Background: Approximately 10% of all hepatitis C virus infections in the United States result from genotype 3 infection. Accordingly, less extensive clinical trial data exists for genotype 3 than with genotype 1. Patients with HCV genotype 3, when compared with HCV non-3 genotypes, have relatively faster rates of fibrosis progression, higher prevalence of severe (Grade 3) steatosis, and a higher incidence of hepatocellular carcinoma. In the current direct-acting antiviral therapy era, patients with genotype 3 infection have been relatively difficult to treat compared with other genotypes, especially in patients with cirrhosis. Recent data with sofosbuvir-velpatasvir are very encouraging, with SVR rates of 97% in treatment-naive patients and 90% in treatment-experienced patients. The cost of recommended therapy for genotype 3 infection ranges from $74,760 to $295,000 (Figure 1). The following discussion regarding initial treatment and retreatment of patients with genotype 3 chronic hepatitis C assumes the patient and their clinician have already made the decision to initiate hepatitis C therapy.
Medications used to Treat Hepatitis C: The HCV Medications section on this web site provides detailed information for each of the FDA-approved medications listed in the treatment recommendations, including links to the full prescribing information and to patient assistance programs. Adherence with the treatment regimen is of paramount importance. Thus, patients should receive detailed counseling regarding the importance of adherence prior to starting therapy, as well as intensive monitoring and follow-up during therapy.