ABSTRACT
The burden of hepatitis C virus (HCV)-related morbidity and mortality continues to rise. Progression to advanced liver disease among HCV-infected individuals generally requires decades, but we are entering an era where those infected with HCV in the 1970s and 1980s are at significant risk of mortality. Liver disease has overtaken drug-related harm as the major cause of mortality in HCV-infected individuals in many settings. Direct-acting antiviral therapies have provided renewed optimism, but HCV treatment uptake will need to increase markedly to reduce liver disease mortality. This review provides updated information on the natural history of HCV, disease-specific causes of mortality among people with HCV, estimates and projections of HCV-related disease burden and mortality and individual and population-level strategies to reduce mortality. The considerable variability in mortality rates within subpopulations of people with HCV will be outlined, such as in people who inject drugs and those with HIV co-infection.
KEYWORDS
Hepatitis C virus - assessment - treatment - care - barriers
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Professor Gregory J. Dore
The Kirby Institute for Infection and Immunity in Society, University of New South Wales
CFI Building, Corner of Boundary and West Streets, Sydney NSW 2010, Australia
Email: gdore@kirby.unsw.edu.au