The management of hepatitis C virus (HCV) in children across the Asia-Pacific region is a pressing issue, highlighting both treatment options and the challenges faced.

Globally, approximately 3.26 million children and adolescents are living with HCV, with significant populations in countries such as Pakistan, China, India, and Nigeria.

Historically, treatment options for HCV in children have been limited, but the introduction of direct-acting antiviral (DAA) therapies has improved the situation significantly.

DAA therapy is now recommended for all children over three years old with HCV, regardless of liver function or genotype, due to its high cure rate.

Despite the effectiveness of DAAs, many HCV patients remain undiagnosed, contributing to ongoing transmission of the virus.

Barriers to HCV screening and diagnosis include low public awareness, stigma, and structural challenges that limit access to testing services.

Regional cooperation and tailored public health strategies are essential to improve screening and treatment access, particularly in the Asia-Pacific region.

Cost-effectiveness studies indicate that early treatment of HCV in children can prevent serious liver complications and reduce healthcare costs.

Efforts to manufacture generic DAAs in countries like India show promise for making treatment more affordable and accessible.

The World Health Organization (WHO) has set ambitious targets to eliminate HCV as a public health threat by 2030, yet significant challenges remain.

Public health strategies must emphasize screening, treatment, and harm reduction programs to meet WHO targets and effectively combat HCV.

Chronic HCV in children often progresses slowly and can remain asymptomatic for over 20 years, complicating early detection efforts.