Treating Hepatitis C in Pakistan. Strategies to Avoid Resistance to Antiviral Drugs

We will determine how best to manage the hepatitis C virus (HCV) epidemic in Pakistan by measuring effectiveness of Pakistan-government sponsored current therapies, emergence of viral resistance, consequences of infection (chiefly liver cancer) and through developing models, based on incidence data, determine the proportion of people who need curative treatment to eliminate HCV, and assess whether targeting can optimise this.

Inclusion Criteria: * Adults over 18yrs old * Willing to undergo hepatitis C testing * Able and willing to give informed consent * Willing to return in 12 months time for repeat testing * Resident in area and not planning to leave the region Exclusion Criteria: * Unwilling to give consent * Unwilling or unable to undergo the necessary procedures * Clinically significant illness (other than HCV) or other major medical condition that may interfere with the subject's treatment, assessment or compliance with protocol. * Co-morbidities limiting life expectancy to less than 12 months