Treatment

• All patients diagnosed with Hepatitis C must be treated with the oral direct acting antivirals unless there is a clear reason not to treat. Some of these conditions are included in the table 7.

• The use of Interferon should not be part of the treatment for hepatitis C.

• The use of Generic medications in the program is acceptable, provided that those medications have been approved by the Saudi FDA, and the regimen has shown encouraging results in real-world data.

• The ideal regimen for hepatitis C should be; simple, affordable, highly efficient, pangenotypic, addresses special needs and without Ribavirin. 

• Until now, no single regimen can cover all different needed for the patients with Hepatitis C. A minority of patients remain in need of special regimens ( decompensated cirrhosis, end stage kidney disease and treatment failure).

• At this point the recommended regimen to treat patients by non-experts at a large scale is limited to Daclatasvir and Sofosbuvir for 12 weeks (Table 8)

• Other more difficult cases will be individualized according to the hepatologist experience with evidence based regimen

• Although successful treatment with Hepatitis C exceeds 90%, it is estimated that 8,000 to 15,000 will need retreatment due to lack of response/relapse.

• The core concepts for retreatment of Hepatitis C are listed in the table 9.