Page 9 - EASL Recommendations on Treatment of Hepatitis C 2015 - Summary
P. 9
Genotype 4, IFN-free Option 3 Genotype 5 or 6, Option 2
• Patients infected with HCV genotype 4 can be treated • Patients infected with HCV genotype 5 or 6 can be
with an IFN-free combination of daily sofosbuvir (400 treated with the IFN-free fixed-dose combination of
mg) and daily simeprevir (150 mg) 12 weeks (B2) sofosbuvir (400 mg) and ledipasvir (90 mg) in a single
tablet administered once daily (A1)
• Based on data with other combinations, adding daily
weight-based ribavirin (1000 or 1200 mg in patients <75 • Patients without cirrhosis, including treatment-naïve
kg or ≥75 kg, respectively) is recommended in patients and treatment-experienced patients, should be treated
with cirrhosis (B2) with this fixed-dose combination for 12 weeks without
ribavirin (B1)
• In patients with cirrhosis with contra-indications to the
use of ribavirin, extending duration of treatment to 24 • Based on data in patients infected with HCV genotype
weeks must be considered (B2) 1, patients with compensated cirrhosis, including
treatment-naïve and treatment-experienced patients,
Genotype 4, IFN-free Option 4 should be treated with this fixed-dose combination for
12 weeks with daily weight-based ribavirin (1000 or
• Patients infected with HCV genotype 4 can be treated 1200 mg in patients <75 kg or ≥75 kg, respectively) (B1)
with an IFN-free combination of daily sofosbuvir (400
mg) and daily daclatasvir (60 mg) for 12 weeks (B2) • Patients with compensated cirrhosis with contra-
indications to the use of ribavirin or with poor tolerance
• Based on data with other combinations, adding daily to ribavirin on treatment should receive the fixed-dose
weight-based ribavirin (1000 or 1200 mg in patients <75 combination of sofosbuvir and ledipasvir for 24 weeks
kg or ≥75 kg, respectively) is recommended in patients without ribavirin (B1)
with cirrhosis (B2)
• Based on data in patients infected with HCV genotype
• In patients with cirrhosis with contra-indications to the 1, treatment with the fixed-dose combination of
use of ribavirin, extending duration of treatment to 24 sofosbuvir and ledipasvir with ribavirin can be prolonged
weeks must be considered (B2) to 24 weeks in treatment-experienced patients with
compensated cirrhosis and negative predictors of
response, such as a platelet count <75 x 103/μl (B1)
Genotype 5 or 6, Option 3
Treatment of HCV genotype 5 or 6 infection • Patients infected with HCV genotype 5 or 6 can be
treated with an IFN-free combination of daily sofosbuvir
The 3 treatment options for patients infected with HCV (400 mg) and daily daclatasvir (60 mg) for 12 weeks
genotypes 5 or 6 are the triple combination of PegIFN-α, (B1)
ribavirin and sofosbuvir, the IFN-free combination of
sofosbuvir and ledipasvir, and the IFN-free combination • Based on data with other combinations, adding daily
of sofosbuvir and daclatasvir. In settings where none of weight-based ribavirin (1000 or 1200 mg in patients <75
these options is available, the combination of PegIFN-α kg or ≥75 kg, respectively) is recommended in patients
and ribavirin remains acceptable. with cirrhosis (B1)
Genotype 5 or 6, Option 1 • In patients with cirrhosis with contra-indications to the
use of ribavirin, extending duration of treatment to 24
weeks must be considered (B1)
• Patients infected with HCV genotype 5 or 6 can be
treated with a combination of weekly PegIFN-α, daily
weight-based ribavirin (1000 or 1200 mg in patients <75
kg or ≥75 kg, respectively), and daily sofosbuvir (400
mg) 12 weeks (B1)
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• Patients infected with HCV genotype 4 can be treated • Patients infected with HCV genotype 5 or 6 can be
with an IFN-free combination of daily sofosbuvir (400 treated with the IFN-free fixed-dose combination of
mg) and daily simeprevir (150 mg) 12 weeks (B2) sofosbuvir (400 mg) and ledipasvir (90 mg) in a single
tablet administered once daily (A1)
• Based on data with other combinations, adding daily
weight-based ribavirin (1000 or 1200 mg in patients <75 • Patients without cirrhosis, including treatment-naïve
kg or ≥75 kg, respectively) is recommended in patients and treatment-experienced patients, should be treated
with cirrhosis (B2) with this fixed-dose combination for 12 weeks without
ribavirin (B1)
• In patients with cirrhosis with contra-indications to the
use of ribavirin, extending duration of treatment to 24 • Based on data in patients infected with HCV genotype
weeks must be considered (B2) 1, patients with compensated cirrhosis, including
treatment-naïve and treatment-experienced patients,
Genotype 4, IFN-free Option 4 should be treated with this fixed-dose combination for
12 weeks with daily weight-based ribavirin (1000 or
• Patients infected with HCV genotype 4 can be treated 1200 mg in patients <75 kg or ≥75 kg, respectively) (B1)
with an IFN-free combination of daily sofosbuvir (400
mg) and daily daclatasvir (60 mg) for 12 weeks (B2) • Patients with compensated cirrhosis with contra-
indications to the use of ribavirin or with poor tolerance
• Based on data with other combinations, adding daily to ribavirin on treatment should receive the fixed-dose
weight-based ribavirin (1000 or 1200 mg in patients <75 combination of sofosbuvir and ledipasvir for 24 weeks
kg or ≥75 kg, respectively) is recommended in patients without ribavirin (B1)
with cirrhosis (B2)
• Based on data in patients infected with HCV genotype
• In patients with cirrhosis with contra-indications to the 1, treatment with the fixed-dose combination of
use of ribavirin, extending duration of treatment to 24 sofosbuvir and ledipasvir with ribavirin can be prolonged
weeks must be considered (B2) to 24 weeks in treatment-experienced patients with
compensated cirrhosis and negative predictors of
response, such as a platelet count <75 x 103/μl (B1)
Genotype 5 or 6, Option 3
Treatment of HCV genotype 5 or 6 infection • Patients infected with HCV genotype 5 or 6 can be
treated with an IFN-free combination of daily sofosbuvir
The 3 treatment options for patients infected with HCV (400 mg) and daily daclatasvir (60 mg) for 12 weeks
genotypes 5 or 6 are the triple combination of PegIFN-α, (B1)
ribavirin and sofosbuvir, the IFN-free combination of
sofosbuvir and ledipasvir, and the IFN-free combination • Based on data with other combinations, adding daily
of sofosbuvir and daclatasvir. In settings where none of weight-based ribavirin (1000 or 1200 mg in patients <75
these options is available, the combination of PegIFN-α kg or ≥75 kg, respectively) is recommended in patients
and ribavirin remains acceptable. with cirrhosis (B1)
Genotype 5 or 6, Option 1 • In patients with cirrhosis with contra-indications to the
use of ribavirin, extending duration of treatment to 24
weeks must be considered (B1)
• Patients infected with HCV genotype 5 or 6 can be
treated with a combination of weekly PegIFN-α, daily
weight-based ribavirin (1000 or 1200 mg in patients <75
kg or ≥75 kg, respectively), and daily sofosbuvir (400
mg) 12 weeks (B1)
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