ravidasvir + sofosbuvir + ribavirin

A fixed-dose combination of **ravidasvir**, **sofosbuvir**, and **ribavirin** used for the treatment of chronic hepatitis C virus (HCV) infection, particularly genotype 4, and sometimes genotype 1 and 3. Ravidasvir is a pangenotypic non-structural protein 5A (NS5A) inhibitor; sofosbuvir is a nucleotide analogue inhibitor of NS5B polymerase; ribavirin is a guanosine analogue with broad antiviral activity but is not effective alone and must be combined with other agents. The regimen is used in both treatment-naïve and treatment-experienced adult patients, with or without compensated cirrhosis. Ribavirin is especially added for patients with cirrhosis or those with difficult-to-cure genotypes. The mechanism involves inhibition of HCV replication: ravidasvir blocks NS5A-mediated RNA replication/assembly; sofosbuvir inhibits NS5B polymerase-dependent replication; ribavirin enhances viral mutagenesis and immune modulation. The combination has shown high sustained virologic response rates (SVR12 95–97%) and is well tolerated, though ribavirin can cause hematological side effects. Developed for affordability to support public health efforts in resource-limited regions, notably Egypt, Malaysia, and Thailand[1][2][4][5][6].