Closing the Hepatitis C Treatment Gap: United States Strategies to Improve Retention in Care

Austin T. Jones; Christopher Briones; Torrence Tran; Lisa Moreno-Walton; Patricia J. Kissinger


J Viral Hepat. 2022;29(8):588-595. 

In This Article

Conclusion and Future Perspectives

Despite DAA therapies boasting efficacy exceeding 95%, the profound treatment gap undermines the effectiveness of these new therapeutics. Strategies to improve the delivery of and retention in HCV care include coupling of HCV services, decentralization of HCV providers, ancillary personnel in the HCV care team, directly observed therapy and novel financial structures for HCV therapy. Those infected with HCV represent a fragile population with numerous comorbidities and competing health priorities. Efforts to improve retention must keep in mind the unique circumstances of this population.

In its 2018 guidelines, the World Health Organization called for a simplified service delivery model. This recommendation should be prioritized. Utilizing standardized algorithms, coupling orders through automated reflex testing and localizing HCV services with other medical specialties would minimize follow-up visits and ease in the navigation of the healthcare system by this underserved population. The interventions in this review aim to streamline HCV health services and improve retention in the HCV continuum of care.

Hepatitis C is a silent epidemic, burdening patients, communities and healthcare systems alike. The treatment delivery strategies discussed in this review are limited by the diagnosis of infected patients. Both the HCV diagnostic and treatment gaps must be addressed to effectively eradicate HCV. Continued research and novel interventions are needed to improve detection and linkage to care for all chronically HCV-infected patients.