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With direct\u2010acting antiviral (DAA) combination therapies such as glecaprevir\/pibrentasvir and velpatasvir\/sofosbuvir, 98% of patients successfully eradicate the virus, even if previous treatments failed or if resistance\u2010associated substitutions (RASs) are present. Adverse events are rare or mild, and patients with compensated cirrhosis and other co\u2010morbidities are often eligible for treatment. However, a small number of patients fail to eradicate the virus even after retreatment. The cause of failure is mainly due to emergence of NS5A P32 deletion mutants after initial DAA therapy in genotype 1b patients, although the reason is unknown for some patients. Alternative therapies that do not rely on NS5A inhibitors, such as sofosbuvir plus ribavirin, can be attempted in these patients. While scaled\u2010up treatment efforts present a challenge, another problem is that many carriers are unaware of their infection. Long\u2010term damage to the liver becomes irreversible, and patients who are not diagnosed in time can develop liver cancer or liver failure even after eliminating the virus. The long\u2010term costs of treatment of advanced liver disease in undiagnosed patients relative to the immediate costs of DAA therapy should be considered. As no vaccine is yet available, eventual elimination of the virus requires identifying and treating undiagnosed cases and screening of high\u2010risk populations such as injection drug users and men who have sex with men and female sex workers.<\/jats:p>","DOI":"10.1111\/liv.15150","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T08:29:16Z","timestamp":1640852956000},"page":"1935-1944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Road to elimination of HCV: Clinical challenges in HCV management"],"prefix":"10.1111","volume":"42","author":[{"given":"C. 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