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HCV Reinfection — SCE Infectious Diseases MCQ

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ModerateHepatitisHCV ReinfectionSCE Infectious Diseases

A 45-year-old man with chronic hepatitis C (genotype 1a) completed DAA therapy and achieved SVR12. He is now re-exposed to HCV through ongoing IVDU and develops a new HCV genotype 3a infection. What is the recommended retreatment approach?

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Correct answer: E — Retreatment with a pangenotypic DAA regimen (e.g. Sofosbuvir/Velpatasvir or Glecaprevir/Pibrentasvir) — DAA retreatment for reinfection is highly effective

HCV reinfection after SVR12 responds well to retreatment with DAAs. The retreatment regimen is chosen based on the new genotype, presence of cirrhosis, and prior DAA exposure. For reinfection with a different genotype (GT3a in this case), a pangenotypic regimen such as Sofosbuvir/Velpatasvir for 12 weeks is appropriate. Addressing ongoing risk factors (harm reduction, needle exchange, OST) is crucial to prevent further reinfection. There is no limit to the number of times DAA treatment can be given.

Reference: EASL 2024 – HCV guidelines; NICE 2024 – HCV treatment