Table 3:
Recommended regimens and durations (weeks) for patients without cirrhosis who have never been treated, according to HCV genotype*
| Regimen | HCV genotype | ||||||
|---|---|---|---|---|---|---|---|
| 1a | 1b | 2 | 3 | 4 | 5 | 6 | |
| Ledipasvir/sofosbuvir (Harvoni) | 8–12 wk† | 8–12 wk† | NR | + ribavirin 12 wk | 12 wk | 12 wk | 12 wk |
| Elbasvir/grazoprevir (Zepatier) | 12–16 wk ± ribavirin‡ | 8–12 wk§ | NR | + sofosbuvir × 12 wk | 12 wk | NR | NR |
| Paritaprevir/ritonavir/ombitasvir + dasabuvir (Holkira Pak) | + ribavirin 12 wk | 12 wk | NR | NR | Paritaprevir/ritonavir/ombitasvir + ribavirin 12 wk | NR | NR |
| Sofosbuvir + daclatasvir (Sovaldi + Daklinza) | 12 wk | 12 wk | 12 wk | 12 wk | NR | NR | NR |
| Sofosbuvir/velpatasvir (Epclusa) | 12 wk | 12 wk | 12 wk | 12 wk | 12 wk | 12 wk | 12 wk |
| Glecaprevir/pibrentasvir (Maviret) | 8 wk | 8 wk | 8 wk | 8 wk | 8 wk | 8 wk | 8 wk |
| Sofosbuvir/velpatasvir/voxilarevir (Vosevi)¶ | NR | NR | NR | NR | NR | NR | NR |
Note: HCV = hepatitis C virus, HIV = human immunodeficiency virus, NR = not recommended.
Where indicated, to be dosed according to weight: ≤ 75 kg: 1000 mg daily; ≥ 75 kg: 1200 mg daily. See Appendix 1 for reference supporting recommendations.
In individuals without cirrhosis and without HIV with a viral load < 6 million IU/mL, an 8-week regimen of ledipasvir/sofosbuvir may be considered.
Resistance testing suggested for people with genotype 1a infection before treatment with elbasvir/grazoprevir. If resistance to nonstructural 5A (NS5A) inhibitors is present, treatment should be extended to 16 weeks with the addition of weight-based ribavirin.
Eight weeks recommended in treatment-naive patients with fibrosis stages F0–F2. For those with F3 or F4, 12 weeks of therapy should be given.
Reserved for individuals who have been treated previously with direct-acting antiviral agents.