Andri Rauch, Bern University Hospital and University of Bern, Switzerland presented on the achievements and remaining challenges of Hepatitis C treatment.

We have all been fortunate to witness the breakthrough in HCV treatment from interferon-based regimens to DAAs:

The improvements in treatment efficacy in SVR genotype 1 infection:

Thus, DAAs achieve high cure rates irrespective of host and viral characteristics.

Changing from complex to simple treatments resulted a few (very welcomed) changes within the past 5 years:

Andri discussed the remaining challenges:

  1. Difficult to treat: cirrhosis, NS5A RAS, GT3
  2. Difficult to treat: renal impairment eGFR <30mL/min or haemodialysis
  3. Drug-drug interactions:
  4. Events after SVR if therapy is started too late:
  5. New epidemics and reinfections
  6. The cascade of care: comparing HCV with HIV (following the 90:90:90 targets). Increase of treatment rates to reduce prevalence by 90% in 2030.
  7. Affordability and reimbursement restrictions
  8. Treatment-as-prevention and risk behaviour

In summary:

Goals of HCV therapy: achievements and challanges.