Hepatitis C Virus Simplified Algorithm for Treatment: Who Is Eligible for Simplified Treatment

Hepatitis C virus (HCV) treatment guidelines are comprehensive and may be most appropriate for experienced HCV specialists. A simplified treatment algorithm is suggested to provide guidance for non-HCV specialists. The simplified HCV treatment algorithm begins with universal HCV screening and diagnosis by testing for HCV antibody with reflex to polymerase chain reaction to detect HCV RNA. The pretreatment evaluation includes assessment of fibrosis/cirrhosis, potential drug-drug interactions and education of patients. The pan-genotypic regimens such as glecaprevir/pibrentasvir or sofosbuvir/velpatasvir are recommended for treatment. Unless clinically indicated, on-treatment monitoring is optional. Confirmation of cure (undetectable HCV RNA 12 weeks post-treatment) is followed by harm-reduction measures, as well as surveillance for hepatocellular carcinoma every 6 months in patients with advanced fibrosis/cirrhosis. Simplified, genotyping/subtyping-free, pan-genotypic anti-HCV treatment must be used to improve access to HCV treatment and increase the global infection cure rates in any setting where genotype and subtype determination is not available, not affordable and/or would limit access to therapy. However, in settings where HCV genotype and subtype determination are available and affordable and would not limit access to care, this information remains useful to optimise the results of anti-HCV therapy.