Hepatitis C — SCE Infectious Diseases MCQ

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ModerateHepatitisHepatitis CSCE Infectious Diseases

A 35-year-old man with HIV (CD4 380 cells/µL, viral load <50 copies/mL on ART) attends for routine blood tests. His anti-HCV antibody is positive and HCV RNA is 45,000 IU/mL. Genotype is 1a. FibroScan shows 6.2 kPa (F1). He has no contraindications to treatment. What is the most appropriate HCV treatment?

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Correct answer: B — Glecaprevir/Pibrentasvir for 8 weeks

For treatment-naive patients with HCV genotype 1a without cirrhosis, Glecaprevir/Pibrentasvir for 8 weeks is one of the recommended pangenotypic regimens. It has minimal drug interactions with common ART agents (check with Dolutegravir-based regimens where interactions are not significant). Sofosbuvir/Velpatasvir for 12 weeks is also acceptable. Interferon-based therapy is obsolete. The key advantage of Glecaprevir/Pibrentasvir here is the shorter 8-week duration for non-cirrhotic patients.

Reference: NICE TA587 2019 – Glecaprevir/Pibrentasvir for HCV; BHIVA 2024 – Hepatitis C/HIV co-infection