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Table 3. Recommended treatment protocols for treatment-experienced people with hepatitis C virus (HCV) infection and compensated liver disease, including people with HCV–HIV coinfection
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Salvage regimen (all doses are orally, daily)
|
Prior treatment history
|
|
Sofosbuvir
+
NS5A inhibitor
|
NS3 PI +
NS5A inhibitor
±
NS5B inhibitor
|
Sofosbuvir + RBV
or
PegIFN + RBV + sofosbuvir
|
PegIFN + RBV
+
NS3 PI
|
PegIFN + RBV
|
|
Sofosbuvir 400 mg
+
Velpatasvir 100 mg
+
Voxilaprevir 100mg
|
Gt 1–6:*^
12 weeks
|
GT 1–6: *^
12 weeks
|
GT 1–6: *^
12 weeks
|
†
|
†
|
|
Glecaprevir 300 mg
+
Pibrentasvir 120 mg
|
Gt 1 only
(PI naive):
16 weeks
|
|
Gt 1, 2, 4, 5, 6:
No cirrhosis:
8 weeks‡
Cirrhosis:
12 weeks
Gt 3: 16 weeks
|
Gt 1 only
(NS5A inhibitor naive):
12 weeks
|
Gt 1, 2, 4, 5, 6:
No cirrhosis:
8 weeks‡
Cirrhosis:
12 weeks
Gt 3: 16 weeks
|
|
Sofosbuvir 400 mg
+
Velpatasvir 100 mg
|
|
|
Gt 1b, 2, 4, 5, 6:*
12 weeks§
|
Gt 1–6:
12 weeks
|
Gt 1–6:
12 weeks§
|
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Gt = genotype; HIV = human immunodeficiency virus; OTVF = on-treatment virological failure (null response, partial response, virological breakthrough or rebound, or intolerance to prior treatment); PegIFN = peginterferon; PI = protease inhibitor; RBV = ribavirin.
* Additional benefit of sofosbuvir + velpatasvir + voxilaprevir over sofosbuvir + velpatasvir has not been demonstrated in adults with genotype 1b, 2, 4, 5 or 6 HCV previously treated with sofosbuvir without an NS5A inhibitor.
^ Sofosbuvir + velpatasvir + voxilaprevir is not yet PBS-listed for the treatment of Gt 1–6 HCV in people in whom DAA therapy has previously failed.
† Sofosbuvir + velpatasvir + voxilaprevir is not PBS-listed for the treatment of non-responders to pegIFN + RBV ± NS3 protease inhibitor.
‡ Studies in people with no cirrhosis enrolled very few patients with advanced fibrosis, and we recommend 12 weeks’ treatment in people with advanced fibrosis (liver stiffnesss > 9.5 kPa).
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