Updated recommendations on treatment of adolescents and children with chronic HCV infection, and HCV simplified service delivery and diagnostics 

Overview

Hepatitis C virus (HCV) infection is a major public health problem and cause of chronic liver disease that leads to approximately 399 000 deaths annually. In 2019, only 21% of the 58 million persons with chronic HCV infection had been diagnosed, and 13%, treated.

These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:

• direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
• simplified HCV service delivery (decentralization, integration and task sharing)
• HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing. 

These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.