Antiviral therapy for hepatitis C: Has anything changed for pregnant/lactating women?

Table 1 Main pharmacokinetic properties of the new direct-acting antivirals

Drug		Molecular weight	Effect of food on absorption	Cytochrome P450 enzymes interaction			Binding to plasma protein	Half-life
				Enzyme	Effect of the drug on the enzyme	Effect of the enzyme on the drug
Sofosbuvir		529.45 Da	Increased absorption, slower rate	NO	None	None	85%	0.5 h/26 h1
Simeprevir		749.93 Da	Increased absorption, slower rate	CYP3A4	Inhibitor	Alter AUC	> 99.9%	10-41 h
Daclatasvir		738.98 Da	Decreased absorption2	CYP3A4	Weak inducer	Alter AUC	> 99%	12-15 h
Ledipasvir		888.9 Da	No effect	CYP3A4	Weak inducer	None	> 99.8%	47 h
Viekirax	Ombitasvir	894.1	Increased absorption	CYP3A4	Inhibitor	Alter AUC	99.9%	21-25 h
	Paritaprevir	765.8 Da					98.6%	5.5 h
	Ritonavir	720.9 Da					99%	4 h
Dasabuvir		493.5 Da	Increased absorption	CYPC19	Inducer	None	99.5% (94.5%3)	6 h
				CYP2C8	None	Alter AUC
				CYP3A4	None	Alter AUC3
				CYPC19	Inducer	None

¹GS-331007 metabolite;

²Following a high-fat meal;

³Dasabuvir M1 metabolite. AUC: Area under the curve; NO: Not metabolized by P450 enzymes; CYP: Cytochrome.