Abstract:

Global prevalence of HCV infection was 0.9% in 2015. With the comprehensive rollout of viral hepatitis elimination efforts, the global prevalence of HCV infection has been reduced to 0.7% by 2020. However, there are still approximately 58 million people living with HCV globally and 15 million newly-diagnosed infections annually ，with 300 000 deaths per year. In 2019, the number of reported newly-diagnosed HCV cases in China reached 625 000, with an age-adjusted incidence rate of 55(47.5－63.2) per million. An epidemiological survey of serum samples in China in 2006 showed that the prevalence of HCV infection in the country was about 0.43%. Data in 2016 indicated that there were 45 300 HCV-related deaths in China, which was the region with highest mortality risk globally. In 2022, WHO proposed new outcome indicators for HCV elimination， including the number of newly-diagnosed HCV patients <350 000 cases per year, incidence of HCV <2/100 000 per year in total population,and incidence for people who inject drugs(PWID) <2/100 person-years. The distribution of HCV genotypes in China also presents certain particularities. Genotype 1b is predominant, accounting for about 62.7%, followed by genotype 2a (17.4%).There is a high prevalence of genotype 3 (5%) in the southwestern region. In recent years, the proportion of genotype 3b has shown a downward trend in the northern regions of China, but an upward trend in other areas. The distribution and evolution of genotypes and subtypes in China have increased the difficulty of eliminating hepatitis C in the country. The WHO recommends screening in high-risk populiation (PWID and prisoners, etc.) and adjusting screening patterns for high-risk groups based on medical records, as well as the government organizing large-scale screen in areas with high prevalence (anti-HCV sero-prevalence ≥ 2% or ≥ 5%). The reinfection rate among people with ongoing risk of HCV infection ，PWID,MSM and prisoners is about 4.13/100 person-years, 2.84/100 person-years, 7.37/person-years, and 7.23/100 person-years ，respectively. Therefore, the WHO suggests repeating HCV testing in people with ongoing risk of HCV infection after HCV cure. Both the 2022 WHO HCV guidelines and the 2022 WHO document on simplified medical services and diagnostic processes for HCV recommend simplifying the HCV diagnostic pathway. The burden of HCV disease in China is heavy, and there still is a certain gap between the current status of HCV infection and treatment and the goal of achieving the goal of eliminating viral hepatitis by 2030.

Key words: Hepatitis C, Epidemiology, Screening, Diagnosis, Elimination