Hepatitis C treatments are highly effective at reaching remission. A person in hepatitis C remission has no detectable amounts of the virus in their blood 12 or 24 weeks after their last treatment.

Hepatitis C infection can be acute or chronic. Acute infections last for less than 6 months, while chronic hepatitis C can be a lifelong condition.

Roughly 58 million people worldwide have chronic hepatitis C, according to the World Health Organization (WHO). Of that number, the Centers for Disease Control and Prevention reports that an estimated 2.4 million Americans have chronic hepatitis C and that there are around 50,300 new cases of acute hepatitis C in the United States annually.

In the U.S., injecting drugs is the main risk factor for acquiring hepatitis C. Untreated hepatitis C can lead to serious liver problems, including cirrhosis and cancer.

It’s important to know that the virus can go into remission with the right treatment. Doctors refer to remission as a sustained virological response (SVR).

SVR means that blood tests cannot detect the hepatitis C virus 12 weeks after a person’s last treatment dose. After this, the virus has likely gone permanently. Doctors may check for the virus again at 24 weeks. Close to 99% of people who achieve an SVR remain virus-free, according to the U.S. Department of Veterans Affairs.

Typically, people who reach SVR:

  • experience improvement in liver inflammation
  • have decreased or regressed fibrosis
  • are twice as likely to have lower inflammation scores
  • have a reduced risk for mortality, liver failure, and liver cancer
  • have a reduced chance of developing other medical conditions

However, the degree of liver damage and fibrosis sustained will affect these physiological improvements. People with significant fibrosis at the time of SVR may require ongoing surveillance for liver complications.

People who recover from hepatitis C are at an increased risk of liver disease progression if other risk factors are present, such as alcohol use disorder, obesity, and diabetes.

Acute and chronic hepatitis C infections may resolve independently. However, this is incredibly rare in chronic cases.

Spontaneous viral clearance of acute hepatitis C

Spontaneous viral clearance of acute infections is possible. However, the rate at which this occurs is a hotly debated topic, as most cases of acute hepatitis C become chronic, according to the CDC.

Current research estimates that acute cases of hepatitis C resolve spontaneously in 15% to 60% of cases.

Spontaneous remission of chronic hepatitis C

For some people, chronic hepatitis C can also clear up on its own, but this is incredibly rare. A 2016 Scottish study found that the rate of spontaneous chronic hepatitis C remission may be as low as 0.36%.

Chronic hepatitis C always requires medical treatment. Anyone with the condition will require ongoing monitoring from a healthcare professional and should always follow their treatment plan to completion.

Drug treatments can help increase your chances of reaching hepatitis C virus remission. Your treatment plan will depend on:

  • Genotype: Your hepatitis C genotype or “blueprint” of the virus depends on your RNA sequence. There are seven genotypes, and most people in the U.S. have genotype 1, per the CDC.
  • Liver damage: Existing liver damage, whether mild or severe, can determine your medication.
  • Previous treatment: Which medications you already take will also influence next steps.

Coinfection and viral interactions

Other conditions, such as HIV and hepatitis B, can alter your treatment plan.

For example, having hepatitis C and B infections simultaneously can speed up disease progression, and antiviral treatment of either condition can also reactivate the other. In addition, certain hepatitis C treatments may not be suitable for people with HIV due to possible drug interactions.

To prevent adverse outcomes, your doctor will screen for possible coinfections and alter your medication programs accordingly.

Medications

After looking at these factors, a healthcare professional will prescribe a course of medication for you to take for 12 to 24 weeks, per the WHO. You may need to take these medications longer. You can talk with your doctor to learn more about the details of your specific treatment plan.

Drugs for hepatitis C may include:

  • daclatasvir (Daklinza) with sofosbuvir (Sovaldi)
  • sofosbuvir with velpatasvir (Epclusa)
  • ledipasvir/sofosbuvir (Harvoni)
  • simeprevir (Olysio)
  • boceprevir (Victrelis)
  • ledipasvir
  • ribavirin (Ribatab)

You may hear some of the newer drugs referred to as direct-acting antiviral (DAA) medications. These target virus replication at specific steps of the hepatitis C life cycle. Your doctor may prescribe other combinations of these drugs.

Talk with your doctor if you’re experiencing discomfort or side effects from your medication. Ask for support if you’re experiencing feelings of depression. Your doctor may have patient advocate resources to offer support to help get you through your treatment and to your goal of being free of hepatitis C.

A recurrence of hepatitis C after achieving SVR is rare. In fact, the chance of a hepatitis C recurrence following DAA treatment is less than 0.5%.

Hepatitis C recurrence may occur due to relapse or reinfection. Relapse is the independent return of the virus after SVR and is incredibly rare. Reinfection occurs when outside factors reintroduce the hepatitis C virus into your system.

Authors of a 2016 review identified risk factors for reinfection as:

  • currently or previously injecting drugs
  • men who have sex with men
  • coinfections, especially ones that compromise your immune system

Recurrence rates can also depend on factors such as genotype, drug regimen, and if you have any other existing conditions.

Doctors can diagnose hepatitis C via blood tests. Typically, the earlier you receive a diagnosis and start treatment, the better your outcome.

Hepatitis C treatments are readily available and highly effective at reaching remission. Remission is when the virus is no longer detectable in your blood 12 to 24 weeks after your last course of treatment.

The hepatitis C genotype, the extent of liver damage, and any preexisting conditions or infections can all affect treatment options. However, the outlook for hepatitis C treatments is typically positive.