Direct-acting antivirals and chronic hepatitis C: towards elimination

Abstract

Hepatitis C virus (HCV) is a major cause of liver morbidity and mortality worldwide with increasing disease burden projected for the next several decades. The timely advent of direct-acting antivirals (DAAs) sparked significant public health responses aimed at HCV elimination by 2030. This review will focus on the implications of the DAAs in terms of medical progress, barriers to HCV elimination as a public health threat, and current gaps that will require further innovation. We utilized PubMed searches with the relevant keywords for articles published in the last 5 years, as well as personal collections of relevant publications. DAAs have proven to be safe and effective. DAAs are well suited for nearly all infected patients, and many countries worldwide have taken on initial treatment scale-up strategies. These unprecedented efforts, albeit significant, face extraordinary challenges related to the high infection burden, stigma, and financial constraints. Currently, few countries are progressing towards HCV elimination, as this attainable public health goal requires explicit, adequately resourced, and coordinated public health prioritization at all levels.