Hepatitis C in Developing Countries: Chapter 2.1 - Public Health and Economic Burden of Hepatitis C Infection in Developing Countries

Hepatitis C virus (HCV) infection represents a global public health and economic problem. It is estimated that 170 million persons (2%–3% of the world's population) are living with HCV infection. HCV infection is characterized with persistence and progression to cirrhosis and liver cancer. Chronic hepatitis C–related liver diseases impose a substantial economic burden on patients, families, and the society. The epidemiology and burden of HCV infection show significant variation throughout the world. The country-specific prevalence rates range from <1% to >10%. Although the incidence and prevalence of HCV in developed countries have recently declined, the prevalence of HCV in developing countries is still high with emergence of new cases. The extremely high cost of recent direct-acting antiviral agents (DAAs), the limited knowledge about testing and treatment, limited accessibility of testing locations, and long waiting lists for accessing HCV care represent major barriers to care of HCV patients in developing countries. Given the high efficacy of DAAs, access to such potent therapies should be urgently improved in developing countries with a high burden of HCV infection. Decreasing the burden of HCV infection in developing, resource-limited countries requires urgent collaboration between international health organizations and local health authorities. Substantial decrease of HCV treatment costs, a strengthening of medical infrastructures, and capacity building of human resources are critical for improving access of patients to affordable recent drugs.