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JAMA Insights
Clinical Update
May 17, 2019

Management of Hepatitis C in 2019

Author Affiliations
  • 1Division of Infectious Diseases, Weill Cornell Medicine, New York, New York
  • 2Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
  • 3Duke Clinical Research Institute, Durham, North Carolina
JAMA. 2019;322(4):355-356. doi:10.1001/jama.2019.5353

In the United States, hepatitis C virus (HCV) infection affects more than 2 million adults1 and is the leading cause of liver-related mortality.2 Therapies that eradicate HCV may prevent progression to cirrhosis, liver decompensation, hepatocellular carcinoma, need for liver transplant, and death.2 HCV eradication also appears to reduce the risk of extrahepatic diseases, including cryoglobulinemic vasculitis and cardiovascular events. Direct-acting antivirals (DAAs), oral drugs that target multiple mechanisms of the HCV life cycle, have been used in combination since 2013. Because of their efficacy and safety, the use of DAAs has substantially improved HCV treatment and made HCV eradication possible for most patients, including patients with HIV infection, severe renal and hepatic impairment, and history of organ transplantation. Individuals living with HCV should be treated to reduce liver-related and all-cause morbidity and mortality and to prevent HCV transmission.3,4 Patients co-infected with HIV and HCV can be treated in the same way as patients with HCV alone.