🟢 Hepatitis C Antiviral Treatment (DAA)
This tool gives the HCV direct-acting-antiviral regimen direction by cirrhosis status and pregnancy, with pre-treatment assessment and the SVR12 endpoint.
Clinical takeaway
Protease-inhibitor regimens are contraindicated in decompensated cirrhosis, which is managed by hepatology with SOF/VEL + ribavirin. (original synthesis · not guideline verbatim)
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When to use
Use to choose a pangenotypic regimen in non-cirrhotic/compensated disease, a specialist SOF/VEL + RBV regimen in decompensation, and to defer therapy in pregnancy.
How it works
No cirrhosis/compensated → SOF/VEL 12 weeks or GLE/PIB 8 weeks. Decompensated → protease inhibitors contraindicated, SOF/VEL + RBV 12 weeks. Pregnant → defer. Endpoint SVR12.
Key points
- Protease-inhibitor regimens are contraindicated in decompensated cirrhosis, which is managed by hepatology with SOF/VEL + ribavirin. (original synthesis · not guideline verbatim)
- Pre-treatment HBsAg screening prevents HBV reactivation during DAA therapy.
- Cirrhotic patients continue HCC surveillance even after achieving SVR.
References
- AASLD-IDSA. Recommendations for Testing, Managing, and Treating Hepatitis C.
- Chinese Society of Hepatology. Guideline for the prevention and treatment of hepatitis C (2022 version).
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Cirrhosis status | No cirrhosis |
|---|---|
| Pregnancy | Yes |
→DispositionDefer DAA in pregnancy
- Note：DAAs are not recommended in pregnancy; antiviral treatment can be given after delivery and the end of breastfeeding. Women of childbearing potential should be screened for pregnancy before treatment and avoid pregnancy during treatment
- Principle：All HCV RNA–positive individuals should receive antiviral treatment at an appropriate time, with the endpoint of SVR12
- Basis：Guideline for the Prevention and Treatment of Hepatitis C (2022 edition)
| Cirrhosis status | Decompensated cirrhosis (Child B/C or prior decompensation) |
|---|---|
| Pregnancy | No |
→Regimen directionSOF/VEL + RBV 12 weeks
- Indication：All HCV RNA–positive individuals should receive antiviral treatment (with very few exceptions of very short life expectancy)
- Recommended regimen：Decompensated: protease inhibitors (e.g. glecaprevir/pibrentasvir) contraindicated; use sofosbuvir/velpatasvir + ribavirin for 12 weeks (RBV contraindicated → no combination, extend to 24 weeks)
- Pre-treatment assessment：Liver disease severity (cirrhosis/decompensation), renal function, quantitative HCV RNA, HBsAg, comorbidities and drug-drug interactions; genotyping may be omitted with a pangenotypic regimen where local 3b prevalence < 5%
Frequently asked questions
- What is Hepatitis C Antiviral Treatment (DAA)?
- This tool gives the HCV direct-acting-antiviral regimen direction by cirrhosis status and pregnancy, with pre-treatment assessment and the SVR12 endpoint.
- How is Hepatitis C Antiviral Treatment (DAA) calculated? What is the core formula?
- No cirrhosis/compensated → SOF/VEL 12 weeks or GLE/PIB 8 weeks. Decompensated → protease inhibitors contraindicated, SOF/VEL + RBV 12 weeks. Pregnant → defer. Endpoint SVR12.
- When is Hepatitis C Antiviral Treatment (DAA) used?
- Use to choose a pangenotypic regimen in non-cirrhotic/compensated disease, a specialist SOF/VEL + RBV regimen in decompensation, and to defer therapy in pregnancy.
- What are the key clinical points for Hepatitis C Antiviral Treatment (DAA)?
- Protease-inhibitor regimens are contraindicated in decompensated cirrhosis, which is managed by hepatology with SOF/VEL + ribavirin. (original synthesis · not guideline verbatim) Pre-treatment HBsAg screening prevents HBV reactivation during DAA therapy. Cirrhotic patients continue HCC surveillance even after achieving SVR.
- What are the limits and cautions when using Hepatitis C Antiviral Treatment (DAA)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Hepatitis C Antiviral Treatment (DAA) calculated in practice? Can you show a worked example?
- Inputs: Cirrhosis status No cirrhosis, Pregnancy Yes → Result: Disposition Defer DAA in pregnancy（Note: DAAs are not recommended in pregnancy; antiviral treatment can be given after delivery and the end of breastfeeding. Women of childbearing potential should be screened for pregnancy before treatment and avoid pregnancy during treatment, Principle: All HCV RNA–positive individuals should receive antiviral treatment at an appropriate time, with the endpoint of SVR12, Basis: Guideline for the Prevention and Treatment of Hepatitis C (2022 edition)） Inputs: Cirrhosis status Decompensated cirrhosis (Child B/C or prior decompensation), Pregnancy No → Result: Regimen direction SOF/VEL + RBV 12 weeks（Indication: All HCV RNA–positive individuals should receive antiviral treatment (with very few exceptions of very short life expectancy), Recommended regimen: Decompensated: protease inhibitors (e.g. glecaprevir/pibrentasvir) contraindicated; use sofosbuvir/velpatasvir + ribavirin for 12 weeks (RBV contraindicated → no combination, extend to 24 weeks), Pre-treatment assessment: Liver disease severity (cirrhosis/decompensation), renal function, quantitative HCV RNA, HBsAg, comorbidities and drug-drug interactions; genotyping may be omitted with a pangenotypic regimen where local 3b prevalence < 5%）