Recommended and alternative regimens listed by pangenotypic, evidence level and alphabetically for:Treatment-Naive and Non-DAA-Experienced Kidney Transplant Patients With Genotype 1-6 Infection, With or Without Compensated Cirrhosisa |
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RECOMMENDED | DURATION | RATING |
Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)b | 12 weeks |
I, Ac IIa, Cd |
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg) | 12 weeks | IIa, C |
Genotype 1, 4, 5, or 6 only: Daily fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg) | 12 weeks | I, A |
ALTERNATIVE | DURATION | RATING |
Genotype 1 or 4 only: Daily fixed-dose combination of elbasvir (50 mg)/ grazoprevir (100 mg) for patients without baseline NS5A RASse for elbasvir | 12 weeks | I, B |
a For decompensated cirrhosis, please refer to the appropriate section. b Dosing is 3 coformulated tablets (glecaprevir [100 mg]/pibrentasvir [40 mg]) taken once daily. Please refer to the prescribing information. c Based on evidence for patients without cirrhosis. d Based on evidence for patients with compensated cirrhosis. e Includes genotype 1a resistance-associated substitutions at amino acid positions 28, 30, 31, or 93 known to confer antiviral resistance. |
Recommended regimen for:DAA-Experienced Kidney Transplant Patients With Genotype 1-6 Infection, With or Without Compensated Cirrhosisa |
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RECOMMENDED | DURATION | RATING |
Daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg), with or without ribavirinb |
12 weeks | IIa, C |
a Excludes CTP class B and class C patients. For decompensated cirrhosis, please refer to the appropriate section. b For patients with cirrhosis and multiple negative baseline characteristic, consideration should be given to adding ribavirin. If renal dysfunction is present, a lower starting dose is recommended. Maximum ribavirin dose is 1000 mg/d for patients who weigh <75 kg and 1200 mg/d for those who weigh ≥75 kg. |
For additional information on treatment of DAA failures post transplant, treatment of decompensated cirrhosis following transplantation, treatment of transplant recipients from HCV-positive donors, and post-transplant drug-drug interactions, please see Patients Who Develop Recurrent HCV Infection Post Liver Transplantation.