Viral Hepatitis C: From Unraveling the Nature of Disease to Cure and Global Elimination

Abstract

Summary.This review summarises the key achievements from the discovery of HCV to the development of effective treatment and global elimination strategies. Better understanding of HCV structure, enzymes and lifecycle led to the introduction of new drug targets and the discovery of DAA. Massive public health interventions are required, such as screening, access to care, treatment and post-care follow up, to make the most of DAA potential. Screening must be supported by fast, accessible, sensitive, specific HCV diagnostic tests and non-invasive methods to determine stage of liver disease. Linkage to care and treatment access are critical components of a comprehensive HCV elimination program and decentralization plays a key role in ensuring their effectiveness. Key messages.Effective and simple screening strategies, rapid diagnostic tools, linkage to healthcare and accessible treatment are key elements to achieve the WHO's goal. Incorporating treatment as prevention strategies into elimination programs together with preventive education and harm reduction interventions can have a profound and lasting impact on reducing both the incidence and prevalence of HCV. However, WHO goal can be challenging to implement because of need for high financial resources and strong political commitment.