OBJECTIVES: METHODS: A search of Medline, Embase, and Cochrane databases (between 2004 and January 2014) was conducted for primary articles/conference abstracts examining social and  lifestyle factors. Analyzed the main ethical arguments are often presented to restrict patients' access to HCV treatment: the balance of risk/benefit, justice, compliance, cost-effectiveness and discrimination. RESULTS: Clinical and individual level barriers to HCV treatment are well evidenced. These include patient and provider concerns regarding co-morbidities, adherence, and side effect management. Social factors affecting treatment access are less well evidenced. In attempting to map these, key barriers fall into the following domains: social stigma, housing, criminalisation, health care systems, and gender. Key facilitating factors to treatment access include: combination intervention approaches encompassing social as well as biomedical interventions and integrated delivery of multidisciplinary care. No trial evaluated effectiveness of treatment on long-term clinical outcomes. CONCLUSIONS: Successful treatment of HCV infection has undeniable long-term benefits with respect to reducing morbidity and mortality. Perhaps the most challenging issue is not whether there will be medical tools to effectively manage and treat HCV infection, but rather whether the economic resources and societal commitment will be adequate to embark on an ambitious agenda to eliminate this global public health problem. Combination intervention approaches need to encompass systemic changes in policy and health care delivery. Future research needs to better delineate social factors affecting treatment access.