Consensus recommendations

Consensus recommendations

Grade

In people with renal impairment, including those with ESRD requiring dialysis no dose adjustment is required for:

  • sofosbuvir + velpatasvir
  • glecaprevir + pibrentasvir
  • sofosbuvir + velpatasvir + voxilaprevir

A1

As ribavirin is renally excreted and cannot be removed by dialysis, if indicated in people with renal disease, it should be used with caution, and treatment should be supervised by a specialist experienced in the treatment of HCV and renal failure

A1

If ribavirin is indicated in people with an eGFR OF 30-50 mL/min/1.73 m2, a low dose (e.g. alternating doses of 200 mg and 400 mg every other day) should be used, with close monitoring of haemoglobin levels.

A1

If ribavirin is indicated in people with an eGFR < 30 mL/min/1.73 m2 or haemodialysis, a very low dose (e.g. 200 mg daily for patients not on haemodialysis; 200 mg pre-dialysis for patients on haemodialysis) should be used, with close monitoring of haemoglobin levels.

A1