Is the hepatitis C virus curable?

Yes, hepatitis C virus (HCV) is curable for many people using newer oral medicines known as the direct-acting antiviral (DAA) agents. In many cases, these treatments can clear the virus in 90% to 95% of patients.

Prior to the oral direct-acting antiviral agents, the standard treatment involved a combination of injectable interferon and oral ribavirin. This regimen was curative in only about 50% of patients, took 6 months or longer to complete, and was often ineffective because patients would stop treatment due to intolerable side effects. These medicines may still be combined today with the newer antivirals.

A liver transplant may be one option if you have severe liver disease, but this does not typically cure HCV and you will still require treatment with medications. Treatment with the newer direct-acting medications before or after your liver transplant may cure your HCV.

There is no vaccine available to prevent hepatitis C, but your doctor may recommend you receive other vaccines, such as for hepatitis A and B.

Is SVR considered a cure?

The oral DAA treatments are capable of causing a sustained virologic response (SVR12), which means that the hepatitis C virus is not detected in the blood 12 weeks or more after completing treatment. Your doctor will monitor your virologic response with blood tests. Most people are considered cured when the virus is no longer present after 12 weeks.

Two or more oral antiviral drugs are typically used together to help prevent resistance in patients treated for HCV. Sometimes these treatments still need to be used with older medications such as ribavirin if you have advanced liver disease. Your chances for a cure may be better if you do not have advanced liver disease and have never received HCV treatment before.

Once you reach an SVR, it is highly unlikely for the hepatitis C virus to be detected again unless you are reinfected. Studies have shown this type of relapse occurs in less than 1% of patients who complete treatment. Also, when the virus is cleared from your blood you can no longer transmit the virus to others. However, you should still take precautions to help prevent catching and spreading HCV.

Any liver damage you have won't be reverse after you reach SVR, but further damage may be minimized with treatment.

Which drugs can cure hepatitis C virus?

Several agents are available by prescription in the U.S. that can lead to a sustained virologic response (SVR12), considered a cure for HCV.

Drug combination antivirals for HCV treatment, often taken as one daily dose, are now approved to ease treatment regimens and tend to be more tolerable.

The newer direct-acting antiviral agents (DAAs) medications to treat HCV include:

• Epclusa (sofosbuvir and velpatasvir)
• Harvoni (ledipasvir and sofosbuvir)
• Mavyret (glecaprevir and pibrentasvir)
• Sovaldi (sofosbuvir) - used with other antivirals (usually ribavirin +/- peginterferon alfa)
• Vosevi (sofosbuvir, velpatasvir and voxilaprevir)
• Zepatier (elbasvir and grazoprevir)

Treatment length can vary from 8 to 24 weeks depending upon factors such as the patient’s liver function, HCV genotype, resistance testing, and whether the patient is just starting treatment or has received treatment in the past.

Related questions

• What types of Hepatitis C does Mavyret treat?
• What types of hepatitis C (HCV) does Vosevi treat?
• What type of Hepatitis C is Zepatier used to treat?

Examples of HCV cures

Epclusa was the first direct-acting antiviral to treat all the major HCV genotypes 1 through 6, with or without cirrhosis. Epclusa is a combination of sofosbuvir (an NS5B inhibitor) and velpatasvir (an NS5A inhibitor).

• Epclusa is used to treat adults and children 3 years of age and older with HCV genotype 1, 2, 3, 4, 5, or 6 infection. Epclusa is used with ribavirin in patients with advanced liver disease (decompensated cirrhosis).
• In approval studies, 95% to 99% of Epclusa-treated patients without cirrhosis or with mild cirrhosis had no virus detected in the blood 12 weeks after finishing the 12-week regimen.
• In patients with moderate to severe cirrhosis, some of whom required ribavirin, 94% were cleared of the virus 12 weeks after finishing treatment.

Mavyret is a combination tablet containing two different medicines: glecaprevir (an NS3/4A protease inhibitor) and pibrentasvir (an NS5A inhibitor).

• Mavyret is used to treat chronic HCV in adults and children 3 years of age and older with genotypes 1 through 6.
• Patients typically take Mavyret for 8 to 16 weeks depending upon their hepatitis C genotype, what treatments they have already received, and existing liver damage.
• Studies submitted to the FDA showed that 92% to 100% of patients treated with Mavyret had no virus detected in their blood after they finished treatment, denoting a cure.

Learn more: Oral Hepatitis C Treatments: The Evolving Landscape

Hepatitis C virus (HCV) is transmitted through contact with infected blood. It can lead to chronic liver disease like cirrhosis, liver cancer, and death. Symptoms of chronic HCV may not appear for 20 to 30 years after infection.

It is important to seek medical testing and treatment for hepatitis C so you can help prevent its spread and have adequate medical care, if needed. Fifteen to twenty percent of people may eliminate the HCV virus completely from their body within 6 months, but most people remain infected and develop chronic hepatitis C.

If you were born from 1945 through 1965, or are at increased risk for HCV infection for other reasons like sharing drug injection equipment, speak to your doctor about being tested for HCV.

The US Centers for Disease Control and Prevention (CDC) now recommends a one-time hepatitis C test for all adults 18 years of age and older and all pregnant women for each pregnancy. CDC continues to recommend people with risk factors, including people who inject drugs, be tested regularly.

Always discuss your treatment options with a healthcare provider.