Guidelines for Treatment of Chronic Hepatitis C
A- Recommendations for Initial Treatment of Hepatitis C Virus–Infected Adults
1- Treatment-naive without cirrhosis or with compensated cirrhosis
- Glecaprevir/pibrentasvir Genotype 1–6 for 8 weeks
- Sofosbuvir/velpatasvir Genotype 1–6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1,4,5, 6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1 without cirrhosis for 8 weeks
- Elbasvir/grazoprevir Genotype 1a,1b, 4 for 12 weeks
- Sofosbuvir/velpatasvir + weight-based ribavirin Genotype 3 for 12 weeks
- Sofosbuvir/velpatasvir/voxilaprevir Genotype 3 for 12 weeks
2- Treatment-naive with decompensated cirrhosis
- Sofosbuvir/velpatasvir + weight-based ribavirin Genotype 1–6 for 12 weeks
- Sofosbuvir/velpatasvir Genotype 1–6 for 24 weeks
- Ledipasvir/sofosbuvir + weight-based ribavirin Genotype 1, 4, 5, 6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1, 4, 5, 6 for 24 weeks
B- Recommendations for Retreatment of Hepatitis C Virus–Infected Adults by Prior Exposure
1- Sofosbuvir-based treatment failure without cirrhosis or with compensated cirrhosis
- Sofosbuvir/velpatasvir/voxilaprevir Genotype 1–6 for 12 weeks
- Glecaprevir/pibrentasvir Genotype 1, 2, 4, 5, 6 for 16 weeks
2- Glecaprevir/pibrentasvir treatment failure without cirrhosis or with compensated cirrhosis
- Glecaprevir/pibrentasvir + sofosbuvir + weight-based ribavirin genotype 1–6 for 16 weeks
- Sofosbuvir/velpatasvir/voxilaprevir genotype 1–6 for 12 weeks
3- Sofosbuvir/velpatasvir/voxilaprevir or sofosbuvir + glecaprevir/pibrentasvir treatment failure without cirrhosis or with compensated cirrhosis
- Glecaprevir/pibrentasvir + sofosbuvir + weight-based ribavirin genotype 1–6 for 16 weeks
- Sofosbuvir/velpatasvir/voxilaprevir + weight-based ribavirin genotype 1–6 for 24 weeks
4- Sofosbuvir- or NS5A inhibitor–based treatment failure with decompensated cirrhosis
- Sofosbuvir/velpatasvir + weight-based ribavirin genotype 1–6 for 24 weeks
- Ledipasvir/sofosbuvir + weight-based ribavirin genotype 1, 4, 5, 6 for 24 weeks
C- Recommendations for Hepatitis C Virus Treatment Post-transplantation
1- Recurrent HCV post liver transplant without cirrhosis
- Glecaprevir/pibrentasvir Genotype 1–6 for 12 weeks
- Sofosbuvir/velpatasvir Genotype 1–6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1, 4, 5, 6 for 12 weeks
2- Recurrent HCV post liver transplant with compensated cirrhosis
- Sofosbuvir/velpatasvir Genotype 1–6 for 12 weeks
- Glecaprevir/pibrentasvir Genotype 1–6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1, 4, 5, 6 for 12 weeks
3- Recurrent HCV post kidney transplant without cirrhosis or with compensated cirrhosis
- Glecaprevir/pibrentasvir Genotype 1–6 for 12 weeks
- Sofosbuvir/velpatasvir Genotype 1–6 for 12 weeks
- Ledipasvir/sofosbuvir Genotype 1, 4, 5, 6 for 12 weeks
- Elbasvir/grazoprevir Genotype 1–4 for 12 weeks
4- HCV-uninfected recipients of liver grafts from HCV-viremic donors
- Glecaprevir/pibrentasvir Genotype 1–6 for 12 weeks
- Sofosbuvir/velpatasvir Genotype 1–6 for 12 weeks
5- HCV-uninfected recipients of non-liver solid organs from HCV-viremic donors
- Glecaprevir/pibrentasvir Genome 1–6 for 8 weeks
- Sofosbuvir/velpatasvir Genome 1–6 for 12 weeks
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services. Please refer to your doctor for medical advice.