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Table 2 Characteristics of DAA and dose adjustments for renal or hepatic impairment

From: Successful treatment of chronic hepatitis C virus genotype 1b infection of a patient with compensated cirrhosis after renal transplantation using daclatasvir-asunaprevir combination therapy: a case report and literature review

Drug Inhibition Induction Substrate Renal impairment Hepatic impairment
Asunaprevir Moderate inhibitor of CYP2D6 Weak inhibitor of CYP3A4 and P-gp Substrate of CYP3A4, P-gp, and OATP1B1 No adjustment needed Should likely be avoided in patients with CTP class B or C disease
Daclatasvir Moderate inhibitor of P-gp and OATP NA Substrate of CYP3A and P-gp No adjustment needed No adjustment needed
Ledipasvir Mild inhibitor of P-gp, BCRP NA Substrate of P-gp No adjustment needed No adjustment needed
Paritaprevir, ritonavir, and ombitasvir plus dasabuvir Inhibitor of CYP3A4, CYP2D6, P-gp, OATP, and BCRP Inhibitor of CYP1A2, CYP2C8, CYP2C9, and CYP2C19 (based on ritonavir pharmacokinetics) Substrate of CYP3A4, CYP2C8, and CYP2D6 Likely no adjustment needed Not recommended in patients with CTP class B disease and contraindicated in patients with CTP class C disease
Simeprevir Mild inhibitor of intestinal CYP3A and CYP1A2; mild inhibitor of OATP and P-gp NA Substrate of CYP3A No adjustment needed Should be used with caution in patients with CTP class B or C disease
Sofosbuvir NA NA Substrate of P-gp Not recommended if GFR <30 mL/min/1.73 m2 No adjustment needed
  1. BCRP breast cancer resistance protein, CTP Child-Turcotte-Pugh, CYP cytochrome P450, DAA direct-acting antiviral drugs, GFR glomerular filtration rate, NA not available, OATP organic anion-transporting polypeptide, P-gp P-glycoprotein. Adapted from Hill et al. [20]