Global Prevention and Public Health Strategies for the Elimination of Hepatitis C

Abstract

Hepatitis C virus (HCV) remains a critical driver of chronic liver disease, cirrhosis, and hepatocellular carcinoma globally. Following the advent of highly effective pangenotypic direct-acting antivirals (DAAs) capable of curing over 95% of infections, the World Health Organization (WHO) established a mandate to eliminate viral hepatitis as a major public health threat by 2030. Achieving this goal requires a reduction of 90% in new chronic infections and a 65% reduction in mortality relative to 2015 baselines. This review synthesizes the human epidemiological burden, primary prevention modalities, innovative diagnostic approaches, and public health frameworks necessary to bridge the gap between treatment capacity and real-world implementation. Despite a highly effective biomedical cure, systemic challenges persist, including low diagnosis rates, high medication costs, and limited micro-elimination coverage among marginalized populations such as people who inject drugs (PWID) and incarcerated individuals. This article outlines successful international strategies, including decentralized screening and integrated harm reduction, and frames the steps required to transition from disease control to population-level eradication.