Sustained Virologic Response to Antiviral Therapy for Chronic Hepatitis C Virus Infection: A Cure and So Much More

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http://cid.oxfordjournals.org/content/52/7/889.abstract?etoc

Clinical Infectious Diseases

Volume52, Issue7

Pp. 889-900

Sustained Virologic Response to Antiviral Therapy for Chronic Hepatitis C Virus

Infection: A Cure and So Much More

L. Pearlman1,3,4 and

Nomi Traub2,3

Correspondence: Pearlman, MD, FACP, Center for Hepatitis C, 285 Blvd NE

Ste 140, Atlanta, GA 30312 (brianpearlman@...).

Abstract

Sustained virologic response (SVR) is defined as aviremia 24 weeks after

completion of antiviral therapy for chronic hepatitis C virus (HCV) infection.

In analyses of SVR durability, the incidence of late relapse is extremely low

(<1%). Histologic regression of both necroinflammation and fibrosis has been

demonstrated in paired liver biopsy samples in SVR-achieving patients. More

noteworthy is the sustained responder's favorable prognosis even with baseline

cirrhosis; despite mostly retrospective analyses, relative to nonresponders or

to those untreated, patients with SVR have significantly fewer liver-related

complications, less hepatocellular carcinoma, and fewer liver-related deaths.

Although HCV is associated with insulin resistance, successful eradication of

HCV appears to reduce the risk of impaired fasting glucose and diabetes

development. In summary, chronic HCV infection is curable with SVR attainment,

and with cure comes improved liver histology and more favorable clinical

outcomes, in comparison with patients who do not achieve the same therapeutic

milestone.

Received September 10, 2010.

Accepted January 19, 2011.

© The Author 2011. Published by Oxford University Press on behalf of the

Infectious Diseases Society of America. All rights reserved. For Permissions,

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