Chronic hepatitis C virus (HCV) infection is a major public health challenge for Australia, affecting approximately 230 000 people who are at risk of progressive liver fibrosis leading to cirrhosis, liver failure and hepatocellular carcinoma (HCC). HCV infection is the most common cause of liver disease requiring liver transplantation in Australia. The burden of liver disease due to HCV is projected to triple by 2030. However, HCV infection is curable, and viral eradication is associated with multiple clinical benefits, including improvement in quality of life, loss of infectivity, regression of cirrhosis, lower risk of liver failure and HCC, and reduction in mortality. Until recently, the treatment of HCV involved interferon therapy, which had limited efficacy and was poorly tolerated. The introduction of direct-acting antiviral (DAA) therapies for HCV that are highly effective and well tolerated is a major medical advance. All Australians living with HCV should now be considered for antiviral therapy. DAAs may be prescribed by any medical practitioner experienced in treating HCV, or in consultation with a specialist experienced in the treatment of HCV, meaning that treatment can occur in the community.
This document presents the Australian recommendations for the management of hepatitis C virus infection: a consensus statement (January 2017). This is a living document that will be updated as new data emerge. Grading of the levels of evidence for the recommendations is described in the methodology section.