7% of cases.
Despite the significant number of infections, only a small fraction of patients received appropriate antiviral treatment. Only 30% of those who tested positive for HCV RNA qualified and received direct-acting antiviral (DAA) treatments due to multiple barriers including prohibitive costs, lack of awareness about the disease, and significant obstacles to accessing healthcare.
“We identified various reasons inhibiting patients from accessing care, such as high costs and low awareness regarding hepatitis C risks,” stated the authors of the article. Such challenges are exacerbated by the limited healthcare infrastructure; during the study period, the First People’s Hospital of Kashi was the sole institution capable of administering DAA.
The retrospective study focused on a population that comprised both urban and rural dwellers from diverse ethnic backgrounds, with a significant representation of ethnic minorities. The research also highlighted concerning trends in hepatitis C infection rates, noting an average annual increase of 11.5% in the Kashi region from 2005 to 2019.
Further, the findings indicated that obstacles to treatment were multifaceted. Among those not receiving DAA treatment, responses revealed that 41.7% cited high costs as the primary barrier, while 31.4% reported co-infection with other diseases such as HIV or syphilis. Others pointed to a lack of awareness regarding the severity of hepatitis C and logistical challenges related to follow-up healthcare visits.
To address these challenges, the study underscores the necessity of implementing tailored public health interventions aimed at raising awareness and improving healthcare access. Ensuring that residents are informed about treatment options and disease risks is vital. Additionally, improving local healthcare infrastructure would play a significant role in streamlining the diagnosis and treatment processes.
This regional epidemic is not merely a local health issue but poses significant global public health challenges, echoing the urgent need for effective strategies to combat hepatitis C, particularly in underserved areas. Finally, the authors of the article emphasized, “To achieve the WHO’s target of eliminating viral hepatitis as a public health threat by 2030, intensified efforts to enhance healthcare access and treatment coverage are essential.”
