Experienced providers need to take treatment decisions on a case-by-case basis. There are a series of virus, host and treatment characteristics that influence the likelihood of treatment success and are useful when assessing the benefits and risks of therapy.
Virus factors
HCV genotype, pretreatment HCV RNA level (viral load-VL) and the evolution of viral quasispecies (cluster of variant viruses that arise from mutations over time in viral population) are strong independent predictors of SVR to SoC therapy, as well as to triple combination therapy with protease inhibitors. HCV Genotype is a major predictor of treatment response. HCV genotypes can be ranked, in a decreasing order of susceptibility to IFN-based treatment, as follows: genotypes 2, 3, 4 and 1. Furthermore, subtype 1b rather than 1a and subtype 2b rather than 2a are likely to respond poorer to IFN-based therapy. Permanent viral eradication (SVR) can be achieved in up to 80% of individuals infected with