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We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C cascade
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Globally, some 71 million people are chronically
infected with hepatitis C virus (HCV). Marginalised populations,
particularly people who inject drugs (PWID), have low testing,
linkage-to-care and treatment rates for HCV. Several models of
care (MoCs) and service delivery interventions have the
potential to improve outcomes across the HCV cascade of care,
but much of the relevant research was carried out when
interferon-based treatment was the standard of care. Often it
was not practical to scale up these earlier models and
interventions because the clinical care needs of patients taking
interferon-based regimens imposed too much of a financial and
human resource burden on health systems. Despite the adoption of
highly effective, all-oral direct-acting antiviral (DAA)
therapies in recent years, approaches to HCV testing and
treatment have evolved slowly and often remain rooted in earlier
paradigms. The effectiveness of DAAs allows for simpler
approaches and has encouraged countries where the drugs are
widely available to set their sights on the ambitious World
Health Organization (WHO) HCV elimination targets. Since a large
proportion of chronically HCV-infected people are not currently
accessing treatment, there is an urgent need to identify and
implement existing simplified MoCs that speak to specific
populations' needs. This article aims to: 1) review the evidence
on MoCs for HCV; and 2) distil the findings into recommendations
for how stakeholders can simplify the path taken by chronically
HCV-infected individuals from testing to cure and subsequent
care and monitoring.
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LAZARUS, Jeffrey V., et al. We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C cascade. Journal of Internal Medicine. 2019. ISSN 0954-6820. [consulted: 17 of October of 2026]. Available at: https://hdl.handle.net/2445/140758