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VA's Updated - Chronic Hepatitis C Virus Infection:Treatment Considerations

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Chronic Hepatitis C Virus (HCV) Infection: Treatment Considerations from the Department of Veterans Affairs National Hepatitis C Resource Center and the HIV, Hepatitis, and Related Conditions Program in the Office of Specialty Care Services

This revision ( October 18 , 2017 ) incorporates updates to treatment regimens for chronic hepatitis C virus (HCV) infection, genotype s 1 -4, including re-treatment of patients who previously failed direct -acting antiviral therapy. A new table (Table 4) , “HCV Direct -Acting Antiviral Agents by Drug Class ” has been added. The section on “ Interpretation of Resistance -Associated Substitutions” has been revised , as have tables showing drug- drug interaction s to provide clinicians with guidance on the concomitant use of HCV drugs and other drugs, including HIV antiretroviral agents ( Table 23 and Table 24 ). The Panel continues to recommend that HIV/HCV-coinfected patients receive the same HCV antiviral regimen s as HCV - monoinfected patients unless ledipasvir/sofosbuvir is being considered, in which case a 12 -week regimen should be used (instead of an 8 -week regimen) . The previous revision included HBV testing and monitoring recommendations prior to starting HCV DAA , which can be found in Appendix D.

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