Regimens for chronic infection Gt 4, 5 & 6 HCV
Regimens for chronic infection with genotype 4 HCV
The combination of elbasvir plus grazoprevir with or without ribavirin is also PBS-listed for the treatment of Gt 4 HCV. It is currently the only IFN-free treatment regimen available under the PBS for treating Gt 4 HCV. The recommended treatment regimen is elbasvir plus grazoprevir for 12 weeks’ duration in people who are treatment-naive, as well as in people who have previously relapsed after treatment with pegIFN and ribavirin (Table 5). 41,42,55 For people who have previously experienced on-treatment failure during pegIFN and ribavirin therapy (partial responders and non-responders), the recommended regimen is elbasvir plus grazoprevir plus ribavirin for 16 weeks’ duration. 43 SVR rates ≥ 95% were observed in Phase III studies using the recommended treat- ment regimens. 41-43,55
Regimens for chronic infection with genotypes 5 and 6 HCV
The treatment regimen for HCV Gt 5 and 6 that is currently available for prescription under the PBS is the combination of sofosbuvir plus pegIFN and ribavirin for 12 weeks (Table 5). In a Phase III study of treatment-naive individuals, this regimen was associated with SVR rates of 96%–100% in a relatively small number of patients with Gt 5 and 6 HCV infection. 47
There are no IFN-free treatment regimens for Gt 5 or 6 HCV currently available on the PBS in Australia. A number of regimens have been shown to be effective for treating Gt 5 and 6 HCV in clinical studies, 56,57 and it is likely that an IFN-free treatment regimen will be approved in Australia in the future.