Usually cure from HBV infection can be made by negative HBs Ag, but in case of HCV the condition is different as anti-HCV antibodies remain positive even if patient get cure from disease.
Hepatitis C testing typically begins with blood testing to detect the presence of antibodies to the HCV, using an enzyme immunoassay.If this test is positive, a confirmatory test is then performed to verify the immunoassay and to determine the viral load.[9] A recombinant immunoblot assay is used to verify the immunoassay and the viral load is determined by a HCV RNA polymerase chain reaction.If there are no RNA and the immunoblot is positive, it means that the person tested had a previous infection but cleared it either with treatment or spontaneously; if the immunoblot is negative, it means that the immunoassay was wrong.It takes about 6–8 weeks following infection before the immunoassay will test positive.
Please review the following articles, as the new direct HCV treatment paradigm is increasing implemented and resultant durable efficacy becomes known:
1. Ann Hepatol. 2015 May-Jun;14(3):325-32.
HCV antiviral therapy in injection drug users: difficult to treat or easy to
cure?
Persico M(1), Coppola N(2), Rosato V(3), Abenavoli L(4), Masarone M(5), De Luna
A(6).
Background and rationale of the study. Hepatitis C infection is very common among injection drug users(IDUs). In clinical practice there is reluctance to treat
IDUs, because considered difficult-to-treat. Aim of this study was to evaluate
the response to antiviral treatment in IDUs compared to non-IDUs.MAIN RESULTS: In this observational retrospective study, 204 non cirrhotic patients(112 IDUs, 92 non-IDUs) with chronic hepatitis C, treated with PEG-IFN and ribavirin in a tertiary centre for IDUs of Southern Italy from 2008 to 2011 were analyzed. Age, sex, genotype, steatosis, response to previous therapy, rapid(RVR), early(EVR), end-of-treatment(ETR), sustained(SVR) virological response were evaluated. IDUs were mainly young and males, with prevalence of genotype 3. A higher SVR rate in IDUs group compared to non-IDUs only in PerProtocol(PP) analysis (90% vs. 78,9% ;p = 0.04). On the contrary, in IntentionToTreat(ITT) analysis, no significant difference was relieved. A higher SVR rate at ITT analyses in naïve non-IDUs patients was found (76,13% vs. 90%, p = 0.021), but at PP analysis wasn't confirmed. Treatment was well tolerated; a higher dropout rate was reported in IDUs (24 patients) compared to non-IDUs (2 patients). In order to exclude the effect of viral genotypes on SVR a genotype matched statistical analysis was done and no difference was found.
CONCLUSIONS: IDUs naïve patients, due to young age and high prevalence of
genotype 3, appear good candidates to dual antiviral therapy with high SVR rates. Dropout is the main non-response cause among these subjects, but through an optimal monitoring program with a multidisciplinary setting, their "difficult to treat" characteristics can be overcome.
2. Can J Gastroenterol Hepatol. 2015 Apr;29(3):125-9.
Increased eligibility for treatment of chronic hepatitis C infection with
shortened duration of therapy: Implications for access to care and elimination strategies in Canada.
Borgia SM, Rowaiye A.
BACKGROUND: All oral, highly effective direct-acting antiviral combinations, such as sofosbuvir-ledipasvir, have recently been licensed in Canada but cost as much as $67,000 for a 12-week course of therapy, representing a major economic barrier to predominately single-payer health care systems such as that found in Ontario. In hepatitis C virus (HCV) genotype 1 noncirrhotic patients with a baseline viral load of
we have the SVR 12 OR SVR 24w ie sustained virological response (=PCR negative ) following stoppage of treatment by 12 w now used instead of 24 w