Curing HCV

The primary goal is to get rid of HCV treating to cure.

In hepatitis C, a sustained virological response, or SVR, means that
a person does not have detectable virus in his/her bloodstream six
months after completing hepatitis C treatment.
Most people who have had an SVR remain virus-free, although there
have been fewer long-term studies of coinfected people than those
with HCV alone.
Although some recent research has found very low levels of hepatitis
C in the blood and liver tissue of some sustained virological
responders, this small quantity of virus may not have any significant
effect on liver health.

Improving liver health
A secondary goal of HCV treatment is to improve liver health by
reducing inflammation, and sometimes, reversing fibrosis. This even
happens in patients who do not have an SVR, although only in
about half the number of cases.
In some cases, the condition of the liver may worsen after HCV
treatment, particularly among people who did not clear the virus;
the reasons for this are unclear.

Reducing Risk of HCV Progression
Studies of people with HCV and HIV/HCV have reported that HCV
treatment reduces the risk of complications (cirrhosis, liver cancer,
and liver-related death), especially for people who have an SVR.
For HCV/HIV-coinfected people, there may be an additional benefit
from HCV treatment: less risk of liver-related side effects from HIV drugs.
Predicting the response to treatment
Several factors can help you predict the likelihood of HCV treatment
response, but the only way to know how you will respond is to treat.
The most significant factors are:
Early response to HCV treatment (see box, page 44)
HCV genotype (2 and 3 are more sensitive to treatment than
1 or 4);
HCV viral load (treatment is more effective with an HCV viral
load below 400,000 IU/mL);
Race (treatment is less effective for African Americans; ongoing
research is looking at this question);
Amount of liver damage and steatosis (treatment is less
effective for cirrhotics and people with steatosis);
HIV status (treatment is less effective for HIV-positive people
than for HIV-negative people);
Insulin resistance and diabetes (these are both more common
among people with HCV versus the general population; HCV
treatment is less effective for people with these conditions;
researchers are studying the effect

Evaluating the response to treatment
The response to HCV treatment is measured by HCV viral load tests at different times.
SVR (sustained virological response): An SVR means that HCV is not detectable in blood six
months after completing treatment. Many experts think of SVR as a cure, and it is an indication of
long-term remission. SVR rates are usually the most important results to look for from a clinical trial.
SVR-12: An SVR-12 means that no hepatitis C virus is detectable in blood three months after
completing treatment. Hepatitis C virus is most likely to re-emerge within 12 weeks after finishing
HCV treatment, so SVR-12 is considered a good predictor of SVR. However, experts agree that
more data are needed before it can replace SVR. SVR-12 is often used for reporting results of
new HCV treatments at medical conferences.