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HCV Treatment Guidelines

March 15, 2014

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Hepatitis C Treatment Guidelines

Hepatitis C virus (HCV) infection affects millions of people around the world and many people who are also infected with HIV. In recent years, new treatments that directly target HCV have revolutionized care and can cure HCV in many cases. Current HCV treatments work very well in people infected with both HIV and HCV. These treatments work by making it difficult for HCV to multiply. For more information about the HCV life cycle, see Fact Sheet 670.

Guidelines for testing, managing and treating HCV were written by the Association for the Study of Liver Diseases and the Infectious Disease Society of America. The panel released the latest guidelines in 2014.

Though only recently approved for use for treating HCV, the HCV protease inhibitors telapravir (see Fact Sheet 682) and boceprevir (see Fact Sheet 683) are no longer recommended.

There are different strains (or genotypes) of HCV. Treatment recommendations may be different for each strain. In patients with prior HCV treatment failure, different regimens are sometimes recommended.

NOTE: These are guidelines, not rules. Patients should receive individualized care from a health care provider with experience treating HCV infection. The full text of these guidelines is available on the Internet at www.hcvguidelines.org/sites/default/files/full_report.pdf


Who Should Be Tested?

HCV testing is recommended at least once for people born between 1945 and 1965 or those with HIV infection. It's also recommended for people who have ever injected drugs, had kidney dialysis, tattoo in an unregulated place, children born to HCV+ mothers. Annual testing is recommended for people who inject drugs or men who have sex with men who are HIV+.

A positive HCV antibody result should be followed by a HCV viral load test to see if there is current infection. If the viral load test is positive, a genetic test to determine the strain (or genotype) of HCV should be done to help decide on treatments. For more information about HCV laboratory tests, see Fact Sheet 671.


Reducing Disease Risk

People living with HCV should:


Genotype 1 Treatment

The guidelines recommend:

The following regimens are not recommended:


Genotype 2 Treatment

The guidelines recommend:

The following regimens are not recommended:


Genotype 3 Treatment

The guidelines recommend:

The following regimens are not recommended:


Genotype 4 Treatment

The guidelines recommend:

The following regimens are not recommended:


Genotype 5 or 6 Treatment

The guidelines recommend:

The following regimens are not recommended:


Laboratory Monitoring

Recommendations for the of monitoring people who are on or have completed therapy is coming soon.


Unique Patient Populations

Recommendations for treating people with acute, or recent HCV infection are coming soon.




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