Glecaprevir-pibrentasvir therapy should be considered for this patient. Hepatitis C is a viral infection of the liver that may lead to acute or chronic disease. It is transmitted primarily via percutaneous exposure to infected blood, often through intravenous drug use or sharing of needles. Sexual transmission is rare. There are six different hepatitis C genotypes, and in the United States, genotype 1 accounts for 60–75% of cases. Antiviral therapy should be considered for all patients with acute or chronic hepatitis C, except for those with a short life expectancy that cannot be reversed by hepatitis C treatment. Direct-acting antiviral regimens interrupt hepatitis C replication and infection and are extremely efficacious and well-tolerated oral agents. These interferon-free, direct-acting antiviral regimens have largely supplanted older therapies as first-line therapeutic options. For treatment-naive, noncirrhotic patients with chronic hepatitis C genotype 1a infection, direct-acting antiviral regimens such as an 8-week course of glecaprevir-pibrentasvir, a 12-week course of ledipasvir-sofosbuvir, or a 12-week course of sofosbuvir-velpatasvir are recommended first-line regimens. A sustained virologic response may be seen in up to 99% of noncirrhotic patients with chronic hepatitis C genotype 1a infection.

No antiviral therapy is needed (B) is incorrect. This patient has chronic hepatitis C infection and should be considered for antiviral therapy. Peginterferon and ribavirin (C) therapy was previously the standard of care for chronic hepatitis C management, leading to a sustained virologic response in up to 50% of genotype 1 patients. However, interferon-free, direct-acting antiviral regimens have now replaced the use of peginterferon and ribavirin due to improved efficacy and safety profiles. Tenofovir (D) is a nucleos(t)ide analog that is a first-line therapy for hepatitis B infection.