26 Jun 2023 • With the development of highly effective direct-acting antivirals that are simple to administer and well-tolerated, the ability to eradicate chronic HCV globally is within reach. This updated version of a 2020 American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA) guideline provides clinicians with a simple evidence-based approach.

KEY POINTS

• To achieve global eradication, HCV screening should be performed in all adults (age, ≥18) and all pregnant people during each pregnancy. Subsequent linkage to treatment is emphasized.
• In most settings, the preferred treatment regimen is glecaprevir/pibentrasvir for 8 weeks or sofosbuvir/velpatasvir for 12 weeks. A notable update is that the glecaprevir/pibentrasvir regimen can be shortened from 12 weeks to 8 weeks in patients with compensated cirrhosis.
• The simplified HCV treatment algorithm now includes minimal monitoring, with no pretreatment genotyping or on-treatment lab monitoring or visits being necessary. In addition, the simplified algorithm can be applied to people living with HIV.
• Based on limited clinical data and expert consensus, interrupting HCV treatment for as long as 7 days is possible without affecting sustained virologic response.
• Updated retreatment recommendations are available specifically for people who do not respond to initial direct-acting antiviral regimens.
• The updated guidance continues to stress the importance of treating unique populations, including people who inject drugs, children and adolescents, incarcerated people, and solid-organ transplant recipients.

Source: Clinical Infectious Diseases | Click to download pdf