Global control of hepatitis C virus

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Science  21 Aug 2015:
Vol. 349, Issue 6250, pp. 790-791
DOI: 10.1126/science.aad1302

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Hepatitis C virus (HCV) infection is a blood-borne disease that infects ~185 million people (~3% of the world's population) worldwide (1). It can result in severe liver disease and is the leading cause of liver cancer in many countries. Although directly acting antivirals (DAAs) that target the viral life cycle have created enormous optimism about controlling HCV infection, achieving that goal remains a substantial challenge. Both acute and chronic infections are largely asymptomatic, infection incidence is rising in the United States (2), and comprehensive screening programs are rare in the most highly endemic regions of the world. As a result, less than 5% of the world's HCV-infected population, and only 50% of the United States' HCV-infected population, are aware that they are infected (3, 4) (see the figure). Most of these individuals will not receive treatment and will remain at risk for transmitting the infection to others. Successful control of HCV infection will most likely require a combination of mass global screening to identify those with infection, treatment, and prevention. Prophylactic HCV vaccination would also go a long way to reducing harm for uninfected people who are at risk.