In 2013, the public health community recognized viral hepatitis as a leading cause of death worldwide. In that year, hepatitis C virus (HCV) infection resulted in more deaths than HIV, tuberculosis, or malaria. This alarming trend continues. Given that preventive strategies reduce the risk of infection, the World Health Organization (WHO) examined the feasibility of eliminating HCV. A WHO analysis outlined targets to eliminate HCV as a public health threat (i.e., 90% reduction in new chronic infections and 65% reduction in mortality). These targets now serve as defined metrics to monitor efforts to achieve HCV elimination worldwide.

Direct-acting antiviral (DAA) agents revolutionized HCV treatment and made the setting of HCV elimination targets more than aspirational. These all-oral medication options improved treatment efficacy so that nearly every individual chronically infected with HCV can expect cure rates higher than 95%. Viral eradication reduces the risk of liver-related mortality as well as all-cause mortality. Finite therapy leads to the elimination of the virus. Thus, successful HCV treatment is instrumental to elimination strategies, particularly for those at highest risk of transmitting the virus.

The safety profile of these DAA agents also allows for their use in many patient subsets that would not have been considered appropriate for interferon (IFN)-based therapy, such as individuals with immune diseases, psychiatric conditions, post-transplant, or advanced liver disease. In addition to expanding our potential pool of patients, this therapeutic advancement has also allowed therapy to occur outside of traditional constructs. A transition in the location of care is imperative as we work towards achieving HCV elimination.

This educational activity includes a didactic component followed by a series of clinical case studies. At the conclusion of this activity, learners should be able to:

  • Define the HCV care continuum from screening and diagnosis to treatment and cure
  • Implement evidence-based clinical management practices for acute and chronic HCV infection
  • Integrate into clinical practice medication adherence strategies to optimize HCV treatment
  • Deploy risk reduction efforts in patients with HCV and concomitant depression or substance use


Disclosure: This activity is made possible through an independent educational grant from Merck & Co.