Which direct-acting antiviral agents (DAAs) are used in the treatment of hepatitis C (Hep C) infection?

Updated: Oct 07, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD  more...
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Answer

There are three classes of approved DAAs: NS3/4A protease inhibitors, NS5A inhibitors, and NS5B polymerase inhibitors (nonnucleoside inhibitors and nucleotide inhibitors). The particular combination of antivirals is determined by genotype. Several novel agents are only available as a fixed-dose combination. The following combinations are currently available:

  • Ledipasvir/sofosbuvir (Harvoni)
  • Elbasvir/grazoprevir (Zepatier)
  • Ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak)
  • Ombitasvir/paritaprevir/ritonavir (Technivie)
  • Glecaprevir/pibrentasvir (Mavyret)
  • Sofosbuvir/velpatasvir/voxilaprevir (Vosevi)
  • Sofosbuvir/velpatasvir (Epclusa): Combination therapy is required because monotherapy with either agent is not efficacious.

For patients with chronic HCV infection and chronic kidney disease (CKD) stage 1, 2, or 3, the following drug regimens do not require dose adjustments [9] :

  • Simeprevir 150 mg
  • Sofosbuvir 400 mg
  • Daily fixed-dose combination of elbasvir (50 mg)/grazoprevir (100 mg)
  • Daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg)
  • Fixed-dose combination of ledipasvir (90 mg)/sofosbuvir (400 mg)
  • Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)
  • Fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100 mg)

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