Genotype 4

  1. G4 naïve NON-CIRRHOTIC
    1. Harvoni [LDV/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 95% SVR12 (intention-to-treat) to 100% SVR12 (per-protocol analysis) [SYNERGY]
    2. Zepatier [Elbasvir and Grazoprevir fixed dose combination] 1 tab daily for 12 weeks à 97% SVR12 (C-EDGE TN; C-SCAPE; C-EDGE COINFECTION)
    3. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 100% SVR12 (ASTRAL-1)
    4. Mavyret [Glecaprevir and Pibrentasvir 3-tablet coformulation] 3 tabs daily [with food] for 8 weeks à 100% SVR12 (SURVEYOR-2) AND 99% SVR12 (ENDURANCE-4)

 

  1. G4 naïve COMPENSATED CIRRHOTIC
    1. Harvoni [LDV/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 95% SVR12 (intention-to-treat) to 100% SVR12 (per-protocol analysis) [SYNERGY]
    2. Zepatier [Elbasvir and Grazoprevir fixed dose combination] 1 tab daily for 12 weeks à ?% SVR12 (C-EDGE TN; C-SCAPE; C-EDGE COINFECTION))
    3. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 100% SVR12 (ASTRAL-1)
    4. Mavyret [Glecaprevir and Pibrentasvir 3-tablet coformulation] 3 tabs daily [with food] for 12 weeks à 99% SVR12 (EXPEDITION-1)

 

  1. G4 naïve DECOMPENSATED CIRRHOTIC
    1. Harvoni [LDV/SOF daily fixed dose combination] 1 tab daily + RBV [INITIAL DOSE OF 600 MG DAILY, INCREASED AS TOLERATED] for 12 weeks à 87% SVR12 (SOLAR-2)
    2. SOF 400MG QD + DCV 60 MG QD + RBV [INITIAL DOSE OF 600 MG DAILY, INCREASED AS TOLERATED] for 12 weeks à ?% SVR12
    3. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily + RBV WBD for 12 weeks à 94% SVR12 (ASTRAL-4)
    4. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 24 weeks à 86% SVR12 (ASTRAL-4) – RBV Ineligible
    5. SOF 400MG QD + DCV 60 MG QD for 24 weeks à ?% SVR12 – RBV Ineligible
  2. G4 prior treatment failure to PEG + RBV NON-CIRRHOTIC
    1. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 100% SVR12 (ASTRAL-1)
    2. Mavyret [Glecaprevir and Pibrentasvir 3-tablet coformulation] 3 tabs daily [with food] for 8 weeks à 93% SVR12 (SURVEYOR-II)

 

  1. G4 prior treatment failure to PEG + RBV COMPENSATED CIRRHOTIC
    1. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks à 100% SVR12 (ASTRAL-1)
    2. Mavyret [Glecaprevir and Pibrentasvir 3-tablet coformulation] 3 tabs daily [with food] for 12 weeks à 100% SVR12 (EXPEDITION-1)

 

  1. G4 prior treatment failure to DAA-EXPERIENCED [INCLUDING NS5A-INHIBITORS] NON-CIRRHOTIC OR COMPENSATED CIRRHOTIC
    1. Vosevi [VEL/SOF/VOX daily fixed dose combination] 1 tab daily for 12 weeks à SVR12 91% [NS5A INHIBITOR EXPERIENCED] AND SVR12 100% [NO NS5A INHIBITOR EXPERIENCE] (POLARIS-1 AND 4)

 

 

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

RBV = Ribavirin [RIBAPAK]

VEL = Velpatasvir [100 mg daily] – NS5A inhibitor

LDV = Ledipasvir [90 mg daily] – NS5A inhibitor

Zepatier = Elbasvir [50 mg] – NS5A inhibitor + Grazoprevir [100 mg daily] – NS3/4A protease inhibitor

Mavyret = Glecaprevir [300 mg] – NS3/4A protease inhibitor + Pibrentasvir [120 mg] – NS5A inhibitor

Vosevi = Sofosbuvir [400 mg] + Velpatasvir [100 mg] + Voxilaprevir [100mg] NS3/4A protease inhibitor

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