Expanding Capacity to Treat Hepatitis C: Overcoming Barriers and New Innovations

Chronic hepatitis C virus (HCV) infection remains a global public health burden and is associated with significant morbidity and mortality. Despite significant advances in the safety and efficacy of antiviral therapy since 2014 due to the rise of oral direct acting antiviral (DAA) regimens, ongoing deficits persist across the care cascade in the USA which will limit success in achieving the objectives of the US National Academies of Sciences, Engineering, and Medicine and the World Health Organization to eliminate chronic HCV in the USA and worldwide. In this review, we discuss the critical role of expanding treatment capacity to enhance these efforts through a multifaceted strategy which incorporates education, training, and multidisciplinary support across clinical settings such as specialty centers, primary care, community health centers, methadone and substance use programs, prisons, and pharmacy-based clinics. Further investment by multiple stakeholders including governmental and non-governmental organizations, public health agencies, medical societies, and advocacy groups will be necessary to meaningfully effect change.