Up to 4 million individuals in the US are estimated to be infected with hepatitis C virus (HCV) and a sizable portion remain undiagnosed. Most infections are asymptomatic, with exposure to HCV often occurring decades earlier. Hepatitis C is responsible for more than 15 000 deaths each year in the US, despite the availability of direct-acting antivirals (DAAs), which can cure more than 95% of people who complete treatment. Identifying and treating individuals in the US with HCV infection, especially before cirrhosis and other complications develop, has been proposed as a national priority. In a 2023 editorial, Fleurence and Collins outlined a federal program that would use DAAs to eliminate HCV in the US. They posited 3 priorities for success: improved availability of point-of-care testing to diagnose HCV infection, broad access to curative medications, and a comprehensive public health effort targeting identification and treatment of those with HCV infection. However, the best approaches to identify and subsequently treat individuals with HCV infection remain unknown.
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