Genotype 4

  1. G4 naïve NON-CIRRHOTIC
    1. Harvoni [LDV/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 95% SVR12 (intention-to-treat) to 100% SVR12 (per-protocol analysis) [SYNERGY]
    2. Technivie [Paritaprevir/r + Ombitasvir daily fixed dose combination] + RBV WBD BID [with food] for 12 weeks –>100% SVR12 [Pearl I]
    3. Zepatier [Elbasvir and Grazoprevir fixed dose combination] 1 tab daily for 12 weeks –> 97% SVR12 (C-EDGE TN; C-SCAPE; C-EDGE COINFECTION)
    4. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 100% SVR12 (ASTRAL-1)
  2. G4 naïve COMPENSATED CIRRHOTIC
    1. Harvoni [LDV/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 95% SVR12 (intention-to-treat) to 100% SVR12 (per-protocol analysis) [SYNERGY]
    2. Technivie [Paritaprevir/r + Ombitasvir daily fixed dose combination] + RBV WBD BID [with food] for 12 weeks –>100% SVR12 [Pearl I]
    3. Zepatier [Elbasvir and Grazoprevir fixed dose combination] 1 tab daily for 12 weeks –> ?% SVR12 (C-EDGE TN; C-SCAPE; C-EDGE COINFECTION))
    4. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 100% SVR12 (ASTRAL-1)
  3. 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 –> 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 –> ?% SVR12
    3. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily + RBV WBD for 12 weeks –> 94% SVR12 (ASTRAL-4)
    4. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 24 weeks –> 86% SVR12 (ASTRAL-4) – RBV Ineligible
    5. SOF 400MG QD + DCV 60 MG QD for 24 weeks –> ?% SVR12 – RBV Ineligible
  4. G4 treatment experienced
    1. Technivie [Paritaprevir/r + Ombitasvir daily fixed dose combination] + RBV WBD BID [with food] for 12 weeks –>100% SVR12 [Pearl I]
    2. Zepatier [Elbasvir and Grazoprevir fixed dose combination] 1 tab daily + RBV WBD BID [with food] for 16 weeks –> 100% SVR12 (C-EDGE TE trial)
    3. Epclusa [VEL/SOF daily fixed dose combination] 1 tab daily for 12 weeks –> 100% SVR12 (ASTRAL-1)

 

Clinic Visits and Labs                                                                                                                  

  1. Initiation of Therapy
  2. Week 2 – CBC, CMP
  3. Week 4 – CBC, CMP, HCV RNA PCR quantitative & hCG
  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 [Solvaldi] – NS5B nucleotide analog polymerase inhibitor

RBV = Ribavirin [RIBAPAK]

VEL = Velpatasvir [100 mg daily] – NS5A inhibitor

LDV = Ledipasvir [90 mg daily] – NS5A inhibitor

Technivie = Paritaprevir [150 mg]/r [100 mg] (NS3/4A protease inhibitor + ritonavir) + Ombitasvir [25 mg] (NS5A inhibitor)

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

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

 

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