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Uprifosbuvir + ruzasvir is an oral, fixed-dose investigational combination of two **direct-acting antiviral agents** targeting hepatitis C virus (HCV). **Uprifosbuvir** is a nucleotide analog prodrug that inhibits the HCV **NS5B RNA polymerase**, blocking viral RNA synthesis by acting as a chain terminator. **Ruzasvir** is an **NS5A inhibitor**, disrupting the assembly of the HCV replication complex and viral replication. This combination has pangenotypic antiviral activity and is developed for use in chronic HCV infection, including among treatment-naïve and treatment-experienced adults with or without compensated cirrhosis. Clinical trials have shown high efficacy (SVR12 rates >90%) for most genotypes (1, 2, 4, 5, 6) but lower efficacy for genotype 3. It is generally well tolerated; common adverse events include fatigue and headache[1][3][5][9].
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