Hepatitis C virus (HCV) can cause both acute and chronic hepatitis. The acute process is self-limited, rarely causes hepatic failure, and usually leads to chronic infection. Chronic HCV infection often follows a progressive course over many years and can ultimately result in cirrhosis, hepatocellular carcinoma, and the need for liver transplantation. (See "Clinical manifestations and natural history of chronic hepatitis C virus infection".)
The goal of treatment is to eradicate hepatitis C virus RNA, which is predicted by the achievement of a sustained virologic response (SVR), defined by the absence of HCV RNA by polymerase chain reaction six months after stopping treatment. An SVR is associated with a 99 percent chance of being HCV RNA negative during long-term follow-up . Achievement of an SVR has also been associated with improved clinical outcomes. (See "Mechanism of action and efficacy of standard interferon alfa for the treatment of chronic hepatitis C virus infection", section on 'Long-term efficacy' and "Overview of the management of chronic hepatitis C virus infection", section on 'Goal of antiviral therapy'.)
This topic will review the treatment of patients with chronic HCV genotype 1. Treatment of patients with other genotypes, data regarding the efficacy of various treatment regimens, experimental agents for the treatment of HCV, the treatment of acute HCV, the selection of patients for treatment, the management of treatment-induced side effects, and factors that predict a response to treatment are discussed elsewhere.
●(See "Overview of the management of chronic hepatitis C virus infection".)
●(See "Treatment regimens for chronic hepatitis C virus genotypes 2, 3, and 4".)