A treatment revolution for those who can afford it? Hepatitis C treatment: new medications, profits and patients

“We are witnessing a revolution in the treatment of hepatitis C virus.... There is no question that these treatments that can save millions of lives must be made universally available at an affordable price.” – Francois Barre-Sinoussi, President of the International AIDS Society [1] Globally, approximately 184 million people are chronically infected with the Hepatitis C virus (HCV), the majority of whom reside in lowand middle-income countries [2]. HCV is a very common co-infection of HIV with an estimated four to five million people affected [3]. While HCV is a global epidemic it has a disproportionate effect on marginalised groups, in particular people who inject drugs (PWID). The global prevalence of HCV among PWID was estimated at 67% in 2010, with more than 10 million PWID living with the virus [4]. Moreover, among PWID who are living with HIV, approximately 75% are co-infected with HCV [5]. While the burden of HCV falls disproportionately upon people who inject drugs, treatment coverage among this group remains extremely low, estimated at just 2%-4% of those eligible for treatment [6]. This is similar to the 4% coverage of antiretroviral therapy among PWID who are living with HIV [7].