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Summary of Recommendations for Patients Who Develop Recurrent HCV Infection Post-Liver Transplantation
 

Recommended Regimens for Treatment-naïve and -Experienced Patients with HCV Genotype 1 or 4 Infection in the Allograft, Including Those with Compensated Cirrhosis
Recommended regimens are listed in groups by level of evidence, then alphabetically.

 

  • Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) with weight-based ribavirin for 12 weeks is a Recommended regimen for patients with HCV genotype 1 or 4 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class I, Level A

     
  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg) with low initial dose of ribavirin (600 mg, increased as tolerated) for 12 weeks is a Recommended regimen for patients with HCV genotype 1 or 4 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class I, Level B

     

Recommended Regimens for Treatment-naïve Patients with HCV Genotype 1 or 4 Infection in the Allograft and with Compensated Liver Disease, Who Are Ribavirin Ineligible
Recommended regimens are listed in groups by level of evidence, then alphabetically.

 

  • Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) for 24 weeks is a Recommended regimen for treatment-naïve patients with HCV genotype 1 or 4 infection in the allograft and with compensated liver disease, who are ribavirin ineligible.
    Rating: Class I, Level B

     
  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg) for 24 weeks is a Recommended regimen for patients with HCV genotype 1 or 4 infection in the allograft and with compensated liver disease, who are ribavirin ineligible.
    Rating: Class II, Level C

     

Recommended Regimen for Treatment-naïve and -Experienced Liver Transplant Recipients with Decompensated Cirrhosis (Child Turcotte Pugh [CTP] Class B or C) Who Have HCV Genotype 1 or 4 Infection in the Allograft
 

  • Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) with low initial dose of ribavirin (600 mg, increased as tolerated) for 12 weeks is a Recommended regimen for liver-transplant recipients with decompensated cirrhosis (CTP class B or C) who have HCV genotype 1 or 4 infection in the allograft.
    Rating: Class I, Level B

     

Alternative Regimens for Patients with HCV Genotype 1 Infection in the Allograft, Including Those with Compensated Cirrhosis
 

  • Daily simeprevir (150 mg) plus sofosbuvir (400 mg) with or without weight-based ribavirin for 12 weeks is an Alternative regimen for patients with HCV genotype 1 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class I, Level B

     

Alternative Regimens for Patients with HCV Genotype 1 Infection in the Allograft, Including Those with Early-stage Fibrosis (Metavir Stage F0-F2)
 

  • Daily fixed-dose combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) plus twice-daily dosed dasabuvir (250 mg) with weight-based ribavirin for 24 weeks is an Alternative regimen for patients with HCV genotype 1 infection in the allograft, who have early-stage fibrosis (Metavir stage F0-F2).
    Rating: Class I, Level B

     

Recommended Regimens for Treatment-naïve and -Experienced Patients with HCV Genotype 2 Infection in the Allograft, Including Those with Compensated Cirrhosis
Recommended regimens are listed in groups by level of evidence, then alphabetically.

 

  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg), with low initial dose of ribavirin (600 mg, increased as tolerated) for 12 weeks is a Recommended regimen for patients with HCV genotype 2 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class II, Level A

     
  • Daily sofosbuvir (400 mg) and weight-based ribavirin for 24 weeks is a Recommended regimen for patients with HCV genotype 2 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class II, Level C

     

Recommended Regimen for Treatment-naïve and -Experienced Patients with HCV Genotype 2 Infection in the Allograft, Including Those with Compensated Cirrhosis, Who Are Ribavirin Ineligible
 

  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg) for 24 weeks is a Recommended regimen for patients with HCV genotype 2 infection in the allograft, including those with with compensated cirrhosis, who are ribavirin ineligible.
    Rating: Class II, Level C

     

Recommended Regimen for Treatment-naïve and -Experienced Liver-Transplant Recipients with Decompensated Cirrhosis (Child Turcotte Pugh [CTP] Class B or C) Who Have HCV Genotype 2 Infection in the Allograft
 

  • Daily sofosbuvir (400 mg) and ribavirin (initial dose 600 mg/day, increased monthly by 200 mg/day as tolerated to weight-based dose) for 24 weeks is a Recommended regimen for liver-transplant recipients with decompensated cirrhosis (CTP class B or C) who have HCV genotype 2 infection in the allograft.
    Rating: Class II, Level C

     

Recommended Regimen for Treatment-naïve and -Experienced Patients with HCV Genotype 3 Infection in the Allograft, Including Those with Compensated Cirrhosis
 

  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg) with low initial dose of ribavirin (600 mg, increased as tolerated) for 12 weeks is a Recommended regimen for patients with HCV genotype 3 infection in the allograft, including those with compensated cirrhosis.
    Rating: Class II, Level A

     

Recommended Regimen for Treatment-naïve and -Experienced Patients with HCV Genotype 3 Infection in the Allograft, Including Those with Compensated Cirrhosis, Who Are Ribavirin Ineligible
 

  • Daily daclatasvir (60 mg) plus sofosbuvir (400 mg) for 24 weeks is a Recommended regimen for patients with HCV genotype 3 infection in the allograft, including those with compensated cirrhosis, who are ribavirin ineligible.
    Rating: Class II, Level C

Changes made July 6, 2016.