You may have recently gotten the news that your hepatitis C Virus (HCV) has been cured. If you have reached sustained virologic response (SVR) and have a follow-up appointment with your doctor, you may be wondering what happens next. Here are a few questions you may want to ask your doctor:
Can I become re-infected with HCV?
A patient who has SVR after being treated for HCV can become re-infected. While the risk is fairly low, it is a real possibility, and it is important to talk to your doctor about behaviors that may put you at risk for re-infection, such as IV drug use. It is also important to know that the chance of relapse and re-infection after SVR for patients who don’t engage in risky behaviors is less than 1%.1
How often should I see my doctor now?
Your doctor will decide how often you will come to see them after you have SVR. This will depend on a lot of factors. Your doctor may want to see you more often if you had liver damage prior to treatment, which can put you at a higher risk for cirrhosis or fibrosis, or if you participate in higher-risk behaviors, which can put you at risk for a relapse or re-infection. Your doctor may also want to continue to run regular blood tests if your liver function tests (LFT) are still not normal. You may not have to see the doctor every time you have a blood test.2
How often should I be monitored for hepatocellular carcinoma (HCC)?
Talk to your doctor about changes you may need to make after you have achieved SVR. Everyone will have different changes they need to make. Patients with fatty liver disease or Type 2 Diabetes may be asked to lose weight and watch their diet. Patients who use IV drugs or drink alcohol should talk to their doctor about how this affects their liver functions after SVR, and how these behaviors can be harmful.3 Your doctor can give you resources to help you make the right changes to keep your liver healthy.
Is it safe to drink alcohol after SVR?
There is no safe amount of alcohol to drink after achieving SVR. Talk to your doctor about drinking alcohol and your specific situation. If you think you are unable to stop drinking alcohol, talk to your doctor about this. It is important to ask your doctor how drinking alcohol can affect your liver, especially if you have cirrhosis or fibrosis.3
Be sure to discuss these questions with your doctor. You may have other questions as well. It may help to write your questions down so you remember what you wanted to ask your doctor. It may also help to take a friend or family member along to your appointment, and ask them to take notes while you talk to your doctor. This can help you remember all the things you and your doctor talk about.
Hill A, Simmons B, Saleem J, Cooke G. Five–Year Risk of Late Relapse or Reinfection With Hepatitis C After Sustained Virological Response: Meta-analysis of 49 Studies in 8534 Patients | CROI Conference. Croiconference.org. http://www.croiconference.org/sessions/five–year-risk-late-relapse-or-reinfection-hepatitis-c-after-sustained-virological-response. Published 2018. Accessed November 15, 2018.
Follow-Up Care After SVR. HepatitisC.net. https://hepatitisc.net/treatment/follow-up-care-after-svr/. Published 2018. Accessed November 15, 2018.
Jacobson I, Lim J, Fried M. Ohsu.edu. https://www.ohsu.edu/xd/health/for-healthcare-professionals/telemedicine-network/for-healthcare-providers/ohsu-echo/heptitisc-and-liver-care/upload/AGA-Guidelines-for-HCV-Long-Term-Monitoring-post-SVR.pdf. Published 2018. Accessed November 15, 2018.