A path to eradication of hepatitis C in low- and middle-income countries

Area of Science:

• Hepatology and Viral Diseases
• Global Public Health
• Antiviral Drug Development

Background:

• Hepatitis C virus (HCV) infection is a major global health concern, particularly in low- and middle-income countries (LMIC).
• Highly effective all-oral direct-acting antiviral (DAA) regimens offer potential cures for HCV, even in high-income nations.
• However, the high cost of these DAA regimens presents a substantial barrier to widespread treatment and global eradication efforts.

Purpose of the Study:

• To highlight the challenges and propose strategies for achieving global HCV eradication.
• To emphasize the disparity in access to advanced HCV treatments between high-income countries and LMIC.
• To outline the necessary steps for ensuring equitable access to HCV diagnostics and therapeutics worldwide.

Main Methods:

• This article synthesizes current knowledge on HCV treatment advancements and access barriers.
• It reviews the global burden of HCV infection and mortality, with a focus on LMIC.
• The authors discuss essential components for a global HCV eradication strategy, including diagnostics, prevention, and treatment access.

Main Results:

• While potent DAA regimens can cure most HCV infections, their high price limits access, especially in LMIC where the majority of the global HCV burden lies.
• Significant challenges impede HCV eradication, including the need for improved low-cost diagnostics (particularly in sub-Saharan Africa), reduced iatrogenic spread, and targeted interventions for people who inject drugs (PWID).
• Public-private partnerships and advocacy, similar to those used for HIV control, are crucial for overcoming access barriers and achieving global HCV eradication.

Conclusions:

• Achieving global HCV eradication necessitates overcoming financial and logistical barriers to treatment access in LMIC.
• Improving diagnostic capabilities, preventing transmission, and ensuring affordable antiviral therapies are critical components of a comprehensive global strategy.
• Collaborative efforts are essential to bridge the gap between therapeutic advancements and equitable access, ultimately aiming for the global elimination of HCV.