Treatment of adults who are not cured with first-line therapy

Management of patients who are not cured of hepatitis C with first-line direct-acting antiviral therapy depends on the reason that cure has not been achieved.

If cure is not achieved as a result of nonadherence or reinfection, patients can be retreated in the community with one of the first-line regimens—see here for patients without cirrhosis, or here for patients who have cirrhosis.

If cure is not achieved as a result of virological failure (less than 5% of patients), an alternative drug regimen (‘salvage therapy’) is required and referral to a specialist centre is recommended. For adults with hepatitis C who do not have cirrhosis or have compensated cirrhosis, and who require salvage therapy, a suitable regimen is: