Table 2.
Hepatitis C virus (HCV) treatment options in HCV/HIV‐coinfected persons
| IFN‐free HCV treatment options | ||||
|---|---|---|---|---|
| HCV GT | Treatment regimen | Treatment duration & RBV usage | ||
| Non‐cirrhotic | Compensated cirrhotic | Decompensated cirrhotics CTP class B/C | ||
| 1 & 4 | SOF + SMP ± RBV | GT 4 only: 12 weeks with RBV or 24 weeks without RBVa | Not recommended | |
| SOF/LDV ± RBV | 8 weeks without RBVb or 12 weeks ±RBVc | 12 weeks with RBVd | ||
| SOF + DCV ± RBV | 12 weeks ± RBVc | 12 weeks with RBVd | ||
| SOF/VEL | 12 weeks | 12 weeks with RBV | ||
| SOF/VEL/VOX | 8 weeksh | 12 weeks | Not recommended | |
| OBV/PTV/r + DSV | 8e‐12 weeks in GT 1b | 12 weeks in GT 1b | Not recommended | |
| OBV/PTV/r + DSV + RBV | 12 weeks in GT 1a | 24 weeks in GT 1a | Not recommended | |
| OBV/PTV/r + RBV | 12 weeks in GT 4 | Not recommended | ||
| EBR/GZR | 12 weeksf | Not recommended | ||
| GLE/PIB | 8 weeks | 12 weeks | Not recommended | |
| 2 | SOF + DCV | 12 weeks | 12 weeks with RBV | |
| SOF/VEL | 12 weeks | 12 weeks with RBV | ||
| SOF/VEL/VOX | 8 weeksh | 12 weeks | Not recommended | |
| GLE/PIB | 8 weeks | 12 weeks | Not recommended | |
| 3 | SOF + DCV ± RBV | 12 weeks ± RBVg or 24 weeks without RBV | 24 weeks with RBV | |
| SOF/VEL ± RBV | 12 weeks ± RBVg or 24 weeks without RBV | 24 weeks with RBV | ||
| SOF/VEL/VOX | 8 weeksh | Not recommended | ||
| GLE/PIB | 8 weeksi | 12 weeksi | Not recommended | |
| 5 & 6 | SOF/LDV ± RBV | 12 weeks ± RBV or 24 weeks without RBVa | 12 weeks with RBVd | |
| SOF + DCV ± RBV | 12 weeks ± RBV or 24 weeks without RBVa | 12 weeks with RBVd | ||
| SOF/VEL | 12 weeks | 12 weeks with RBV | ||
| SOF/VEL/VOX | 8 weeksh | 12 weeks | Not recommended | |
| GLE/PIB | 8 weeks | 12 weeks | Not recommended | |
DCV, daclatasvir; DSV, dasabuvir; EBR, elbasvir; GLE, glecaprevir; GZR, grazoprevir; LDV, ledipasvir; OBV, ombitasvir; PIB, pibrentasvir; PTV/r, paritaprevir/RTV; RBV, ribavirin; SMP, simeprevir; SOF, sofosbuvir; VEL, velpatasvir; VOX, voxilaprevir; RAS, resistance associated substitutions.
In treatment experienced persons RBV treatment for 12 weeks or prolong treatment to 24 weeks without RBV.
8 weeks treatment without RBV only in treatment‐naïve persons with F < 3 and baseline HCV‐RNA < 6 million IU/mL.
Addition of RBV in GT1a treatment experienced persons, but not in persons without NS5A RASs, if RASs testing is available.
In persons intolerant to RBV, treatment may be prolonged to 24 weeks. RBV can be omitted in treatment‐naïve or ‐experienced persons with compensated cirrhosis without baseline NS5A RAS.
8 weeks treatment without RBV only in persons without cirrhosis.
Extension of treatment to 16 weeks and addition of RBV in persons with GT1a with baseline HCV‐RNA > 800.000 IU/mL and NS5A RASs and in HCV GT4 experienced persons with HCV‐RNA > 800.000 IU/mL.
Addition of RBV only in treatment experienced persons with baseline NS5A RASs, if RAS testing available; if these persons are intolerant to RBV, treatment may be prolonged to 24 weeks without RBV.
Extension of treatment to 12 weeks in DAA treatment experienced persons.
Treatment duration in HCV GT3 who failed previous treatment with IFN and RBV ± SOF or SOF and RBV should be 16 weeks.