From www.HCVGuidance.org on July 02, 2022

Treatment-Naive Genotype 1a Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 1a Patients Without Cirrhosis

RECOMMENDED DURATION RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)a  8 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) 12 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) for patients who are HIV-uninfected and whose HCV RNA level is <6 million IU/mL 8 weeks I, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
ALTERNATIVE DURATION RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) 12 weeks I, A
a Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 1a With Compensated Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 1a Patients With Compensated Cirrhosisa 

RECOMMENDED DURATION RATING
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) 12 weeks I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeks I, B
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. For patients with HIV/HCV coinfection, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 1b Without Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Patients Genotype 1b Without Cirrhosis

RECOMMENDED DURATION RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) 12 weeksa I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) 12 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) for patients who are HIV-uninfected and whose HCV RNA level is <6 million IU/mL 8 weeksc I, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
a An 8-week regimen can be considered in those with genotype 1b infection and mild fibrosis (see text for details).​
b Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.​
c For HIV/HCV coinfected patients, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 1b With Compensated Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 1b Patients With Compensated Cirrhosisa 

RECOMMENDED DURATION RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) 12 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) 12 weeks I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeksc I, B
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 For HIV/HCV-coinfected patients, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 2 Without Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 2 Patients Without Cirrhosis

RECOMMENDED DURATION RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)a 8 weeks I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
a Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 2 With Compensated Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 2 Patients With Compensated Cirrhosisa

RECOMMENDED DURATION RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeksc I, B
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 For HIV/HCV-coinfected patients, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 3 Without Cirrhosis

Recommended regimens listed alphabetically for:

Treatment-Naive Genotype 3 Patients Without Cirrhosis

RECOMMENDED DURATION RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)a 8 weeks I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
a Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 3 With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 3 Patients With Compensated Cirrhosisa

RECOMMENDED DURATION RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeksc I, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) for patients without baseline NS5A RAS Y93H for velpatasvir 12 weeks I, A
ALTERNATIVE DURATION RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) with weight-based ribavirin for patients with baseline NS5A RAS Y93H for velpatasvir 12 weeks IIa, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) for patients with baseline NS5A RAS Y93H for velpatasvir 12 weeks IIa, B
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 For HIV/HCV-coinfected patients, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 4 Without Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 4 Patients Without Cirrhosis

RECOMMENDED DURATION RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) 12 weeks I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)a 8 weeks I, A
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg)b 12 weeks I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
a Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information.
b An 8-week regimen can be considered in patients with favorable baseline characteristics (ie, no cirrhosis, HCV RNA <6 million IU/mL, and absence of genotype 4r).
Last update: 
September 29, 2021

Treatment-Naive Genotype 4 With Compensated Cirrhosis

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 4 Patients With Compensated Cirrhosisa 

RECOMMENDED DURATION RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeksc I, B
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) 12 weeks IIa, B
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) 12 weeks IIa, B
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 For HIV/HCV-coinfected patients, a treatment duration of 12 weeks is recommended.

 

Last update: 
September 29, 2021

Treatment-Naive Genotype 5 or 6

Recommended regimens listed by evidence level and alphabetically for:

Treatment-Naive Genotype 5 or 6 Patients With and Without Compensated Cirrhosisa 

RECOMMENDED DURATION RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b 8 weeksc I, Ad
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) 12 weeks I, B
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg)e 12 weeks IIa, B
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 For HIV/HCV-coinfected patients, a treatment duration of 12 weeks is recommended.
d For compensated cirrhosis, rating is I, B.
e Not recommended for genotype 6e if subtype is known.

 

Last update: 
September 29, 2021


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