hepatic and biliary disorders
Hepatitis C, Chronic
Prognosis for Chronic Hepatitis C
Prognosis depends on whether patients have a sustained virologic response (SVR), ie, no detectable HCV-RNA at 12 weeks after completion of treatment. 99% chance of remaining HCV RNA–negative and are typically considered cured. Nearly 95% of patients with an SVR have improved histologic findings, including fibrosis and histologic activity index; in addition, risk of progression to cirrhosis, hepatic failure, and liver-related death is reduced. In patients who have cirrhosis and portal hypertension and who were treated with interferon-based regimens, an SVR has been shown to reduce portal pressures and significantly reduce risk of hepatic decompensation, liver-related death, all-cause mortality, and hepatocellular carcinoma ( Prognosis reference ). Likelihood of achieving an SVR with direct-acting antiviral regimens seems to depend mostly on the following: Degree of liver fibrosis Response to prior treatment HCV genotype 1.van der Meer AJ, Veldt BJ, Feld JJ, et al: Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis.JAMA308(24):2584-2593, 2012. 