Collaborator: Dr. Viviana Arroyo Veguilla, PharmD August 2026
Globally, hepatitis C (HCV) continues to be one of the leading causes of chronic liver disease. However, the current therapeutic landscape is radically different from that of previous decades. And because the introduction of direct-acting antivirals (DAAs) has led to cure rates of over 95% in the majority of adequately treated patients,1 today’s challenge for physicians is no longer just to identify infected people, but to ensure they complete their treatment and achieve a sustained virologic response (SVR), which is considered the functional cure for the infection.1
HVC infection can remain asymptomatic for years. Without a timely diagnosis and treatment, it can progress to liver fibrosis, cirrhosis, hepatocellular carcinoma, liver failure, and extrahepatic manifestations that significantly increase morbidity and mortality.3 That’s why detection, diagnostic confirmation by viral RNA, as well as early linkage to treatments continue to be fundamental pillars of clinical care.2, 3.
Currently, international guidelines recommend treating virtually all people with chronic hepatitis C infections, regardless of viral genotype, given that pangenotypic regimens have significantly simplified management, and allow for shorter, safe and more effective treatments.2, 4
Available therapeutic alternatives include sofosbuvir/velpatasvir (Epclusa®), Harvoni®, Mavyret® y Zepatier®6,7. These agents have consistently demonstrated high rates of sustained virologic responses in a wide variety of populations, including patients with compensated liver disease, co-infections, and multiple comorbidities.2,4
Although current treatments are considerably simpler than interferon-based regimens used in the past, adherence continues to be a critical determinant of therapeutic success.4 Frequent missed doses, premature treatment discontinuations, or barriers to complete clinical follow-up may compromise virial eradication and reduce the likelihood of achieving SVR.4
Therefore, patient education from the first visit is essential. Explaining that hepatitis C is a curable disease, and that each treatment dose directly contributes to therapeutic success, is key to significantly improving adherence and persistence to treatment.4,5 To optimize these results, you must:
DAAs have a favorable safety profile, and are generally tolerated well.,4 However, some patients may experience headaches, fatigue, nausea, insomnia or gastrointestinal discomfort during treatment.4
Nevertheless, the appearance of these symptoms should not automatically lead to treatment discontinuation. On the contrary, this represents an opportunity to strengthen communication between doctor and patient. Early management of adverse effects, evaluations of possible drug interactions, and joint development of strategies to improve tolerability can promote therapeutic continuity and maximize the chances of cure.4,5
It’s also essential to review other drugs used by the patient, such as nutritional supplements, vitamins, and herbal products before starting treatment, as certain interactions can affect the effectiveness of DAAs, or increase the risk of adverse events.2,5
Sustained virologic response, considered the functional cure for hepatitis C, is associated with improved clinical outcomes and a substantial reduction in the long-term consequences of chronic infection.³ From a public health perspective, each cured patient also represents an opportunity to decrease future transmission of the virus and bring healthcare systems closer to the goals set by the World Health Organization.1
The evidence is clear: Hepatitis C is a curable disease. However, the cure does not depend only on the availability of highly effective treatments. It also depends on the ability of the clinical team to promote adherence, anticipate barriers, manage side effects in a timely manner, and accompany the patient throughout the therapeutic process. When doctor and patient work together, healing ceases to be a possibility, and becomes an expected and achievable result.
