From the Guidelines
Sustained Virologic Response (SVR) is the goal of hepatitis C treatment and is considered a cure, defined as undetectable hepatitis C virus in the blood 12 weeks after completing treatment, as stated in the most recent and highest quality study 1.
Definition of SVR
SVR is achieved when a patient undergoes a course of direct-acting antiviral medications for 8-12 weeks, with common regimens including Epclusa (sofosbuvir/velpatasvir) 400mg/100mg once daily or Mavyret (glecaprevir/pibrentasvir) 300mg/120mg once daily with food.
Factors Influencing SVR Rates
Factors influencing SVR rates include adherence to medication, viral genotype, and the presence of cirrhosis, as noted in 1 and 1.
Benefits of Achieving SVR
Achieving SVR significantly reduces the risk of liver disease progression, liver cancer, and liver-related mortality, as stated in 1 and 1.
Long-term Health Benefits
Regular follow-ups and liver health monitoring are recommended even after achieving SVR to ensure long-term health benefits, as patients with cirrhosis remain at risk of life-threatening complications, although the risk of HCC and all-cause mortality is significantly reduced, but not eliminated, in cirrhotic patients who clear HCV compared to untreated patients and non-sustained virological responders 1.
Treatment Duration and Regimens
Treatment duration can vary based on liver health, viral genotype, and prior treatment history, with the primary goal of HCV therapy being to cure the infection, which results in eliminating detectable circulating HCV after cessation of treatment, as stated in 1 and 1.
Recent Developments in HCV Treatment
Recent data suggest that the risk of HCC and all-cause mortality is significantly reduced, but not eliminated, in cirrhotic patients who clear HCV compared to untreated patients and non-sustained virological responders, with new therapeutic strategies aiming toward higher efficacy, shortened treatment, easier administration, and improved tolerability and patient adherence, as noted in 1, 1, and 1.
From the FDA Drug Label
Sustained virologic response (SVR12), defined as HCV RNA less than LLOQ at 12 weeks after the cessation of treatment, was the primary endpoint in both trials.
Sustained Virologic Response (SVR) is defined as HCV RNA less than the lower limit of quantification (LLOQ) at 12 weeks after the cessation of treatment.
- Key points:
- SVR is measured 12 weeks after treatment cessation
- HCV RNA must be less than the LLOQ to be considered SVR
- This definition is used as the primary endpoint in clinical trials 2
From the Research
Definition of Sustained Virologic Response (SVR)
- Sustained virological response (SVR) is defined as a long-lasting response, associated with a reduced risk of cirrhosis and hepatocellular carcinoma (HCC) 3.
- SVR is considered a cure for hepatitis C infection, with rates of SVR above 90% achievable with certain direct-acting antiviral (DAA) regimens 4.
Factors Associated with SVR
- Host factors, such as age, ethnicity, insulin resistance, and genetic variations, can play important roles in achieving SVR 5.
- The genotype of the hepatitis C virus, baseline viral load, and viral kinetics can also be used as predictors of response-guided therapy 5.
- The presence of advanced liver disease, suboptimal treatment, and NS5A mutations can be causes of failure to achieve SVR with DAA treatment 6.
Treatment Duration and SVR
- Treatment duration can impact SVR rates, with longer treatment durations (48 weeks) resulting in higher SVR rates compared to shorter treatment durations (24 weeks) 7.
- However, for patients with low baseline viremia and a rapid virological response, shorter treatment durations (24 weeks) may be sufficient to achieve high SVR rates 7.