A 44-year-old man with compensated cirrhosis from chronic hepatitis C (genotype 1b) is treated with glecaprevir/pibrentasvir (8-week regimen). At end of treatment and 12 weeks post-treatment, HCV RNA is undetectable. This is defined as:
- A End-of-treatment response only; requires 24-week follow-up for cure
- B Sustained virological response at 12 weeks (SVR12), considered a virological cure ✓
- C Partial virological response
- D Spontaneous viral clearance
Correct answer: B. Sustained virological response at 12 weeks (SVR12), considered a virological cure
Explanation
SVR12 (undetectable HCV RNA at 12 weeks after completion of antiviral therapy) is the standard definition of virological cure of hepatitis C infection, as it correlates with SVR24 in >99% of cases and with durable long-term clearance. Direct-acting antiviral (DAA) regimens such as glecaprevir/pibrentasvir (Maviret) achieve SVR12 rates of 97–100% in most genotypes with 8 weeks in non-cirrhotic patients and 12 weeks in compensated cirrhosis. Achieving SVR significantly reduces risk of hepatocellular carcinoma, decompensation, and liver-related mortality.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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