Purpose: The FDA has recently approved an end-point SVR12 for use in HCV trials with direct acting antiviral agents [DAA]. However, 4-6% of patients had viral relapse between 12 and 24 weeks post-treatment with Sofosbuvir despite having achieved SVR12 [EASL 2013]. Our study evaluated whether assessment of serum HCV RNA at 4 and 12 weeks post-treatment was as reliable in predicting SVR as serum HCV RNA at 24 weeks post-treatment in HCV genotype 1 patients who received Telaprevir, PEG-IFN and ribavirin therapy. Methods: A single-center retrospective cohort study was conducted on HCV patients who had achieved end-of treatment [EOT] virological response on therapy with Telaprevir, PEG-IFN and ribavirin therapy between June, 2011 and January, 2013. HCV RNA levels were measured at EOT and post-treatment weeks four, 12 and 24 using a sensitive TMA assay (lower limit of detection of 5 IU/L). Viral relapse was defined as re-appearance of detectable serum HCV RNA between the EOT and post-treatment. SVR was defined as undetectable HCV RNA at 24 weeks post-treatment. Results: One hundred patients were treated from June, 2011 to January, 2013. Thirty-three patients completed 24 weeks of therapy [Group 1], and 25 completed 48 weeks of therapy [Group 2] with undetectable HCV RNA EOT response. In Group 1, at four weeks post-therapy, 23 patients remained negative and one relapsed, with nine remaining non-compliant. In the same group after 12 weeks post-therapy, 21 patients remained negative and two relapsed. And after 24 weeks post-therapy, the remaining 21 patients had undetectable serum HCV RNA. In Group 2 at four weeks post-therapy, 12 patients remained negative and two relapsed with a total of 11 patients being non-compliant. After 12 weeks post therapy, 10 patients remained negative and two relapsed. And after 24 weeks post-therapy, just as those in Group 1, all patients remained HCV RNA undetectable. Conclusion: The study supports that the assessment of serum HCV RNA at 12 weeks post-treatment has a 100% positive predictive value [PPV] in predicting SVR24 in genotype 1 patients receiving DAA therapy. Furthermore, SVR24 is unnecessary, or rather, patients should no longer be required to come back for a third post-therapy visit, which, if implemented, will reduce the cost of disease burden. Unfortunately, however, SVR4 may miss post-treatment early relapses, as it only has a PPV of 89%. Although future prospective or larger retrospective studies would be helpful in further validating these conclusions, according to this data that parallels the FDA's findings, SVR12 is needed while SVR24 is not.