A management approach is proposed for HCV treatment. The situation is promising as newer drugs provide a clear improvement in efficacy. However, the clinical trial evidence has some limitations. These include a lack of head-to-head comparisons of efficacy among different new drugs in the same study population; potential differences in drug effects in actual practice compared with those observed in the trials; and a lack of knowledge of mid to long term treatment results or of the evolution of patients who are cured of the virus when fibrosis is already at an advanced stage. The exorbitant costs of these treatments greatly limit their use.