Guides

Introduction to DAAs: treatment and management

Treating HCV

PatternDAA stands for direct-acting antivirals. 

DAAs cure HCV in more than 95% of people. This usually involves just one or two pills a day for 8 to12 weeks.

Thia lao involves very few or only mild side effects.

Different DAA classes

As with HIV drugs, each class of DAA works at a different stage of the HCV life cycle. 

DAAs are also used in combinations. 

The three classes are:

  • HCV protease inhibitors (PIs).
  • Nucleotide polymerase inhibitors. 
  • NS5A inhibitors. 

Adherence is very important. This is defined as taking more than 95% of doses on time.

What are the goals of treatment?

There are two goals of HCV treatment.

One is to cure HCV and the other is to improve liver health.

Goal 1: curing HCV

The first goal of treatment is to clear HCV. This is called a cure. 

A cure is defined as having an undetectable HCV viral load during 12 weeks after the last dose (SVR-12). SVR stands for sustained viral (or virologic) response.

Up to 99% of people who have an SVR-12 stay HCV-free. This is regardless of HIV status. 

Although HCV can sometimes return after treatment is finished, this is usually within four weeks. 

However, being cured does not protect you against HCV reinfection.

Goal 2: improving liver health

The second goal of HCV treatment is to improve liver health.

This occurs from reducing liver inflammation. As well as preventing further damage, fibrosis can sometimes be partially reversed. These improvements usually happen in people who are cured. 

Being cured reduces the risk of liver cirrhosis, liver cancer and liver failure in both HIV negative and HIV positive people. 

In HIV positive people, a cure lowers the risk of death from liver-related and HIV-related causes, even with cirrhosis.

HCV treatment might also reduce liver-related side effects from ART.

Last updated: 1 November 2024.