title: Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran.
  
  
  METHODS
  The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rdnational consensus on management of Hepatitis C in Iran, held on 22ndof July 2016.
  
  
  RESULTS
  Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered.
  
  
  CONCLUSIONS
  Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.
authors: Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
authors: Seyed Moayed
authors: SM
authors: Alavian
authors: Viral Hepatitis Clinical Research Program, The Kirby Institute, The University of New South Wales (UNSW Australia), Sydney, Australia.
authors: Behzad
authors: B
authors: Hajarizadeh
authors: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors: Kamran
authors: K
authors: Bagheri Lankarani
authors: Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
authors: Heidar
authors: H
authors: Sharafi
authors: Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Nasser
authors: N
authors: Ebrahimi Daryani
authors: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Shahin
authors: S
authors: Merat
authors: Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Minoo
authors: M
authors: Mohraz
authors: Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Masoud
authors: M
authors: Mardani
authors: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors: Mohamad Reza
authors: MR
authors: Fattahi
authors: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Hossein
authors: H
authors: Poustchi
authors: Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
authors: Mehri
authors: M
authors: Nikbin
authors: Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Mahmood
authors: M
authors: Nabavi
authors: Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors: Peyman
authors: P
authors: Adibi
authors: Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
authors: Masood
authors: M
authors: Ziaee
authors: Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
authors: Bita
authors: B
authors: Behnava
authors: Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran; Student's Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors: Mohammad Saeid
authors: MS
authors: Rezaee-Zavareh
authors: Department of Medicine, Gastroenterology Division 1, AM and A Migliavacca Center for the Study of Liver Disease, Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy.
authors: Massimo
authors: M
authors: Colombo
authors: New York Associates in Gastroenterology, Bronx, New York, USA.
authors: Hatef
authors: H
authors: Massoumi
authors: Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Abdul Rahman
authors: AR
authors: Bizri
authors: Cleveland Clinic, Cleveland, OH, USA.
authors: Bijan
authors: B
authors: Eghtesad
authors: Gastroenterology and Hepatology Department, Gouin Hospital, Clichy, France.
authors: Majid
authors: M
authors: Amiri
authors: Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, IR Iran.
authors: Ali
authors: A
authors: Namvar
authors: Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
authors: Khashayar
authors: K
authors: Hesamizadeh
authors: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Reza
authors: R
authors: Malekzadeh
keywords: Consensus; Disease Elimination; Hepatitis C; Iran; Therapy