{"id":1054,"date":"2024-11-01T12:00:16","date_gmt":"2024-11-01T12:00:16","guid":{"rendered":"http:\/\/localhost.localdomain\/wpmu\/guides\/?page_id=1054"},"modified":"2025-01-20T15:49:17","modified_gmt":"2025-01-20T15:49:17","slug":"current-daa-combinations","status":"publish","type":"page","link":"https:\/\/i-base.info\/guides\/hepc\/current-daa-combinations","title":{"rendered":"Current DAA combinations"},"content":{"rendered":"

Current single DAAs and fixed dose combination (FDC) tablets are listed in Table 2 below.<\/strong><\/p>\n

Table 2. DAAs, genotypes and NICE comments (2024) *
\n<\/b><\/p>\n\n\n\n\n\n\n\n\n
Regimen and drug classes<\/b><\/td>\nGenotypes\u00a0<\/span><\/b><\/td>\nDuration<\/b><\/td>\nContraindications and ART interactions<\/b><\/td>\n<\/tr>\n
Elbasvir\/grazoprevir\n

(NS5A inhibitor\/protease inhibitor)<\/p><\/td>\n

G1 & 4<\/td>\n8 weeks (no cirrhosis)\u00a0<\/span>\n

12 weeks (compensated cirrhosis).\u00a0<\/span><\/p><\/td>\n

People with decompensated cirrhosis (CPT class B and C).\u00a0<\/span>\n

Cannot be used with HIV protease inhibitors, efavirenz, nevirapine and etravirine, fostemsavir, elvitegatvir\/c.<\/p><\/td>\n<\/tr>\n

Sofosbuvir\/ledipasvir (NS5B inhibitor\/NS5A inhibitor), with or without ribavirin (RBV*)\u00a0<\/span><\/td>\nG1,4,5 & 6<\/td>\n8-12 weeks (no cirrhosis) & 12 weeks with RBV for G5 & G6, and for compensated and decompensated cirrhosis).\u00a0<\/span><\/td>\n* See: cautions and side effects with RBV.\n

Interactions with lopinavir\/r; monitor renal function if used with tenofovir.<\/p><\/td>\n<\/tr>\n

Glecaprevir\/pibrentasvir\n

(NS5A inhibitor\/protease inhibitor)<\/p><\/td>\n

All<\/td>\n8 weeks (no cirrhosis)\n

or<\/p>\n

8-12 weeks (compensated cirrhosis).<\/p><\/td>\n

People with decompensated cirrhosis (CPT class B and C).\n

Cannot be used with HIV protease inhibitors, efavirenz, nevirapine and etravirine.<\/p><\/td>\n<\/tr>\n

Sofosbuvir\/velpatasvir\u00a0<\/span>\n

(NS5B inhibitor\/NS5A inhibitor), with or without ribavirin (RBV*)\u00a0<\/span><\/p><\/td>\n

All<\/td>\n12 weeks (no cirrhosis and compensated cirrhosis); 12 weeks plus RBV (for G3 and compensated\u00a0 <\/span>and all genotypes with decompensated cirrhosis).<\/td>\n* See: cautions and side effects with RBV.\u00a0<\/span>\n

Interactions with efavirenz, etravirine\u00a0 <\/span>nevirapine; \u00a0 <\/span>monitor renal function if used with tenofovir<\/p><\/td>\n<\/tr>\n

Sofosbuvir\/velpatasvir\/voxilaprevir\u00a0<\/span>\n

(NS5B + NS5A + protease inhibitor)<\/p><\/td>\n

All<\/td>\n12 weeks.<\/td>\nPeople with decompendated cirrhosis.\n

Interactions with boosted atazanivir, boosted darunavir lopinavir\/r, fostemsavir, monitor renal function if used with tenofovir<\/p><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

* Ribavirin (RBV) can cause anemia (low red blood cell count), nausea, diarrhea, rash, fatigue, headache, itching, insomnia irratibility, deoression and suicidial thoughts; it cannot be used by people with sickle cell disease, thalassemia, or serious heart disease. RBV causes birth defects and should not be used by any partner planning a pregnancy during treatment and for 6 months after.<\/p>\n

Source: EACS Guidelines, V 12.1 2024.
\nwww.eacsociety.org\/guidelines\/eacs-guidelines<\/a><\/p>\n

For interactions between DAAs and other medicines:
\nhep-druginteractions.org\/checker<\/a><\/p>\n

<\/h2>\n

Introduction to DAAs<\/h2>\n

DAA stands for direct-acting antivirals. These drugs target HCV.<\/p>\n

DAAs cure more than 95% of people, usually from one or two pills a day for 12 weeks (but sometimes for longer).<\/p>\n

So in an ideal world, the next step after finding out you have HCV should just be a short course of treatment. No extra monitoring or testing, just treatment and cure.<\/p>\n

However, the high prices charged for DAAs means that access to treatment is limited for most people globally, including some people in the UK.<\/p>\n

How well does treatment work?<\/h2>\n

The high cure rates (more than 95%) shows that DAAs are effective enough to treat nearly everyone.<\/p>\n

Even in people with cirrhosis, although cure rates are lower, they are still around 80%.<\/p>\n

Different DAA classes<\/h2>\n

As with HIV drugs, each class of DAA works at a different stage of the HCV life cycle.<\/p>\n

These classes are:<\/p>\n