Vosevi is suitable for specific hepatitis C virus (HCV) infected patients, and medication for this special population needs to be adjusted according to physiological conditions or strengthened monitoring. The following will explain the classification of applicable populations and medication precautions for special groups, covering key scenarios such as pregnancy and liver and kidney dysfunction.

1. Scope of applicable population

(1) Genotype coverage: mainly used for the treatment of adult HCV genotype 1-6 infections, especially for those who have failed previous treatments and have significant therapeutic effects.

(2) Co infection: Suitable for patients with HCV/HIV-1 co infection, but attention should be paid to the interaction of antiretroviral drugs.

2. Medication guidelines for special populations

2.1 Pregnant women

(1) Risk Warning: Animal experiments have shown that the components of sofosbuvir may cause embryotoxicity, and should be avoided during pregnancy.

(2) Necessary use: Those who require treatment must undergo a fetal risk assessment and sign an informed consent form.

2.2 Breastfeeding women

(1) Drug distribution: Vepatasvir can be secreted into breast milk at a concentration of 3-5 times that of maternal plasma.

(2) Medication recommendation: Suspend breastfeeding during treatment and within 7 days after the last dose.

2.3 Child patients

(1) Age limit: Currently, there is no established safety and efficacy data for children under 12 years old or weighing less than 35kg.

(2) Adolescent medication: For those aged 12 and above, the dosage should be adjusted according to their weight, and each kilogram of body weight should be accurately calculated.

2.4 Elderly patients

(1) Dose adjustment: Patients aged 65 and above do not require routine dose reduction, but need to strengthen electrocardiogram monitoring of QT interval.

(2) Combination therapy: Pay special attention to the contraindications of combination therapy with arrhythmogenic drugs such as amiodarone.

2.5 Liver dysfunction

(1) Mild impairment: Child Pugh Class A patients do not require dose adjustment.

(2) Severe damage: Child Pugh B/C grade is contraindicated as it may increase the risk of liver failure.

2.6 Renal insufficiency

(1) Mild to moderate damage: Patients with eGFR ≥ 30mL/min can use the standard dosage.

(2) End stage renal disease: Medication should be administered after dialysis, and blood drug concentration fluctuations should be monitored.