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Abstract：
Hepatitis C virus (HCV) remains a significant global health challenge. Approximately 50 million people were living with chronic hepatitis C based on the World Health Organization as of 2024, contributing extensively to global morbidity and mortality. The advent and approval of several direct-acting antiviral (DAA) regimens significantly improved HCV treatment, offering potentially high rates of cure for chronic hepatitis C. However, the promising aim of eventual HCV eradication remains challenging. Key challenges include the variability in DAA access across different regions, slightly variable response rates to DAAs across diverse patient populations and HCV genotypes/subtypes, and the emergence of resistance-associated substitutions (RASs), potentially conferring resistance to DAAs. Therefore, periodic reassessment of current HCV knowledge is needed. An up-to-date review on HCV is also necessitated based on the observed shifts in HCV epidemiological trends, continuous development and approval of therapeutic strategies, and changes in public health policies. Thus, the current comprehensive review aimed to integrate the latest knowledge on the epidemiology, pathophysiology, diagnostic approaches, treatment options and preventive strategies for HCV, with a particular focus on the current challenges associated with RASs and ongoing efforts in vaccine development. This review sought to provide healthcare professionals, researchers, and policymakers with the necessary insights to address the HCV burden more effectively. We aimed to highlight the progress made in managing and preventing HCV infection and to highlight the persistent barriers challenging the prevention of HCV infection. The overarching goal was to align with global health objectives towards reducing the burden of chronic hepatitis, aiming for its eventual elimination as a public health threat by 2030.
摘要：
丙型肝炎病毒（HCV）仍然是一个重大的全球健康挑战。根据世界卫生组织，截至2024年，约有5000万人患有慢性丙型肝炎，这对全球发病率和死亡率造成了广泛的影响。几种直接作用抗病毒（DAA）方案的出现和批准显着改善了HCV治疗，提供潜在的高治愈率的慢性丙型肝炎，然而，最终根除HCV的有希望的目标仍然具有挑战性.主要挑战包括不同地区DAA访问的可变性，不同患者人群和HCV基因型/亚型对DAA的反应率略有不同，以及抗性相关替换(RAS)的出现，可能赋予DAAs抗性。因此,需要定期重新评估当前的HCV知识.根据观察到的HCV流行病学趋势的变化，还需要对HCV进行最新的审查。不断发展和批准治疗策略，以及公共卫生政策的变化。因此，目前的全面审查旨在整合流行病学的最新知识，病理生理学,诊断方法，HCV的治疗选择和预防策略，特别关注当前与RAS相关的挑战和疫苗开发的持续努力。这篇评论试图为医疗保健专业人员提供，研究人员,和政策制定者有必要的见解，以更有效地解决HCV负担。我们旨在强调在管理和预防HCV感染方面取得的进展，并强调挑战HCV感染预防的持续障碍。总体目标是与全球卫生目标保持一致，以减轻慢性肝炎的负担，目标是到2030年最终消除其作为公共卫生威胁。
