WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitic C virus infection

Summary

WHO estimates that in 2015, 71 million persons were living with chronic hepatitis C virus (HCV) infection worldwide and that 399 000 died from cirrhosis or hepatocellular carcinoma caused by HCV infection. In May 2016, the World Health Assembly endorsed the Global Health Sector Strategy (GHSS) on viral hepatitis, which proposes to eliminate viral hepatitis as a public health threat by 2030 (90% reduction in incidence and 65% reduction in mortality). Elimination of viral hepatitis as a public health threat requires 90% of those infected to be diagnosed and 80% of those diagnosed to be treated.

Since the last update to the Guidelines was issued in 2016, three key developments have prompted changes in terms of when to treat and what treatments to use. First, the use of safe and highly effective direct-acting antiviral (DAA) regimens for all persons improves the balance of benefits and harms of treating persons with little or no fibrosis, supporting a strategy of treating all persons with chronic HCV infection, rather than reserving treatment for persons with more advanced disease. Second, since 2016, several new, pangenotypic DAA medicines have been approved by at least one stringent regulatory authority, reducing the need for genotyping to guide treatment decisions. Third, the continued substantial  reduction in the price of DAAs has enabled treatment to be rolled out rapidly in a number of low- and middle- income countries.

These guidelines aim to provide evidence-based recommendations on the care and treatment of persons diagnosed with chronic HCV infection. They update the care and treatment section of the WHO Guidelines for the screening, care and treatment of persons with hepatitis C infection issued in April 2016. The 2017 Guidelines on hepatitis B and C testing update the screening section.