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Jung: Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? – Treatment of Chronic Hepatitis C Genotype 2 and 3
Review Article

Korean J Gastroenterol 2016;67(3):132-136.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.67.3.132

Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? – Treatment of Chronic Hepatitis C Genotype 2 and 3

Young Kul Jung

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea

Correspondence to: Young Kul Jung, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea. Tel: +82-31-412-7623, Fax: +82-31-412-5582, E-mail: 93cool@hanmail.net

Copyright © 2016 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/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ever since direct-acting antiviral agents (DAA) have been approved and released into the world, numerous studies on the efficacy, adverse effects and drug-drug interactions of interferon-free DAA combination therapy have been studied and published. With all oral DAA therapy showing sustained virological response rate of 80–90% with minimal adverse events, HCV eradication has now become a realistic goal. DAA combination treatments were approved and adapted to practice in Korea in 2015, and Korean Association for the Study of the Liver (KASL) has revised the guideline based on the systematic approach that reflects evidence-based medicine and expert opinions. In this article, new recommendations for treatment of chronic HCV genotype 2 and 3 infected patients will be introduced base on KASL practice guidelines for management of hepatitis C that has been updated in 2015.

Keywords: Antiviral agents, Evidence-based medicine, Genotype, Chronic hepatitis C

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Fig. 1.
Sustained virological response (SVR) of naïve treatment for chronic HCV genotype 2 infected patients. PR, peginterferon alfa-2a (180 μg subcutaneous/week) or peginterferon alfa-2b (1.5 μg subcutaneous/kg/week) and ribavirin; SOF, sofosbuvir 400 mg daily; R, ribavirin (weight-based dose [1,000 mg daily if <75 kg; 1,200 mg daily if ≥75 kg]); DAC, daclatasvir 60 mg daily.
kjg-67-132f1.tif
Fig. 2.
Sustained virological response (SVR) of naïve treatment for chronic HCV genotype 3 infected patients. PR, peginterferon alfa-2a (180 μg subcutaneous/week) or peginterferon alfa-2b (1.5 μg subcutaneous/kg/week) and ribavirin; SOF, sofosbuvir 400 mg daily; R, ribavirin (weight-based dose [1,000 mg daily if <75 kg; 1,200 mg daily if ≥75 kg]); DAC, daclatasvir 60 mg daily.
kjg-67-132f2.tif
Table 1.
Recommendations for Treatment of Chronic HCV Genotype 2 Infected Patients
Type Recommendation (primary) Alternative
Treatmentnaive
 Non-cirrhosis SOF/R (12 wk) DAC/SOF (12 wk)
 Cirrhosis SOF/R (16 wk) PR (24 wk)
PR Treatment-experienced
 Non-cirrhosis SOF/R (12 wk) DAC/SOF (12 wk)
 Cirrhosis SOF/R (16–24 wk) SOF/PR (12 wk)

This table is adapted from 2015 clinical practice guidelines: management of hepatitis C by Korean Association for the Study of the Liver.

SOF, sofosbuvir 400 mg daily; R, ribavirin (weight-based dose [1,000 mg daily if <75 kg; 1,200 mg daily if ≥75 kg]); DAC, daclatasvir 60 mg daily; PR, peginterferon alfa-2a (180 μ g subcutaneous/ week) or peginterferon alfa-2b (1.5 μ g subcutaneous/kg/week) and ribavirin.

Table 2.
Recommendations for Treatment of Chronic HCV Genotype 3 Infected Patients
Type Recommendation (primary) Alternative
Treatmentnaive
 Non-cirrhosis DAC/SOF (12 wk) SOF/R (24 wk)
 Cirrhosis DAC/SOF±R (24 wk) SOF/PR (12 wk)
    PR (24 wk)
PR Treatment-experienced
 Non-cirrhosis DAC/SOF (12 wk) SOF/R (24 wk, non-cirrhosis only)
 Cirrhosis DAC/SOF±R (24 wk) SOF/PR (12 wk)

This table is adapted from 2015 clinical practice guidelines: management of hepatitis C by Korean Association for the Study of the Liver.

DAC, daclatasvir 60 mg daily; SOF, sofosbuvir 400 mg daily; R, ribavirin (weight-based dose [1,000 mg daily if <75 kg; 1,200 mg daily if 75 kg]); PR, peginterferon alfa-2a (180 μ g subcutaneous/ week) or peginterferon alfa-2b (1.5 μ g subcutaneous/kg/week) and ribavirin.

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