A practical overview of the treatment of chronic hepatitis C virus infection

Background: Although hepatitis C virus (HCV) infection is associated with significant morbidity and mortality, <2% of affected individuals in Australia receive treatment. New direct-acting antiviral (DAA) therapies are now available on the Pharmaceutical Benefits Scheme (PBS), and can be prescribed by any general practitioner (GP) in consultation with an experienced specialist. Objective: This article provides an overview for GPs on the principles involved in assessing and treating patients with chronic hepatitis C within a community setting. Discussion: Treatment with DAA medications listed on the PBS should be considered for all patients with chronic HCV infection. These regimens are well tolerated, highly efficacious and have all-oral administration. A thorough pre-treatment evaluation should be undertaken, and patients with cirrhosis, significant comorbidities or potential drug-drug interactions should be referred to a specialist. Successful eradication of HCV is characterised by undetectable HCV ribonucleic acid viral load on polymerase chain reaction testing 12 weeks after treatment completion, although antibodies to HCV may remain positive for the rest of the patient's life.