Summary: Kidney Transplant Patients
Post Kidney Transplantation: Genotype 1-6
Recommended and alternative regimens listed by pangenotypic, evidence level and alphabetically for:
Treatment-Naive and Non-DAA-Experienced Kidney Transplant Patients With Genotype 1-6 Infection, With or Without Compensated Cirrhosisa 
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RECOMMENDED
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DURATION
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RATING 
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Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b
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12 weeks
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I, Ac
IIa, Cd
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Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)
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12 weeks
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IIa, C
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Genotype 1, 4, 5, or 6 only: Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg)
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12 weeks
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I, A
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ALTERNATIVE
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DURATION
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RATING
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Genotype 1 or 4 only: Daily fixed-dose combination of elbasvir (50 mg)/ grazoprevir (100 mg) for patients without baseline NS5A RASse for elbasvir
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12 weeks
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I, B
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a For decompensated cirrhosis, please refer to the appropriate section.
b Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.
c Based on evidence for patients without cirrhosis.
d Based on evidence for patients with compensated cirrhosis.
e Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance.
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Recommended regimen for:
DAA-Experienced Kidney Transplant Patients With Genotype 1-6 Infection, With or Without Compensated Cirrhosisa
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RECOMMENDED
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DURATION
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RATING
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Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg), with or without ribavirinb
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12 weeks
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IIa, C
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a Excludes CTP class B and class C patients. For decompensated cirrhosis, please refer to the appropriate section.
b For patients with cirrhosis and multiple negative baseline characteristic, consideration should be given to adding ribavirin. If renal dysfunction is present, a lower starting dose is recommended. Maximum ribavirin dose is 1000 mg/d for patients who weigh <75 kg and 1200 mg/d for those who weigh ≥75 kg.
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For additional information on treatment of DAA failures post transplant, treatment of decompensated cirrhosis following transplantation, treatment of transplant recipients from HCV-positive donors, and post-transplant drug-drug interactions, please see Patients Who Develop Recurrent HCV Infection Post Liver Transplantation.
