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Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

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Ghany, Marc G., Morgan, Timothy R., AASLD‐IDSA Hepatitis C Guidance Panel·2020·Hepatology
DOI 10.1002/hep.31060
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Abstract

The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) initiated the hepatitis C virus (HCV) guidance project (hereafter HCV guidance) in 2013. The AASLD-IDSA HCV guidance website (www.HCVGuidelines.org) disseminates up-to-date, peer-reviewed, unbiased, evidence-based recommendations to aid clinicians making decisions regarding the testing, management, and treatment of HCV infection. Using a web-based system enables timely and nimble distribution of the HCV guidance, which is periodically updated in near real time as necessitated by emerging research data, recommendations from public health agencies, the availability of therapeutic agents, or other significant developments affecting the rapidly evolving hepatitis C arena. The value and utility of the online HCV guidance to the community of hepatitis C care providers throughout the world is evidence by the nearly 10 million pageviews by 1.5 million users originating from 228 countries and territories since the January 2014 launch of the website. A major update of the HCV guidance was released electronically in November 2019. This HCV guidance update summarizes and highlights key new or amended recommendations since the previous October 2018 print publication.1 The advent of safe, well-tolerated, and highly efficacious (>95% cure rate)2 direct-acting antiviral (DAA) therapy for HCV infection has ushered in an era in which elimination of hepatitis C is conceivable. In 2016, the World Health Organization (WHO) proposed a global health sector strategy to eliminate hepatitis C as a public health threat by 2030 and developed an action plan to facilitate this goal.3 In response to the WHO action plan, the National Academies of Science, Engineering, and Medicine (NASEM) developed a US strategy for the elimination of hepatitis C.4 Key elements of the elimination plan include improved detection of undiagnosed cases, increased linkage and access to care for newly diagnosed persons, and expanded treatment access. Many of the recommendations included in the latest update to the HCV guidance and highlighted herein align with and support the goals of the NASEM and WHO strategies to move from control to eventual elimination of hepatitis C. Topics addressed include universal and risk-based hepatitis C screening, simplified treatment algorithms for treatment-naive adults without cirrhosis or with compensated cirrhosis, hepatitis C management in the pediatric population, acute hepatitis C testing and management, and transplantation of organs from HCV-viremic donors into HCV-negative recipients. For detailed evidence reviews related to these topics and information addressing other aspects of HCV testing and management, see the online HCV guidance (www.HCVGuidelines.org). The HCV guidance was developed and is updated by a volunteer panel (representing the AASLD and the IDSA) of hepatology and infectious diseases clinicians with hepatitis C expertise using an evidence-based review of available data, including information presented at scientific conferences and published in peer-reviewed journals. Based on scientific evidence and expert opinion, recommendations are rated by the level of evidence (I, II, or III) and the strength of the recommendation (A, B, or C) using a system adapted from the American College of Cardiology and the American Heart Association.5, 6 See the original AASLD–IDSA hepatitis C guidance publication7 or the HCV guidance website for additional details about the processes and methods employed. All recommendations are reviewed and approved by the governing boards of the AASLD and the IDSA. The HCV guidance panel classifies therapeutic regimens as recommended, alternative, or not recommended based on patient factors (i.e., treatment-naive versus experienced, cirrhosis status, and comorbidities) and viral characteristics (i.e., genotype, subtype, resistance-associated substitutions). Recommended regimens are considered equivalent; alternative regimens are effective but, compared to recommended regimens, have potential disadvantages, limitations for use in certain patient populations, or less supporting data. The identification of risk factors associated with contracting HCV infection served as the basis for the risk-based hepatitis C screening recommendations issued by the US Centers for Disease Control and Prevention (CDC) in 1998.8 Although sensitive for the identification of persons with chronic HCV infection, risk-based screening failed to identify the majority of individuals with HCV infection due to both clinician and patient barriers.9-12 Analysis of the 2003-2010 National Health and Nutrition Examination Survey prevalence data demonstrated that approximately three fourths of individuals with chronic hepatitis C in the United States belonged to the 1945-1965 birth cohort.13 Based on these data, both the CDC and the US Preventive Services Task Force (USPSTF) recommended one-time hepatitis C sc

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Metadata

Authors
Ghany, M. G., Morgan, T. R., & Panel, A. H. C. G.
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-02
Volume
71
Issue
2
Pages
686-721
ISSN
  • 0270-9139 (ISSN-L)
  • 1527-3350
DOI
10.1002/hep.31060
OpenAlex
W2992772421
Cited by
955
References
12
FWCI
66.55
Type
journal article
Language
en
Open access
green
Licence

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CoChat. (2026). Citation check: Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. https://app.cochat.ai/papers/10.1002/hep.31060
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Ghany, M. G., Morgan, T. R., & Panel, A. H. C. G. (2020). Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Hepatology. https://doi.org/10.1002/hep.31060

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