A 58-year-old man with HCV genotype 1 cirrhosis (Child-Pugh A) is started on sofosbuvir/velpatasvir for 12 weeks. His treatment response is assessed by HCV RNA at 12 weeks post-treatment completion. A sustained virological response (SVR12) defined as undetectable HCV RNA at 12 weeks after treatment end achieves cure in what approximate percentage of patients with pan-genotypic direct-acting antivirals?

• A Approximately 50–60%
• B Approximately 70–80%
• C Approximately 85–90%
• D Greater than 95% ✓

Explanation

Modern pan-genotypic direct-acting antiviral (DAA) regimens such as sofosbuvir/velpatasvir (ASTRAL trials) achieve SVR12 rates exceeding 95–98% across all HCV genotypes, including genotype 1, even in patients with compensated cirrhosis. This represents a paradigm shift from interferon-based therapy which achieved only 40–60% SVR. SVR12 is considered a virological cure and is associated with reduced hepatic decompensation and HCC incidence.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.