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LEDIPASVIR/ SOFOSBUVIR TAB,ORAL

Clinical Criteria Summary

Exclusion Criteria

  • Limited life expectancy
  • Documented ongoing nonadherence to prescribed medications or medical treatment
  • Concurrent use of drugs not recommended with LDV/SOF (e.g., cytochrome P450 inducers, amiodarone/dronaderone, rosuvastatin > 10mg/day, high-dose proton pump inhibitors)
  • Hepatitis B surface antigen (HBsAg) positive and not on antiviral treatment with entecavir or tenofovir
  • Contraindication to ribavirin (RBV) if RBV is indicated

Inclusion Criteria

  • Care provided by and/or in consultation with a VA/VA Community Care Hepatitis C specialist
  • HCV genotype (GT) 1, 4, 5 or 6
  • Treatment regimen and duration consistent with HCV GT and patient characteristics
  • Completed hepatitis B screening: at minimum HBsAg, HBV core antibody (anti-HBc), and HBV surface antibody (anti-HBs)
  • Adherence counseling performed including laboratory follow-up and documented understanding by patient
  • Additional Inclusion Criteria (One of the following must be met)
  • GT 1, 4, 5 or 6, treatment-naïve with or without compensated cirrhosis
  • GT 1, 4, 5 or 6, treatment-naïve with decompensated cirrhosis and no contraindication to ribavirin
  • GT 1, treatment-experienced (pegylated interferon or NS3/4A inhibitor only) with decompensated cirrhosis and no contraindication to ribavirin

Ribavirin Contraindications

  • History of significant cardiac disease
  • Significant anemia
  • Pregnancy
  • Men whose female partner is pregnant or plans to become pregnant

Source Documents