Consensus recommendations

Consensus recommendations

Grade

All individuals with chronic HCV infection should be considered for antiviral therapy.

A1

Choice of treatment regimen should be based on:

  • patient preference, taking into consideration duration of treatment and number of pills
  • the potential for drug-drug interactions
  • the presence or absence of cirrhosis
  • the presence or absence of decompensated liver disease
  • prior treatment history

A1

Women of childbearing potential should be cautioned to avoid pregnancy while receiving DAA treatment.

B1
Men and women of childbearing potential should be cautioned to avoid pregnancy while receiving ribavirin-containing antiviral regimens and for up to 6 months after stopping.

A1

Breastfeeding women should not be treated with DAAs.

B1

People who are treatment-naive (see Table 2)

First-line treatment regimens for people with no cirrhosis:

  • sofosbuvir + velpatasvir for 12 weeks
  • glecaprevir + pibrentasvir for 8 or 12 weeks

A1

First-line treatment regimens for people with cirrhosis and compensated liver disease:

  • sofosbuvir + velpatasvir for 12 weeks
  • glecaprevir + pibrentasvir for 8 (or 12) weeks
 A1

People in whom DAA therapy has failed (see Table 3)

People in whom first-line DAA therapy fails should be referred to a specialist centre for consideration of salvage therapy.

B1

The recommended treatment regimen for people with compensated liver disease in whom first-line DAA therapy has failed is:

  • sofosbuvir + velpatasvir + voxilaprevir for 12 weeks

A1

Dose reduction or dose interruption of DAA therapies is not recommended.

A1

DAA therapies for HCV should not be used in combinations other than those that have demonstrated efficacy in prospective clinical trials.

B1