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This drug combination is a quadruple therapy regimen consisting of sofosbuvir, velpatasvir, ribavirin, and peginterferon alfa-2b, specifically investigated for the re-treatment of chronic hepatitis C virus (HCV) infection in patients who have failed or relapsed after prior direct-acting antiviral (DAA) therapy. Sofosbuvir is a nucleotide analog that inhibits the HCV NS5B RNA-dependent RNA polymerase, while velpatasvir is an NS5A inhibitor that disrupts viral replication and assembly. Ribavirin is a guanosine analog with broad antiviral activity, and peginterferon alfa-2b is a pegylated cytokine that stimulates the host immune response via the interferon-alpha/beta receptor. This intensive regimen aims to overcome resistance in difficult-to-treat populations, such as those with genotype 3 or cirrhosis, by combining multiple mechanisms of action.
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