Global treatment rate and barriers to direct‐acting antiviral therapy: A systematic review and meta‐analysis of 146 studies and 1 760 352 hepatitis C virus patients

Background Global data on the treatment rate with direct‐acting antivirals (DAAs) for chronic hepatitis C (CHC) are sparse. We aimed to evaluate the CHC treatment rate and barriers to treatment in the DAA era. Methods We searched PubMed, EMBASE and Cochrane from inception to 5 August 2021, for relevant articles. Patients treated with DAAs without interferon (IFN) therapy were categorized as IFN‐free DAAs. Patients receiving DAA with IFN or unclear IFN status were categorized as DAA/IFN. Results We identified and analysed data from 146 studies (1 760 352 CHC patients). DAA/IFN treatment rate was 16.0% (95% CI: 9.9–23.3, 49 studies, 886 535 patients). IFN‐free DAA treatment rate was 52.3% (95% CI: 46.2–58.4, 123 studies, 1 276 754 patients): 45.4% in North America, 64.2% in South America (1 study), 90.4% in Africa (most data from Egypt), 54.4% in Europe, 60.7% in Australia and 60.5% in Asia, (p