Genotype 1a Treatment-naïve Patients Without Cirrhosis
Per the IDSA guidelines, a fixed dose of Zepatier (50 mg of elbasvir/100 mg of grazoprevir) daily for 12 weeks is recommended for this population if NS5A resistance is absent. This recommendation was based on a study group that included subjects between the ages of 20-78 years old with HCV genotype 1 or 4 infections. Subjects either received Zepatier or placebo daily for 12 weeks. 92% of those with genotype 1 infection who received Zepatier were cured after 12 weeks.
A fixed dose of Zepatier (50 mg of elbasvir/100 mg of grazoprevir) daily, with weight-based ribavirin for 16 weeks may be used in patients who have baseline NS5A resistance to elbasvir. In a limited study, 6 out of 6 subjects who received this combination were cured.
A fixed dose of Harvoni (90 mg of ledipasvir/400 mg of sofosbuvir) daily for 12 weeks is recommended. A study demonstrated a cure rate of 98% in treatment-naïve patients without cirrhosis.
Viekira Pak plus dasabuvir plus ribavirin
A fixed dose of Viekira Pak (150 mg of paritaprevir/100 mg of ritonavir/25 mg of ombitasvir) daily plus dasabuvir 250 mg twice daily with weight-based ribavirin for 12 weeks is recommended. A clinical study demonstrated that Viekira Pak with the use of ribavirin for 12 weeks had significantly higher cure rates (97%) than using Viekira Pak alone (90%).
A fixed dose of Olysio (simeprevir) 150 mg plus Sovaldi (sofosbuvir) 400 mg daily for 12 weeks is recommended. A study demonstrated that 97% of subjects achieved a cure after receiving this combination for 12 weeks.
Daklinza plus Sovaldi
Another recommendation is 60 mg of Daklinza (daclatasvir) plus 400 mg of Sovaldi (sofosbuvir) daily for 12 weeks. In a phase III trial, the cure rate was 96%.
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