Hepatitis C Treatment Considerations - Viral Hepatitis and Liver Disease
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Viral Hepatitis and Liver Disease

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Hepatitis C Treatment Considerations

for Veterans and the Public

Chronic Hepatitis C Virus (HCV) Infection: Treatment Considerations - Hepatitis C

Contents

Full PDF Version

Introduction

March 2021 revision incorporates:

  • Universal HCV testing for adults aged 18-79 years, and repeated testing for patients with ongoing risk exposure.
  • The treatment section has been updated to include 8 weeks of glecaprevir pibrentasvir (Mavyret) in all HCV genotypes who are treatment-naive with compensated cirrhosis (CTP A) without a history of decompensation; 12 weeks can be considered for patients with poor prognostic factors. Treatment has been updated to include SOF-based therapy in patients with chronic kidney disease, including those on hemodialysis.
  • Patients with acute HCV infection can be treated with DAAs upon initial diagnosis (based on detectable HCV RNA) without awaiting spontaneous resolution if appropriate. Selection for HCV treatment should include patients who become reinfected with HCV after initially achieving sustained virologic response.
  • Treatment regimens for post transplant patients have been updated.