Evaluations of Community-based Healthcare Management for Patients with Chronic Viral Hepatitis - Shanghai Municipality, China, 2012-2023.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Current strategies for chronic viral hepatitis prevention and control include immunization, prevention of mother-to-child transmission, expanded testing, antiviral therapy, and national drug price negotiations. To advance high-quality, integrated prevention and treatment services, a decentralized service delivery approach may be beneficial.

WHAT IS ADDED BY THIS REPORT?: The chronic viral hepatitis community-based healthcare management program in Shanghai delivered comprehensive service packages across 4 categories encompassing 10 distinct interventions, including epidemiological investigation, health education, free testing, community dispensing services, and immunization to family caregivers. The enrolled patients increased substantially from baseline, and antiviral treatment utilization rates reached 64.5% and 58.2% in 2019 and 2023 from 24.5% in 2012. Concurrently, abnormality rates for hepatitis B virus deoxyribonucleic acid (HBV DNA), alanine aminotransferase (ALT), total bilirubin (TBIL), and hepatic fibrosis indices decreased significantly. The 2023 aMAP score demonstrated a significant reduction in hepatocellular carcinoma risk among patients under management. Additionally, community dispensing services were accessed by 14.1% (2019) and 18.2% (2023) of enrolled patients.

WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: The community-based healthcare management program could effectively decentralize hepatitis-related testing and treatment services, and create a favorable environment for the viral hepatitis elimination efforts.