An estimated 71 million people around the world are chronically infected with hepatitis C virus (HCV). Marginalised populations, and particularly people who inject drugs, have low testing and treatment rates for HCV. Several models of care and service delivery interventions have the potential to improve outcomes, but much of the relevant research was carried out when interferon-based treatment was the standard of care.

Despite the more recent adoption of highly effective, all-oral direct-acting antiviral (DAA) therapies in recent years, approaches to HCV testing have evolved slowly and often remain rooted in earlier paradigms. The effectiveness of DAAs allows for simpler approaches and has encouraged countries where the drugs are widely available to set their sights on the ambitious World Health Organization HCV elimination targets.

Since a large proportion of chronically HCV-infected people are not currently diagnosed and/or diagnosed late, there is an urgent need to identify them and link them to care. This presentation reviews the current state of play in the field of HCV focusing on innovative testing initiatives and the need for tailored, people-centred approaches. This includes expanding where testing can take place and by whom, and ultimately bringing the testing services closer to the client through point-of-care diagnostics when relevant.