Editing Hepatitis C (section)

====No prior treatment====
* HCV genotype 1a (no cirrhosis): 8 weeks of [[glecaprevir/pibrentasvir]] or [[ledipasvir/sofosbuvir]] (the latter for people who do not have [[HIV/AIDS]], are not [[African-American]], and have less than 6 million HCV viral copies per milliliter of blood) or 12 weeks of [[elbasvir/grazoprevir]], ledipasvir/sofosbuvir, or [[sofosbuvir/velpatasvir]].<ref name="HCVGuidelinesGenotype1a">{{cite book | title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 1a Without Cirrhosis | chapter-url=https://www.hcvguidelines.org/treatment-naive/gt1a/no-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref> [[Sofosbuvir]] with either [[daclatasvir]] or [[simeprevir]] may also be used.<ref name=IDSA2017>{{cite web | title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C |url=http://hcvguidelines.org/sites/default/files/full-guidance-pdf/HCVGuidance_April_12_2017_b.pdf|access-date=28 July 2017|date=12 April 2017|url-status=dead|archive-url=https://web.archive.org/web/20170710035751/http://hcvguidelines.org/sites/default/files/full-guidance-pdf/HCVGuidance_April_12_2017_b.pdf|archive-date=2017-07-10}}</ref>
* HCV genotype 1a (with compensated [[cirrhosis]]): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of elbasvir/grazoprevir, ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. An alternative treatment regimen of elbasvir/grazoprevir with weight-based ribavirin for 16 weeks can be used if the HCV is found to have antiviral resistance mutations against NS5A protease inhibitors.<ref name="HCVGuidelinesGenotype1acompensated">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C| chapter = Treatment: Naive Genotype 1a With Compensated Cirrhosis | chapter-url= https://www.hcvguidelines.org/treatment-naive/gt1a/compensated-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 1b (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or ledipasvir/sofosbuvir (with the aforementioned limitations for the latter as above) or 12 weeks of elbasvir/grazoprevir, ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. Alternative regimens include 12 weeks of [[ombitasvir/paritaprevir/ritonavir]] with [[dasabuvir]] or 12 weeks of [[sofosbuvir]] with either [[daclatasvir]] or [[simeprevir]].<ref name="HCVGuidelinesGenotype1b">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 1b Without Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt1b/no-cirrhosis | via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 1b (with compensated cirrhosis): 8 weeks of [[Glecaprevir/pibrentasvir|glecaprevir]]/pibrentasvir or 12 weeks of [[elbasvir/grazoprevir]], ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. A 12-week course of paritaprevir/ritonavir/ombitasvir with dasabuvir may also be used.<ref name="HCVGuidelinesGenotype1bcompensated">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 1b With Compensated Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt1b/compensated-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 2 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir. Alternatively, 12 weeks of sofosbuvir/daclatasvir can be used.<ref name="HCVGuidelinesGenotype2">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment; Naive Genotype 2 Without Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt2/no-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 2 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/[[velpatasvir]]. An alternative regimen of sofosbuvir/daclatasvir can be used for 16–24 weeks.<ref name="HCVGuidelinesGenotype2compensated">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment – Naive Genotype 2 With Compensated Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt2/compensated-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 3 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir or sofosbuvir and daclatasvir.<ref name="HCVGuidelinesGenotype3">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C |chapter = Treatment: Naive Genotype 3 Without Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt3/no-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 3 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, or if certain antiviral mutations are present 12 weeks of sofosbuvir/velpatasvir/[[voxilaprevir]] (when certain antiviral mutations are present), or 24 weeks of sofosbuvir and daclatasvir.<ref name="HCVGuidelinesGenotype3compensated">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 3 With Compensated Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt3/compensated-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 4 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, elbasvir/grazoprevir, or ledipasvir/sofosbuvir. A 12-week [[ombitasvir/paritaprevir/ritonavir]] regimen is also acceptable in combination with weight-based [[ribavirin]].<ref name="HCVGuidelinesGenotype4">{{cite book|title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 4 Without Cirrhosis| chapter-url = https://www.hcvguidelines.org/treatment-naive/gt4/no-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 4 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, elbasvir/grazoprevir, or ledipasvir/sofosbuvir is recommended. A 12-week course of ombitasvir/paritaprevir/ritonavir with weight-based [[ribavirin]] is an acceptable alternative.<ref name="HCVGuidelinesGenotype4compensated">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 4 With Compensated Cirrhosis| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt4/compensated-cirrhosis| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>
* HCV genotype 5 or 6 (with or without compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir is recommended. If cirrhosis is present, then a 12-week course of sofosbuvir/velpatasvir, or [[ledipasvir/sofosbuvir]] is an alternative option.<ref name="HCVGuidelinesGenotypes5and6">{{cite book |title=HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C | chapter = Treatment: Naive Genotype 5 or 6| chapter-url=https://www.hcvguidelines.org/treatment-naive/gt5-6| via = www.hcvguidelines.org|publisher=American Association for the Study of Liver Diseases|access-date=26 April 2017}}</ref>

More than 95% of people with chronic infection can be cured when treated with medications;<ref name=CDC2019>{{cite web |title=Hepatitis C Questions and Answers for Health Professionals |url=https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm |website=www.cdc.gov |access-date=23 July 2019 |language=en-us |date=2 July 2019}}</ref><!-- Quote = Over 90% of HCV-infected persons can be cured of HCV infection regardless of HCV genotype, with 8-12 weeks of oral therapy --> this could be expensive, but by 2022 prices had dropped dramatically.<ref name=whofactsheet/> The combination of [[Sofosbuvir/velpatasvir/voxilaprevir|sofosbuvir, velpatasvir, and voxilaprevir]] may be used in those who have previously been treated with sofosbuvir or other drugs that inhibit [[Hepatitis C virus nonstructural protein 5A|NS5A]] and were not cured.<ref>{{cite press release | title=FDA approves Vosevi for Hepatitis C|url=https://www.fda.gov/news-events/press-announcements/fda-approves-vosevi-hepatitis-c |website=U.S. [[Food and Drug Administration]] (FDA) |access-date=27 July 2017|date=18 July 2017|url-status=live|archive-url=https://web.archive.org/web/20170723062106/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm567467.htm|archive-date=23 July 2017}}</ref>

Before 2011, treatments consisted of a combination of [[pegylated interferon]] alpha and [[ribavirin]] for a period of 24 or 48 weeks, depending on HCV [[genotype]].<ref name=AFP2010 /> This treatment produces cure rates of 70–80% for genotype 2 and 3, respectively, and 45–70% for genotypes 1 and 4.<ref name=NEJM2013>{{cite journal | vauthors = Liang TJ, Ghany MG | title = Current and future therapies for hepatitis C virus infection | journal = The New England Journal of Medicine | volume = 368 | issue = 20 | pages = 1907–17 | date = May 2013 | pmid = 23675659 | pmc = 3893124 | doi = 10.1056/NEJMra1213651 }}</ref> Adverse effects with these treatments were common, with 50–60% of those being treated experiencing [[Influenza-like illness|flu-like symptoms]] and nearly a third experiencing depression or other emotional issues.<ref name=AFP2010 /> Treatment during the first six months of infection (the acute stage) is more effective than when {{nowrap|hepatitis C}} has entered the chronic stage.<ref name=Tah2009 /> In those with chronic hepatitis B, treatment for hepatitis C results in reactivation of hepatitis B about 25% of the time.<ref name="Mücke2018">{{cite journal | vauthors = Mücke MM, Backus LI, Mücke VT, Coppola N, Preda CM, Yeh ML, Tang LS, Belperio PS, Wilson EM, Yu ML, Zeuzem S, Herrmann E, Vermehren J | display-authors = 6 | title = Hepatitis B virus reactivation during direct-acting antiviral therapy for hepatitis C: a systematic review and meta-analysis | journal = The Lancet. Gastroenterology & Hepatology | volume = 3 | issue = 3 | pages = 172–180 | date = March 2018 | pmid = 29371017 | doi = 10.1016/S2468-1253(18)30002-5 }}</ref>