Peginterferon/Ribavirin-Experienced, Genotype 1a Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 1a Patients Without Cirrhosis
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients without baseline NS5A RASs^a for elbasvir	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
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)	12 weeks	I, A
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) with dasabuvir (600 mg) as part of an extended-release regimen or plus twice-daily dosed dasabuvir (250 mg), and weight-based ribavirin	12 weeks	I, A
Daily simeprevir (150 mg) plus sofosbuvir (400 mg)	12 weeks	I, A
Daily daclatasvir (60 mg)^c plus sofosbuvir (400 mg)	12 weeks	I, B
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for patients with baseline NS5A RASs^a for elbasvir	16 weeks	IIa, B
^a Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance. Baseline testing for these RASs is recommended for patients receiving elbasvir/grazoprevir-based regimens. ^b This is a 3-tablet coformulation. Please refer to the prescribing information. ^c The dose of daclatasvir may need to be increased or decreased when used concomitantly with cytochrome P450 3A/4 inducers and inhibitors, respectively. Please refer to the prescribing information and the section on HIV/HCV coinfection for patients on antiretroviral therapy.

Last update:

May 24, 2018

Peginterferon/Ribavirin-Experienced, Genotype 1a Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 1a Patients With Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients without baseline NS5A RASs^b for elbasvir	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	12 weeks	I, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based ribavirin	12 weeks	I, A
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for patients with baseline NS5A RASs^b for elbasvir	16 weeks	I, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance. Baseline testing for these RASs is recommended for patients receiving elbasvir/grazoprevir-based regimens. ^c This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

May 24, 2018

Peginterferon/Ribavirin-Experienced, Genotype 1b Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 1b 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)	12 weeks	I, A
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)	12 weeks	I, A
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) with dasabuvir (600 mg) as part of an extended-release regimen or plus twice-daily dosed dasabuvir (250 mg)	12 weeks	I, A
Daily simeprevir (150 mg) plus sofosbuvir (400 mg)	12 weeks	I, A
Daily daclatasvir (60 mg)^b plus sofosbuvir (400 mg)	12 weeks	I, B
^a This is a 3-tablet coformulation. Please refer to the prescribing information. ^b The dose of daclatasvir may need to be increased or decreased when used concomitantly with cytochrome P450 3A/4 inducers and inhibitors, respectively. Please refer to the prescribing information and the section on HIV/HCV coinfection for patients on antiretroviral therapy.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 1b Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 1b Patients With Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 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	12 weeks	I, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based ribavirin	12 weeks	I, A
Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) with dasabuvir (600 mg) as part of an extended-release regimen or plus twice-daily dosed dasabuvir (250 mg)^c	12 weeks	I, A
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information. ^c Please see statement on FDA warning regarding the use of paritaprevir/ritonavir/ombitasvir ± dasabuvir in patients with cirrhosis.

Last update:

September 21, 2017

NS3 Protease Inhibitor + Peginterferon/Ribavirin-Experienced, Genotype 1 Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: NS3 Protease Inhibitor (Telaprevir, Boceprevir, or Simeprevir) + Peginterferon/Ribavirin-Experienced, Genotype 1 Patients Without Cirrhosis
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)^a	12 weeks	IIa, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for all genotype 1b patients, and genotype 1a patients without baseline NS5A RASs^b for elbasvir	12 weeks	IIa, B

Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for genotype 1a patients with baseline NS5A RASs^b for elbasvir	16 weeks	IIa, B
^a This is a 3-tablet coformulation. Please refer to the prescribing information. ^b Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance.

Last update:

September 21, 2017

NS3 Protease Inhibitor + Peginterferon/Ribavirin-Experienced, Genotype 1 Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: NS3 Protease Inhibitor (Telaprevir, Boceprevir, or Simeprevir) + Peginterferon/Ribavirin Treatment-Experienced, Genotype 1 Patients With Compensated Cirrhosis^a
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	12 weeks	IIa, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based ribavirin	12 weeks	I, A
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for all genotype 1b patients, and genotype 1a patients without baseline NS5A RASs^c for elbasvir	12 weeks	IIa, B

Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for genotype 1a patients with baseline NS5A RASs^c for elbasvir	16 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information. ^c Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance.

Last update:

September 21, 2017

Non-NS5A Inhibitor, Sofosbuvir-Containing Regimen-Experienced, Genotype 1 Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Non-NS5A Inhibitor, Sofosbuvir-Containing Regimen-Experienced, Genotype 1 Patients Without Cirrhosis
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100mg) for genotype 1a patients	12 weeks	I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^a, regardless of subtype	12 weeks	IIa, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) for genotype 1b patients	12 weeks	IIa, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based ribavirin, except in simeprevir failures	12 weeks	IIa, B
^a This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

Non-NS5A Inhibitor, Sofosbuvir-Containing Regimen-Experienced, Genotype 1 Patients With Compensated Cirrhosis

Recommended regimens listed by evidence level and alphabetically for: Non-NS5A Inhibitor, Sofosbuvir-Containing Regimen-Experienced, Genotype 1 Patients With Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) for genotype 1a patients	12 weeks	I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b, regardless of subtype	12 weeks	IIa, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) for genotype 1b patients	12 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

NS5A Inhibitor DAA-Experienced Genotype 1 Patients

Recommended and alternative regimens for: NS5A Inhibitor DAA-Experienced, Genotype 1 Patients With or Without Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100mg)	12 weeks	I, A
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b except NS3/4 protease inhibitor inclusive DAA combination regimens	16 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 2 Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, 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
ALTERNATIVE	DURATION	RATING
Daily daclatasvir (60 mg)^b plus sofosbuvir (400 mg)	12 weeks	IIa, B
^a This is a 3-tablet coformulation. Please refer to the prescribing information. ^b The dose of daclatasvir may need to be increased or decreased when used concomitantly with cytochrome P450 3A/4 inducers and inhibitors, respectively. Please refer to the prescribing information and the section on HIV/HCV coinfection for patients on antiretroviral therapy.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 2 Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 2 Patients With Compensated Cirrhosis^a
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	12 weeks	I, B
ALTERNATIVE	DURATION	RATING
Daily daclatasvir (60 mg)^c plus sofosbuvir (400 mg)	16 to 24 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information. ^c The dose of daclatasvir may need to be increased or decreased when used concomitantly with cytochrome P450 3A/4 inducers and inhibitors, respectively. Please refer to the prescribing information and the section on HIV/HCV coinfection for patients on antiretroviral therapy.

Last update:

September 21, 2017

DAA-Experienced (Including NS5A Inhibitors), Genotype 2 Patients With or Without Compensated Cirrhosis

Recommended regimens listed by evidence level for: Sofosbuvir + Ribavirin-Experienced, Genotype 2 Patients With or Without Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)	12 weeks	I, B
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b	12 weeks	IIb, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information.

Recommended regimen for:

Sofosbuvir + NS5A-Experienced, Genotype 2 Patients With or Without Compensated Cirrhosis^a

RECOMMENDED

DURATION

RATING

Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg)

12 weeks

I, B

^a For decompensated cirrhosis, please refer to the appropriate section.

Last update:

May 24, 2018

Peginterferon/Ribavirin-Experienced, Genotype 3 Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 3 Patients Without Cirrhosis
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)^a	12 weeks	I, A
ALTERNATIVE	DURATION	RATING
Daily daclatasvir (60 mg)^b plus sofosbuvir (400 mg)^a	12 weeks	I, A
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^c	16 weeks	IIa, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg) when Y93H is present	12 weeks	IIb, B
^a Baseline RAS testing for Y93H is recommended. If the Y93H substitution is identified, a different regimen should be used, or weight-based ribavirin should be added as an alternative option. ^b The dose of daclatasvir may need to be increased or decreased when used concomitantly with cytochrome P450 3A/4 inducers and inhibitors, respectively. Please refer to the prescribing information and the section on HIV/HCV coinfection for patients on antiretroviral therapy. ^c This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 3 Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 3 Patients With Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose elbasvir (50 mg)/grazoprevir (100 mg) plus sofosbuvir (400 mg)	12 weeks	I, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg)	12 weeks	IIb, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) plus weight-based ribavirin	12 weeks	I, B
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b	16 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

DAA-Experienced (Including NS5A Inhibitors), Genotype 3 Patients With or Without Compensated Cirrhosis

Recommended regimen for: DAA-Experienced (Including NS5A Inhibitors), Genotype 3 Patients With or Without Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/ voxilaprevir (100 mg)	12 weeks	I, A

For patients with prior NS5A inhibitor failure and cirrhosis, weight-based ribavirin is recommended.	12 weeks	IIa, C
^a For decompensated cirrhosis, please refer to the appropriate section.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 4 Patients Without Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 4 Patients Without Cirrhosis
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)^a	8 weeks	I, B
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients who experienced virologic relapse after prior peginterferon/ribavirin therapy	12 weeks	IIa, B
Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg)	12 weeks	IIa, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) plus weight-based ribavirin	12 weeks	I, A
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for patients with prior on-treatment virologic failure (failure to suppress or breakthrough) while on peginterferon/ribavirin	16 weeks	IIa, B
^a This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 4 Patients With Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 4 Patients With Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)	12 weeks	I, A
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) for patients who experienced virologic relapse after prior peginterferon/ribavirin therapy	12 weeks	IIa, B
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b	12 weeks	IIa, B
ALTERNATIVE	DURATION	RATING
Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) plus weight-based ribavirin^c	12 weeks	I, A
Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg) plus weight-based ribavirin for patients with prior on-treatment virologic failure (failure to suppress or breakthrough) while on peginterferon/ribavirin	16 weeks	IIa, B
Daily ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based ribavirin	12 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information. ^c Please see statement on FDA warning regarding the use of paritaprevir/ritonavir/ombitasvir ± dasabuvir in patients with cirrhosis.

Last update:

September 21, 2017

DAA-Experienced (Including NS5A Inhibitors), Genotype 4 Patients, With or Without Compensated Cirrhosis

Recommended regimen for:

DAA-Experienced (Including NS5A Inhibitors), Genotype 4 Patients, With or Without Compensated Cirrhosis^a

RECOMMENDED

DURATION

RATING

Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg)

12 weeks

I, A

^a For decompensated cirrhosis, please refer to the appropriate section.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 5 or 6 Patients With or Without Compensated Cirrhosis

Recommended and alternative regimens listed by evidence level and alphabetically for: Peginterferon/Ribavirin-Experienced, Genotype 5 or 6 Patients With or Without Compensated Cirrhosis^a
RECOMMENDED	DURATION	RATING
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b for patients without cirrhosis	8 weeks	IIa, B

Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)^b for patients with compensated cirrhosis	12 weeks	I, B
Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg)	12 weeks	IIa, B
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)	12 weeks	IIa, B
^a For decompensated cirrhosis, please refer to the appropriate section. ^b This is a 3-tablet coformulation. Please refer to the prescribing information.

Last update:

September 21, 2017

DAA-Experienced (Including NS5A Inhibitors), Genotype 5 or 6 Patients With or Without Compensated Cirrhosis

Recommended regimen for:

DAA-Experienced (Including NS5A Inhibitors), Genotype 5 or 6 Patients With or Without Compensated Cirrhosis^a

RECOMMENDED

DURATION

RATING

Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg)

12 weeks

IIa, B

^a For decompensated cirrhosis, please refer to the appropriate section.

Last update:

September 21, 2017

Peginterferon/Ribavirin-Experienced, Genotype 1a Patients Without Cirrhosis

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