Recommended regimens listed by evidence level and alphabetically for:Treatment-Naive Genotype 1a Patients Without Cirrhosis |
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|---|---|---|
| RECOMMENDED | DURATION |
RATING 
|
| Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients without baseline NS5A RASs for elbasvira | 12 weeks | 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 |
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|
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| 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 |
|
a Includes genotype 1a resistance-associated substitutions (RASs) at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance. If 1 or more RASs are present, another recommended regimen should be used. b Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information. |
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Recommended regimens listed by evidence level and alphabetically for:
Treatment-Naive Genotype 1a Patients With Compensated Cirrhosisa
|
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|---|---|---|
| RECOMMENDED | DURATION |
RATING
|
| Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients without baseline NS5A RASsb for elbasvir | 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)c | 8 weeks | I, B |
|
a For decompensated cirrhosis, please refer to the appropriate section. b Includes genotype 1a RASs at amino acid position 28, 30, 31, or 93 known to confer antiviral resistance. If 1 or more RASs are present, another recommended regimen should be used. c 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. |
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Recommended regimens listed by evidence level and alphabetically for:Treatment-Naive Patients Genotype 1b Without Cirrhosis |
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|---|---|---|
| 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 |
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| 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. |
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Recommended regimens listed by evidence level and alphabetically for:
Treatment-Naive Genotype 1b Patients With Compensated Cirrhosisa
|
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|---|---|---|
| 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. |
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Recommended regimens listed by evidence level and alphabetically for:Treatment-Naive Genotype 2 Patients Without Cirrhosis |
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|---|---|---|
| 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. | ||
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. |
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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. | ||
Recommended and alternative regimens listed by evidence level and alphabetically for:
Treatment-Naive Genotype 3 Patients With Compensated Cirrhosisa
|
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|---|---|---|
| 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. |
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Recommended regimens listed by evidence level and alphabetically for:Treatment-Naive Genotype 4 Patients Without Cirrhosis |
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|---|---|---|
| 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). |
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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. |
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Recommended regimens listed by evidence level and alphabetically for:
Treatment-Naive Genotype 5 or 6 Patients With and Without Compensated Cirrhosisa
|
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|---|---|---|
| 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. |
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