Considerations in HCV Treatment
- Before initiating antiviral therapy, clinicians should assess CrCl, HIV and HBV status, and the degree of fibrosis, among other factors. (A1)
- See the NYSDOH AI guideline Pretreatment Assessment in Adults With Chronic HCV Infection.
- Clinicians new to HCV treatment should consult a specialist in treatment of liver disease or viral hepatitis when treating patients who:
- Have severe renal impairment (CrCl <30 mL/min) and/or are undergoing hemodialysis. (A3)
- Require retreatment after treatment failure of any DAA regimen. (B3)
- Clinicians should prescribe RBV with caution for patients with a CrCl <50 mL/min. (A1)
- If prescribed, a reduced dose of 200 mg per day is required.
- Non-RBV-containing regimens can be prescribed without dose adjustments for patients with CrCl ≥30 mL/min.
Contraindications
- Clinicians should not prescribe RBV for treatment of the following patients:
- Female or male patients planning conception within 6 months of the last dose of RBV. (A2)
- Male patients who have pregnant partners. (A2)
