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Sofosbuvir + daclatasvir is a combination of two direct-acting antiviral (DAA) agents originally developed for the treatment of chronic hepatitis C virus (HCV) infection. Sofosbuvir is a nucleotide analog that inhibits the HCV NS5B RNA-directed RNA polymerase, while daclatasvir inhibits the HCV non-structural protein 5A (NS5A). For COVID-19, this combination was repurposed by Shin Poong Pharmaceutical Co. Ltd. and evaluated in a Phase 2 clinical trial for symptomatic outpatients with mild disease. The rationale for its use against SARS-CoV-2 is based on evidence suggesting that these DAAs may have activity against the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp), thereby potentially inhibiting viral replication.
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