The goal of treatment was to cure HCV infection in order to prevent cirrhosis, cirrhotic decompensation, hepatocellular carcinoma (HCC), severe extrahepatic manifestations, and death. Treatment endpoints were undetectable HCV RNA (≤15 IU/mL) by sensitive methods at 12 weeks (SVR12) and 24 weeks (SVR24) after the end of treatment (i.e., sustained virologic response, SVR). In patients with progressive fibrosis and cirrhosis, HCV clearance reduces the incidence of decompensation and, although not completely eliminated, reduces the risk of HCC, and monitoring for HCC should be continued in these patients. In patients with decompensated cirrhosis, HCV clearance may reduce the need for liver transplantation, and it is not clear whether HCV clearance affects the medium- and long-term survival of these patients. Indications for treatment: Which patients need treatment? Treatment should be considered in all primary and treated patients with chronic liver disease in the compensated or decompensated phase due to HCV. Priority should be given to patients with significant liver fibrosis or cirrhosis (METAVIR score F3 to F4). Patients with decompensated cirrhosis (Child-Pugh class B or C) should receive urgent treatment with an interferon-free (IFN) regimen. For patients with moderate fibrosis (METAVIR score F2), treatment is reasonable. For patients with no or mild disease (METAVIR score F0 to F1) and without extrahepatic manifestations such as symptomatic vasculitis associated with HCV-associated mixed cryoglobulinemia, HCV immune complex-associated nephropathy, or non-Hodgkin B-cell lymphoma, the indication and timing of treatment can be individualized. Treatment is not recommended for patients with limited life expectancy due to non-hepatic related coexisting disease.