In the past, treatment of chronic hepatitis C (HCV) infection required the combination therapy of pegylated interferon and ribavirin which was associated with many side effects and had a success rate of about 50%. As a result, the uptake of treatment was rather low. Early treatment of chronic HCV infection can halt the progression of liver damage, prevent the complications of liver disease and decrease the liver related mortality. With the advent of direct acting antiviral (DAA) agents, the success rate (sustained virological remission at week 12 or week 24) of treating chronic HCV infection is more than 95% and even approaches 100%. The pan-genotypic property of some of the DAAs coupled with a short duration of therapy has increased the uptake of treatment in the population of chronic HCV patients but this was hindered by the cost of the DAAs in the initial phase. In Hong Kong, majority of the patients with chronic HCV infection are still managed in the public sector. There is a good collection of epidemiological and drug treatment data of chronic HCV patients being managed at the Hospital Authority in The Hong Kong HCV Registry The introduction of more and more pan-genotypic DAAs into the Hospital Authority Drug Formulary and the progressive expansion of indications from cirrhosis to advanced fibrosis, to mild fibrosis and currently to all patients with chronic HCV infection will hasten the elimination of chronic hepatitis C infection in our local population. Together with other strategies to enhance the awareness, screening and diagnosis of chronic HCV, better linkage to care and treatment, we are getting closer to the World Health Organization target of HCV elimination by 2030.
