The Time to Eradicate Hepatitis C Is Now

COMMENTARY

The Time to Eradicate Hepatitis C Is Now

William F. Balistreri, MD

Disclosures

March 17, 2020

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It is becoming easier to imagine a world without hepatitis C, thanks to direct-acting antivirals (DAAs) that result in cure rates of over 95% across all genotypes after only 8-12 weeks of oral administration.

Dr Harvey J. Alter, the pioneering virologist whose work led to the discovery of hepatitis C virus (HCV), indulged this very same thought in a 2019 lecture. He noted that the concept that HCV "might be eradicated even in the absence of a vaccine" is no longer a fantasy. Yet, he was also clear that making this a reality would require some arduous steps, beginning largely with the implementation of robust screening efforts to identify asymptomatic individuals who may not know they have HCV.

That reality is now here. The US Preventive Services Task Force (USPSTF) recently recommended that "all adults aged 18 to 79 years be screened for HCV infection," a major change from their 2013 guidelines recommending limited screening of high-risk individuals and baby boomers. This updated strategy is in response to the efficacy and safety of DAAs, combined with emerging evidence that the HCV epidemic, paralleling the rise in opioid use, has broadened to envelop younger age groups.

The Centers for Disease Control and Prevention has also proposed "at least

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