Table 3: DAAs choices in special conditions [9,16,24,25].

Condition of the patients Suggested regimens
HBV/HCV coinfection Risk of HBV reactivation during HCV treatment; Treatment for HBV is indicated for HBsAg (+) patients
HIV/HCV coinfection Same recommended regimen as patients without HIV; Drug-drug interactions should be carefully evaluated.
CKD, stage 4 or 5

Elbasvir/grazoprevir (genotype 1,4), glecaprevir/pibrentasvir (genotype 1-6),

or Ombitasvir/paritaprevir/r + dasabuvir (genotype 1,4)

Decompensated Cirrhosis

Genotype 1,4,5,6:

Ledipasvir/sofosbuvir + ribavirin (low dose from 600 mg till tolerated) for 12 weeks Velpatasvir/sofosbuvir + weight-based ribavirin for 12 weeks

(if ribavirin is not eligible, prolonged treatment course to 24 weeks)

Genotype 1,4:

Daclatasvir + sofosbuvir + ribavirin (low dose from 600 mg till tolerated) for 12 weeks (if ribavirin is not eligible, prolonged treatment course to 24 weeks)