HCV Microelimination for High-risk Special Populations

J Infect Dis. 2023 Sep 13;228(Suppl 3):S168-S179. doi: 10.1093/infdis/jiac446.


The World Health Organization has set tremendous goals to eliminate viral hepatitis by 2030. However, most countries are currently off the track for achieving these goals. Microelimination is a more effective and practical approach that breaks down national elimination targets into goals for smaller and more manageable key populations. These key populations share the characteristics of being highly prevalent for and vulnerable to hepatitis C virus (HCV) infection. Microelimination allows for identifying HCV-infected people and linking them to care more cost-effectively and efficiently. In this review, we discuss the current obstacles to and progress in HCV microelimination in special populations, including uremic patients undergoing hemodialysis, people who inject drugs, incarcerated people, people living in hyperendemic areas, men who have sex with men with or without human immunodeficiency virus (HIV) infection, transgender and gender-diverse populations, and sex workers. Scaling up testing and treatment uptake to achieve HCV microelimination may facilitate global HCV elimination by 2030.

Keywords: care cascade; commercial sex worker; direct-acting antiviral; end-stage renal disease; hemodialysis; injection drug use; men who have sex with men; transgender and gender-diverse populations.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biological Transport
  • Hepacivirus
  • Hepatitis C* / epidemiology
  • Hepatitis C* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Sexual and Gender Minorities*