Era of direct acting anti-viral agents for the treatment of hepatitis C

Table 6 Genotype 2-6 infection - treatment-experienced

	First line therapy	Alternative regimen
Genotype 2 infection - treatment-experienced
Pegylated IFN/ribavirin-experienced without cirrhosis	Glecaprevir/Pibrentasvir (Mavyret) - 8 wk or Sofosbuvir/Velpatasvir (Epclusa) - 12 wk	Daclatasvir (Daklinza) plus Sofosbuvir (Sovaldi) - 12 wk
Pegylated IFN/ribavirin-experienced with compensated cirrhosis	Sofosbuvir/Velpatasvir (Epclusa) - 12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 12 wk	Daclatasvir (Daklinza) plus Sofosbuvir (Sovaldi) - 16 to 24 wk
Sofosbuvir plus ribavirin-experienced with or without compensated cirrhosis	Sofosbuvir/Velpatasvir (Epclusa) - 12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 12 wk
Genotype 3 infection - treatment-experienced
Pegylated IFN/ ribavirin-experienced without cirrhosis	Sofosbuvir/Velpatasvir (Epclusa) - 12 wk	Daclatasvir (Daklinza) plus Sofosbuvir (Sovaldi) - 12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 16 wk or Sofosbuvir/Velpatasvir/Voxilaprevir - 12 wk
Pegylated IFN/ ribavirin-experienced with compensated cirrhosis	Elbasvir/Grazoprevir (Zepatier) - 12 wk or Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) -12 wk	Sofosbuvir/Velpatasvir (Epclusa) plus weight-based ribavirin - 12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 16 wk
DAA-experienced including NS5A inhibitors with or without compensated cirrhosis	Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) - 12 wk or in case of NS5A inhibitor failure and cirrhosis - Vosevi plus weight-based Ribavirin - 12 wk
Genotype 4 infection - treatment-experienced
Pegylated IFN/ ribavirin-experienced without cirrhosis	Sofosbuvir/Velpatasvir (Epclusa) -12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 8 wk or Elbasvir/Grazoprevir (Zepatier) in virologic relapse - 12 wk or Ledipasvir/Sofosbuvir (Harvoni) - 12 wk	Ombitasvir 25 mg/Paritaprevir 150 mg/Ritonavir 100 mg plus weight based Ribavirin - 12 wk or Elbasvir/Grazoprevir (Zepatier) with weight-based Ribavirin (in case of prior on-treatment virologic failure) - 16 wk
Pegylated IFN/ ribavirin-experienced with compensated cirrhosis	Sofosbuvir/Velpatasvir (Epclusa) - 12 wk or Elbasvir/Grazoprevir (Zepatier) in virologic relapse - 12 wk or Glecaprevir/Pibrentasvir (Mavyret) - 12 wk	Ombitasvir 25 mg/Paritaprevir 150 mg/ Ritonavir 100 mg plus weight based Ribavirin - 12 wk or Elbasvir/Grazoprevir (Zepatier) with weight-based Ribavirin (in case of prior on-treatment virologic failure - 16 wk or Ledipasvir/Sofosbuvir (Harvoni) plus weight-based Ribavirin) - 12 wk
DAA-experienced including NS5A inhibitors with or without compensated cirrhosis	Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) - 12 wk
Genotype 5 or 6 infection - treatment-experienced (recommended regimen)
Pegylated IFN/ ribavirin-experienced with or without compensated cirrhosis	Glecaprevir/Pibrentasvir (Mavyret) - 8 wk for patients without cirrhosis and 12 wk for patients with compensated cirrhosis or Ledipasvir/Sofosbuvir (Harvoni) plus weight-based Ribavirin - 12 wk or Sofosbuvir/Velpatasvir (Epclusa) - 12 wk
DAA-experienced including NS5A inhibitors with or without compensated cirrhosis	Sofosbuvir/Velpatasvir/ Voxilaprevir (Vosevi) - 12 wk

IFN: Interferon; DAA: Direct acting anti-viral agent.