Table 2.
Recommended regimen for the treatment of HCV with direct-acting antivirals-based combination therapies.
| Genotype | Presence of cirrhosis | Recommended regimen | Alternative regimen | Strength of recommendation | Quality of evidence |
|---|---|---|---|---|---|
| 1a | Without cirrhosis | DCV + SOF (12 weeks) LDV + SOF (12 weeks)a |
SMV + SOF (12 weeks)c
OBV + PTV/r + DSV + R (12 weeks) |
Strong | Moderate |
| With cirrhosis | DCV + SOF (24 weeks) DCV + SOF + R (12 weeks) LDV + SOF (24 weeks) LDV + SOF + R (12 weeks)b |
SMV + SOF (24 weeks)c
SMV + SOF + R (12 weeks)c OBV + PTV/r + DSV + R (24 weeks) |
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|
| |||||
| 1b | Without cirrhosis | DCV + SOF (12 weeks) LDV + SOF (12 weeks)a |
SMV + SOF (12 weeks) OBV + PTV/r + DSV (12 weeks) |
Strong | Moderate |
| With cirrhosis | DCV + SOF (12 weeks) LDV + SOF (12 weeks) |
SMV + SOF (24 weeks) SMV + SOF + R (12 weeks) OBV + PTV/r + DSV + R (12 weeks) |
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|
| |||||
| 2 | Without cirrhosis | SOF + R (12 weeks) | DCV + SOF (12 weeks) | Strong | Low |
| With cirrhosis | SOF + R (16 weeks) | DCV + SOF (12 weeks) | |||
|
| |||||
| 3 | Without cirrhosis | DCV + SOF (12 weeks) SOF + R (24 weeks) |
Strong | Low | |
| With cirrhosis | DCV + SOF + R (24 weeks) | SOF + PegIFN + R (12 weeks) | |||
|
| |||||
| 4 | Without cirrhosis | DCV + SOF (12 weeks) LDV + SOF (12 weeks) |
SMV + SOF (12 weeks) OBV + PTV/r + R (12 weeks) |
Strong | Moderate |
| With cirrhosis | DCV + SOF (24 weeks) DCV + SOF + R (12 weeks) LDV + SOF (24 weeks) LDV + SOF + R (12 weeks)b |
SMV + SOF (24 weeks) SMV + SOF + R (12 weeks)c OBV + PTV/r + R (24 weeks) |
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|
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| 5 | Without cirrhosis | LDV + SOF (12 weeks) | SOF + PegIFN + R (12 weeks) | Conditional | Very Low |
| With cirrhosis | LDV + SOF (24 weeks) LDV + SOF + R (12 weeks)b |
SOF + PegIFN + R (12 weeks) | |||
|
| |||||
| 6 | Without cirrhosis | LDV + SOF (12 weeks) | SOF + PegIFN + R (12 weeks) | Conditional | Very Low |
| With cirrhosis | LDV + SOF (24 weeks) LDV + SOF + R (12 weeks)b |
SOF + PegIFN + R (12 weeks) | |||
DCV: daclatasvir; LDV: ledipasvir; SMV: simeprevir; SOF: sofosbuvir; OBV: ombitasvir; PTV: paritaprevir; DSV: dasabuvir; R: ribavirin; r: ritonavir; PegIFN: pegylated interferon.
aTreatment may be shortened to 8 weeks in treatment-naïve persons without cirrhosis if their baseline HCV RNA level is below 6 million (6.8 log) IU/mL. The duration of treatment should be shortened with caution.
bIf platelet count <75 × 103/μL, then 24 weeks' treatment with ribavirin should be given.
c If positive for the Q80K variant, a simeprevir/sofosbuvir regimen should not be chosen.