Trends in the Epidemiology and Management of Hepatitis C in the Era of Direct-acting Antivirals

Ribeiro Pereira^*
*Correspondence: Ribeiro Pereira, Department of Medical Sciences, New University of Lisbon, Lisbon, Portugal, Email:

Introduction

Hepatitis C, a viral infection primarily affecting the liver, has long been a significant global health concern. However, with the advent of direct-acting antivira therapies, the landscape of hepatitis C management has undergone a remarkable transformation. Historically, hepatitis C has posed a formidable challenge to public health due to its insidious nature and the lack of effective treatment options. The virus, primarily transmitted through blood-to-blood contact, including intravenous drug use and unsafe medical procedures, had led to a significant burden of chronic liver disease, including cirrhosis and hepatocellular carcinoma. Over the decades, efforts to combat hepatitis C have focused on prevention strategies, blood screening and limited treatment options, such as interferon-based therapies, which often carried substantial side effects and yielded modest cure rates [1].

Description

Consequently, the global prevalence of hepatitis C remained stubbornly high, with an estimated 71 million people living with chronic hepatitis C infection worldwide. However, the introduction of DAA therapies marked a paradigm shift in the management of hepatitis C. These drugs target specific viral proteins essential for replication, offering high cure rates with shorter treatment durations and minimal adverse effects. As a result, the epidemiology of hepatitis C began to undergo significant changes. The emergence of DAA medications, such as sofosbuvir, ledipasvir, daclatasvir and others, revolutionized the landscape of hepatitis C treatment. These drugs boast cure rates exceeding 95% across various genotypes of the virus, making hepatitis C a curable disease for the majority of patients. Additionally, the shorter treatment durations, typically ranging from 8 to 12 weeks, enhance treatment adherence and reduce the burden on healthcare systems.

One of the most remarkable aspects of DAA therapies is their efficacy across diverse patient populations, including those with advanced liver disease, HIV coinfection and renal impairment. Moreover, the oral administration of these medications eliminates the need for injections, further improving patient acceptability and convenience. The widespread availability of generic versions of DAAs in many countries has facilitated access to treatment for a broader segment of the population, including resource-limited settings. However, despite these advancements, challenges persist in achieving universal access to hepatitis C treatment, particularly in low- and middle-income countries where healthcare infrastructure and funding constraints pose barriers to widespread implementation [2,3]. The introduction of DAA therapies has had a profound impact on the epidemiology of hepatitis C. The high cure rates associated with these drugs translate into reduced incidence of advanced liver disease, including cirrhosis and HCC and lower rates of hepatitis C transmission.

Furthermore, successful treatment of hepatitis C reduces the burden on healthcare systems by decreasing the need for liver transplantation and long-term management of complications associated with chronic infection. In addition to the clinical benefits, the advent of DAA medications has sparked optimism regarding the prospect of hepatitis C elimination as a public health threat. The World Health Organization (WHO) has set ambitious targets for hepatitis C elimination, aiming to reduce new infections by 90% and mortality by 65% by 2030. The availability of highly effective and well-tolerated DAA therapies forms the cornerstone of these elimination efforts, alongside strategies for prevention, screening and linkage to care. The era of direct-acting antivirals represents a transformative period in the management of hepatitis C [4,5]. These medications have revolutionized treatment paradigms, offering cure rates exceeding 95% with minimal side effects and shorter treatment durations.

Conclusion

As a result, the epidemiology of hepatitis C is evolving, with declining incidence rates and reduced burden of advanced liver disease. However, challenges remain in ensuring universal access to hepatitis C treatment, particularly in resource-limited settings. Efforts to address these challenges must focus on strengthening healthcare systems, expanding access to affordable diagnostics and medications and implementing comprehensive prevention and screening programs. Nevertheless, the advent of DAA therapies has brought us closer than ever to the goal of hepatitis C elimination. With continued investment in research, healthcare infrastructure and public health initiatives, we have the opportunity to significantly reduce the global burden of hepatitis C and improve the lives of millions affected by this disease.

Acknowledgement

None.

Conflict of Interest

None.

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