DIH-LING LUH2026-10-162026-10-162026-12-01Pure ID: 14995878Pure UUID: 9659fbbe-aeb3-4aff-b0f7-23819a09e87f10.1038/s41467-026-72912-9https://www.scopus.com/pages/publications/105044938907https://scholars.csmu.edu.tw/handle/123456789/25701Chronic hepatitis C virus (HCV) infection remains a major cause of liver disease worldwide and requires effective strategies to achieve elimination targets. Taiwan has a substantial HCV burden, with prevalence varying by region; in Changhua County, prevalence was 4.3% before large-scale intervention. In 2019, Changhua launched a county-wide micro-elimination program—the Changhua Integrated Program to Stop Hepatitis C Infection (CHIPS-C)—which combined existing population screening with targeted outreach to higher-risk groups and decentralized delivery of curative direct-acting antiviral (DAA) treatment. Using individual-level data from a population-based cohort, we compared care cascade performance before and after CHIPS-C implementation. The program was associated with increased screening coverage (53.7% to 90.2%) and fewer individuals screened to achieve similar numbers of diagnosed infections. Improvements were driven by streamlined confirmatory testing and coordinated care delivery. Here we show that CHIPS-C substantially increased the adjusted treatment completion rate (83.9% vs 38.7% before implementation). Model-based projections indicate that these gains could reduce HCV-related liver cancer and mortality to levels meeting World Health Organization elimination targets by 2030. These findings demonstrate that integrating risk-based targeting with existing health systems can markedly improve efficiency and outcomes, providing a scalable model for accelerating HCV elimination in diverse settings.enjournal article