Hepatitis C Cure and Treatment

Definition of Cure

A cure is defined as undetectable HCV RNA 12 weeks after treatment completion (SVR12), measured by a sensitive molecular assay with a lower limit of detection, representing permanent viral eradication in the vast majority of cases 1

Modern DAA regimens achieve cure rates exceeding 95-97% across all patient populations, including those historically difficult to treat 2
The American Association for the Study of Liver Diseases recommends sofosbuvir/velpatasvir for 12 weeks (SVR rate 98% for genotype 1a) 3

Curing HCV infection prevents the complications of chronic liver disease, including cirrhosis, hepatic decompensation, hepatocellular carcinoma, and death 1
The European Association for the Study of the Liver notes that curing HCV infection also improves quality of life and removes stigma 1

Patients with established cirrhosis (F4) or advanced fibrosis (F3) remain at reduced but ongoing risk for hepatocellular carcinoma even after achieving SVR, and require continued HCC surveillance with ultrasound every 6 months indefinitely 2

The American College of Gastroenterology recommends that all patients with chronic HCV should be offered treatment without delay, with priority given to patients with significant fibrosis or any degree of cirrhosis (F2-F4) 1
The World Health Organization suggests that individuals at risk of transmitting HCV, such as people who inject drugs, men who have sex with men with high-risk practices, women of childbearing age wishing to conceive, and hemodialysis patients, should also be prioritized for treatment 1