Update on hepatitis C virus management

Abstract

Purpose of review: Despite the efficacy of direct-acting antiviral (DAA) therapy, hepatitis C virus (HCV) remains a significant contributor to liver-related morbidity and mortality. This review summarizes the approach to HCV treatment, the simplified treatment algorithm for most patients, the management of special populations, and future directions for HCV interventions.

Recent findings: Pan genotypic DAA regimens have high cure rates and can be managed by nonspecialist providers, and the simplified treatment approach provides a clear algorithm for workup and treatment decisions among treatment-naive patients without decompensated cirrhosis. Additionally, advancements in point of care diagnostics have the potential to further expand access to screening and linkage to care. Despite these breakthroughs, barriers to accessing care and the stigmatization of high-risk populations continue to undercut progress towards HCV elimination. Continued implementation of innovative screening and treatment strategies are required to overcome rising HCV prevalence.

Summary: HCV cure is achievable for nearly all patients, but reaching HCV elimination goals will require a comprehensive approach that increases screening, expands access to simplified treatment, and avoids stigmatization of at-risk populations. Targeting healthcare disparities and removing barriers to treatment uptake are crucial to achieving elimination targets.

Keywords: direct-acting antivirals; hepatitis C virus; hepatitis C virus elimination; simplified hepatitis C virus treatment algorithm.