Hepatitis C
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Treatment algorithm
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer
recent infection
initiate antiviral therapy
Treatment should be initiated in all patients with acute hepatitis C virus (HCV) infection with viraemia without awaiting spontaneous resolution. The same regimens that are used for chronic infection are recommended for acute infection (see below).[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org
chronic infection suitable for simplified treatment: any genotype
antiviral therapy
Eligible patients include adults with chronic hepatitis C infection who do not have cirrhosis and have not previously received treatment for hepatitis C infection. Patients with known or suspected hepatocellular carcinoma, those with history of liver transplantation, or patients who are pregnant or hepatitis B surface antigen (HBsAg) positive are not eligible for simplified treatment. In patients with HIV, the simplified approach should not be used in those on tenofovir disoproxil-containing regimens if their eGFR is <60 mL/minute due to the need for additional monitoring.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
antiviral therapy
Eligible patients include adults with chronic hepatitis C infection who have compensated cirrhosis (based on recommended criteria) and have not previously received treatment for hepatitis C infection. Liver biopsy is required. Patients with a current or prior episode of decompensated cirrhosis, end-stage renal disease, known or suspected hepatocellular carcinoma, history of liver transplantation, or patients who are pregnant or hepatitis B surface antigen (HBsAg) positive are not eligible for simplified treatment. In patients with HIV, the simplified approach should not be used in those on tenofovir disoproxil-containing regimens if their eGFR is <60 mL/minute due to the need for additional monitoring.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation. Recommended in patients with genotype 1, 2, 4, 5, or 6 only. Patients with genotype 3 require NS5A resistance-associated substitution testing first. Those without Y93H can be treated with this regimen.
chronic infection not suitable for simplified treatment and treatment-naive: genotype 1a
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 8-12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation.
An 8-week duration is recommended in patients who are not infected with HIV, and whose HCV RNA is <6 million IU/mL.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
Secondary options
elbasvir/grazoprevir: 50 mg (elbasvir)/100 mg (grazoprevir) orally once daily for 12 weeks
More elbasvir/grazoprevirAvailable in a fixed-dose formulation. For use in patients without baseline NS5A polymorphisms.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
Secondary options
elbasvir/grazoprevir: 50 mg (elbasvir)/100 mg (grazoprevir) orally once daily for 12 weeks
More elbasvir/grazoprevirAvailable in a fixed-dose formulation. For use in patients without baseline NS5A polymorphisms.
chronic infection not suitable for simplified treatment and treatment-naive: genotype 1b
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
elbasvir/grazoprevir: 50 mg (elbasvir)/100 mg (grazoprevir) orally once daily for 12 weeks
More elbasvir/grazoprevirAvailable in a fixed-dose formulation.
OR
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 8-12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation.
An 8-week duration is recommended in patients who are not infected with HIV, and whose HCV RNA is <6 million IU/mL.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 8 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
elbasvir/grazoprevir: 50 mg (elbasvir)/100 mg (grazoprevir) orally once daily for 12 weeks
More elbasvir/grazoprevirAvailable in a fixed-dose formulation.
OR
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
chronic infection not suitable for simplified treatment and treatment-naive: genotype 2
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
OR
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
chronic infection not suitable for simplified treatment and treatment-naive: genotype 3
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
RAS testing for Y93H is recommended for cirrhotic patients. If present, ribavirin should be included in the regimen or sofosbuvir/velpatasvir/voxilaprevir should be considered.
Secondary options
sofosbuvir/velpatasvir/voxilaprevir: 400 mg (sofosbuvir)/100 mg (velpatasvir)/100 mg (voxilaprevir) orally once daily for 12 weeks
More sofosbuvir/velpatasvir/voxilaprevirAvailable in a fixed-dose formulation. Only use if Y93H mutation is present.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation. Only use if Y93H mutation is present.
and
ribavirin: weight <75 kg: 1000 mg/day orally given in 2 divided doses for 12 weeks; weight ≥75 kg: 1200 mg/day orally given in 2 divided doses for 12 weeks
More ribavirinContraindicated in pregnancy and in men whose female partners are pregnant.
chronic infection not suitable for simplified treatment and treatment-naive: genotype 4
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
OR
elbasvir/grazoprevir: 50 mg (elbasvir)/100 mg (grazoprevir) orally once daily for 12 weeks
More elbasvir/grazoprevirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 8-12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation. An 8-week regimen can be considered in patients with favourable baseline characteristics (i.e., no cirrhosis, HCV RNA <6 million IU/mL, and absence of genotype 4r).
chronic infection not suitable for simplified treatment and treatment-naive: genotype 5 or 6
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). The specific regimen depends on the genotype and the presence or absence of cirrhosis. Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 8 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
OR
sofosbuvir/velpatasvir: 400 mg (sofosbuvir)/100 mg (velpatasvir) orally once daily for 12 weeks
More sofosbuvir/velpatasvirAvailable in a fixed-dose formulation.
OR
ledipasvir/sofosbuvir: 90 mg (ledipasvir)/400 mg (sofosbuvir) orally once daily for 12 weeks
More ledipasvir/sofosbuvirAvailable in a fixed-dose formulation. Not recommended for genotype 6e if subtype is known.
chronic infection not suitable for simplified treatment and treatment-experienced: all genotypes
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
sofosbuvir/velpatasvir/voxilaprevir: 400 mg (sofosbuvir)/100 mg (velpatasvir)/100 mg (voxilaprevir) orally once daily for 12 weeks
More sofosbuvir/velpatasvir/voxilaprevirAvailable in a fixed-dose formulation. Add weight-based ribavirin in patients with genotype 3 infection if cirrhosis is present and there are no contraindications.
Secondary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 16 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation. This regimen is not recommended for patients with prior exposure to an NS5A inhibitor plus NS3/4 protease inhibitor regimens (e.g., elbasvir/grazoprevir). It is also not recommended in patients with genotype 3 infection with sofosbuvir/NS5A inhibitor experience.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 16 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation.
and
sofosbuvir: 400 mg orally once daily for 16 weeks
and
ribavirin: weight <75 kg: 1000 mg/day orally given in 2 divided doses for 16 weeks; weight ≥75 kg: 1200 mg/day orally given in 2 divided doses for 16 weeks
More ribavirinContraindicated in pregnancy and in men whose female partners are pregnant.
OR
sofosbuvir/velpatasvir/voxilaprevir: 400 mg (sofosbuvir)/100 mg (velpatasvir)/100 mg (voxilaprevir) orally once daily for 12 weeks
More sofosbuvir/velpatasvir/voxilaprevirAvailable in a fixed-dose formulation. Add weight-based ribavirin in patients with compensated cirrhosis.
antiviral therapy
Direct-acting oral agents are recommended by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA). Recommended regimens are outlined below; however, as these guidelines are updated regularly, the latest version should be consulted for the most up-to-date recommendations.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org Different guidelines may be used in different countries.
Primary options
glecaprevir/pibrentasvir: 300 mg (glecaprevir)/120 mg (pibrentasvir) orally once daily for 16-24 weeks
More glecaprevir/pibrentasvirAvailable in a fixed-dose formulation. Extension of treatment regimen to 24 weeks should be considered in extremely difficult cases (e.g., genotype 3 with cirrhosis) or failure following sofosbuvir plus glecaprevir/pibrentasvir.
and
sofosbuvir: 400 mg orally once daily for 16-24 weeks
and
ribavirin: weight <75 kg: 1000 mg/day orally given in 2 divided doses for 16-24 weeks; weight ≥75 kg: 1200 mg/day orally given in 2 divided doses for 16-24 weeks
More ribavirinContraindicated in pregnancy and in men whose female partners are pregnant.
OR
sofosbuvir/velpatasvir/voxilaprevir: 400 mg (sofosbuvir)/100 mg (velpatasvir)/100 mg (voxilaprevir) orally once daily for 24 weeks
More sofosbuvir/velpatasvir/voxilaprevirAvailable in a fixed-dose formulation.
and
ribavirin: weight <75 kg: 1000 mg/day orally given in 2 divided doses for 24 weeks; weight ≥75 kg: 1200 mg/day orally given in 2 divided doses for 24 weeks
More ribavirinContraindicated in pregnancy and in men whose female partners are pregnant.
decompensated cirrhosis
referral to specialist
Includes patients with moderate or severe hepatic impairment (Child-Pugh class B or C) who may or may not be candidates for liver transplantation, including those with hepatocellular carcinoma.
Patients should be referred to a physician with experience in treating these patients, ideally in a liver transplant centre. Treatment regimen will depend on the genotype of the patient and eligibility to receive ribavirin.[66]American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance: recommendations for testing, managing, and treating hepatitis C. Dec 2023 [internet publication]. https://www.hcvguidelines.org
Some direct-acting oral agents are contraindicated or not recommended in patients with moderate-to-severe hepatic impairment (Child-Pugh B or C). The US Food and Drug Administration has received rare reports of worsening liver function or liver failure when these patients are treated with the following drugs: elbasvir/grazoprevir; glecaprevir/pibrentasvir; sofosbuvir/velpatasvir/voxilaprevir; and ombitasvir/paritaprevir/ritonavir ± dasabuvir. These drugs are not indicated in patients with moderate-to-severe hepatic impairment and should not be prescribed in patients with a history of prior hepatic decompensation.[94]US Food and Drug Administration. FDA drug safety communication: FDA warns of serious liver injury risk with hepatitis C treatments Viekira Pak and Technivie. Oct 2015 [internet publication]. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-serious-liver-injury-risk-hepatitis-c-treatments-viekira-pak [95]US Food and Drug Administration. FDA drug safety communication: FDA warns about rare occurrence of serious liver injury with use of hepatitis C medicines Mavyret, Zepatier, and Vosevi in some patients with advanced liver disease. Aug 2019 [internet publication]. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-rare-occurrence-serious-liver-injury-use-hepatitis-c-medicines-mavyret-zepatier-and A specialist should be consulted when deciding on an appropriate antiviral regimen for patients with moderate-to-severe hepatic impairment.
Patients who develop recurrent hepatitis C infection post liver transplant should also be referred to a specialist for treatment.
Choose a patient group to see our recommendations
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer
Use of this content is subject to our disclaimer