sofosbuvir + daclatasvir + ribavirin + peginterferon

This is a four-drug combination regimen consisting of sofosbuvir, daclatasvir, ribavirin, and peginterferon. It is used for the treatment of chronic hepatitis C virus (HCV) infection, particularly in patients with difficult-to-treat genotypes or those with cirrhosis or prior treatment failure. Sofosbuvir is a nucleotide analog NS5B polymerase inhibitor that blocks HCV RNA replication. Daclatasvir is an NS5A inhibitor that interferes with viral replication and assembly. Ribavirin is a nucleoside analog antiviral that enhances viral clearance through multiple mechanisms including inhibition of viral RNA synthesis and immunomodulation. Peginterferon alfa (pegylated interferon alpha) stimulates the immune response against HCV by enhancing host antiviral defenses[1][2][6]. This combination may be considered in specific clinical scenarios where direct-acting antivirals alone are insufficient or when previous regimens have failed.