Updated Guidelines to 2016 by World Health Organization "WHO"

1. GUIDELINES FOR THE SCREENING AND
TREATMENT OF HCV.
Amr Flifel * Mostafa Hefnawy*
*Medical cadet of Armed Forces College Of Medicine.

3. Persons for Whom HCV Testing Is
Recommended
 It is recommended that HCV serology testing be offered to individuals who are part of a population with high HCV
seroprevalence or who have a history of HCV risk exposure/behaviour.

4. Screening
Nucleic acid testing for the detection of HCV RNA be
performed directly following a
positive HCV serological test to establish the
diagnosis of HCV infection, in addition to the
assessment for starting treatment for HCV infection.

5. Priority to receive treatment ?!

6. General treatment recommendations
 All patients should be assessed for antiviral treatment.
 DAA regimens be used for hepatitis C infection rather than regimens with pegylated
interferon/ribavirin.
 Boceprevir- or telaprevir NOT RECOMMENDED.
 Daclatasvir, ledipasvir and sofosbuvir can be prescribed to all patients.
 Paritaprevir, simeprevir and pegylated interferon can’t be prescribed to patients with
decompensated cirrhosis “Liver failure” .Specialized care + accurate degree of cirrhosis.
 Pegylated interferon with ribavirin is recommended for chronic HCV infection rather than
standard non-pegylated interferon with ribavirin
 Pegylated interferon with ribavirin is still the only recommended medicine for children and
adolescents and, as an alternative regimen, for certain genotypes.
 HCV genotypes 5 and 6 infection and genotype 3 infection with cirrhosis, an interferon-
based regimen – sofosbuvir/pegylated interferon/ribavirin – is still recommended as an
alternative treatment option.

7. Treatment Regimens

8. Treatment for people without cirrhosis

9. Treatment for people with cirrhosis

10. Treatment Duration

11. Alternative
 If genotype 1a-infected patient is positive for the Q80K variant, a simeprevir/sofosbuvir
regimen should not be chosen.
 Without cirrhosis For genotype 1a :ombitasvir/paritaprevir/ritonavir/dasabuvir and
ribavirin for 12 weeks
 genotype 1b : ombitasvir/paritaprevir/ritonavir/dasabuvir for 12 weeks.
 With cirrhosis For genotype 1a : ombitasvir/paritaprevir/ritonavir/dasabuvir and
ribavirin for 24 weeks;
 genotype 1b :ombitasvir/paritaprevir/ritonavir/dasabuvir and ribavirin for 12 weeks.
 Treatment may be shortened to 8 weeks in treatment-naive persons without cirrhosis if
their baseline HCV RNA level is below 6 million IU/mL.
 If platelet count <75 x 103 /µL, then 24 weeks’ treatment with ribavirin should be given.

12. Contraindication DDA

13. Contraindication Ribavirin

14. Contraindication pegylated interferon

15. THANK YOU VERY MUCH INDEED 