Published online Oct 28, 2015. doi: 10.4254/wjh.v7.i24.2543
Peer-review started: May 5, 2015
First decision: June 3, 2015
Revised: September 7, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: October 28, 2015
In the era of highly effective direct acting antiviral (DAA) drugs for the treatment of chronic hepatitis C (CHC) infection, where eradication is almost ensured with minimal side effects, all hepatitis C carriers should benefit theoretically. In the real world setting however, only a small proportion will benefit at this time point due to the multiple barriers to accessing therapy. Given that universal treatment is unlikely, treatment with DAAs will likely be restricted to those with the highest health benefits, and for those who can afford the high expense of a treatment course. Those with the highest unmet needs include those who have failed previous interferon-based therapy or who are interferon-ineligible with evidence of active disease, those with advance liver disease, and those with recurrence of hepatitis C after liver transplantation. In the future, the focus should be on increasing access to treatment for those infected with CHC.
Core tip: Chronic hepatitis C has become an easily curable disease with new direct acting antivirals (DAAs). However, due to multiple barriers to therapy, only those with highest unmet clinical needs including those with prior treatment failure, cirrhosis, and post-liver transplant, will likely receive therapy. DAAs have been shown to be highly efficacious in these groups.