The goal of hepatitis C treatment is to cure the virus, which can be done with a combination of drugs. The specific meds used and the duration of treatment depend on a number of factors, including HCV genotype (genetic structure of the virus), past treatment experience, degree of liver damage, ability to tolerate the prescribed treatment, and whether the person is waiting for a liver transplant or is a transplant recipient. In some cases, hep C treatment may be limited by your health insurance plan or drug formulary.

There are a number of approved therapies to treat hepatitis C, such as Harvoni, Daklinza, Olysio, Sovaldi, Technivie, Viekira Pak and Zepatier. Some drugs, such as Harvoni are a combination of drugs formulated in to one daily pill. Some drugs may be prescribed together with or without ribavirin. In rare cases, peginterferon is also prescribed, but has largely been replaced by newer treatments. 

When hepatitis C treatment is working, the virus usually becomes undetectable within four to 12 weeks and remains that way throughout treatment. People are considered cured when they have achieved what is known as a sustained virologic response (SVR), or continuation of this undetectable status, 12 to 24 weeks after completing therapy.

Here are the recommendations for HCV treatment for all genotypes from the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA)

AASLD HCV Treatment Recommendations for Treatment-Naive People without Decompensated Cirrhosis (Child-Pugh B or C) or Certain Co-existing Medical Conditions, such as Kidney Disease or HCV Recurrence Post-Liver Transplant:


Genotype 1a

no cirrhosis

Recommended*
  • Daklinza + Sovaldi for 12 weeks
  • Harvoni for 12 weeks
  • Olysio + Sovaldi for 12 weeks
  • Viekira Pak + ribavirin for 12 weeks
  • Zepatier for 12 weeks (without baseline NS5A RAVs1)
Alternative
  • Zepatier + ribavirin for 16 weeks (with baseline NS5A RAVs1)

Genotype 1a

compensated cirrhosis

Recommended*
  • Harvoni for 12 weeks
  • Zepatier for 12 weeks (without baseline NS5A RAVs1)
Alternative
  • Daklinza + Sovaldi with/without ribavirin for 24 weeks
  • Olysio + Sovaldi with/without ribavirin for 24 weeks
  • Viekira Pak + ribavirin for 24 weeks
  • Zepatier + ribavirin for 16 weeks (with baseline NS5A RAVs1)

Genotype 1b

no cirrhosis

Recommended*
  • Daklinza + Sovaldi for 12 weeks
  • Harvoni for 12 weeks
  • Olysio + Sovaldi for 12 weeks
  • Viekira Pak for 12 weeks
  • Zepatier for 12 weeks
Alternativen/a

Genotype 1b

compensated cirrhosis

Recommended*
  • Harvoni for 12 weeks
  • Viekira Pak for 12 weeks
  • Zepatier for 12 weeks
Alternative
  • Daklinza + Sovaldi with/without ribavirin for 24 weeks
  • Olysio + Sovaldi with/without ribavirin for 24 weeks

Genotype 2

no cirrhosis

Recommended*
  • Daklinza + Sovaldi for 12 weeks if ribavirin-intolerant
  • Sovaldi + ribavirin for 12 weeks
Alternativen/a

Geontype 2

compensated cirrosis

Recommended*
  • Daklinza + Sovaldi for 16 to 24 weeks if ribavirin-intolerant
  • Sovaldi + ribavirin for 16 to 24 weeks
Alternativen/a

Genotype 3

no cirrhosis

Recommended*
  • Daklinza + Sovaldi for 12 weeks
  • Sovaldi + ribavirin + PEG2 for 12 weeks
Alternative
  • Sovaldi + ribavirin for 24 weeks if ineligible for Daklinza or PEG2

Geontype 3

compensated cirrosis

Recommended*
  • Daklinza + Sovaldi for 12 weeks with/without ribavirin for 24 weeks
  • Sovaldi + ribavirin + PEG2 for 12 weeks
Alternative
  • Sovaldi + ribavirin for 24 weeks if ineligible for Daklinza or PEG2

Genotype 4

no cirrhosis

Recommended*
  • Harvoni for 12 weeks
  • Technivie + ribavirin for 12 weeks
  • Zepatier for 12 weeks
Alternative
  • Sovaldi + ribavirin + PEG2 for 12 weeks

Geontype 4

compensated cirrosis

Recommended*
  • Harvoni for 12 weeks
  • Technivie + ribarivin for 12 weeks
  • Zepatier for 12 weeks
Alternative
  • Sovaldi + ribavirin + PEG2 for 12 weeks

Genotype 5

with/without

compensated cirrhosis

Recommended*
  • Harvoni for 12 weeks
Alternative
  • Sovaldi + ribavirin + PEG2 for 12 weeks

Genotype 6

with/without

compensated cirrhosis

Recommended*
  • Harvoni for 12 weeks
Alternative
  • Sovaldi + ribavirin + PEG2 for 12 weeks


* When more than one treatment is recommended, they are listed alphabetically

RAVs = resistance-associated variants 
PEG = peginterferon


For those needing information about medication for advanced liver disease, visit HCV treatment recommendations for those with decompenstated cirrhosis. Click on HCV Treatment Post-Transplantation for information about HCV recurrence following liver transplantation. 

For more information about the different classes of HCV treatment and a list of approved HCV treatment, click here.

Medications that are NOT recommended for HCV treatment- naïve:

Genotype 1 

  • Sovaldi + ribavirin for 24 weeks
  • Peginterferon plus ribavirin with or without Incivek, Olysio, Sovaldi, or Victrelis for 12 to 48 weeks
  • Monotherapy with peginterferon, ribavirin or a direct-acting antiviral

Genotype 2

  • Peginterferon plus ribavirin for 24 weeks
  • Monotherapy with peginterferon, ribavirin or a direct-acting antiviral
  • Regimens using Incivek, Harvoni, or Victrelis

Genotype 3

  • Peginterferon plus ribavirin for 24 to 48 weeks
  • Monotherapy with peginterferon, ribavirin or a direct-acting antiviral
  • Regimens using Incivek, Olysio, or Victrelis

Genotype 4, 5, 6

  • Peginterferon plus ribavirin with/without Olysio for 24 to 48 weeks
  • Monotherapy with peginterferon, ribavirin or a direct-acting antiviral
  • Regimens using Incivek or Victrelis

Does treatment work for African Americans?
Historically, HCV treatment was less effective for African Americans than for Caucasians. This is partly explained by genetics: Researchers identified a gene that is linked with response to pegylated interferon-based treatment, called IL-28B (see "How is it diagnosed, and what tests are used?" for more information on IL-28B). However, clinical trials of new generation of HCV drugs did not find any difference in cure rates between black and non-black study participants.

Does treatment work for Latinos?
Hepatitis C seems to progress more rapidly in Latinos than in people from other racial and ethnic groups. However, in the clinical trials of Sovaldi and other new HCV antivirals, there was no apparent difference in success rates with the drug among Latinos than among non-Latinos.

Last Revised: February 25, 2016