Acute hepatitis C infection: New approaches to surveillance, treatment and prevention

In high-income countries, hepatitis C virus (HCV) infection is predominantly acquired through injecting drug use. Acute HCV, generally considered to be the first 6 months of HCV infection, remains underdiagnosed since new infections are most often asymptomatic and there are practical problems in surveillance and testing individuals at high-risk of infection. While the chronic HCV treatment landscape is changing rapidly with the advent of direct acting anti-viral agents, treatment recommendations for acute HCV infection are based on smaller, largely observational studies and all regimens still include pegylatedinterferon. This review considers surveillance and diagnostic strategies as individual and population-based approaches to managing acute HCV, examines current evidence for acute treatment particularly among people who inject drugs, and discusses recent literature modeling the impact of treatment on HCV epidemiology and its cost-effectiveness.