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ledipasvir + dalbavancin refers to the co-administration or combination of the hepatitis C virus (HCV) NS5A inhibitor ledipasvir and the long-acting lipoglycopeptide antibiotic dalbavancin. This therapeutic approach has been investigated in clinical research (notably in the Phase 4 trial NCT03544450) to address the dual burden of chronic HCV infection and acute bacterial skin and skin structure infections (ABSSSI) in high-risk populations, such as people who inject drugs (PWID). Ledipasvir functions by binding to the HCV NS5A protein, which is essential for viral RNA replication and virion assembly. Dalbavancin exerts its bactericidal effect by interfering with bacterial cell wall synthesis; it binds to the D-alanyl-D-alanine terminal of peptidoglycan precursors in Gram-positive bacteria, preventing cross-linking and leading to cell death. In clinical practice, ledipasvir is typically administered as part of a fixed-dose combination with sofosbuvir (Harvoni).
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