Question 8 - Hepatitis C Coinfection Question Bank

HIV Clinical Care Question Bank

Hepatitis C CoinfectionQuestion 8/10

A 45-year-old woman with HIV and chronic hepatitis C virus (HCV) coinfection is being evaluated to start HCV treatment. She has suppressed HIV RNA levels on a regimen of dolutegravir-lamivudine. She meets all criteria for the simplified HCV treatment. In addition, she is clinically stable and has had no complications related to her cirrhosis. Because her insurance company will only cover sofosbuvir-velpatasvir, an HCV genotype is ordered, and she has HCV genotype 3.

Assuming that she will receive sofosbuvir-velpatasvir for treatment, what is the next recommended step?

Treat with sofosbuvir-velpatasvir for 16 weeks

Treat with sofosbuvir-velpatasvir for 8 weeks

Treat with sofosbuvir-velpatasvir plus ribavirin for 8 weeks

Order NS5A resistance testing

Provide Question Feedback

Prev Skip

Sign In or Register Progress Not Saved!
Since you are not signed in, your progress won't be saved.

Question Last Updated
May 8th, 2026

Table 1. Simplified HCV Treatment Regimens in Adults with HIV: Adult and Adolescent OI Guidelines

Treatment-Naive Patients Without Cirrhosis
Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 8 weeks (AI), or Sofosbuvir-velpatasvir (400 mg/100 mg tablet): one tablet daily for 12 weeks (AI)
Treatment-Naive Patients with Compensated Cirrhosis
HCV Genotypes 1, 2, 4, 5, 6
Preferred Therapy Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 8 weeks (AIII), or Sofosbuvir-velpatasvir (400 mg/100 mg tablet): one tablet daily for 12 weeks (AI) Alternative Therapy Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 12 weeks (CI)
HCV Genotype 3
Preferred Therapy Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 8 weeks (AIII) Alternative Therapy Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 12 weeks (CI), or Sofosbuvir-velpatasvir tablet (400 mg/100 mg tablet): one tablet daily, with or without ribavirin for 12 weeks pending results of NS5A resistance testing (CI)
Treatment of Acute HCV Infection
Glecaprevir-pibrentasvir (100 mg/40 mg tablet): three tablets daily for 8 weeks (AII), or Sofosbuvir-velpatasvir (400 mg/100 mg tablet): one tablet daily for 12 weeks (AII)
Recommendations for treatment after direct-acting antiviral failure are not provided; see the corresponding section in AASLD/IDSA HCV Treatment Guidance. Rating of strength of recommendation for the statement: A = Strong; B = Moderate; C = Weak Quality of evidence for the recommendation: I = One or more randomized trials with clinical outcomes and/or validated laboratory endpoints; II = One or more well-designed, non-randomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion

Source:

Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. National Institutes of Health, HIV Medicine Association, and Infectious Diseases Society of America. Hepatitis C virus. Last updated: January 18, 2023 [HIV.gov]

Screening and Diagnosis

Basic HIV Primary Care

Antiretroviral Therapy

Co-Occurring Conditions

Prevention of HIV

Key Populations