A patient has confirmed genotype 1b chronic hepatitis C infection. Current first-line treatment per Indian guidelines is:
- A Pegylated interferon-alpha plus ribavirin for 48 weeks
- B Sofosbuvir 400 mg + ledipasvir 90 mg once daily for 12 weeks (pangenotypic DAA)
- C Ribavirin monotherapy 1000–1200 mg daily for 24 weeks
- D Sofosbuvir + velpatasvir 400/100 mg once daily for 12 weeks ✓
Explanation
Current WHO and Indian NTEP/NACP guidelines recommend pangenotypic direct-acting antiviral (DAA) regimens. Sofosbuvir/velpatasvir (SOF/VEL) is pangenotypic (effective for all genotypes 1–6) with sustained virological response rates >95% at 12 weeks and is the preferred first-line regimen. Sofosbuvir/ledipasvir has no activity against genotype 3, limiting its pangenotypic use. Interferon-based regimens are now obsolete due to toxicity and lower SVR. Ribavirin monotherapy is not effective against HCV. DAA therapy has revolutionised HCV cure rates with minimal side effects.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.