Table 2.
Therapeutic options in the treatment of infections with different HCV genotypes
| Genotype | Population | Drugs | Duration of therapy |
|---|---|---|---|
| 1 | Fibrosis at F1-F2 | BOC + PegIFNα + RBV DCV + ASV PTV/r/OBV + DSV PTV/r/OBV + DSV + RBV SOF + DCV SOF/LDV TVR + PegIFNα + RBV SMV + PegIFNα + RBV SOF + PegIFNα + RBV |
28-48 weeks (incl. 24-32 weeks of BOC) 24 weeks 12 weeks in patients infected with G1b 12 weeks in patients infected with G1a* 12 weeks 12 weeks 24-48 weeks (incl. 12 weeks of TVR) 24 weeks (incl. 12 weeks of SMV) 12 weeks |
| Advanced fibrosis (F3-F4)Contraindications to or intolerance of IFN (Tables 3 and 4) | DCV + ASV PTV/r/OBV + DSV PTV/r/OBV + DSV PTV/r/OBV + DSV + RBV PTV/r/OBV + DSV + RBV SOF + DCV SOF + DCV + RBV SOF/LDV SOF + RBV SOF + SMV +/– RBV |
24 weeks 12 weeks if F3, in patients infected with G1b 12 weeks if F4, in patients infected with G1b 12 weeks if F3, in patients infected with G1a 24 weeks if F4, in patients infected with G1a* 12 weeks if F3 24 weeks if F4 12 weeks if F3; 24 weeks in F4 24 weeks 12 weeks |
|
| Decompensated liver function | SOF/LDV + RBV | 24 weeks | |
| 2 | Untreated patients | PegIFNα + RBV | 16-24 weeks |
| Contraindications to or intolerance of IFN Inefficacy of PegIFNα + RBV in patients with advanced fibrosis (F3-F4) Decompensated liver function |
SOF + RBV | 12 weeks (24 weeks if F4) | |
| 3 | Untreated patients | PegIFNα + RBV | 16-24 weeks |
| Contraindications to or intolerance of IFN Decompensated liver function |
SOF + RBV | 24 weeks | |
| Inefficacy of PegIFNα + RBV in patients with fibrosis (F1-F2) | SOF + PegIFNα + RBV | 12 weeks | |
| Inefficacy of triple drug therapy or SOF + RBV or fibrosis (F3-F4) | SOF + DCV + RBV SOF/LDV + RBV |
24 weeks 24 weeks |
|
| 4 | Fibrosis at F1-F2 | DCV + PegIFNα + RBV PTV/r/OBV + RBV SMV + PegIFNα + RBV SOF + DCV SOF/LDV SOF + PegIFNα + RBV |
24 weeks 12 weeks 24 weeks (incl. 12 weeks of SMV) 12 weeks 12 weeks 12 weeks |
| Advanced fibrosis (F3-F4) Contraindications to or intolerance of IFN |
PTV/r/OBV + RBV SOF + DCV SOF + DCV + RBV SOF/LDV SOF + SMV +/– RBV |
12 weeks if F3; 24 weeks if F4 12 weeks if F3 24 weeks if F4 12 weeks if F3; 24 weeks if F4 12 weeks |
|
| Decompensated liver function | SOF/LDV + RBV | 24 weeks | |
| 5 and 6 | Untreated patients and inefficacy of previous therapy | SOF + PegIFNα + RBV | 12 weeks |
| Contraindications to or intolerance of IFN Advanced fibrosis (F4) or history of decompensated liver function |
SOF + RBV | 24 weeks |
*
In patients infected with virus of an unknown genotype 1 subtype or with mixed genotype 1 infection the recommended treatment is the same as in patients infected with virus of genotype 1α