Hepatitis C Treatment Guidelines

First-Line Treatment Recommendations

The American Association for the Study of Liver Diseases recommends a pangenotypic direct-acting antiviral (DAA) regimen consisting of either sofosbuvir/velpatasvir for 12 weeks or glecaprevir/pibrentasvir for 8-12 weeks, depending on cirrhosis status and treatment history, for the treatment of chronic hepatitis C virus (HCV) infection 1, 2
Treatment-naïve and treatment-experienced patients with HCV genotypes 1a, 1b, 2, 4, 5, or 6 should receive either sofosbuvir/velpatasvir for 12 weeks or glecaprevir/pibrentasvir for 8 weeks, according to the European Association for the Study of the Liver 1, 2

The same HCV treatment regimens can be used in HIV-coinfected patients as in patients without HIV infection, with dose adjustments needed in case of interactions with antiretroviral drugs, as recommended by the World Health Organization 3
In settings where HCV genotype and subtype determination are available and affordable, this information remains useful to optimize the virological results of HCV therapy, according to the American Association for the Study of Liver Diseases 1

For patients with cirrhosis, even after achieving sustained virologic response (SVR), continue monitoring for hepatocellular carcinoma with ultrasound every 6 months, as recommended by the European Association for the Study of the Liver 4