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Chronic active hepatitis C

Last edited: 4/10/2026

Overview

Chronic active hepatitis C (HCV) is a persistent viral infection that can lead to liver damage. Direct-acting antiviral (DAA) therapies have significantly improved treatment outcomes, but challenges remain in achieving cure across the entire care cascade 1.

Diagnosis

  • Diagnosis of HCV infection is confirmed with a positive HCV ribonucleic acid (RNA) test 1.
  • The provided abstracts do not detail specific diagnostic criteria for "chronic active" hepatitis C or grading systems.
  • Management

  • Direct-acting antiviral (DAA) therapy is the standard of care for HCV 1.
  • Among individuals with positive HCV RNA tests, 41% initiated treatment, 38% completed treatment, and 29% achieved cure in a meta-analysis 1.
  • Cure rates varied by population, with 51% cure in individuals with substance use disorder compared to 17% in another unspecified group 1.
  • Special Populations

  • HCV screening rates were 43% in prisons or jails and 20% in emergency departments 1.
  • Linkage to care rates were 62% for homeless individuals and 26% for individuals diagnosed in emergency departments 1.
  • The provided abstracts do not contain specific information on pregnancy, pediatrics, elderly, or other comorbidities.
  • Key Recommendations

  • Direct-acting antiviral (DAA) therapy is the recommended treatment for hepatitis C virus (HCV) infection 1. (Evidence: Moderate)
  • Efforts should focus on improving linkage to care, treatment initiation, and completion to increase HCV cure rates 1. (Evidence: Moderate)
  • Targeted screening and linkage to care strategies are needed for vulnerable populations, such as those in correctional facilities, emergency departments, and the homeless population 1. (Evidence: Moderate)
  • References

    1 Hernandez-Con P, Wilson DL, Tang H, Unigwe I, Riaz M, Ourhaan N et al.. Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis. American journal of preventive medicine 2023. link

    Original source

    1. [1]
      Hepatitis C Cascade of Care in the Direct-Acting Antivirals Era: A Meta-Analysis.Hernandez-Con P, Wilson DL, Tang H, Unigwe I, Riaz M, Ourhaan N et al. American journal of preventive medicine (2023)

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