1SCOPE AND OBJECTIVES

Introduction and objectives

Most of the existing guidelines for the treatment of hepatitis C have been developed by specialist medical organizations and relate to the treatment of persons living in high-income countries. There are no evidence-based treatment guidelines that focus on persons living in low- and middle-income countries. In addition, these are the first WHO guidelines dealing with the topics of screening and management of HCV infection. The objective of these guidelines is to provide evidence-based recommendations on screening for HCV infection, and the care and treatment of persons with HCV infection. These guidelines are meant to provide a framework for the development or strengthening of hepatitis C treatment programmes in low- and middle-income countries. Although most of the recommendations deal with treatment issues, recommendations related to screening and care are included to reinforce the importance of the continuum of care that is a key element of the clinical management HCV infection. Each of these topics is complex and includes many dimensions that could not be assessed by the Guidelines Development Group. In the screening section, there is no discussion of the selection of laboratory tests; in the care section, the Group only assessed one intervention (alcohol reduction counselling), and in the area of treatment, there are no recommendations regarding the management of complications of HCV, including cirrhosis and hepatocellular carcinoma.

Target audience

These guidelines are primarily targeted at policy-makers in ministries of health working in low- and middle-income countries who formulate country-specific treatment guidelines and who plan infectious diseases treatment programmes. These guidelines are intended to assist officials as they develop national hepatitis C treatment plans and policy, and guideline documents. In addition, it is anticipated that nongovernmental agencies and health professionals organizing treatment and screening services for hepatitis C will use the guidelines to define the necessary elements of such services. These guidelines will also be a useful resource for clinicians who manage persons with HCV infection.

Related WHO materials and guidelines

These are the first WHO guidelines on the screening, care and treatment of persons with HCV infection. They are intended to complement existing guidance on the primary prevention of HCV and other bloodborne viruses by improving blood and injection safety, and health care for people who inject drugs (PWID) and other vulnerable groups, including those living with HIV (see section 2.4 for related WHO guidelines).

This guidelines document will be revised in 2016. Because a number of new medicines are expected to become available in the meantime, WHO will issue interim guidance twelve months after publication of these guidelines to provide recommendations regarding newly approved medicines.