Genotype 3

  1. G3 naïve NON-CIRRHOTIC
    1. SOF 400MG QD + DCV 60 MG QD for 12 weeks –> 98% SVR12 (ALLY-3)
    2. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 98% SVR12 (ASTRAL-3)

 

  1. G3 naïve COMPENSATED CIRRHOTIC
    1. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 93% SVR12 (ASTRAL-3)
    2. SOF 400MG QD + DCV 60 MG QD + RBV for 12 weeks –> 86% SVR12 (ALLY-3+)
    3. SOF 400MG QD + DCV 60 MG QD [+/- RBV WBD] for 24 weeks –> 88% SVR4 (HEZODE; EASL 2015)

 

  1. G3 prior treatment failure NON-CIRRHOTIC
    1. SOF 400MG QD + DCV 60 MG QD for 12 weeks –> 92% SVR12 (ALLY-3)
    2. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 95% SVR12 (ASTRAL-3)

 

  1. G3 prior treatment failure COMPENSATED CIRRHOTIC
    1. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily + RBV WBD for 12 weeks –> ?% SVR12 [89% SVR12 without RBV – ASTRAL-3]
    2. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily + RBV WBD for 24 weeks –> 76% SVR12 [Gane – EASL 2016 in patients who have failed a NS5A inhibitor]
    3. SOF 400MG QD + DCV 60 MG QD for 12 weeks –> 69% SVR12 (ALLY-3)
    4. SOF 400MG QD + DCV 60 MG QD [+/- RBV WBD] for 24 weeks –> 88% SVR4 (HEZODE; EASL 2015)

 

  1. G3 DECOMPENSATED CIRRHOTIC
    1. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily + RBV WBD for 12 weeks –> 85% SVR12 [ASTRAL-4]
    2. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 24 weeks –> ?% SVR12 – RBV Ineligible
    3. SOF 400MG QD + DCV 60 MG QD + RBV WBD for 12 weeks –> 70% SVR12 (FOSTER UK EAP GROUP)
    4. SOF 400MG QD + DCV 60 MG QD for 12 weeks –> 71% SVR12 (FOSTER UK EAP GROUP)

 

Clinic Visits & Labs                                                                                                                                  

  1. Initiation of Therapy
  2. Week 2 – CBC, CMP
  3. Week 4 – CBC, CMP, HCV RNA PCR quantitative & hCG [If RBV]
  4. Week 8 – CBC, CMP
  5. Week 12 – CBC, CMP, HCV RNA PCR quantitative & hCG
  6. Week 16 – CBC, CMP
  7. Week 20 – CBC, CMP
  8. Week 24 – CBC, CMP, HCV RNA PCR quantitative & hCG
  9. Week 4 Post Therapy – CBC, CMP, HCV RNA PCR quantitative & hCG
  10. Week 12 Post Therapy – CBC, CMP, HCV RNA PCR quantitative & hCG – SVR12

 

SOF = Sofosbuvir [Sovaldi] – NS5B nucleotide analog polymerase inhibitor

VEL = Velpatasvir [100 mg daily] – NS5A inhibitor

DCV = Daclatasvir [60 mg daily] [DAKLINZA] – NS5A inhibitor

 

Pending additional data, baseline NS5A RAV testing should be considered in all treatment-experienced genotype 3 patients without cirrhosis. If the Y93H variant is identified, weight-based ribavirin should be added to the treatment course.

 

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