Preferred Treatment Approach for HCV-Monoinfected and HIV/HCV-Coinfected
Patients
Abbreviations: PEG-IFN = peginterferon; RBV = ribavirin; Tx = treatment
Dosages: PEG-IFN alfa-2a 180 mcg subcutaneously weekly or PEG-IFN alfa-2b 1.5 mcg/kg subcutaneously weekly; RBV 1,000 mg (<75 kg) or 1,200 mg (≥75 kg) orally daily (in two divided doses) with food; simeprevir 150 mg orally daily with food; sofosbuvir 400 mg orally daily
* Regardless of cirrhosis; ** GT1a with Q80K polymorphism may be associated with lower SVR; *** 16 weeks of sofosbuvir/ribavirin in treatment-experienced cirrhotics may improve SVR
Interferon (IFN) ineligible or intolerant criteria: Platelet count <75,000/mm3; Decompensated liver cirrhosis (Child-Turcott-Pugh (CTP) Class B or C, CTP score ≥7); Severe mental health conditions that may be exacerbated by interferon and/or respond poorly to medical therapy (with risks of interferon use documented by Mental Health evaluation); Autoimmune diseases that may be exacerbated by interferon-mediated immune modulation; Inability to complete a prior treatment course due to documented interferon-related adverse effects (Table 5).
Genotype 1
Genotype 2
Genotype 3
Abbreviations: PEG-IFN = peginterferon; RBV = ribavirin; Tx = treatment
Dosages: PEG-IFN alfa-2a 180 mcg subcutaneously weekly or PEG-IFN alfa-2b 1.5 mcg/kg subcutaneously weekly; RBV 1,000 mg (<75 kg) or 1,200 mg (≥75 kg) orally daily (in two divided doses) with food; simeprevir 150 mg orally daily with food; sofosbuvir 400 mg orally daily
* Regardless of cirrhosis; ** GT1a with Q80K polymorphism may be associated with lower SVR; *** 16 weeks of sofosbuvir/ribavirin in treatment-experienced cirrhotics may improve SVR
Interferon (IFN) ineligible or intolerant criteria: Platelet count <75,000/mm3; Decompensated liver cirrhosis (Child-Turcott-Pugh (CTP) Class B or C, CTP score ≥7); Severe mental health conditions that may be exacerbated by interferon and/or respond poorly to medical therapy (with risks of interferon use documented by Mental Health evaluation); Autoimmune diseases that may be exacerbated by interferon-mediated immune modulation; Inability to complete a prior treatment course due to documented interferon-related adverse effects (Table 5).
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