Introduction

Chronic hepatitis C virus (HCV) infection is a major public health challenge for Australia, affecting about 120 000 people who are at risk of progressive liver fibrosis leading to cirrhosis, liver failure and hepatocellular carcinoma (HCC).

Before the introduction of direct-acting antiviral (DAA) therapy, HCV infection was a common cause of liver disease (and liver cancer) requiring liver transplantation in Australia. It remains an important cause of liver-related morbidity and mortality in people who progress to cirrhosis.

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 DAAs for HCV that are highly effective and well tolerated was a major medical advance.

All Australian adults living with HCV should now be considered for antiviral therapy. DAAs may be prescribed by any medical practitioner or nurse 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 (2022). 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.