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The diagnosis of acute HCV infection is particularly challenging in immunocompromised, reinfected, and superinfected patients due to difficulty in detecting anti-HCV antibody seroconversion and HCV ribonucleic acid from a previously negative antibody response. With an excellent treatment effect on chronic HCV infection, recently, clinical trials investigating the benefit of direct-acting antivirals (DAAs) treatment for acute HCV infection have been conducted. Based on the results of cost-effectiveness analysis, DAAs should be initiated early in acute HCV infection prior to spontaneous viral clearance. Compared to the standard 8\u201312 week-course of DAAs for chronic HCV infection, DAAs treatment duration may be shortened to 6\u20138 weeks in acute HCV infection without compromising the efficacy. Standard DAA regimens provide comparable efficacy in treating HCV-reinfected patients and DAA-na\u00efve ones. For cases contracting acute HCV infection from HCV-viremic liver transplant, a 12-week course of pangenotypic DAAs is suggested. While for cases contracting acute HCV infection from HCV-viremic non-liver solid organ transplants, a short course of prophylactic or pre-emptive DAAs is suggested. Currently, prophylactic HCV vaccines are unavailable. In addition to treatment scale-up for acute HCV infection, practice of universal precaution, harm reduction, safe sex, and vigilant surveillance after viral clearance remain critical in reducing HCV transmission.<\/jats:p>","DOI":"10.3350\/cmh.2022.0349","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:24:16Z","timestamp":1676939056000},"page":"623-642","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Acute hepatitis C virus infection: clinical update and remaining challenges"],"prefix":"10.3350","volume":"29","author":[{"given":"Chen-Hua","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-7952","authenticated-orcid":true,"given":"Jia-Horng","family":"Kao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1902","reference":[{"key":"ref1","volume-title":"Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection","year":"2018"},{"key":"ref2","first-page":"396","volume-title":"Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study","year":"2022"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/nejm200107053450107"},{"key":"ref4","first-page":"2051","volume-title":"Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa","author":"Liu","year":"2014"},{"key":"ref5","first-page":"34","volume-title":"The present and future disease burden of hepatitis C virus (HCV) infection with today\u2019s treatment paradigm","author":"Razavi","year":"2014"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.176"},{"key":"ref7","volume-title":"Global progress report on HIV, viral hepatitis and sexually transmitted infections","year":"2021"},{"key":"ref8","volume-title":"Global hepatitis report 2017"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099677"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080948"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1258\/095646204322637182"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12151"},{"key":"ref13","first-page":"30","volume-title":"Prevention of hepatitis C in Italy: lessons from surveillance of type-specific acute viral hepatitis. 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