Hepatitis C genotype 3 is the predominant genotype in India. A treatment-naive patient with HCV genotype 3 and compensated cirrhosis is being evaluated. Which DAA regimen is recommended by current Indian guidelines?
- A Sofosbuvir + daclatasvir for 24 weeks with weight-based ribavirin ✓
- B Sofosbuvir + ledipasvir for 12 weeks
- C Glecaprevir/pibrentasvir for 8 weeks
- D Pegylated interferon + ribavirin for 48 weeks
Explanation
For HCV genotype 3 with cirrhosis, sofosbuvir (NS5B inhibitor) + daclatasvir (NS5A inhibitor) for 24 weeks combined with ribavirin achieves SVR12 rates of 86–89% per WHO 2018 guidelines and Indian National Guidelines. Ledipasvir has limited activity against genotype 3. Glecaprevir/pibrentasvir is pan-genotypic and highly active but is given for 12 weeks in non-cirrhotic genotype 3 and 16 weeks in cirrhotic patients per international guidelines; the Indian formulary includes sofosbuvir-daclatasvir as the primary public health option. Interferon-based regimens are now obsolete for most patients.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.