To investigate the awareness of hepatitis C prevention, treatment knowledge and the status of antiviral therapy (ART) among former hepatitis C patients in Fengtai District, Beijing, and to analyze the influencing factors.

A cross-sectional survey design was adopted to conduct on-site questionnaire surveys among hepatitis C cases whose current residential addresses were in Fengtai District, Beijing, and were reported in China Disease Prevention and Control Information System from January 2004 to December 2024. The awareness of prevention and treatment knowledge and antiretroviral therapy (ART) status of hepatitis C patients with different characteristics were analyzed by Chi-square test, and the influencing factors were analyzed by multivariate Logistic regression.

Total of 737 patients with hepatitis C were included. The highest proportion of patients were identified through screening before blood transfusion, surgery or invasive procedures (including hemodialysis), accounting for 33.8% (249/737); followed by patients identified through routine health check-ups, accounting for 32.3% (238/737); 24.2% (178/737) of participants were detected due to clinical symptoms or abnormal liver function. Among the risk behavioral factors for possible infection in epidemiological history, 32.8% (242/737) of patients had a history of invasive medical behaviors such as visits to private clinics or street-side unlicensed shops. The overall awareness rate of hepatitis C prevention and treatment knowledge in enrolled cases was 72.3% (533/737). Multivariate Logistic regression analysis showed that affordable out-of-pocket cost (>2 000 RMB: aOR=1.473, 95%CI: 1.030-2.108, P=0.034) and employment status (not retired: aOR=1.616, 95%CI: 1.022-2.557, P=0.040) were both influencing factors for the awareness rate of hepatitis C prevention and treatment knowledge among hepatitis C patients; while employment status (retired: aOR=0.556, 95%CI: 0.337-0.918, P=0.022), medical insurance type (urban employee medical insurance: aOR=3.476, 95%CI: 1.234-9.791, P=0.018; urban resident medical insurance: aOR=3.683, 95%CI: 1.295-10.473, P=0.014) and affordable out-of-pocket cost (≤2 000 RMB: aOR=0.474, 95%CI: 0.323-0.694, P<0.001) were all influencing factors for receiving ART among hepatitis C patients. Total of 657 blood samples were collected, among which, 199 were positive for HCV RNA, with a positive rate of 30.3% (199/657). Six genotypes were identified in the 199 cases with successful genotyping, and genotype 1b was the predominant strain (66.3%, 132/199).

The awareness rate of hepatitis C prevention and treatment knowledge among previously reported hepatitis C patients in Fengtai District is relatively high, but the ART treatment rate remains low. Targeted health education, treatment initiation mobilization interventions and supplementary special subsidies for low-income populations should be implemented to improve the patients’ willingness to receive ART. Continuous supervision and standardization of invasive medical practices in private clinics and unregulated medical institutions should be strengthened to cut off iatrogenic transmission routes. Hepatitis C virus antibody screening should be promoted as part of routine health check-up programs for high-risk populations, and individuals with a history of high-risk behaviors should be encouraged to proactively undergo screening, so as to achieve early detection and early diagnosis.