From:  Direct-acting antivirals and management of hepatitis C: updates on treatment guidelines

 Recommendations for treatment of HCV-infected treatment-experienced adults with or without compensated cirrhosis according to the EASL 2020 guidelines.

RegimenDurationFailed regimenComments
SOF/VEL/VOX ± weight-based RBV (1,000 or 1,200 mg in patients < 75 kg or ≥ 75 kg, respectively)12 weeks for up to 16–24 weeksProtease inhibitor and/or NS5A inhibitor-containing regimenFor patients without cirrhosis or with compensated cirrhosis
Addition of RBV and/or prolonging treatment in difficult-to-cure patients only*
SOF + G/P ± weight-based RBV
(1,000 or 1,200 mg in patients < 75 kg or ≥ 75 kg, respectively)		12 weeks for up to 16–24 weeksProtease inhibitor and/or NS5A inhibitor-containing regimenFor patients without cirrhosis or with compensated cirrhosis and who have predictors of lower response**
Addition of RBV and/or prolonging treatment in difficult-to-cure patients only*
G/P + weight-based RBV (1,000 or 1,200 mg in patients < 75 kg or ≥ 75 kg, respectively)24 weeksSOF/VEL/VOX
SOF/VEL + weight-based RBV (1,000 or 1,200 mg in patients < 75 kg or ≥ 75 kg, respectively)24 weeksProtease inhibitor and/or NS5A inhibitor-containing regimenFor patients with decompensated cirrhosis
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* Difficult-to-cure patients: patients with NS5A RASs who failed twice or more to achieve SVR after a combination regimen including a protease and/or an NS5A inhibitor; ** predictors of lower response: advanced liver disease, multiple courses of DAA-based treatment, complex NS5A RAS profile. SOF: sofosbuvir; VEL: velpatasvir; VOX: voxilaprevir; RBV: ribavirin; G/P: glecaprevir/pibrentasvir.