Is SVR really 100 % cure ??

[GINGERPAL]

I did triple tx (with incevik)  for 24 wks and just had a 2 ½ month post tx VL test and so far I am negative.
One of my nurses told me that if at 6 months I am still negative that I am 100 % cured from Hep C;
but my other nurse told me that it is about a 95 % cure and that I should continue to get yearly VL tests to confirm whether or not the virus comes back.
I am wondering what the medical reports say about this and what your doctors have said.
Thanks….Gingerpal

[GINGERPAL]

Thanks for your responses.  Every once in awhile, there is someone who says that the virus came back without the person causing it to come back.  And I don’t understand how the virus would come back a number of years later, as I thought this virus replicated quickly.  At any rate, all I am wishing for....for myself and everyone else .... is SVR.
  

[pooh55811]

From: Oxford Journals, Clinical Infectious Diseases

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

"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."  ..........

"In a follow-up period of up to 48 weeks after SVR achievement with pegylated interferon with ribavirin and a protease inhibitor in phase 2 trials, no cases of late relapse had yet occurred."  ..........

"In chronic HCV infection, therapy-induced SVR is a clinically meaningful end point (Table 4). SVR is a durable marker of viral eradication, because evidence for extrahepatic residual viremia is limited, and multiple reports demonstrate that late relapse is rarely observed; SVR is tantamount to cure. Besides posttherapy improvement in hepatic histologic damage, it is likely that SVR-achieving patients have a diminution in HCV-related insulin resistance and in diabetes development and, relative to therapy nonresponders, have a striking reduction in liver-related complications and mortality." ..........

"In conclusion, SVR should no longer be considered to be a surrogate end point, but a clinically meaningful end point of successful therapy for hepatitis C infection; SVR represents a cure and so much more. "

Full article here (very informative and interesting):

http://cid.oxfordjournals.org/content/52/7/889.full


I found this article valuable, not only because it confirms SVR is tantamount to cure, but because it outlines several other benefits (health improvements) to treating and attaining SVR:  
1) decreased incidence of HCC
2) decreased Insulin Resistance  
3) histologic improvements on posttreatment biopsies relative to pretherapy. Both fibrosis (stage) and inflammatory activity (grade) usually regress.
4) liver-related complications, including decompensation, hepatocellular carcinoma, and liver-related death, are less frequent in sustained virologic responders relative.

[can-do-man]

It don't get any better then over 99%. The last PCR my doctor gave me was 14 months post tx... Congrats on your 2 and a half month und status, looks like you made it also.

Based on their findings, the study authors conclude, These results show that an SVR following treatment with peginterferon alfa-2a alone or in combination with ribavirin is durable in almost all (>99%) patients with chronic HCV infection, validating the use of the word cured? for those achieving an SVR.

Commentary

The results announced today are encouraging because it is rare in the treatment of life-threatening viral diseases that can we tell patients they have the chance for a cure,? said Dr. Mitchell L. Shiffman, Professor of Medicine, Chief of Hepatology and Medical Director of the Liver Transplant Program, Virginia Commonwealth University Medical Center, and study author. ?But in hepatitis C today, we are able to help some patients achieve an outcome that effectively enables them to put their disease behind them.

http://www.hepcukforum.org/phpBB2/viewtopic.php?t=6750