Eradication of hepatitis C infection: The importance of targeting people who inject drugs

H epatitis C virus (HCV) affects 170 million people worldwide and causes significant morbidity and mortality. In high-income countries, people who inject drugs (PWID) are at greatest risk of HCV infection. Until recently HCV eradication seemed unlikely, but recent advances in HCV treatment and improved understanding of the effectiveness of harm-reduction intervention effectiveness give reason for optimism. Current HCV treatments can cure 75% of patients and new drugs will further improve effectiveness (over 90% cure) and improve tolerability. If HCV treatment can be delivered effectively to those at highest risk of onward transmission, significant reductions in future HCV cases are possible. The feasibility of disease eradication must be assessed on both scientific criteria (e.g., epidemiological susceptibility, effective and practical intervention available, and demonstrated feasibility of elimination) and political criteria (e.g., burden of disease, cost of intervention). With effective, curative treatment now available, HCV meets these criteria.