Author information

¹Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

²Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.

³Infectious Diseases, Cherokee Nation Health Services, Tahlequah, Oklahoma, USA.

⁴Department of Medicine, Division of Infectious Diseases, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.

⁵Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.

⁶Department of Medicine, Division of Infectious Diseases and Geographic Medicine, University School of Medicine, Stanford, CaliforniaUSA.

⁷Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Atlanta, Georgia, USA.

⁸Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

⁹Hepatology and Liver Center, Massachusetts General Hospital, Boston, Massachusetts, USA.

Abstract

The current multiday diagnosis and treatment paradigm for hepatitis C virus (HCV) infection results in far fewer patients receiving treatment with direct-acting antiviral agents than those with diagnosed HCV infection. To achieve HCV elimination, a paradigm shift in access to HCV treatment is needed from multiday testing and treatment algorithms to same-day diagnosis and treatment. This shift will require new tools, such as point-of-care (POC) antigen tests or nucleic acid tests for HCV and hepatitis B virus (HBV) and nucleic acid tests for human immunodeficiency virus (HIV) that do not require venous blood. This shift will also require better use of existing resources, including expanded access to HCV treatment and available POC tests, novel monitoring approaches, and removal of barriers to approval. A same-day diagnosis and treatment paradigm will substantially contribute to HCV elimination by improving HCV treatment rates and expanding access to treatment in settings where patients have brief encounters with healthcare.