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Kim: 2017 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines of Chronic Hepatitis C: What's New?
Brief Summary of Practice Guideline

Korean J Gastroenterol 2018;71(6):315-318.

Published online: 4 October 2018

DOI: https://doi.org/10.4166/kjg.2018.71.6.315

2017 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines of Chronic Hepatitis C: What's New?

Kyung-Ah Kim

Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea

Correspondence to: Kyung-Ah Kim, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea. Tel: +82-31-910-7847, Fax: +82-31-910-7219, E-mail: kakim@paik.ac.kr

Received 31 May 2018       Revised 8 June 2018       Accepted 8 June 2018

Copyright © 2018 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

With the advent of highly effective direct-acting antiviral agents (DAA), the treatment of hepatitis C virus infections continues to change. The Korean Association for the Study of the Liver updated guidelines for the management of hepatitis C were revised in 2015 in accordance with the introduction of new DAA into practice and a results of domestic and overseas research in late 2017. More effective and convenient DAAs are also recommended for each genotype depending on the presence of cirrhosis and treatment experience. DAA treatment in patients with chronic kidney disease is feasible. The treatment guidelines for DAA failure are also presented. The guidelines need to be revised constantly as new drugs are developed and the results of clinical research and experience accumulate.

Keywords: Hepatitis C, Therapeutics, Direct-acting antiviral agents, Guideline

References

1. Korean Association for the Study for the Liver. KASL clinical practice guidelines: management of hepatitis C. Clin Mol Hepatol. 2016; 22:76–139.
2. Yeon JE. Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: comparison of guidelines from other continents, 2017 AASLD/IDSA and 2016 EASL. Clin Mol Hepatol. 2018 May 2. [Epub ahead of print].
crossref
3. Reddy KR, Bourlière M, Sulkowski M, et al. Ledipasvir and sofosbuvir in patients with genotype 1 hepatitis C virus infection and compensated cirrhosis: an integrated safety and efficacy analysis. Hepatology. 2015; 62:79–86.
crossref
4. Kowdley KV, Gordon SC, Reddy KR, et al. Ledipasvir and sofosbuvir for 8 or 12 weeks for chronic HCV without cirrhosis. N Engl J Med. 2014; 370:1879–1888.
crossref
5. Kwo P, Gane EJ, Peng CY, et al. Effectiveness of elbasvir and grazoprevir combination, with or without ribavirin, for treatmentexperienced patients with chronic hepatitis C infection. Gastroenterology. 2017; 152:164–175.e4.
crossref
6. Zeuzem S, Ghalib R, Reddy KR, et al. Grazoprevir-elbasvir combination therapy for treatmentnaive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection: a randomized trial. Ann Intern Med. 2015; 163:1–13.
7. Zeuzem S, Foster GR, Wang S, et al. Glecaprevir-pibrentasvir for 8 or 12 weeks in HCV genotype 1 or 3 infection. N Engl J Med. 2018; 378:354–369.
crossref
8. Asselah T, Kowdley KV, Zadeikis N, et al. Efficacy of glecaprevir/pibrentasvir for 8 or 12 weeks in patients with hepatitis C virus genotype 2, 4, 5, or 6 infection without cirrhosis. Clin Gastroenterol Hepatol. 2018; 16:417–426.
crossref
9. Feld JJ, Jacobson IM, Hézode C, et al. Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection. N Engl J Med. 2015; 373:2599–2607.
crossref
10. McCaughan GW, Thwaites PA, Roberts SK, et al. Sofosbuvir and daclatasvir therapy in patients with hepatitis C-related advanced decompensated liver disease (MELD ≥ 15). Aliment Pharmacol Ther. 2018; 47:401–411.
crossref

Table 1.
Treatment of HCV Genotype 1 Infection in Chronic Hepatitis or Compensated Cirrhosis
  Treatment naive PR experienced
  Chronic hepatitis Compensated cirrhosis Chronic hepatitis Compensated cirrhosis
  1b 1a 1b 1a 1b 1a 1b 1a
Ledipasvir/sofosbuvir 12 wk/8wk a 12 wk 12 wk 12 wk±R/24 wk 12 wk±R/24 wk
Elbasvir/grazoprevir 12 wk 12 wk 12 wk 12 wk 12 wk 12 wk 12wk 12 wk
    (16 wk+R b)   (16 wk+R b)   (16 wk+R b)   (16 wk+R b)
Ombitasvir/paritaprevir/ritonavir+dasabuvir 12 wk 12 wk+R 12 wk 24 wk+R 12 wk 12 wk+R 12 wk 24 wk+R
Daclatasvir+sofosbuvir 12 wk 12 wk+R/24 wk 12 wk 12 wk+R/24 wk
Daclatasvir+asunaprevir 24 wk   24 wk   24 wk   24 wk  
Glecaprevir/pibrentasvir 8 wk 12 wk 8 wk 12 wk
Sofosbuvir/velpatasvir 12 wk 12 wk 12 wk 12 wk

HCV, hepatitis C virus; PR, pegylated interferon alpha+ribavirin; wk, weeks; R, weight-based ribavirin; HIV, human immunodeficiency virus.

a Without liver cirrhosis, without HIV coinfection, and HCV RNA <6×106 IU/mL

b Presence of NS5A resistance-associated substitution.

Table 2.
Treatment of HCV Genotype 2 Infection in Chronic Hepatitis or Compensated Cirrhosis
  Treatment naive PR experienced
  Chronic hepatitis Compensated cirrhosis Chronic hepatitis Compensated cirrhosis
Sofosbuvir+R 12 wk 16 wk 12 wk 16–24 wk
Daclatasvir+sofosbuvir 12 wk 12 wk 12 wk 12 wk
Glecaprevir/pibrentasvir 8 wk 12 wk 8 wk 12 wk
Sofosbuvir/velpatasvir 12 wk 12 wk 12 wk 12 wk
PR 24 wk 24 wk − −

HCV, hepatitis c virus; R, weight-based ribavirin; wk, weeks; PR, pegylated interferon alpha+ribavirin 800 mg.

Table 3.
Treatment of Decompensated Cirrhosis
  Genotype 1, 4, 5, 6 Genotype 2, 3
Ledipasvir/sofosbuvir 12 wk+R a/24 wk  
Daclatasvir+sofosbuvir 12 wk+R a/24 wk 12 wk+R a/24 wk
Sofosbuvir/velpatasvir 12 wk+R/24 wk 12 wk+R/24 wk

wk, weeks; R, weight-based ribavirin.

a ribavirin started from 600 mg/day.

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