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Recommendations of the CADTH for Treating Chronic Viral Hepatitis Genotype 1 with Direct-Acting Agents

Description

Current therapy of chronic viral hepatitis C is highly dynamic, with multiple regimens involving direct-acting agents (DAA). Therapeutic regimens vary based on viral genotype and disease severity. Therapy is best directed by a physician who are experienced in treating viral hepatitis.


Patient selection: chronic hepatitis C virus, genotype 1

 

Direct-acting agents (DAA) include:

(1) sofosbuvir (SOF)

(2) ledipasvir (LDV)

(3) paritaprevir (PAR)

(4) ritonavir (RIT)

(5) ombitasvir (OMB)

(6) dasabuvir (DAS)

 

Parameters:

(1) "experience" with pegylated interferon (PI) plus ribavirin (RBV) therapy (treatment naive)

 

Regimens:

(1) ledipasvir and sofosbuvir

(2) paritaprevir/ritonavir + ombitasvir + dasabuvir +/- ribavirin

 

where:

• Ribavirin is not needed for the second regimen if genotype 1b without cirrhosis.

• Usual duration of therapy is 12 weeks.

• Therapy for 24 weeks with the second regimen is recommended for genotype 1a AND cirrhosis AND null response to interferon plus ribavirin.

• Regimen 1 is recommended if previously treated with a protease inhibitor, interferon and ribavirin regimen.


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