Can Hepatitis C Treatment Be Shortened to 8 Weeks? RESOLVE Challenges the 12-Week Standard: The Lancet | October 2026

What Did the Study Find?

The Indian RESOLVE trial randomised 880 treatment-naive adults with chronic HCV infection without cirrhosis to sofosbuvir 400 mg/velpatasvir 100 mg once daily for 8 versus 12 weeks across five public hospitals.

• In the primary per-protocol analysis, SVR12 was 98.8% with 8 weeks vs 99.0% with 12 weeks, meeting the prespecified 5% non-inferiority margin.
• ITT results were also non-inferior: 93.5% vs 91.8%, with missing SVR12 counted as treatment failure.
• Importantly, 83% had genotype 3 HCV, traditionally considered more difficult to treat.
• In genotype 3, per-protocol SVR12 remained excellent: 99.4% with 8 weeks vs 98.8% with 12 weeks.
• More than one-third had F2–F3 fibrosis, and the 8-week strategy remained non-inferior in this subgroup on both PP and ITT analyses.
• Only 9 virological failures occurred among 816 per-protocol participants.
• There were no drug-related serious adverse events or treatment discontinuations due to adverse events.

Why Does It Matter?

Sofosbuvir–velpatasvir is inexpensive and widely available as a generic in many low- and middle-income countries. Reducing treatment from 12 to 8 weeks means one-third less drug, fewer healthcare visits and potentially better treatment completion—important advantages for population-level HCV elimination programs.

GastroAGI Takeaway

Eight weeks of sofosbuvir–velpatasvir may be enough for treatment-naive, non-cirrhotic chronic HCV—even in a predominantly genotype 3 population and in patients with F2–F3 fibrosis.

This is potentially practice-changing evidence, but the boundaries matter: patients with cirrhosis, HBV/HIV coinfection, advanced renal failure, injection drug use and several reinfection-risk groups were excluded.

The immediate implication is therefore not “8 weeks for everyone,” but strong randomised evidence supporting a shorter, cheaper pan-genotypic regimen in appropriately selected non-cirrhotic patients—with major potential implications for HCV elimination programs.