HCV infection is curable. In clinical trials, roughly 95 percent of those who took the newest medications were cured. HCV treatment is easier and shorter than ever before.
When HCV treatment is working, the virus will become undetectable in the blood within four to 12 weeks and will remain that way throughout treatment. People are considered cured when they have achieved a continuation of this undetectable status for 12 to 24 weeks after completing therapy. This is known as a sustained virologic response (SVR). The chances of HCV returning after 24 weeks of remaining clear of the virus are nearly zero.
Regarding who should be treated, the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America state the following: "Successful hepatitis C treatment results in sustained virologic response (SVR), which is tantamount to virologic cure, and as such, is expected to benefit nearly all chronically infected persons. Evidence clearly supports treatment in all HCV-infected persons, except those with limited life expectancy (less than 12 months) due to non-liver-related comorbid conditions."
In the past, acute hepatitis C infections (those that are less than six months) were treated differently than chronic HCV infections. This changed with the availability of new medications. HCV guidelines recommend delaying treating a new infection for a minimum of six months, and allowing time to see if the body will clear HCV on its own. This is called spontaneous clearance. If spontaneous clearance does not occur, then the HCV infection is treated as a chronic one.
Whether this is your first hepatitis C treatment, or you have been treated before, a variety of new HCV medications are available. Your doctor will prescribe medication and the length of treatment needed based on your health history and laboratory tests. The prescribed treatment is based on:
Your HCV genotype (the genetic structure of the virus)
Your viral load (how much virus is in your blood)
Your past treatment experience
If you have cirrhosis
If you are a liver transplant recipient or on the transplant waiting list
Your ability to tolerate the prescribed treatment
In some cases, your health insurance plan or drug formulary may determine if you are eligible for treatment, and what drug regimen will be used.