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Table 5 Drug interactions of HCV Direct Acting Antiviral agents with ARTa

From: Contemporary HCV pangenotypic DAA treatment protocols are exclusionary to real world HIV-HCV co-infected patients

HCV DAA ART drug name Effect on concentration Comments
Sofosbuvir/Velpatasvir
  Efavirenz ↓ velpatasvir Coadministration not recommended
Tenofovir disoproxil (TDF) ↑ tenofovir Renal monitoring for tenofovir associated adverse reactions.
Tipranavir/ritonavir ↓ sofosbuvir
↓ velpatasvir
Coadministration not recommended
Glecaprevir/Pibrentasvir
  Atazanavir ↑ glecaprevir
↑ pibrentasvir
Coadministration contraindicated due to increased risk of ALT elevations
Darunavir/Lopinivir/ritonovir ↑ glecaprevir
↑ pibrentasvir
Coadministration not recommended
Efavirenz ↓ glecaprevir
↓ pibrentasvir
Coadministration not recommended
  1. DAA direct acting antiviral, HCV hepatitis C virus, ALT alanine aminotransferase
  2. aReference: Hepatitis C guidance: AASLD-IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus. Hepatology. 2015;62(3):932–954