A Simplified Algorithm for the Management of Hepatitis C Infection

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• The World Health Organization aims to eliminate hepatitis C virus (HCV) infection.
• Current treatment guidelines are complex, limiting frontline healthcare provider (HCP) engagement.
• A simplified approach is crucial for global HCV elimination.

Purpose of the Study:

• To develop a user-friendly, scalable algorithm for HCV management and treatment.
• To guide non-specialist HCPs in treating HCV infection.
• To increase treatment capacity for HCV elimination.

Main Methods:

• A consensus meeting of 13 HCV specialists in September 2018.
• Development of a simplified, step-by-step treatment algorithm.
• Inclusion of universal screening, platelet-based fibrosis assessment, and pan-genotypic regimens.

Main Results:

• A universal screening and diagnosis pathway using HCV antibody and RNA testing.
• Platelet count for initial fibrosis assessment.
• Recommended pan-genotypic regimens: glecaprevir/pibrentasvir or sofosbuvir/velpatasvir.
• Optional on-treatment monitoring and confirmed cure via HCV RNA testing 12 weeks post-treatment.

Conclusions:

• The algorithm simplifies HCV management for frontline HCPs.
• It facilitates increased screening and treatment capacity.
• This strategy supports the global goal of HCV elimination.