Abstract
Approximately 3% of the world population is estimated to have a chronic hepatitis C virus (HCV) infection and 500,000 individuals die from its consequences yearly. Persons who inject drugs (PWID) bear the majority of the disease burden in high-income countries. Drug substitution programmes have helped reduce HCV transmissions among PWID. However, recent epidemics of sexually transmitted HCV infections in HIV-infected men who have sex with men demonstrated the changing nature of the HCV epidemic. HCV therapy is undergoing a revolution, as new interferon-free, oral treatments eradicate HCV infections in almost all treated patients. As a consequence, the eradication of HCV has become a matter of debate and is becoming an important future public health target. However, for this to be achieved, many challenges need to be addressed, including the poor uptake of HCV testing, the high cost of the new antiviral combinations and the high frequency of re-infections after treatment in some populations.
Highlights
The hepatitis C virus (HCV) was discovered in 1989, after having been first described as “non-A, non-B hepatitis”, a cause of chronic hepatitis in transfusion recipients in the 1970s [1, 2]
We summarise the most important aspects and recent trends in HCV epidemiology, and describe the impact of new management strategies at the individual and population level, before discussing the ultimate goal of HCV eradication and related challenges
The landscape of HCV epidemiology in HIV-infected patients has changed in recent years due to the increasing role played by its sexual transmission in men who have sex with men (MSM) and the decreasing incidence in injection drug use in Persons who inject drugs (PWID)
Summary
3% of the world population is estimated to have a chronic hepatitis C virus (HCV) infection and 500,000 individuals die from its consequences yearly. Persons who inject drugs (PWID) bear the majority of the disease burden in high-income countries. Drug substitution programmes have helped reduce HCV transmissions among PWID. HCV therapy is undergoing a revolution, as new interferon-free, oral treatments eradicate HCV infections in almost all treated patients. The eradication of HCV has become a matter of debate and is becoming an important future public health target. For this to be achieved, many challenges need to be addressed, including the poor uptake of HCV testing, the high cost of the new antiviral combinations and the high frequency of re-infections after treatment in some populations
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