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Strains on healthcare resources during the COVID\u201019 pandemic negatively impacted the progress toward the World Health Organization goal to eliminate HCV by 2030, especially among persons who inject drugs (PWID). Here, we present a holistic conceptual framework termed LOTUS (Leveraging Opportunities for Treatment\/User Simplicity), designed to integrate the current HCV practice landscape and invigorate HCV treatment programs in the setting of endemic COVID\u201019: (A) treatment as prevention (especially among PWID), (B) recognition that HCV cure may be achieved with variable adherence with evidence supporting some forgiveness for missed doses, (C) treatment of all persons with active HCV infection (viremic), regardless of acuity, (D) minimal monitoring (MinMon) during treatment, and (E) rapid test and treat (TnT). The objective of this article is to review the current literature supporting each LOTUS petal; identify remaining gaps in knowledge or data; define the remaining barriers facing healthcare providers; and review evidence\u2010based strategies for overcoming key barriers.<\/jats:p>","DOI":"10.1111\/jvh.13927","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T07:59:39Z","timestamp":1709539179000},"page":"342-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leveraging opportunities for treatment\/user simplicity (LOTUS): Navigating the current treatment landscape for achieving hepatitis C virus elimination among persons who inject drugs"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2145-6352","authenticated-orcid":false,"given":"Mark S.","family":"Sulkowski","sequence":"first","affiliation":[{"name":"The Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Martinez","sequence":"additional","affiliation":[{"name":"University at Buffalo Buffalo New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gia L.","family":"Tyson","sequence":"additional","affiliation":[{"name":"Ochsner Health Baton Rouge Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7856-6691","authenticated-orcid":false,"given":"Kathleen","family":"Scholz","sequence":"additional","affiliation":[{"name":"Central Outreach Wellness Centers Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-4809","authenticated-orcid":false,"given":"Ricardo A.","family":"Franco","sequence":"additional","affiliation":[{"name":"The University of Alabama at Birmingham Heersink School of Medicine Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Kohli","sequence":"additional","affiliation":[{"name":"Arizona Liver Health Chandler Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan F.","family":"Julius","sequence":"additional","affiliation":[{"name":"Avenues Recovery Covington Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulina","family":"Deming","sequence":"additional","affiliation":[{"name":"University of New Mexico Health Sciences Center Albuquerque New Mexico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Fink","sequence":"additional","affiliation":[{"name":"Main Line Health Wynnewood Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisa","family":"Lynch","sequence":"additional","affiliation":[{"name":"University of Utah Health Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3916-4278","authenticated-orcid":false,"given":"Marina","family":"Roytman","sequence":"additional","affiliation":[{"name":"University of California San Francisco Fresno California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0041-3668","authenticated-orcid":false,"given":"Tuesdae R.","family":"Stainbrook","sequence":"additional","affiliation":[{"name":"TruCare Internal Medicine &amp; 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