Hep C is more common than you might think.

According to the Centers for Disease Control and Prevention, an estimated 2.7 to 3.9 million Americans are currently infected. More recent estimates put that number at between 3.2 million and 5 million.

But a lot of those people aren’t even aware they have Hep C. That’s because the symptoms of an acute infection tend to be mild, resembling something like a cold or flu. In a lot of cases, they’re nonexistent.

When the infection passes the six-month mark—it does in between 75 and 85 percent of cases—chronic hepatitis C sets in. It has no symptoms, but causes silent liver damage. It’s common to live with the disease for a decade or more before even realizing anything is wrong. And by then, the liver damage may be substantial. Hep C kills around 20,000 Americans each year.

But all that is about to change. In the U.S., public health officials have an ambitious plan to eradicate the disease by 2030. All they need to do is convince the federal government to purchase the rights to one several pricey antiviral drugs that are being used to treat the virus’s six strains.

Though they’re not a “cure” per se, these FDA-approved oral medications work on about 95 percent of patients, eliminating the hep C virus such that it is no longer detectable in the bloodstream.

Another of the drugs’ significant advantages is that they come with very little risk of side effects. (Past treatments, which included weekly interferon injections, produced intense side effects and were often unsuccessful at getting rid of the virus.) In addition, patients can now be treated in a mere 12 weeks, something that doctors are calling “revolutionary,” even if it’s not quite a cure.

But though the success rate of these direct-acting antivirals (DAAs) is high, tens of thousands of people will remain infected. According to Drs. Averell Sherker and Jay Hoofnagle of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, curative treatments are “not going to get significantly better” from this point onward.

They suggest that patients who fail to respond to treatments or relapse might also fail to respond to the antiviral cocktails that are currently being tested in clinical trials. A recent meta-analysis of DAA clinical trials found that people with chronic kidney disease were the least likely to respond to the new Hep C meds, with success rates occasionally as low as 90 percent.

Still, the cost of these drugs might be the most significant barrier. The treatment can cost upwards of $150,000.

For now, it’s only a cure for those who can afford it.

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