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What happens to the liver after a Sustained Virologic Response?

Question from K.--

Hi, I have a question about post treatment biopsies. Many people have come with biopsies that 6 months to 1 year post treatment, despite being viral negative still show some inflammation. The conclusions by the pathologists are chronic low grade hepatitis. What is meant by this, many of these people are given the impression by the treating internist that they are HCV free, but wonder what can be causing this "low grade hepatitis". Can you comment on this. thanks Ken

Dr. Chung writes--

The full resolution of histologic changes following even sustained response can take some time. with long term followup, it appears that the picture continues to improve, so that those who have had biopsies 5-10 yrs after sustained responses experience normalization or near-normalization. a followup biopsy may be in order over the long term. RC