From the Guidelines
Yes, Hepatitis C can be resolved with a cure rate of over 95% using direct-acting antiviral (DAA) medications. The primary goal of HCV therapy is to cure the infection, which is achieved by obtaining a sustained virological response (SVR), defined as undetectable HCV RNA after treatment completion 1.
Key Points to Consider
- Treatment duration and regimen: The treatment duration and regimen depend on factors such as viral genotype, liver damage extent, and previous treatment history 1.
- Common treatment regimens: Common treatment regimens include Epclusa (sofosbuvir/velpatasvir), Mavyret (glecaprevir/pibrentasvir), and Harvoni (ledipasvir/sofosbuvir) 1.
- Side effects and monitoring: Most patients take one pill daily with minimal side effects like headache, fatigue, or nausea, and regular blood tests during and after treatment monitor viral load and liver function 1.
- Importance of early treatment: Early treatment is crucial to prevent progression to cirrhosis, liver cancer, or liver failure, and to reduce the risk of hepatocellular carcinoma (HCC) and all-cause mortality 1.
- Cure and reinfection: After achieving sustained virologic response (undetectable virus 12 weeks after treatment completion), patients are considered cured, but being cured does not provide immunity against reinfection, so preventive measures remain important 1.
From the FDA Drug Label
Clearance of HCV infection with direct acting antivirals may lead to changes in hepatic function, which may impact safe and effective use of concomitant medications. The FDA drug label does not answer the question.
From the Research
Resolution of Hepatitis C
- Hepatitis C can be resolved with the use of direct-acting antiviral (DAA) medications, which have been shown to be highly effective in achieving sustained virological response (SVR) rates of 95% or higher 2, 3, 4, 5, 6.
- The treatment regimen and duration may vary depending on the genotype of the virus, the presence of cirrhosis, and other factors, but most patients can be cured with 8-12 weeks of treatment 2, 3, 6.
- Studies have demonstrated that DAA medications such as sofosbuvir/velpatasvir, glecaprevir/pibrentasvir, and others can achieve high SVR rates in patients with different genotypes of hepatitis C, including those with compensated or decompensated cirrhosis 2, 3, 4, 5, 6.
Treatment Outcomes
- The overall SVR rate for patients treated with DAA medications has been reported to be around 97-100% in some studies 4.
- Patients with genotype 2 infection have been shown to have high SVR rates with DAA medications, with some studies reporting rates of 95-100% 4.
- The presence of cirrhosis may affect treatment outcomes, but DAA medications have still been shown to be effective in achieving high SVR rates in patients with compensated or decompensated cirrhosis 2, 3, 5, 6.
Post-Treatment Follow-Up
- After completing treatment, patients should be followed up to monitor for hepatocellular carcinoma and esophageal varices, especially those with compensated cirrhosis 6.
- Abdominal ultrasonography and upper endoscopy should be performed every 6 months and every 2-3 years, respectively, in patients with compensated cirrhosis 6.
- In the absence of cirrhosis, no liver-related follow-up is recommended 6.